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Purpose: The objective of this review is to provide a comprehensive analysis of risk management practices in the healthcare sector, with a particular focus on identifying challenges and strategies in Moroccan hospitals., Design/methodology/approach: A literature search was carried out on several academic search engines using search terms reflecting the relationship between risk management and public hospitals in Morocco., Findings: The Moroccan public hospital is confronted with several disjunctions, which can be sources of multiple risks. This influences the quality of care provided to patients and can sometimes threaten their vital prognosis. The risk management process can help health professionals, researchers and risk managers to be agile and identify and anticipate risks in order to avoid serious accidents that can affect the whole organization, especially after the pandemic lived experiences (COVID-19)., Originality/value: Protecting human life in an environment where risks are omnipresent is a dilemma that every hospital organization must confront. So, risk management in the hospital is not a simple process, given the interaction of several components and the sensitivity of the field. Risk management in this establishment must be rigorous because every error can cost human life. In this sense, the analysis of risk management processes in Moroccan hospitals, based on what really exists, enables the identification of shortcomings in order to master the risk management system and thus protect goods and services as well as human life, which is the ultimate goal of the hospital organization's existence., (© Emerald Publishing Limited.)

Background: Anaemia remains the main cause of deferral in blood donation. However, in Morocco, pre-donation haemoglobin measurement is not systematic., Objectives: The aim of this study was to determine the prevalence of anaemia and associated factors such as sex, age and iron deficiency among blood donors in eastern Morocco in order to improve donor management practices., Methods/materials: The study involved 2013 blood donors from the BRO Biobank. Blood samples were analysed using an automatic blood cell analyser for complete blood counts. Serum ferritin was measured by chemical and immunological analyser. Anaemia was defined as haemoglobin levels less than 13 g/dL in men and 12 g/dL in women, according to the WHO recommendation., Results: The overall prevalence of anaemia in eastern Morocco was 9.84% and it varied significantly by region. The majority of anaemic individuals were iron-deprived (88.64%). Anaemia was much higher in females (14.74%) than in males (5.46%). The highest prevalence of anaemia among females was in the age group of 18-20 years (25.2%), while among males it was in the age group of 61-65 years (18.52%)., Conclusions: The high prevalence of anaemia among blood donors in eastern Morocco highlights the need to implement pre-donation haemoglobin assessment in donor selection guidelines and to consider optional ferritin testing for at-risk populations. Moreover, educating donors about iron deficiency and iron-rich diets is essential for sustaining donor health and eligibility., (© 2025 British Blood Transfusion Society.)

Fish mass mortality events (FMMEs) represent an escalating ecological crisis, significantly threatening aquatic biodiversity, particularly in North African freshwater ecosystems. Addressing a critical knowledge gap in this region, our study presents the first comprehensive assessment of FMMEs in Moroccan aquatic ecosystems, including freshwater systems and estuaries, based on meticulous monitoring from January 2020 to December 2022. During this three-year period, we documented 18 FMMEs across 16 distinct ecosystems, with a notable increase in frequency observed during the summer and autumn months. Estuaries emerged as critical hotspots for these events, exhibiting the highest frequency of FMMEs and highlighting their vulnerability to climatic and anthropogenic pressures. Our findings indicate a staggering loss of at least 7.8 million fish, with Atherina boyeri, accounted and identified as the most affected species by FMMEs. The families Cyprinidae and Mugilidae experienced the most substantial impacts, including significant biomass losses in Chelon saliens, Chelon labrosus, and Cyprinus carpio. Additionally, endemic species such as Luciobarbus maghrebensis and Luciobarbus rabatensis also faced considerable declines. These events underscore severe ecological disruptions and provide novel insights into species distribution and interactions, including the first recorded presence of Oreochromis niloticus in previously undocumented regions. This research underscores the urgent need for targeted conservation strategies and proactive interventions to mitigate the ecological and socioeconomic ramifications of FMMEs. By addressing these critical issues, we can better protect Moroccan freshwater ecosystems that are at risk of further biodiversity loss., Competing Interests: Declarations. Ethics approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objectives: Managing severe pneumonia remains a challenge. Rapid diagnostic tests, such as multiplex polymerase chain reaction (mPCR), facilitate quick microorganism identification and may enable timely and appropriate antimicrobial therapy. However, studies from low-income countries are scarce. This study aimed to evaluate the diagnostic characteristics of mPCR and its impact on antibiotic therapy and outcomes in critically ill patients with pneumonia., Design: Multicenter observational study., Setting: Twelve ICUs across Morocco., Patients: Adult patients with pneumonia requiring invasive mechanical ventilation, including community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP)., Interventions: None., Measurements and Main Results: Respiratory samples were analyzed using both mPCR and conventional microbiological methods. The diagnostic performance of mPCR was evaluated, including its sensitivity and specificity. Additionally, the appropriateness of mPCR-induced modifications in empiric antibiotic therapy and their impact on patient outcomes were assessed. A total of 210 patients were included, with a median age of 50 years (range, 33-67 yr), of whom 66.2% were male. Pneumonia types were distributed as 30% CAP, 58% VAP, and 12% HAP. mPCR demonstrated a sensitivity of 96.9% (95% CI, 92.3-99.2%) and a specificity of 92% (95% CI, 91-93%). Following mPCR, antibiotic therapy modifications were observed in 58% of patients (n = 122), including de-escalation or cessation in 11% (n = 23), escalation in 26.5% (n = 56), adequacy adjustments in 7.5% (n = 16), and initiation of antibiotics in 13% (n = 27). The appropriateness of antibiotic therapy increased significantly from 38.7% (n = 83) to 67% (n = 141; difference, 27.5%; 95% CI, 18.3-36.7; p < 0.0001). Generalized mixed model analysis revealed that appropriate post-mPCR antibiotic therapy was associated with reduced mortality (adjusted odds ratio, 0.37; 95% CI, 0.15-0.93; p = 0.038)., Conclusions: Our findings suggest that the use of mPCR is associated with a significant improvement in the appropriateness of empiric antibiotic therapy and is also associated with a positive impact on the outcome of patients with pneumonia., Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)

Cutaneous leishmaniasis (CL) is commonly seen in pediatric patients in endemic areas, including Morocco. This retrospective, single center study details 64 confirmed pediatric cases of CL treated with oral clarithromycin 15 mg/kg/day for 10 days per month, for a total of three months. Lesions improved in 96.8% of cases and the treatment was well tolerated. Clarithromycin seems a safe and effective alternative to intralesional injections of meglumine antimoniate., (© 2025 Wiley Periodicals LLC.)

In Morocco, pregnant women commonly use phytotherapy to facilitate childbirth. However, data on the safety and effects of medicinal plants during labor remain scarce and limited from a toxicological point of view. This retrospective descriptive study investigates the epidemiological, clinical and obstetric profiles of women who used medicinal plants during labor and delivery at the regional hospital of Guelmim. Data were collected from the records of women who gave birth between 2015 and 2021. A total of 22 523 files were examined, including 216 cases of women who had used medicinal plants during labor and delivery. Among these women, 57.8% were young primigravidas and primiparous women, the majority (83.79%) having received prenatal care and 78.24% of women having been admitted in the latency phase. In 65% of cases, delivery took place vaginally, with a significant reduction in the duration of labor. Nevertheless, 34.72% of women underwent a caesarean section. Complications were noted in 58.79% of cases: foetal and neonatal distress, post-partum haemorrhage, meconium-stained amniotic fluid, uterine hyperkinesis, premature rupture of membranes, neonatal death and perineal tears. These complications occurred in women who had used medicinal plants such as Lepidium sativum L., Crocus sativus L., Cinnamomum verum J. Presl. and Peganum harmala L, raising about a possible link. Further research is needed to better understand the effects of these plants and their consequences for maternal-foetal health. The frequent association of these plants with adverse effects suggests that they may contribute to the complications observed during labor and delivery. Further research is needed to assess the risks in the obstetric context and establish clear recommendations on its use.

Objective: The Mediterranean diet (MD) is a dietary pattern associated with several health benefits, including reduction of risk for various cancers. We conducted a study to investigate associations between adherence to the MD and colorectal cancer (CRC) subtype risk among Moroccan adults., Design: A matched case-control study., Setting: The five major university hospitals in Morocco., Participants: A total of 3032 subjects (1516 CRC patients and 1516 controls) matched on age, sex and center, were recruited between September 2009 and February 2017 at five major hospitals in Morocco. Diet was assessed using a validated Food Frequency Questionnaire (FFQ). Adherence to the Mediterranean diet was assessed through a score, ranging from 0 (no adherence) to 10 (maximal adherence) and divided into three categories (low, middle and high). Conditional logistic regression was performed to calculate multivariable odd ratios (OR) and 95% confidence intervals (CI) with low adherence (score 0-3) as referent, adjusting for potential confounding factors., Results: Close adherence to the Mediterranean diet (score 6-9) was associated with reduced risk of CRC (ORa = 0.74, 95% CI 0.63-0.86); rectal cancer (ORa = 0.73, 95% CI 0.58- 0.90) and colon cancer (ORa = 0.74, 95% CI 0.60-0.92)., Conclusion: Our study, conducted in a southern Mediterranean population, adds to the evidence suggesting a protective effect of MD against CRC risk.

This study assesses the impact of drought and upstream dam construction on agriculture in arid and semi-arid regions with the Middle Draa Valley (MDV) case study in Morocco. This valley, nestled in the arid landscapes of Morocco, has a rich tapestry of history, culture, and natural beauty. However, its oases are facing a water shortage crisis due to the effects of climate change and human pressure on water resources for irrigation. We analyzed the Standardized Precipitation Evapotranspiration Index (SPEI) and the Normalized Difference Vegetation Index (NDVI) to monitor vegetation dynamics in this valley. First, the SPEI shows a declining trend, indicating increasing water scarcity, which has led to the overexploitation of groundwater and significant vegetation degradation. Second, the NDVI remained relatively stable until 2015 but has since declined, signaling ecosystem deterioration. Third, the correlation between SPEI and NDVI in the oases suggests that vegetation depends not only on precipitation and evapotranspiration but also on other factors such as insufficient releases from upstream dams and the use of groundwater for irrigation. This is confirmed by analyses of the correlation between dam releases and NDVI, as well as data on groundwater table levels. This situation poses an urgent warning for decision-makers to consider which water management measures and agricultural practices to adopt. The most practical solution to avoid further degradation of the oases in the short term is to conserve the remaining groundwater resources exclusively for irrigation date palms and to develop strict long-term water policies., Competing Interests: Declarations. Ethics approval: All authors have read, understood, and have complied as applicable with the statement on “Ethical responsibilities of Authors” as found in the Instructions for Authors. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Cutaneous leishmaniasis is a significant public health concern globally. This study aims to evaluate the impact of cutaneous leishmaniasis on the quality of life of patients in the Draa-Tafilalet region of Morocco. In this cross-sectional study, data were collected from 87 patients between December 2022 and July 2023 using the Skindex-16 questionnaire. The results revealed that cutaneous leishmaniasis has a mild to moderate impact on health-related quality of life, with 26.4 % of participants reporting a low impact and 73.6 % reporting a moderate impact. A significant gender difference was observed in Skindex-16 scores, with moderate impact being more prevalent among females (60.90 % vs. 30.10 %, p = 0.002). Furthermore, facial lesions were associated with a statistically significant reduction in quality of life, particularly in the emotional (p < 0.001) and functioning (p = 0.01) domains. These findings highlight the need for targeted management strategies that address the substantial impact of cutaneous leishmaniasis on patients' quality of life. Future studies with larger sample sizes and extended follow-up periods are warranted to further elucidate the effects of cutaneous leishmaniasis on patients' well-being., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Moroccan Arabic is a regional variety of spoken Arabic that contains linguistic features, which make it distinct from other dialects. Moroccan Arabic, for instance, contains a larger number of words with consonant clusters, a result of a historical vowel reduction process, compared to other Eastern varieties. Even within Moroccan Arabic, there is variation across speakers that is relatively understudied. The present study investigates across- and within-speaker factors that condition variation in the duration of acoustic separation between adjacent consonants in word-initial clusters in Moroccan Arabic. Three factors are examined: speaking style (clear vs fast speech), speaker region of origin (the Easternmost region of Morocco vs other regions), and speaker first language (Moroccan Arabic vs an Amazigh language). It is determined that (1) speakers produce more frequent, and longer when present, consonant separation in clear speech; (2) Amazigh-Arabic bilingual speakers produce higher rates and longer durations of consonant separations between adjacent consonants; and (3) regional dialect variation is also observed: speakers of Easternmost Moroccan Arabic produce more frequent and longer consonant separations than speakers from other Moroccan regions. Results are discussed for implications of speech production models as well as for theories of sound change., (© 2025 Acoustical Society of America.)

The ethics committee for biomedical research of Casablanca (CERBC) was born within the Faculty of Medicine and Pharmacy of Casablanca (FMPC) in Morocco in 1989, following the impetus of some teachers who were aware, from their specialties and their concerns, to the protection of people who took part in clinical trials. From the start, the committee faced difficulties in giving itself regulatory legitimacy. Subsequently, it was necessary to make a major educational and communication effort with the medical staff in order to explain the notions of ethics and bioethics, which were unknown at the time to most of the doctors at the University Hospital. However, general medical ethics teaching has been provided to medical students at the Casablanca faculty since 1979. Thirty-five years after its creation, the sustainability of the CERBC is only due to the perseverance of its members and their activism with all authorities that directly or indirectly affect biomedical research in Morocco., (Copyright © 2024 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

A study was conducted to analyze the essential oil of Pulicaria mauritanica (PMEO) and investigate its antibacterial and antioxidant properties using in-vitro and in-silico methods. The essential oil was extracted using the hydrodistillation technique, and its chemical composition was identified via GC/MS analysis. The chemical composition of the oil shows that the major components of PMEO are carvotanacetone (67.92 %) followed by 2,5-dimethoxy-p-cymene (3.62 %), eucalyptol (1.76 %) and tetrahydrocarvone (1.32 %). The antibacterial and antioxidant effects against DPPH free radicals and ferric-reducing power were tested using in-vitro microdilution method. The antibacterial activity showed a strong sensitivity against Bacillus subtilis and Proteus mirabilis with an inhibition zone of (22.33±1.78 mm and 19.3±0.68 mm, respectively; the lowest MIC and MBC values were (MIC=MBC=1.56 mg/mL). However, computational studies were carried out using molecular docking studies. The analysis of the interaction nature between (PMEO) essential oil and tyrosyl-tRNA synthetase from Staphylococcus aureus aids in understanding the antibacterial properties of essential oil molecules and their mechanism of action. The in-silico toxicity and pharmacokinetics results show that 4-candidate molecules have potential antibacterial properties and suggest that PMEO could be a source of natural antioxidants and antibacterial agents., (© 2024 Wiley-VHCA AG, Zurich, Switzerland.)

Introduction: We live in the era of information technology (IT) innovations in the health sector, this has led to the appropriation of new organizational models which are profoundly changing the practice of medicine. Our study aims to determine the challenges of new digital technologies in the Moroccan health system, the case of the cardiology department - B - of the Ibn Sina University Hospital Center., Materials and Methods: This is a single-center observational descriptive-analytical study carried out at the level of the cardiology department - B- for 6 months, from September 1, 2022. Questionnaires were distributed in paper form to staff-affiliated medical doctor or carrying out their internships, using a digital device within the service., Results: Thirty-one (31) responses were collected, with a participation rate of 78%; the age of the respondents varies between 21 to 55 years with an average of 30.3± 8.71 years with a female predominance of 67.7% and almost half of the health professionals in our sample 42% were residents. The most deployed digital device is the Hospital Information System (HIS) in 80.6%; 93.5% of respondents noted that saving of time is one of the advantages of telemedicine and 71% of respondents who affirmed that the better monitoring of patients located in isolated areas in order to avoid forgoing care. 74.2% of respondents considered that technical problems constituted an obstacle to the deployment of remote procedures; compared to 22.2% for a weak diagnosis; 64.5% of respondents noted that training would be a major lever for integrating more remote activities into their practices and 54.5% of respondents are in favor of adapted time slots., Conclusion: The benefits perceived by respondents of these digital tools are numerous, although there are obstacles preventing digital transformation from reaching its full potential. The use of new digital technologies in this health sector responds to positive challenges in terms of organizational and educational efficiency; this requires the coordination of all stakeholders. The cardiology department -B - is a space conducive to the implementation of new digital technologies., Competing Interests: Déclaration de liens d'intérêts Les auteurs déclarent n'avoir aucun lien d'intérêt en relation avec cet article., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Coal mining produces coal mine waste rock (CMWR), posing significant environmental risks, including acid mine drainage (AMD) if unmanaged. The Jerada Mine in eastern Morocco has accumulated CMWR since it began operations in 1936, with no rehabilitation efforts until 2001. This study assessed the stability of the T08 pile, which has been deposited over five decades across various oxidation zones. More than 400 samples from 13 drill holes were thoroughly analyzed, including particle size distribution, X-ray fluorescence (XRF), and other advanced techniques, culminating in a 3D model to identify potentially acid-forming (PAF) zones. Particle sizes (D 30 and D 90 ) ranged from 16.3 to 16.5 μm in low-oxidation zones to 353.3-409 μm in highly oxidized areas, respectively. Sulfur content varied from 0.32 to 2.05 wt% for sulfide and from 0.0013 to 0.17 wt% for sulfate, with an acidification potential ranging from 14.42 to 29.2 kg CaCO₃/ t and negative net neutralization potential (NNP) from -35.12 to -11.14 kg CaCO₃/ t . NAG tests revealed a low pH of approximately 4 and acidity levels exceeding safety thresholds, with low neutralizing minerals content. Pyrite was the dominant sulfide, alongside ankerite, hematite, and goethite. Highly oxidized zones exhibited larger particle size distributions, increasing porosity and airflow. Thereby, enhancing oxidation and converting iron into different oxidation states. This process affects sulfur speciation, leading to sulfate formation. The 3D model estimated 3.8 Mt of PAF material in the upper pile, highlighting a heterogeneous distribution linked to porosity and oxidation levels, underscoring the necessity for further kinetic testing to evaluate long-term AMD risks., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Surgical management of patients with severe aortic regurgitation (AR) in the setting of significantly impaired left ventricle (LV) function generally carries very high operative risk. The aim of this study is to assess the short and long-term outcomes of aortic valve replacement (AVR) in a selected young Moroccan population., Materiel and Methods: This is a retrospective study between January 2008 and June 2022 including all patients who underwent AVR for massive isolated AR with an LV ejection fraction EF ≤35%., Results: In this center, a total of 3820 patients were operated for valvular disease, from which 110 had important AR. Overall, 42 patients of 110 patients had an LV ejection fraction≤35%, and benefited from AVR. Rheumatic cause was predominant (50%). Preoperative characteristics find an average age of 46.3 ±14.4 years with male prevalence. Only two deaths are noted in the immediate postoperative period. At the 15 years follow-up, the survival was 86.8%. Clinical improvement was present in the majority of patients. The mean LVEF post-AVR has increased by an average of 16% with proof of reverse remodeling., Conclusions: In this series, patients benefited largely from AVR with good postoperative outcomes. The global operative mortality was acceptable (4.7%). The long-term survival (86.8%) was better than that described in the western series. Therefore, our results should encourage a surgical approach for those patients., Competing Interests: Conflict of interest statement The authors report no conflicts of interest, (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

The recent decline in the health status of deep-sea habitats around the world has pushed the need to document and map their distribution to preserve them in their marine ecosystems. This work describes deep-water coral habitats (133-729 m) and their associated communities, based on nine ROV video transects. These transects cover a 171 km sub-seafloor profile within a predefined 5560 km 2 area along the North Atlantic coast of Morocco, surveyed in 2020 as part of a coral habitat mapping study under the FAO-NANSEN programme. The nine sites were initially explored using multibeam echosounder, to generate a detailed bathymetry map allowing for the positioning of video transects. Megafauna and sediment composition was recorded along transects, and in total 1854 individuals were annotated, and 59 taxa were identified. To identify coral communities and related species assemblages, we used a cluster analysis for classification and the ordination analysis Detrended Correspondence Analysis (DCA) to identify the environmental drivers behind the community patterns. Eight environmental variables were compared with the DCA ordination results, and the important variables were bedrock, mud and depth. The results revealed six megabenthic communities. Three groups were associated with soft sediments, mainly mud. Group I, at depths of 605-726 m, was characterized by Ceriantharia and Synaphobranchus kaupii. Group V, at 133 m depth, was dominated by Ceriantharia. Group VI, consisting of Centrostephanus sp. and a fish community (Scorpaenidae, Capros aper, and Macroramphosus sp.), was found at 201 m depth. In mixed bottoms, where mud is the dominant substrate, Group II was characterized by Crinoidea and sea pens (Funiculina quadrangularis and Virgularia mirabilis) at a depth range of 207-369 m, while Group III, found at depths of 465-602 m, was characterized by sea pens (Pennatula phosphorea and Funiculina quadrangularis), Crinoidea, and the key species Isidella elongata. Group IV, at 207 m depth, was represented by Sertularella sp. and Ellisella paraplexauroides as the dominant species. This first study about mapping deep sea coral habitats in the North Atlantic coast of Morocco reveals the identification of different habitats and new species. It contributes to Strengthen Science for Conservation and Sustainable Management of Deep-Water Corals in Morocco., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Hemodialysis patients' adherence to hemodialysis sessions, medication, diet and, fluid restriction is an essential condition to ensure effective treatment. Therefore, this study aimed to assess the overall adherence of hemodialysis patients in the Marrakech-Safi region of Morocco., Methods: A quantitative cross-sectional study of hemodialysis patients at the Safi, Youssoufia and Ibn Tofail public hemodialysis centers was conducted in the last trimester of 2023 using a questionnaire (ESRD-AQ), which was completed by analyzing patient records and interviewing patients during the hemodialysis session., Results: A total of 199 patients were included in this study. Women accounted for 53.3% of patients, 73.9% were under 65 years, 55.8% had been on hemodialysis for more than 5 years, and 62.8% had an Inter-dialytic-weight (IDW) ≥ 2.5 kg. Mean scores for adherence to hemodialysis, medication, diet and fluid restriction were 534.92 ± 98.71 out of 600, 113.32 ± 50.86 out of 200, 75.38 ± 42.00 out of 200 and 52.51 ± 53.59 out of 200, respectively. Regarding overall adherence, 24.1% had low adherence, 63.8% had moderate adherence, and 12.1% had good adherence, with a mean score of 793.99 ± 151.28 out of 1200. Our results showed that male gender (p = 0.010, ORa = 5.61), young age (p = 0.004, ORa = 8.48), and short duration on hemodialysis (p = 0.001, ORa = 23.91) were risk factors for low overall adherence., Conclusion: Our results justify the increased need for educational programs aimed at improving the overall adherence of hemodialysis patients., (© 2024 International Society for Apheresis and Japanese Society for Apheresis.)

The human immunodeficiency virus (HIV), a retrovirus targeting the immune system and the primary agent causing acquired immunodeficiency syndrome (AIDS), can have fatal consequences. Although antiretroviral treatment has significantly reduced mortality and comorbidity in people living with HIV (PLHIV), its impact on metabolic syndrome (MetS) remains notable. Several genome-wide association studies have identified a link between the glucokinase gene ( GCK ) and MetS, particularly in type 2 diabetes. However, no studies have investigated the association between this gene and HIV status. Our study aims to evaluate the association of the rs1799884 polymorphism in the GCK gene with HIV status in a group of Moroccan patients. This case-control study includes 207 PLHIV and 181 HIV-uninfected controls. Genotyping of the rs1799884 polymorphism in the GCK gene was performed using a predesigned TaqMan single-nucleotide polymorphism genotyping assay. The genotypic distribution between PLHIV and HIV-uninfected controls revealed a significant difference. Patients with the CT genotype had a 4.47-fold increased risk of infection [odds ratio (OR) = 4.47; 95% confidence interval (CI) = 2.75-7.29; p = .001]. However, the TT genotype conferred protection against HIV in a recessive model (OR = 0.50; 95% CI = 0.28-0.91; p = .021). Interestingly, the risk associated with the CT genotype was even higher in AIDS-related cases (OR = 9.37; 95% CI = 4.32-20.36; p = .0001). Additionally, under the dominant model, individuals with CT and TT genotypes had a 7.67-fold increased risk of infection (OR = 7.67; 95% CI = 3.60-16.36; p < .0001). However, the TT genotype under the recessive model was not significantly associated with disease progression. No significant association was observed between these genotypes and CD4 count; however, there was a significant variation in viral load after treatment. Our findings suggest that the rs1799884-C/T variant of the GCK gene may influence susceptibility to HIV status, progression to AIDS, and response to treatment.

This study investigates the evolution and genetic diversity of SARS-CoV-2 strains circulating in Morocco to track the spread, clade distributions and mutations of the virus across various regions from February 2020 to June 2024. The genome sequences were retrieved from the GISAID database. A total of 2630 SARS-CoV-2 genome sequences were analyzed using bioinformatic tools such as Nextclade, followed by phylogenetic and statistical analyses. The study highlights the predominance of the GRA clade (Omicron variant) since November 2021, while clades such as G, GH, GR, and GRY were identified earlier. The GRA clade exhibited the highest number of non-synonymous mutations, particularly in the Spike (S) gene, suggesting strong evolutionary pressure. The correlation analysis between structural and non-structural proteins revealed key interactions between S and NSP5, providing insights into the viral replication and assembly processes. This work gives new insights to the dynamics of SARS-CoV-2 in Morocco and underscores the importance of ongoing genomic surveillance to respond to emerging variants and potential future outbreaks., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.)

In the last decades, natural and anthropogenic pressures have caused observable changes in the argan landscape despite its significance in Morocco. Remote sensing data can be used to monitor these changes over time and provide information on vegetation health and land cover changes. This study assesses the performance of supervised methods (support vector machine, maximum likelihood, and minimum distance) and unsupervised classification method (Isodata) for mapping the argan forest in the Smimou area of Essaouira province using remote sensing data from Landsat-5 and Landsat-8 (1985 and 2019). Additionally, the impact of the resampling method and the digital elevation model (DEM) integration on the classification results have been examined. The ground truth data were collected and randomly divided into two categories: 234 samples to calibrate the classification algorithms and 340 samples for validation. Maximum likelihood supervised classification achieved an overall accuracy (OA) of 89.62% (kappa = 0.84) and 87.58% (kappa = 0.81) in 1985 and 2019, respectively. Using resampling techniques on normalized difference vegetation index (NDVI) products, aiming for a 10 m resolution, the NDVI results yielded an OA of 91.60% in 1985 and 88.85% in 2019. Further integration of DEM (30-m resolution) with NDVI, which was resampled to a 10 m resolution, achieved an OA of 92.27% and 92.37% for 1985 and 2019, respectively., Competing Interests: Declarations: All authors have read, understood, and have complied as applicable with the statement on “Ethical responsibilities of Authors” as found in the Instructions for Authors. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: The quality of life (QOL) of people with multiple sclerosis (MS) is considerably poorer than the QOL of people with other chronic diseases. QOL management should not be restricted to only clinical aspects but also factors modifying QOL. The aim of this study was to identify the sociodemographic and clinical determinants of QOL in people with MS., Methods: A cross-sectional study conducted from 2022 to 2023 included 200 participants aged 18 and over recruited from the Hassan II University Medical Hospital in Fez, Morocco. QOL assessment was performed using the Arabic version of the Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaire. Univariate analysis using Student t test, analysis of variance, and Pearson correlation was performed, followed by multiple linear regression analysis to determine the main factors associated with QOL., Results: QOL was impaired in the physical health (PH) (48.51±22.08) and mental health (MH) (48.69±17.18) components of the MSQOL-54. Male sex, unemployment, and high scores on the Expanded Disability Status Scale (EDSS) were factors significantly associated with lower scores on both the PH and MH components. In contrast, later age at MS diagnosis and older age were significantly associated with worse PH and MH, respectively. EDSS score was a strong predictor of QOL (PH: β = -34.983; 95% CI, -39.64 to -30.31; MH: β = -23.383; 95% CI, -27.62 to -19.14)., Conclusions: The results highlight the importance of sociodemographic and clinical determinants of QOL. Clinicians need to integrate a biopsychosocial approach into therapeutic education programs, considering the risk factors and specific needs of people with MS to optimize their QOL., (© 2025 Consortium of Multiple Sclerosis Centers.)

Background:  The psychological approach can provide valuable insights into vaccination behaviour, especially in high-risk contexts. It offers new perspectives for effective interventions to improve vaccination behaviour., Aim:  To investigate key factors influencing stress related to vaccination in emergency situations among healthcare professionals., Setting:  Eastern region of Morocco., Methods:  We conducted a descriptive and analytical cross-sectional study involving 221 healthcare professionals in the Eastern region of Morocco. A snowball sampling method was used to select the participants who were administered a questionnaire. Logistic regression analysis was performed with p  0.05 being the level of statistical significance., Results:  The participants had a median age of 25.5 years (30-34.5) and were predominantly females (68.3%). Vaccination coverage stood at 84.6%, with a positive perception of 77.8%. The analysis of the Perceived Stress Scale (PSS) revealed that 51.6% (n = 114) of healthcare professionals experienced stress towards vaccination. Females were almost two times more susceptible to experiencing vaccination stress (p = 0.03). Furthermore, the analysis showed that vaccination profile (p = 0.02), accepting the vaccine for any reason other than its accessibility (p = 0.03) and having a previous coronavirus disease 2019 infection (p = 0.03), were significantly associated with stress. In contrast, healthcare professionals based at the university hospital had a significantly lower stress level (p = 0.01)., Conclusion:  Moroccan healthcare professionals exhibited high vaccine acceptance and positive perceptions, particularly among vaccinated individuals despite notable stress around immunisation.Contribution: These insights can guide governments and policymakers in developing strategies to enhance healthcare workers' awareness and understanding of vaccination.

The long-term stability of orally transmitted ethnopharmacopoeias is of interest, but difficult to study for lack of information on plants used by a specific past culture. Similarities between modern Italian ethnopharmacopoeias and Dioscorides' classical text have been proposed to derive from modern replacement of traditional practices with those from published translations of Dioscorides. Ibn al-Baytar produced the best compendium of medicinal substances in medieval Islamic science. He gave "Berber" common names for some plants, which were presumptively used by North African Amazigh people. Since Amazigh traditional knowledge was largely transmitted orally, with little access to medieval literature, this allows comparison of historic (>750 years ago) practices and modern practices that are unlikely to be causally derived. Presumptive identities for Ibn al-Baytar's plants with Berber names were obtained from key references. Recent ethnomedicinal publications from Amazigh-populated areas in North Africa were surveyed for reports of those species and homologous common names. Of 46 historically used plants, an estimated 60.9% are still used in Amazigh regions, 78.6% with homologous common names. This is likely to underestimate persistence of species use across the entire local pharmacopoeia. Second, emulating a published analysis of Dioscorides, plants reported by three large recent studies in Amazigh regions were compared with plants recorded by Ibn al-Baytar and in a comprehensive modern Moroccan reference. Between 58.2% and 73.8% of species included in individual studies were recorded by Ibn al-Baytar; of the 46 shared among all three, 82.6% were recorded by Ibn al-Baytar and 100% by the modern reference. An historical compilation may be more likely to mention plants that are widely used today simply because a thorough author could document most plants that were widely used at the time; use of such data to assess causality should take that effect into consideration.

Alzheimer's disease is a neurodegenerative disorder that impairs neurocognitive functions. Acetylcholinesterase, Butyrylcholinesterase, Monoamine Oxidase B, Beta-Secretase, and Glycogen Synthase Kinase Beta play central roles in its pathogenesis. Current medications primarily inhibit AChE but fail to halt or reverse disease progression due to the multifactorial nature of Alzheimer's. This underscores the necessity of developing multi-target ligands for effective treatment. This study investigates the potential of phytochemical compounds from Moroccan medicinal plants as multi-target agents against Alzheimer's disease, employing computational approaches. A virtual screening of 386 phytochemical compounds, followed by an assessment of pharmacokinetic properties and ADMET profiles, led to the identification of two promising compounds, naringenin (C23) and hesperetin (C24), derived from Anabasis aretioides. These compounds exhibit favourable pharmacokinetic profiles and strong binding affinities for the five key targets associated with the disease. Density functional theory, molecular dynamics simulations, and MM-GBSA calculations further confirmed their structural stability, with a slight preference for C24, exhibiting superior intermolecular interactions and overall stability. These findings provide a strong basis for further experimental research, including in vitro and in vivo studies, to substantiate their potential efficacy in Alzheimer's disease., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Guerguer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The first partial skeleton of a carcharodontosaurid theropod was described from the Egyptian Bahariya Oasis by Ernst Stromer in 1931. Stromer referred the specimen to the species Megalosaurus saharicus, originally described on the basis of isolated teeth from slightly older rocks in Algeria, under the new genus name Carcharodontosaurus saharicus. Unfortunately, almost all of the material from the Bahariya Oasis, including the specimen of Carcharodontosaurus was destroyed during World War II. In 1996, a relatively complete carcharodontosaurid cranium was described from similar aged rocks in Morocco and designated the neotype of the species Carcharodontosaurus saharicus in 2007. However, due to the destruction of the original material, comparisons of the neotype to the Egyptian fossils have so far only been done cursorily. A detailed reexamination of the available information on the Egyptian carcharodontosaurid, including a previously undescribed photograph of the exhibited specimen, reveals that it differs from the Moroccan neotype in numerous characters, such as the development of the emargination of the antorbital fossa on the nasals, the presence of a horn-like rugosity on the nasal, the lack of a dorsoventral expansion of the lacrimal contact on the frontals, and the relative enlargement of the cerebrum. The referability of the Egyptian specimen to the Algerian M. saharicus is found to be questionable, and the neotype designation of the Moroccan material for C. saharicus is accepted here under consideration of ICZN Atricle 75, as it both compares more favorably to M. saharicus and originates from a locality closer to the type locality. A new genus and species, Tameryraptor markgrafi gen. et sp. nov, is proposed for the Egyptian taxon. The theropods of the Bahariya Oasis and the Moroccan Kem Kem Group are thus not as closely related as previously thought, and the proposed faunal similarities between these two strata need further examination., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Kellermann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Low- and middle-income countries are facing a rapid increase in nutritional problems, particularly in Africa, where undernutrition, overweight and micronutrient deficiencies coexist, creating a double burden of malnutrition and a challenge to public health policies. In this context, Morocco stands out for its early nutritional transition, characterized by a moderate prevalence of overweight and undernutrition and elevated levels of micronutrient deficiencies. The aim of this study was to assess the weight status of women of childbearing age and identify its determinants to suggest ways to improve it. The study was conducted in the province of Essaouira in Morocco, which is characterized by a predominance of rural areas and multidimensional poverty. We conducted a quantitative cross-sectional survey of 1,466 married women of childbearing age via stratified random sampling. Data were collected via questionnaires and anthropometric measurements; we applied the WHO curves to classify BMI. Data entry and statistical processing were performed via SPSS ® v. 26. The results show that women's weight status is worrisome, with an average BMI of 26.4 kg/m². The prevalence of overweight was 61.6% (BMI ≥ 25 kg/m 2 ), with 17.9% of women being obese. Bivariate analysis revealed that age, education level, socioprofessional activity, family structure, household income and parity were significantly associated with overweight. Binary logistic regression confirmed that women's age and level of education are major determinants of overweight/obesity. There is a need to strengthen public health policies aimed at reducing overweight and obesity among women of childbearing age in Morocco, with an emphasis on nutrition education and monitoring their weight status throughout their reproductive lives., Competing Interests: Declarations. Ethics approval and consent to participate: We obtained free and informed consent from all participants in the study. Their autonomy was respected; they had the right to freely withdraw from the study at any time. Authorizations were obtained from the University Hospital Ethics Committee of Marrakech (Num 18/2021) and the Marrakech-Safi Regional Health Directorate. Competing interests: The authors declare no competing interests. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests., (© 2025. The Author(s).)

Objectives: To assess whether metformin therapy for type 2 diabetes (T2DM) was associated with a reduced mortality rate in patients hospitalized for COVID-19 compared to other antihyperglycemic drugs., Methods: This retrospective study included patients with T2DM who tested positive for SARS-CoV-2 between 1 August 2020 and 1 August 2021. The patients were required to be aged over 18 years old and to be undergoing treatment for hyperglycemia, whether with metformin, other oral antidiabetic drugs, or insulin. A data exploitation sheet was completed for each patient. The Jamovi (https://www. jamovi .org/) software was applied to conduct the statistical analyses. Multivariate logistic regression was used to determine whether metformin use was associated with reduced mortality among patients with T2DM and COVID-19., Results: We identified 115 COVID-19 patients with T2DM, of whom 41 were on metformin, 35 patients were on insulin, and 39 patients were on other oral antihyperglycemic agents; the average age of patients was 65.5±13.2 years, and 52.2% were male. The mortality rate was lower in the metformin user group (21.1%) compared to the non-user group (78.9%). The multivariate logistic regression model indicated that age (OR=1.06; 95% CI (1.02-1.10); p=0.002) and glycemia (OR=1.49; 95% CI (1.05-2.11); p=0.024) were significantly associated with mortality in patients with T2DM and COVID-19. Whereas, the use of metformin was identified as a protective factor (OR=0.34 95% CI (0.12-0.95); p=0.041)., Conclusion: This study highlighted that metformin seems to be associated with significantly decreased mortality in adults with T2DM and COVID-19., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Ethics Committee of Biomedical Research (CERB) issued approval N/R: Dossier n°L/21. Data access and patient anonymity were respected according to national and international guidelines. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2025, Benfathallah et al.)

Congenital neutropenia (CoN) is a heterogeneous group of inborn errors of immunity (IEI) characterized by recurrent infections and early onset of neutropenia (NP). This study aimed to investigate the demographic and clinical data of children with CoN and idiopathic neutropenia (IN) in Morocco. We performed a retrospective study of patients with CoN and analyzed the clinical and laboratory findings of patients with CoN and IN diagnosed between 1999 and 2018 in a clinical immunology unit of a large pediatric hospital. We identified 88 patients, 51 with IN and 37 with CoN. Fifty-seven percent were males, and 43% were females, ranging from 1 month to 19 years. The median age at onset was 8 months, and the median at diagnosis was 36 months. Consanguinity was observed in 57% of the cases, and a history of recurrent infections in the siblings was found in 27.3%. The most common infectious complications were ear, nose, and throat (ENT) infections, skin and soft tissue infections, and lung infections. Patients with CoN were classified into seven syndromes: 9 with severe congenital neutropenia, 11 with cyclic neutropenia, 6 with glycogen storage disease type 1b, 5 with poikiloderma with neutropenia, 3 with Griscelli syndrome, 2 with Hermansky-Pudlak syndrome type II, and 1 with Cohen syndrome. This study provides a comprehensive overview of CoN and IN in a pediatric cohort from Morocco, representing the country's most considerable single-center investigation of these conditions. Our findings highlight the significant burden of CoN, accounting for 5% of IEI in the Moroccan registry, a proportion higher than in some neighboring countries. The study emphasizes the early onset and severity of bacterial infections in CoN patients, underlining the critical need for timely and accurate diagnosis., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval: The ethics committee of the Ibn Rochd University Hospital, Faculty of Medicine, and Pharmacy Casablanca of Hassan II University approved the study., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Infertility has significant implications on health. It affects physical, emotional, and social wellbeing. In Morocco, about 12% of couples or live with infertility. In 2013 the first public Assisted Reproductive Technology (ART) Center was established at the Maternity and Reproductive Health Hospital les Orangers in Rabat, Morocco. This qualitative study explores the experiences of infertility among couples who have benefited from diagnosis and treatment at ART center. The study represents a part of the overall evaluation of this first public ART centre in Morrocco., Methods: Data were collected through in-depth patient interviews. A semi-structured interview guide was used to elicit the perspectives and experiences couples with infertility. Data collection occurred between January and March 2023. Inductive thematic analysis was conducted to explore the experiences of infertility among the couples., Results: The study showed that couples with infertility were exposed to negative experiences such as (i) biomedical experiences (diagnostic delays, fragmented care, multiplicity of treatments), (ii) social experiences (gendered social pressures, stigma, discrimination, marital challenges, isolation and disrupted social routines), (iii) mental experiences (anger, anxiety, depression, and mood changes) as well as (iv) financial limitations (out of pocket payments and financial indebtedness). Solutions addressing these challenging experiences were suggested by interviewed couples including continued quality and respectful care to enhance biomedical experiences; public education campaigns to educate the public and destigmatize infertility to improve social experience, inclusion of psychosocial services as part of fertility integrated care to enhance psychological experiences, and enhanced financial protection, and service decentralisation to mitigate negative financial pressures., Conclusion: Couples with infertility are exposed to various challenges in the biomedical, social, psychological, and financial domains. A health system strengthening approach is essential to address those challenges, and multiple strategies are needed to improve the experiences of couples with infertility in Morocco. Given interconnectedness between biomedical, social, psychological, and financial divers of experiences, a holistic approach is required to comprehensively improve the experiences of infertile couples and address all the issues faced by couples during their treatment journey., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2025 Benbella, Mburu, Zaidouni, Elomrani, Yahyane, Gholbzouri, Kiarie and Bezad.)

The venom of scorpions has been the subject of numerous studies. However, their taxonomic identification is not a simple task, leading to misidentifications. This study aims to provide a practical approach for identifying scorpions based on the venom molecular mass fingerprint (MFP). Specimens (251) belonging to fifteen species were collected from different regions in Morocco. Their MFPs were acquired using MALDI-MS. These were used as a training dataset to generate predictive models and a library of mean spectral profiles using software programs based on machine learning. The computational model achieved an overall recognition capability of 99 % comprising 32 molecular signatures. The models and the library were tested using a new dataset for external validation and to evaluate their capability of identification. We recorded an accuracy classification with an average of 97 % and 98 % for the computational models and the library, respectively. To our knowledge, this is the first attempt to demonstrate the potential of MALDI-MS and MFPs to generate predictive models capable of discriminating scorpions from family to species levels, and to build a library of species-specific spectra. These promising results may represent a proof of concept towards developing a reliable approach for rapid molecular identification of scorpions in Morocco. SIGNIFICANCE OF THE STUDY: With their clinical importance, scorpions may constitute a desirable study model for many researchers. The first step in studying scorpion is systematically identifying the species of interest. However, it can be a difficult task, especially for the non-experts. The taxonomy of scorpions is primarily based on morphometric characters. In Morocco, the high number of species and subspecies mainly endemic, and the morphological similarities between different species may result in false identifications. This was observed in many reports according to the scorpion experts. In this study, we describe a reliable practical approach for identifying scorpions based on the venom molecular mass fingerprints (MFPs). By using two software programs based on machine learning, we have demonstrated that these MFPs contains sufficient inter-specific variation to differentiate between the scorpion species mentioned in this study with a good accuracy. Using a drop of venom, this new approach could be a rapid, accurate and cost saving method for taxonomic identification of scorpions in Morocco., Competing Interests: Declaration of competing interest The authors declare that they have no conflict interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

This study aimed to investigate the molecular prevalence and genetic characterization of EHV-1 and EHV-4 in equid populations in Morocco. A total of 154 equids (114 horses, 9 donkeys, and 31 mules) were sampled, with nasal swabs and tissue samples subjected to multiplex real-time PCR for the detection of EHV-1 and EHV-4. Additionally, an isolate from the tissue of an aborted horse fetus was included in the analysis. A subset of EHV-positive samples underwent virus isolation followed by whole-genome sequencing. PCR assays revealed that 42 samples (27%) tested positive for EHV-4, while only 3 samples (1.94%) were positive for EHV-1. Attempts to isolate the virus from EHV-4-positive samples were unsuccessful. However, virus isolation was successful in an EHV-1-positive nasopharyngeal sample from a donkey. Phylogenetic and molecular characterization reclassified the EHV-1 isolated from the donkey as an EHV-8. Meanwhile, the EHV-1 isolated from the aborted fetal tissue was classified as a clade 1 EHV-1 virus. This study is the first to report the molecular prevalence and genetic characterization of EHV-1 and EHV-4 in equid populations in Morocco, providing valuable insights into the distribution and genetic diversity of these viruses in the region.

We conducted surveys of Mediterranean beaches in Egypt, Morocco, and Tunisia including 37 macro-litter (> 25 mm) and 41 meso-litter (5-25 mm) assessments. Our study identified key litter items and assessed pollution sources on urban, semi-urban, tourist, and semi-rural beaches. Macro-litter concentration averaged 5032 ± 4919 pieces per 100 m or 1.71 ± 2.28 pieces/m 2 , with higher values observed on urban (mean 2.63 pieces/m 2  ± 3.03) and tourist (mean 1.23 pieces/m 2  ± 0.91) beaches. Similarly, urban (mean 9.91 pieces/m 2  ± 12.70) and tourist beaches (mean 5.32 pieces/m 2  ± 4.48) revealed elevated levels of meso-litter contamination, particularly in the upper third of the beach, which contained the highest quantities both in terms of number (51%) and weight (50%). 55% of the macro-litter and 35% of the meso-litter originated from human shoreline activities and poor waste management. Given the width of some beaches and their high levels of pollution, the standard 100 m macro-litter approach was impractical. To enable cost-effective, long-term monitoring, we adapted it to a faster 10 m transect approach, which provided reliable data on the top 25 litter items, accounting for 82% of beach pollution. Our Sand Rake method effectively quantified pollution on both cleaned and uncleaned beaches, addressing the often neglected meso-litter size fraction. The high pollution levels, top litter items, and identified sources indicate that beach cleaning alone will not solve the pollution problem. Efforts to raise environmental awareness, enhanced waste management, and law enforcement are needed to improve the situation in a sustainable way., Competing Interests: Declarations. Ethical approval: All the authors have read, understood, and have complied as applicable with the statement on “Ethical responsibilities of Authors” as found in the Instructions for Authors. Animal ethics and consent to participate.: Not applicable. Consent for publication: The authors certify that the publisher is permitted to publish this work. Competing Interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Many factors contribute to the development and the progression of Multiple Sclerosis (MS), including Human Leukocyte Antigen (HLA) molecules. Some of them are considered as predisposing, like DRB1*15, DRB1*13, DRB1*03, DRB1*04, DQB1*06, DQB1*02, while HLA A2, HLA B44, DRB1*11, and DRB1*12 are rather considered as protective. Data about such associations in the Moroccan population remain unknown. The aim of this study was to determine the frequency of HLA class I (A and B) and II (DR and DQ) linked to Multiple Sclerosis (MS) in a healthy population from the South of Morocco. Materials and Methods: A cross-sectional study was carried out over the 2016-2023 period on 685 Moroccan healthy individuals, including 355 males and 330 females. Of the total sample tested, 685 underwent HLA class I typing, of which 305 also benefited from HLA class II typing. HLA class I typing was executed using the CDC (complement dependent cytotoxicity) technique (OneLambda™, Los Angeles CA, USA), and HLA class II typing was performed by either PCR-SSP (sequence-specific primer, OneLambda) or PCR-SSO (sequence-specific oligonucleotides) using the Luminex Xmap (Lifecodes, Immucor, Peachtree, Corners, GA, USA) system. Results: From different HLA molecules potentially predisposing to MS, our investigations showed that DRB1*03, DRB1*13, DRB1*15, DRB1*04, and DQB1*02 were observed in 19.2%, 15.8%, 13.31%, 12.7% and 31% respectively, while the frequency of those considered as protective, namely HLA-A2, HLA-B44, and HLA-DRB1*11 was 23.31%, 9.21% and 10.1% respectively. Conclusions: The findings of our study give evidence that among predisposing HLA class II molecules, DR allele groups were more prevalent, mostly DRB1*03, with also a high frequency of DQB1*06, while HLA-A2 marked the supposed protective specificities. These results need to be supported by complementary studies particularly in MS patients.

This study comprehensively analyzes the mineral and heavy metal profiles of seven honey types, focusing on the contents of potassium (K), calcium (Ca), magnesium (Mg), iron (Fe), zinc (Zn), manganese (Mn), copper (Cu), cadmium (Cd), and lead (Pb), with particular emphasis on honey produced in eastern Morocco. Multifloral honey was found to have the highest total mineral content (661 mg/kg), while rosemary honey had the lowest (201.31 mg/kg), revealing the strong influence of floral and botanical origin. Darker honey, such as multifloral and jujube, were richer in minerals, with potassium consistently being the most abundant, followed by calcium, magnesium, and iron, while cadmium and lead remained within safe, trace-level concentrations. Additionally, sugar profiling showed that all samples contained fructose, glucose, maltose, turanose, erlose, sucrose, and palatinose, with particularly high fructose and glucose contents in multifloral honey. Principal component analysis (PCA) accounted for 75% of the variation and identified three distinct groups of honey based on mineral content multifloral, eucalyptus, and rosemary. Multifloral and eucalyptus honey had higher concentrations of iron, magnesium, and calcium, whereas rosemary honey was richer in zinc and copper. The findings underscore the potential of honey as a marker of environmental quality and suggest that eastern Morocco honey possesses favorable characteristics for national and international commercialization.

Background: Hemoglobin G-Siriraj is a rare hemoglobin variant caused by a β-globin gene mutation (HBB: c.22G>A). The focus of this paper is aimed mainly at the chromatographic and electrophoretic properties of hemoglobin G-Siriraj for a presumptive identification. Notably, this is the first documented case of hemoglobin G-Siriraj in Morocco., Methods: This hemoglobin variant was discovered in a 44-year-old Moroccan patient while measuring HbA1c with high-performance liquid chromatography. The discrepancies between capillary electrophoresis and the acid agarose electrophoresis led to suspicion of heterozygous hemoglobin G-Siriraj. Only the globin gene analysis can identify definitively this rare hemoglobin variant., Conclusions: Rare hemoglobin variants represent a diagnostic challenge. Contextualizing cytological and biochemical explorations based on clinical data is essential for effectively guiding diagnosis.

Context: Palliative care is an essential health service, with over 56.8 million people needing it yearly, particularly in low- and middle-income countries. The World Health Assembly has recognized palliative care as an ethical responsibility and called for comprehensive primary health care. The World Health Organization has published a technical report titled "Assessing the Development of Palliative Care Worldwide," as a crucial first step in addressing palliative care. The report includes 14 indicators to help decision-makers identify service provision gaps and inform health priorities, piloted by WHO's ATLANTES in Benin, Morocco, and Uruguay as part of a global assessment., Objectives: To describe, for the three countries, the primary outcomes and lessons learned to enable replication in further countries., Methods: A step-by-step description of the assessment project, a summary of the main results obtained through evaluations, and a description of how the selected countries effectively implemented the WHO indicators through a six-step process, including a phase of action plan design. We advocated a 'Do-it-yourself' approach., Results: The summary data from three country reports reveals national development at a national level. A SWOT analysis involving consultants and program managers was conducted. A stakeholder guide was developed, providing trigger questions and practical recommendations for assessing development using specific indicators. Full information can be found in the specific published reports., Conclusion: The WHO approach has proven effective in identifying health system deficiencies and disseminating information about palliative care evaluation processes. The report provides a 'Do-it-yourself' approach, encouraging self-management without expert guidance., (Copyright © 2024 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Healthcare-associated infections are still a worrying health problem that complicates patient care and increases morbidity and mortality. The incidence of infections in hemodialysis patients is still high and they constitute the second cause of hospitalization and death in this category., Aims: The study's objective was to evaluate nursing and medical staff's involvement in hospital hygiene., Methods: This is an observational study that took place within the hemodialysis unit of a Moroccan university hospital from March 2021 to June 2021. A surface swabbing technique for bacteriological examination was also carried out., Results: The study revealed some shortcomings regarding hand hygiene which was respected by the nurses in only 17.5% of sessions and in 42.2% by the doctors. Other shortcomings in asepsis measures, were also noted such as the non-change of gloves after skin preparation (1.03%) and before manual compression. The serological status of patients concerning HBV, HVC, and HIV was also not always known (31.1%). The bacteriological samples from the surfaces also showed colonization of the medical devices and the ultrasound scanner used for the ultrasound-guided introduction of the central catheters. The results of the study showed some deviations concerning the recommendations; however, they are comparable to other studies conducted internationally, especially in terms of hand hygiene., Conclusion: Our study results highlight some shortcomings adherence to hygiene measures like inconsistent disinfection of medical devices and dialysis stations, as well as insufficient hand hygiene practices among some staff members. However, we observed an improvement in practices following the implementation of awareness-raising sessions. To maintain improved hygiene practices and prevent infections, it is crucial to provide ongoing training for staff, ensure adequate resources, and regularly monitor compliance with hygiene standards., (© 2024 International Society for Hemodialysis.)

The pervasive presence of microplastics (MPs) in the environment is well established, yet many critical questions remain about their distribution and potential impacts on both ecological and human health. To assess the risks that MPs pose, especially through marine ecosystems and human consumption, monitoring their ingestion by fish in natural environments is essential. This study investigated the contamination of 12 fish species, the most commonly consumed in Morocco, collected from the Atlantic Ocean off the Moroccan coast. Analysis of 240 fish (20 individuals per species) revealed that 100 % of the samples contained microplastics. MPs were detected in the gills, gonads, and gastrointestinal tracts of all 12 species. The average abundance of microplastics per fish ranged from 20.6 to 133.2 MPs, with the forms identified as fragments (60 %), fibers (30 %), films (8 %), and pellets and foams (1 %). Additionally, omnivorous and demersal species presented the highest levels of MP contamination. Infrared spectroscopy (ATR-FTIR) analysis identified seven polymers, with high-density polyethylene (34 %), polyethylene terephthalate (30 %), and polypropylene (17.5 %) being the most prevalent. The microplastics were predominantly dark or light in color, with a notable presence of red and blue particles. Fish ingest various sizes of microplastics, primarily particles smaller than 1 mm. Scanning electron microscopy coupled with energy dispersive X-ray analysis (SEM/EDX) revealed that most MPs exhibited visible signs of weathering and contained inorganic components on their surfaces. The potential risk of MPs to fish, as assessed by the polymer hazard index (PHI), was categorized as level V, indicating that MPs may pose significant risks to human health. The highest estimated daily intake (EDI) of microplastics was found in children (1620 MPs/year), whereas the lowest intake was estimated in women (350 MPs/year) and men (337 MPs/year). Given the widespread presence of microplastics in commonly consumed fish species in Morocco, there is an urgent need for regulatory measures to ensure the safety of fisheries, both for domestic consumption and export. Policymakers should consider the development of guidelines for acceptable levels of microplastic contamination in fish to safeguard public health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Zoos are considering to be essential places for the conservation of wild animal species. It is essential to prevent their infection by pathogens especially for those belonging to threatened or extinct species. Zoo captive animals are susceptible to several Culicoides and mosquito borne-viruses. In order to further evaluate the risk of pathogen transmission in zoos, it is essential to identify the presence of potential vector species, as well as the animals bitten by those vectors. For this purpose, Culicoides and mosquito species composition was investigated in ten sites from March to June 2021 for Culicoides (18 collection nights) and in four sites from April to June 2022 for mosquitoes (16 collection nights) at the National Zoological Garden of Rabat (ZGR), Morocco. Culicoides (Diptera: Ceratopogonidae) were collected using Onderstepoort Veterinary Institute traps (UV-light/suction traps (OVI type)), every two weeks. Mosquitoes (Diptera: Culicidae) were collected using BG-Pro mosquito trap (BGP) combined with a CO2 source as an attractant, on two consecutive days every two weeks. The blood meal of engorged Culicoides was amplified by PCR, sequenced, and blasted for host species identification. In total, 1584 individuals belonging to the Culicoides genus were collected (88.25 % females and 11.75 % males) belonging to at least 13 different species. Among the species collected, Culicoides newsteadi (33.28 %), C. imicola (23.74 %), C. circumscriptus (18.88 %) and C. obsoletus/C. scoticus (7.96 %) constituted the majority of the total catches. These species are proven or suspected vector species of bluetongue and African hose sickness viruses in the Mediterranean basin. For mosquitoes, 455 individuals belonging to four species of three genera were collected (97.58 % females and 2.42 % males): Culex pipiens s.l. (94.29 %) (vector species of West Nile and Rift Valley fever viruses), Culiseta longiareolata (4.81 %), Aedes detritus s.l. and Ae. caspius (representing together less than 1.00 %). The results of blood meal analyses revealed that Culicoides fed on humans (n = 7), camels (n = 2), and common eland (n = 2). The composition of Culicoides and mosquito fauna is characteristic of the Rabat region. The composition is thus mostly determined by the environment rather than by the animal species presence. The results highlighted that Culicoides fed on humans and ruminants. It is therefore likely that the zoo's animals could be threatened by arboviruses transmitted by domestic animals in the region. Particular attention must be paid to the prevention of vector-borne diseases to ensure the proper conservation of species., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Phosphorus is the corner stone of global food security, with no alternative to its critical role in agriculture and other applications. Most of it is sourced from phosphate rock, yet the environmental impacts of its mining and processing are not comprehensively documented. This study provides a life cycle assessment (LCA) of phosphate rock mining and beneficiation in Morocco, focusing on one of the largest sites in the Gantour basin. Our findings reveal that diesel combustion during mining and beneficiation is the dominant contributor to environmental impacts. Interestingly, the use of renewable energy for electricity significantly reduces its share to the overall impact, varying from 0.02% to 13.4% across different indicators. A sensitivity analysis further shows that shifting to wind energy reduces Global Warming Potential (GWP) by 21% compared to relying on the Moroccan grid mix. The partial reliance on non-conventional water sources also emerges as a key factor in reducing water-related impacts. Moreover, exploring energy alternatives for calcination and drying highlights promising reductions: a 57.6% decrease in GWP for electrified processes and a 41% reduction in freshwater eutrophication using selective catalytic reduction. By shedding light on the environmental footprint of Morocco's current phosphate mining and processing strategies, this work seeks to inform and inspire further research as well as suggesting sustainable alternatives to adopt in this industry., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: This study aimed to develop and evaluate the validity and reliability of dentists' radiation protection knowledge, attitudes, and practices (DRP-KAPs) questionnaire., Methods: This study was conducted using a stepwise approach. In the first step, items were generated to determine the relevant content and domains after a thorough literature review. In the second step, the content validity of the questionnaire was assessed by seven experts using face and content validity. The content validity index for relevance and clarity (I-CVI, S-CVI/Av, and S-CVI/UA) and the content validity ratio (CVR) were performed. Then, the questionnaire was pre-tested with 10 dentists for face validation. In the third step, reliability was assessed using internal consistency (Kuder-Richardson-20 (KR-20) and Cronbach's alpha) and test-retest (Kappa and intraclass correlation coefficient [ICC]) methods by filling out the questionnaire by 100 dentists practicing in the Rabat-Salé-Kénitra region, in Morocco., Results: The finalized DRP-KAPs questionnaire contains 41 items covering knowledge, attitudes and practices (KAPs). The I-CVIs, S-CVI/UA and S-CVI/AV and CVR values of the 41 items were ≥0.86 for each item, ≥0.82, ≥0.97, and ≥0.71, respectively. With regard to internal consistency reliability, the KR-20 coefficients for the knowledge and practice domains were 0.70 and 0.68, respectively, and the Cronbach alpha for the attitude domain was 0.73. The DRP-KAPs questionnaire has good reliability with the ICC coefficients for attitude items ranging from 0.57 to 0.95 and Kappa coefficients for knowledge and practice items ranging from 0.64 to 1 and 0.77 to 1, respectively., Conclusion: The developed DRP-KAPs questionnaire was found to be a noteworthy tool for assessing radiation protection among dentists, with acceptable internal consistency, good ICC and Kappa coefficients, and good content validity indices., (© 2024 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.)

This study examines the concentrations of arsenic (As), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), iron (Fe), mercury (Hg) and zinc (Zn) in three fish species (Sardina pilchardus, Engraulis encrasicolus, Trachurus trachurus) from Betoya Bay, collected in winter and summer. Significant variations were observed between tissues (p < 0.05), with the liver being the most contaminated. A seasonal increase in Potentially Toxic Elements (PTEs) was observed during the wet season, particularly for As, Cd, Hg and Zn in S. pilchardus. The Metal Pollution Index (MPI) showed no overall toxicity except in the liver (3.07-6.69). The Estimated daily intake (EDI) values remain below the provisional tolerable daily intake limits, indicating no health risk. However, Cd and Fe values exceed these limits in children. The Hazard Quotient (HQ) and Total Hazard Quotient (THQ) indices associated with muscle consumption suggest a non-carcinogenic risk for adults. For children, a hazard was identified for iAs in S. pilchardus in winter and in T. trachurus in both seasons. Furthermore, the carcinogenic risk indices (CR iAs and CR Cr ) indicate a potential risk for certain species, both for adults and children, highlighting the need for measures to reduce PTE contamination. In the short term, PTE concentrations in fish do not appear to pose an immediate risk to human health or ecosystems. However, there is evidence of long-term accumulation due to human activities, which could be of concern. It is recommended that bioaccumulation analyses and exposure monitoring of local populations be included in future studies to better anticipate and manage potential risks., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

We conducted a retrospective study of 83 cases of immune thrombocytopenia (IT) in patients under 20 years of age. The aim was to provide an overview of IT in our young patients. The median age was 10 years, with a predominance of females (71 %). The most common reason for consultation was cutaneous (65 %) or mucocutaneous (24 %) haemorrhagic syndrome of moderate severity (Buchanan grade 3) in 54 % of cases. Initial thrombocytopenia ≤ 20000/mm³ was noted in 77 % of cases, with a median of 8000/mm³. Myelograms were requested in 51 patients. Corticosteroids continued to be the most commonly prescribed drug (87 %), with intravenous immunoglobulins used immediately in 5 patients. Rituximab and eltrombopag were used in 18 patients (22 %) after failure of first-line treatment. Splenectomy was performed in 11 patients, with a good response rate of 82 %. Chronic disease progression was seen in 31 % of patients. The overall prognosis was good, with male gender and Buchanan haemorrhagic grade 3 suggesting a more favourable outcome.

Objective: This study aimed to investigate loss to follow-up (LFU) rates within breast and cervical cancer screening programs in Kenitra-Morocco, identifying contributing factors from both patient and healthcare worker perspectives to enhance care continuity., Methods: The study was a non-experimental, mixed-methods design conducted in three-phases. We started by identifying LFU women and their characteristics from medical records, interviewing LFU women to ascertain reasons for discontinuation, and surveying healthcare workers for perceived determinants of LFU through semi-structured questionnaires. The study covered primary healthcare centers, the Reproductive Health Reference Center (RCRH) in Kenitra, and the National Institute of Oncology (NIO) in Rabat., Results: Of 1,225 women studied, 94 cancer cases were diagnosed, with LFU rates varying across care stages. Key factors associated with LFU included age (p<0.005, OR=1.67, CI[1.2-2.4]), marital status (p<0.03, OR=0.8, CI[0.65-0.98]), distance from healthcare facilities (p<0.00, OR=2, CI[1.3-4.0]), and medical coverage (p<0.03, OR=2.3, CI[1.3-4.0]). Healthcare workers cited poor communication, organizational issues, and staffing shortages as barriers to follow-up., Conclusions: The study underscores LFU's multifaceted reasons in Kenitra's cancer screening programs, suggesting improvements in communication after a positive screening test, re-engagement strategies, and financial accessibility. Addressing these issues is essential for reducing LFU rates, enhancing cancer care outcomes, and decreasing breast and cervical cancer mortality in Morocco.

Camel contagious ecthyma is a highly infectious viral skin disease that affects camels and causes economic losses. This study reports the isolation and the phylogenetic analysis of contagious ecthyma virus among camels in Morocco. The disease was detected in four among fifteen camels with severe papules on the lips and nares. Samples of skin crusts were collected and pooled for virus isolation and titration, PCR testing, and histopathological examination. PCR was used to amplify the B2L gene and the resulting product was sequenced and analyzed genetically. The study's findings indicate the presence of characteristic microscopic changes of poxvirus infection in the examined tissues and the virus was isolated on two cells (lambs testis and Vero) and showed distinct growth patterns. The virus grew rapidly on TA cells and delayed growth on Vero cells. The third passage showed cytopathic effects characterized by cell aggregation. Sequence analysis of the B2L gene revealed 100 % similarity to the camel contagious Ecthyma virus isolated from Ethiopia. The camel virus isolates can be classified into two genetic clades according to the B2L gene sequence: the Asian lineage, which includes isolates from Saudi Arabia, Bahrain, and India, and the African lineage, which includes isolates from the Sudan. In conclusion, this is the first instance of the camel contagious ecthyma virus being identified in North Africa in a herd of camels following exposure to stress. Moreover, the progression of the disease was closely monitored from onset to recovery in a setting without the bacterial complication often observed in the field. The virus exhibited opportunistic behavior, exploiting the stress response. Further studies are warranted to evaluate the pathogenicity of the virus in camels and to genetically characterize the circulating virus from different regions. This will be highly beneficial in the development of an appropriate vaccine., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Managing type 1 diabetes in school is a real challenge for teachers, parents, and students themselves. Involving school educators in providing care and support is becoming more of a necessity than a luxury to facilitate access to healthcare services in schools for children with type 1 diabetes., Objectives: Our work aimed to assess the background knowledge of teachers on type 1 diabetes and evaluate the impact of an educational intervention in improving this knowledge., Methods: We included 346 participants working in elementary schools in Oujda City, Morocco. We collected data on anonymous data sheets. Then, a first pre-coded questionnaire was distributed to the participants to assess their background knowledge of type 1 diabetes. Afterward, a simplified educational session was delivered to them. Subsequently, the same pre-coded questionnaire was distributed for evaluation after education., Results: Around 84% of the participants recognized polyuria and polydipsia as major signs of diabetes. Only 35.3% of them knew the definition of hypoglycemia. Hyperglycemia was identified by 65% of the participants. About 40% believed children cannot exercise, while 55.5% thought taking free sugar before exercise was mandatory. We found a significant correlation between a good level of knowledge and knowing a person with diabetes (aOR=2.66, CI95%: 1.51- 4.70, p=0.001). There was a significant improvement in knowledge after the educational intervention (p=0.0001)., Conclusion: Our study showed a lack of information about type 1 diabetes among teachers. We also proved the effectiveness of targeted education in correcting misconceptions and encouraging awareness of type 1 diabetes., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Hemoglobinopathies represent the most commonly inherited autosomal recessive blood disorders in the world. The aim of this study was to determine the carrier frequency and molecular basis of hemoglobinopathies among blood donors in eastern Morocco. This is the first study of its kind for this country., Methods: Healthy blood donors of the BRO Biobank were included in this study. Blood samples were analyzed using an automatic blood cell analyzer for complete blood counts. Hemoglobin fractions were analyzed by capillary electrophoresis and serum ferritin was measured on a chemical and immunological analyzer. Suspected hemoglobinopathy carriers were further characterized by Sanger sequencing, Gap PCR and PCR-RFLP., Results: The study involved 2013 blood donors, of whom 1063 were male and 950 were female (sex ratio male-to-female of 1.1). The median age of these donors was 35 years. The overall carrier frequency of hemoglobinopathies was 1.84 %, with β-thalassemia carriers being the most prevalent (0.65 %) followed by HbAC (0.55 %), α-thalassemia carriers (0.30 %), HbAS (0.1 %), HbAG-Philadelphia (0.1 %), HbAD-Ouled Rabah (0.05 %) and HbAO-Arab (0.05 %). Additionally, novel β-thalassemia variants (C6(-G) and -83(A > G)) and a structural variant (Hb D-Ouled Rabah) were discovered for the first time in Morocco., Conclusions: This study provided the first report on carrier frequency and molecular basis of hemoglobinopathies among healthy donors in Morocco. These findings are valuable for the implementation of carrier screening and genetic diagnosis for hemoglobinopathies. Furthermore, these results justify the need to introduce pre-donation screening for hemoglobinopathy carriers in Morocco, particularly in areas with a high prevalence of carriers to enhance the overall quality of the national blood supply., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)

Glyphosate, a widely used herbicide in global agriculture, poses potential health risks due to environmental and dietary exposure. This study evaluated urinary concentrations of glyphosate and its metabolite, amino-methyl phosphonic acid (AMPA), among farmers and non-farmers in Morocco's Fez-Meknes region, using liquid chromatography-tandem mass spectrometry. Glyphosate was detected in 57.14 % of farmers, 35.41 % of indirectly exposed residents, and 24 % of controls, while AMPA was present in 5.35 % of farmers only. Average glyphosate levels were 0.176 μg/L in farmers, 0.098 μg/L in indirectly exposed individuals, and 0.069 μg/L in controls, with AMPA averaging 0.253 μg/L in farmers. Sociodemographic factors, such as education level, farm residence, and herbicide storage, significantly influenced glyphosate levels, while reusing pesticide containers strongly correlated with elevated glyphosate and AMPA concentrations. Estimated daily intakes (EDIs), hazard quotients (HQs), and a hazard index (HI) were calculated to analyze the obtained data from a health risk perspective. Farmers had higher EDIGM values for AMPA (0.303 µg/d/kg) and Glyphosate (0.140 µg/d/kg) compared to the control group, which had significantly lower values of 0.110 µg/d/kg for AMPA and 0.080 µg/d/kg for Glyphosate. The HQs were calculated considering 0.5 mg/kg BW/day as an acceptable daily intake (ADI), which EFSA has established as a health-based reference value for both analytes. The values obtained were lower than 1, indicating that the health risk from Glyphosate and AMPA exposure was considered acceptable for the studied population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Following the introduction of rotavirus vaccination into the Moroccan National Immunization Program, the prevalence of the disease has decreased by nearly 50%. However, evidence on the economic value of rotavirus vaccinations in Morocco is limited. This health economic analysis evaluated, from both country payer and societal perspectives, the costs and the cost-effectiveness of three rotavirus vaccines using a static, deterministic, population model in children aged < 5 years in Morocco. Included vaccines were HRV (2-dose schedule), HBRV (3-dose schedule) and BRV-PV 1-dose vial (3-dose schedule). One-way and probabilistic sensitivity analyses were conducted to assess the impact of uncertainty in model inputs. The model predicted that vaccination with HRV was estimated to result in fewer rotavirus gastroenteritis events (-194 homecare events, -57 medical visits, -8 hospitalizations) versus the 3-dose vaccines, translating into 7 discounted quality-adjusted life years gained over the model time horizon. HRV was associated with lower costs versus HBRV from both the country payer (-$1.8 M) and societal (-$4.1 M) perspectives, and versus BRV-PV 1-dose vial from the societal perspective (-$187,000), dominating those options in the cost-effectiveness analysis. However, costs of BRV-PV 1-dose vial were lower than HRV from the payer perspective, resulting in an ICER of approximately $328,376 per QALY, above the assumed cost effectiveness threshold of $3,500. Vaccination with a 2-dose schedule of HRV may be a cost-saving option and could lead to better health outcomes for children in Morocco versus 3-dose schedule rotavirus vaccines.

Background: Nucleotide-binding oligomerization domain 1 (NOD1) and NOD2 are involved in carcinogenic processes by recognizing bacterial cell wall components and triggering inflammation. This study explored the association between genetic variations in NOD1 and NOD2 and susceptibility to hepatocellular carcinoma (HCC) and its progression in a Moroccan population., Methods: Genotyping of NOD1 rs2075820 (C>T) and NOD2 rs718226 (A>G) was performed using the TaqMan allelic discrimination assay in 467 Moroccan individuals. The cohort included 156 patients with hepatocellular carcinoma (HCC), 155 patients with liver cirrhosis (LC) diagnosed with HBV, HCV, or MASLD, and 156 controls., Results: The NOD1 rs2075820 variant showed no association with HCC susceptibility or progression, which is consistent with in silico predictions. However, the NOD2 rs718226 G allele and GG genotype were more common in the HCC group compared to the cirrhosis and control groups. Individuals with the homozygous G variant had a 2-fold higher risk for HCC (ORad = 2.12; CI=1.01-4.44; Pad = 0.04). Those with the GG genotype also had an increased risk of HCC (GG vs. AG+AA ORad = 2.28; CI=1.15-4.54; Pad = 0.016). Furthermore, GG genotype carriers had a significantly higher risk of HCC progression (OR ad  = 2.58; CI=1.26-5.31; P ad ​ = 0.031). Individuals with the rs718226 minor allele had a significantly elevated risk of progressing from LC to HCC (OR ad  = 1.50; CI=1.07-2.09; P ad  = 0.016). Stratification analysis indicated that men had a higher risk of HCC progression compared to women (OR ad  = 4.63; CI=1.53-14.00 vs. OR ad  = 2.73; CI=1.05-7.09)., Conclusion: The NOD1 rs2075820 polymorphism does not appear to be a genetic risk factor for susceptibility to HCC. In contrast, the non-coding NOD2 rs718226 variant significantly increases HCC susceptibility and promotes liver cancer progression in the Moroccan population. Further studies involving larger cohorts are warranted to definitively confirm or refute the effects of NOD1 and NOD2 genetic variants on liver cancer susceptibility and progression., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)