Linagliptin, a DPP-4 inhibitor, activates AMPK/FOXO3a and suppresses NFκB to mitigate the debilitating effects of diethylnitrosamine exposure in rat liver: Novel mechanistic insights.

Accumulating evidence suggests that dysregulation of FOXO3a plays a significant role in the progression of various malignancies, including hepatocellular carcinoma (HCC). FOXO3a inactivation, driven by oncogenic stimuli, can lead to abnormal cell growth, suppression of apoptosis, and resistance to anticancer drugs. Therefore, FOXO3a emerges as a potential molecular target for the development of innovative treatments in the era of oncology. Linagliptin (LNGTN), a DPP-4 inhibitor known for its safe profile, has exhibited noteworthy anti-inflammatory and anti-oxidative properties in previous in vivo studies. Several potential molecular mechanisms have been proposed to explain these effects. However, the capacity of LNGTN to activate FOXO3a through AMPK activation has not been investigated. In our investigation, we examined the potential repurposing of LNGTN as a hepatoprotective agent against diethylnitrosamine (DENA) intoxication. Additionally, we assessed LNGTN's impact on apoptosis and autophagy. Following a 10-week administration of DENA, the liver underwent damage marked by inflammation and early neoplastic alterations. Our study presents the first experimental evidence demonstrating that LNGTN can reinstate the aberrantly regulated FOXO3a activity by elevating the nuclear fraction of FOXO3a in comparison to the cytosolic fraction, subsequent to AMPK activation. Moreover, noteworthy inactivation of NFκB induced by LNGTN was observed. These effects culminated in the initiation of apoptosis, the activation of autophagy, and the manifestation of anti-inflammatory, antiproliferative, and antiangiogenic outcomes. These effects were concomitant with improved liver function and microstructure. In conclusion, our findings open new avenues for the development of novel therapeutic strategies targeting the AMPK/FOXO3a signaling pathway in the management of chronic liver damage.

Tracking the therapeutic efficacy of a ketone mono ester and ß-hydroxybutyrate for ulcerative colitis in rats: New perspectives.

Ulcerative colitis (UC) is an inflammatory condition that affects the colon's lining and increases the risk of colon cancer. Despite ongoing research, there is no identified cure for UC. The recognition of NLRP3 inflammasome activation in the pathogenesis of UC has gained widespread acceptance. Notably, the ketone body ß-hydroxybutyrate inhibits NLRP3 demonstrating its anti-inflammatory properties. Additionally, BD-AcAc 2 is ketone mono ester that increases ß-hydroxybutyrate blood levels. It has the potential to address the constraints associated with exogenous ß-hydroxybutyrate as a therapeutic agent, including issues related to stability and short duration of action. However, the effects of ß-hydroxybutyrate and BD-AcAc 2 on colitis have not been fully investigated. This study found that while both exogenous ß-hydroxybutyrate and BD-AcAc 2 produced the same levels of plasma ß-hydroxybutyrate, BD-AcAc 2 demonstrated superior effectiveness in mitigating dextran sodium sulfate-induced UC in rats. The mechanism of action involves modulating the NF-κB signaling, inhibiting the NLRP3 inflammasome, regulating antioxidant capacity, controlling tight junction protein expression and a potential to inhibit apoptosis and pyroptosis. Certainly, BD-AcAc 2's anti-inflammatory effects require more than just increasing plasma ß-hydroxybutyrate levels and other factors contribute to its efficacy. Local ketone concentrations in the gastrointestinal tract, as well as the combined effect of specific ketone bodies, are likely to have contributed to the stronger protective effect observed with ketone mono ester ingestion in our experiment. As a result, further investigations are necessary to fully understand the mechanisms of BD-AcAc 2 and optimize its use.

Unraveling the miRNA Puzzle in Atherosclerosis: Revolutionizing Diagnosis, Prognosis, and Therapeutic Approaches.

PURPOSE OF REVIEW: To eradicate atherosclerotic diseases, novel biomarkers, and future therapy targets must reveal the burden of early atherosclerosis (AS), which occurs before life-threatening unstable plaques form. The chemical and biological features of microRNAs (miRNAs) make them interesting biomarkers for numerous diseases. We summarized the latest research on miRNA regulatory mechanisms in AS progression studies, which may help us use miRNAs as biomarkers and treatments for difficult-to-treat diseases. RECENT FINDINGS: Recent research has demonstrated that miRNAs have a regulatory function in the observed changes in gene and protein expression during atherogenesis, the process that leads to atherosclerosis. Several miRNAs play a role in the development of atherosclerosis, and these miRNAs could potentially serve as non-invasive biomarkers for atherosclerosis in various regions of the body. These miRNAs have the potential to serve as biomarkers and targets for early treatment of atherosclerosis. The start and development of AS require different miRNAs. It reviews new research on miRNAs affecting endothelium, vascular smooth muscle, vascular inflammation, lipid retention, and cholesterol metabolism in AS. A miRNA gene expression profile circulates with AS everywhere. AS therapies include lipid metabolism, inflammation reduction, and oxidative stress inhibition. Clinical use of miRNAs requires tremendous progress. We think tiny miRNAs can enable personalized treatment.

Morphological and molecular characterization of Eimeria magna infecting local rabbit (Oryctolagus cuniculus) in Alkarg City, Saudi Arabia.

Coccidiosis is one of the most prevalent diseases found in local rabbits (Oryctolagus cuniculus), which is caused by the Eimeria. The study aimed to more reliably identify Eimeria species (Eimeria magna) infecting Local Rabbits in Alkarg City, Saudi Arabia, based the method on the molecular properties and morphological and molecular biological techniques. Sub-spheroidal oocysts measuring 21-27 × 12-16 (24 × 14.4) µm (20 n) and with a length/width (L/W) ratio of 0.9-1.1 (1.0) were identified by microscopic analysis of a fecal sample. Oocysts feature a bi-layered wall that is 1.0-1.2 (1.1) µm thick. About two-thirds of the wall's thickness is made up of a smooth outer layer. A polar granule is present, but neither a micropyle nor an oocyst residuum is present. The ovoidal sporozoites measure 15-18 × 8-11 (16.5 × 9.5) µm, have an L/W ratio of 1.6-1.8 (1.7), and take up around 21% of the oocyst's total surface. The mean size of the sub-Stieda body is 1.4 × 2.3 µm, while the average size of the Stieda body is 0.9 × 1.8 µm. The para-Stieda body is lacking. Sporocyst residuum appears membrane-bound and has an uneven form made up of several granules. With two refractile bodies below the striations and pronounced striations at the more pointed end, sporozoites are vermiform, measuring an average of 11.6 × 4.0 µm. The results of the sequencing for the 18S rDNA gene confirmed the species of Eimeria parasites found in the host (rabbits). The current parasite species is closely related to the previously described and deposited E. magna and deeply embedded in the genus Eimeria (family Eimeriidae). According to the findings, single oocyst molecular identification of Eimeria may be accomplished through consistent use of the morphological and molecular results. It is possible to draw the conclusion that the current research supplies relevant facts that help assess the potential infection and future control measures against rabbit coccidiosis to reduce the financial losses that can be incurred by the rabbit industry in Saudi Arabia.

Item analysis: the impact of distractor efficiency on the difficulty index and discrimination power of multiple-choice items.

BACKGROUND: Distractor efficiency (DE) of multiple-choice questions (MCQs) responses is a component of the psychometric analysis used by the examiners to evaluate the distractors' credibility and functionality. This study was conducted to evaluate the impact of the DE on the difficulty and discrimination indices. METHODS: This cross-sectional study was conducted from April to June 2023. It utilizes the final exam of the Principles of Diseases Course with 45 s-year students. The exam consisted of 60 type A MCQs. Item analysis (IA) was generated to evaluate KR20, difficulty index (DIF), discrimination index (DIS), and distractor efficiency (DE). DIF was calculated as the percentage of examinees who scored the item correctly. DIS is an item's ability to discriminate between higher and lower 27% of examinees. For DE, any distractor selected by less than 5% is considered nonfunctional, and items were classified according to the non-functional distractors. The correlation and significance of variance between DIF, DI, and DE were evaluated. RESULTS: The total number of examinees was 45. The KR-20 of the exam was 0.91. The mean (M), and standard deviation (SD) of the DIF of the exam was 37.5(19.1), and the majority (69.5%) were of acceptable difficulty. The M (SD) of the DIS was 0.46 (0.22), which is excellent. Most items were excellent in discrimination (69.5%), only two were not discriminating (13.6%), and the rest were of acceptable power (16.9%). Items with excellent and good efficiency represent 37.3% each, while only 3.4% were of poor efficiency. The correlation between DE and DIF (p = 0.000, r= -0.548) indicates that items with efficient distractors (low number of NFD) are associated with those having a low difficulty index (difficult items) and vice versa. The correlation between DE and DIS is significantly negative (P = 0.0476, r=-0.259). In such a correlation, items with efficient distractors are associated with low-discriminating items. CONCLUSIONS: There is a significant moderate negative correlation between DE and DIF (P = 0.00, r = -0.548) and a significant weak negative correlation between DE and DIS (P = 0.0476, r = -0.259). DIF has a non-significant negative correlation with DIS (P = 0.7124, r = -0.0492). DE impacts both DIF and DIS. Items with efficient distractors (low number of NFD) are associated with those having a low difficulty index (difficult items) and discriminating items. Improving the quality of DE will decrease the number of NFDs and result in items with acceptable levels of difficulty index and discrimination power.

Identification of Eimeria acervulina (Apicomplexa: Eimeriidae) infecting the broiler chicken Gallus gallus domesticus through morphology and molecular analyses.

Coccidiosis is an intestinal protozoan disease that affects the poultry industry worldwide. The severity of this disease varies depending on the identity of the infectious agents. Therefore, this study was carried out to identify the Eimeria species that affect broiler chickens, Gallus gallus domesticus, through morphological and molecular phylogenetic analyses. Twenty-five faecal samples were collected from the broiler chickens in a commercial poultry farm in Riyadh (Saudi Arabia). Using the floatation technique, faeces were examined microscopically for the Eimeria occurrence. Identification of Eimeria species was performed based on morphological criteria and molecular tools (DNA amplification for the partial small subunit ribosomal RNA (18S rRNA), internal transcribed spacer (ITS)-1, and mitochondrial cytochrome c oxidase I (COI) genes. In this study, 32% (8 out of 25) of collected samples were found to be positive for coccidiosis. After sporulation in potassium dichromate (K2Cr2O7), the sporulated oocysts were observed as ovoid and measured 18.37-23.19 µm (19.87) long and 15.07-18.67 µm (16.46) wide, with the anterior location of a polar granule and absence of micropyle. These Eimeria oocysts were assumed to size and shape characteristics of Eimeria acervulina. Molecular analysis was conducted on the sequences of the polymerase chain reaction products from the three genes studied (18S rRNA, ITS-1, and COI). At the three genes, results showed that the resultant sequences clustered with E. acervulina from different regions confirming morphological description. This study highlighted the importance of molecular techniques to detect avian Eimeria species more than the traditional morphology-based tool to optimise the appropriate anticoccidial strategies for long-term control in the studied area.

Identification of sheep eimerian parasites, Eimeria crandallis and Eimeria faurei, employing microscopic and molecular tools.

Coccidiosis, caused by apicomplexan Eimeria species, is a protozoan disease that affects various species of wild and domestic animals. However, data available on Eimeria diversity in ruminants in Saudi Arabia is meagre. Therefore, this study was designed to investigate some eimerian parasites infecting sheep (Sawakni and Harrie breeds) using microscopy and molecular methods for the first time in Saudi Arabia. Twenty-four fecal samples were collected from sheep farms. Based on the floatation technique, eimerian oocysts were observed in 8 of the 24 (33.33%) fecal samples. The coccidian-positive samples were subjected to fecal culture in a shallow layer of 2.5% potassium dichromate (K2 Cr2 O7 ). Detected eimerian oocysts were described micromorphometrically as the basis for traditional oocyst identification. Morphologically, the sporulated oocysts were similar to those of sheep eimerian parasies; Eimeria faurei and Eimeria crandallis. PCR products from the two eimerian species detected from Sawakni and Harrie breeds were sequenced and were found to be distinct from each other with mutations at five positions. One of them clustered with E. crandallis with 99.8%-100% identity with sequences available in GenBank. E. crandallis was obtained from two Sawakni sheep and two Harrie sheep. The other sequences grouped with E. faurei with 99.8% identity with the only sequences available in GenBank. E. crandallis was detected from both Sawakni and Harrie breeds whereas E. faurei was detected only from Sawakni sheep. The findings of this study have implications for the importance of morphometric identification with advanced molecular tools to confirm the identities of sheep Eimeria species and to address the taxonomic study of this eimeriid parasite at the species level.

Ambroxol, a mucolytic agent, boosts HO-1, suppresses NF-κB, and decreases the susceptibility of the inflamed rat colon to apoptosis: A new treatment option for treating ulcerative colitis.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease of unknown etiology that increases the risk of developing colorectal cancer and imposes a lifelong healthcare burden on millions of patients worldwide. Current treatment strategies are associated with significant risks and have been shown to be fairly effective. Hence, discovering new therapies that have better efficacy and safety profiles than currently exploited therapeutic strategies is challenging. It has been well delineated that NF-κB/Nrf2 crosstalk is a chief player in the interplay between oxidative stress and inflammation. Ambroxol hydrochloride, a mucolytic agent, has shown antioxidant and anti-inflammatory activity in humans and animals and has not yet been examined for the management of UC. Therefore, our approach was to investigate whether ambroxol could be effective to combat UC using the common acetic acid rat model. Interestingly, a high dose of oral ambroxol (200 mg/kg/day) reasonably improved the microscopic and macroscopic features of the injured colon. This was linked to low disease activity and a reduction in the colonic weight/length ratio. In the context of that, ambroxol boosted Nrf2 activity and upregulated HO-1 and catalase to augment the antioxidant defense against oxidative damage. Besides, ambroxol inactivated NF-κB signaling and its consequent target pro-inflammatory mediators, IL-6 and TNF-α. In contrast, IL-10 is upregulated. Consistent with these results, myeloperoxidase activity is suppressed. Moreover, ambroxol decreased the susceptibility of the injured colon to apoptosis. To conclude, our findings highlight the potential application of ambroxol to modify the progression of UC by its anti-inflammatory, antioxidant, and antiapoptotic properties.

Prevalence and influencing factors of self-medication during the COVID-19 pandemic in the Arab region: a multinational cross-sectional study.

BACKGROUND: The novel coronavirus pandemic (COVID-19) has begun with a wave of misinformation and fear of infection. This may have led people to self-medicate inappropriately. The World Health Organization describes self-medication (SM) as utilizing medicines to relieve symptoms or health conditions without consulting a physician. Inappropriate drug use is a burden on both health resources and patient health in the Arab region. This study aimed to detect the prevalence and influencing factors of self-medication among the general Arab population during the COVID-19 pandemic. METHODS: A multinational cross-sectional study was conducted among the general population of ten Arab countries from early August to late October 2021. Participants aged 18 years or older could join the study via social media platforms. A convenience sampling technique was used. A developed and validated web-based questionnaire was used to collect data on self-medication practice, associated influencing factors, information sources, commonly used medications, and commonly treated conditions. Descriptive, univariate, and multivariate regression analyses were applied using IBM SPSS v 26 and R v 4.0.0 software. RESULTS: A total of 8163 participants completed the questionnaire, and 518 participants were excluded from the analysis due to inconsistencies in their data. Almost two-thirds (62.7%) of participants reported practicing self-medication during the COVID-19 pandemic. At the country level, Egypt had the highest prevalence of self-medication practice (72.1%), while Palestine had the lowest prevalence (40.4%). The most commonly used drugs were analgesics, antipyretics, and vitamins (86, 65.1, and 57.1%, respectively), while antitussives and antibiotics scored 47.6 and 43.3%, respectively. Experience with similar health conditions (74.6%) and urgency of the problem (47.2%) were the most frequent factors that led to self-medication. Additionally, 38.2% of the self-medicated participants (SMPs) used drugs as prophylaxis against COVID-19. Pharmacist consultation was the most common source of information about self-medication (66.7%). Multivariate analysis showed that predictors of self-medication were older age (p = 0.008), presence of chronic illness (p = 0.015), and having monthly income or medical insurance that does not cover the treatment cost (p = 0.001, p < 0.001, respectively). CONCLUSION: Self-medication is considered a common practice across the Arab population. It is necessary to regulate policies and raise awareness among the public about self-medication.

Morphological, molecular, and histopathological studies on Hadjelia truncata from Columba livia domestica and its role as an environmental biological indicator.

Pigeons are a cosmopolitan group of birds with abundant and large populations associated with human activities. This study focused on determining parasitic infections within domestic pigeons (Columba livia domestica). Forty-eight pigeons were examined for infections, of which 29.16% were infected with a nematode parasite, identified as Hadjelia truncata (Habronematidae), under the koilin layer of their gizzards. The population of nematodes in infected gizzards did not exceed 20 adult worms. DNA from the gizzard worms was extracted and subjected to PCR using primers that amplify the partial 18S rDNA and cytochrome C oxidase subunit I (COX I) regions. Identification of this parasite based on microscopic study revealed the presence of trilobed lips with cephalic papillae and amphidial pores, as well as other characteristic features. In males, spicules were unequal with the presence of six pedunculated pairs of caudal papillae (4 pre- and 2 post-anal) and a tail surrounded with caudal ala. In females, the vulva was a rounded aperture located in front of the posterior end of the esophagus and uteri, which was filled with numerous embryonated eggs. DNA Sequences from partial 18S rDNA were homologous to sequences obtained from H. truncata in GenBank with a high percentage of identity. DNA sequences from mitochondrial gene COX I, however, were unique, and they were the first sequenced for H. truncata, since no sequences for this taxon were previously available in GenBank. Histopathological examination revealed enlargement of infected gizzards in comparison to non-infected ones, with the presence of necrosis and interstitial infiltration in the koilin layer. Concentrations of heavy metals (Fe, Cu, Zn, Cd, Cr, and Co) were measured using inductivity-coupled plasma in tissues (liver, muscles, and gizzards) from infected and non-infected pigeons as well as their parasites. Results showed different affinities of metals to tissues. Recovered parasites can minimize element concentration from their pigeon tissues. In Saudi Arabia, this study was considered the first report identifying pigeon nematodes and evaluating of the effects of their pathogenicity on the animals' welfare, as well as their application as a useful tool for monitoring environmental pollution.

Feasibility of magnetic nano adsorbent impregnated with activated carbon from animal bone waste: Application for the chromium (VI) removal.

Chromium is the heavy metal which existing in the effluents cause extensive discomfort to the environmental components. Bone waste is widely generated in food processing industries and restaurants. It is now used by switching into activated carbon. By co-precipitation procedure, the activated carbon is coated with a nano adsorbent. The Fe3O4-BAC adsorbent potential was established in this study via several batch tests. The adsorbing adverts had super magnetic behavior, and the magnetization value was 22 emu/g. The SEM imaging of the Fe3O4-BAC shows an improved morphology of 100-446 nm, and the nanoparticles were monodispersed. The present investigation also delves into the study of system parameters on the removal of metal ions. Optimal adsorption has been found at the acidic pH at the contact time of 60min for the adsorbent amount of 5 g/L. Maximum capacity of adsorption by nano adsorbent was 27.86 mg/g. Thermodynamic and isotherm tests have established the process viability. In addition, the kinetic studies establish the inclination of the studied Fe3O4-BAC towards pseudo-first order models. Hence, Fe3O4-BAC could be potential adsorbent to remove chromium from an aqueous solution.

Mosquitocidal effect of monoterpene ester and its acetyl derivative from Blumea mollis (D. Don) Merr against Culex quinquefasciatus (Diptera: Culicidae) and their insilico studies.

The present study was conducted to assess the mosquitocidal efficiency of compound isolated from Blumea mollis (D. Don) Merr against Culex quinquefasciatus. Eggs and larvae of Cx. uinquefasciatus were exposed to different concentrations 0.5, 1.0, 1.5 and 2.0 ppm of compounds prepared using DMSO. Compound 1 was identified as (4R, 5S)-4-hydroxy-7-tigloyloxy carvotanacetone, from which new derivative was synthesized and confirmed as (4R, 5S)-4-acetoxy-7-tigloyloxy carvotanacetone. Both the compounds presented larvicidal and ovicidal activities. Compounds 1 and 2 at 2-ppm concentration showed 64% and 78% larval mortality in 24 h, respectively. The LC50and LC90values of compounds 1 and 2 on Cx. quinquefasciatus larvae were 1.73, 1.27 and 4.59, 3.33 ppm, respectively. The eluted compound 1 and synthesized compound 2 presented 68% and 77% of ovicidal activity, respectively, against eggs of Cx. quinquefasciatus at 120 h post-treatment. Histopathological studies of the compound-treated larvae revealed serious damage on the larval midgut cells. Furthermore, compounds 1 and 2 was tested for toxicity study and the results showed both the compounds were found to be harmless to non-target organism Poecilia reticulata. Computational analysis of compound 2 showed strong binding interaction with the AChE1 of Cx. quinquefasciatus. These results clearly suggest that compounds from Blumea mollis could act as good mosquitocidal agents against Cx.quinquefasciatus and compound 2 was first time reported.

Progress Toward Measles Elimination - Eastern Mediterranean Region, 2013-2019.

In 1997, during the 41st session of the Regional Committee for the Eastern Mediterranean, the 21 countries in the World Health Organization (WHO) Eastern Mediterranean Region* (EMR) passed a resolution to eliminate† measles (1). In 2015, this goal was included as a priority in the Eastern Mediterranean Vaccine Action Plan 2016-2020 (EMVAP) (2), endorsed at the 62nd session of the Regional Committee (3). To achieve this goal, the WHO Regional Office for the Eastern Mediterranean developed a four-pronged strategy: 1) achieve ≥95% vaccination coverage with the first dose of measles-containing vaccine (MCV1) among children in every district of each country through routine immunization services; 2) achieve ≥95% vaccination coverage with a second MCV dose (MCV2) in every district of each country either through implementation of a routine 2-dose vaccination schedule or through supplementary immunization activities§ (SIAs); 3) conduct high-quality, case-based surveillance in all countries; and 4) provide optimal measles clinical case management, including dietary supplementation with vitamin A (4). This report describes progress toward measles elimination in EMR during 2013-2019 and updates a previous report (5). Estimated MCV1 coverage increased from 79% in 2013 to 82% in 2018. MCV2 coverage increased from 59% in 2013 to 74% in 2018. In addition, during 2013-2019, approximately 326.4 million children received MCV during SIAs. Reported confirmed measles incidence increased from 33.5 per 1 million persons in 2013 to 91.2 in 2018, with large outbreaks occurring in Pakistan, Somalia, and Yemen; incidence decreased to 23.3 in 2019. In 2019, the rate of discarded nonmeasles cases¶ was 5.4 per 100,000 population. To achieve measles elimination in the EMR, increased visibility of efforts to achieve the measles elimination goal is critically needed, as are sustained and predictable investments to increase MCV1 and MCV2 coverage, conduct high-quality SIAs, and reach populations at risk for not accessing immunization services or living in areas with civil strife.

A novel coccidian (Apicomplexa: Eimeriidae) from Scotophilus leucogaster (Chiroptera: Vespertilionidae) in southern Saudi Arabia.

A novel species of coccidia, resembling a member of the genus Eimeria, was found in bats, Scotophilus leucogaster, collected in southern Saudi Arabia has been described on the basis of unsporulated oocysts and DNA sequencing of the Internal Transcribed Spacer 1 (ITS1) and partial 18S rDNA regions. Unsporulated oocysts of this form are ovoidal to spheroidal and had a 2-layered wall, 1.5-2.0 (1.9 ± 0.2); the outer layer was light blue with striations, and thicker than the inner, darker layer. No micropyle was present. Unsporulated oocysts (N = 150) measured 27.2 × 22.1 (25-30 × 20-25), length width ratio, 1.2 (1.1-1.4). There was no evidence of an oocyst residuum and/or polar granule. This parasite was detected in 2/7 (29%) S. leucogaster collected from southern Saudi Arabia. Oocysts incubated at 25 °C in 2.5% K2Cr2O7 did not sporulate after > 1 month. Unsporulated oocyst measurements were compared with other coccidian parasites of bats that discharge oocysts in their feces. Sequences of the ITS1 and the 18S rDNA regions obtained from the unsporulated oocysts grouped this coccidium from S. leucogaster with eimerian species from various rodent and squirrel species. It is critical that future investigators obtain fully sporulated oocysts of this coccidium for full description of the parasite recovered in our study so it can be correctly assigned to genus and given an accurate binomial.

Progress Toward Measles Elimination - Pakistan, 2000-2018.

In 1997, the 21 countries in the World Health Organization (WHO) Eastern Mediterranean Region* (EMR) passed a resolution during the 41st session of the Regional Committee for the Eastern Mediterranean to eliminate measles† (1). In 2015, this goal was included as a priority in the Eastern Mediterranean Vaccine Action Plan 2016-2020 (2), approved at the 62nd session of the Regional Committee (3). To achieve measles elimination, the WHO Regional Office for the Eastern Mediterranean developed the following four-pronged strategy: 1) achieve ≥95% vaccination coverage with the first dose of measles-containing vaccine (MCV) among children in every district of each country through routine immunization services; 2) achieve ≥95% vaccination coverage with a second MCV dose in every district of each country either through implementation of a routine 2-dose vaccination schedule or through supplementary immunization activities (SIAs)§; 3) conduct high-quality, case-based measles surveillance in all countries; and 4) provide optimal measles clinical case management, including dietary supplementation with vitamin A (4). Pakistan, an EMR country with a population of approximately 200 million, accounts for nearly one third of the overall EMR population. This report describes progress and challenges toward measles elimination in Pakistan during 2000-2018. During the study period, estimated coverage with the first MCV dose (MCV1) increased from 57% in 2000 to 76% in 2017. The second MCV dose (MCV2) was introduced nationwide in 2009, and MCV2 coverage increased from 30% in 2009 to 45% in 2017. During 2000-2018, approximately 232.5 million children received doses of MCV during SIAs. Reported confirmed measles incidence increased from an average of 24.6 per 1 million persons during 2000-2009 to an average of 80.4 during 2010-2018, with peaks in 2013 (230.3) and 2018 (153.6). In 2017 and 2018, the rates of suspected cases discarded as nonmeasles after investigation were 2.1 and 1.5 per 100,000 population, reflecting underreporting of cases. To achieve measles elimination, additional efforts are needed to increase MCV1 and MCV2 coverage, develop strategies to identify and reach communities not accessing immunization services, and increase sensitivity of case-based measles surveillance in all districts.

Nd:YAG laser for epithelial ingrowth after laser in situ keratomileusis.

PURPOSE: To evaluate the efficacy of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for treatment of epithelial ingrowth after laser in situ keratomileusis (LASIK). PATIENTS AND METHODS: Fifty-eight patients with epithelial ingrowth presented to Sohag refractive center, Sohag, Egypt, between January 2015 and March 2017. Only 41 patients (18 females and 23 males, mean age: 33.4 years) involving 41 eyes were indicated for treatment by Nd:YAG laser as the rest of the eyes were only under observation. Patients with epithelial ingrowth were recognized at a mean of 6 months after primary LASIK procedure (range: 2-16 months). Four eyes had undergone previous LASIK enhancements. Four eyes had the epithelial ingrowth removed by flap lift and scrapping. The mean intensity of the spots used was 0.8 mJ with variable number of shots depending on the size and density of the epithelial ingrowth area. Twenty-eight eyes showed complete regression after one session, while the rest necessitated 2-3 sessions for complete resolution. Mean follow-up period was 8 months (range 5-12 months). RESULTS: Epithelial ingrowth was treated successfully in all 41 eyes. The uncorrected visual acuities were 20/20, and there was no evidence of recurrent epithelial ingrowth after 6 months with no complications reported. CONCLUSION: YAG laser is a simple, effective outpatient procedure for the management of epithelial ingrowth after LASIK.

Physical-Model-Checking to Detect Switching-Related Attacks in Power Systems.

Recent public disclosures on attacks targeting the power industry showed that savvy attackers are now capable of occulting themselves from conventional rule-based network intrusion detection systems (IDS), bringing about serious threats. In order to leverage the work of rule-based IDS, this paper presents an artificially intelligent physical-model-checking intrusion detection framework capable of detecting tampered-with control commands from control centers of power grids. Unlike the work presented in the literature, the work in this paper utilizes artificial intelligence (AI) to learn the load flow characteristics of the power system and benefits from the fast responses of the AI to decode and understand contents of network packets. The output of the AI is processed through an expert system to verify that incoming control commands do not violate the physical system operational constraints and do not put the power system in an insecure state. The proposed content-aware IDS is tested in simulation on a 14-bus IEEE benchmark system. Experimental verification on a small power system, with an IEC 61850 network architecture is also carried out. The results showed the accuracy of the proposed framework in successfully detecting malicious and/or erroneous control commands.

The hairy lizard: heterothermia affects anaesthetic requirements in the Arabian oryx (Oryx leucoryx).

OBJECTIVE: To study the effect of heterothermia on anaesthetic drug requirements in semi-free ranging Arabian oryx and to assess the temperature quotient (Q10) of oxygen consumption. STUDY DESIGN: Prospective observational study and controlled metabolic experiment. ANIMALS: Sixty-eight anaesthetic events in 59 Arabian oryx from Mahazat As-Sayd protected area, Saudi Arabia METHODS: Anaesthesia was induced by remote injection of 25 mg ketamine, 10 mg midazolam and 0.5 mg medetomidine with a variable amount of etorphine based on a target dosage of 20 µg kg-1 and subjective assessment of body mass. Animals not recumbent within 15 minutes or insufficiently anaesthetized were physically restrained and administered supplementary etorphine intravenously depending on the anaesthetic depth. Body temperature (Tb) was measured rectally immediately upon handling of each animal. From six anaesthetized oryx, expiratory gasses for oxygen analysis and metabolic rate calculation were collected at two Tbs; before and after submersion in ice water for approximately 30 minutes. RESULTS: Forty-two animals (62%) became recumbent with the initial dose, with a mean induction time (± standard deviation) of 9 ± 2 minutes. The remaining animals could be handled but needed 0.3 ± 0.1 mg etorphine intravenously to reach the desired level of anaesthesia. There was a significant positive correlation between Tb and effective etorphine dosage (R2 = 0.48, p < 0.0001). Average Tb of the six animals in which metabolic rate was measured decreased from 40.0 ± 0.5°C immediately after induction to 35.5 ± 0.5°C after cooling. This reduction was associated with a reduction in oxygen uptake from 3.11 ± 0.33 to 2.22 ± 0.29 mL O2 minute-1 kg-1, reflected in Q10 of 2.17 ± 0.14. CONCLUSIONS AND CLINICAL RELEVANCE: Tb significantly affects anaesthetic requirements in Arabian oryx and should be considered when selecting dosages for anaesthetic induction for species showing diurnal heterothermy.

On the origin of mongrels: evolutionary history of free-breeding dogs in Eurasia.

Although a large part of the global domestic dog population is free-ranging and free-breeding, knowledge of genetic diversity in these free-breeding dogs (FBDs) and their ancestry relations to pure-breed dogs is limited, and the indigenous status of FBDs in Asia is still uncertain. We analyse genome-wide SNP variability of FBDs across Eurasia, and show that they display weak genetic structure and are genetically distinct from pure-breed dogs rather than constituting an admixture of breeds. Our results suggest that modern European breeds originated locally from European FBDs. East Asian and Arctic breeds show closest affinity to East Asian FBDs, and they both represent the earliest branching lineages in the phylogeny of extant Eurasian dogs. Our biogeographic reconstruction of ancestral distributions indicates a gradual westward expansion of East Asian indigenous dogs to the Middle East and Europe through Central and West Asia, providing evidence for a major expansion that shaped the patterns of genetic differentiation in modern dogs. This expansion was probably secondary and could have led to the replacement of earlier resident populations in Western Eurasia. This could explain why earlier studies based on modern DNA suggest East Asia as the region of dog origin, while ancient DNA and archaeological data point to Western Eurasia.

Resistance to cancer chemotherapy: failure in drug response from ADME to P-gp.

Cancer chemotherapy resistance (MDR) is the innate and/or acquired ability of cancer cells to evade the effects of chemotherapeutics and is one of the most pressing major dilemmas in cancer therapy. Chemotherapy resistance can arise due to several host or tumor-related factors. However, most current research is focused on tumor-specific factors and specifically genes that handle expression of pumps that efflux accumulated drugs inside malignantly transformed types of cells. In this work, we suggest a wider and alternative perspective that sets the stage for a future platform in modifying drug resistance with respect to the treatment of cancer.