Factors associated with hospitalization for seasonal influenza in Morocco.

Background: Morocco is actively working towards expanding its influenza vaccine policy to cover high-risk groups, as recommended by the World Health Organization (WHO). Aims: We assessed the risk factors for influenza-associated hospitalization for severe acute respiratory infections (SARI) that occurred during the last 5 seasons. Methods: We conducted a retrospective, analytical study among patients recruited in the ambulatory and hospital sites of the influenza sentinel surveillance system in Morocco between 2014 and 2019. Using multiple logistic regression, we compared the characteristics of influenza-positive patients with SARI to those with influenza-like illness (ILI) to identify factors associated with severe disease. Results: We included 1323 positive influenza patients with either SARI (41.7%) or ILI diagnosis (58.3%). A(H1N1)pdm09, A(H3N2) and influenza B, respectively, contributed 49.2%, 29.5% and 20.6% of the cases. The main risk factors considered in the bivariate analysis were found in the multivariate analysis to be significantly associated with influenza-related hospitalization (SARI): age < 2 years (aOR = 7.08, P < 0.001); age ≥ 65 years (aOR = 3.59, P < 0.001); diabetes (aOR = 1.98, P = 0.017); obesity (aOR = 2.94, P = 0.034); asthma or chronic respiratory disease (aOR = 4.99, P < 0.001); chronic renal failure (aOR = 4.74, P = 0.005); pregnancy (aOR = 7.49, P < 0.001); and the A(H1N1)pdm09 subtype (aOR = 1.82, P < 0.001). Conclusion: This study provides epidemiological evidence for the expected benefit of an influenza vaccination strategy for high-risk groups as recommended by the WHO.

Explanatory predictive model for COVID-19 severity risk employing machine learning, shapley addition, and LIME.

The rapid spread of SARS-CoV-2 threatens global public health and impedes the operation of healthcare systems. Several studies have been conducted to confirm SARS-CoV-2 infection and examine its risk factors. To produce more effective treatment options and vaccines, it is still necessary to investigate biomarkers and immune responses in order to gain a deeper understanding of disease pathophysiology. This study aims to determine how cytokines influence the severity of SARS-CoV-2 infection. We measured the plasma levels of 48 cytokines in the blood of 87 participants in the COVID-19 study. Several Classifiers were trained and evaluated using Machine Learning and Deep Learning to complete missing data, generate synthetic data, and fill in any gaps. To examine the relationship between cytokine storm and COVID-19 severity in patients, the Shapley additive explanation (SHAP) and the LIME (Local Interpretable Model-agnostic Explanations) model were applied. Individuals with severe SARS-CoV-2 infection had elevated plasma levels of VEGF-A, MIP-1b, and IL-17. RANTES and TNF were associated with healthy individuals, whereas IL-27, IL-9, IL-12p40, and MCP-3 were associated with non-Severity. These findings suggest that these cytokines may promote the development of novel preventive and therapeutic pathways for disease management. In this study, the use of artificial intelligence is intended to support clinical diagnoses of patients to determine how each cytokine may be responsible for the severity of COVID-19, which could lead to the identification of several cytokines that could aid in treatment decision-making and vaccine development.

Machine learning approaches in Covid-19 severity risk prediction in Morocco.

The purpose of this study is to develop and test machine learning-based models for COVID-19 severity prediction. COVID-19 test samples from 337 COVID-19 positive patients at Cheikh Zaid Hospital were grouped according to the severity of their illness. Ours is the first study to estimate illness severity by combining biological and non-biological data from patients with COVID-19. Moreover the use of ML for therapeutic purposes in Morocco is currently restricted, and ours is the first study to investigate the severity of COVID-19. When data analysis approaches were used to uncover patterns and essential characteristics in the data, C-reactive protein, platelets, and D-dimers were determined to be the most associated to COVID-19 severity prediction. In this research, many data reduction algorithms were used, and Machine Learning models were trained to predict the severity of sickness using patient data. A new feature engineering method based on topological data analysis called Uniform Manifold Approximation and Projection (UMAP) shown that it achieves better results. It has 100% accuracy, specificity, sensitivity, and ROC curve in conducting a prognostic prediction using different machine learning classifiers such as X_GBoost, AdaBoost, Random Forest, and ExtraTrees. The proposed approach aims to assist hospitals and medical facilities in determining who should be seen first and who has a higher priority for admission to the hospital.

Risk Factors of COVID-19 Critical Outcomes in the Eastern Mediterranean Region: Multicountry Retrospective Study.

BACKGROUND: The establishment of empirical evidence in the Eastern Mediterranean Region necessitates the implementation of wide-scale studies to describe the demographic, clinical features, and severity profile of patients with COVID-19. OBJECTIVE: This study aims to assess the patterns of COVID-19 severity and mortality in seven countries, and to determine the risk factors of COVID-19 severity and mortality. METHODS: This multicountry study was based on a retrospective review of medical records of hospitalized patients confirmed to have COVID-19. This study includes data from Iraq, Pakistan, Sudan, Somalia, Morocco, Egypt, and Yemen. All demographic and clinical data were extracted from hospital records (paper files) by trained data collectors. RESULTS: A total of 4141 patients were included in this study from seven countries. Comorbidities were reported by nearly half of the patients, with hypertension (n=1021, 24.7%) and diabetes (n=939, 22.7%) being the most common. Older age, diabetes mellitus, hypertension, and heart diseases were significantly associated with COVID-19 severity and mortality. Ever smoking and renal diseases were significantly associated with severity but not mortality, while male gender, respiratory diseases, and malignancy were significantly associated with mortality but not severity. CONCLUSIONS: The study confirms the role of comorbidities and demographic features on the severity and mortality of COVID-19. Understanding the contributing factors ensures attentive care and informs clinical management of patients with poorer prognoses in the early stages of diseases.

Platelet Function in Viral Immunity and SARS-CoV-2 Infection.

Platelets, as nonnucleated blood components, are classically recognized for their pivotal role in hemostasis. In recent years, however, accumulating evidence points to a nonhemostatic role for platelets, as active participants in the inflammatory and immune responses to microbial organisms in infectious diseases. This stems from the ability of activated platelets to secrete a plethora of immunomodulatory cytokines and chemokines, as well as directly interplaying with viral receptors. While much attention has been given to the role of the cytokine storm in the severity of the coronavirus disease 2019 (COVID-19), less is known about the contribution of platelets to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, we give a brief overview on the platelet contribution to antiviral immunity and response during SARS-CoV-2 infection.

Influenza epidemiology and risk factors for severe acute respiratory infection in Morocco during the 2016/2017 and 2017/2018 seasons.

INTRODUCTION: in order to implement an influenza vaccination program for high-risk-groups in Morocco, as recommended by the World Health Organization, an epidemiological study indicating the influenza virus effect in the development of complicated influenza for subjects with co-morbidity was required. The present study aims to evaluate the risk factors for severe acute respiratory infections caused by influenza in risk groups. METHODS: this research is based on the epidemiological and virological surveillance data of severe acute respiratory infections and influenza-like illness during the 2016/2017 and 2017/2018 seasons. It was realized using a retrospective series study with a descriptive and analytical purpose. RESULTS: the over-recruitment of pediatric cases with a severe acute respiratory infection has been significantly rectified because cases of severe acute respiratory infections under 15 years old in the 2017/2018 season represent only 57.9%, whereas they represented 75.9% of the total cases of severe acute respiratory infections during the 2016/2017 season. The influenza positivity rate has increased globally and specifically by age group, clinical service and co-morbidity. The risk factors considered were significantly associated with hospitalization for influenza-associated severe acute respiratory infections. The multivariate logistic regression analysis considers male sex (OR=2.1), age ≥65 years (OR=5.4), presence of influenza cases in the surroundings (OR=0.1), diabetes (OR=7.5) and chronic respiratory disease (OR=10.9) as risk factors influenza-associated severe acute respiratory infections. CONCLUSION: the risk assessment of influenza-associated severe acute respiratory infections in high-risk groups revealed national epidemiological findings, particularly for diabetics and the elderly. An influenza vaccination program for these high-risk-groups becomes much recommended in Morocco.

3D culture of mouse gastric stem cells using porous microcarriers.

The lining epithelium of the stomach includes multipotent stem cells which undergo proliferation and migration-associated differentiation. These cells give rise to multiple cell lineages that produce mucus, acid, pepsinogen and various hormones/peptides. A 3D culture for stem cells would facilitate identification of the factors that control proliferation and/or differentiation programs. Here, we report on the use of disk-like ImmobaSil HD silicone-rubber matrix based microcarriers that are permeable to oxygen and reduce the creation of toxic environment within the center of the microcarrierd for culturing the mouse gastric stem (mGS) cells. We define several parameters that affect the initial cell attachment such as size of cell inoculum, serum concentration, mode and speed of agitation. We show that although such a microcarrier allows for attachment and growth of gastric stem cells, it does not lend itself and does not support the functional differentiation of such cells.

Enhancement of monoclonal antibody production in CHO cells by exposure to He-Ne laser radiation.

This study tested the effectiveness of laser biostimulation in small-scale cultures in vitro. We investigated the response of recombinant CHO cells, which are used for the production of monoclonal antibody, to low level laser radiation. The cells were irradiated using a 632.8 nm He-Ne laser in a continuous wave mode at different energy doses. We incubated the irradiated cells in small batch cultures and assessed their proliferation and productivity at various time intervals. Compared to untreated cells, the irradiated cells showed a significant increase in antibody production. Moreover, the results showed that laser irradiation did not affect viability and slightly enhanced proliferation rate.

Cellular and transcriptomic analysis of human mesenchymal stem cell response to plasma-activated hydroxyapatite coating.

Atmospheric pressure plasma has recently emerged as a technique with a promising future in the medical field. In this work we used the technique as a post-deposition modification process as a means to activate hydroxyapatite (HA) coatings. Contact angle goniometry, optical profilometry, scanning electron microscopy morphology imaging and X-ray photoelectron spectroscopy analysis demonstrate that surface wettability is improved after treatment, without inducing any concomitant damage to the coating. The protein adsorption pattern has been found to be preferable for MSC, and this may result in greater cell attachment and adhesion to plasma-activated HA than to untreated samples. Cell cycle distribution analysis using flow cytometry reveals a faster transition from G(1) to S phase, thus leading to a faster cell proliferation rate on plasma-activated HA. This indicates that the improvement in surface wettability independently enhances cell attachment and cell proliferation, which is possibly mediated by FAK phosphorylation. Pathway-specific polymerase chain reaction arrays revealed that wettability has a substantial influence on gene expression during osteogenic differentiation of human MSC. Plasma-activated HA tends to enhance this process by systemically deregulating multiple genes. In addition, the majority of these deregulated genes had been appropriately translated, as confirmed by ELISA protein quantification. Lastly, alizarin red staining showed that plasma-activated HA is capable of improving mineralization for up to 3 weeks of in vitro culture. It was concluded from this study that atmospheric pressure plasma is a potent tool for modifying the biological function of a material without causing thermal damage, such that adhesion molecules and drugs might be deposited on the original coating to improve performance.

In vitro and in vivo bioactivity of CoBlast hydroxyapatite coating and the effect of impaction on its osteoconductivity.

The novel non-thermal CoBlast process has been used recently to create a hydroxyapatite coating on metallic substrates with improved biological response compared to an uncoated implant. In this study, we compared the biological effect of coatings deposited by this process and the industrial standard technique - plasma-spray. Physicochemical properties of these two coatings have been found to be significantly different in that CoBlast HA is less rough but more hydrophilic than the plasma-spray HA as evidenced by data obtained from profilometry and goniometry. Mesenchymal stem cell attachment and adhesion are enhanced on CoBlast HA. Analysis by a combination of EDX and ICP suggests that the higher crystallinity retained by the CoBlast HA result in slower coating dissolution. Detailed in vitro evaluation reveals that plasma-spray HA might induce slightly faster cell proliferation and earlier osteogenic differentiation, but CoBlast HA becomes equivalent to it by the late osteogenic stage. PCR array facilitated the identification of differentially regulated genes involved in various functional aspects of in vitro osteogenesis by the CoBlast HA coating. The expression level of the functional protein products of these genes are in agreement with the PCR data. Coating metallic screws with HA significantly improves the in vivo osseointegration. By measuring of removal force using torque measurement instrument and analyzing the patterns found in X-ray images it is demonstrated that the two HA coatings elicit comparable osseointegration. Using simulated impaction model, CoBlast HA is shown to maintain better performance in cell attachment and mineralization than plasma-spray HA, especially following significant impactions. This might indicate a potentially greater osteoconductivity of CoBlast HA coating in shear-stress associated surgical applications. Collectively, it was demonstrated that CoBlast HA is an effective alternative to plasma-spray HA coating and a promising replacement for specialized surgical applications.

Osteoconductivity and growth factor production by MG63 osteoblastic cells on bioglass-coated orthopedic implants.

We have produced Bioglass coatings for Orthopedic implants by using a novel coating technique, CoBlast. The two resultant surfaces, designated BG and hydroxyapatite (HA)/BG, were compared with their HA counterpart, OsteoZip in terms of osteoblastic cell attachment, adhesion, proliferation, differentiation, and growth factor production. BG and HA/BG were demonstrated by goniometry to be more hydrophilic than OsteoZip. This corresponded to enhanced protein adsorption, cell attachment, and cell adhesion documented by both quantitative and qualitative assessments. BG and HA/BG surfaces had a significant initial release of Si and Ca ions, and this was consistent with elevated cell proliferation and basic fibroblast growth factor levels. However, OsteoZip, being similar to HA/BG, exhibited better osteogenic differentiation than BG did, shown by augmented differentiation marker activity at both protein and mRNA levels. Sandwich ELISA was used to quantify angiopoietin and inducible nitric oxide synthase which are involved in peri-prosthetic angiogenesis and aseptic loosening of total hip replacement, respectively. Both Bioglass-derived coatings provide superior initial osteoconductivity to OsteoZip, and HA/Bioglass composite coating outruns in long-term osteogenic differentiation and prognostic bioprocesses. The novel coatings discovered in this study have significant potential in providing both orthopedic and therapeutic functions.

Monitoring pH and dissolved oxygen in mammalian cell culture using optical sensors.

Here, we have studied two parameters critical to process control in mammalian cell culture; dissolved oxygen (dO(2)) and pH, measured with fluorescent sensors thus allowing the study of the metabolic state of cells in culture without removing or damaging cells during cultivation. Two cell lines, namely, NS0 and CHO were batch-grown in 24-well plates at different serum concentrations with the sensors implemented in the bottom of each well. The data showed a good relationship between the dO(2) and pH data obtained from fluorescent probes and the growth and death characteristics of cells. The method has provided a high throughput on-line multi-parametric analysis of mammalian cell cellular activity.

Prediction of recombinant protein production in an insect cell-baculovirus system using a flow cytometric technique.

The baculovirus expression vector system (BEVS) utilising the Autographa californica nucleopolyhedrovirus (AcMNPV) is widely becoming the system of choice for the production of many recombinant protein products due to the high yields obtained. However, there is a need to develop a simple reliable on-line method to monitor the production of recombinant proteins that have no intrinsic reporter properties. Here we utilise flow cytometry to measure cell size, granularity and DNA content in a single step analysis and correlate these parameters with the production of the recombinant protein beta-galactosidase. Clear correlations between these parameters and productivity are made with forward and side scatter signals showing the highest correlation coefficients. Measuring these parameters does not require any processing of the cells from culture to analysis. These parameters can therefore be used successfully to predict the amount of recombinant protein product in a BEVS system on-line.

The role of p21cip1 in adaptation of CHO cells to suspension and protein-free culture.

The up-regulation of cyclin-dependent kinase inhibitor p21 has been shown to enhance productivity of monoclonal antibodies and has been linked to various regulatory processes. To identify the potential role of p21 in adaptation to suspension and protein-free cultures, we studied the survival and growth of anchorage- and serum-dependent CHO cell lines that differed only in the period of p21-induced arrest. p21 overexpression led to rapid adaptation of cells to suspension and protein-free cultures. The period taken to achieve adaptation was correlated with the time the cells were arrested after transfer from the monolayer and serum-fed culture. Interestingly, cell aggregation associated with protein-free suspension culture was reduced in p21 culture in response to the loss of cellular adherence. The processes of adaptation to suspension and arrest did not decrease monoclonal antibody productivity. In contrast, following adaptation to protein-free growth media, an overall increase in specific productivity was observed. The ability of cells to survive in protein-free suspension cultures was due to the requirement of G1 cells to growth factors and to their relatively high resistance to the hydrodynamic forces. This improved process has the advantage of reducing the duration of critical path activity for developing CHO commercial cell lines from 72 to 36 days.

Non-invasive flow cytometric monitoring of pHi in cell culture processes using EGFP.

We have described a new method for monitoring of cell culture processes using green fluorescent protein (GFP) fluorescent intensity. GFP has been used as a non-invasive fluorescent reporter for various cellular processes. In this study, enhanced (EGFP) was found to be a very sensitive indicator of pHi in in vitro cell culture, and responded rapidly to extracellular pH (pHe) changes. EGFP transfected cells were evaluated for pHi changes by flow cytometry, by measuring EGFP fluorescent intensity, and compared to that of the pH-sensitive fluoroprobe, SNARF. EGFP intensity was found to reflect pHi values of cells at different pHe in the presence of nigericin and was affected by the addition of HCl and NaOH. Significant changes in pHi were detected at different stages of batch culture and when using different cell density and media composition. The EGFP assay can be used to minimise the perturbation of cells and processes under study, thus leading to accurate information about the physiological state of single cells in a population. The results establish the application of EGFP as a non-invasive indicator of pHi for monitoring of mammalian cell culture processes.

Molecular analysis of the sex-determining region of the platyfish Xiphophorus maculatus.

Due to the presence of genetically well-defined sex chromosomes, with a relatively restricted sex-determination region containing markers identified at the molecular level, the platyfish Xiphophorus maculatus is one of the best models for the positional cloning of a master sex-determining gene in fish. Both male and female heterogametes and three different types of sex chromosomes have been described in the platyfish, with several loci involved in pigmentation, melanoma formation, and sexual maturity closely linked to the master sex-determining locus. Using the melanoma-inducing oncogene Xmrk, its protooncogenic counterpart egfrb, as well as other X- and Y-linked molecular markers, bacterial artificial chromosome (BAC) contigs have been assembled for the sex-determining region of X. maculatus, which was mapped by fluorescent in situ hybridization to the subtelomeric region of the sex chromosomes. Initial sequence analysis of these contigs revealed several gene candidates and uncovered syntenies with different mammalian and chicken autosomes, supporting an independent origin of sex chromosomes in platyfish and tetrapods. Strikingly, the sex determination region of the platyfish is very instable and frequently undergoes duplications, deletions, and transpositions. This instability might be linked to the high genetic variability affecting sex determination and other sex-linked traits in Xiphophorus.

NucleoCounter-An efficient technique for the determination of cell number and viability in animal cell culture processes.

The NucleoCounter is a novel, portable cell counting device based on the principle of fluorescence microscopy. The present work establishes its use with animal cells and checks its reliability, consistency and accuracy in comparison with other cytometric techniques. The main advantages of this technique are its ability to handle a large number of samples with a high degree of precision and its simplicity and specificity in detecting viable cells quantitatively in a heterogeneous culture. The work addresses and overcomes the problems of subjectivity, and some of the inherent sampling errors associated with using the traditional haemocytometer and Trypan Blue exclusion method. NucleoCounter offers reduced intra- and inter-observer variation as well as consistency in repetitive analysis that establishes it as an efficient and highly potential device for at-line monitoring of animal cell processes. Furthermore, since the only manual steps required are sample aspiration and mixing with two reagents, it is feasible that the whole method could be automated and brought on-line for process monitoring and control.

[Comparative analysis of genetic structure of 2 species of marine fish Dicentrarchus labrax and Dicentrarchus punctatus]. / Analyse comparée de la structure génétique de deux espèces de poissons marins apparentées et sympatriques Dicentrarchus labrax et Dicentrarchus punctatus.

We present here the genetic structure existing among five samples of the spotted sea bass Dicentrarchus punctatus, and we compare it to what prevails in the common sea bass D. labrax, a congeneric species sampled on almost the same geographical range. A genetic distance tree inferred from the polymorphism at six microsatellite loci shows a distinct pattern for the two species. D. labrax samples appears to be genetically more homogeneous with a global Fst of 3% as compared to the 10% observed at D. punctatus, indicating a lesser level of gene flow in the latter species. While appearing more differentiated, D. punctatus presents no clear geographical organisation of its genetic variability in opposition to D. labrax samples. This allows us to propose this pair of closely relative species as a good candidate for the study by comparative analysis of the biological and/or historical factors affecting genetic differentiation in marine environment.