Evaluation of awareness and performance towards COVID-related disinfectant use among the university communities in Lebanon.

BACKGROUND: The fast spread of COVID-19 reinforced the daily use of disinfectants around the world. However, the awareness gap of disinfectant use could lead to health risks during the prevention of the pandemic. This study aims to assess the level of awareness and performance towards COVID-related disinfectant use among various university communities (student, staff, and faculty) in Lebanon. METHODS: A cross-sectional study was conducted between December 2021 and June 2022 among 925 participants (males and females aged between 18 and 64 years old) from academic settings in Lebanese universities using convenience sampling. An online validated survey (score-based questionnaire) of personal disinfectants' utilization was conducted to evaluate the awareness and performance levels using SPSS (version 21). Mann-Whitney and Kruskal-Wallis tests were used to check significant differences in awareness and performance levels among gender, age, provinces, educational level, university status, and field of study. Friedman test was used to test for significant differences in performance level questions pre-and post-COVID-19. The Spearman correlation test was used to determine the correlation between the awareness and performance of the respondents regarding the use of disinfectants. RESULTS: It was found that the majority of the respondents showed a weak level of awareness (70.8%) while their performance (61.9%) was moderate. Spearman's correlation analysis concluded a weak correlation between the awareness and performance levels (p < 0.01). The Mann-Whitney test indicated that there was a significant difference (p < 0.05) in awareness and performance levels between males and females. Another notable variable was the educational level of the respondents (p < 0.05) with postgraduate degrees holders recording higher mean scores of awareness than the ones with undergraduate and high school degrees as per Kruskal-Wallis test. Significant differences were shown in awareness scores among the age groups and in performance scores among the field of study (p < 0.05). CONCLUSIONS: The study findings highlighted the necessity of awareness campaigns and training programs addressing the technical handling of disinfectants among the communities in Lebanon. Lebanese governmental authorities (Ministry of Public Health, MoPH, and Ministry of Education and Higher Education, MEHE), and the healthcare professionals and public health researchers in Lebanon may utilize this new evidence to initiate public health interventions as a part of the United Nations (UN) sustainability goal of wellbeing (Sustainable Development Goal 3, SDG 3).

Association between visual impairment and sleep duration in college students: A study conducted in UAE and Lebanon.

Objective: To examine whether self-reported sleep duration and visual impairment were associated among College students. Participants: Students (n = 1002, age 17-35 years) from Lebanon and the United Arab Emirates. Methods: Students were asked to complete a validated questionnaire between October 2018 and May 2019. The questions were related to sociodemographics, lifestyle characteristics, visual impairment status, sleeping pattern, mobile-phone use and chronic conditions. Results: 18.3% of the respondents reported to suffer from visual impairment. Among them, 72.7% were females (p < .001), 65% admitted to frequently use mobile phones before sleeping (p < .001), 54.6% reported to sleep less than 7 h (p = .008) and 71.6% reported to suffer from sleep disturbances (p = .05). Visual impairment was associated with poor sleep quality (p < .001), mobile phone use before sleeping (p < .01) and daily stress (p < .05). Conclusion: Visual impairment in college students is associated with short sleep duration, mobile phone use before sleeping and stress level.

Hand hygiene during the spread of COVID-19: a cross-sectional study of awareness and practices among academic institutions in Lebanon.

Introduction: During the pandemic, the World Health Organization has recommended hand hygiene as one of the effective preventive measures to limit the global spread of COVID-19. However, the awareness gap of hand hygiene protocols could increase the spread of COVID-19 and consequently increase the absenteeism rate among academic institutions. This study aims to assess hand hygiene awareness and practices levels among various university communities in Lebanon. Methods: A cross-sectional study was conducted between December 2021 and June 2022 among 1,291 participants from academic settings in Lebanese universities. An online survey (score-based questionnaire) of hand hygiene was conducted to evaluate the awareness and practices among university communities (faculty, staff, and students). Mann-Whitney and Kruskal-Wallis tests were used to determine whether significant differences exist in the levels of awareness with regard to gender, age, provinces, educational level, and university status. Pearson's chi-squared test was applied to assess differences among the sample characteristics and participants' practice of hand hygiene. Results: It was found that most of the participants showed a moderate level of awareness (76.4%) with a mean score of 7.59 out of 12 (SD = 1.68). The Mann-Whitney test indicated that females recorded higher levels of awareness than males with a significant difference of 102, 104: p < 0.05. Another notable variable was the educational level of the participants with university degrees holders recording higher scores of awareness than the ones with high school degrees as per the Kruskal-Wallis test (p < 0.05). Significant differences were also shown in awareness scores among the age groups and the university status (p < 0.05). The Pearson's chi-squared test results showed that females used alcohol-based hand rubs or soap and water more frequently than males (p < 0.05). However, males significantly preferred the frequent use of water alone compared to females (p < 0.05). Conclusion: The study findings highlighted the necessity of awareness campaigns and health educational programs addressing the technical skills of hand hygiene among both genders (especially males) of the academic communities in Lebanon.

N-homocysteinylation of tau and MAP1 is increased in autopsy specimens of Alzheimer's disease and vascular dementia.

The pathomechanisms that associate a deficit in folate and/or vitamin B12 and the subsequent hyperhomocysteinemia with pathological brain ageing are unclear. We investigated the homocysteinylation of microtubule-associated proteins (MAPs) in brains of patients with Alzheimer's disease or vascular dementia, and in rats depleted in folate and vitamin B12, Cd320 KO mice with selective B12 brain deficiency and H19-7 neuroprogenitors lacking folate. Compared with controls, N-homocysteinylated tau and MAP1 were increased and accumulated in protein aggregates and tangles in the cortex, hippocampus and cerebellum of patients and animals. N-homocysteinylation dissociated tau and MAPs from ß-tubulin, and MS analysis showed that it targets lysine residues critical for their binding to ß-tubulin. N-homocysteinylation increased in rats exposed to vitamin B12 and folate deficit during gestation and lactation and remained significantly higher when they became 450 days-old, despite returning to normal diet at weaning, compared with controls. It was correlated with plasma homocysteine (Hcy) and brain expression of methionine tRNAsynthetase (MARS), the enzyme required for the synthesis of Hcy-thiolactone, the substrate of N-homocysteinylation. Experimental inactivation of MARS prevented the N-homocysteinylation of tau and MAP1, and the dissociation of tau and MAP1 from ß-tubulin and PSD95 in cultured neuroprogenitors. In conclusion, increased N-homocysteinylation of tau and MAP1 is a mechanism of brain ageing that depends on Hcy concentration and expression of MARS enzyme. Its irreversibility and cumulative occurrence throughout life may explain why B12 and folate supplementation of the elderly has limited effects, if any, to prevent pathological brain ageing and cognitive decline. Copyright © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Augmented Quadruple-Phase Contrast Media Administration and Triphasic Scan Protocol Increases Image Quality at Reduced Radiation Dose During Computed Tomography Urography.

PURPOSE: The aim of this article was to investigate the opacification of the renal vasculature and the urogenital system during computed tomography urography by using a quadruple-phase contrast media in a triphasic scan protocol. MATERIALS AND METHODS: A total of 200 patients with possible urinary tract abnormalities were equally divided between 2 protocols. Protocol A used the conventional single bolus and quadruple-phase scan protocol (pre, arterial, venous, and delayed), retrospectively. Protocol B included a quadruple-phase contrast media injection with a triphasic scan protocol (pre, arterial and combined venous, and delayed), prospectively. Each protocol used 100 mL contrast and saline at a flow rate of 4.5 mL. Attenuation profiles and contrast-to-noise ratio of the renal arteries, veins, and urogenital tract were measured. Effective radiation dose calculation, data analysis by independent sample t test, receiver operating characteristic, and visual grading characteristic analyses were performed. RESULTS: In arterial circulation, only the inferior interlobular arteries in both protocols showed a statistical significance (P < 0.05). Venously, the inferior vena cava, proximal and distal renal veins demonstrated a significant opacification reduction in protocol B than in protocol A (P < 0.001). Protocol B showed a significantly higher mean contrast-to-noise ratio than protocol A (protocol B: 22.68 ± 13.72; protocol A: 14.75 ± 5.76; P < 0.001). Radiation dose was significantly reduced in protocol B (7.38 ± 2.22 mSv) than in protocol A (12.28 ± 2.72 mSv) (P < 0.001). Visual grading characteristic (P < 0.027) and receiver operating characteristic (P < 0.0001) analyses demonstrated a significant preference for protocol B. CONCLUSIONS: In computed tomography urography, augmented quadruple-phase contrast media and triphasic scan protocol usage increases the image quality at a reduced radiation dose.

Late Maternal Folate Supplementation Rescues from Methyl Donor Deficiency-Associated Brain Defects by Restoring Let-7 and miR-34 Pathways.

The micronutrients folate and vitamin B12 are essential for the proper development of the central nervous system, and their deficiency during pregnancy has been associated with a wide range of disorders. They act as methyl donors in the one-carbon metabolism which critically influences epigenetic mechanisms. In order to depict further underlying mechanisms, we investigated the role of let-7 and miR-34, two microRNAs regulated by methylation, on a rat model of maternal deficiency. In several countries, public health policies recommend periconceptional supplementation with folic acid. However, the question about the duration and periodicity of supplementation remains. We therefore tested maternal supply (3 mg/kg/day) during the last third of gestation from embryonic days (E) 13 to 20. Methyl donor deficiency-related developmental disorders at E20, including cerebellar and interhemispheric suture defects and atrophy of selective cerebral layers, were associated with increased brain expression (by 2.5-fold) of let-7a and miR-34a, with subsequent downregulation of their regulatory targets such as Trim71 and Notch signaling partners, respectively. These processes could be reversed by siRNA strategy in differentiating neuroprogenitors lacking folate, with improvement of their morphological characteristics. While folic acid supplementation helped restoring the levels of let-7a and miR-34a and their downstream targets, it led to a reduction of structural and functional defects taking place during the perinatal period. Our data outline the potential role of let-7 and miR-34 and their related signaling pathways in the developmental defects following gestational methyl donor deficiency and support the likely usefulness of late folate supplementation in at risk women.

256 Slice Multi-detector Computed Tomography Thoracic Aorta Computed Tomography Angiography: Improved Luminal Opacification Using a Patient-Specific Contrast Protocol and Caudocranial Scan Acquisition.

CLINICAL RELEVANCE STATEMENT: Caudocranial scan direction and contrast injection timing based on measured patient vessel dynamics can significantly improve arterial and aneurysmal opacification and reduce both contrast and radiation dose in the assessment of thoracic aortic aneurysms (TAA) using helical thoracic computed tomography angiography (CTA). OBJECTIVES: To investigate opacification of the thoracic aorta and TAA using a caudocranial scan direction and a patient-specific contrast protocol. MATERIALS AND METHODS: Thoracic aortic CTA was performed in 160 consecutive patients with suspected TAA using a 256-slice computed tomography scanner and a dual barrel contrast injector. Patients were subjected in equal numbers to one of two contrast protocols. Patient age and sex were equally distributed across both groups. Protocol A, the department's standard protocol, consisted of a craniocaudal scan direction with 100 mL of contrast, intravenously injected at a flow rate of 4.5 mL/s. Protocol B involved a caudocranial scan direction and a novel contrast formula based on patient cardiovascular dynamics, followed by 100 mL of saline at 4.5 mL/s. Each scan acquisition comprised of 120 kVp, 200 mA with modulation, temporal resolution 0.27 seconds, and pitch 0.889:1. The dose length product was measured between each protocol and data generated were compared using Mann-Whitney U nonparametric statistics. Receiver operating characteristic analysis, visual grading characteristic (VGC), and κ analyses were performed. RESULTS: Mean opacification in the thoracic aorta and aneurysm measured was 24 % and 55%, respectively. The mean contrast volume was significantly lower in protocol B (73 ± 10 mL) compared with A (100 ± 1 mL) (P<0.001). The contrast-to-noise ratio demonstrated significant differences between the protocols (protocol A, 18.2 ± 12.9; protocol B, 29.7 ± 0.61; P < 0.003). Mean effective dose in protocol B (2.6 ± 0.4 mSv) was reduced by 19% compared with A (3.2 ± 0.8 mSv) (P < 0.004). Aneurysmal detectability demonstrated significant increases by receiver operating characteristic and visual grading characteristic analysis for protocol B compared with A (P < 0.02), and reader agreement increased from poor to excellent. CONCLUSIONS: Significant increase in the visualization of TAAs following a caudocranial scan direction during helical thoracic CTA can be achieved using low-contrast volume based on patient-specific contrast formula.

Imaging in multiple sclerosis: A new spin on lesions.

This article evaluates the most relevant state-of-the-art magnetic resonance (MR) techniques that are clinically available to investigate multiple sclerosis (MS). The presence of hypo- and hyperintense lesions on T1- and T2-weighted magnetic resonance imaging (MRI) sequences in white matter (WM) is a common finding that is occasionally a diagnostic challenge for the radiologist. The technical requirements and how they may help to understand, classify or follow-up these pathologies are briefly summarized. The gold standard for MS diagnosis is pathological correlation. Yet due to limited availability of biopsy and autopsy material, there is a high demand for imaging as a diagnostic as well as prognostic indicator. With the progress in MRI during the last decade, MRI now plays a leading role in the diagnosis and follow-up of MS. A number of correlative pathological and MR studies have helped to define pathological substrates of MS in focal lesions and normal appearing white matter (NAWM). Vascular spaces mimicking MS lesions have been minimized by the enhanced differentiation of WM and grey (GM) matter parenchyma. The aim of this article is to enhance the current understanding of histopathology and radiological characteristics of MS lesions in space and time.

Homocysteinylation of neuronal proteins contributes to folate deficiency-associated alterations of differentiation, vesicular transport, and plasticity in hippocampal neuronal cells.

Despite the key role in neuronal development of a deficit in the methyl donor folate, little is known on the underlying mechanisms. We therefore studied the consequences of folate deficiency on proliferation, differentiation, and plasticity of the rat H19-7 hippocampal cell line. Folate deficit reduced proliferation (17%) and sensitized cells to differentiation-associated apoptosis (+16%). Decreased production (-58%) of S-adenosylmethionine (the universal substrate for transmethylation reactions) and increased expression of histone deacetylases (HDAC4,6,7) would lead to epigenomic changes that may impair the differentiation process. Cell polarity, vesicular transport, and synaptic plasticity were dramatically affected, with poor neurite outgrowth (-57%). Cell treatment by an HDAC inhibitor (SAHA) led to a noticeable improvement of cell polarity and morphology, with longer processes. Increased homocysteine levels (+55%) consecutive to folate shortage produced homocysteinylation, evidenced by coimmunoprecipitations and mass spectrometry, and aggregation of motor proteins dynein and kinesin, along with functional alterations, as reflected by reduced interactions with partner proteins. Prominent homocysteinylation of key neuronal proteins and subsequent aggregation certainly constitute major adverse effects of folate deficiency, affecting normal development with possible long-lasting consequences.