Mammary fat globules as a source of mRNA to model alterations in the expression of some milk component genes during lactation in bovines.

BACKGROUND: The milk's nutritional value is determined by its constituents, including fat, protein, carbohydrates, and minerals. The mammary gland's ability to produce milk is controlled by a complex network of genes. Thereby, the fat, protein, and lactose synthesis must be boost in milk to increase milk production efficiency. This can be accomplished by fusing genetic advancements with proper management practices. Therefore, this study aimed to investigate the association between the Lipoprotein lipase (LPL), kappa casein CSN3, and Glucose transporter 1 (GLUT1) genes expression levels and such milk components as fat, protein, and lactose in different dairy breeds during different stages of lactation. METHODS: To achieve such a purpose, 94 milk samples were collected (72 samples from 36 multiparous black-white and red-white Holstein-Friesian (HF) cows and 22 milk samples from 11 Egyptian buffaloes) during the early and peak lactation stages. The milk samples were utilized for milk analysis and genes expressions analyses using non- invasive approach in obtaining milk fat globules (MFGs) as a source of Ribonucleic acid (RNA). RESULTS: LPL and CSN3 genes expressions levels were found to be significantly higher in Egyptian buffalo than Holstein-Friesian (HF) cows as well as fat and protein percentages. On the other hand, GLUT1 gene expression level was shown to be significantly higher during peak lactation than early lactation. Moreover, lactose % showed a significant difference in peak lactation phase compared to early lactation phase. Also, fat and protein percentages were significantly higher in early lactation period than peak lactation period but lactose% showed the opposite pattern of Egyptian buffalo. CONCLUSION: Total RNA can be successfully obtained from MFGs. The results suggest that these genes play a role in glucose absorption and lactose synthesis in bovine mammary epithelial cells during lactation. Also, these results provide light on the differential expression of these genes among distinct Holstein-Friesian cow breeds and Egyptian buffalo subspecies throughout various lactation phases.

An Exploration of Lived Experiences of Sexually and Gender Diverse Staff Members in Higher Education: A Case Study.

Sexually and gender diverse staff in Higher Education Institutions may experience a sense of belonging and acceptance in inclusive environments, but may also face discrimination and bias, leading to feelings of isolation and exclusion. This paper reports on findings from 40 in-depth interviews and six focus group discussions with LGBTQIA+ self-identified staff members in a HEI and LGBTQIA+ allies who may identify as LGBTQIA+ themselves. Findings reveal that first impressions when joining a university as a staff member may have a long-lasting effect, while both positive and negative experiences are present. Further, a pattern is developed among gay men who may be placing more emphasis on their relationship with line managers, which can be supportive but at times toxic, unsupportive and inattentive. In addition to this, the findings highlight discrimination faced by staff, its impact on their wellbeing, and the significance of visibility and representation. This paper concludes that lived experiences of LGBTQIA+ staff members in Higher Education continue to be mixed with a high percentage of staff experiencing discrimination, primarily in the form of microaggressions, but institutions need to be more pro-active to foster safe spaces for all with more inclusive policies and practices.

Clinical utility, reproducibility, and radiologist acceptance of ILD-RADS.

PURPOSE: To investigate the clinical utility, reproducibility, and radiologists' acceptance of the Interstitial Lung Disease Imaging-Reporting and Data System (ILD-RADS). METHOD: In this single-institutional retrospective study, three radiologists independently reviewed the chest high-resolution CT (HRCT) scans of 111 consecutive patients diagnosed with ILDs. They assessed the HRCT pulmonary features using the ILD-RADS template and assigned an ILD-RADS category (1-4) to each scan based on the identified imaging pattern. Patients were classified into idiopathic pulmonary fibrosis (IPF) (n = 14) and non-IPF ILD (n = 97) groups based on clinical diagnoses determined by multidisciplinary discussion. Association between ILD-RADS categories and clinical diagnoses was assessed using the Chi-square test for trend. Reproducibility was evaluated using kappa (k) scores, and radiologists' acceptance of the ILD-RADS was evaluated with a questionnaire. RESULTS: We found a significant association between the ILD-RADS categories and patients' clinical diagnoses (P ≤ 0.0001) for the three readers, with a trend toward increased assignment of ILD-RADS-1 to IPF patients (50 %-57.1 %), and ILD-RADS-4 to non-IPF patients (46.4 %-49.5 %). The ILD-RADS categories showed excellent intra-reader agreement (k = 0.873) and moderate inter-reader agreement (k = 0.440). ILD-RADS-1 and -4 categories showed the highest inter-reader agreement (k = 0.681 and 0.481, respectively). Radiologists gave a positive response to using the ILD-RADS in daily practice. CONCLUSIONS: The clinical utility of the ILD-RADS was demonstrated by the significant association between the ILD-RADS categories and patients' clinical diagnoses, particularly the ILD-RADS-1 and -4 categories. Excellent intra-reader and moderate inter-reader reproducibility was observed. ILD-RADS has the potential to be widely accepted for standardized HRCT reporting among radiologists.

miRNAs dysregulation in ankylosing spondylitis: A review of implications for disease mechanisms, and diagnostic markers.

Epigenetic processes, including non-coding RNA, histone modifications, and DNA methylation, play a vital role in connecting the environment to the development of a disorder, especially when there is a favorable genetic background. Ankylosing Spondylitis (AS) is a chronic type of spinal arthritis that highlights the significance of epigenetics in diseases related to autoimmunity and inflammation. MicroRNAs (miRNAs) are small non-coding RNAs that are involved in both normal and aberrant pathological and physiological gene expression. This study focuses on the pathophysiological pathways to clarify the role of miRNAs in AS. We have conducted a thorough investigation of the involvement of miRNAs in several processes, including inflammation, the production of new bone, T-cell activity, and the regulation of pathways such as BMP, Wnt, and TGFß signaling. Undoubtedly, miRNAs play a crucial role in enhancing our comprehension of the pathophysiology of AS, and their promise as a therapeutic strategy is quickly expanding.

Predicting the Consistency of Pituitary Macroadenomas: The Utility of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient Measurements for Surgical Planning.

Understanding the consistency of pituitary macroadenomas is crucial for neurosurgeons planning surgery. This retrospective study aimed to evaluate the utility of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) as non-invasive imaging modalities for predicting the consistency of pituitary macroadenomas. This could contribute to appropriate surgical planning and therefore reduce the likelihood of incomplete resections. The study included 45 patients with pathologically confirmed pituitary macroadenomas. Conventional MRI sequences, DWIs, ADC maps, and pre- and post-contrast MRIs were performed. Two neuroradiologists assessed all of the images. Neurosurgeons assessed the consistency of the tumor macroscopically, and histopathologists examined it microscopically. The MRI findings were compared with postoperative data. According to the operative data, macroadenomas were divided into the two following categories based on their consistency: aspirable (n = 27) and non-aspirable tumors (n = 18). A statistically significant difference in DWI findings was found when comparing macroadenomas of different consistencies (p < 0.001). Most aspirable macroadenomas (66.7%) were hyperintense according to DWI and hypointense on ADC maps, whereas most non-aspirable macroadenomas (83.3%) were hypointense for DWI and hyperintense on ADC maps. At a cut-off value of 0.63 × 10-3 mm2/s, the ADC showed a sensitivity of 85.7% and a specificity of 75% for the detection of non-aspirable macroadenomas (AUC, 0.946). The study concluded that DWI should be routinely performed in conjunction with ADC measurements in the preoperative evaluation of pituitary macroadenomas. This approach may aid in surgical planning, ensure that appropriate techniques are utilized, and reduce the risk of incomplete resection.

The prognostic value of bone marrow retention index and bone marrow-to-liver ratio of baseline 18F-FDG PET/CT in diffuse large B-cell lymphoma.

OBJECTIVE: To determine prognostic value of bone marrow retention index (RI-bm) and bone marrow-to-liver ratio (BLR) measured on baseline dual-phase 18F-FDG PET/CT in a series of newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL) treated homogeneously with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy. PATIENTS AND METHODS: This prospective study enrolled 135 patients with newly diagnosed DLBCL. All patients underwent dual-phase 18F-FDG PET/CT. The following PET parameters were calculated for both tumor and bone marrow: maximum standardized uptake value (SUVmax) at both time points (SUVmax early and SUVmax delayed), SUVmax increment (SUVinc), RI, and BLR. Patients were treated with R-CHOP regimen and response at end of treatment was assessed. RESULTS: The final analysis included 98 patients with complete remission. At a median follow-up of 22 months, 57 patients showed no relapse, 74 survived, and 24 died. The 2-year relapse-free survival (RFS) values for patients with higher and lower RI-bm were 20% and 65.1%, respectively (p < 0.001), and for patients with higher and lower BLR were 30.2% and 69.6%, respectively (p < 0.001). The 2-year overall survival (OS) values for patients with higher and lower RI-bm were 60% and 76.3%, respectively (p = 0.023), and for patients with higher and lower BLR were 57.3% and 78.6%, respectively (p = 0.035). Univariate analysis revealed that RI-bm and BLR were independent significant prognostic factors for both RFS and OS (hazard ratio [HR] = 4.02, p < 0.001, and HR = 3.23, p < 0.001, respectively) and (HR = 2.83, p = 0.030 and HR = 2.38, p = 0.041, respectively). CONCLUSION: Baseline RI-bm and BLR were strong independent prognostic factors in DLBCL patients. CLINICAL RELEVANCE STATEMENT: Bone marrow retention index (RI-bm) and bone marrow-to-liver ratio (BLR) could represent suitable and noninvasive positron emission tomography/computed tomography (PET/CT) parameters for predicting pretreatment risk in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) who were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy. KEY POINTS: • Bone marrow retention index (RI-bm) and bone marrow-to-liver ratio (BLR) are powerful prognostic variables in diffuse large B-cell lymphoma (DLBCL) patients. • High BLR and RI-bm are significantly associated with poor overall survival (OS) and relapse-free survival (RFS). • RI-bm and BLR represent suitable and noninvasive risk indicators in DLBCL patients.

The Impact of Adding Digital Breast Tomosynthesis to BI-RADS Categorization of Mammographically Equivocal Breast Lesions.

Digital mammography (DM) is the cornerstone of breast cancer detection. Digital breast tomosynthesis (DBT) is an advanced imaging technique used for diagnosing and screening breast lesions, particularly in dense breasts. This study aimed to evaluate the impact of combining DBT with DM on the BI-RADS categorization of equivocal breast lesions. We prospectively evaluated 148 females with equivocal BI-RADS breast lesions (BI-RADS 0, 3, and 4) with DM. All patients underwent DBT. Two experienced radiologists analyzed the lesions. They then assigned a BI-RADS category for each lesion according to the BI-RADS 2013 lexicon, using DM, DBT, and integrated DM and DBT. We compared the results based on major radiological characteristics, BI-RADS classification, and diagnostic accuracy, using the histopathological examination of the lesions as a reference standard. The total number of lesions was 178 on DBT and 159 on DM. Nineteen lesions were discovered using DBT and were missed by DM. The final diagnoses of 178 lesions were malignant (41.6%) and benign (58.4%). Compared to DM, DBT produced 34.8% downgrading and 32% upgrading of breast lesions. Compared with DM, DBT decreased the number of BI-RADS 4 and 3. All the upgraded BI-RADS 4 lesions were confirmed to be malignant. The combination of DM and DBT improves the diagnostic accuracy of BI-RADS for evaluating and characterizing mammographic equivocal breast lesions and allows for proper BI-RADS categorization.

Magnetic Resonance Imaging Features of Rhino-Orbito-Cerebral Mucormycosis in Post-COVID-19 Patients: Radio-Pathological Correlation.

There has been a notable increase in rhino-orbito-cerebral mucormycosis (ROCM) post-coronavirus disease 2019 (COVID-19), which is an invasive fungal infection with a fatal outcome. Magnetic resonance imaging (MRI) is a valuable tool for early diagnosis of ROCM and assists in the proper management of these cases. This study aimed to describe the characteristic MRI findings of ROCM in post-COVID-19 patients to help in the early diagnosis and management of these patients. This retrospective descriptive study was conducted at a single hospital and included 52 patients with COVID-19 and a histopathologically proven ROCM infection who were referred for an MRI of the paranasal sinuses (PNS) due to sino-orbital manifestations. Two radiologists reviewed all the MR images in consensus. The diagnosis was confirmed by histopathological examination. The maxillary sinus was the most commonly affected PNS (96.2%). In most patients (57.7%), multiple sinuses were involved with the black turbinate sign on postcontrast images. Extrasinus was evident in 43 patients with orbital involvement. The pterygopalatine fossa was involved in four patients. Three patients had cavernous sinus extension, two had pachymeningeal enhancement, and one had epidural collection. The alveolar margin was affected in two patients, and five patients had an extension to the cheek. The awareness of radiologists by the characteristic MRI features of ROCM in post-COVID-19 patients helps in early detection, early proper management, and prevention of morbid complications.

Eichhornia crassipes from wastes to valuable products in water purification and influence on growth and impregnability in overwhelmed broiler chickens.

Background: The implementation of green technologies is continually gaining attention worldwide and was considered for removing water pollutants and treating municipal water before its disposal. Aim: Evaluation of the laboratory antimicrobial actions and chelating activities, and the field influence of Eichhornia crassipes on performance, biochemical and immunoglobulin concentrations, and intestinal microbiota in overwhelmed broiler chickens. Methods: We assessed the laboratory antimicrobial actions of E. crassipes 1% suspension against bacterial (Escherichia coli O157: H7 and Salmonella Typhimurium) and fungal (Aspergillus niger and Candida albicans) microorganisms using a 96-well minimal inhibitory concentration, and the chelating activities of E. crassipes against calcium sulfate and copper sulfate. Also, we designed randomly four equal groups out of 200 1-day-old Ross® 308 chicks on a deep litter system. Three groups (G1, G2, and G3) were supplied daily with E. crassipes suspension of 1% from the third day until the end of the experiment, while the fourth group (G4) received non-treated tap water. Broilers of G1-3 were challenged with calcium sulfate (75 mg.l-1), copper sulfate (200 mg.l-1), and S. Typhimurium (1.5 × 106 CFU.ml-1) polluted water respectively on the 7th, 14th, 21st, 28th, 35th days of age. We collected 1,914 samples by the end of the study, these samples included 90 E. crassipes pollutants and 480 E. crassipes microbial mixes, 192 sera, 192 intestinal swabs, and 960 tissues. Results: Eichhornia crassipes treated water reveals highly significant (p < 0.01) improvements in water quality assessments and a highly significant (p < 0.01) increase in dissolved oxygen levels compared to tap water. Eichhornia crassipes 1% achieved a 100% adsorption capability for calcium and copper sulfate after 1-hour and 100% bactericidal (E. coli O157: H7 and S. Typhimurium) and fungicidal (A. niger and C. albicans) actions after 1, 2, 2, and 2-hours, respectively. Broilers treated with 1% E. crassipes revealed highly significant (p < 0.01) improvements in performance indices, carcasses characteristics, biochemical and immunological parameters, and highly significant (p < 0.01) decreases of cortisol hormone and bacteriological parameters in all treated broiler groups compared to the control. Conclusion: Eichhornia crassipes 1% reveals a significant improvement in drinking water quality, as well as produces high adsorptive and antimicrobial actions. Eichhornia crassipes 1% improved performance traits, carcass quality, and intestinal microbiota in overwhelmed broilers.

Disordered Eating Behaviors and Insulin Restriction in Saudi Adolescents and Young Adults with Type 1 Diabetes.

Background and Objectives: The prevalence of disordered eating behaviors (DEBs) in type 1 diabetes (T1D) has been studied globally; however, data from Saudi Arabia and Arab-speaking countries are scarce. This study aimed to measure the prevalence of DEBs and associated clinical characteristics in adolescents and young adults with T1D, and the impact of DEBs on glycemic parameters. Materials and Methods: A total of 265 adolescents and young adults with T1D (aged 12-25 years) were recruited randomly from the registry at the Jazan Endocrinology and Diabetes Center, Saudi Arabia. Participants completed the Diabetes Eating Problem Survey-Revised (DEPS-R) questionnaire. Other measures included hemoglobin A1c (HbA1c) in addition to sociodemographic, anthropometric, and clinical data. Results: The prevalence of DEBs among T1D was 27.2%. Females (32.5%) had a higher proportion of DEBs than males (18.6%) (p = 0.01). About 27% of the participants reported insulin restriction. A history of hospital admission in the previous 6 months due to DKA and frequent hypoglycemia was more frequently reported in T1D participants with DEBs compared to those without (p = 0.03). Participants with DEBs had higher HbA1c and higher BMI compared to those without DEBs. Conclusions: Adolescents and young adults with T1D with disordered eating and insulin restriction have higher glycated hemoglobin, and are at higher risk of DKA. Routine screening for DEBs should be an essential element in diabetes care, especially among highly vulnerable groups.

Skin colonization of Staphylococcus aureus harboring superantigen toxin genes and its correlation with serum IL-22 level in psoriasis patients.

Psoriasis is a chronic debilitating skin disease with an estimated prevalence reaching 2% of the worldwide population. Psoriatic disease is driven by the interactions among innate and adaptive immune systems with structural components of the skin. Interleukin (IL)-22 mediates keratinocyte proliferation and epidermal hyperplasia, and changes in the structure of skin flora can play a role in the secretion of IL-22. The aim of this study was to correlate serum levels of IL-22 and Staphylococcus aureus toxins with disease activity in plaque psoriasis. The study group included 50 patients with mild, moderate, and severe psoriasis. The control group comprised 20 sex- and age-matched apparently healthy volunteers. IL-22 concentration was assessed in sera of patients and the control group by using the ELISA technique. The serum levels of IL-22 in patients were higher than in the control group, but the difference was statistically insignificant (P=0.413). Serum IL-22 levels were positively correlated with the Psoriasis Area and Severity Index (PASI) score of psoriasis patients (P=0.0003). The IL-22 serum levels in patients colonized with toxigenic strains of S. aureus were significantly higher than in patients colonized with non-toxigenic strains (P= 0.028). In conclusion, IL-22 plays a role in the pathogenesis of psoriasis, and its secretion can be triggered by the toxins produced by S. aureus colonizing the skin of patients.

Antibiotics use and its association with Multi-Drug Resistance in a Tertiary Care Geriatrics Hospital in Egypt.

INTRODUCTION: Multi-Drug Resistance (MDR) is common in hospitalized geriatric patients. The study aims to investigate the pattern of antibiotic use and determine its association with MDR in hospitalized geriatric patients. METHODOLOGY: A retrospective cohort study including 193 geriatric patients admitted to a Geriatric Intensive Care Unit (GICU) in a tertiary care Geriatrics hospital in Egypt, throughout a consecutive 6 months duration. A review of medical records was done to extract clinical, socio-demographic, and prescribing data on antibiotics throughout admission. The presence of MDR organisms (MDROs) was determined by reviewing culture and sensitivity reports. Descriptive statistics and logistic regression analysis were performed. RESULTS: 181 (93.8%) patients received at least 1 antibiotic. Cephalosporins were the most commonly consumed antibiotics (24%). MDROs were significantly associated with receiving ≥ 3 antibiotics. Longer hospital stay was a predictor of multiple antibiotics use (Odds Ratio of 1.075). MDROs were prevalent in 110 (57.0 %) patients. Klebsiella species were the most frequent MDROs (26%) with the highest susceptibility to amikacin. CONCLUSIONS: The study provides a detailed description of both antibiotics use and MDR among hospitalized geriatric patients in Egypt. It gives a novel insight into the ongoing drug-pathogen combinations in acute healthcare settings of the aged. This data has a potential role in applying antimicrobial stewardship programs for hospitalized geriatric patients to mitigate antimicrobial resistance in similar settings.

Nile tilapia bones as eco-friendly alternative in water treatment and enhancing performance and immunity in broiler chickens.

Background: Water pollution has become a major threat to the environment and the living so an eco-friendly bio-filter was chosen for its merits over conventional techniques. Aim: Investigating the purifying activities of the Tilapia bone powder against inorganics, heavy metals, and microbial water pollutants and its impacts on performance, biochemical and antioxidant levels, cortisol and immunoglobulin concentrations, and intestinal microbiota in challenged broiler chickens. Methods: The in-vitro activity of Tilapia bone powder was evaluated against magnesium chloride and lead nitrate using tube minimal inhibitory concentration (MIC), as well as against Escherichia coli O1527:H7, Salmonella Typhimurium, Mycoplasma gallisepticum, Aspergillus niger, Trichophyton mentagrophytes, and Candida albicans using a 96-micro-well MIC. A total of 250 1-day-old Hubbard chicks were divided into five groups on a deep litter system. Chicks were supplemented daily with Tilapia bone powder (1 g/l) for 4-6 hours from the 3rd day. Challenges were served on the 7th, 14th, 21st, 28th, and 35th days for four broiler groups using magnesium chloride (100 mg/l), lead nitrate (350 mg/l), E. coli (2.4 × 1012 CFU/ml), S. Typhimurium (1.8 × 108 CFU/ml), respectively, and the 5th group was assigned as a control. A total of 2,250 samples (90 Tilapia-pollutants mixes, 480 Tilapia-microbial mixes, 240 sera, 240 intestinal swabs, and 1,200 tissue samples) were collected. Results: Tilapia bone powder 1% reveals a 100% reduction in the lead after 1 hour, total and calcium hardness after 0.5 hours, as well as 100% killing efficacy against E. coli O1527:H7, S. Typhimurium, M. gallisepticum, A. niger, T. mentagrophytes, and C. albicans after 0.5, 1, 1, 1, 1, and 1 hour, respectively. Tilapia bone powder 1% treated water reveals highly significant (p < 0.01) increases in dissolved oxygen and declines in physicochemical and microbial parameters compared with tap water. Challenged treated broilers revealed highly significant (p < 0.01) increases in weight gains, performance index, body weights, carcasses, and organs weights, immunoglobulin concentrations, and antioxidant levels, as well as highly significant (p < 0.01) improvements in feed conversions, feed and water intakes, biochemical profile, cortisol hormone, and intestinal microbiota. Conclusion: Tilapia bone powder provided significant in-vitro adsorptive and antimicrobial actions, as well as supported the broiler chickens to mitigate the polluted water stress accompanied by enhanced performance, carcass quality, immunity, and intestinal microbiota.

The efficiency of natural-ecofriendly clay filters on water purification for improving performance and immunity in broiler chickens.

Background: Innovative water treatments and purification processes have become a point of interest to provide solutions and meet the basic water requirements and demands. Clay plays a key role in environmental protection from pollutants through ion exchange and/or adsorption. Aim: The study evaluated the adsorption and antimicrobial efficiency of clay in purifying polluted water, as well as the influence of clay-purified water on performance, immunity, and microbial counts. Methods: The experimented 280 one-day-old Hubbard broilers were divided into seven groups on a deep litter system. Polluted water (lead nitrate; 500 mg/l, calcium sulfate; 80 mg/l, yeast extract 5%; 5 mg/l, diazinon; 2.5 ml/l, Salmonella Typhimurium; 1.5 × 106 CFU/ml, and Eimeria tenella; 1 × 105 OPG/ml) was filtered using plastic basins of 1 m3 supplied with 60 cm layer of clay. Broiler groups (G1 to G6) were supplied with clay-filtered and G7 with control tape water. A total of 2,182 samples, including 54 water samples, 266 sera, 266 duodenal swabs, 266 breast muscles, 266 fecal samples, and 1,064 organs including liver, spleen, heart, and bursa of Fabricius were collected. Results: Weight gains, performance indices, water intakes, water/feed intake ratios, live body weights, carcasses weights, edible and immune organs' weights, immunoglobulin G and M, total antioxidant capacity, lactate dehydrogenase, malondialdehyde, and superoxide dismutase revealed highly significant (p < 0.01) increases in all broiler groups supplemented with clay-filtered water compared to the control group. Meanwhile, total protein, alanine aminotransferase, creatinine, glucose, triglycerides, total cholesterol, cortisol hormone, total bacterial and Enterobacteriaceae counts, total Salmonella counts, and E. tenella counts revealed highly significant (p < 0.01) declines in all broiler groups supplemented with clay-filtered water compared to the control group. Conclusion: Clay filters provided high filtration, adsorption, and antimicrobial efficiency against polluted water, enhanced water quality, and improved performance and immunity in broiler chickens.

Efficacy of Dexmedetomidine Infusion Without Loading Dose on Hemodynamic Variables and Recovery Time During Craniotomy: A Randomized Double-blinded Controlled Study.

BACKGROUND: Maintaining hemodynamic stability during intracranial surgery is one of the most important tasks. There is no general agreement regarding which anesthetics are optimal for craniotomy. Propofol and short-acting opioids are usually used, but their use is not without side effects. Recently, dexmedetomidine has been considered a safe alternative in different surgeries. OBJECTIVES: We aimed to assess the efficacy of 0.5 µg/kg/h dexmedetomidine infusion without loading dose as an adjunct to general anesthesia for craniotomy. METHODS: A prospective, randomized, double-blinded, parallel-group, placebo-controlled trial was conducted. Setting: Single university teaching hospital's operating rooms and postoperative intensive care unit. Patients: A total of 50 patients scheduled for elective supratentorial craniotomy participated in this study. Interventions: Patients were randomly divided into either control group (group C) and Dexmedetomidine group (group D). Main outcome measure: Intraoperative hemodynamics measurements at specific timings. RESULTS: We found that dexmedetomidine had significantly maintained mean arterial blood pressure and heart rate (P-value < 0.001); with lower intraoperative fentanyl and propofol consumption in group D (132 ± 35 µg and 14 ± 30 mg, respectively) when compared to group C (260 ± 38 µg and 534 ± 66 mg, respectively). Finally, a lesser sedation level was noticed in the dexmedetomidine group, together with a significantly lesser recovery time of 10.3 ± 4 min. CONCLUSIONS: Dexmedetomidine infusion without loading dose could be an efficacious and safe agent in achieving hemodynamic stability with intraoperative opioid-sparing effect and lesser recovery time.

Synoptic Overview of Exotic Acacia, Senegalia and Vachellia (Caesalpinioideae, Mimosoid Clade, Fabaceae) in Egypt.

For the first time, an updated checklist of Acacia, Senegalia and Vachellia species in Egypt is provided, focusing on the exotic species. Taking into consideration the retypification of genus Acacia ratified at the Melbourne International Botanical Congress (IBC, 2011), a process of reclassification has taken place worldwide in recent years. The review of Acacia and its segregates in Egypt became necessary in light of the available information cited in classical works during the last century. In Egypt, various taxa formerly placed in Acacia s.l., have been transferred to Acacia s.s., Acaciella, Senegalia, Parasenegalia and Vachellia. The present study is a contribution towards clarifying the nomenclatural status of all recorded species of Acacia and its segregate genera. This study recorded 144 taxa (125 species and 19 infraspecific taxa). Only 14 taxa (four species and 10 infraspecific taxa) are indigenous to Egypt (included now under Senegalia and Vachellia). The other 130 taxa had been introduced to Egypt during the last century. Out of the 130 taxa, 79 taxa have been recorded in literature. The focus of this study is the remaining 51 exotic taxa that have been traced as living species in Egyptian gardens or as herbarium specimens in Egyptian herbaria. The studied exotic taxa are accommodated under Acacia s.s. (24 taxa), Senegalia (14 taxa) and Vachellia (13 taxa). Identification keys for the studied genera, generic groups and species have been provided using different taxonomic criteria. For each taxon, the validated name with the first citation followed by relevant Egyptian citations, typification, synonyms, distinctive features, origin, ecology (when available), utilisation and selected specimens are provided. The study revealed the presence of 22 newly recorded taxa in Egypt. Additionally, a list of excluded, unvalidated and unresolved names is given.

Moderations in performance, immunity, tissue architecture, and vaccine viability induced by water magnetization in broiler farms.

BACKGROUND AND AIM: Water magnetization contributes to increased molecular ionization and fluidity, which improves biological activities. This study tests the influence of magnetic water on the viability of the Newcastle vaccine and the survival of Escherichia coli and SalmonellaTyphimurium, as well as the influence of magnetic water in face of water impurities' challenges on performance, immunity, and tissue architecture in broiler chickens. MATERIALS AND METHODS: An in vitro 96-micro-well plate minimal inhibitory concentration was utilized to test the influence of water, saline, and magnetic water on Newcastle vaccine viability and E. coli O157:H7 and S. Typhimurium survival. The 245 experimental 1-day-old female Ross® 308 broilers used in this study were divided into seven groups of 35 birds each. Broilers were provided with magnetic drinking water (13,200 gausses) for 6 h daily from the 5th day and were challenged on days 14, 21, 28, and 35 using sodium chloride (700 mg/L), calcium sulfate (80 mg/L), lead acetate (500 mg/L), yeast extract 5% (5 mg/L), diazinon (2.5 mL/L), and E. coli O157:H7 (1.6 × 109 CFU/mL). A total of 2040 samples (96 diluent-Newcastle virus vaccine mixes, 96 microbial-magnetic water mixes, 231 sera, 231 intestinal swabs, and 1386 organ samples) were collected. RESULTS: An in vitro trial revealed highly significant (p<0.01) declines of 94.13%, 84.53%, and 10.31% in the Newcastle vaccine titer in water, saline, and magnetic water, respectively, and 54.91% and 39.89% in E. coli O157:H7 and S. Typhimurium survival, respectively, after 4 h. In all challenged groups, broilers exhibited highly significant (p<0.01) increases in performance, carcass/organs weight, immunoglobulin G, immunoglobulin M, and Lactobacillus counts; significant improvement in tissue architecture and biochemical parameters; and highly significant (p<0.01) reductions in cortisol, superoxide dismutase, and total bacterial and Enterobacteriaceae counts. CONCLUSION: Magnetic water could maintain vaccine viability and vaccination efficiency, reduce microbial survival, and minimize the negative influence of all induced challenges.

Examining Heterogeneity of Food Fortification and Biofortification Business Models: Emerging Evidence for a Typology.

Efforts to address Micronutrient deficiencies (MNDs) in lower-and middle-income countries (LMICs) have been gaining pace in recent years. Commodities such as staple foods (e.g., cereals, roots, and tubers) and condiments (e.g., salt) have been targeted as 'vehicles' for fortification and biofortification through numerous projects and initiatives. To date, there have been mixed experiences with delivery and coverage with very little documented on the range of business models applied in different geographies, business conditions and polities and this makes classification and measurement of success and failure difficult. This research aims to address this gap in knowledge through proposing a typology that clarifies similarities (internal heterogeneity) and differences (external heterogeneity) between models and that can allow all types to be defined by the combination of attributes. Building on a comprehensive literature review; NVivo was used to code initiatives from 34 key references (955 cases in total) which have been grouped into 17 categories. Using non-metric multidimensional scaling (NMDS) we find evidence of four business model groupings that typify fortification initiatives: (1) Large-scale private, unregulated, (2) Mixed-Scale, private, unregulated (3) Large-scale, public-private, regulated; and (4) Large-scale, private, regulated. We characterise these four groups with country examples and suggest that this typology can help the discourse around viability of food fortification initiatives.

Case Report: Prolonged Viral Shedding in Six COVID-19 Patients.

COVID-19 has surfaced as a multi-organ disease predominantly affecting the respiratory system. Detection of the viral RNA through reverse transcriptase-PCR (RT-PCR) from a nasopharyngeal or throat sample is the preferred method of diagnosis. Recent evidence has suggested that COVID-19 patients can shed the SARS-CoV-2 for several weeks. Herein, we report six cases of COVID-19 who had persistently positive SARS-CoV-2 on repeat RT-PCR testing reaching up to 9 weeks. The spectrum of cases described ranges from asymptomatic infection to severe COVID-19 pneumonia. A full understanding of the virus's transmission dynamics needs further research. Prolonged viral shedding currently has unclear implications on the management and isolation decisions-the role of the cycle threshold (Ct) value in guiding therapeutic decisions is yet to be clarified. More data on the relationship between Ct values and viral cultivation are needed, especially in patients with prolonged viral shedding, to understand the virus's viability and infectivity.

An overview of healthcare-associated infections in a tertiary care hospital in Egypt.

BACKGROUND: Healthcare-associated infection (HAI) is a major problem in healthcare facilities and is associated with increased morbidity and mortality and prolonged hospital stay. This study aims to determine the incidence rate, risk factors, and bacterial aetiology of HAI in a tertiary care hospital in Mansoura, Egypt. METHODS: This is a prospective observational study carried out over 12 months in different departments of Mansoura New General Hospital (MNGH). Data were collected from patient's records and laboratory results of the ongoing HAI surveillance program. RESULTS: The incidence of HAI was 3.7% among 6912 patients studied. The independent predictors of HAI were multiple devices (AOR=88.1), central venous catheter (CVC) (AOR=34), urinary catheter (AOR=28.9) and length of stay >20 days (AOR=3.1). Surgical site infections (SSI) were the most frequent (24%) followed by catheter associated urinary tract infections (CAUTI) (20%). The most frequently isolated pathogens were Klebsiella spp. (27.2%), and E. coli (18%). CONCLUSIONS: HAI is a significant problem in MNGH. Klebsiella spp. were the predominant causative organisms of HAI, as has been described in other studies from developing countries.