Potential antioxidant, α-glucosidase, butyrylcholinesterase and acetylcholinesterase inhibitory activities of major constituents isolated from Alpinia officinarum hance rhizomes: computational studies and in vitro validation.

Alpinia officinarum is a commonly used spice with proven folk uses in various traditional medicines. In the current study, six compounds were isolated from its rhizomes, compounds 1-3 were identified as diarylheptanoids, while 4-6 were identified as flavonoids and phenolic acids. The isolated compounds were subjected to virtual screening against α-glucosidase, butyrylcholinesterase (BChE), and acetylcholinesterase (AChE) enzymes to evaluate their potential antidiabetic and anti-Alzheimer's activities. Molecular docking and dynamics studies revealed that 3 exhibited a strong binding affinity to human a α- glucosidase crystal structure compared to acarbose. Furthermore, 2 and 5 demonstrated high potency against AChE. The virtual screening results were further supported by in vitro assays, which assessed the compounds' effects on α-glucosidase, cholinesterases, and their antioxidant activities. 5-Hydroxy-7-(4-hydroxy-3-methoxyphenyl)-1-phenylheptan-3-one (2) showed potent antioxidant effect in both ABTs and ORAC assays, while p-hydroxy cinnamic acid (6) was the most potent in the ORAC assay. In contrary, kaempferide (4) and galangin (5) showed the most potent effect in metal chelation assay. 5-Hydroxy-1,7-diphenylhepta-4,6-dien-3-one (3) and 6 revealed the most potent effect as α-glucosidase inhibitors where compound 3 showed more potent effect compared to acarbose. Galangin (5) revealed a higher selectivity to BChE, while 2 showed the most potent activity to (AChE).

Numerical investigation of sand erosion rate in a horizontal axis wind turbine.

Renewable energy represents an important alternative solution for many energy problems nowadays and a tool for a healthier environment by reducing carbon footprints resulting from burning fossil fuels. However, more work needs to be done towards maximizing the energy produced from renewable energy methods and making sure that the infrastructure used stays in service for a longer duration. Sand erosion phenomena is responsible for the degradation of the wind turbine blades and hence the decrease in their performance and life. In the current research, a numerical study of both performance and sand erosion of a Small-Scale Horizontal Axis Wind Turbine (SS-HAWT) is carried out. This study introduces new sights of instantaneous and forecasted erosion rates within the blade of the wind turbines. Three-dimensional E216 airfoil blades of radius 0.5 m are established according to blade element momentum theory. Sand particles with different mass flow rates of 0.001, 0.002 and 0.003 kg/s and uniform diameters of 50, 100 and 200 µm have been selected as eroding particles under two different average air velocities of 8 m/s and 10 m/s. The results indicate that the performance of wind turbines is enhanced as the flow separation at the suction side is shifted to the trailing edge. Furthermore, the optimum tip speed ratio is about 5 at an air velocity of 8 m/s with a power coefficient of 0.432. In terms of erosion findings, V-shaped scars are reported near the leading edge of the blades. In addition, the instantaneous erosion rate grows exponentially with the tip speed ratio. Therefore, the yearly prediction of maximum erosion depth at the optimum operating conditions is obtained to be 5.7 mm/year in some spots of the turbine blades.

Isolated laryngeal tuberculosis: A diagnostic dilemma.

INTRODUCTION AND IMPORTANCE: Primary laryngeal tuberculosis (PLTB) is a rare condition. The symptoms and findings are not specific in most of the cases. Patients are diagnosed essentially based on histopathological examination and mycobacterial culture. CASE REPORT: We report the case of a 42-year-old woman who presented to our hospital with dysphonia and dysphagia. Direct laryngoscopy revealed a lesion of the supraglottis. CT scan found a diffuse thickening of the entire surface of the larynx. A biopsy confirmed the diagnosis of tuberculosis. CLINICAL DISCUSSION: Primary laryngeal tuberculosis is a rare clinical entity despite its close anatomical and physiological proximity to the lungs. CONCLUSION: Clinician should keep in mind the existence of primary laryngeal tuberculosis to avoid delayed diagnosis and treatment, which can lead to high morbidity and mortality.

[Long Noncoding RNAs MEG3, TUG1, and hsa-miR-21-3p Are Potential Diagnostic Biomarkers for Coronary Artery Disease].

Peripheral blood biomarkers are of particular importance to diagnose certain diseases including coronary artery disease (CAD) due to their non-invasiveness. Investigating the expression of noncoding RNAs (ncRNAs) paves the way to early disease diagnosis, prognosis, and treatment. Consequently, in this research, we aimed to investigate a panel of ncRNAs as potential biomarkers in patients with coronary artery disease. Two different groups have been designed (control and CAD). All participants were subjected to interviews and clinical examinations. Peripheral blood samples were collected, and plasma was extracted. At the same time, target ncRNAs have been selected based on literature review and bioinformatic analysis, and later they underwent investigation using quantitative real-time PCR. The selected panel encompassed the long non-coding RNAs (lncRNAs) MEG3, TUG1, and SRA1, and one related microRNA (miRNA): hsa-miR-21-3p. We observed statistically significant upregulation in MEG3, TUG1, and hsa-miR21-3p in CAD patients compared to control participants (p-value < 0.01). Nevertheless, SRA1 exhibited downregulation with no statistical significance (p-value > 0.05). All ncRNAs under study displayed a significantly strong correlation with disease incidence, age, and smoking. Network construction revealed a strong relationship between MEG3 and TUG1. ROC analysis indicated high potentiality for hsa-miR-21-3p to be a promising biomarker for CAD. Moreover, MEG3 and TUG1 displayed distinguished diagnostic discrimination but less than hsa-miR-21-3p, all of them exhibited strong statistical significance differences between CAD and control groups. Conclusively, this research pinpointed that MEG3, TUG1, and hsa-miR-21-3p are potential biomarkers of CAD incidence and diagnosis.

Epidemiological manifestations and impact of healthcare-associated infections in Libyan national hospitals.

BACKGROUND: Healthcare-associated infection is a serious global problem, particularly in developing countries. In North African countries, comprehensive research on the incidence and effects of such infections is rare. This study evaluated the epidemiology and determined the impact of healthcare-associated infections in Libyan national teaching hospitals. METHODS: A prospective longitudinal study was carried out in Libya's four largest teaching and referral hospitals (Tripoli Medical Center, Tripoli-Central Hospital, Benghazi Medical Center, and Sabha Medical Center) from November 1, 2021, to October 31, 2022. The epidemiological events and the parameters incorporated in this study were based on the data published by the Libyan Centers for Disease Control. The surveillance was carried out on all patients admitted to the wards of medicine, surgery, intensive care, gynecology & obstetrics, and pediatrics in all four hospitals. Trained staff reviewed the medical records and compared the percentages of patients with healthcare-associated infections. Bio-statistical and multivariable logistic regression analyses were carried out to test the variables associated with healthcare-associated infections and the resulting deaths. RESULTS: A total of 22,170 hospitalized patients in four hospitals were included in the study. Hospital-acquired infection was reported in 3037 patients (13.7%; 95% CI: 12.9-14.4%). The highest incidence was in Benghazi Medical Center (17.9%; 95% CI: 16.9-18.7%), followed by Sabha Medical Center (14.8%; 95% CI:14.9-16.51%). Surgical site infection was the most prevalent (31.3%), followed by ventilator-associated pneumonia (29.3%), urinary tract infection (26.8%), and bloodstream infection (12.6%). Patients with healthcare-associated infections experienced severe morbidity requiring intervention. New antimicrobial regimens were needed for 1836 patients (93%), and 752 patients (34%) required admission to intensive care. Surgical intervention, respiratory support, and inotropes were also needed as a consequence of HAI events. CONCLUSIONS: The high incidence of healthcare-associated infections in Libyan hospitals should be considered a major problem and a serious burden. This should alert healthcare authorities at the national and hospital levels to the urgent need for preventive and control strategies to combat hospital-acquired infections.

Ameliorative Effects of some Natural Antioxidants against Blood and Cardiovascular Toxicity of Oral Subchronic Exposure to Silicon Dioxide, Aluminum Oxide, or Zinc Oxide Nanoparticles in Wistar Rats.

The present study determines the possible protective role of fig fruit extract with olive oil and date palm fruit extract (FOD) in decreasing the oral subchronic blood and cardiovascular toxicity of SiO2NPs, Al2O3NPs, or ZnONPs. The present study used 80 male Wistar rats (8 groups, n = 10) distributed according to the treatment. The FOD treatments were used at their recommended antioxidant doses. All nanoparticles (NPs) were given orally and daily at doses of 100 mg/kg for 75 days. The oral administration of different NPs alone led to dramatic, oxidative stress, inflammatory markers, blood coagulation, endothelial dysfunction markers, myocardial enzymes, hematological parameters, lipid profile, and histopathological features compared with the control group. The FOD-NP-treated groups recorded significantly ameliorated blood and cardiovascular toxicity hazards compared to the groups administered with the NPs alone. In conclusion, the administration of FOD provides considerable chemopreventive and ameliorative effects against NP toxicity.

In Vitro and In Silico Pharmacological and Cosmeceutical Potential of Ten Essential Oils from Aromatic Medicinal Plants from the Mascarene Islands.

In this study, 10 essential oils (EOs), from nine plants (Cinnamomum camphora, Curcuma longa, Citrus aurantium, Morinda citrifolia, Petroselinum crispum, Plectranthus amboinicus, Pittosporum senacia, Syzygium coriaceum, and Syzygium samarangense) were assessed for their antimicrobial, antiaging and antiproliferative properties. While only S. coriaceum, P. amboinicus (MIC: 0.50 mg/mL) and M. citrifolia (MIC: 2 mg/mL) EOs showed activity against Cutibacterium acnes, all EOs except S. samarangense EO demonstrated activity against Mycobacterium smegmatis (MIC: 0.125-0.50 mg/mL). The EOs were either fungistatic or fungicidal against one or both tested Candida species with minimum inhibitory/fungicidal concentrations of 0.016-32 mg/mL. The EOs also inhibited one or both key enzymes involved in skin aging, elastase and collagenase (IC50: 89.22-459.2 µg/mL; 0.17-0.18 mg/mL, respectively). Turmerone, previously identified in the C. longa EO, showed the highest binding affinity with the enzymes (binding energy: -5.11 and -6.64 kcal/mol). Only C. aurantium leaf, C. longa, P. amboinicus, P. senacia, S. coriaceum, and S. samarangense EOs were cytotoxic to the human malignant melanoma cells, UCT-MEL1 (IC50: 88.91-277.25 µg/mL). All the EOs, except M. citrifolia EO, were also cytotoxic to the human keratinocytes non-tumorigenic cells, HaCat (IC50: 33.73-250.90 µg/mL). Altogether, some interesting therapeutic properties of the EOs of pharmacological/cosmeceutical interests were observed, which warrants further investigations.

The synbiotic mixture of Bacillus licheniformis and Saccharomyces cerevisiae extract aggravates dextran sulfate sodium induced colitis in rats.

BACKGROUND: Uncertain effects of probiotics and/or prebiotics have been reported in experimental and clinical colitis. This study aims to examine the effects of a synbiotic combination comprising Bacillus licheniformis DSM 17236 and Saccharomyces cerevisiae cell wall extract on dextran sulfate sodium (DSS)-induced colitis in Sprague Dawley rats. METHODS: Acute colitis was induced in rats by oral administration of DSS 3.5% for 7 days. Fifty rats were divided equally into five groups; one control group and the other groups were induced with colitis and treated with or without the tested synbiotic, mixed with diet, for 28 days and sulfasalazine (100 mg/kg) via intragastric tube once daily for 14 days. RESULTS: Symptomatically, the synbiotic administration raised the disease activity index (DAI) to comparable scores of the DSS group, specially from the 2nd to 7th days post DSS intoxication. It also induced a significant (p < 0.05) amplification of WBCs, myeloperoxidase (MPO), malondialdehyde (MDA), nuclear factor kappa B (NF-kB) expression and proinflammatory cytokines tumor necrosis factor alpha (TNFα), interferon gamma (INFγ), and interleukin-1 beta (IL-1ß) while depressed the antioxidant enzymes glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD) when compared with the DSS and control groups. The DSS intoxicated and Synbiotic+DSS groups showed desquamations of the covering epithelium, noticeable diffuse leukocytic infiltrations, sever catarrhal enteritis, ischemic colitis with diffuse coagulative necrosis of the entire colonic mucosa. Contrarily, sulfasalazine proved to be effective in the reduction of the tested inflammatory markers and the pathological degenerative changes of the DSS ulcerative colitis. CONCLUSION: The examined synbiotic did not ameliorate but aggravated the DSS-induced colitis, so it should be subjected to intensive experimental and clinical testing before their use in animals and human.

Prevalence of extended-spectrum ß-lactamase-producing Enterobacterales in retail sheep meat from Zagazig city, Egypt.

BACKGROUND: The goal of this study was to investigate the prevalence of extended-spectrum ß-lactamase production in Enterobacterales isolated from retail sheep meat in Zagazig, Egypt. METHODS: One hundred random samples of sheep meat were collected from different retail butcher shops (n = 5) in the city of Zagazig, Egypt. Bacterial isolates were identified by MALDI-TOF MS and screened for antibiotic susceptibility by disk diffusion; further genotypic characterization of ß-lactamase-encoding genes was performed with Real-Time PCR. E. coli strains were phylotyped with the Clermont triplex PCR method. RESULTS: Of the total of 101 bacterial isolates recovered from retail sheep meat samples, 93 were E. coli, six were Enterobacter cloacae and two were Proteus mirabilis. As many as 17% of these 100 samples showed ESBL phenotypes, all were E. coli. The blaCTX-M genes were detected in seven isolates (six were blaCTX-M-15 and one was blaCTX-M-14), three isolates harboured blaTEM (all were blaTEM-one), and two carried genes of the blaSHV family (both were blaSHV-12). Eight E. coli isolates expressed ESBL phenotype but no blaTEM, blaSHV or blaCTX-M genes were detected by PCR. ESBL- positive E. coli isolates were nearly equally distributed over the commensal groups A/B1 and the virulent group D. CONCLUSION: Nearly one in five sheep meat samples was contaminated with ESBL-E. coli. This further corroborates the potential role played by contaminated meat in the increasing resistance rates that have been reported worldwide.

Skeletal muscle atrophy and myosteatosis are not related to long-term aneurysmal subarachnoid hemorrhage outcome.

The prognosis of aneurysmal subarachnoid hemorrhage (aSAH) is highly variable. This study aims to investigate whether skeletal muscle atrophy and myosteatosis are associated with poor outcome after aSAH. In this study, a cohort of 293 consecutive aSAH-patients admitted during a 4-year period was retrospectively analyzed. Cross-sectional muscle measurements were obtained at the level of the third cervical vertebra. Muscle atrophy was defined by a sex-specific cutoff value. Myosteatosis was defined by a BMI-specific cutoff value. Poor neurological outcome was defined as modified Rankin Scale 4-6 at 2 and 6-month follow-up. Patient survival state was checked until January 2021. Generalized estimating equation was performed to assess the effect of muscle atrophy / myosteatosis on poor neurological outcome after aSAH. Cox regression was performed to analyze the impact of muscle atrophy and myosteatosis on overall survival. The study found that myosteatosis was associated with poor neurological condition (WFNS 4-5) at admission after adjusting for covariates (odds ratio [OR] 2.01; 95%CI 1.05,3.83; P = .03). It was not associated with overall survival (P = .89) or with poor neurological outcomes (P = .18) when adjusted for other prognostic markers. Muscle atrophy was not associated with overall survival (P = .58) or neurological outcome (P = .32) after aSAH. In conclusion, myosteatosis was found to be associated with poor physical condition directly after onset of aSAH. Skeletal muscle atrophy and myosteatosis were however irrelevant to outcome in the Western-European aSAH patient. Future studies are needed to validate these finding.

Clinical Applications of Quantitative Perfusion Imaging with a C-Arm Flat-Panel Detector-A Systematic Review.

C-arm systems with digital flat-panel detectors are used in interventional radiology and hybrid operating rooms for visualizing and performing interventions on three-dimensional structures. Advances in C-arm technology have enabled intraoperative quantitative perfusion imaging with these scanners. This systematic review provides an overview of flat-panel detector C-arm techniques for quantifying perfusion, their clinical applications, and their validation. A systematic search was performed for articles published between January 2000 and October 2022 in which a flat-panel detector C-arm technique for quantifying perfusion was compared with a reference technique. Nine articles were retrieved describing two techniques: two-dimensional perfusion angiography (n = 5) and dual-phase cone beam computed tomography perfusion (n = 4). A quality assessment revealed no concerns about the applicability of the studies. The risk of bias was relatively high for the index and reference tests. Both techniques demonstrated potential for clinical application; however, weak-to-moderate correlations were reported between them and the reference techniques. In conclusion, both techniques could add new possibilities to treatment planning and follow-up; however, the available literature is relatively scarce and heterogeneous. Larger-scale randomized prospective studies focusing on clinical outcomes and standardization are required for the full understanding and clinical implementation of these techniques.

A new framework for warehouse assessment using a Genetic-Algorithm driven analytic network process.

A novel way of integrating the genetic algorithm (GA) and the analytic network process (ANP) is presented in this paper in order to develop a new warehouse assessment scheme, which is developed through various stages. First, we define the main criteria that influence a warehouse performance. The proposed algorithm that integrates the GA with the ANP is then utilized to determine the relative importance values of the defined criteria and sub-criteria by considering the interrelationships among them, and assign strength values for such interrelationships. Such an algorithm is also employed to linguistically present the relative importance and the strength of the interrelationships in a way that can circumvent the use of pairwise comparisons. Finally, the audit checklist that consists of questions related to the criteria is integrated with the proposed algorithm for the development of the warehouse assessment scheme. Validated on 45 warehouses, the proposed scheme has been shown to be able to identify the warehouse competitive advantages and the areas where more improvements can be achieved.

The Epidemiological and Spatiotemporal Characteristics of the 2019 Novel Coronavirus Disease (COVID-19) in Libya.

COVID-19 is a global pandemic that has affected all aspects of life. Understanding its geographical and epidemiological characteristics has become particularly important in controlling the spread of the pandemic. Such studies are lacking in North African countries, particularly in Libya, which has the second largest area of any country in Africa and the longest coast facing Europe. The objectives of this study are to determine the epidemiological parameters and spatiotemporal patterns of COVID-19 and outline strategies for containing the spread and consequences of the pandemic. This comprehensive study included all the confirmed cases of COVID-19 since its emergence in Libya on March 24, 2020 until July 31, 2020. The epidemiological characteristics of COVID-19 were analyzed and the spatial dynamic trends were explored. Regional counts of weekly reported cases were used to characterize the spatial dynamics of COVID-19. A total of 3,695 confirmed cases of COVID-19 were recorded: 2,515 men (68.1%) and 1,180 women (31.9%), with a male-to-female ratio of 2.1:1. Ages ranged between 2 and 78 years. Older patients infected with COVID-19 were at a risk of higher disease severity and mortality. Broad geographic variability and spatiotemporal spread variation of the COVID-19 pandemic in Libya was observed, indicating a significant increase of COVID-19 spread starting in the middle of July 2020, particularly in the western and southern regions, although it was consistently reported in the central and eastern regions as well. Assessing the spatiotemporal dynamics of COVID-19 in the early stages of the epidemic is particularly important in understanding the pandemic spread. Such assessments are essential for designing effective prevention and control programs aimed at reducing the impact of the COVID- 19 pandemic, particularly in countries with limited resources.

Comorbidities, mortality and survival in patients with pyoderma gangrenosum: a Danish nationwide registry-nested case-control study.

BACKGROUND: Pyoderma gangrenosum (PG) is an ulcerative skin disease associated with comorbidities and increased mortality; however, the literature on this topic is scarce. OBJECTIVES: To investigate the mortality, prevalence and risk of comorbidities in patients with PG. METHODS: This nationwide registry nested case-control study included all inpatients and outpatients diagnosed with PG in tertiary dermatology centres in Denmark between 1 January 1994 and 31 December 2016. Each case was matched on date of birth and sex with 10 unique controls. The Danish National Patient Registry was used to identify all patients and to gather information on comorbidity. Information on age, sex, vital status and emigration was obtained from the Danish Civil Registration System. The outcomes were 19 different comorbidities and all-cause mortality. Prevalence was assessed from odds ratios (ORs) for specific comorbidities at the time of PG diagnosis. The risk of developing specific comorbidities and death was assessed using hazard ratios (HRs) obtained using the Cox proportional-hazards model. RESULTS: A total of 1604 patients with PG were matched with 16 039 controls. Some associations were known, e.g. inflammatory bowel disease [OR 19·15 (15·27-24·02), HR 6·51 (4·24-10·01)], while others have not been described previously, e.g. osteoporosis [OR 1·57 (1·22-2·02), HR 2·59 (2·08-3·22)]. Mortality was significantly increased among patients with PG [HR 2·79 (2·57-3·03)]. CONCLUSIONS: Patients with PG have increased mortality and an increased prevalence and risk of both previously reported and novel comorbidities that may have severe consequences if left undiagnosed. Our findings are mainly related to moderate and severe PG.

Effect of cereal type and plant extract addition on the growth performance, intestinal morphology, caecal microflora, and gut barriers gene expression of broiler chickens.

Feeding broiler chickens on diets based on cereal grains of high non-starch polysaccharides content such as wheat and barley can negatively impact their performance and gut health. Plant extracts can be used as a potential tool to alleviate these negative effects. The present study assessed the effects of dietary cereal type and the inclusion of a plant extract blend (PEB) on the growth performance, intestinal histomorphology, caecal microflora, and gene expression of selected biomarkers for gut integrity in broiler chickens in a 42-d experiment. Ross-308 male broilers were assigned into different dietary treatments and fed on two cereal types (corn- vs. wheat/barley-based) with/without added graded concentrations of a PEB (0, 250, 500, 1000, and 2000 mg/kg diet). There were no significant differences in the growth performance parameters, intestinal histomorphology, and caecal microflora due to the impact of dietary cereal type. However, lactobacilli count in the caecal microflora was increased in the group fed on a corn-based diet. The PEB supplementation especially at a level of 500 to 1000 mg/kg diet significantly increased the average BW and decreased the feed conversion ratio. It also increased the villi length of duodenum, jejunum, and ileum, decreased the duodenal crypt depth, and increased the villi length to crypt depth ratio in the duodenum, jejunum and ileum. Supplementation of the PEB decreased the total bacterial and coliform count and increased the lactobacilli count in a linear pattern. Gene expression of Occludin and Junction Adhesion Molecule was significantly increased in the PEB supplemented diets, whereby no influence was observed on mucin expression. In conclusion, supplementation of a PEB at levels of 500-1000 mg/kg can be used as a tool to improve broiler performance and gut health.

Gemcitabine induced pneumonitis: a case report and review of literature.

We are reporting a case of pneumonitis in an 81 year old-aged woman due to gemcitabine who was successfully managed with steroids. We also reviewed the literature and found previous case reports of gemcitabine induced pneumonitis.We reported this case to alert physicians to be aware of this infrequent and sometimes fatal complication from gemcitabine.

The Lebanese left ventricular assist device experience, a success story despite the odds.

BACKGROUND AND AIM: Heart failure is still a leading cause of mortality and morbidity. Assist devices are reserved for advanced heart failure patients with no other therapeutic options. We aim in this paper to describe the characteristics and outcome of Lebanese left ventricular assist device (LVAD) patients. RESULTS: From 2010 till December 2019, 78 patients were implanted with assist devices at the Beirut cardiac Institute, 82 pumps were used. To the most recent follow up after 10 years, 26 patients died (34%). 24 patients of 35 (68%) survived more than 5 years. Seven patients only (9%) died during one month of surgery. One year mortality was 19% (15 patients). The leading cause of early mortality was infection, whereas cerebrovascular accidents CVA were the leading cause of late mortality. Pump thrombosis occurred in 12% of the cases. The most serious long term complication was haemorrhagic CVA. Only seven patients (9%) received heart transplantation, with a mean time on support prior to transplantation of 1303 ± 213 days. CONCLUSION: In this manuscript we reported the characteristics and outcome of the largest population of LVAD patients in Lebanon. The survival rate was 81% at one year. These findings were comparable to the international registries except for rates of heart transplantation. More efforts should be made to encourage organ donation in Lebanon.