Search

INTRODUCTION: The fibrous posterior atlanto-occipital membrane (PAOM) at the craniocervical junction is typically removed during decompression surgery for Chiari malformation type I (CM-I); however, its importance and ultrastructural architecture have not been investigated in children. We hypothesized that there are structural differences in the PAOM of patients with CM-I and those without. METHODS: In this prospective study, blinded pathological analysis was performed on PAOM specimens from children who had surgery for CM-I and children who had surgery for posterior fossa tumors (controls). Clinical and radiographic data were collected. Statistical analysis included comparisons between the CM-I and control cohorts and correlations with imaging measures. RESULTS: A total of 35 children (mean age at surgery 10.7 years; 94.3% white) with viable specimens for evaluation were enrolled: 24 with CM-I and 11 controls. There were no statistical demographic differences between the two cohorts. Four children had a family history of CM-I and five had a syndromic condition. The cohorts had similar measurements of tonsillar descent, syringomyelia, basion to C2, and condylar-to-C2 vertical axis (all p>0.05). The clival-axial angle was lower in patients with CM-I (138.1 vs. 149.3 degrees, p = 0.016). Morphologically, the PAOM demonstrated statistically higher proportions of disorganized architecture in patients with CM-I (75.0% vs. 36.4%, p = 0.012). There were no differences in PAOM fat, elastin, or collagen percentages overall and no differences in imaging or ultrastructural findings between male and female patients. Posterior fossa volume was lower in children with CM-I (163,234 mm3 vs. 218,305 mm3, p

Recent work shows that ambient exposure in everyday situations can yield implicit knowledge of a language that an observer does not speak. We replicate and extend this work in the context of Spanish in California and Texas. In Word Identification and Wellformedness Rating experiments, non-Spanish-speaking Californians and Texans show implicit lexical and phonotactic knowledge of Spanish, which may be affected by both language structure and attitudes. Their knowledge of Spanish appears to be weaker than New Zealanders' knowledge of Māori established in recent work, consistent with structural differences between Spanish and Māori. Additionally, the strength of a participant's knowledge increases with the value they place on Spanish and its speakers in their state. These results showcase the power and generality of statistical learning of language in adults, while also highlighting how it cannot be divorced from the structural and attitudinal factors that shape the context in which it occurs.

This study aimed to investigate the differences in Religiosity (R), Mental Immunity (MI), and Psychological Well-Being (PWB) in patients with diabetes due to gender and age group variables, and to detect the best predictors of PWB in diabetic patients within the Bayesian framework. The study was conducted from May 2022 to February 2023 on a random sample of 186 Saudis diagnosed with diabetes. After obtaining participants' consent, they completed three R, MI, and PWB scales. Bayesian Independent Samples t-test was performed to identify differences, and Bayesian linear regression analysis was used to reveal the best prediction model of PWB. The results of the Bayesian independent samples t-test indicated strong evidence supporting the alternative hypothesis H1, suggesting differences between male and female diabetic patients in R, MI, and PWB, with Bayesian factor values exceeding 10 (8.338×10+23, 1.762×10+25, and 1.866×10+24), and Cohen's δ of (-1.866, -1.934, -1.884). These results indicated that females with diabetes have higher means of R, MI, and PWB compared to males. However, the results also suggested evidence for the null hypothesis H0 of no differences in R, MI, and PWB among diabetic patients due to age group, with Bayesian factor values (0.176, 0.181, and 0.187) less than 1.00 and small Cohen's δ of (-0.034, -0.050, -0.063). Bayesian linear regression analysis detected strong evidence that the model including MI is the best predictive model (BF10 for mental immunity is 1.00 and for the other two models are 0.07 and 4.249×10-16) for the PWB of diabetic patients, however, there is no evidence that the model including R or the interaction between R and MI is the best predictor of PWB for diabetic patients. These findings highlight the need for direct psychological care services for male diabetic patients and the urgent need to enhance IM in diabetic patients to improve their PWB. Furthermore, results recommended that healthcare providers in Saudi Arabia integrate MI interventions into diabetes care programs.

This study aims to assess the level of metal contamination and the ecological risk index at the abandoned Zaida Pb/Zn mining site in eastern Morocco and identify native plant species found on the site that can be used in site rehabilitation through phytoremediation strategies. Samples from seven native and abundant plant species at the site, along with their rhizospheric soils, were collected and analyzed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) to determine the concentrations of various metal(loid)s, including As, Cu, Ni, Cd, Sb, Zn, and Pb. Indicators of soil pollution and ecological risks were also assessed, including the enrichment factor (EF), pollution index (PI), and ecological risk index (ERI). The Biological Accumulation Coefficient (BAC), Translocation Factor (TF), and Biological Concentration Factor (BCF) of plant samples were calculated. The results reveal polymetallic soil contamination, with notably higher concentrations of Pb, Cu and Zn, reaching respectively 5568 mg kg-1 DW, 152 mg kg-1 DW, and 148 mg kg-1 DW, indicating a significant potential ecological risk. The enrichment factor (EF) was also assessed for each metal(loid)s, and the results indicated that the metal contamination was of anthropogenic origin and linked to intensive mining activities in Zaida. These findings are supported by the pollution index (PI) ranging from 1.6 to 10.01, which reveals an extremely high metal(loid)s pollution level. None of the plant species exhibited a hyperaccumulation of metal(loid)s. However, Artemisia herba alba demonstrated a strong capacity to accumulate Pb in its aboveground parts, with a concentration of 468 mg kg-1 DW. Stipa tenacissima, Retama spherocarpa, and Astragalus armatus, showed a significant Pb accumulation in their roots reaching 280, 260, and 256 mg kg-1 DW.respectively. Based on BAC, TF, and BCF, Stipa tenacissima exhibited potential for Ni and Cd phytostabilization, as well as the ability for Zn phytoextraction. Additionally, Artemisia herba alba displayed the capability to phytoextract Cd and had a high propensity to translocate all the studied metal(loid)s. Astragalus armatus has the potential to be used in the phytostabilization of Zn and Ni, as well as for the phytoextraction of As and Sb. These native species from the Zaida site, although not hyperaccumulators, have the potential to contribute significantly to the phytoextraction or phytostabilization of potentially toxic elements (PTEs). Moreover, they can serve as vegetative cover to mitigate the erosion and dispersion of metal(loid)s.

Maintaining stable voltage levels is essential for power systems' efficiency and reliability. Voltage fluctuations during load changes can lead to equipment damage and costly disruptions. Automatic voltage regulators (AVRs) are traditionally used to address this issue, regulating generator terminal voltage. Despite progress in control methodologies, challenges persist, including robustness and response time limitations. Therefore, this study introduces a novel approach to AVR control, aiming to enhance robustness and efficiency. A custom optimizer, the quadratic wavelet-enhanced gradient-based optimization (QWGBO) algorithm, is developed. QWGBO refines the gradient-based optimization (GBO) by introducing exploration and exploitation improvements. The algorithm integrates quadratic interpolation mutation and wavelet mutation strategy to enhance search efficiency. Extensive tests using benchmark functions demonstrate the QWGBO's effectiveness in optimization. Comparative assessments against existing optimization algorithms and recent techniques confirm QWGBO's superior performance. In AVR control, QWGBO is coupled with a cascaded real proportional-integral-derivative with second order derivative (RPIDD2) and fractional-order proportional-integral (FOPI) controller, aiming for precision, stability, and quick response. The algorithm's performance is verified through rigorous simulations, emphasizing its effectiveness in optimizing complex engineering problems. Comparative analyses highlight QWGBO's superiority over existing algorithms, positioning it as a promising solution for optimizing power system control and contributing to the advancement of robust and efficient power systems.

The Traffic Locus of Control scale (T-LOC) serves as a measure of drivers' personality attributes, providing insights into their perceptions of potential causes of road traffic crashes (RTCs). This study meticulously evaluated the psychometric properties of the Arabic version of T-LOC (T-LOC-A) among Lebanese drivers. Additionally, the study aimed to explore associations between the T-LOC scale and various driving variables, including driver behavior, accident involvement, and traffic offenses. A cross-sectional study was conducted among Lebanese drivers using a face-to-face approach. The validation of the Arabic version of T-LOC (T-LOC-A) occurred through a two-stage process: translating and culturally adapting T-LOC in the first stage, and testing its psychometric properties in the second stage. Data were collected using a comprehensive self-reported questionnaire in Arabic, covering demographic and travel-related variables, risk involvement, and measures such as the Driver Behavior Questionnaire (DBQ) and T-LOC. Exploratory factor analysis and confirmatory factor analysis were performed to scrutinize the factorial structure of T-LOC. Pearson correlation and chi-square tests were used for continuous and categorical variables, respectively. Two logistic regression analyses were executed to probe associations between T-LOC and involvement in road traffic crashes (RTCs) and T-LOC subscales with the occurrence of traffic offenses. The study included 568 drivers, predominantly male (69%) and aged between 30 and 49 years (42.1%). The findings revealed that T-LOC-A exhibited robust psychometric properties, with excellent reliabilities (α = 0.85) and adherence to the original four-factor structure, encompassing self (α = 0.88), other drivers (α = 0.91), vehicle/environment (α = 0.86), and fate (α = 0.66). The multidimensional structure was statistically supported by favorable fit indices. Gender differences revealed men attributing responsibility to other drivers, while women leaned towards fate and luck beliefs. Regarding driver behavior, the "other drivers" and self-dimensions of T-LOC-A correlated positively with aggressive violations. The fate dimension showed positive associations with aggressive violations and lapses. The "other drivers" subscale correlated positively with errors, and the vehicle/environment subscale with lapses. External T-LOC factors were positively associated with accident involvement, while the "LOC self" factor emerged as a protective element. In terms of traffic offenses, "LOC fate" displayed a positive association, while the "LOC self" factor showed a protective effect. In conclusion, the Arabic T-LOC is a reliable and valuable instrument, suggesting potential improvements in driving safety by addressing drivers' locus of control perceptions.

[This corrects the article DOI: 10.1371/journal.pone.0145919.].

We present an analytical framework aimed at predicting the local brain activity in uncontrolled experimental conditions based on multimodal recordings of participants' behavior, and its application to a corpus of participants having conversations with another human or a conversational humanoid robot. The framework consists in extracting high-level features from the raw behavioral recordings and applying a dynamic prediction of binarized fMRI-recorded local brain activity using these behavioral features. The objective is to identify behavioral features required for this prediction, and their relative weights, depending on the brain area under investigation and the experimental condition. In order to validate our framework, we use a corpus of uncontrolled conversations of participants with a human or a robotic agent, focusing on brain regions involved in speech processing, and more generally in social interactions. The framework not only predicts local brain activity significantly better than random, it also quantifies the weights of behavioral features required for this prediction, depending on the brain area under investigation and on the nature of the conversational partner. In the left Superior Temporal Sulcus, perceived speech is the most important behavioral feature for predicting brain activity, regardless of the agent, while several features, which differ between the human and robot interlocutors, contribute to the prediction in regions involved in social cognition, such as the TemporoParietal Junction. This framework therefore allows us to study how multiple behavioral signals from different modalities are integrated in individual brain regions during complex social interactions.

The gut microbiome is increasingly being appreciated as a master regulator of animal health. However, avian gut microbiome studies commonly focus on birds of economic importance and the gut microbiomes of raptors remain underexplored. Here we examine the gut microbiota of 29 captive falcons-raptors of historic importance-in the context of avian evolution by sequencing the V4 region of the 16S rRNA gene. Our results reveal that evolutionary histories and diet are significantly associated with avian gut microbiota in general, whereas diet plays a major role in shaping the falcon gut microbiota. Multiple analyses revealed that gut microbial diversity, composition, and relative abundance of key diet-discriminating bacterial genera in the falcon gut closely resemble those of carnivorous raptors rather than those of their closest phylogenetic relatives. Furthermore, the falcon microbiota is dominated by Firmicutes and contains Salmonella at appreciable levels. Salmonella presence was associated with altered functional capacity of the falcon gut microbiota as its abundance is associated with depletion of multiple predicted metabolic pathways involved in protein mass buildup, muscle maintenance, and enrichment of antimicrobial compound degradation, thus increasing the pathogenic potential of the falcon gut. Our results point to the necessity of screening for Salmonella and other human pathogens in captive birds to safeguard both the health of falcons and individuals who come in contact with these birds.

BackgroundThere is an increasing awareness that sleep disturbances are a risk factor for dementia. Prior case-control studies suggested that brain grey matter (GM) changes involving cortical (i.e, prefrontal areas) and subcortical structures (i.e, putamen, thalamus) could be associated with insomnia status. However, it remains unclear whether there is a gradient association between these regions and the severity of insomnia in older adults who could be at risk for dementia. Since depressive symptoms and sleep apnea can both feature insomnia-related factors, can impact brain health and are frequently present in older populations, it is important to include them when studying insomnia. Therefore, our goal was to investigate GM changes associated with insomnia severity in a cohort of healthy older adults, taking into account the potential effect of depression and sleep apnea as well. We hypothesized that insomnia severity is correlated with 1) cortical regions responsible for regulation of sleep and emotion, such as the orbitofrontal cortex and, 2) subcortical regions, such as the putamen.Methods120 healthy subjects (age 74.8±5.7 years old, 55.7% female) were recruited from the Hillblom Healthy Aging Network at the Memory and Aging Center, UCSF. All participants were determined to be cognitively healthy following a neurological evaluation, neuropsychological assessment and informant interview. Participants had a 3T brain MRI and completed the Insomnia Severity Index (ISI), Geriatric Depression Scale (GDS) and Berlin Sleep Questionnaire (BA) to assess sleep apnea. Cortical thickness (CTh) and subcortical volumes were obtained by the CAT12 toolbox within SPM12. We studied the correlation of CTh and subcortical volumes with ISI using multiple regressions adjusted by age, sex, handedness and MRI scan type. Additional models adjusting by GDS and BA were also performed.ResultsISI and GDS were predominantly mild (4.9±4.2 and 2.5±2.9, respectively) and BA was mostly low risk (80%). Higher ISI correlated with lower CTh of the right orbitofrontal, right superior and caudal middle frontal areas, right temporo-parietal junction and left anterior cingulate cortex (p

BackgroundAlexithymia can be associated with worse addictive traits, while emotional intelligence is associated with better addictive outcomes. In Lebanon, the prevalence of cigarette and waterpipe smoking is on the rise, although people are aware of the associated harms. Also, around 11% of Lebanese adults have experienced alcohol use disorder (AUD). This study aimed to assess the association between alexithymia, emotional intelligence, smoking (cigarette and waterpipe), and AUD among a sample of Lebanese adults.MethodsA web-based cross-sectional study carried out between February and April 2020, during the lockdown period, enrolled 408 community-dwelling adults. The survey link was shared on social media to reach participants from all Lebanese districts/governorates.ResultsTaking antidepressants (Beta = 4.37) was significantly associated with more cigarette dependence, while female gender (Beta = -1.52) and having a high vs. low monthly income (Beta = 1.02) were significantly associated with less cigarette dependence. None of the variables, including alexithymia, were significantly associated with waterpipe dependence. Female gender (Beta = -0.15) and higher emotional intelligence (Beta = -0.003) were significantly associated with less AUD, whereas higher alexithymia (Beta = 0.003) was significantly associated with more AUD.ConclusionThis study could demonstrate a significant association between alexithymia and cigarette smoking and alexithymia and alcohol consumption. Future research is warranted to investigate the mediating effect of emotional intelligence and how these results may be used to meet the needs of alexithymic individuals with addictions.

Aqueous humor dynamics are commonly assessed by infusing fluid into the eye and measuring intraocular pressure (IOP). From the pressure-flow relationship, conventional outflow facility is estimated to study glaucomatous processes that lower facility or identify therapeutics that enhance facility in hopes of restoring healthy IOP levels. The relative merits and limitations of constant flow (CF), gravity-driven constant pressure (CPg), and pump-driven constant pressure (CPp) infusion techniques were explored via simulations of a lumped parameter viscoelastic model of the eye. Model parameter values were based on published perfusion system properties and outflow facility data from rodents. Step increases in pressure or flow were simulated without and with IOP noise recorded from enucleated eyes, anesthetized animals, and conscious animals. Steady-state response levels were determined using published window and ratio criteria. Model simulations show that all perfusion techniques estimate facility accurately and that ocular fluid dynamics set a hard limit on how fast measurements can be taken. This limit can be approached with CPg and CPp systems by increasing their gain but not with CF systems, which invariably take longest to settle. Facility experiment duration is further lengthened by inclusion of IOP noise, and data filtering is needed for steady-state detection with in vivo noise. The ratio criterion was particularly affected because noise in the flow data is amplified by the higher gain of CPg and CPp systems. A recursive regression method is introduced, which can ignore large transient IOP fluctuations that interfere with steady-state detection by fitting incoming data to the viscoelastic eye model. The fitting method greatly speeds up data collection without loss of accuracy, which could enable outflow facility measurements in conscious animals. The model may be generalized to study response dynamics to fluid infusion in other viscoelastic compartments of the body and model insights extended to optimize experiment design.

With over 1,400 species worldwide, bats represent the second largest order of mammals after rodents, and are known to host major zoonotic pathogens. Here, we estimate the presence of pathogens in autochthonous bat populations. First, we set out to check our samples for PCR amplification efficiency by assessing the occurrence of inhibited PCR reactions from different types of bat samples with amplifying the housekeeping gene β-actin. Second, we investigated the presence of five targeted pathogens in a French bat population using PCR. We targeted viral RNA of Canine distemper virus, Alphacoronavirus, Lyssavirus, Rotavirus and bacterial Leptospira DNA. To do so, we screened for these viruses in bat faecal samples as well as in oropharyngeal swab samples. The presence of Leptospira was assessed in urine, kidney, lung and faecal samples. Results showed a frequency of inhibited reactions ranging from 5 to 60% of samples, varying according to the sample itself and also suspected to vary according to sampling method and the storage buffer solution used, demonstrating the importance of the sampling and storage on the probability of obtaining negative PCR results. For pathogen assessment, rotavirus and alphacoronavirus RNA were detected in Myotis myotis, Myotis daubentonii, Myotis emarginatus and Rhinolophus ferrumequinum bats. Rotaviruses were also detected in Barbastella barbastellus. The presence of alphacoronavirus also varied seasonally, with higher frequencies in late summer and October, suggesting that juveniles potentially play an important role in the dynamics of these viruses. Leptospira DNA was detected in M. myotis and M. daubentonii colonies. The 16S rRNA sequences obtained from Leptospira positive samples showed 100% genetic identity with L. borgpetersenii. Neither canine distemper virus nor lyssavirus RNA were detected in any of the tested samples. This study is the first to show the presence of Leptospira in autochthonous French bats in addition to coronavirus and rotavirus RNA previously reported in European autochthonous bats.

Intraocular pressure (IOP) is heavily influenced by the resistance of trabecular outflow pathways through which most of the aqueous humor produced by the eye continuously drains. The standard method of quantifying outflow resistance and other aspects of ocular fluid dynamics is eye cannulation, which allows for direct measurement and manipulation of IOP and flow in animal models. Since the method is invasive, indirect techniques that are slower and less accurate must be used for chronological studies. A novel technology is introduced that can autonomously measure outflow facility in conscious rats multiple times a day. A smart portable micropump infuses fluid into the eye through a permanently-implanted cannula and dynamically adjusts flow rate using a unique proportional feedback algorithm that sets IOP to a target level, even though IOP fluctuates erratically in awake free-moving animals. Pressure-flow data collected by the system from anesthetized rats were validated against intraocular recordings with commercial pressure and flow sensors. System and sensor estimates of outflow facility were indistinguishable, averaging 23 ± 3 nl·min-1·mmHg-1 across animals (n = 11). Pressure-flow data were then collected round-the-clock for several days from conscious rats, while outflow facility was measured every few hours. A significant diurnal facility rhythm was observed in every animal (n = 4), with mean daytime level of 22 ± 10 nl·min-1·mmHg-1 and mean nighttime level of 15 ± 7 nl·min-1·mmHg-1. The rhythm correlated with diurnal changes in IOP and likely contributed prominently to those changes based on the day-night swing in facility magnitude. Hence, the portable smart pump offers a unique tool for repeated long-term monitoring of outflow facility and other possible parameters of ocular health. It could also be useful in animal glaucoma studies for reversibly inducing acute or chronic ocular hypertension without explicitly damaging trabecular outflow pathways.

Phosphorus deficiency induces biochemical and morphological changes which affect crop yield and production. Prompt fluorescence signal characterizes the PSII activity and electron transport from PSII to PSI, while the modulated light reflection at 820 (MR 820) nm investigates the redox state of photosystem I (PSI) and plastocyanin (PC). Therefore, combining information from modulated reflection at 820 nm with chlorophyll a fluorescence can potentially provide a more complete understanding of the photosynthetic process and integrating other plant physiological measurements may help to increase the accuracy of detecting the phosphorus deficiency in wheat leaves. In our study, we combined the chlorophyll a fluorescence and MR 820 signals to study the response of wheat plants to phosphorus deficiency as indirect tools for phosphorus plant status characterization. In addition, we studied the changes in chlorophyll content index, stomatal conductance (gs), root morphology, and biomass of wheat plants. The results showed an alteration in the electron transport chain as a specific response to P deficiency in the I-P phase during the reduction of the acceptor side of PSI. Furthermore, P deficiency increased parameters related to the energy fluxes per reaction centers, namely ETo/RC, REo/RC, ABS/RC, and DIo/RC. P deficiency increased the values of MRmin and MRmax and decreased νred, which implies that the reduction of PSI and PC became slower as the phosphorus decreased. The principal component analysis of the modulated reflection and chlorophyll a fluorescence parameters, with the integration of the growth parameters as supplementary variables, accounted for over 71% of the total variance in our phosphorus data using two components and provided a reliable information on PSII and PSI photochemistry under P deficiency.

This study introduces the global-local least-squares support vector machine (GLocal-LS-SVM), a novel machine learning algorithm that combines the strengths of localised and global learning. GLocal-LS-SVM addresses the challenges associated with decentralised data sources, large datasets, and input-space-related issues. The algorithm is a double-layer learning approach that employs multiple local LS-SVM models in the first layer and one global LS-SVM model in the second layer. The key idea behind GLocal-LS-SVM is to extract the most informative data points, known as support vectors, from each local region in the input space. Local LS-SVM models are developed for each region to identify the most contributing data points with the highest support values. The local support vectors are then merged at the final layer to form a reduced training set used to train the global model. We evaluated the performance of GLocal-LS-SVM using both synthetic and real-world datasets. Our results demonstrate that GLocal-LS-SVM achieves comparable or superior classification performance compared to standard LS-SVM and state-of-the-art models. In addition, our experiments show that GLocal-LS-SVM outperforms standard LS-SVM in terms of computational efficiency. For instance, on a training dataset of 9, 000 instances, the average training time for GLocal-LS-SVM was only 2% of the time required to train the LS-SVM model while maintaining classification performance. In summary, the GLocal-LS-SVM algorithm offers a promising solution to address the challenges associated with decentralised data sources and large datasets while maintaining high classification performance. Furthermore, its computational efficiency makes it a valuable tool for practical applications in various domains.

Recent work shows that ambient exposure in everyday situations can yield implicit knowledge of a language that an observer does not speak. We replicate and extend this work in the context of Spanish in California and Texas. In Word Identification and Wellformedness Rating experiments, non-Spanish-speaking Californians and Texans show implicit lexical and phonotactic knowledge of Spanish, which may be affected by both language structure and attitudes. Their knowledge of Spanish appears to be weaker than New Zealanders' knowledge of Māori established in recent work, consistent with structural differences between Spanish and Māori. Additionally, the strength of a participant's knowledge increases with the value they place on Spanish and its speakers in their state. These results showcase the power and generality of statistical learning of language in adults, while also highlighting how it cannot be divorced from the structural and attitudinal factors that shape the context in which it occurs.

The underlying anatomical structure is fundamental to the study of brain networks, but the role of brainstem from a structural perspective is not very well understood. We conduct a computational and graph-theoretical study of the human structural connectome incorporating a variety of subcortical structures including the brainstem. Our computational scheme involves the use of Python DIPY and Nibabel libraries to develop structural connectomes using 100 healthy adult subjects. We then compute degree, eigenvector, and betweenness centralities to identify several highly connected structures and find that the brainstem ranks highest across all examined metrics, a result that holds even when the connectivity matrix is normalized by volume. We also investigated some global topological features in the connectomes, such as the balance of integration and segregation, and found that the domination of the brainstem generally causes networks to become less integrated and segregated. Our results highlight the importance of including the brainstem in structural network analyses.

Until now, the solubilization capacities of insoluble mineral P by soil microorganisms have been screened in vitro with media containing NH4+ as a nitrogen source. This presence of NH4+ will lead to an acidification of the medium responsible for the solubilization of the insoluble P. However, besides proton release, the production of organic acids can play a very important role in the release of free P. This physiological mechanism can largely depend on the source of nitrogen (NH4+vs NO3-) assimilated by the bacteria but the influence of the N source on the production of organic acids has yet to be studied. Our aim was to investigate if the N source assimilated by bacteria and the soil characteristics such as the dominant N source (NH4+vs NO3-) and CaCO3 contents might influence the bacterial capacities to solubilize rock phosphate. To fill this objective, we screened the capacity of bacteria isolated from 3 soils to solubilize rock phosphate in vitro in presence of NH4+or NO3-. Then, we selected the most efficient bacterial strains to identify and quantify the release of organic anions into the medium. Among the two hundred and forty-three bacterial strains isolated from the 3 soils, nine and seven isolates were identified with the highest % rock phosphate-solubilization values with NH4+ or NO3- as the sole N-source. Only one strain was able to release free Pi with NH4+ or NO3- as the sole N-source. The most predominant organic acids released by almost all isolates were gluconic acid, lactic acid, glycolic acid, acetic acid, formic acid and pyruvic acid regardless the N-source. However, with NO3- as source of N, the highest concentrations on those acids were found together with the highest release of free Pi into the medium. Molecular analysis of 16S rRNA indicated that almost all strains belonged to Bacillus and Paenibacillus genera. The PCA analysis between soil properties and bacterial capacities to release organic acids and free Pi also revealed that soil factors such as CaCO3 and soil NO3- content positively influenced the release of organic acids by bacteria grown in vitro. Our results concluded that the bacterial rock phosphate-solubilization was intimately related to organic acids production which in turn seemed to be driven by the assimilation of NO3- by bacteria. Therefore, the N-source might be considered a key factor to take into consideration during the screening and selection of suitable strains involved in the P-solubilization.

BackgroundWaterpipe (WP) use is rapidly increasing among young people worldwide due to the widespread misperception that it is safer than cigarette smoking. Health warning labels (HWLs) can effectively communicate tobacco-related health risks but have yet to be developed for WP. This study aimed to optimize and adapt a set of 16 pictorial WP-specific HWLs, developed by an international Delphi study, to the Tunisian context. HWLs were grouped into four themes: WP health risks, WP harm to others, WP-specific harms, and WP harm compared to cigarettes.MethodsUsing a mixed method approach, we conducted ten focus groups combined with a survey among young WP users and nonusers (N = 63; age 18-34 years). In the survey, participants rated the HWLs on several communication outcomes (e.g., reaction, harm perception, effectiveness) and were then instructed to view all HWLs in each theme and rank them in the order of overall perceived effectiveness, from the most to the least effective. Afterward, participants provided in-depth feedback on HWLs and avenues for improvement. Mean effectiveness rating scores and percentages of participants' top-ranked HWLs were calculated. Discussions were audio-taped, transcribed verbatim, and analyzed thematically.ResultsThe top-ranked HWLs were those showing oral cancers, orally transmitted diseases, and a sick child. Focus group discussion illustrated that these selections were based on participants' reactions to the direct impact of WP on a person's physical appearance and evoking guilt over children's exposure to WP smoke. Suggestions for improvement highlighted the need to use the local dialect and more affirmative statements (e.g., avoiding "may" or "can").ConclusionsThis study is the first in North Africa to attempt to advance HWLs policy as the World Health Organization recommended. The results of this study can be used as a basis for implementing WP-specific health messages in the Eastern Mediterranean Region.

Driving anger may vary across countries due to culture. This might affect driver behavior, which, in turn, impacts the driving outcomes. This study aims to investigate the relationship between socio-demographic variables, driving anger, and the self-reported aberrant behavior among Lebanese drivers and to determine which anger dimension is linked to driving behavior. A cross-sectional study was conducted among eligible Lebanese drivers from all Lebanese governorates. Data were collected using an anonymous Arabic self-reported questionnaire that included demographic information, driving-related variables, and two scales: the Driver Behavior Questionnaire (DBQ) and the Driver Anger Scale (DAS). Four hierarchical regressions were performed taking the DBQ subscales as the dependent variable and the DAS subscales as independent variables. Out of 1102 surveyed drivers, 68.4% were males, having a mean age of 34.6 ± 12.3 years and an average driving experience of 13.5 ± 10.8 years. DBQ, DAS, and their subscales showed good reliability. Older age and female gender were negatively associated with the tendency of committing aggressive violations. However, being a professional driver and increasing annual mileage were positively associated with a higher tendency to commit aggressive violations. In addition to these factors, a higher educational level was found associated with a lower risk of driver's involvement in traffic violations. However, increased driving experience was associated with a higher tendency to commit aggressive violations. Reported driving errors were also found positively associated with older age, increasing mileage, and being a professional driver. However, larger driving experience and higher education were found protectors from erroneous behavior. Hierarchical regression showed that anger prompted by hostile gesture, discourtesy, police presence, traffic obstruction, and slow driving were positively associated with aggressive violations. All the DAS subscales were found to be positively associated with ordinary violations. traffic obstruction was also found associated with a higher tendency of drivers to commit lapses, as well as anger, which originated from police presence and slow driving which were found also positively associated with errors. Driver anger dimensions were found positively associated with aberrant driver behavior. To overcome road anger, there is a need to train drivers on coping strategies to restrain aberrant driving behavior.

Women's breast cancer is one of the most significant healthcare issues for the human race that demands a proactive strategy for a cure. In this study, the cytotoxic activity (MTT assay) of two natural steroidal compounds, protodioscin and dioscin, against two major subtypes of human breast cancer estrogen receptor-positive (ER-positive)/MCF-7 and triple-negative breast cancer (TNBC)/MDA-MB-468), was assessed. The clonogenic capacity was evaluated using the clonogenic assay. Oxidative stress was determined by measuring the formation of malondialdehyde and H2O2 and the assessment of total antioxidant enzyme activities (SOD, GPx, GR, and TrxR). Protodioscin and dioscin were highly cytotoxic against the tested cell lines (1.53 μM

Since Health care workers (HCWs) are at high occupational risk for COVID-19, they are prioritized for immunization. This study aimed to assess the acceptance rate of the COVID-19 vaccine among HCWs and to identify its determinants. A web-based cross-sectional study was conducted between10 and 31 December 2020 among Lebanese HCWs. The Health Belief Model (HBM) was used as a theoretical framework. Multivariable logistic analyses were carried out to identify the factors associated with the acceptance of the COVID-19 vaccine among HCWs. A total of 1800 HCWs have completed the survey. Around half (58.10%) of them were frontline HCWs and aged between (30–49) years old. Over two-thirds (67.33%) of the participants have received the seasonal influenza vaccine. The acceptance rate of the COVID-19 vaccine among surveyed HCWs was 58%. HCWs who were male (aOR = 1.99, 95% CI (1.41–2.80)), working in the frontlines (aOR = 1.61, 95% CI (1.17–2.21), and those who have received influenza vaccination for the current year (aOR = 1.38, 95% CI(0.99–1.92)) were more willing to get the COVID-19 vaccine. However, factors such as living in rural areas (aOR = 0.61, 95% CI (0.44–0.84)), and being previously diagnosed with COVID-19 (aOR = 0.66, 95%CI (0.45–0.96) were found negatively associated with vaccine acceptance. In terms of health beliefs items, concerns related to the novelty of vaccine (aOR = 0.42, 95% CI (0.25–0.71)), side effects/vaccine safety (aOR = 0.41, 95% CI (0.23–0.73), reliability of manufacturer (aOR = 0.43, 95% CI (0.30–0.63)), and the number of required doses (aOR = 0.58, 95% CI (0.40–0.84)) were also negatively associated with the willingness to get vaccinated against COVID-19. Remarkably, concerns such as the limited accessibility (aOR = 1.68, 95% CI (1.14–2.47)), and availability of vaccines (aOR = 2.16, 95% CI (1.46–3.20)) were associated with an increased likelihood of willingness to receive the COVID-19 vaccine. With regards to cues of action, receiving reliable and adequate information about the vaccine (aOR = 1.98, 95% CI (1.36–2.88)), recommendation by health authorities (aOR = 1.93, 95% CI(1.33–2.81)), and recommendations from health facilities (aOR = 2.68, 95% CI(1.80–3.99)) were also positively associated with vaccine acceptance. Lastly, perception of COVID-19 vaccine benefits by HCWs in terms of protecting them and their close contacts (patients, family members, and friends) from COVID-19 infection (aOR = 4.21, 95% CI (2.78–7.11)) was associated with an increased likelihood of vaccine uptake. The moderate acceptance rate of the COVID-19 vaccine among HCWs found in our study could have broader extents. Understanding and pointing out factors impairing vaccine acceptance such as concerns about the novelty of vaccine and manufacturers’ reliability are required to reach a higher vaccination rate.

Temporary changes in the menstrual cycle have recently been reported following SARS-CoV-2 vaccination. In the current study, we aimed to screen menstrual cycle changes following SARS-CoV-2 infection in Saudi Arabia. The type and duration of these changes have been screened in relation to the severity of coronavirus disease symptoms and vaccination status. In total, 956 individuals responded: sixty-nine did not get the COVID-19 vaccine, while the remaining were vaccinated with either a single dose of ChAdOx1 vaccine (n:45) or BNT162b2 vaccine (n: 142) or two doses of the vaccine (n:700) using BNT162b2 (n:477), ChAdOx1 (n:89) or ChAdOx1/ BNT162b2 (n:134). Approximately 26.1% (18/69) of the subjects who did not receive the SARS-CoV-2 vaccine and 15.3% (29/188) and 26.4% (185/700) of the subjects who received single and double doses of the vaccines, respectively, reported menstrual cycle changes. The persistence of menstrual cycle changes for more than six months was reported by 6.4% (61/956) of the participants. These changes were significantly correlated with the severity of COVID-19 infection. We concluded that menstrual cycle changes, associated with COVID-19 infection, increase due to the severity of COVID-19 infection. Thus, menstrual cycle changes are among the long-term effects associated with COVID-19 infection.

BackgroundThere is a growing literature showing that critically ill COVID-19 patients have an increased risk of pulmonary co-infections and superinfections. However, studies in developing countries, especially African countries, are lacking. The objective was to describe the prevalence of bacterial co-infections and superinfections in critically ill adults with severe COVID-19 pneumonia in Morocco, the micro-organisms involved, and the impact of these infections on survival.MethodsThis retrospective study included severe COVID-19 patients admitted to the intensive care unit (ICU) between April 2020 and April 2021. The diagnosis of pulmonary co-infections and superinfections was based on the identification of pathogens from lower respiratory tract samples. Co-infection was defined as the identification of a respiratory pathogen, diagnosed concurrently with SARS-Cov2 pneumonia. Superinfections include hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). A multivariate regression analysis was performed to identify factors independently associated with mortality.ResultsData from 155 patients were analyzed. The median age was 68 years [62-72] with 87% of patients being male. A large proportion of patients (68%) received antibiotics before ICU admission. Regarding ventilatory management, the majority of patients (88%) underwent non-invasive ventilation (NIV). Sixty-five patients (42%) were placed under invasive mechanical ventilation, mostly after failure of NIV. The prevalence of co-infections, HAP and VAP was respectively 4%, 12% and 40% (64 VAP/1000 ventilation days). The most isolated pathogens were Enterobacterales for HAP and Acinetobacter sp. for VAP. The proportion of extra-drug resistant (XDR) bacteria was 78% for Acinetobacter sp. and 24% for Enterobacterales. Overall ICU mortality in this cohort was 64.5%. Patients with superinfection showed a higher risk of death (OR = 6.4, 95% CI: 1.8-22; p = 0.004).ConclusionsIn this single-ICU Moroccan COVID-19 cohort, bacterial co-infections were relatively uncommon. Conversely, high rates of superinfections were observed, with an increased frequency of antimicrobial resistance. Patients with superinfections showed a higher risk of death.

Background The COVID-19 pandemic was one of the most devastating health crises the world has seen. One of its mental health consequences includes fear of being infected, which could lead to anxiety. This study aimed to assess the fear related to the COVID-19 pandemic and its associated factors among the adult population in Lebanon. Methods A cross-sectional study was conducted in Lebanon between February 26th and April 29th, 2021. Data was collected through an online survey among adults aged 18 years and older. Information on sociodemographic and clinical characteristics of the participants, fear and death anxiety related to the COVID-19 pandemic, depression, and anxiety were collected. Multivariable linear regression analyses were carried out to identify the predictors of fear related to the COVID-19 pandemic. Results A total of 1840 participants were included in the analysis of which 62.9% were females and 62.2% were single. The age of the participants ranged from 18 to 70 years with a mean of 26.6 ±8.8 years. Of the total participants, 41.9% felt uncomfortable thinking about the novel Coronavirus and 35.4% of candidates became nervous/anxious when watching the news about COVID-19 on social media. About one-third of the participants (33.7%) were afraid of COVID-19 and 23.8% were afraid of losing their life because of the disease. Concerning somatic symptoms of fear, 7.9% reported increased heart races or palpitations whenever they thought about getting infected with COVID-19, 3.7% complained about sleep disturbances while 2.5% developed tremors or sweating in their hands when they thought about Coronavirus. In addition, Death anxiety related to the COVID-19 pandemic was one of the most fear-related factors (B = 0.191, 95% CI (0.172 to 0.211), P-value < 0.0001). Conclusion This study provides insights on the impact of COVID-19 on individuals at the level of fear in Lebanon. Death anxiety was identified as the most significant predictor of fear related to the COVID-19 pandemic. Considering the negative psychological effects of fear, it is necessary to educate the adults on how to deal with death anxiety and implement psychological interventions and counseling programs to relieve fear and improve the mental health of Lebanese adults.

Background The COVID-19 pandemic claimed millions of lives worldwide without clear signs of abating despite several mitigation efforts and vaccination campaigns. There have been tremendous interests in understanding the etiology of the disease particularly in what makes it severe and fatal in certain patients. Studies have shown that COVID-19 patients with kidney injury on admission were more likely to develop severe disease, and acute kidney disease was associated with high mortality in COVID-19 hospitalized patients. Methods This study investigated 819 COVID-19 patients admitted between January 2020-April 2021 to the COVID-19 ward at a tertiary care center in Lebanon and evaluated their vital signs and biomarkers while probing for two main outcomes: intubation and fatality. Logistic and Cox regressions were performed to investigate the association between clinical and metabolic variables and disease outcomes, mainly intubation and mortality. Times were defined in terms of admission and discharge/fatality for COVID-19, with no other exclusions. Results Regression analysis revealed that the following are independent risk factors for both intubation and fatality respectively: diabetes (p = 0.021 and p = 0.04), being overweight (p = 0.021 and p = 0.072), chronic kidney disease (p = 0.045 and p = 0.001), and gender (p = 0.016 and p = 0.114). Further, shortness of breath (pConclusions Collectively our data show that high creatinine levels were significantly associated with fatality in our COVID-19 study patients, underscoring the importance of kidney function as a main modulator of SARS-CoV-2 morbidity and favor a careful and proactive management of patients with elevated creatinine levels on admission.

With more than 1400 chiropteran species identified to date, bats comprise one-fifth of all mammalian species worldwide. Many studies have associated viral zoonoses with 45 different species of bats in the EU, which cluster within 5 families of bats. For example, the Serotine bats are infected by European Bat 1 Lyssavirus throughout Europe while Myotis bats are shown infected by coronavirus, herpesvirus and paramyxovirus. Correct host species identification is important to increase our knowledge of the ecology and evolutionary pattern of bat viruses in the EU. Bat species identification is commonly determined using morphological keys. Morphological determination of bat species from bat carcasses can be limited in some cases, due to the state of decomposition or nearly indistinguishable morphological features in juvenile bats and can lead to misidentifications. The overall objective of our study was to identify insectivorous bat species using molecular biology tools with the amplification of the partial cytochrome b gene of mitochondrial DNA. Two types of samples were tested in this study, bat wing punches and bat faeces. A total of 163 bat wing punches representing 22 species, and 31 faecal pellets representing 7 species were included in the study. From the 163 bat wing punches tested, a total of 159 were genetically identified from amplification of the partial cyt b gene. All 31 faecal pellets were genetically identified based on the cyt b gene. A comparison between morphological and genetic determination showed 21 misidentifications from the 163 wing punches, representing ~12.5% of misidentifications of morphological determination compared with the genetic method, across 11 species. In addition, genetic determination allowed the identification of 24 out of 25 morphologically non-determined bat samples. Our findings demonstrate the importance of a genetic approach as an efficient and reliable method to identify bat species precisely.

In stressful situations such as the COVID-19-pandemic, unpleasant emotions are expected to increase while pleasant emotions will likely decrease. Little is known about the role cognitive appraisals, information management, and upregulating pleasant emotions can play to support emotion regulation in a pandemic. In an online survey (N = 1682), we investigated predictors of changes in pleasant and unpleasant emotions in a German sample (aged 18-88 years) shortly after the first restrictions were imposed. Crisis self-efficacy and felt restriction were predictors of changes in unpleasant emotions and joy alike. The application of emotion up-regulation strategies was weakly associated with changes in joy. Among the different upregulation strategies, only "savouring the moment" predicted changes in joy. Our study informs future research perspectives assessing the role of upregulating pleasant emotions under challenging circumstances.

Parenting interventions offer an evidence-based method for the prevention and early intervention of child mental health problems, but to-date their population-level effectiveness has been limited by poor reach and engagement, particularly for fathers, working mothers, and disadvantaged families. Tailoring intervention content to parents' context offers the potential to enhance parent engagement and learning by increasing relevance of content to parents' daily experiences. However, this approach requires a detailed understanding of the common parenting situations and issues that parents face day-to-day, which is currently lacking. We sought to identify the most common parenting situations discussed by parents on parenting-specific forums of the free online discussion forum, Reddit. We aimed to understand perspectives from both mothers and fathers, and thus retrieved publicly available data from r/Daddit and r/Mommit. We used latent Dirichlet allocation to identify the 10 most common topics discussed in the Reddit posts, and completed a manual text analysis to summarize the parenting situations (defined as involving a parent and their child aged 0-18 years, and describing a potential/actual issue). We retrieved 340 (r/Daddit) and 578 (r/Mommit) original posts. A model with 31 latent Dirichlet allocation topics was best fitting, and 24 topics included posts that met our inclusion criteria for manual review. We identified 45 unique but broadly defined parenting situations. The majority of parenting situations were focused on basic childcare situations relating to eating, sleeping, routines, sickness, and toilet training; or related to how to respond to child negative emotions or difficult behavior. Most situations were discussed in relation to infant or toddler aged children, and there was high consistency in the themes raised in r/Daddit and r/Mommit. Our results offer potential to tailor parenting interventions in a meaningful way, creating opportunities to develop content and resources that are directly relevant to parents' lived experiences.

COVID-19 pandemic has led to psychological health issues one of which is fear. This study validates the Arabic version of the fear of COVID-19 scale and suggests a new cutoff score to measure fear of COVID-19 among the Syrian Population. A total of 3989 participants filled an online survey consisting of socio-demographic information, the fear of COVID-19 scale, the patient health questionnaire 9-item, and the generalized anxiety disorder 7-item. Receiver operating characteristic analysis was used to define cutoff scores for the fear of COVID-19 scale in relation to generalized anxiety disorder 7-item and the patient health questionnaire 9-item. The Cronbach α value of the Arabic fear of COVID-19 scale was 0.896, revealing good stability and internal consistency. The inter-item correlations were between [0.420–0.868] and the corrected item-total correlations were between [0.614–0.768]. A cutoff point of 17.5 was deduced from the analysis. According to the deduced cutoff point, 2111(52.9%) were categorized as extreme fear cases. This cutoff score deduced from this study can be used for screening purposes to distinguish community members that may be prone to developing extreme fear of COVID-19. Therefore, early preventive and supportive measures can then be delivered.

Software-defined networks offer a new approach that attracts the attention of most academic and industrial circles due to the features it contains. However, some loopholes make such modern networks vulnerable to many types of attacks. Among the most important types of these attacks is the Distributed Denial of Service (DDoS) attack, which in turn affects the network's performance and delays many real user requests. As one of the main features of SDN is the centralization of all the control plane in the SDN controller, it becomes a central point of attack that may compromise the whole network. Hence, in our proposed approach, we aim to mitigate the DDoS attack that maybe launched to compromise the SDN controller, flood the control plane and cripple the entire network. Many DDoS mitigation scheme have been proposed, however, determining the threshold between legitimate requests and malicious requests is still a challenging task. Our proposed approach relies on a two-phases algorithm that assigns a variable trust value for every user. This trust value is compared with schemes relying on a threshold value that changes dynamically and assists in detecting the DDoS attack. The first phase of our two-phases algorithm is Header fields extraction, and the second phase is calculating the trust value based on header fields information. Our proposed approach shows better performance than related detection schemes in terms of accuracy, detection rate, and false-positive rate. Where the accuracy of the system reaches up to 98.83% which is high compared to other traditional methods.

The "Latescibacteria" (formerly WS3), member of the Fibrobacteres-Chlorobi-Bacteroidetes (FCB) superphylum, represents a ubiquitous candidate phylum found in terrestrial, aquatic, and marine ecosystems. Recently, single-cell amplified genomes (SAGs) representing the "Latescibacteria" were obtained from the anoxic monimolimnion layers of Sakinaw Lake (British Columbia, Canada), and anoxic sediments of a coastal lagoon (Etoliko lagoon, Western Greece). Here, we present a detailed in-silico analysis of the four SAGs to gain some insights on their metabolic potential and apparent ecological roles. Metabolic reconstruction suggests an anaerobic fermentative mode of metabolism, as well as the capability to degrade multiple polysaccharides and glycoproteins that represent integral components of green (Charophyta and Chlorophyta) and brown (Phaeophycaea) algae cell walls (pectin, alginate, ulvan, fucan, hydroxyproline-rich glycoproteins), storage molecules (starch and trehalose), and extracellular polymeric substances (EPSs). The analyzed SAGs also encode dedicated transporters for the uptake of produced sugars and amino acids/oligopeptides, as well as an extensive machinery for the catabolism of all transported sugars, including the production of a bacterial microcompartment (BMC) to sequester propionaldehyde, a toxic intermediate produced during fucose and rhamnose metabolism. Finally, genes for the formation of gas vesicles, flagella, type IV pili, and oxidative stress response were found, features that could aid in cellular association with algal detritus. Collectively, these results indicate that the analyzed "Latescibacteria" mediate the turnover of multiple complex organic polymers of algal origin that reach deeper anoxic/microoxic habitats in lakes and lagoons. The implications of such process on our understanding of niche specialization in microbial communities mediating organic carbon turnover in stratified water bodies are discussed.

Since December 2019, the coronavirus disease (COVID-19) pandemic has catapulted the world into a marked health crisis, with over 29 million cases and >930,000 deaths. To better detect affected individuals at an early stage and stop disease progression to an advanced stage, several studies have been conducted to identify the clinical, biological, and radiological characteristics of COVID-19. This study aimed to enrich the literature by critically analyzing the clinical and biological characteristics of 134 patients from the North African Mediterranean region, including numerous genetic, epigenetic, and environmental factors that may influence disease evolution. This single-center retrospective study included all patients older than 18 years confirmed to have COVID-19 and hospitalized at the Cheikh Khalifa University Hospital affiliated with Mohammed VI University of Health Sciences, Casablanca, Morocco. Clinical, demographic, and biological data were analyzed in a cohort of severe and non-severe patients. Univariate analysis was performed to identify factors predictive of severity. There were 134 patients: the median age was 53 years, and 54.5% were male. Of these, 89 had mild to moderate disease; 45 had severe to critical disease, of which 14 died and 31 survived. Advanced age, presence of comorbidities, male sex, and infection in ethnic or family groups were risk factors for progression to severe disease. The presence of abnormalities in the following parameters were strongly associated with progression to severe disease: white blood cells (WBC), neutrophils, lymphocytes, C-reactive protein (CRP), procalcitonin, D-dimers, lactate dehydrogenase (LDH), ferritin, creatinine, aspartate aminotransferase (ASAT), and alanine aminotransferase (ALAT) during both admission and hospitalization. Based on these results and an extensive literature review, we recommend that clinicians closely monitor the biological parameters identified herein and perform immunological and genetic studies.

BackgroundOn January 30th 2020, the World Health Organization (WHO) declared a international health emergency due to the unprecedented phenomenon of COVID-19. After this declaration countries swiftly implemented a variety of health policies. In this work we examine how rapid countries responded to this pandemic using two events: the day in which the first case of COVID-19 was reported, and first day in which countries used school closure as one of the measures to avoid outbreaks. We also assessed how countries' health systems, globalization, economic development, political systems, and economic integration to China, Republic of Korea and Italy increased the speed of adoption.MethodsWe compiled information from multiple sources, from December 31st 2019 to June 1st 2020, to trace when 172 countries reported their first COVID-19 case and implemented school closure to contain outbreaks. We applied cross-national Weibull survival analysis to evaluate the global speed of detection of first COVID-19 reported cases and school closure.ResultsTen days after WHO declared COVID-19 to be an international emergency, relative to seven days from this declaration, countries were 28 (95% CI: 12-77) times more likely to report first COVID-19 cases and 42 (95% CI: 22-90) times more likely to close schools. One standard deviation increase in the epidemic security index rises the rate of report first cases by 37% (Hazard Ratio (HR) 1.37 (95% CI: 1.09-1.72) and delays the adoption for school closures by 36% (HR 0.64 (95% CI:0.50-0.82). One standard deviation increase in the globalization index augments the adoption for school closures by 74% (HR 1.74 (95% CI:1.34-2.24).ConclusionAfter the WHO declared a global emergency, countries were unprecedently acting very rapidly. While countries more globally integrated were swifter in closing schools, countries with better designed health systems to tackle epidemics were slower in adopting it. More studies are needed to assess how the speed of school closures and other policies will affect the development of the pandemic.

The Arab population encompasses over 420 million people characterized by genetic admixture and a consequent rich genetic diversity. A number of genetic diseases have been reported for the first time from the population. Additionally a high prevalence of some genetic diseases including autosomal recessive disorders such as hemoglobinopathies and familial mediterranean fever have been found in the population and across the region. There is a paucity of databases cataloguing genetic variants of clinical relevance from the population. The availability of such a catalog could have implications in precise diagnosis, genetic epidemiology and prevention of disease. To fill in the gap, we have compiled DALIA, a comprehensive compendium of genetic variants reported in literature and implicated in genetic diseases reported from the Arab population. The database aims to act as an effective resource for population-scale and sub-population specific variant analyses, enabling a ready reference aiding clinical interpretation of genetic variants, genetic epidemiology, as well as facilitating rapid screening and a quick reference for evaluating evidence on genetic diseases.

BackgroundCOVID 19 is the most recent cause of Adult respiratory distress syndrome ARDS. Invasive mechanical ventilation IMV can support gas exchange in patients failing non-invasive ventilation, but its reported outcome is highly variable between countries. We conducted a systematic review and meta-analysis on IMV for COVID-associated ARDS to study its outcome among different countries.MethodsCENTRAL, MEDLINE/PubMed, Cochrane Library, and Scopus were systematically searched up to August 8, 2020. Studies reporting five or more patients with end point outcome for severe COVID 19 infection treated with IMV were included. The main outcome assessed was mortality. Baseline, procedural, outcome, and validity data were systematically appraised and pooled with random-effect methods. Subgroup analysis for different countries was performed. Meta-regression for the effect of study timing and patient age and were tested. Publication bias was examined. This trial was registered with PROSPERO under registration number CRD42020190365.FindingsOur electronic search retrieved 4770 citations, 103 of which were selected for full-text review. Twenty-one studies with a combined population of 37359 patients with COVID-19 fulfilled the inclusion criteria. From this population, 5800 patients were treated by invasive mechanical ventilation. Out of those, 3301 patients reached an endpoint of ICU discharge or death after invasive mechanical ventilation while the rest were still in the ICU. Mortality from IMV was highly variable among the included studies ranging between 21% and 100%. Random-effect pooled estimates suggested an overall in-hospital mortality risk ratio of 0.70 (95% confidence interval 0.608 to 0.797; I2 = 98%). Subgroup analysis according to country of origin showed homogeneity in the 8 Chinese studies with high pooled mortality risk ratio of 0.97 (I2 = 24%, p = 0.23) (95% CI = 0.94-1.00), similar to Italy with a low pooled mortality risk ratio of 0.26 (95% CI 0.08-0.43) with homogeneity (p = 0.86) while the later larger studies coming from the USA showed pooled estimate mortality risk ratio of 0.60 (95% CI 0.43-0.76) with persistent heterogeneity (I2 = 98%, pInterpretationThe study included the largest number of patients with outcome findings of IMV in this current pandemic. Our findings showed that the use of IMV for selected COVID 19 patients with severe ARDS carries a high mortality, but outcome has improved over the last few months and in more recent studies. The results should encourage physicians to use this facility when indicated for severely ill COVID-19 patients.

Quantitative measurement of nanoscale surface roughness of articular cartilage tissue is significant to assess the surface topography for early treatment of osteoarthritis, the most common joint disease worldwide. Since it was not established by clinical diagnostic tools, the current studies have been suggesting the use of alternative diagnostic tools using pre-clinical methods. This study aims to measure the nanoscale surface roughness of articular cartilage tissue utilizing biospeckle which is used as a non-destructive and non-contact optical imaging technique. An experimental setup was implemented to capture biospeckle images from twelve cross-section areas of articular cartilage tissue gathered from bovine knee joints at 632 nm wavelength laser radiation. Then, to analyze the biospeckle image, a second-order statistical-based method was proposed through the combination of 308 highly correlated statistical features extracted from implemented gray-level co-occurrence matrices by employing principal component analysis. The result indicated that the measurement of the nanoscale surface roughness based on the first principal component only is able to provide accurate and precise quantitative measurement of early signs of articular cartilage degeneration up to 2500 nm.

ObjectivesNomophobia, an abbreviation of "No mobile phone phobia", is characterized by the illogical fear of being detached from the mobile phone or unable to use it. Research have provided evidence of an association between increased cellular phone use and multiple health issues, such as anxiety, depression, insomnia, and others. To our knowledge, there are no Lebanese studies about nomophobia, despite the high incorporation rate of mobile phones in Lebanon and the likelihood of suffering from anxiety, depression, and other conditions due to nomophobic attitudes. The study objectives were to validate and confirm psychometric properties of the Nomophobia Questionnaire (NMP-Q) and examine the associations between particular psychological conditions (anxiety, depression, stress, insomnia and impulsivity) and nomophobia among a representative sample of Lebanese people.MethodsThis cross-sectional study was carried out between January and July 2019. It enrolled 2260 residents of the community randomly selected from Lebanon's Mohafazat. Two villages per sub-district and households from each village were chosen using a random sampling technique. A questionnaire was distributed randomly to the households. SPSS version 25 was used to perform the statistical analysis. A multinomial regression was computed taking the nomophobia categories as the dependent variable (and taking the absence of nomophobia as the reference category) and all variables that showed a significant association in the bivariate analysis as independent variables.ResultsA total of 2260 (80.71%) out of 2800 questionnaires distributed was collected back. The mean age of the participants was 27.98 ± 9.66 years (58.8% females). Moreover, the mean nomophobia score was 71.56 ± 26.92 (median = 71; minimum = 14; maximum = 140). The results showed that 46 (2.0%) had no nomophobia, 769 (34.1%) mild nomophobia [95% CI 0.322-0.361], 1089 (48.3%) moderate nomophobia [95% CI 0.463-0.504] and 349 (15.5%) severe nomophobia [95% CI 0.140-0.170]. Items of the nomophobia scale converged over a solution of three factors that had an Eigenvalue over 1 (Factor 1 = emotions associated to losing connectedness, Factor 2 = not being able to communicate, Factor 3 = not being able to access information; total variance explained = 66.65%, and Cronbach's alpha = 0.948). The results of a multinomial regression, taking the nomophobia score as the dependent variable, showed that higher age was significantly associated with lower odds of having mild (aOR = 0.97), moderate (aOR = 0.93) and severe (aOR = 0.97) nomophobia respectively. Higher anxiety (aOR = 1.09) and higher insomnia (aOR = 1.04) were significantly associated with higher odds of having severe nomophobia.ConclusionThe results suggest a positive correlation between nomophobia and psychological conditions. There is a need for longitudinal and prospective studies that furnish information with regards of the impact of time on the variables measured, in order to better understand the nature, causes, and attributes of nomophobia.

BackgroundA putative link between asthma and asthma severity with the occurrence of cancer has been suggested but has not been fully investigated. The objective of this study is to assess the incidence of all types of cancer in a cohort of asthmatic patients.Methods and findingsA single center cohort retrospective study was conducted to investigate the role of asthma as a potential risk factor for various cancers. Participants were followed for a period of 9 years from 01/01/2010 to 30/12/2018 and cancer incidence and its determinants were collected in asthmatic patients and controls from the same population source but without any respiratory disease. Overall, 2,027 asthma patients and 1,637 controls were followed up for an average of 9 years. The statistical analysis showed that 2% of asthma patients were diagnosed with various cancers, resulting in an incidence rate of cancer of 383.02 per 100,000 persons per year which is significantly higher than the 139.01 per 100,000 persons per year observed in matched controls (p-value < 0.001). The top four cancers reported among asthmatics were breast, colon, lung and prostate cancer. Lung cancer in asthmatics had the longest diagnosis period with a mean of 36.6 years compared to the shortest with prostate cancer with 16.5 years.ConclusionsThis study shows that asthma patients are at increased risk of different types of cancers with asthma severity and goiter as the main factors that may increase the risk of developing cancers among asthmatic patients.

IntroductionSeveral studies have described typical clinical manifestations, including fever, cough, diarrhea, and fatigue with COVID-19 infection. However, there are limited data on the association between the presence of neurological manifestations on hospital admission, disease severity, and outcomes. We sought to investigate this correlation to help understand the disease burden.MethodsWe delivered a multi-center retrospective study of positive laboratory-confirmed COVID-19 patients. Clinical presentation, laboratory values, complications, and outcomes data were reported. Our findings of interest were Intensive Care Unit (ICU) admission, intubation, mechanical ventilation, and in-hospital mortality.ResultsA total of 502 patients with a mean age of 60.83 ± 15.5 years, of them 71 patients (14.14%) presented with altered mental status, these patients showed higher odds of ICU admission (OR = 2.06, 95%CI = 1.18 to 3.59, p = 0.01), mechanical ventilation (OR = 3.28, 95%CI = 1.86 to 5.78, p < 0.001), prolonged (>4 days) mechanical ventilation (OR = 4.35, 95%CI = 1.89 to 10, p = 0.001), acute kidney injury (OR = 2.18, 95%CI = 1.28 to 3.74, p = 0.004), and mortality (HR = 2.82, 95%CI = 1.49 to 5.29, p = 0.01).ConclusionThis cohort study found that neurological presentations are associated with higher odds of adverse events. When examining patients with neurological manifestations, clinicians should suspect COVID-19 to avoid delayed diagnosis or misdiagnosis and lose the chance to treat and prevent further transmission.

Uranium, perhaps the most strategically important component of heavy minerals, finds particular significance in the nuclear industry. In prospecting trenches, the radioactivity of 238U and 232Th provides a good signature of the presence of heavy minerals. In the work herein, the activity concentrations of several key primordial radionuclides (238U, 232Th, and 40K) were measured in prospecting trenches (each of the latter being of approximately the same geometry and physical situation). All of these are located in the Seila area of the South Eastern desert of Egypt. A recently introduced industry standard, the portable hand-held RS-230 BGO gamma-ray spectrometer (1024 channels) was employed in the study. Based on the measured data, the trenches were classified as either non-regulated (U activity less than 1000 Bq kg-1) or regulated (with 238U activity more than 1000 Bq kg-1). Several radiological hazard parameters were calculated, statistical analysis also being performed to examine correlations between the origins of the radionuclides and their influence on the calculated values. While the radioactivity and hazard parameters exceed United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) guided limits, the mean annual effective doses of 0.49 and 1.4 mSv y-1 in non-regulated and regulated trenches respectively remain well below the International Commission on Radiological Protection (ICRP) recommended 20 mSv/y maximum occupational limit. This investigation reveals that the studied area contains high uranium content, suitable for extraction of U-minerals for use in the nuclear fuel cycle.

The NATURE-HF registry was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). This is a prospective, multicenter, observational survey conducted in Tunisian Cardiology centers. A total of 2040 patients were included in the study. Of these, 1632 (80%) were outpatients with chronic HF (CHF). The mean hospital stay was 8.7 ± 8.2 days. The mortality rate during the initial hospitalization event for AHF was 7.4%. The all-cause 1-year mortality rate was 22.8% among AHF patients and 10.6% among CHF patients. Among CHF patients, the older age, diabetes, anemia, reduced EF, ischemic etiology, residual congestion and the absence of ACEI/ ARBs treatment were independent predictors of 1-year cumulative rates of rehospitalization and mortality. The female sex and the functional status were independent predictors of 1-year all-cause mortality and rehospitalization in AHF patients. This study confirmed that acute HF is still associated with a poor prognosis, while the mid-term outcomes in patients with chronic HF seems to be improved. Some differences across countries may be due to different clinical characteristics and differences in healthcare systems.

No previous study assessed the combined effect of olive pruning residues (OLPR) and spent coffee grounds (SCG) on P. ostreatus production and nutritional value. The aim of this study was to determine the capacity of P. ostreatus to degrade lignocellulosic nature of combined OLPR and SCG as well as their resultant nutrient composition. A complete randomized design was adopted with five treatments: S1:100%wheat straw (WS) (control), S2:33%WS+33%SCG+33%OLPR,S3:66%WS+17%SCG+17%OLPR,S4:17%WS+66%SCG+17%OLPR, and S5:17%WS+17%SCG+66%OLPR, and ten replicates per treatment. Substrate's and mushroom's composition were analyzed on chemical scale, including fatty acids and heavy metals profiles, following international standards. Only S1, S2, and S3 were productive, with comparable biological yield, economical yield, and biological efficiency. Organic matter loss decreased with increasing proportions of OLPR and SCG. Percentage lignin loss was higher in S1 than in S2 and S3 (53.51, 26.25, and 46.15% respectively). Mushrooms of S3 had some enhanced nutritional attributes compared to control: decrease in fat, increase in protein, increase in monounsaturated fatty acids, and lower zinc accumulation. Lead was less accumulated in S2 than S1 mushrooms. Sodium content of mushroom decreased in S2 and S3. The latter substrates yielded mushrooms with lower polyunsaturated fatty acids (PUFA) and higher saturated fatty acids (SFA) contents. All mushrooms had a valuable PUFA/SFA. This study suggests using OLPR and SCG in low proportions as nutritional supplements to the commercial wheat straw.

In sub-Saharan Africa growing season precipitation is affected by climate change. Due to this, in Cameroon, it is uncertain how some crops are vulnerable to growing season precipitation. Here, an assessment of the vulnerability of maize, millet, and rice to growing season precipitation is carried out at a national scale and validated at four sub-national scales/sites. The data collected were historical yield, precipitation, and adaptive capacity data for the period 1961-2019 for the national scale analysis and 1991-2016 for the sub-national scale analysis. The crop yield data were collected for maize, millet, and rice from FAOSTAT and the global yield gap atlas to assess the sensitivity both nationally and sub-nationally. Historical data on mean crop growing season and mean annul precipitation were collected from a collaborative database of UNDP/Oxford University and the climate portal of the World Bank to assess the exposure both nationally and sub-nationally. To assess adaptive capacity, literacy, and poverty rate proxies for both the national and regional scales were collected from KNOEMA and the African Development Bank. These data were analyzed using a vulnerability index that is based on sensitivity, exposure, and adaptive capacity. The national scale results show that millet has the lowest vulnerability index while rice has the highest. An inverse relationship between vulnerability and adaptive capacity is observed. Rice has the lowest adaptive capacity and the highest vulnerability index. Sub-nationally, this work has shown that northern maize is the most vulnerable crop followed by western highland rice. This work underscores the fact that at different scales, crops are differentially vulnerable due to variations in precipitation, temperature, soils, access to farm inputs, exposure to crop pest and variations in literacy and poverty rates. Therefore, caution should be taken when transitioning from one scale to another to avoid generalization. Despite these differences, in the sub-national scale, western highland rice is observed as the second most vulnerable crop, an observation similar to the national scale observation.

Urodynamic studies in rats and mice are broadly used to examine pathomechnisms of disease and identify and test therapeutic targets. This review aims to highlight the effects of the anesthetics on the lower urinary tract function and seeks to identify protocols that allow recovery from anesthesia and repeated measurements while preserving the function which is being studied. All studies published in English language, which compared the data obtained under various types of anesthesia and the urodynamics performed in awake animals were included. It appears that urethane, an anesthetic recommended extensively for the investigation of lower urinary tract function, is appropriate for acute urodynamic studies only. Major advantages of urethane are its stability and ability to preserve the micturition reflex. Due to its toxicity and carcinogenicity, urethane anesthesia should not be used for recovery procedures. This review evaluated available alternatives including propofol, isoflurane and combinations of urethane, ketamine/xylazine, ketamine/medetomidine, and/or fentanyl/fluanisone/midazolam. Different effects have been demonstrated among these drugs on the urinary bladder, the urethral sphincter, as well as on their neuroregulation. The lowest incidence of adverse effects was observed with the use of a combination of ketamine and xylazine. Although the variations in the reviewed study protocols represent a limitation, we believe that this summary will help in standardizing and optimizing future experiments.

BackgroundUp till today, studies carried in Lebanon have focused more on the prevalence of HIV and behaviors and quality of life of infected individuals, however, none of these studies discussed the degree of stigma towards these populations. Therefore, the aim of this study is to measure the rate of stigma in terms of knowledge, attitude and practice towards patients living with Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) (PLWHA) and examine the factors associated with this stigma.MethodsA cross-sectional survey, enrolling 862 participants, was carried across the five governorates in Lebanon: Beirut, Mount Lebanon, North, South and Bekaa. The survey was a self-administered questionnaire which covered information about participants' general demographics, their knowledge, attitudes, practices and awareness towards HIV/AIDS in Lebanon., attitudes towards PLWHA, practices related to HIV/AIDS and awareness regarding HIV/AIDS situation in Lebanon.ResultsThe response rate to the survey was 78.36% (862 participants). Being Muslim (Beta = -2.56) or Druze (Beta = -2.64) compared to Christians were significantly associated with lower knowledge towards HIV/AIDS, whereas having a secondary (Beta = 2.71) and a university (Beta = 3.04) levels of education compared to illiteracy and higher age (Beta = 0.05) were significantly associated with higher knowledge. Higher knowledge (Beta = 0.66) was significantly associated with better attitude, whereas higher age (Beta = -0.14) and being Muslim compared to Christian (Beta = -3.44) were significantly associated with worse attitude. Better attitude (Beta = 0.02) was significantly associated with better practice, whereas females compared to males (Beta = -0.39), having a secondary level of education compared to illiteracy (Beta = -0.88) and being Muslim compared to Christian (Beta = -0.32) were significantly associated with worse practice.ConclusionOur results stress the need for educational programs, advocacy campaigns and policies to help reduce HIV stigma. This will then help start developing interventions and strategies for a possible reduction in the stigmatization level.