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Dendritic cells (DCs) play an important role in the formation of the immune response, and they are involved in the pathogenesis of autoimmune diseases. Targeting DCs has thus emerged as a new therapeutic modality in the management of inflammatory and autoimmune diseases. DCs can be manipulated ex vivo and then injected back into humans to suppress the immune response. They can also be manipulated in vivo by delivering specific molecules into the DCs. Co-stimulatory molecules that shape DCs interaction with T cells can also be targeted to suppress immunity. This review tackles the latest advances in each of the 3 presented approaches.

Background. There is growing strong scientific evidence over the past few decades that the Mediterranean diet (MD) has protective effects on cardiometabolic health. Objective. This study aimed to assess MD adherence and its association with sociodemographic and lifestyle factors among women living in two Moroccan provinces, El Jadida and Tetouan, located at different distances from the Mediterranean Sea. Material and methods. It is a cross-sectional study involved 355 subjects of which 55.8% reside in the province of El Jadida, and data on socio-demographic characteristics, lifestyle, cardiovascular risks, medical history and of food frequency consumption were collected. Compliance with the MD was assessed with a simplified MD adherence score based on the weekly frequency of consumption of eight food groups. Results. The overall mean Simplified Mediterranean Diet Score was 4.37 ± 1.47 with inadequate compliance in 55.2% of the sample. No significant association was found between adherence to MD and geographic, socio-demographic, lifestyle or the major cardiovascular risk factors. However, the participants do not comply with half of the recommendations based on the Mediterranean diet pyramid. The lowest level of compliance was observed for olive oil, followed by sweets, eggs, potatoes, fruits, red meat, vegetables, legumes, olives, nuts and seeds. The increased contribution of sugars, dairy products and meat to the overall food intake is significant in the category with high adherence to MD. Conclusion. The study data indicate that Mediterranean Diet is far from being a global pattern in this Moroccan population. The study draws attention to the need for a promoting intervention to maintain this pattern as the original diet in the region.

Background: In recent decades, the Moroccan population has changed its dietary practices, particularly those related to meal-taking. It is about irregular meal schedules, reduced frequency and shorter time of meal-taking times, as well as a decrease in family meal-taking. All these factors are likely to influence its nutritional status. Objective: The aim is to study meal-taking practices, their determinants and their implications on weight status. In this study, meal-taking practices are defined by the regularity of the schedule, the frequency and the duration of the meals as well as the family commensality. Material and Methods: This work data are part of a study conducted among 507 households in the region of Rabat-Salé-Kenitra in Morocco, with a validated conceptual and methodological framework. The questionnaire was completed with one member of each household and the body mass index (BMI) was determined by an impedance meter. Results: The main results indicate that the majority of the surveyed population was aged 35 years (59%), female (52%), urban (70%), with a BMI ≥25 kg/m2 (51%), took usually three meals a day (89%), spent less than 90 minutes a day in meals and snacks (60%), had irregular meal schedule (69%), and usually eat at least two meals or snacks a day with family (49%). The univariate analysis showed that urban area was a factor favoring variations of meal times, the male sex was a factor favoring three meals a day, the level of higher education was a factor penalizing the daily duration of meals, and that marital status “married” was a factor favoring family commensality. In addition, variable meal times were revealed as a factor contributing to overweight/obesity, and meal times ≥90 min were revealed as a protective factor of overweight/ obesity. Conclusion. The study identified factors associated with meal times, frequency and duration. The results obtained will serve as a basis for the development of educational actions for a change in behavior conducive to health.

Background: Low birth weight (LBW) is a major health problem responsible for neonatal mortality and morbidity such as diabetes, obesity and cardiovascular disease in adulthood. Objective. This case-control study aims to compare data on the intake of energy, macro and micronutrient in two groups of pregnant women, who gave birth to low birth weight (LBW) babies named cases and those who gave birth to babies of normal weight (NW) called controls. Material and methods: The collection of information was done using an established questionnaire for 400 pregnant women, allowing the collection of data on socio-demographic and obstetrical factors. Nutritional intake was obtained by recording food consumption using the 24-hour recall method. Anthropometric measurements of parturient and fundal height (FH) were measured before delivery. Results: The mean FH of the cases was 25.69±0.13 and that of the controls was 31.83±0.06. The gestational age of the cases was on average 31.65±0.21 week of amenorrhea (WA) against 38.04±0.08 WA for the controls. 37% of LBW newborns had an Apgar score < 7 (p< 0.001) and 71% were hospitalized in neonatal intensive care (p

Background: Few studies have investigated tolerability, blinding, and double-blinding of High-Definition transcranial Direct Current Stimulation (HD-tDCS) at amplitudes above 2 milliamps (mA). Objective: We examined a) tolerability of HD-tDCS during stimulation sessions and b) blinding and double blinding of participants and study team members. Methods: Data from a mixed neurologic sample of 292 older adults were pooled from 3046 HD-tDCS sessions (2329 active; 717 sham). Per electrode amplitudes ranged from 1 mA to 4 mA with total currents up to 10 mA. Participants completed a standardized sensation (tolerability) questionnaire after each session. Participants and study team members stated whether the participant received active or sham stimulation at the end of various sessions. Data were collapsed into the presence/absence of a symptom due to low rates of positive responding and were analyzed for both differences and bioequivalency. Results: There were no safety-related adverse events. HD-tDCS was well tolerated with mostly no (“none”) or “mild” sensations reported across sessions, regardless of active or sham condition and in both stimulation naïve and experienced participants. There were no significant differences in side effects between active and sham, with some achieving bioequivalence. Tingling and itching were significantly more common after lower (

Background. The locations of food purchase have an impact on the quality of food consumed. Objective. To examine food purchasing habits at traditional and modern markets, their associated factors, and their effects on consuming natural and processed foods. Material and methods. This work used a validated conceptual and methodological framework of a study conducted among 507 households in the Rabat-Salé-Kenitra region in Morocco. Data on sociodemographic and economic characteristics and the frequency of food purchasing were collected from household representatives through a population survey. The food frequency questionnaire was used to collect frequency of consumption of 20 foods, including 10 natural and 10 processed. The associations between the variables were studied by the Chi-square test with a level of significance of p

Since the fall of 2019, Lebanon has been facing an economic crisis that has imposed many challenges on its healthcare system in its entirety. In this review, we propose a methodology to inform healthcare policy and apply it on cardiovascular disease (CVD) healthcare with emphasis on ischemic heart disease (IHD). The main goal of this methodology is reducing unnecessary expenditure while maintaining quality and access. CVD, and particularly IHD, is the most common reason for hospitalizations in Lebanon. Lebanon also has a high density of catheterization labs, higher than countries with higher prevalence of disease. Additionally, we found coronary to be are more expensive in comparison to other countries. To reduce healthcare costs without compromising quality and access we propose solutions targeting healthcare financing, payment for services, healthcare organizations, behaviors of providers, payers, and patients, and above all government regulation.

Background. Dietary diversity and variety scores represent tools for measuring the overall quality of diets. In children, they are good indicators of their nutritional status and growth. Objective. The aim of this study was to assess the consumption and eating habits as well as the lifestyle of Moroccan adolescents attending school in the city of El Jadida. Material and methods. A sample of 463 children of both sexes, aged 9 to 17, attending four schools in the city of El Jadida was studied. Eating habits and information on socioeconomic level are assessed using questionnaires and weight and height were measured on participants. Results. According to the dietary diversity score (DDS) classes, 2.4% of the children surveyed were with low DDS, 55.7% moderate and 41.9%, with high DDS. The mean DDS was 5.67 ± 1.03 in underweight children and 5.53 ± 1.5 in those with overweight (obesity included) and the food variety scores (DVS) were of 12.94±3.24 food items and 10.81±3.25 in the 2 groups respectively. In addition, data analyzes show that children from parents with a low level of education had higher averages of DDS and DVS (DDS: 5.54 ± 0.84; SVA: 10.65 ± 2.32) compared to those of parents with medium education level (DDS: 5.31±0.96; DVS: 9.72±2.62) or high level (DDS: 5.17±0.93; DVS: 9.36 ±2.42). In addition, children from parents of high economic level had a lower averages of DDS and DVS (DDS: 5.24 ± 0.88; DVS: 8.84 ± 2.10) compared to those of parents of low economic level (DDS: 5.36±1.00; DVS: 10.14±2.85). The sugary products were consumed by 56.3% of underweiht children, 75% of normal-weight children and 67% of overweight children (including obese). The estimated total energy intake (TEI) was higher than the Recommended Daily Allowances (RDA) in underweight 2933 Kcal/d and in overweight (including obese) children 3061.75 Kcal/d, while the mean daily intakes of folate, calcium, iron, potassium and zinc were lower than the (RDA). The food groups consumed by the majority of children were cereals (98.5%), fruits and vegetables (87.7%), and sweet products (69.8%) while oilseed products and fat were less consumed (9.7% and 7.8% respectively). Conclusion. The study data show that the adolescents diet were moderately diverse, little varied and poor in certain nutrients essential for their nutritional status and growth. The study draws attention to the need for parents to be aware of the benefits of improving the diet quality and weight status of adolescents.

Background. Micronutrient malnutrition is a serious public health problem in most developing countries, including Morocco, due to poor and therefore lower quality diets that lack dietary diversity. Objective. The present study aimed to assess dietary diversity and variety and their relationship with micronutrient adequacy in children and adolescents with type 1 diabetes (T1D). Materials and methods. A cross-sectional study was carried among 240 children and adolescents with T1D. Weight and height were measured and BMI was calculated. Dietary intake data were obtained from two 24-h recalls. A Dietary diversity (DDS) and dietary variety scores (DVS) and mean adequacy ratio (MAR) and nutritional adequacy ratios (NARs) were calculated and compared according to sociodemographic/anthropometric categories. Results. 52.1% of the patients were female. The mean age of the patients was 8.49 ± 4.1 years. The mean BMI was 19.44 ± 5.24 kg/m2; the mean DDS was 4.62±1.20 and the mean MAR was 0.66 ± 0.11. Older children living in rural areas have a low DDS/DVS. Parental education and income level are associated with DDS/DVS. General and central obesity were significantly elevated in children with high DDS. In addition, a high intake of vegetables, eggs, fiber and micronutrients (Magnesium, Calcium, Potassium, Zinc, Phosphorus and Vit B1) is associated with a high DDS; however, high DVS is associated with high consumption of dairy products, carbohydrates and low intake of protein and fat. There are also positive correlations between DDS/DVS and NARs for various nutrients. Conclusion. The quality of the respondents’ diets are moderately diversified. DDS or DVS can be used as indicators of micronutrient adequacy in Moroccan T1D children. Nutritional education needs to be strengthened to improve dietary diversity in children, especially in rural areas.

Background. Currently, T1D is one of the most common chronic diseases in children and adolescents. The International Diabetes Federation (IDF) estimates that more than 1.1 million children and adolescents are living with (T1D). A few studies have evaluated the relationship between dietary intake and glycemic control (GC) in people with T1D, and in particular, children and adolescents. Objective. The aim of this study was to evaluate the relationship between anthropometric characteristics, lipid profile, inflammation, dietary intake and GC in comparison with international guidelines. Materials and methods. The study included a sample of 240 children, aged 15 years old or less with T1D. A structured questionnaire was used to collect information on the socio-demographic status, disease characteristics, and diet of the participants. Weight, height, and WC were measured and WHtR and BMI were calculated. Biochemical measurements were determined. Dietary intake was assessed using three 24-hour recalls. Results. Saturated fat intake was five times higher than recommended. Only 8.3% of participants reached the recommended level of fiber. Overweight, obesity, TC, TG, HDL and CRP were significantly higher in children with poor GC to those with good GC. In addition, participants with poor GC had significantly low intakes of calories, carbohydrates, fiber, MUFAs, and PUFAs and high intakes of fat and SFAs. The use of Bivariate correlation analyses showed that calorie, protein, fat and fiber intake were positively correlated with weight, height, WC, and GO, whereas carbohydrate intake was negatively associated with these parameters. On the contrary, CO showed a negative correlation with calorie, protein, fat and fiber intake and a positive correlation with carbohydrate intake. Conclusions. The results revealed that the dietary quality was poor and adherence to dietary recommendations was low with insufficient fiber intake and excess SFA. These results suggest that GC can be improved by a healthy, balanced diet by increasing fiber intake and limiting SFA intake.

Background. Low birth weight (LBW) is considered to be one of the most important indicators of a newborn's chances of survival, and a major risk of medium- and long-term morbidity. Objective. To identify risk factors associated with low birth weight newborns among pregnant women during childbirth in Moroccan hospital environment with a view to proposing avenues of intervention for its prevention. Material and methods. Data concerning the weight of newborns at birth, nutritional education, pregnancy monitoring and other risk factors, etc. were collected from 312 pregnant women who gave birth in the maternity ward of El-Jadida Provincial Hospital in Morocco. Results. The study identified 156 cases of newborns with LBW and 156 controls of normal-weight newborns. After adjustment for the variables included in the analysis, the determined factors associated with LBW are nutritional education [OR: 6.22 (2.60-14.87), P

Background. Low birth weight (LBW) is an important predictor of neonatal morbidity and mortality. It reflects the nutritional status of the mother and the quality of health care services during pregnancy. Objective. The objective of this study is to determine the factors associated with low birth weight of children born to Moroccan pregnant women in the province of El Jadida. Material and Methods. This cross-sectional case-control study was carried out in the maternity ward of El Jadida provincial hospital on 344 parturient women, half of whom had given birth to children with an LBW and the other half of children with normal weight (NW) at birth. Information on maternal gestational and socioeconomic characteristics as well as eating habits was collected using a questionnaire and anthropometric measurements were taken on the newborns. Results. The study identified 172 parturient who gave birth to newborns with LBW and 172 parturient who gave birth to newborns of NW. The proportions of LBW are greater in first-time mothers (50.6%) and professionally inactive (86.6%). The mean weight of LBW newborns is 2013.95 ± 372.95g compared to 3380 ± 217.59g for NW newborns. The determined factors associated with LBW are the low socio-economic level (OR = 3.18; 95% CI: 1.09-9.23), insufficient monitoring of prenatal consultation (OR = 2.91; 95% CI: 1, 71-4.95), origin from rural areas (OR = 0.52; 95% CI: 0.30-0.91) and lack of nutritional education (OR = 0.17; 95% CI: 0, 09-0.34). The daily calcium intake in mothers of newborns with LBW is 33.82% of the recommended daily allowance (RDA), the daily iron requirement coverage was 50%, folates 66, 16% and zinc 87.72% of the RDA. Conclusions. Well-targeted and coordinated education and awareness-raising actions on early pregnancy and feeding pregnant women could have a positive impact on improving the birth rate of children with a weight deficit.

Background Carotid webs (CaWs) may explain embolic strokes particularly in young patients with cerebral embolism of otherwise undetermined cause. We aim to describe the radiological patterns of infarction in patients with symptomatic CaWs. Methods Retrospective analysis of a symptomatic CaW database (September 2014–July 2019) from 2 comprehensive stroke centers. Magnetic resonance imaging scans were reviewed independently by 2 blinded raters. Patterns of acute infarction included territorial (involving ≥2 arterial subdivisions), cortical (affecting 1 arterial subdivision), 1or multiple small cortical infarcts, borderzone infarcts (cortical or internal), striatocapsular lacunes (

Abstract Background Maternal satisfaction with the breastfeeding experience is an important determinant of breastfeeding success. There is currently no valid tool to measure perceived maternal satisfaction with breastfeeding in the Arab context. Methods This cohort study tested the Maternal Breastfeeding Evaluation Scale (MBFES) on 450 healthy Lebanese mothers for internal consistency reliability and construct validity. Participants were recruited between April 2018 and February 2020. Results The Cronbach’s alpha reliability coefficient of the Arabic MBFES (MBFES-A) was 0.87. Exploratory factor analysis revealed that it has three components: Infant Satisfaction/Growth, Maternal Enjoyment/Role Attainment, and Lifestyle/Body Image with reliability coefficients of 0.88, 0.87, and 0.68, respectively. Four items were deleted because of low factor loadings and three items were relocated to the Infant Satisfaction/Growth subscale based on their factor loadings. Participants who were exclusively breastfeeding at one and/or 3 months had higher mean MBFES-A total and Infant Satisfaction/Growth and Maternal Enjoyment/Role Attainment subscale scores than participants who were partially breastfeeding, and significantly higher mean scores than mothers who were not breastfeeding (all p values

A woman in her 50s presented with hyper-religiosity, auditory hallucinations, episodes of staring associated with unresponsiveness and stiffening of her entire body. A broad workup excluded autoimmune encephalitis, sarcoidosis, and prion disease. She was diagnosed with PERM (progressive encephalomyelitis with rigidity and myoclonus) syndrome which was supported by elevated cerebrospinal fluid (CSF) autoantibodies against glutamic acid decarboxylase (GAD) glutamic acid decarboxylase. She responded to treatment with corticosteroids and weekly rituximab therapy over four weeks. PERM is an autoimmune condition which is a rare variant of stiff person syndrome involving rigidity, dysautonomia and encephalopathy. PERM requires the clinician to have a high index of clinical suspicion to recognize and treat.

Sol–gel method was applied for synthesis of TiO2 nanoparticles in the existence of different volumes of ethanol (10–50 mL) with the purpose to find optimized synthesis conditions. Also, nickel doped TiO2 nanoparticles (Ni/TiO2 molar ratio: 0.1-1.0%) were prepared by the similar technique but in the existence of 10 mL ethanol and heated at different temperatures (300 °C –600 °C). XRD, SEM/EDX, UV-Vis DRS, FTIR and Raman spectroscopy were applied to identify the structural and morphological characteristics of the as-synthesized samples. XR diffraction results verified that TiO2 samples prepared with various volumes of ethanol (10–50 mL) consist of anatase and brookite phases up to 500 °C and rutile phase at 600 °C. The intensity of brookite diffraction decreased with the increase of calcination temperatures. Also, the low ethanol volume favored for formation of rutile phase at 600 °C. The addition of Ni(II) during the preparation of TiO2 nanoparticles prevented the formation of rutile phase. The undoped samples were synthesized with 10 and 20 mL ethanol and treated at 500 °C displayed the best catalytic performance for photocatalytic treatment of E 131 VF dye solution (rate constant: 0.051 and 0.061 (a.u) respectively). Ni doped TiO2 samples displayed lower photoactivity and rate constant.

Background & Aims: Liver injury due to coronavirus disease 2019 (COVID-19) is being increasingly recognized. Abnormal liver chemistry tests of varying severities occur in a majority of patients. However, there is a dearth of accompanying liver histologic studies in these patients. Methods: The current report details the clinical courses of 2 patients having severe COVID-19 hepatitis. Liver biopsies were analyzed under light microscopy, portions of liver tissue were hybridized with a target probe to the severe acute respiratory syndrome coronavirus-2 S gene, and small sections from formalin-fixed paraffin-embedded liver tissue were processed for electron microscopy. Results: The liver histology of both cases showed a mixed inflammatory infiltrate with prominent bile duct damage, endotheliitis, and many apoptotic bodies. In situ hybridization and electron microscopy suggest the intrahepatic presence of severe acute respiratory syndrome coronavirus-2, the findings of which may indicate the possibility of direct cell injury. Conclusions: On the basis of the abundant apoptosis and severe cholangiocyte injury, these histopathologic changes suggest a direct cytopathic injury. Furthermore, some of the histopathologic changes may resemble acute cellular rejection occurring after liver transplantation. These 2 cases demonstrate that severe COVID-19 hepatitis can occur even in the absence of significant involvement of other organs.

RESUMO: A pesquisa aqui apresentada foi construída na premissa que a educação em ciências deve superar um ensino voltado à aprendizagem de conceitos científicos, indo em direção a uma educação crítica e conectada com questões políticas da modernidade, como as relações entre ciência e patriarcado. A partir da recorrência na literatura de Marie Curie como exemplo de mulher na ciência, desenvolvemos a pesquisa com vistas a responder a seguinte questão: quais condições possibilitaram Marie Curie a participar da ciência e como a compreensão dessas condições permite caminhos na educação em ciências capazes de promover discussões a respeito dos baixos números de exemplos femininos na história da ciência. Com base em referenciais da educação em ciências e da História Cultural da Ciência, construímos subsídios para responder à pergunta de pesquisa, apontando que trazer exemplos de mulheres na ciência é insuficiente para uma suposta representatividade feminina. Isso porque a visibilidade de uma cientista depende de suas condições de participar das práticas científicas e, portanto, para termos mais mulheres na ciência, as condições estruturais para elas trabalharem devem ser ampliadas.

Abstract Background Excessive bone formation in the entheses is one of the features of peripheral spondyloarthritis (SpA). Complex pathological mechanisms connecting inflammation, mechanical stress, and ossification are probably involved. We focused on bone morphogenetic protein (BMP)-2, -4, and -7 as possible mediators of this process. Methods BMP-2, -4, and -7 concentration was measured by ELISA in synovial fluids (SFs) of SpA (n = 56) and osteoarthritic (n = 21) patients. Mouse organotypic ankle cultures were challenged by a pro-inflammatory cocktail. Mouse primary chondrocytes, osteoblasts, or tenocytes were treated with TNF-α, interleukin (IL)-17, or IL-22 and/or subjected to cyclic stretch, or with recombinant BMP-2 or -4. Results In SpA SFs, if BMP-7 was barely detectable, BMP-2 concentration was higher and BMP-4 was lower than in osteoarthritic samples, so that BMP-2/BMP-4 ratio augmented 6.5 folds (p

Introduction: Mechanical thrombectomy (MT) has become the standard of care in patients with large vessel occlusion after trials have demonstrated (MT) improved outcomes in acute ischemic stroke (AIS) as compared to medical therapy. Despite leading to high reperfusion rates, MT patients are at high risk for recurrent ischemic events and complications of stroke. We performed an analysis to evaluate temporal trends in readmission of post‐MT among stroke patients over a three‐year period. Methods: From the Healthcare Cost and Utilization Project Nationwide Readmission Database, we obtained in‐hospital adult patient data with a principal diagnosis of AIS in the US from 2016 to 2018. AIS, MT, thrombolysis treatment and other diagnosis were identified based on International Classification of Diseases, 10th Revision, Clinical Modification codes. We compared the trend of 30‐day readmission in AIS patients who received MT, thrombolysis only and neither treatment with linear regression. Using Clinical Classifications Software Refined tool, we categorized the readmission principal diagnoses of patients underwent MT into groups. All analyses were performed in Stata/SE 15.1 software. Results: Of the 1,271,958 patients admitted from throughout the US with AIS within the study period, 1,130,737 (88.90%) did not receive thrombolysis nor MT, 100,737 (7.92%) received thrombolysis only, and 40,849 (3.21%) underwent MT with or without thrombolysis. The endovascular treatment rate doubled from 2016 (2.40%) to 2018 (4.11%, p < 0.0001). From 2016 to 2018, the readmission rate has significantly decreased from 15.00% to 12.04% (absolute risk reduction (ARR) 2.96%, p = 0.0001) in patients who underwent MT, decreased from 10.46% to 9.51% (ARR 0.95%, p = 0.0097) in patients who received thrombolysis only, and decreased from 11.96% to 11.56% (ARR 0.40%, p = 0.0130) in patients received neither therapy. Among all the patients who underwent MT during the three‐year period, sepsis (1.88%), cerebral infarction (1.59%), sequelae of cerebral infarction (0.82%), cardiac dysrhythmias (0.67%) and heart failure (0.49%) were the most common principal readmission diagnoses. From 2016 to 2018, there were significant decreases in rate of readmissions with septic infection (p = 0.0001), sequelae of cerebral infarction (p < 0.0001), and heart failure (p = 0.0123), but no significant change in cerebral infarction (p = 0.4853) and cardiac dysrhythmias (p = 0.1834). Conclusions: Over three years, the rate of readmissions in AIS patients receiving MT significantly declined, particularly in rate of readmissions in sepsis, sequelae of cerebral infarction, and heart failure. Improved reperfusion rate and better outcomes may explain the reduction in post‐MT complication rate, which needs further studies.