Biphasic calcium phosphate doped with zirconia nanoparticles for reconstruction of induced mandibular defects in dogs: cone-beam computed tomographic and histopathologic evaluation.

The present study aimed to evaluate osteogenic potential and biocompatibility of combining biphasic calcium phosphate with zirconia nanoparticles (4Zr TCP/HA) compared to biphasic calcium phosphate (TCP/HA) for reconstruction of induced mandibular defects in dog model. TCP/HA and 4Zr TCP/HA scaffolds were prepared. Morphological, physicochemical, antibacterial, cytocompatibility characterization were tested. In vivo application was performed in 12 dogs where three critical-sized mandibular defects were created in each dog. Bone defects were randomly allocated into: control, TCP/HA, and 4Zr TCP/HA groups. Bone density and bone area percentage were evaluated at 12 weeks using cone-beam computed tomographic, histopathologic, histomorphometric examination. Bone area density was statistically increased (p < 0.001) in TCP/HA and 4Zr TCP/HA groups compared to control group both in sagittal and coronal views. Comparing TCP/HA and 4Zr TCP/HA groups, the increase in bone area density was statistically significant in coronal view (p = 0.002) and sagittal view (p = 0.05). Histopathologic sections of TCP/HA group demonstrated incomplete filling of the defect with osteoid tissue. Doping with zirconia (4Zr TCP/HA group), resulted in statistically significant increase (p < 0.001) in bone formation (as indicated by bone area percentage) and maturation (as confirmed by Masson trichrome staining) compared to TCP/HA group. The newly formed bone was mature and organized with more trabecular thickness and less trabecular space in between. Physicochemical, morphological and bactericidal properties of combining zirconia and TCP/HA were improved. Combining zirconia and TCP/HA resulted in synergistic action with effective osteoinduction, osteoconduction and osteointegration suggesting its suitability to restore damaged bone in clinical practice.

Photocoagulation with GREENLIGHT© laser in radiation-induced haemorrhagic cystitis: Results of a single-center series.

INTRODUCTION: Radiation-induced haemorrhagic cystitis (RIHC) is one complication of the pelvic radiotherapy. The GREENLIGHT© laser (GL) has been barely studied in the treatment of radiation cystitis. The primary objective was to evaluate the efficacy of GL in refractory RIHC patients (RRC) in a single-centre series. MATERIALS AND METHODS: Twenty-nine patients were treated by GL bladder photocoagulation (GLBP). These patients showed signs of refractory haematuria in the context of RIHC. The primary endpoint was the absence of haematuria that would require a subsequent surgical intervention. Secondary endpoints were postoperative hospitalization length of stay, the occurrence of complications according to the Clavien-Dindo classification, the occurrence of functional urinary disorders and the number of cystectomies. RESULTS: After a median follow-up of 30 months, 24 (82.7%) patients had no recurrence of haematuria. No postoperative complications were reported. A disabling overactive bladder secondary to the procedure occurred in 9 patients (31.0%). Two patients needed a cystectomy at 1 and 11 months. CONCLUSION: GLBP may constitute an efficient line of treatment for RIHC. Despite overactive bladder it allowed to avoid or delay cystectomy.

Uretero-arterial fistula: Six new cases and systematic review of the literature.

AIM: Secondary uretero-arterial fistulas (SUAF) are uncommon, underrated and threatening for any patient. Gross hematuria is a clinical symptom of this pathology for patients with history of pelvic radiotherapy, complex pelvic surgery or long-term ureteral stenting. The purpose of this work is to assess risk factors, diagnosis and treatment of SUAF. METHODS: Monocentric and retrospective series of 6 new cases illustrated by a literature review through MedLine and Pubmed using the keywords "arterio-ureteral fistula", "arterio iliac fistula" and "ilio-ureteral fistula". We excluded uretero-arterial fistula following vascular surgery. RESULTS: Our series included 4 men and 2 women. All patients had a history of complex pelvic surgery and long-term ureteral stenting. Three patients had history of pelvic radiotherapy. They all had inaugural macroscopic haematuria episode. Two fistula cases were diagnosed on 5 repeated CT-scans. In 2 out of 5 cases, arteriography highlighted the fistula. Fistulas were generally located at the left common iliac artery. An endovascular stent was placed in 5 out of 6 cases. One patient needed open surgery. After treatment, 3 patients remained alive, 3 patients died either by a fistula relapse or by complications late in the treatment. CONCLUSION: SUAF are uncommon, but serious. Today, there is no specific recommendation regarding complex treatment of these fistulas. Endovascular stents seem to be a good therapeutic option. LEVEL OF PROOF: 3.

Prevalence of and factors associated with low Back pain, thoracic spine pain and neck pain in Bashkortostan, Russia: the Ural Eye and Medical Study.

BACKGROUND: Back pain and neck pain are leading causes of the burden of disease worldwide, while information about their prevalence in Russia is missing. METHODS: The population-based Ural Eye and Medical Study was conducted in a rural and urban region in Bashkortostan/Russia. As part of a detailed systematic examination, we assessed the prevalence of low back pain, thoracic spine pain and neck pain in an interview with standardized questions in 5397 study participants (mean age:58.6 ± 10.6 years;range:40-94 years). RESULTS: The mean prevalence of low back pain, thoracic spine pain and neck pain was 2912/5397 (54.0%;95% confidence interval (CI):52.6,55.3), 1271/5397 (23.6%;95%CI:22.4,24.7), and 1570/5397 (29.1%;95%CI:27.9,30.3), respectively. A higher prevalence of low back pain was associated with females (P = 0.04;odds ratio (OR):1.14;95%CI:1.004,1.30), younger age (P < 0.001;OR:0.99;95%CI:0.98,0.99), higher body mass index (P = 0.002;OR:1.02;95%CI:1.01,1.03), lower frequency of vigorous activities during leisure time (P = 0.001;OR:0.79;95%CI:0.69,0.90), more time spent sitting and reclining (P = 0.03;OR:1.00;95%CI:1.00,1.00), higher serum concentration of high-density lipoproteins (P = 0.004;OR:1.10;95%CI:1.03,1.18), higher prothrombin index (P = 0.003;OR:1.01;95%CI:1.003,1.01), higher prevalence of a history of cardiovascular disease (P = 0.004;OR:1.23;95%CI:1.07,1.42), falls (P < 0.004;OR:1.71;95%CI:1.45,2.00), bone fractures (P = 0.01;OR:1.18;95% CI:1.03,1.34), unconsciousness (P < 0.001;OR:1.78;95%CI:1.40,2.25), osteoarthritis (P < 0.001;OR:2.76;95%CI:2.34,3.26), iron-deficiency anemia (P < 0.001;OR:1.87;95%CI:1.41,2.50), and thyroid disorder (P = 0.004;OR:1.37;95%CI:1.10,1.70), fewer days of vegetable intake (P < 0.001;OR:0.89;95%CI:0.85,0.93), smaller amounts of salt intake (P = 0.008;OR:0.97;95%CI:0.94,0.99), higher anxiety score (P < 0.001;OR:1.05;95%CI:1.03,1.06), and in women, history of menopause (P = 0.02;OR:1.36;95%CI:1.05,1.75). The prevalence of thoracic spine pain and neck pain showed similar associations. CONCLUSIONS: In a Russian population, the prevalence of low back pain, thoracic spine pain and neck pain (54.0, 23.6 and 29.1%, respectively) were correlated with parameters such as the female sex, younger age, higher body mass index, higher anxiety score, higher prevalence of a history of cardiovascular disease, lower frequency of vigorous activities and more time spent sitting or reclining. These data may be of interest for assessing the burden of back and neck pain in Russia as part of the global burden of disease.

Prevalence and associated factors of anemia in a Russian population: the Ural eye and medical study.

BACKGROUND: Although anemia is one of the leading causes of the global burden of disease, information about its prevalence in Russia is mostly missing. We therefore assessed its prevalence and associated factors in a Russian population. METHODS: The population-based Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals (mean age:59.0 ± 10.7 years;range:40-94 years) who underwent a standardized interview and detailed general examination. The definition of anemia was based on the hemoglobin concentration (definition #1:hemoglobin concentration < 140 g/L in men,< 130 g/L in women; definition #2:hemoglobin concentration < 130 g/L in men,< 120 g/L in women [World Health Organization definition]). RESULTS: Higher hemoglobin concentration (mean:142.6 ± 14.8 g/L; range:80-171 g/L) was associated (multivariable analysis) with male gender (P < 0.001; standardized regression coefficient beta:-0.20), higher waist-hip circumference ratio (P < 0.001;beta:0.05), higher prevalence of car ownership (P < 0.001;beta:0.05), higher blood concentrations of bilirubin (P < 0.001;beta:0.05) and triglycerides (P < 0.001;beta:0.06), lower erythrocyte sedimentation rate (P < 0.001;beta:-0.32), and shorter blood clotting time (P < 0.001;beta:-0.39). Using definition #1 and #2, anemia was detected in 1385 individuals (23.6%;95% confidence interval CI)CI:22.5,24.7) and in 453 individuals (7.7%;95%CI:7.0,8.4), respectively. Prevalence of moderate anemia (hemoglobin concenttration:110 g/L-80 g/L), detected in 165 individuals (2.8%;95%CI:2.4,3.2), increased with younger age (P = 0.008;odds ratio (OR):0.98;95%CI:0.96,0.99), female gender (P < 0.001;OR:2.52;95%CI:1.47,4.33), higher erythrocyte sedimentation rate (P < 0.001;OR:1.08;95%CI:1.06,1.09), longer blood clotting time (P < 0.001;OR:8.56;95%CI:5.68,12.9), and marginally significantly, with a lower waist-hip circumference ratio (P = 0.058;OR:0.13;95%CI:0.02,1.07). In women, it was significantly (P < 0.001) higher before menopause (8.8%;95%CI:6.4,11.1) than after menopause (3.5%;95%CI:2.8,4.3). CONCLUSIONS: In this Russian population as compared to populations from countries with a similar socio-demographic index, anemia prevalence was relatively low. As in other populations, higher anemia prevalence was strongly and inversely associated with menopause, and to a minor degree, with lower waist-hip circumference ratio and lower socio-economic background.

Effect of Laser Bio-Stimulation on Mandibular Distraction Osteogenesis: An Experimental Study.

PURPOSE: The aim of this study was to evaluate the osseous response to laser bio-stimulation clinically and histologically during distraction osteogenesis (DO) induced in the mandibles of mongrel dogs. MATERIALS AND METHODS: Thirty dogs were divided into 3 groups of 10 (5 with and 5 without laser treatment) according to sacrifice periods (2, 4, and 8 weeks after distraction). DO was performed between the mandibular second and third premolars using an internal linear distractor. After a 7-day latency period, the distractor was activated at the rate of 1 mm per day for 10 days followed by a consolidation period during which the right mandibular side was irradiated with a diode laser (wavelength [λ], 970 nm; power, 2 W; spot size, 320 µm; total energy [E], 840 J), whereas the control group was not irradiated, after distraction. Histologic specimens were prepared and histomorphometric analysis of specimens was performed. RESULTS: Clinical examinations showed that the low-intensity laser diode had a pronounced effect on the quality and quantity of newly formed bone in the DO regenerate in the laser groups compared with the control groups. Histopathologic sections from laser groups I, II, and III displayed the bio-stimulatory effect of laser on new bone through an increased rate of osteoblast proliferation and differentiation, an accelerated rate of intramembranous ossification, and increased neoangiogenesis compared with the control groups. Moreover, the histomorphometric results showed that mean bone trabecular size, bone trabecular total area, and bony area fraction of the regenerate were larger and statistically significant (P < .05) especially in laser groups I and II (early stages of bone formation) compared with the control groups. CONCLUSION: The low-level diode laser had a positive role as a potential bio-stimulator and local inducer in enhancing bone formation during DO and resulted in early stability of the bone regenerate, a shorter total treatment time, and improved new bone quality and quantity.

Genetic diversity of Plasmodium vivax metacaspase 1 and Plasmodium vivax multi-drug resistance 1 genes of field isolates from Mauritania, Sudan and Oman.

BACKGROUND: Plasmodium vivax is the second most important human malaria parasite, widely spread across the world. This parasite is associated with important issues in the process toward malaria elimination, including potential for relapse and increased resistance to chloroquine. Plasmodium vivax multi-drug resistant (pvmdr1) is suspected to be a marker of resistance although definitive evidence is lacking. Progress has been made in knowledge of biological factors affecting parasite growth, including mechanisms of regulated cell death and the suspected role of metacaspase. Plasmodium vivax metacaspase1 (PvMCA1-cd) has been described with a catalytic domain composed of histidine (H372) and cysteine (C428) residues. The aim of this study was to test for a link between the conserved histidine and cysteine residues in PvMCA1-cd, and the polymorphism of the P. vivax multi-drug resistant gene (pvmdr1). RESULTS: Thirty P. vivax isolates were collected from Mauritania, Sudan, and Oman. Among the 28 P. vivax isolates successfully sequenced, only 4 samples showed the conserved His (372)-Cys (428) residues in PvMCA1-cd. Single nucleotide polymorphisms observed were H372T (46.4%), H372D (39.3%), and C428R (85.7%). A new polymorphic catalytic domain was observed at His (282)-Cys (305) residues. Sequences alignment analysis of pvmdr1 showed SNP in the three codons 958, 976 and 1076. A single SNP was identified at the codon M958Y (60%), 2 SNPs were found at the position 976: Y976F (13%) and Y976V (57%), and 3 SNPs were identified at the position 1076: F1076L (40%), F1076T (53%) and F1076I (3%). Only one isolate was wildtype in all three codons (MYF), 27% were single MYL mutants, and 10% were double MFL mutants. Three new haplotypes were also identified: the triple mutant YVT was most prevalent (53.3%) distributed in the three countries, while triple YFL and YVI mutants (3%), were only found in samples from Sudan and Mauritania. CONCLUSIONS: Triple or quadruple mutants for metacaspase genes and double or triple mutants for Pvmdr1 were observed in 24/28 and 19/28 samples. There was no difference in the frequency of mutations between PvMCA1-cd and Pvmdr1 (P > 0.2). Histidine and cysteine residues in PvMCA1-cd are highly polymorphic and linkage disequilibrium with SNPs of Pvmdr1 gene may be expected from these three areas with different patterns of P. vivax transmission.

Efficacy of photobiomodulation using diode laser 650 nm combined with nano-cellulose and nano-amorphous calcium phosphate in bone healing of rabbit tibial defects assessed by H&E staining and computed tomography.

BACKGROUND: The purpose of the current study was to evaluate the effect of Diode LLLT 650 nm, TEMPO oxidized Nano-fibrillated cellulose mixed with Nano-Amorphous calcium phosphate, and their combination on bone healing in rabbit tibia using H&E staining and computed tomography. METHODS: Eighteen adult male New Zealand rabbits were selected, two circular bone defects were created in each tibia, resulting in four bony defects in each rabbit, representing the four tested groups; group A (negative control), group B (filled with mineralized nano-cellulose), group C (combination), group D (laser). Animals were euthanized after two weeks and one month, defects were assessed by CT for bone density, then histological samples were examined by H&E stain. RESULTS: In both evaluation periods, group D recorded the greatest mean area percent of new bone formation and bone density, followed by group A, while group C recorded the lowest value. Groups A and D showed full closure of the defects, while groups B and C showed partial defect closure with retained bone graft material. H&E and CT showed that Laser group had the best results of defects healing, bone density and new bone formation, followed by the negative control group. CONCLUSIONS: Diode laser 650nm photobiomodulation significantly improved bone defects healing. Mineralized nano-cellulose experimental bone substitute material showed a delayed effect in bone healing and graft material resorption. The combination of LLLT with the graft material had no positive outcome on bone defect healing.

The Progress Towards National Malaria Elimination: The Experience of Oman.

Objectives: Despite a significant reduction in the global case incidence and mortality of malaria in the past 20 years, malaria continues to wreak havoc on people's health across the globe. Oman is a malaria-free country, meeting the World Health Organization's (WHO) criteria, having no indigenous malaria case documented since 2010, and maintaining that status for three consecutive years. Oman has a national strategy for prevention of re-establishment of malaria and to maintain their malaria-free status. In this paper, we explore Oman's malaria elimination progress and provide recommendations for accelerating and sustaining malaria free status using WHO malaria elimination strategies. Methods: Secondary data from the years 1976 to 2020 was extracted from official sources utilized to assess progress. A review and epidemiological analysis of malaria cases, species classification, and source of infection was conducted. The data and situation were compared to WHO malaria elimination pillars. Results: The number of malaria cases reported from 1976 to 2020 was 298 070, a decline from 1.6 to 0.1 per 1000 population. Of the 4415 cases reported between 1994-2004, 98.0% were classified as imported and 73.0% of people diagnosed with malaria were 20-34 years old. The number of autochthonous cases began to decline in 1994 from a high of 4415 cases (3.6 per 1000 population) to zero by 2004 with no deaths attributed to autochthonous malaria cases after the year 2000. By 2020, Plasmodium falciparum accounted for 86.0% of cases, P. vivax cases declined to 9.0% and P. malaria and P. ovale comprised the remaining 6.0% of case notifications. Conclusions: Oman achieved malaria elimination status in 2013. To maintain this status, it is essential to adopt a national prevention strategy of re-establishment of malaria and maintain malaria-free status targets.

Litoarbolide A: an undescribed sesquiterpenoid from the Red Sea soft coral Litophyton arboreum with an in vitro anti-malarial activity evaluation.

Soft corals distributed across the Red Sea coasts are a rich source of diverse and bioactive natural products. Chemical probing of the Red Sea soft coral Litophyton arboreum led to isolation and structural characterization of an undescribed sesquiterpenoid, litoarbolide A (1), along with 14 previously reported metabolites (2-15). The chemical structures of the isolates were assigned based on NMR as well as high resolution electrospray ionization mass spectrometry (HR-ESI-MS) data. Litoarbolide A is supposed to be the biosynthetic precursor to other sesquiterpenoids, which formed via further post-translational modifications. Furthermore, these metabolites were evaluated for anti-malarial activity, where only the acyclic sesquiterpenoid of a sec-germacrane nucleus (7) showed an activity against chloroquine-sensitive (D6) and chloroquine-resistant (W2) strains of Plasmodium falciparum with IC50 at 3.7 and 2.2 mg/mL, respectively. Moreover, the isolated metabolites were all non-toxic to the Vero cell line. These findings support the consideration of L. arboreum in further natural anti-malarial studies.

Central corneal thickness and its associations in a Russian population. The Ural eye and Medical Study.

BACKGROUND: To assess central corneal thickness (CCT) and its associations in a Russian population. METHODS: The population-based Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals. As part of an ophthalmological and general examination, CCT was measured by Scheimflug imaging. RESULTS: The study included 5792 (98.2%) participants (age:58.8 ± 10.6 years;range: 40-94 years) with available bilateral CCT measurements. Mean CCT was larger in Russians than non-Russians (549.5 ± 32.8 µm versus 539.2 ± 33.9 µm; P < 0.001). In multivariable analysis, thicker CCT was associated (regression coefficient r:0.43) with younger age (standardized regression coefficient beta:-0.09; non-standardized regression coefficient B:-0.29;95% confidence interval (CI):-0.39,-0.20; P < 0.001), male sex (beta:0.05; B:3.10; 95%CI:1.18,5.03; P = 0.002), urban region of habitation (beta:0.10; B:6.83; 95%CI:4.61, 9.05; P < 0.001), Russian ethnicity (beta:0.04; B:3.48; 95%CI:1.04, 5.91; P = 0.005), higher level of education (beta:0.04; B:0.97;95%CI:0.29,1.66; P = 0.006), higher serum bilirubin concentration (beta:0.05;B:0.15; 95%CI:0.07,0.23;P < 0.001), lower corneal refractive power (beta:-0.09;B:11.92; 95%CI:-2.50,-1.35; P < 0.001), smaller anterior chamber angle (beta:-0.07;B:-0.38;95%CI:-0.52,-0.24;P < 0.001), higher IOP readings (beta:0.38; B:3.47; 95%CI:3.21,3.73; P < 0.001), and higher rise in IOP readings by medical mydriasis (beta:0.07; B:0.88;95%CI:0.54,1.22;P < 0.001). In that model, CCT was not associated with body height (P = 0.14), previous cataract surgery (P = 0.10), axial length (P = 0.18) or prevalence of glaucoma (P = 0.11). The mean inter-eye difference in CCT was 8.52 ± 13.9 µm (median:6.0;95CI:8.16,8.88). A higher inter-eye CCT difference was associated with older age (beta:0.08; B:0.11;95%CI:0.07,0.15; P = 0.01), lower level of education (beta:-0.04;B:-0.34; 95%CI:-0.60,-0.08; P < 0.001) and status after cataract surgery (beta:0.04; B:2.92;95%CI:1.02,4.83; P = 0.003). INTRODUCTION CONCLUSIONS: In this ethnically mixed population from Russia with an age of 40+ years, mean CCT (541.7 ± 33.7 µm) was associated with parameters such as younger age, male sex, Russian ethnicity, and higher educational level. These associations may be taken into account when the dependence of IOP readings on CCT are considered. Glaucoma prevalence was unrelated to CCT.

Crystal structure of the redox-active cofactor dibromothymoquinone bound to circadian clock protein KaiA and structural basis for dibromothymoquinone's ability to prevent stimulation of KaiC phosphorylation by KaiA.

KaiA protein that stimulates KaiC phosphorylation in the cyanobacterial circadian clock was recently shown to be destabilized by dibromothymoquinone (DBMIB), thus revealing KaiA as a sensor of the plastoquinone (PQ) redox state and suggesting an indirect control of the clock by light through PQ redox changes. Here we show using X-ray crystallography that several DBMIBs are bound to KaiA dimer. Some binding modes are consistent with oligomerization of N-terminal KaiA pseudoreceiver domains and/or reduced interdomain flexibility. DBMIB bound to the C-terminal KaiA (C-KaiA) domain and limited stimulation of KaiC kinase activity by C-KaiA in the presence of DBMIB demonstrate that the cofactor may weakly inhibit KaiA-KaiC binding.

Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster-randomised controlled trial.

OBJECTIVE: To examine the association between a mobile phone intervention and skilled delivery attendance in a resource-limited setting. DESIGN: Pragmatic cluster-randomised controlled trial with primary healthcare facilities as the unit of randomisation. SETTING: Primary healthcare facilities in Zanzibar. POPULATION: Two thousand, five hundred and fifty pregnant women (1311 interventions and 1239 controls) who attended antenatal care at one of the selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery. All pregnant women were eligible for study participation. METHODS: Twenty-four primary healthcare facilities in six districts in Zanzibar were allocated by simple randomisation to either mobile phone intervention (n = 12) or standard care (n = 12). The intervention consisted of a short messaging service (SMS) and mobile phone voucher component. MAIN OUTCOME MEASURES: Skilled delivery attendance. RESULTS: The mobile phone intervention was associated with an increase in skilled delivery attendance: 60% of the women in the intervention group versus 47% in the control group delivered with skilled attendance. The intervention produced a significant increase in skilled delivery attendance amongst urban women (odds ratio, 5.73; 95% confidence interval, 1.51-21.81), but did not reach rural women. CONCLUSIONS: The mobile phone intervention significantly increased skilled delivery attendance amongst women of urban residence. Mobile phone solutions may contribute to the saving of lives of women and their newborns and the achievement of Millennium Development Goals 4 and 5, and should be considered by maternal and child health policy makers in developing countries.

Hyperlipoproteinemia(a) and Severe Coronary Artery Lesion Types.

Diffuse atherosclerosis and calcification of the coronary arteries (CA) create serious difficulties for coronary artery bypass grafting (CABG). The aim of this study was to compare demographic indicators, lipids, and clinical results one year after CABG in patients with different phenotypes of coronary artery (CA) disease. In total, 390 patients hospitalized for elective CABG were included in a single-center prospective study. Demographic data, lipids (total, low-density lipoprotein and high-density lipoprotein cholesterol, and triglycerides), and lipoprotein(a) (Lp(a)) concentrations were analyzed for all patients. Major adverse cardiovascular events (MACE) included myocardial infarction, stroke, percutaneous coronary intervention, and death from cardiac causes within one year after surgery. No significant outcome differences were found between the groups with diffuse vs. segmental lesions, nor the groups with and without calcinosis for all studied parameters except for Lp(a). Median Lp(a) concentrations were higher in the group of patients with diffuse compared to segmental lesions (28 vs. 16 mg/dL, p = 0.023) and in the group with calcinosis compared to the group without it (35 vs. 19 mg/dL, p = 0.046). Lp(a) ≥ 30 mg/dL was associated with the presence of diffuse lesions (OR = 2.18 (95% CI 1.34-3.54), p = 0.002), calcinosis (2.15 (1.15-4.02), p = 0.02), and its combination (4.30 (1.81-10.19), p = 0.0009), irrespective of other risk factors. The risk of MACE within one year after CABG was higher for patients with combined diffuse and calcified lesions vs. patients with a segmental lesion without calcinosis (relative risk = 2.38 (1.13-5.01), p = 0.02). Conclusion: Diffuse atherosclerosis and coronary calcinosis are associated with elevated Lp(a) levels, independent of other risk factors. The risk of MACE in the first year after surgery is significantly higher in patients with diffuse atherosclerosis and coronary calcinosis, which should be considered when prescribing postoperative treatment for such patients.

Osteogenic potential of calcium silicate-doped iron oxide nanoparticles versus calcium silicate for reconstruction of critical-sized mandibular defects: An experimental study in dog model.

Objective: To evaluate bioactivity and osteogenic potential of calcium silicate (CS)-doped iron oxide (Fe2O3) nanoparticles versus pure CS in the reconstruction of induced critical-sized mandibular defects. Design: CS-doped Fe2O3 was prepared; morphological and microstructure identification of nanoparticles were made. An in vivo randomised design was developed on 24 adult male dogs where four critical-sized mandibular defects were created in each dog. Bone defects were allocated into control, CS, CS-3% Fe2O3 and CS-10% Fe2O3 group. Dogs were euthanized at 1 and 3 months (12 dog/time) for histopathologic and histomorphometric evaluation. Results: At three months, bone formation and maturation were evident where mean ± SD percent of mature bone was 2.66 ± 1.8, 9.9 ± 2.5, 22.9 ± 4.9, and 38.6 ± 8.1 in control, CS, CS-3% Fe2O3, and CS-10% Fe2O3 groups respectively. A high significant (P < 0.001) increase in area percent of mature bone was recorded in CS, CS-3% Fe2O3, and CS- 10% Fe2O3 groups compared to control group (73%, 88% and 93.3% respectively). Significant increase (P < 0.001) in area of mature bone was recorded in CS-3% Fe2O3 and CS-10% Fe2O3 groups compared to CS group. A significant increase (P < 0.001) in area of mature bone formation was detected in CS-10% Fe2O3 group compared to other groups. Conclusion: CS-doped Fe2O3 has good osteoconductive, biocompatible properties with promoted bone regeneration. Fe2O3 has synergistic effect in combination with CS to promote bone formation. Increasing concentration of Fe2O3 nanoparticles resulted in improved osteogenesis and maturation. Results suggests that the novel CS-Fe2O3 alloplasts could be used for reconstruction of critical-sized bone defects.

Occurrence and antibiogram of multidrug-resistant Salmonella enterica isolated from dairy products in Libya.

Background and Aim: Foodborne illnesses are a serious challenge to human health and the economic sector. For example, salmonellosis remains a burden in developed and developing nations. Rapid and reliable molecular methods to identify Salmonella strains are essential for minimizing human infection. This study aimed to identify Salmonella spp. in raw milk and dairy products using conventional and molecular techniques and to test the antibiotic susceptibility of the isolated strains. Materials and Methods: One hundred and thirty-one milk and dairy product samples were randomly collected from different localities in Libya. Samples were examined for the presence of Salmonella by conventional culture techniques, including cultivation in Rappaport-Vassiliadis broth and streaking on xylose lysine deoxycholate agar. Identification also used polymerase chain reaction and partial sequencing of 16S rDNA. Twenty-four antibiotics were used for the examination of antimicrobial resistance of Salmonella spp. isolates with the agar disk diffusion method (Kirby-Bauer technique). Multi-antibiotic resistance index and antibiotic resistance index (ARI)for Salmonella enterica isolates were calculated. Results: Twenty-one of 131 samples (16%) were positive for Salmonella spp. recovered from 9 (16%), 2 (11%), 4 (22.2%), and 6 (46%) samples of raw cow milk, fermented raw milk, and fresh locally made soft cheeses, Maasora and Ricotta), respectively. Samples of ice cream, milk powder, and infant formula showed no Salmonella spp. contamination. Only 9 of 21 (42.8%) isolates were confirmed as S. enterica by partial sequence 16S rDNA analysis. All isolates were resistant to amoxycillin, bacitracin, penicillin G, lincomycin, vancomycin, clindamycin, and cloxacillin with an ARI of 0.042. In contrast, all tested strains were sensitive to levofloxacin, doxycycline, and ciprofloxacin. In addition, all of the tested isolates (100%) were resistant to more than one antibiotic. Conclusion: This study demonstrated the applicability of molecular techniques, compared with conventional methods, as preferable for the identification of Salmonella in milk and dairy products and thus reduction of milk-borne transmission to the consumers. From the view of public health, isolation and identification of Salmonella multidrug-resistant strains from raw cow`s milk and locally prepared dairy products sold in the Libyan markets indicate the need to improve the handling and processing of milk and dairy products to minimize the prevalence of Salmonella, one of the most important foodborne microorganisms that cause food poisoning.

Sarcoroseolides A-D, four undescribed cembranoids from the Red Sea soft coral Sarcophyton roseum.

Four undescribed cembranoids, sarcoroseolides A-D (1-4) along with nine reported related cembranoids (5-13) were isolated from the soft coral Sarcophyton roseum. The chemical structures of sarcoroseolides A-D were elucidated by extensive 1 D and 2 D NMR as well as HR-ESIMS spectroscopic data. Moreover, the geometric and absolute configurations were assigned by the modified Mosher's method and/or NOESY experiments. The extract and the isolated metabolites were evaluated for their potential anti-inflammatory and cytotoxic activities.

Key Sectors in the Economy of Saudi Arabia.

This study shows the key sector for the economy of Saudi Arabia based on input-output model analyses. They derived the analyses from the economy of the Kingdom of Saudi Arabia (KSA) using 35 economic sectors. We found that four leading sectors exceeded the values of the linkage coefficients with a value of 1, represented by both chemicals and pharmaceutical products, namely, manufacturing basic metals (S13), transportation and storage (S24), and other business sector services (S31). According to the unbalanced growth theory, more attention is paid to these sectors that are the primary engine for the rest of the sectors and their growth. The results obtained are beneficial for success of the economic policy of Saudi Arabia. By observing the different influences, it is possible to identify the policies expected to have more significant indirect impacts on other sectors in Saudi Arabia and are likely to develop a prudent economic policy. Given the economic dependence on oil, it is also essential to be acquainted with the different sectors that are probable to have an overall effect on the economy for strategic and operationally effective analysis that can help.

An adjuvant effect of Metformin as an anti-fibrotic agent when administered with the anti-schistosomal Praziquantel in Schistosoma mansoni infected mice.

Schistosomiasis is the second most common parasitic disease post Malaria around the world. Praziquantel (PZQ) is known as the most efficient anti- schistosomal drug but has no anti-fibrotic effect. Metformin (Met) is a well-known drug for type 2 diabetes. This study aimed to evaluate the role of Met as anti-schistosomal and anti-fibrotic agents alone or in combination with PZQ treatment. Forty male CD1 mice were divided into four groups (n=10 mice) as following; the first group (Gp1) was served as a negative control. Gp2, Gp3, Gp4, and Gp5 were infected with (60-80) S. mansoni cercariae. After a month of infection, Gp3 was administered orally with PZQ (500 mg/Kg) for 2 consecutive days. Gp4 was administered orally with Met (150 mg/Kg) for 15 consecutive days, and Gp5 was orally administered with PZQ followed by Met for 15 consecutive days at the same doses as in Gp 3 and 4. The results showed that PZQ had potent worms and egg reduction in liver and intestine tissues with no anti-fibrotic effect of the granuloma formation. However, Met or PZQ/Met treatment postinfection led to a reduction in egg count in both liver and intestine tissues with a significant reduction in granuloma site. Treatment of S. mansoni-infected mice with Met or PZQ/Met ameliorated the hematological and biochemical alterations induced by S. mansoni infection. Collectively, Met has no anti-schistosomal activity but led to a reduction in egg deposition and showed an anti-fibrotic effect on granulomatous development either when used alone or in combination with PZQ treatment. This study shed light on the possible role of Met as an anti-fibrotic agent when administered with PZQ for S. mansoni infected humans.

Analysis of deformable distortion in the architecture of leaf xylary vessel elements of Carthamus oxycantha caused by heavy metals stress using image registration.

Anatomical study of leaf xylary vessel elements of Carthamus oxycantha under various intensities of lead (Pb) and nickel (Ni) stress (200, 400, 600, and 800 mg Pb(NO3 )2 , NiCl2 ·6H2 O/kg of the soil) was conducted. The deformations caused due to metal stress were detected using point-based image registration technique. Initially, a set of corresponding feature points called landmarks was selected for warping of two-dimensional microscopic images of deformed/source vessel (stressed) to its normal/target (unstressed) counterpart. The results show that the target registration error is less than 3 mm using real plant image datasets. The stress caused alterations mainly in diameter, size, and shape of the cells. Average cell diameter and average wall diameter of vessels were measured with "Image J." The range of decrease in average cell diameter from 18.566 to 13.1 µm and the range of increase in average wall diameter was from 5.166 to 10.1 µm, with increase in stress factor through 200, 400, 600, and 800 mg Pb(NO3 )2 , NiCl2 ·6H2 O/kg of the soil. We noted large deformation in the form of shrinkage in cell size and diminution in its diameter. The diminution in diameter and the shrinkage in cell size of vessel cells may be due to the deposition of wall materials. It can be a possible strategy to limit the water flow to overcome the rapid mobility and transportation of the excess amount of metals to safeguard the cellular components from unpleasant consequences of metallic stress.