The influence of breed's difference on the hemogram and biochemistry profile of goats raised in Libya during winter.

Background: In Libya, goats are considered as one of the most important livestock in which there are many breeds of goats such as Kurdi, Hegazi, Cyprus, Shami, and Mahali. A little hematological and biochemical information is known on these goat breeds raised in Libya. Aim: The main purpose was to verify the effect of breed variations on the hematological and biochemical parameters of goat breeds raised in Libya. Methods: The blood samples were collected in the winter season from 70 clinically healthy animals of different breeds for hematology and biochemical analysis. Results: Regarding the effect of breeds on blood hematology, significantly higher number (p < 0.01) of Mid cells were found in Hegazi (3.12 ± 1.30 × 103/µl) and Cyprus (2.41 ± 1.69 × 103/µl) when compared to other goat's breeds including Kurdi (2.28 ± 0.95 × 103/µl), Shami (1.90 ± 0.84 × 103/µl), and Mahali (1.37 ± 0.88 × 103/µl). Moreover, the percentage of Mid cells was highest in Hegazi (22.34% ± 9.40%), 11.40% ± 4.34%), followed by Kurdi (17.71% ± 8.16%), Cyprus (15.84% ± 8.33%), Shami (13.38% ± 5.76%), and lowest in Mahali (11.40% ± 4.34%). There are significant differences (p < 0. 01) in hemoglobin (Hb), red blood cells (RBCs), hematocrit (HCT), mean corpuscular hemoglobin (MCH), red cell width distribution-coefficient of variation (RDW-CV, %), and red cell distribution width-standard deviation (RDW-SD, fl) values among all different breeds of Libyan goats. The results of biochemistry displayed significant changes among the studied goats' breeds, where the highest serum alanine aminotransferase (ALT, U/L) activity was observed in Cyprus (17.81 ± 7.95) and Shami (17.27 ± 1.15) compared with Hegazi (15.31 ± 6.13) and Mahali (14.60 ± 0.46), while Kurdi breed (11.68 ± 7.95) showed the lowest ALT activity. Moreover, significant differences (p < 0.01) in serum lactate dehydrogenase (LDH, U/l), total and direct bilirubin, glucose (GLU), creatinine, lipid profile, and electrolyte levels were recorded among different breeds used in this study. On the other hand, non-significant variations (p >0. 05) are reported in aspartate aminotransferase (U/l), alkaline phosphatase (U/l), total protein (g/dl), albumin (g/dl), urea and magnesium (Mg, mg/dl) levels. Conclusion: These results showed a significant difference between some blood parameters of goat breeds raised in Libya. This could aid veterinarians in interpreting laboratory data properly in order to improve the management and conservation of those breeds.

Metazoan ectoparasites of Lithognathus mormyrus (Linnaeus, 1758) from the western coast of Libya.

Background: Lithognathus mormyrus fish is one of the fish of high economic importance in the countries of the world in general and the Mediterranean countries in specific, including the Libyan Sea waters, for this it is necessary to know everything related to this type of fish, including its infection with parasites. Parasites are considered one of the factors threatening the life of fish, being one of the food chains and the ecological composition of life. Aim: The current study aims to isolate and identify the parasites that infect the L. mormyrus. Methods: A total of 368 specimens of L. mormyrus were collected by fishermen, from the western coast of Libya. The study was focused on metazoan parasites. When fish were fully examined for the presence of ectoparasites under a dissecting microscope with incident light, the software camera connected with a microscope and semichon' acetocarmine technique for identification of parasites. Results: Two species of Monogenea (Encotyllabe valley, Pagellicotyle mormyri, and Lamellodiscus spp.), Isopoda (Gnathia), Copepoda (Lernaeolophus sultanus), and Annelidae (Trachelobdella lubrica) has been isolated from this species of fish. The highest prevalence of infection was Gnathia parasites (8.47%). Conclusion: There were differences in the parasite species that infect L. mormyrus from one country to another, and also from city to other cities in the same country, as in the Tunisian waters.

Immunohistochemical study of scrapie in naturally affected sheep in the east of Libya.

Background: The most common natural prion disease that primarily affects sheep and goats is scrapie. It belongs to a group of disorders known as transmissible spongiform encephalopathies, which impact both humans and animals. Aim: The research is aimed to examine and confirm the presence of scrapie in Libya using immunohistochemistry (IHC) techniques. Methods: Brain samples were collected from thirty-three sheep older than two years of age showing clinical signs resembling to scrapie during the period between 2018 and 2023, regardless of race or gender. Three animals, six months old, healthy, and without any symptoms, were used as negative controls. Different parts of the brain, including the obex and cerebellum, were taken from each case. The IHC technique used in this study involved staining with monoclonal antibody L42 and DAB (3,3'-diaminobenzidine) as a chromogenic substrate. Results: The IHC examination showed the expression of prion proteins in brain tissue in twenty-three samples. The staining intensity was markedly observed in the neuronal cell bodies and around blood vessels. Conclusion: The findings of this study provide evidence that scrapie exists in Libya.

Seroprevalence of brucellosis in sheep and goats from Al Jufrah district in Libya.

Introduction: brucellosis is a global neglected zoonotic disease affecting mainly livestock, causing communicable and zoonotic infections. This study aimed to investigate the seroprevalence and determine epidemiological risk factors associated with Brucella infection in sheep and goats in Al Jufrah central district of Libya. Methods: sera samples from 555 animals (goats (n=320) and sheep (n=235)) sheep) were obtained and subjected to the Rose Bengal Plate Test (RBPT) then further confirmed by a validated Enzyme Linked Immunosorbent assay (ELISA). Collected data was analyzed using Statistical Package for the Social Sciences (SPSS). Results: in total, 2.7% were ELISA seropositive for brucellosis with the highest seropositivity rate among the studied animals from Sokna with 5.8% (n=13/225) followed by 0.7% (n=2/285) in Waddan and 0% (n=0/45) in Houn. Only location was identified as a significant risk and no significant differences were identified between seropositivity and the age studied groups, species of animals, gender, and size of farms (p-value>0.05). Conclusion: the present study provides important information on the epidemiological status of Brucella infection in an important region in North Africa. Prevention control systems adopting "One Health" concept, and regional and international collaboration are important to control brucellosis and other zoonotic and transboundary diseases.

Cross-cultural adaptation of the Arabic version of the oral health values scale.

AIMS: The study aimed to adapt the original English-language oral health values scale (OHVS) to the Arabic culture and to test its psychometric properties. METHODS: The original OHVS was translated into Arabic language and pre-tested using cognitive interviewing. The psychometric properties of Arabic OHVS were examined in a sample comprising 416 Libyan adults aged 18-70 years, recruited from the main public and private dental clinics in Benghazi. The participants' demographic information, oral health behaviour, perceived oral health, the Arabic version of the OHVS (A-OHVS), dental neglect scale, oral health-related quality of life, oral health literacy, simplified oral hygiene index (OHI-S), and decayed, missing, and filled teeth index (DMFT) were collected. Psychometric properties were tested using content validity, construct validity, discriminating validity, internal consistency, test-retest reliability, and floor as well as ceiling effects were examined. RESULTS: The Arabic OHVS was successfully and smoothly developed. It showed an acceptable level of equivalence to the original version, The A-OHVS presented an overall Cronbach's Alpha of 0.74 and the average score was 40.02, ranging between 26 and 54. All hypotheses predefined to test construct validity were confirmed. The bivariate correlation between A-OHVS and other health indicators shows a significant positive correlation between A-OHVS and oral health literacy (p = 0.000). On the other hand, statistically significant negative correlations were observed between A-OHVS and dental neglect and quality of life (p ≤ 0.001) as well as DMFT and OHI-S (p ≤ 0.001). Floor or ceiling effects were not observed. CONCLUSIONS: The A-OHVS was shown to be a valid and reliable tool for assessing oral health values in the Arabic-speaking population.

The oral health care system in Libya: a case study.

BACKGROUND: This study aims to describe the Libyan oral health care system in terms of its structure, function, workforce, funding, reimbursement and target groups. METHODS: A single descriptive case study approach and multiple sources of data collection were used to provide an in-depth understanding of the Libyan oral health care system. A purposeful sample of the key informants (Managers of oral health centers, dentists of various specialties with experience in the field, dentists, nurses, dental technicians, and officials in the affairs of medical insurance) was recruited. The case and its boundaries were guided by the study's aim. Both qualitative and quantitative analyses were conducted. Descriptive statistics were used for quantitative data. Framework analysis, informed by the study objectives, was used to analyze interviews and documents. RESULTS: The analysis showed that oral health services are integrated into medical services. The provision of dental care is mainly treatment-based, in the private sector. The oral health services in the public sector are mainly emergency care and exodontia. The dental workforce included in the study were mostly dentists (89% General Dental Practitioners (GDPs), 11% specialists), with a marked deficiency in dental technicians and nurses. Around 40% of dentists work in both the private and public sectors. The government provides the funding for the public sector, but the private sector is self-funded. No specific target group(s) nor clear policies were reported. However, the system is built around primary health care as an overarching policy. Dental caries is the most common oral problem among Libyan preschool children affecting around 70% and is the most common cause of tooth loss among adults. CONCLUSION: The oral health care system in Libya is mainly privatized. The public health services are poorly organized and malfunctioning. There is an urgent need to develop policies and plans to improve the oral health care system in Libya.

Diversity of hard ticks parasitizing farm animals in the Qarabulli region, Northwestern Libya.

Background: There are 26 species of ticks known to exist in Libya. Despite the presence of a number of investigations on ticks in Libya, there are no published studies on ticks in the Al-Qarboulli area. Aim: The aim of this study was to identify the tick species infesting farm animals in the Qarabulli region. Methods: Ticks were collected manually on a monthly basis from the examined hosts (cattle, sheep, dogs, and camels) that were selected randomly in the period between July 2021 and June 2022. Results: A total of 717 ticks were collected on 775 hosts, eight tick species were encountered: Hyalomma excavatum (41.00%), Rhipicephalus sanguineus (23.43%), Hyalomma dromedarii (12.13%), Hyalomma marginatum (9.21%), Hyalomma anatolicum (8.51%), Rhipicephalus annulatus (5.30%), Hyalomma rufipes (0.28%), and Boophilus microplus (0.14%). The mean prevalence of all species was 22.32%. The mean intensity of all species was 0.93 ticks per host. The presence of ticks among the months of the year varied among tick species. Conclusion: The results showed high tick infestation in farm animals of Qarabulli, Libya, suggesting an increased risk of tick-borne diseases. This highlights the need for preventative measures and public awareness to reduce tick populations. Further studies are recommended to understand the spread of tick-borne diseases in the area.

Genetic diversity of North African populations in the 17q21 genomic region.

The demographic history of human populations in North Africa has been characterized by complex migration processes that have determined the current genetic structure of these populations. We examined the autosomal markers of eight sampled populations in northern Africa (Tunisia and Libya) to explore their genetic structure and to place them in a global context. We genotyped a set of 30 autosomal single-nucleotide polymorphisms (SNPs) extending 9.5 Mb and encompassing the 17q21 inversion region. Our data include 403 individuals from Tunisia and Libya. To put our populations in the global context, we analyzed our data in comparison with other populations, including those of the 1000 Genomes Project. To evaluate the data, we conducted genetic diversity, principal component, STRUCTURE, and haplotype analyses. The analysis of genetic composition revealed the genetic heterogeneity of North African populations. The principal component and STRUCTURE analyses converged and revealed the intermediate position of North Africans between Europeans and Asians. Haplotypic analysis demonstrated that the normal (H1) and inverted (H2) polymorphisms in the chromosome 17q21 region occur in North Africa at frequencies similar to those found in European and Southwest Asian populations. The results highlight the complex demographic history of North Africa, reflecting the influence of genetic flow from Europe and the Near East that dates to the prehistoric period. These gene flows added to demographic factors (inbreeding, endogamy), natural factors (topography, Sahara), and cultural factors that play a role in the emergence of the diverse and heterogeneous genetic structures of North African populations. This study contributes to a better understanding of the complex structure of North African populations.

A rapid mixed-methods assessment of Libya's primary care system.

BACKGROUND: Libya has experienced decades of violent conflict that have severely disrupted health service delivery. The Government of National Unity is committed to rebuilding a resilient health system built on a platform of strong primary care. AIM: Commissioned by the government, we set out to perform a rapid assessment of the system as it stands and identify areas for improvement. DESIGN AND SETTING: We used a rapid applied policy explanatory-sequential mixed-methods design, working with Libyan data and Libyan policymakers, with supporting interview data from other primary care policymakers working across the Middle East and North Africa region. METHOD: We used the Primary Health Care Performance Initiative framework to structure our assessment. Review of policy documents and secondary analysis of WHO and World Bank survey data informed a series of targeted policymaker interviews. We used deductive framework analysis to synthesise our findings. RESULTS: We identified 11 key documents and six key policymakers to interview. Libya has strong policy commitments to providing good quality primary care, and a high number of health staff and facilities. Access to services and trust in providers is high. However, a third of facilities are non-operational; there is a marked skew towards axillary and administrative staff; and structural challenges with financing, logistics, and standards has led to highly variable provision of care. CONCLUSION: In reforming the primary care system, the government should consolidate leadership, clarify governance structures and systems, and focus on setting national standards for human resources for health, facilities, stocks, and clinical care.

Public Health Impacts of Ambient Particulate Matter Pollution in Libya from 1990 to 2019: An Analysis of the 2019 Global Burden of Disease (GBD) Study.

Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM2.5) in Libya, drawing on data from the Global Burden of Disease Study 2019. By integrating satellite-based estimates, chemical transport models, and ground-level measurements, PM2.5 exposure and its effects on mortality and disability-adjusted life years (DALYs) across the different sexes and all age groups from 1990 to 2019 are estimated. Our findings reveal that the annual population-weighted mean PM2.5 concentration in Libya was 38.6 µg/m3 in 2019, marking a 3% increase since 1990. In the same year, PM2.5 was responsible for approximately 3368 deaths, accounting for 11% of all annual deaths in the country. Moreover, a total of 107,207 DALYs were attributable to PM2.5, with ischemic heart disease being the leading cause, representing 46% of these DALYs. The analysis also highlights a significant burden of years of life lost (YLLs) at 89,113 and years lived with disability (YLDs) at 18,094, due to PM2.5. Given the substantial health risks associated with air pollution, particularly from ambient particulate matter, Libyan authorities must implement effective policies aimed at reducing air pollution to enhance healthcare outcomes and preventive services.

A novel RYR1 pathogenic variant - Common among Libyan Jews and associated with a broad phenotypic spectrum.

Mutated skeletal muscle ryanodine receptor-1 (RYR1) gene is associated with a spectrum of autosomal dominant and recessive RyR1-related disorders with a wide phenotype. This report describes a variable phenotype associated with a previously unreported RYR1 frameshift pathogenic variant, (NM_000540.2) c.12815_12825del; p.Ala4272Glyfs*307, common in Libyan Jews. Clinical and genetic features of 14 carriers from 8 unrelated families were collected. There were 12 heterozygotes and 2 compound heterozygotes. Six heterozygotes (median age 49.8) were asymptomatic, and six (median age 24.5) presented with myopathy (n = 3) or severe arthrogryposis-like features, severe scoliosis, pes planus, post-anesthesia malignant hyperthermia, or cystic hygroma (in a fetus) (n = 1 each). None had an abnormal echocardiogram study or elevated creatine phosphokinase (CPK) levels. One bi-allelic carrier had a severe skeletal phenotype and myopathy; the other was a fetus with a cystic hygroma. Assessment of variant frequency in 447 Libyan Jews who underwent exome testing for unrelated reason yielded a prevalence of 1:55. The RYR1 p.Ala4272Glyfs*307 variant is common in Libyan Jews. It is associated with a broad phenotypic spectrum, with possible presentation among heterozygotes. Further genotype-phenotype studies are essential to delineate the clinical significance of the variant in mono- and bi-allelic carriers.

Exploring ketoacidosis frequency and risk factors in childhood-onset type 1 diabetes: an 8-year retrospective study (2011-2018) at a tertiary paediatric hospital in Tripoli, Libya.

OBJECTIVES: Diabetic ketoacidosis (DKA) stands as a critical, acute complication of type 1 diabetes. Despite its severity, there exists a dearth of data concerning the frequency and prevalence of DKA at the onset of type 1 diabetes in Libyan children. This study aimed to ascertain the frequency of DKA during the initial presentation of type 1 diabetes among children aged 0.5-14 years admitted to Tripoli Children's Hospital between 2011 and 2018. METHODS: Employing a retrospective approach, the study examined the proportion of children with newly diagnosed type 1 diabetes who presented with DKA. Data analysis included estimating DKA frequency concerning age at presentation, sex, and age groups. The comparative analysis involved assessing DKA frequency between 0.5 and <2 and 2-14 years age groups. Logistic regression analysis evaluated the impact of age group, sex, and family history of type 1 diabetes on DKA and severe DKA occurrence. RESULTS: Among 497 children with newly diagnosed type 1 diabetes, 39.2 % presented with DKA, of these 44.5 % had severe DKA. Females exhibited a higher DKA rate than males (OR 1.63, 95 % CI 1.13-2.34, p=0.009). Very young children (0.5 to <2 years) presented with DKA more frequently than those aged 2-14 years (OR 4.73, 95 % CI 2.65-8.47, p<0.001), and they were more likely to present in severe DKA (63.9 vs. 39.1 %, [OR 7.26, 95 % CI 3.65-14.41, p<0.001]). CONCLUSIONS: The frequency of DKA at type 1 diabetes onset among children admitted to Tripoli Children's Hospital is notably high, with nearly half of the DKA episodes categorized as severe. Very young children notably demonstrated a fivefold increase in the likelihood of presenting with DKA.

Analysis of BRCA1 germline variants (exons 5, 11 and 20) in breast cancer families from Libya.

Breast cancer (BC) is a leading cause of cancer deaths in Libyan women. BRCA1 variants differ globally due to the diversity of genetic makeup and populations history. Their distribution, prevalence, and significance in Libyans remain largely unexplored. This study investigated the characteristics and distribution of BRCA1 variants in exons 5, 11, and 20 in Libyan families with BC. Thirty-six BC patients at ≤ 45 years, between 46-50 years and with a family history of breast, ovarian, pancreatic or prostate cancer in close relatives, or with triple-negative BC, were selected from 33 unrelated families during 2018-2020 at the National Cancer Institute, Sabratha, Libya. From these 33 families, 20 women (18 BC patients and two unaffected) were screened for BRCA1 exons 5, 11 and 20 using Sanger sequencing. All families completed an epidemiology and family history questionnaire. Twenty-seven variants (26 in exon 11 and 1 in exon 20, minor allele frequency of < 0.01) were detected in 10 of 18 unrelated families (55.6%.) Among the 27 variants, 26 (96%) were heterozygous. A frameshift pathogenic variant, c.2643del, and one novel variant c.1366A>G were identified. Furthermore, seven variants with unknown clinical significance were detected: c.1158T>A, c.1346C>G, c.1174C>G, c.3630 G>T, c.3599A>T, and c.3400 G>C in exon 11, and c.5244T>A in exon 20. Six variants with conflicting pathogenicity interpretations, c. 3460T>A, c. 3572 G>A, c. 3700 G>C, c. 1246C>G, c. 1344C>G, and c. 1054 G>A, were also identified. Twelve benign/likely benign variants were identified. Rare BRCA1 variants that have not been reported in North Africa were found in Libyan patients. These findings provide preliminary insights into the BRCA1 variants that could contribute to hereditary BC risk in Libyans. Further functional, computational, and population analyses are essential to determine their significance and potential impact on BC risk, which could ultimately lead to more personalized management strategies.

First records of Secretargas transgariepinus (Argasidae) in Libya and Jordan: corrections of collection records and detection of microorganisms.

The primarily bat-associated argasid tick, Secretargas transgariepinus (White, 1846), is a member of the Afrotropical and southern Palaearctic fauna. Probably because of its secretive life style, little is known about this species and records of its collection are scant. Based on morphological revisions of the available specimens, we report new Middle Eastern records for this tick species that had been misidentified as other bat-associated argasid taxa. These specimens are larvae from three localities, and represent the first records of S. transgariepinus from two countries: one larva from Sabratha (Libya) was collected from an unidentified bat species (possibly Eptesicus isabellinus), seven larvae from Azraq-Shishan (Jordan), and 78 larvae from Shamwari (Jordan) were all collected from Otonycteris hemprichii. Twenty larvae from Shamwari were also tested for the presence of both, viral or bacterial microorganisms by PCR. Three ticks were found to be infected with the Murid gammaherpesvirus 68 (MHV-68), one with Borrelia burgdorferi sensu lato, and four with a Rickettsia sp. closely related to Rickettsia slovaca. The findings represent a first evidence for the occurrence of these possible pathogens in S. transgariepinus.

Prevalence of multi-drug resistant bacteria in intensive care units at Tripoli University Hospital, Tripoli, Libya.

Among hospitalized patients worldwide, infections caused by multidrug-resistant (MDR) bacteria are a major cause of morbidity and mortality. This study aimed to isolate MDR bacteria from five intensive care units (ICUs) at Tripoli University Hospital (TUH). A prospective cross-sectional study was conducted over a seven-month period (September 2022 to March 2023) across five ICUs at TUH. A total of 197 swabs were collected from Patients', healthcare workers' and ICUs equipment. Samples collected from patients were nasal swabs, oral cavity swabs, hand swabs, sputum specimens, skin swabs, umbilical venous catheter swabs, and around cannula. Swabs collected from health care workers were nasal swabs, whereas ICUs equipment's samples were from endotracheal tubes, oxygen masks, and neonatal incubators. Identification and antimicrobial susceptibility test was confirmed by using MicroScan auto SCAN 4 (Beckman Coulter). The most frequent strains were Gram negative bacilli 113 (57.4%) with the predominance of Acinetobacter baumannii 50/113 (44%) followed by Klebsiella pneumoniae 44/113 (40%) and Pseudomonas aeruginosa 6/113 (5.3%). The total Gram positive bacterial strains isolated were 84 (42.6%), coagulase negative Staphylococci 55 (66%) with MDRs (89%) were the most common isolates followed by Staphylococcus aureus 15 (17.8%). Different antibiotics were used against these isolates; Gram- negative isolates showed high resistance rates to ceftazidime, gentamicin, amikacin and ertapenem. A. baumannii were the most frequent MDROs (94%), and the highest resistance rates in Gram-positive strains were observed toward ampicillin, oxacillin, ampicillin/sulbactam and Cefoxitin, representing 90% of total MDR Gram-positive isolates. ESBL and MRS were identified in most of strains. The prevalence of antibiotic resistance was high for both Gram negative and Gram positive isolates. This prevalence requires strict infection prevention and control intervention, continuous monitoring, implementation of effective antibiotic stewardship, immediate, concerted and collaborative action to monitor its prevalence and spread in the hospital.

Impact of presynchronization and Ovsynch on early postpartum ovarian activity and fertility of dairy cows in Libya.

Background: Reproductive efficiency affects dairy cow profitability. Ovarian function in postpartum (P.P.) has been better understood using ultrasound and hormonal assays. Optimizing ovulation synchronization and carefully timing artificial insemination (TAI) can greatly enhance reproductive rates in dairy cows. Aim: This experiment was designed to investigate the reproductive performance and ovarian activity in early postpartum lactating dairy cows using the Presynch-PGF2α, Ovsynch protocol, and TAI. Methods: Randomly the cows were assigned to a control group and a treatment group, based on the chronological order of their calving date. On day 14 P.P., both groups received two cloprostenol treatments, 14 days apart. Ultrasonographic inspections were conducted on day 14 to check ovarian activity and uterine contents. On day 11, after presynchronization, cows in the treatment group were given 100 µg IM. of cystorelin, followed by a luteolytic dose of 500 µg IM., cloprostenol on day 7, and a second dose of cystorelin on day 8 (36 hours later). After the second cystorelin injection by 16-20 hours, cows were inseminated, while the control group had all cows displaying spontaneous estrus between day 0 and day 28 were artificially inseminated. Results: Ovarian activity began to improve at 82.61% on day 19 P.P., with complete recovery between days 24 and 27 P.P. The second cloprostenol injection approached, causing follicular size to reach 8.41 ± 1.04 mm. After the second injection, ovarian activity switched from follicular to luteal, with corpus luteum rates of 23.91% and 26.1%. The presynchronized PGF2α regimen significantly enhanced ovarian activity from days 19-35 P.P. Ovulation and pregnancy rates in the Ovsynch group were 54.2% and 41.7% at the first timed artificial insemination (TAI), compared to 54.5% and 31.8% in the control group. There was no significant impact between them; it was just high in the presynchronized Ovsynch group. However, the P.P. period was minimized to 47-49 days till the first AI reached a 41.7% pregnancy rate and 20.8% at the second AI, for an overall 62.5%. Conclusion: The current study concludes that presynchronization during preservice in clinically normal P.P. dairy cows reduces P.P. duration, increases ovarian activity performance, and reduces ovarian dysfunctions from day 19 to day 35 P.P., as well as improves the pregnancy rate.

Antimicrobial resistance and carbapenemase dissemination in Pseudomonas aeruginosa isolates from Libyan hospitals: a call for surveillance and intervention.

Pseudomonas aeruginosa is a multidrug-resistant bacterium capable of forming biofilms. This study aimed to assess resistance of clinical isolates from Libyan hospitals to antipseudomonal antibiotics, the prevalence of selected extended-spectrum ß-lactamases and carbapenemase genes among these isolates, and the microorganisms' capacity for alginate and biofilm production. Forty-five isolates were collected from four hospitals in Benghazi and Derna, Libya. Antimicrobial susceptibility was determined using agar disc diffusion. The presence of resistance genes (blaCTXM, blaTEM, blaSHV-1, blaGES-1, blaKPC, and blaNDM) was screened using PCR. Biofilm formation was quantified via the crystal violet assay, while alginate production was measured spectrophotometrically. Resistance to antipseudomonal antibiotics ranged from 48.9% to 75.6%. The most prevalent resistance gene was blaNDM (26.7%), followed by blaGES-1 (17.8%). Moreover, all isolates demonstrated varying degrees of biofilm-forming ability and alginate production. No statistically significant correlation was found between biofilm formation and alginate production. The dissemination of resistant genes in P. aeruginosa, particularly carbapenemases, is of great concern. This issue is compounded by the bacteria's biofilm-forming capability. Urgent intervention and continuous surveillance are imperative to prevent further deterioration and the catastrophic spread of resistance among these formidable bacteria.

Strategic choices of migrants and smugglers in the Central Mediterranean sea.

The sea crossing from Libya to Italy is one of the world's most dangerous and politically contentious migration routes, and yet over half a million people have attempted the crossing since 2014. Leveraging data on aggregate migration flows and individual migration incidents, we estimate how migrants and smugglers have reacted to changes in the border enforcement regime, namely the rise in interceptions by the Libyan Coast Guard starting in 2017 and the corresponding decrease in the probability of rescue to Europe. We find support for a deterrence effect in which attempted crossings along the Central Mediterranean route declined, and a diversion effect in which some migrants substituted to the Western Mediterranean route. At the same time, smugglers adapted their tactics. Using a strategic model of the smuggler's choice of boat size, we estimate how smugglers trade off between the short-run payoffs to launching overcrowded boats and the long-run costs of making less successful crossing attempts under different levels of enforcement. Taken together, these analyses shed light on how the integration of incident- and flow-level datasets can inform ongoing migration policy debates and identify potential consequences of changing enforcement regimes.

Hepatitis B Virus Infection in Eastern Libya: Current Efforts for Overcoming Regional Barriers for Its Elimination.

Approximately 2.2% of Libyans have chronic hepatitis B (CHB) and are at the highest risk of developing end-stage disease complications. Several resource-limited countries, including Libya, may be far from achieving the WHO goal of hepatitis B elimination by 2030 as a result of several testing and linkage to care (LTC) barriers. In Libya, data about the current HBV infection situation is scarce. Therefore, our study aimed to evaluate the trends of HBV in eastern Libya, Tobruk region, and try to identify the region-specific gaps and barriers that could potentially delay the WHO goal of HBV elimination. An eighteen-year retrospective review of records of the main district medical center in the region was done to estimate the trends of HBV infection and qualitative interviews with the clinical staff of the CHB registry in the region were conducted to investigate the current status of HBV management. Out of 392,952 records, 371 (0.09%) HBV-positive were recorded and declining trends of the infection were noticed over the study period. Until late 2019, there was no linkage to care or follow-up for people with HBV infection. However, a CHB registry was established in late 2019 to manage HBV infections in the region, yet there are several barriers such as the lack of diagnostic infrastructure for liver function assessment and antiviral treatment. Despite the significant decline observed in the occurrence of HBV infection and introduction of important HBV management steps such as establishment of the CHB registry, there are still several barriers that could delay the elimination of the infection.

Flow cytometric detection of leukemic blasts in Libyan pediatric patients with acute lymphoblastic leukemia.

The diagnosis of acute lymphoblastic leukemia (ALL), which is the most common type of cancer in children, has become more accurate with the use of flow cytometry. Here, this technology was used to immunophenotype leukemic cells in peripheral blood samples from Libyan pediatric ALL patients. We recruited 152 newly diagnosed patients at Tripoli Medical Center (Tripoli, Libya) by morphological examination of blood and bone marrow. Twenty-three surface and cytoplasmic antigen markers were used to characterize B and T cells in circulating blood cells by four-color flow cytometry. Six children (3.9%) turned out to have biphenotypic acute leukemia, 88 (57.9%) had B ALL, and 58 (38.1%) had T ALL. There were 68 cases of pro-B ALL CD10-positive (44.7%), 8 cases of pro-B ALL CD10-negative (5.2%), 6 cases of pre-B ALL (3.9%), and 6 of mature-B ALL (3.9%). CD13 was the most commonly expressed myeloid antigen in ALL. We present immunophenotypic data for the first time describing ALL cases in Libya. The reported results indicate that the most common subtype was pro-B ALL, and the frequency of T-ALL subtype was higher compared to previous studies. Six cases were positive for both myeloid and B lymphoid markers. Our findings may provide the basis for future studies to correlate immunophenotypic profile and genetic characteristics with treatment response among ALL patients.