Outcomes of High-Dose Versus Low-Dose Vitamin D on Prognosis of Sepsis Requiring Mechanical Ventilation: A Randomized Controlled Trial.

Background: Critically ill patients with sepsis have a high incidence of vitamin D deficiency. Vitamin D promotes the synthesis of human cathelicidin antimicrobial peptide, a precursor of LL-37, which is a part of the innate immune system. This study investigated the effectiveness and safety of the early administration of high-dose enteral vitamin D3 in comparison with low-dose vitamin D3 in patients with sepsis requiring mechanical ventilation (MV). Methods: Eighty adult patients with sepsis requiring MV with known vitamin D deficiency were randomly assigned to receive either an enteral 50 000 IU (Group I) or 5000 IU (Group II) vitamin D supplementation. Clinical and laboratory parameters were evaluated at baseline and on days 4 and 7 between the study groups. The change in serum procalcitonin (PCT) levels on day 7 was the primary outcome, while the change in serum LL-37 levels on day 7, changes in sequential organ failure assessment (SOFA) score, and clinical pulmonary infection score on day 7, MV duration, and hospital length of stay (LOS) were the secondary outcomes. Results: The (day 7-day 0) change in serum PCT and LL-37 levels and SOFA score were significantly different in Group I (P = .010, P < .001, and P < .001, respectively). The SOFA score was significantly different on days 4 and 7 in Group I (P < .001 and P < .001, respectively). The incidence of early ventilator-associated pneumonia was significantly different between both treatment groups (P = .025). The hospital LOS was shorter in Group I (P < .001). No 25-hydroxyvitamin-D toxicity was observed in either group. Conclusions: Early enteral administration of high-dose vitamin D3 in critically ill patients with sepsis requiring MV along with standard treatment for sepsis decreased serum procalcitonin levels, increased serum LL-37 levels, and ameliorated illness severity scores.

Valorization of Citrus peels: GC/MS-based metabolites profiling, multivariate analysis, and antiaging potential.

Aging and agro-waste are major challenges. Natural ingredients are preferred in skincare. This study intended to isolate the essential oils (EO) from the leftover peels obtained from three commonly edible Citrus species fruit peels, namely Citrus paradisi (grapefruit), Citrus sinensis (sweet orange), and Citrus deliciosa (mandarin). Gas chromatography/mass spectrometry analysis identified volatile constituents in EO and headspace aroma. Multivariate analysis distinguished between the three species. The antiaging effects of Citrus EO were assessed in vitro and in silico, studying volatile interactions with target enzymes. C. sinensis peels had the highest oil yield, rich in monoterpenes. C. paradisi and C. deliciosa contained sesquiterpenes. Limonene dominated the hydrodistilled EO: 94.50% in C. paradisi, 96.80% in C. sinensis, and 80.66% in C. deliciosa. Unsupervised multivariate analysis of Citrus species revealed that  d-limonene, γ-terpinene, and ß-pinene are the key phytochemical markers contributing to their diverse chemical composition. C. paradisi exhibited the highest enzyme inhibitory activity, with IC50 values of 12.82, 27.58, and 18.16 µg/mL for tyrosinase, elastase, and collagenase, respectively. In silico studies showed that the volatiles can inhibit the tested antiaging enzymes. According to these findings, the investigated agro-waste might slow aging in skin care.

Anticoagulants versus Antiplatelet Treatment in the Medical Management of Carotid Floating Thrombus.

BACKGROUND: Carotid free-floating thrombus (CFT) is a rare cause of stroke describing an intraluminal thrombus that is loosely associated with the arterial wall and manifesting as a filling defect fully surrounded by flow on vascular imaging. Unfortunately, there is no clear consensus among experts on the ideal treatment for this pathology. METHODS: Retrospective analysis of acute ischemic stroke (AIS) and transient ischemic attack (TIA) patients diagnosed with CFT on computed tomography angiogram (CTA) between January 2015-March 2023. We aimed to compare two treatment regimens: anticoagulation (ACT) and antiplatelet (APT) in the treatment of CFT. APT regimens included the use of dual or single antiplatelets (DAPT or SAPT; aspirin, clopidogrel and ticagrelor) and ACT regimens included the use of direct oral anticoagulants, warfarin, heparin or low molecular weight heparin +/- ASA. Patients that underwent mechanical thrombectomy were excluded. RESULTS: During study time there were 8252 acute ischemic stroke hospitalizations, of which 135 (1.63 %) patients were diagnosed with CFT. Sixty-six patients were included in our analysis. Patients assigned to APT were older (60.41years ± 12.82;p < 0.01). Other demographic variables were similar between ACT and APT groups. Complete CFT resolution on repeat vascular imaging was numerically higher at 30 days (58.8 vs 31.6 %, respectively; p = 0.1) and at latest follow-up (70.8 vs 50 %; p = 0.1) on ACT vs APT, respectively without reaching statistical significance. Similarly, there was numerically higher rates of any ICH with ACT compared to APT but it did not achieve statistical significance (27.6 % vs 13.5 %; p = 0.5). There were similar rates of PH1/2 hemorrhagic transformation, independence at discharge and similar hospital length of stay between ACT and APT groups. Patients assigned to APT were more likely to be discharged on their assigned treatment compared to those assigned to ACT (86.5 vs 55.2 %; p < 0.001). The rate of 30-day recurrent stroke was comparable among ACT and APT at 30 days (3.4 vs 0 %; p = 0.1, respectively). Subgroup analysis comparing exclusive ACT vs Dual APT lead to similar results. CONCLUSION: Our study showed comparable efficacy and safety outcomes in CFT patients who were exclusively managed medically with ACT vs APT. Larger prospective studies are needed.

Modulation of growth performance, feed utilization, and physiological traits in redbelly Tilapia (Tilapia zillii) through environmental and sex-based interactions.

This study explored the combined influence of tank color, stocking density, and gender on Tilapia zillii's performance and well-being. In this 120-day trial, 320 T. zillii, each initially weighing 10.0 ± 0.1 g/fish, were distributed among 24 tanks. The experiment included eight distinct treatment combinations, varying tank color (blue and green), stocking density (10 and 30 fish/m3) and sex (monosexual and mixed). The results showed that blue tanks improved specific growth rate and condition factor, while green tanks were better for feed utilization. Density at 30 fish/m3 showed the highest mean values of final body weight and total length, weight gain (WG), and gain length. Mono-sex outperformed mixed-sex ones in WG and daily growth. Interactions between color, density and sex were significant, affecting growth and feed utilization. Green tanks were best for protein profiles, while blue tanks excelled in glucose. A density of 10 fish/m3 yielded the highest protein profiles, and mono-sex fish had higher protein profiles. For lipid profiles, green tanks were superior, and density affected lipid profiles. Mixed-sex populations were best for certain lipid profile parameters. Interactions between these factors also played a significant role, making the biochemical profiles of T. zillii a complex interplay of various factors. The results explored that tank color, fish density and sex influence the activity of nonspecific immune enzymes in the liver of T. zillii. Blue tanks and lower fish density led to higher nonspecific immune enzymes, while mono-sex fish exhibited more significant nonspecific immune enzymes. Complex interactions between these factors also influenced nonspecific immune enzyme activities. Blue tanks increased malondialdehyde (MDA) levels, while green tanks raised glutathione S-transferases (GST) and catalase (CAT) levels. Lower fish density led to higher MDA, while higher density increased GST and CAT. Mono-sex fish had more MDA and GST, while mixed-sex fish showed greater CAT levels. Complex interactions among these factors affected the antioxidant levels in T. zillii. In summary, our study suggests that rearing T. zillii in green tanks at higher densities (30 fish/m3) and in mono-sex conditions yields the best results in terms of growth and overall performance.

Customized scan bodies to facilitate intraoral scanning for full arch implant prosthesis: A dental technique.

This article presents the design of customized resin scan bodies with different forms and their use to facilitate intraoral scanning of a maxillary full arch implant case with five implants. The aim is to limit the distance between the scan bodies and to create definite landmarks to facilitate the scanning process in full arch implant cases.

Evaluation of ultrathin semirigid ureteroscopy in terms of efficiency and cost compared to flexible ureteroscopy in treating proximal ureteric stones: a prospective randomized multicenter study.

PURPOSE: To investigate the outcome and cost-effectiveness of ultrathin 6-7.5-Fr semirigid ureteroscopy in treating proximal ureteric stones compared to flexible ureteroscopy. METHODS: Two hundred and twenty patients with a solitary proximal ureteric stone were eligible for ureteroscopy (stone size = 1-2 cm). Patients were randomly subdivided into two groups: Group I included 105 patients who underwent ultrathin semirigid ureteroscopy and group II included 115 patients who underwent flexible ureteroscopy. Both groups were compared regarding successful stone access, operation time, reoperation rates, the financial cost to stone-free, complications, and stone clearance at 4 and 8 weeks. RESULTS: Groups I and II had no significant differences regarding patient demographics, stone criteria, and hospitalization time. In contrast, the mean operative time was significantly longer in group II (p < 0.001). The overall scope-to-stone access rate was 89.5%. It was 87.6% compared to 91.3% (p = 0.32), while the stone-free rate was 81.9% versus 87.8% (p = 0.22) for groups I and II, respectively. Intraoperative and postoperative complications were statistically insignificant between the study groups. The cost/person in Egyptian pounds was 8619 ± 350 in group I, compared to 17,620 ± 280 in group II (p < 0.001); similarly, the cost to attain the stone-free rate was 8950 ± 720 in group I compared to 17,950 ± 500 in group II. CONCLUSION: Ultrathin semirigid ureteroscopy is safe, durable, and considered a cost-effective method for treating upper ureteric calculi compared to the flexible ureteroscopy and could be considered a first treatment option in developing countries.

Effect of metformin as an adjuvant therapy to letrozole on estradiol and other biomarkers involved in the pathogenesis of breast cancer in overweight and obese postmenopausal women: a pilot study.

INTRODUCTION: Metformin may provide a therapeutic benefit in different types of malignancy. PURPOSE: We aimed at evaluating the effect of metformin as an adjuvant therapy to letrozole on estradiol and other biomarkers involved in the pathogenesis of breast cancer in overweight and obese postmenopausal women. METHODS: Seventy-five postmenopausal stages II-III breast cancer female patients were assessed for eligibility in an open-labeled parallel pilot study. Forty-five patients met the inclusion criteria and were assigned into three arms: the lean arm (n = 15) women who received letrozole 2.5 mg/day, the control arm (n = 15) overweight/obese women who received letrozole 2.5 mg/day, and the metformin arm (n = 15) overweight/obese women who received letrozole 2.5 mg/day plus metformin (2000 ± 500 mg/day). The intervention duration was 6 months. Blood samples were obtained at baseline and 6 months after intervention for the measurement of serum estradiol, leptin, osteocalcin levels, fasting blood glucose concentration, and serum insulin. RESULTS: After the intervention and as compared to the control arm, the metformin arm showed a significantly lower ratio to the baseline (significant reduction) for estradiol (p = 0.0433), leptin (p < 0.0001), fasting blood glucose (p = 0.0128), insulin (p = 0.0360), osteocalcin serum levels (p < 0.0001), and the homeostatic model assessment of insulin resistance "HOMA-IR" value (p = 0.0145). There was a non-significant variation in the lactate ratio to the baseline among the three study arms (p = 0.5298). CONCLUSION: Metformin may exert anti-cancer activity by decreasing the circulating estradiol, leptin, and insulin. Metformin might represent a safe and promising adjuvant therapy to letrozole in overweight/obese postmenopausal women with breast cancer. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05053841/Registered September 23, 2021 - Retrospectively.

Effect Of Texting And Handwriting On Hand-Grip And Key-Pinch Strength Among Female-Collegiate Students: Randomized Controlled Trial.

OBJECTIVE: To evaluate immediate and long-term effect of texting or handwriting on hand-grip and key-pinch strength among healthy female students. Methods: The single-blind, randomised controlled trial was conducted between February and April 2021 after approval from the ethics review committee of the College of Medical Rehabilitation Sciences, Taibah University, Saudi Arabia, and comprised female Physio Therapy students aged 19-23 years who were right-hand dominant and had normal body mass index. The subjects used smartphones and electronic gadgets for >2hrs daily, writing more than 10min/day. They were randomised using sealed envelopes into five groups. Group A practised 10min texting, group B 15min texting, group C 10min writing, group D 15min writing, and group E used the phones only for talking or watching, with no texting or writing, and was taken as the control group. Hand-grip strength and key- pinch strength were assessed one minute before starting, and within one minute after having finished the assigned hand activity. All measurements were recorded in the sitting position using a single hand-grip dynamometer. Data was analysed using SPSS 23. RESULTS: Of the 65 individuals assessed, 60(92.3%) were initially enrolled, but the study was finished by 50(83.3%) subjects with a mean age of 20.88±0.98 years and mean body mass index 20.8±2.30kg/m2. There were 12(24%) subjects in group A, 7(14%) in group B, 12(24%) in group C, 10(20%) in group D and 9(18%) in group E. The association of the time-based groups with hand-grip and key-pinch strength was not significant (p>0.05). CONCLUSIONS: Texting and handwriting did not have any significant immediate effect on hand- grip or key-pinch strength. Clinical Trial Number: (NCT04810416).

Assessment of tooth positions of printed complete dentures with different designs and tooth positioning techniques.

PURPOSE: To evaluate the accuracy of tooth positions in printed complete dentures with different designs and teeth positioning techniques. MATERIALS AND METHODS: Five different designs of complete dentures and teeth positioning techniques were evaluated in this in vitro study. In Group I, the denture bases and teeth were designed as a single piece. In groups II and III, the denture bases were designed separately, and the denture teeth were designed as separate teeth. In groups IV and V, the denture bases were designed separately, and the denture teeth were designed as a single piece. Teeth positioning keys were designed for groups III and V. The dentures of all groups were scanned, and the data were imported to the surface matching software to evaluate the accuracy of the teeth positions. Statistical analysis was done using One -way ANOVA of Variance. The significance level was set at p ≤ 0.05. RESULTS: The results showed that the highest deviations of the positions of the canines (0.0781 ± 0.0154 mm) and the first molars (0.0611 ± 0.0055 mm) were found in Group II. On the other hand, Group I showed the least deviations of the positions of the canines (0.0287 ± 0.0054 mm) and molars (0.0354 ± 0.005 mm). CONCLUSIONS: The most accurate tooth positions are obtained in monolithic printed complete dentures. Fewer deviations in tooth positions occur when denture teeth are designed as a single piece.

Assessment of corneal endothelial cell parameters using specular microscopy in previously infected SARS-CoV-2 patients.

PURPOSE: To examine the long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the corneal endothelium. METHODS: This was a comparative, cross-sectional study that included subjects who had recovered from SARS-CoV-2 infection for at least 6 months (group 1) and a group of age- and sex-matched controls with no prior symptomatology or documentation of SARS-CoV-2 infection (group 2). After full ophthalmological evaluation, specular microscopy was used to examine the endothelial cell parameters, including endothelial cell density, coefficient of variation, hexagonality, average area, and central corneal thickness. RESULTS: Sixty-four and 53 right eyes were included in groups 1 and 2, respectively. No statistically significant differences were detected in any of the examined specular parameters between the two groups. CONCLUSION: SARS-CoV-2 infection may have no delayed sequel on the corneal endothelium. Future prospective studies with repeated examinations in the same subjects would be useful.

NOXA1-dependent NADPH oxidase 1 signaling mediates angiotensin II activation of the epithelial sodium channel.

The activity of the epithelial Na+ channel (ENaC) in principal cells of the distal nephron fine-tunes renal Na+ excretion. The renin-angiotensin-aldosterone system modulates ENaC activity to control blood pressure, in part, by influencing Na+ excretion. NADPH oxidase activator 1-dependent NADPH oxidase 1 (NOXA1/NOX1) signaling may play a key role in angiotensin II (ANG II)-dependent activation of ENaC. The present study aimed to explore the role of NOXA1/NOX1 signaling in ANG II-dependent activation of ENaC in renal principal cells. Patch-clamp electrophysiology and principal cell-specific Noxa1 knockout (PC-Noxa1 KO) mice were used to determine the role of NOXA1/NOX1 signaling in ANG II-dependent activation of ENaC. The activity of ENaC in the luminal plasma membrane of principal cells was quantified in freshly isolated split-opened tubules using voltage-clamp electrophysiology. ANG II significantly increased ENaC activity. This effect was robust and observed in response to both acute (40 min) and more chronic (48-72 h) ANG II treatment of isolated tubules and mice, respectively. Inhibition of ANG II type 1 receptors with losartan abolished ANG II-dependent stimulation of ENaC. Similarly, treatment with ML171, a specific inhibitor of NOX1, abolished stimulation of ENaC by ANG II. Treatment with ANG II failed to increase ENaC activity in principal cells in tubules isolated from the PC-Noxa1 KO mouse. Tubules from wild-type littermate controls, though, retained their ability to respond to ANG II with an increase in ENaC activity. These results indicate that NOXA1/NOX1 signaling mediates ANG II stimulation of ENaC in renal principal cells. As such, NOXA1/NOX1 signaling in the distal nephron plays a central role in Na+ homeostasis and control of blood pressure, particularly as it relates to regulation by the renin-ANG II axis.NEW & NOTEWORTHY Activity of the epithelial Na+ channel (ENaC) in the distal nephron fine-tunes renal Na+ excretion. Angiotensin II (ANG II) has been reported to enhance ENaC activity. Emerging evidence suggests that NADPH oxidase (NOX) signaling plays an important role in the stimulation of ENaC by ANG II in principal cells. The present findings indicate that NOX activator 1/NOX1 signaling mediates ANG II stimulation of ENaC in renal principal cells.

Efficacy of Hibiscus sabdariffa on Reducing Blood Pressure in Patients With Mild-to-Moderate Hypertension: A Systematic Review and Meta-Analysis of Published Randomized Controlled Trials.

We aimed to assess the efficacy of Hibiscus sabdariffa in patients with mild-to-moderate hypertension or metabolic syndrome (MetS) by comparing it against placebo, antihypertensive drugs, or other herbal products. Four databases were searched for randomized clinical trials (RCTs) examining the efficacy of H. sabdariffa in patients with mild-to-moderate hypertension or hypertension associated with MetS. Data on the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were extracted and analyzed using Review Manager Version 5.3. A total of 13 RCTs (1205 participants) were analyzed. Hibiscus sabdariffa significantly reduced both SBP and DBP compared with placebo (mean difference -6.67, P = 0.004 and -4.35 mm Hg, P = 0.02). Subgroup analysis showed that change in SBP and DBP was statistically significant in patients with only hypertension, whereas not significant in patients with hypertension associated with MetS. When H. sabdariffa was compared with active controls (antihypertensive drugs or other herbals), the change in SBP and DBP was not statistically significant (all P > 0.05). Hibiscus sabdariffa is effective in reducing the SBP and DBP in patients with mild-to-moderate hypertension, but was neither effective in those with MetS nor superior to antihypertensive drugs. Further RCTs are required to determine the long-term efficacy of H. sabdariffa and to describe patients who would benefit most from this treatment.

Impact of FOXP1 rs2687201 genetic variant on the susceptibility to HCV-related hepatocellular carcinoma in Egyptians.

Hepatocellular carcinoma (HCC) constitutes a challenging health problem in Egypt due to the high incidence of hepatitis C virus (HCV) infection. Improved understanding of genetic mechanisms underlying the individual predisposition to HCC will lead to enhancements in the early diagnosis, treatment, and prevention of this disease. Transcription factor forkhead box P1 (FOXP1) is involved in the cellular processes of proliferation, differentiation, metabolism, and longevity. In addition, it has been implicated in hepatic tumorigenesis. The present study explored the association of C/A single-nucleotide polymorphism in the FOXP1 gene (rs2687201) with HCC susceptibility in HCV Egyptian patients. The study included 108 patients with HCV-dependant HCC, 86 HCV patients, and 80- age and gender-matched healthy controls. rs2687201 genotyping was performed by allelic discrimination method using TaqMan real-time PCR assays while FOXP1 gene expression and protein level were determined using qRT-PCR and enzyme-linked immunoassay, respectively. Our results revealed a significant association between FOXP1 rs2687201 and HCC risk where (A) allele was significantly more frequent in patients with HCC compared to controls (odds ratio [OR]: 1.88, 95% confidence interval [CI]: 1.17-3.04, p = 0.01) and to HCV patients (OR: 1.85, 95% CI: 1.62-2.94, p = 0.012). Furthermore, FOXP1 gene and protein expression levels were remarkably higher in (CA + AA) than in CC genotype carriers in a dominant model. The (CA + AA) genotype displayed a significantly shorter overall survival than the CC genotype in HCC patients. In conclusion, FOXP1 gene polymorphism rs2687201 is significantly associated with HCC, but not with HCV infection, in Egyptian patients.

Periodically aperiodic pattern of SARS-CoV-2 mutations underpins the uncertainty of its origin and evolution.

Various lineages of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have contributed to prolongation of the Coronavirus Disease 2019 (COVID-19) pandemic. Several non-synonymous mutations in SARS-CoV-2 proteins have generated multiple SARS-CoV-2 variants. In our previous report, we have shown that an evenly uneven distribution of unique protein variants of SARS-CoV-2 is geo-location or demography-specific. However, the correlation between the demographic transmutability of the SARS-CoV-2 infection and mutations in various proteins remains unknown due to hidden symmetry/asymmetry in the occurrence of mutations. This study tracked how these mutations are emerging in SARS-CoV-2 proteins in six model countries and globally. In a geo-location, considering the mutations having a frequency of detection of at least 500 in each SARS-CoV-2 protein, we studied the country-wise percentage of invariant residues. Our data revealed that since October 2020, highly frequent mutations in SARS-CoV-2 have been observed mostly in the Open Reading Frame (ORF) 7b and ORF8, worldwide. No such highly frequent mutations in any of the SARS-CoV-2 proteins were found in the UK, India, and Brazil, which does not correlate with the degree of transmissibility of the virus in India and Brazil. However, we have found a signature that SARS-CoV-2 proteins were evolving at a higher rate, and considering global data, mutations are detected in the majority of the available amino acid locations. Fractal analysis of each protein's normalized factor time series showed a periodically aperiodic emergence of dominant variants for SARS-CoV-2 protein mutations across different countries. It was noticed that certain high-frequency variants have emerged in the last couple of months, and thus the emerging SARS-CoV-2 strains are expected to contain prevalent mutations in the ORF3a, membrane, and ORF8 proteins. In contrast to other beta-coronaviruses, SARS-CoV-2 variants have rapidly emerged based on demographically dependent mutations. Characterization of the periodically aperiodic nature of the demographic spread of SARS-CoV-2 variants in various countries can contribute to the identification of the origin of SARS-CoV-2.

Intrapartum ultrasound measurement of the lower uterine segment thickness in parturients with previous scar in labor: a cross-sectional study.

BACKGROUND: There is a lack of reliable methods to estimate the risk of uterine rupture or dehiscence during a trial of labor in women with previous cesarean sections. This study aimed to assess the lower uterine segment and myometrial thickness by ultrasonography in women with previous cesarean sections during labor and assess their association with the uterine defect. METHODS: A cross-sectional study was conducted on 161 women in the active phase of labor having one previous cesarean section. The study was conducted et al.-Azhar University Hospital, Assiut City, Egypt, from March 2018 to March 2019. Ultrasound measurements of lower uterine segment thickness and myometrial thickness were conducted by vaginal and abdominal ultrasound by two observers. The correlation of both thicknesses with the uterine defect was analyzed. RESULTS: Uterine defects were reported in 42 women (25.9%), uterine rupture in four women (2.5%), and dehiscence in 38 women (23.5%). The uterine defects were not associated with maternal factors (maternal age, gestational age at labor, body mass index, birth weight, interpregnancy, and inter-delivery interval). Receiver operating curve analysis demonstrated that lower uterine segment thickness was linked with uterine defect, with an area under the curve of 60% (95% CI, 51-70%, P = 0.044). Myometrial thickness was also linked to the uterine defect, with an area under the curve of 61% (95% CI, 52-71%, P = 0.025). Full lower uterine segment thickness of 2.3 mm and myometrial thickness of 1.9 mm were the cutoff value with the best combination of sensitivity and specificity for the uterine defect. Lower uterine segment thickness (OR = 0.49, 95%CI 0.24-0.96) and myometrial thickness (OR = 0.44, 95%CI 0.20-0.94) were significantly associated with the uterine defect. Lower uterine segment thickness (OR = 0.41, 95%CI 0.22-0.76) and myometrial thickness (OR = 0.33, 95%CI 0.16-0.66) were also significantly associated with cesarean section delivery. CONCLUSION: A lower uterine segment thickness of 2.3 mm and myometrial thickness of 1.9 mm during the first stage of labor are associated with a high risk of uterine defects during a labor trial. These measurements during labor can have a practical application in deciding the mode of delivery in women with previous cesarean sections and might reduce uterine rupture.

Influence of perinatal deltamethrin exposure at distinct developmental stages on motor activity, learning and memory.

BACKGROUND: Perinatal exposure to deltamethrin (DM) causes attention-deficit/ hyperactivity disorder-like behaviors. However, the vulnerable time window to DM exposure and the possible mechanism are obscure. We aimed to identify the critical window(s) at perinatal stages for DM exposure and the possible mechanism. METHOD: Pregnant mice were exposed to DM (0.5 mg/kg) at three different prenatal stages [gestational day (GD) 0-5, 6-15 and 16-birth (16-B)] and early postnatal stage (PD 0-10). Locomotor activity, learning and memory were evaluated using open field and Y-maze test, respectively. Nissl staining and western blots were used to examine the neuronal loss and the protein expression, respectively. RESULTS: Perinatal exposures to DM had no effect on reproductive and growth index of offspring. However, mice receiving DM exposure during GD 16-B displayed significantly higher mortality suggesting GD 16-B is the most vulnerable time window to DM exposure. Prenatal but not early postnatal DM exposure impaired locomotor activity, learning and memory, and caused neuron loss in the dentate gyrus of male offspring. However, neither prenatal nor postnatal DM exposure affected mouse behavior of female offspring. Prenatal DM exposures decreased the protein levels of NR2A and NR2B in both hippocampi and cerebral cortices of male offspring. However, female mice receiving DM exposure at GD 16-B but not other stages displayed increased expression levels of NR2A and NR2B in hippocampi. CONCLUSION: Prenatal but not early postnatal DM exposure impairs the neuron development in male but not female mice. Altered NMDA receptor expression may correlate to DM-induced behavioral deficits.

Optogenetic Control of PIP2 Interactions Shaping ENaC Activity.

The activity of the epithelial Na+ Channel (ENaC) is strongly dependent on the membrane phospholipid phosphatidylinositol 4,5-bisphosphate (PIP2). PIP2 binds two distinct cationic clusters within the N termini of ß- and γ-ENaC subunits (ßN1 and γN2). The affinities of these sites were previously determined using short synthetic peptides, yet their role in sensitizing ENaC to changes in PIP2 levels in the cellular system is not well established. We addressed this question by comparing the effects of PIP2 depletion and recovery on ENaC channel activity and intracellular Na+ levels [Na+]i. We tested effects on ENaC activity with mutations to the PIP2 binding sites using the optogenetic system CIBN/CRY2-OCRL to selectively deplete PIP2. We monitored changes of [Na+]i by measuring the fluorescent Na+ indicator, CoroNa Green AM, and changes in channel activity by performing patch clamp electrophysiology. Whole cell patch clamp measurements showed a complete lack of response to PIP2 depletion and recovery in ENaC with mutations to ßN1 or γN2 or both sites, compared to wild type ENaC. Whereas mutant ßN1 also had no change in CoroNa Green fluorescence in response to PIP2 depletion, γN2 did have reduced [Na+]i, which was explained by having shorter CoroNa Green uptake and half-life. These results suggest that CoroNa Green measurements should be interpreted with caution. Importantly, the electrophysiology results show that the ßN1 and γN2 sites on ENaC are each necessary to permit maximal ENaC activity in the presence of PIP2.

Exploring physical performance using basic fitness test among collegiate students.

OBJECTIVE: To determine the effect of recreational status, body weight and risk factors on physical fitness of general students and on agility of physical therapy students. METHODS: The cross-sectional study was conducted at Taibah University, Medina, Kingdom of Saudi Arabia, from November 2018 to April 2019, and comprised general and physical therapy students from the College of Medical Rehabilitation Sciences. Data was obtained related to risk factors, like overweight, smoking and recreational status. Upper body strength, agility and endurance were measured using flexed-arm hang, 11x10 shuttle sprint test, and 1000-meter run test respectively. Data was analysed using SPSS 23. RESULTS: Of the 50 subjects, 30(60%) were physical therapy students and 20(40%) were general students. Overall mean age of the sample was 21.54±1.83 years (range: 18-26), and mean body mass index was 23.34±3.37kg/m2 (range: 16.8-29.4kg/m2). The mean values for overweight status and number of risk factors were significantly different for the shuttle-sprint test (p<0.05), but were non-significant for the recreational status (p>0.05). All the assessed variables had non-significant association (p>0.05) in terms of flexed-arm hang test. Overall, 29(58%) subjects could not complete the 1000-meter run test, and 44(88%) found it a strong exertion. Conclusions: Unhealthy lifestyle significantly impaired physical fitness. gain by the diabetics.

Timed Up and Go and Five Times Sit to Stand Test among community ambulant, overweight, obese Saudi elderly population.

OBJECTIVE: To investigate the effect of Timed Up and Go category on the Five Times Sit to Stand Test, and to determine the role of recreational status on Timed Up and Go rating. METHODS: The descriptive, cross-sectional study was conducted between October 2018 and April 2019 at the College of Medical Rehabilitation Sciences, Taibah University, Madina, Saudi Arabia, and comprised community-ambulant retired overweight or obese subjects of either gender aged 60-69 years. Timed Up and Go, Five Times Sit to Stand Test and Single-Leg Stance Test were used to measure basic mobility, transitional skills and static balance respectively. Data was analysed using SPSS 23. RESULTS: Of the 150 subjects, 108(72%) were males and 42(28%) were females. The overall mean age was 63.1}2.5 years and the mean body mass index was 29.6}3.8 kg/m2. There were 46(31.5%) subjects who were freely mobile, 60(41.1%) who were mostly independent and 40(27.4%) who had variable mobility. Also, 36(24%) subjects were recreationally active, while 114(76%) were recreationally inactive. The freely mobile subjects managed to finish the Five Times Sit to Stand Test in less time than the other groups (p<0.05). The recreationally active subjects took significantly less time to finish the Timed Up and Go test compared to the inactive. Besides, the males had longer Single-Leg Stance Test timing than females (p<0.05). CONCLUSIONS: The elderly belonging to different Timed Up and Go mobility categories demonstrated variable Five Times Sit to Stand abilities, with the recreational mobility status significantly affecting the category.

Reliability and Validity of Arabic Translation of Child Sexual Abuse Questionnaire for Use in Children and Adolescents.

Child Sexual Abuse Questionnaire was developed to assess Child Sexual Victimization experiences, and the associated characteristics and circumstances. The aim of the study is to evaluate the reliability and validity of the Arabic Child Sexual Abuse Questionnaire (CSAQ) in a sample of Egyptian children. The original CSAQ-English was translated into Arabic based on the established guidelines. Then, a cross-sectional study was carried out on a group of 150 male and female Egyptian children aging 8-14 years to test the translated questionnaire for validity and reliability. The Statistical analysis was performed to internal consistency, Item-Total correlation, as well as Inter-Item correlation. Cronbach's Alpha coefficient to assess internal consistency was found to be satisfactory, 0.88 and 0.89 for CSA without physical contact items and CSA with physical contact items, respectively. The item-total correlations were found to be within r = .234; P = .004 to r = .927; P = <0.001, while Inter-item correlations ranged from 0.125 to 0.928. The CSAQ-Arabic version is a reliable and valid tool that can be used by researchers in clinical practice to measure sexual victimization experiences in Arabic-speaking children based on the content and face validation together with a good internal reliability.