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The hydrogeochemical properties and evolution of groundwater in the Essaouira syncline basin in northwestern Morocco were investigated in this study, with a total of 447 samples during different campaigns (April 2017, May 2018, March 2019, and July 2020). These samples were analyzed for major ions and stable and radioactive water isotopes (δ2H, δ18O, and 3H). With decreasing rainfall from climate change in Morocco, it is crucial to assess the sustainability of groundwater reserves. This shortage leads to the degradation of water and soil quality. To ensure sustainable water management and preserve the environment in the study area, it is necessary to assess groundwater quality for drinking and irrigation, take precautions, and establish management plans. This study assessed groundwater quality using two water quality index methods (WQI and IWQI). Several natural processes control groundwater mineralization, including the dissolution of evaporite and carbonate minerals, cation exchange phenomena, evaporation, and seawater intrusion. According to the results obtained using the WQI method, all groundwater samples in the study area are generally of poor quality and must be treated before being used for domestic purposes. Based on the results obtained by the IWQI method, the samples are suitable for use as irrigation water, especially for plants resistant to high salinity concentrations. Stable isotope measurements (δ2H and δ18O) indicate that Atlantic precipitation continuously recharges the recharge areas of the Essaouira Basin. Thus, the low values of tritium (3H) in groundwater mean that the freshwater in the Essaouira Basin is ancient.

Among hospitalized patients worldwide, infections caused by multidrug-resistant (MDR) bacteria are a major cause of morbidity and mortality. This study aimed to isolate MDR bacteria from five intensive care units (ICUs) at Tripoli University Hospital (TUH). A prospective cross-sectional study was conducted over a seven-month period (September 2022 to March 2023) across five ICUs at TUH. A total of 197 swabs were collected from Patients’, healthcare workers’ and ICUs equipment. Samples collected from patients were nasal swabs, oral cavity swabs, hand swabs, sputum specimens, skin swabs, umbilical venous catheter swabs, and around cannula. Swabs collected from health care workers were nasal swabs, whereas ICUs equipment’s samples were from endotracheal tubes, oxygen masks, and neonatal incubators. Identification and antimicrobial susceptibility test was confirmed by using MicroScan auto SCAN 4 (Beckman Coulter). The most frequent strains were Gram negative bacilli 113 (57.4%) with the predominance of Acinetobacter baumannii 50/113 (44%) followed by Klebsiella pneumoniae 44/113 (40%) and Pseudomonas aeruginosa 6/113 (5.3%). The total Gram positive bacterial strains isolated were 84 (42.6%), coagulase negative Staphylococci 55 (66%) with MDRs (89%) were the most common isolates followed by Staphylococcus aureus 15 (17.8%). Different antibiotics were used against these isolates; Gram- negative isolates showed high resistance rates to ceftazidime, gentamicin, amikacin and ertapenem. A. baumannii were the most frequent MDROs (94%), and the highest resistance rates in Gram-positive strains were observed toward ampicillin, oxacillin, ampicillin/sulbactam and Cefoxitin, representing 90% of total MDR Gram-positive isolates. ESBL and MRS were identified in most of strains. The prevalence of antibiotic resistance was high for both Gram negative and Gram positive isolates. This prevalence requires strict infection prevention and control intervention, continuous monitoring, implementation of effective antibiotic stewardship, immediate, concerted and collaborative action to monitor its prevalence and spread in the hospital.

Introduction: Albuca amoena Batt. is an endemic plant from Morocco used for treating melanoma or leishmaniasis. The aim of this study is to test the antioxidant, photoprotective, cytotoxic, and antimicrobial properties of this plant. Methods: The extracts of the aerial and bulbous parts were obtained by hydroalcoholic maceration of the plant. Their antioxidant potentials were evaluated in vitro using four methods of 2,2-diphenyl-1picrylhydrazil (DPPH), 2,2’-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), ferric reducing antioxidant power (FRAP) assay, and total antioxidant capacity assay (TAC). The photoprotective properties were evaluated through the study of UVA and UVB absorbance and antityrosinase activity. The cytotoxic activity was determined against two breast cancer cell lines (MCF-7 and MDA-MB-231) and one human colorectal cancer cell line (HT-29) using the 3-[4,5-Dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) method. In addition, the antimicrobial activity was tested on six pathogens: Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Staphylococcus aureus, and Candida albicans by using the disc diffusion method. Results: The results showed that the UVA and UVB absorptive proprieties of the extracts were similar to those used as positive controls: Methyl salicylate and zinc oxide. Moreover, the antioxidant and antityrosinase properties of the studied extracts were found to be weakly active. The extracts had strong cytotoxicity activities, especially against HT-29 cell line. However, the extracts did not show any antibacterial activity. Conclusion: According to the results of this study, the extracts can be used as a sunscreen to avoid dermal anomalies and as a new source of cytotoxic bioactive compound.

المخلص: أهداف البحث: الغرض الرئيسي للدراسة الحالية هو تحديد التركيب الكيميائي وتقييم السلامة والنشاط المضاد للأكسدة والنشاط المضاد للدهون الزائدة للمستخلص المائي من الأعشاب الطبية التوكريوم تاكوميتينس. طرق البحث: تم تقييم تحليل الفيتوكيميائي (المحتوى الكلي للفينول والفلافونويد وأحماض الهيدروكسي الحمضية)، والنشاط المضاد للأكسدة (قوة التخفيض الفريك للأكسدة، حمض الأزينوبيس الاثيل البنزوثيازولين السلفونيك، الديفينيل البيكريل الهيدرازيل، واختبارات القدرة الكلية المضادة للأكسدة)، السمية الحادة، والنشاط المضاد للدهون الزائدة وفقا لنماذج المقالات والدراسات. في حين تم تحديد التوصيف الفيتوكيميائي بواسطة كروماتوغرافيا الغاز المرتبطة بطيف الكتلة بعد التميثل. النتائج: كشف المستخلص المائي من التوكريوم تاكوميتينس عن محتوى عالي من البوليفينولات الكلية وأحماض الهيدروكسي الحمضية وكمية قليلة من الفلافونويدات الكلية. بالإضافة إلى ذلك، أظهر المستخلص نشاط مضاد للأكسدة ملحوظ. كان البنزين، (هيكسيل أوكسي)-(19,32%) و 2,6 أ-ميثانو-6أ-اتش-اندينو[4,5-ب]أوكسيرين، أوكتاهيدرو – (1أ.ألفا.، 2.بيتا.، 3أ.ألفا.، 6أ.بيتا.، 6ب.ألفا.)-(32,42%)، دي-فوكوز (5,47%)، 5-هيدروكسيميثيلفورفورال (5,47%) والجواياكول (3,19%) هي المركبات الرئيسية في المستخلص. تم تقدير الجرعة الوسطى المميتة بين 500 و 2000 ملغم / كغ. علاوة على ذلك، أظهر المستخلص المائي من التوكريوم تاكوميتينس في 500 و 250 ملغم / كغ نشاطا مضادا للدهون الزائدة في الجسم مثيرا للاهتمام. الاستنتاجات: الجدير بالذكر أن المستخلص من التوكريوم تاكوميتينس له قدرة دوائية هامة وتركيب كيميائي متنوع. Abstract: Objective: The main purpose of the present work was to determine the chemical composition, safety, and antioxidant and antihyperlipidemic activities of an aqueous extract of Teucrium takoumitense. Methods: Phytochemical analysis (total phenolic, total flavonoid, and total hydroxycinnamic acid contents), antioxidant activity (ferric-reducing antioxidant power, 2,2ʹ-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid, 2,2-diphenyl-1-picrylhydrazil, and total antioxidant capacity tests), acute toxicity, and antihyperlipidemic activity were evaluated according to established models. In addition, the phytochemical profile was determined by methylation followed by gas chromatography-mass spectrometry (GC/MS). Results: The aqueous extract of T. takoumitense had a high content of total polyphenols (87.01 ± 0.31 mg gallic acid equivalent (GAE)/g extract) and hydroxycinnamic acid (2.28 ± 0.1 g/100 g Powdered Material) and a low content of total flavonoids (2.99 ± 0.16 mg GAE/g extract). In addition, the extract demonstrated remarkable antioxidant activity (DPPH IC50 = 76.67 ± 0.56 μg/mL, ABTS IC50 = 89.65 ± 0.27 μg/mL, FRAP EC50 = 296.32 ± 0.86 μg/mL, TAC value = 43 ± 0.27 mg EAA/g extract). The main compounds were identified as benzene, (hexyloxy)- (19.32%), 2,6a-methano-6aH-indeno[4,5-b]oxirene, octahedro-(1a.alpha., 2.beta., 3a.alpha., 6a.beta., 6b.alpha.)- (32.42%), d-fucose (5.47%), 5-hydroxymethylfurfural (5.47%) and guaiacol (3.19%). The LD50 was estimated to be between 500 and 2000 mg/kg. Furthermore, at 500 and 250 mg/kg, the aqueous extract of T. takoumitense exhibited good antihyperlipidemic activity in vivo. Conclusion: T. takoumitense extract has significant pharmacological potential and a varied chemical composition.

Objective: To investigate the Pinus halepensis extracts and determine its healing and antibacterial effects, and to evaluate the treatment of skin burns. Methods: Aqueous and ethanolic extracts and topical based on Aleppo pine plant extracts were prepared. Thirty male and female Wistar rats were used to study the cutaneous toxicity of extracts from the bark of P. halepensis . The extracts’ healing potential for burn wounds were also assessed by evaluating the clinical and macroscopic aspects of the wounds. The antibacterial activity of crude extracts of P. halepensis as well as its wound healing abilities was verified in this investigation. Results: In animals with acute dermal toxicity, there were no signs of treatment-related toxicity or death. The extracts of these plants could be transformed into phytomedicines for the treatment of infected wounds. The results demonstrated that formulated ointments are successful in treating second-degree burns in rats and may be suitable for the short-term therapeutic treatment of second-degree burns. Conclusion: This study successfully answered our problem, regarding the efficacy of our extract for treating second-degree burns in rats. Further studies are needed to confirm these results by identifying the molecules responsible for these activities and examining their mechanism of action.

Objective: To assess the acute and subacute toxicity as well as the phytochemical composition of two extracts and three fractions of Ammi majus L. Methods: The aqueous extracts were prepared separately by maceration for 48 h and by infusion for 1 h, while the fractions were prepared by the Soxhlet extractor, successively employing cyclohexane, ethyl acetate, and ethanol. The acute toxicity study was carried out in accordance with the OECD N°423 guideline at a single dose (2000 mg/kg) in mice for 14 days. The subacute toxicity study was performed by a daily oral administration of 250 mg/kg for 10 days and 100 mg/kg doses for 28 days. Phytochemical screening was performed using staining and precipitation reactions, while the chemical characterization of some analytes was detected by HPLC-MS/MS analysis. Results: In the acute toxicity study, no signs of toxicity such as convulsion, salivation, diarrhea, sleep and coma were observed during 30 minutes and 14 days, so the lethal dose was higher than 2000 mg/kg for each extract and fraction. The subacute toxicity results showed that at a dose of 250 mg/kg, 61.10% of the animals died and the rest developed morbidity. On the other hand, at a dose of 100 mg/kg, all the animals were still alive after 28 days, with no morbidity and the biochemical parameters were normal with no abnormalities in the liver, kidneys and pancreas. Phytochemical screening indicated the presence of flavonoids, tannins, coumarins, and free quinones and the absence of alkaloids and anthocyanins. Conclusions: The extracts and fractions of Ammi majus L. are not toxic in the short and long term with a varied chemical composition. Toxicological tests on animals other than rodents and in the long term (more than 28 days) are needed to further confirm the safety of Ammi majus extracts.

Highlights Water quality has improved during lockdown due to COVID-19. Assessment of water drinking and irrigation by two models (WQI, and IWQI) in a semi-arid environment. The main source of groundwater recharge in coastal aquifers is rainfall, based on a stable isotope (δ2H, δ18O).

Objectives: The aim of this work is to evaluate the in vitro antioxidant, hypoglycemic, and antiobesity effects of Euphorbia resinifera extracts and investigate the phenolic constituents and the toxicity of these extracts.Methods : Phytochemical screening was performed to detect polyphenols and flavonoids. Antioxidant activity was evaluated by four methods (DPPH, ABTS, H2O2, and xanthine oxidase inhibition). The hypoglycemic effect was determined by the inhibition of α-amylase and α-glucosidase enzymes in vitro and via a starch tolerance study in normal rats. The antiobesity effect was estimated by in vitro inhibition of lipase.Results : Phytochemical screening revealed that the ethanolic extract was rich in polyphenols (99 ± 0.56 mg GEA/g extract) and tannins (55.22 ± 0.17 mg RE/g extract). Moreover, this extract showed higher antioxidant activity in different tests: the DPPH assay (IC50 = 53.81 ± 1.83 μg/mL), ABTS assay (111.4 ± 2.64 mg TE/g extract), H2O2 (IC50 = 98.15 ± 0.68 μg/mL), and xanthine oxidase (IC50 = 10.26 ± 0.6 μg/mL). With respect to hypoglycemic effect, the aqueous and ethanolic extracts showed IC50 values of 119.7 ± 2.15 μg/mL and 102 ± 3.63 μg/mL for α-amylase and 121.4 ± 1.88 and 56.6 ± 1.12 μg/mL for α-glucosidase, respectively, and the extracts lowered blood glucose levels in normal starch-loaded rats. Additionally, lipase inhibition was observed with aqueous (IC50 = 25.3 ± 1.53 μg/mL) and ethanolic (IC50 = 13.7 ± 3.03 μg/mL) extracts.Conclusion : These findings show the antioxidant, hypoglycemic, and hyperlipidemic effects of E. resinifera extracts, which should be investigated further to validate their medicinal uses and their pharmaceutical applications.

Introduction: Albuca amoena is a Moroccan-Algerian endemic medicinal plant with various implications. The aim of this study is to identify phytochemical compounds of the plant, check its acute toxicity, and test its anti-depressive, anxiolytic, and analgesic effects on the central nervous system (CNS). Methods: The estimation of chemical compounds was carried out according to coloring and precipitation reactions. The Organization of Economic Cooperation and Development guidelines 423 and 402 made it possible to verify the acute toxicity of the plant orally and dermally. The sedative activity was performed according to 4 tests: rotarod, hole-board, traction, and chimney tests. The anti-depressive, anxiolytic, and analgesic effects were evaluated by forced swimming, light/dark, and writhing tests, respectively. Results: The phytochemical analysis showed that A. amoena contained a mixture of phytochemical compounds like terpenes, alkaloids, and polyphenols. According to the acute toxicity tests, the lethal dose of 50% (LD50) of A. amoena hydroalcoholic extract was between 300 and 2000 mg/kg orally and higher than 2000 mg/kg dermally. Moreover, the result of the behaviour tests of sedative and analgesic activities revealed that A. amoena hydroalcoholic extract exerted positive effects on the CNS. Conclusion: These results show the anti-depressive, anxiolytic, and analgesic effects of the bioactive substances present in A. amoena on the CNS and provide access to further investigations to highlight the main compounds of this plant and their mechanisms of actions.

Abstract The city of Essaouira is located along the north-west coast of Morocco, where groundwater is the main source of drinking, domestic and agricultural water. In recent decades, the salinity of groundwater has increased, which is why geochemical techniques and environmental isotopes have been used to determine the main sources of groundwater recharge and salinization. The hydrochemical study shows that for the years 1995, 2007, 2016 and 2019, the chemical composition of groundwater in the study area consists of HCO3–Ca–Mg, Cl–Ca–Mg, SO4–Ca and Cl–Na chemical facies. The results show that from 1995 to 2019, electrical conductivity increased and that could be explained by a decrease in annual rainfall in relation to climate change and water–rock interaction processes. Geochemical and environmental isotope data show that the main geochemical mechanisms controlling the hydrochemical evolution of groundwater in the Cenomanian–Turonian aquifer are the water–rock interaction and the cation exchange process. The diagram of δ2H = 8 * δ18O + 10 shows that the isotopic contents are close or above to the Global Meteoric Water Line, which suggests that the aquifer is recharged by precipitation of Atlantic origin. In conclusion, groundwater withdrawal should be well controlled to prevent groundwater salinization and further intrusion of seawater due to the lack of annual groundwater recharge in the Essaouira region.

Introduction: Pinus halepensis is a medicinal plant used in traditional medicine for treatment of various pathologies including diabetes. The objective of this study is to perform a phytochemical study and to evaluate the antioxidant and antidiabetic activities of extracts of the bark of P. halepensis. Methods: Total polyphenols, flavonoids and tannins were determined by the Folin Ciocalteu method, aluminum trichloride reagent (AlCl3) and vanillin assay. Evaluation of the antioxidant activity was carried out using 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2’-azinobis- (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and ferric reducing agent (ferric reducing). The antidiabetic activity was first revealed by enzymatic inhibition tests through measuring the residual activities of α-amylase and α-glucosidase, and then, by oral tolerance tests of glucose and starch in male Wistar rats. To verify the safety of plant extracts, acute oral toxicity was determined. Results: The phytochemical analysis showed that the extracts of P. halepensis were rich in phenolic compounds. The anti-oxidation activity tests revealed a significant reducing power towards the radicals tested. In addition, P. halepensis inhibited the enzymes involved in diabetes (α-amylase and α-glucosidase) at very low concentrations. These effects were verified in the in vivo approach, in particular by using the starch tolerance test. Conclusion: P. halepensis extracts showed remarkable antioxidant and antidiabetic effects. However, further investigations are necessary to identify the main compounds of P. halepensis and to evaluate their antioxidant and antidiabetic effects.

Morphological microwave imaging has shown interesting results on reconstructing biological objects inside the human body, and these parameters represent their actual biological condition, but not their biological activity. In this paper, we propose a novel microwave technique to locate the low-frequency (f≃1 kHz) -modulated signals produced by a microtag mimicking an action potential and proved it in a cylindrical phantom of the brain region. A set of two combined UWB microwave applicators, operating in the 0.5 to 2.5 GHz frequency band and producing a nsec interrogation pulse, is able to focus its radiated field into a small region of the brain containing the microtag with a modulated photodiode. The illuminating UWB microwave field was first modulated by the low-frequency (f≃1 kHz) electrical signal produced by the photodiode, inducing modulated microwave currents into the microtag that reradiating back towards the focusing applicators. At the receiving end, the low-frequency (f≃1 kHz) -modulated signal was first extracted from the full set of the backscattered signals, then focused into the region of interest and spatially represented in the corresponding region of the brain, resulting in a spatial resolution of the images in the order of 10 mm.

In this article, the novel approach to equations of motion for serial manipulators developed in literature by Bertrand and Bruneau (2013) is extended to make it usable for manipulators with general joints (i.e., prismatic and/or rotational). In this method, the dynamic model is explicitly and directly obtained from the structural parameters of the manipulator and matrix algebra without intermediate heavy calculations such as energy derivation. The correctness and efficiency of the described method are demonstrated through simulation of the dynamical equations of a 5-DOF SCARA robot. The simulation results obtained using the new formulation were compared with those derived by Kane’s method, Lagrange–Euler formulation, and GIM (generalized inertia matrix)-Christoffel’s algorithm, which proves the efficiency and correctness of the presented model. It was concluded that the new formulation requires less CPU time to generate explicit closed-form inverse dynamics. Finally, to illustrate the power of the new formulation in real-time control, a trajectory tracking control for the SCARA manipulator based on the numeric and symbolic computation of the inverse dynamic is established, and it is shown that the numeric and symbolic approaches based on our method are equivalent. As a consequence, the applicability of the new formulation in real-time model-based control is proved.

The need for non-ionizing techniques for medical imaging applications has led to the use of microwave signals. Several systems have been introduced in recent years based on increasing the number of antennas and frequency bandwidth to obtain high resolution and good accuracy in locating objects. A novel microwave imaging system that reduces the number of required antennas for precise target location appropriate for medical applications is presented. The proposed system consists of four UWB extended gap ridge horn (EGRH) antennas covering the frequency band from 0.5 GHz to 1.5 GHz mounted on a cylindrical phantom that mimics the brain in an orthogonal set of two EGRH probes. This configuration has the ability to control both the longitudinal and transversal dimensions of the reconstructed target’s image, rather than controlling the spatial resolution, by increasing the frequency band that can be easily affected by medium losses. The system is tested numerically and experimentally by the detection of a cylindrical target within a human brain model.

Purpose – This paper aims to report on a survey of medium and large Irish firms to ascertain reasons for not changing to more advanced costing techniques, namely, activity-based costing (ABC). Developments in technology and recent poor economic conditions would suggest that the technique could be adopted more by firms, as they make increased efforts to keep costs under control. Design/methodology/approach – A survey instrument was used to gather data drawing from the top 1,000 Irish firms. From a useable population of 821 organisations, a response rate of 20.75 per cent was achieved. Findings – Findings show a rate of adoption of ABC of 18.7 per cent, which is lower than previous studies in an Irish context. The level of information technology in firms is not a key factor for non-adoption. Instead, the main reasoning for non-adoption revolve around stable existing costing methods, which firms expressed satisfaction with. Originality/value – This research suggests the adoption of ABC is not necessarily driven by external factors such as technology and economic shocks, at least in the context of Ireland. It also suggests that costing techniques may be deeply embedded within organisations and are less likely to be subject to change.

Low-cost and flexible radio frequency identification (RFID) tag for automatic identification, tracking, and monitoring of blood products is in great demand by the healthcare industry. A robust performance to meet security and traceability requirements in the different blood sample collection and analysis centers is also required. In this paper, a novel low-cost and flexible passive RFID tag is presented for blood sample collection tubes. The tag antenna is based on two compact symmetrical capacitive structures and works at the ultra-high frequency (UHF) European band (865 MHz−868 MHz). The tag antenna is designed considering the whole dielectric parameters such as the blood, substrate and tube. In this way, it operates efficiently in the presence of blood, which has high dielectric permittivity and loss. Measurement results of the proposed tag have confirmed simulation results. The measured performance of the tag shows good matching in the desired frequency band, leading to reading ranges up to 2.2 m, which is 4.4 times higher than typical commercial tags. The potential of this tag as a sensor to monitor the amount of blood contained in clinic tubes is also demonstrated. It is expected that the proposed tag can be useful and effective in future RFID systems to introduce security and traceability in different blood sample collection and analysis centers.

Objective: Systemic sclerosis (SSc) is a connective tissue disorder characterized by collagen deposits in various organs. Skin involvement is one of the most common symptoms and along with vascular damage, may deteriorate hand functions. However, the status of hand functions has generally been investigated using patient-reported measures in patients with SSc. The aim of the present study was to investigate performance-based hand functions in patients with SSc using the Sollerman Hand Function Test (SHFT)., Methods: A total of 39 patients with SSc (33 females) were included in the study. Twenty-four patients were classified as limited cutaneous SSc (lcSSc), while 15 patients were classified as diffuse cutaneous SSc (dcSSc). Hand-related physical characteristics were evaluated using the Modified Hand Mobility in Scleroderma Test, grip strength, and pinch strengths. The Duruoz Hand Index (Cochin Hand Functional Disability Scale), Disability of Arm, Shoulder, and Hand Questionnaire, Health Assessment Questionnaire, and Scleroderma Health Assessment Questionnaire were used as patient-reported measures. Performance-based hand functions were evaluated using SHFT., Results: No significant differences were observed between lcSSc and dcSSc subtypes regarding performance-based and patient-reported hand functions (p > 0.05). SHFT scores significantly correlated with hand-related physical characteristics and patient-reported hand functions (p < 0.05). The highest correlation was determined between SHFT and the Duruoz Hand Index (rho: -0.652, p < 0.001)., Conclusion: According to our results, performance-based hand functions seem not to be affected by disease subtype. Performance-based hand functions may partially be captured by the patient-reported outcomes, especially the Duruoz Hand Index, in patients with SSc., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: Systemic sclerosis (SSc) is a chronic autoimmune disease that affects the connective tissues and leads to physical, emotional, and social challenges for patients. Evaluating health-related quality of life (HRQoL) with a disease-specific tool may be preferable for improving patient care and treatment outcomes. The aim of this study was to translate the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) into Turkish and to investigate its psychometric properties., Methods: Eighty-six patients with SSc (mean age 51.8 ± 11.7 years, 80 females) participated in the study. Convergent validity was explored by correlation analyses between Turkish SScQoL and Short-Form 36 (SF-36), European Quality of Life Survey-5 Dimensions (EQ-5D), EQ-5D Visual Analog Scale (EQ-VAS), and Scleroderma Health Assessment Questionnaire (SHAQ). Cronbach's alpha was calculated to test internal consistency. Turkish SScQoL was readministered after 7-14 days to fifty-eight patients for determining test re-test reliability. Intraclass correlation coefficients in 95% confidence interval (ICCs [95%CI]) were calculated to examine the agreement between two assessments. Values greater than 15% and an absolute skewness value < 1 were recognized as the presence of a floor or ceiling effect., Results: SScQoL correlated significantly with SF-36 subdomains (r = -0.347 to -0.618, p < 0.01), EQ-5D (r = -0.535, p < 0.01), EQ-VAS (r = -0.636, p < 0.01), and SHAQ global score (r = 0.521, p < 0.01). SScQoL demonstrated excellent internal consistency (Cronbach's alpha = 0.917), and good to excellent test-retest reliability (ICC [95%CI] = 0.85 [0.76-0.91]). No floor/ceiling effects were observed., Conclusion: The Turkish version of SScQoL seems to have adequate psychometric properties and can be used to evaluate HRQoL in clinical and research settings. Key points • Turkish version of SScQoL is a valid and reliable tool for measuring health-related quality of life of patients with systemic sclerosis. • SScQoL is the only diseases-specific quality of life measurement for systemic sclerosis available in Turkish. • Patients with limited and diffuse SSc seem to be similar in terms of self-reported health-related quality of life., (© 2023. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Background: Various visual semi-quantitative staging systems based on high-resolution computed tomography are used to evaluate inflammatory rheumatologic disease-associated interstitial lung disease. We aimed in this retrospective study to evaluate whether tomographic fibrosis score, a new visual semi-quantitative staging system, was a predictor of mortality and the relationship between tomographic fibrosis score and respiratory function tests in patients with systemic sclerosis-associ- ated interstitial lung disease., Methods: The patients who have been followed up at a single-center rheumatology clinic for the last 5 years and met the American College of Rheumatology / European League Against Rheumatism (ACR-EULAR) 2013 systemic sclerosis classification criteria were included in the study. Clinical data were obtained retrospectively from patient records, including patients' characteristics, pulmonary function test (forced vital capacity), diffusing capacity of the lung for carbon monoxide test, high-reso- lution computed tomography results, medication history, and serological test results. High-resolution computed tomography of the patients diagnosed with interstitial lung disease were assessed for the study. The radiologists scored the extent of parenchymal abnormalities (ground glass opacification, reticulation, honeycombing, and consolidation) and calculated tomographic fibrosis score and also traction bronchiectasis score for each patient., Results: Fifty-two patients (46 female, median age 60 (Q1-Q3:47-66) years) were included in this study. The median disease duration, follow-up time, interstitial lung disease duration, and time from sys- temic sclerosis diagnosis to interstitial lung disease diagnosis were 80 (59-143) months, 78 (50-119) months, 63 (43-81) months, and 4 (0-58) months, respectively. The median tomographic fibrosis score and traction bronchiectasis score of the patients were 3.08% (1.33-8.06) and 0 (0-2), respectively. There was a moderate direct correlation between tomographic fibrosis score and traction bronchiectasis score (r = +0.472, P < .001). Additionally, there was a mod- erate inverse correlation between tomographic fibrosis score and diffusing capacity of the lung for carbon monoxide at diagnosis (r = -0.554, P = .011). During the follow-up period, 12 (23%) patients died. Kaplan-Meier Test (P = 0.009) and Cox regression analysis (B: 4.673, 95% confidence interval, 1.321-16.529, P = .017) revealed that tomographic fibrosis score ≥ 5% was associated with mortality. Multivariate analysis was not performed due to the small number of patients., Conclusion: An inverse relationship was found between tomographic fibrosis score and diffusing capacity of the lung for carbon monoxide at diagnosis. The odds ratio for mortality was 4.7 when tomographic fibrosis score was ≥5%. Tomographic fibrosis score may be useful for predicting mor- tality and respiratory function in patients with systemic sclerosis-associated interstitial lung disease.

Introduction/objective: The respiratory system is often affected by systemic sclerosis (SSc), a connective tissue disease characterized by fibrosis, vasculopathy, and inflammation. As a result, especially exertional dyspnea may occur in SSc patients. Evaluation of attitudes towards dyspnea is important in terms of preventing negative consequences such as kinesiophobia. However, no validated tool is available for assessing dyspnea-related kinesiophobia for patients with SSc. The aim of the present study was to perform the Turkish validation of the Breathlessness Beliefs Questionnaire for SSc (BBQ-SSc), which was adapted from the Tampa Kinesiophobia Scale, and to investigate its relationships with physical and clinical characteristics., Method: Fifty patients with SSc (47 females) were included in the study. The patients were evaluated regarding pulmonary function tests, respiratory muscle strength, patient-reported dyspnea, quality of life related to respiratory problems, mood, and fatigue. The patients were re-evaluated 1 week later for the test-retest reliability of the BBQ-SSc., Results: Internal consistency (Cronbach's alpha: 0.862) and test-retest validity (ICC: 0.831; 95% CI: 0.702-0.907) of the 12-item Turkish BBQ-SSc were found to be good. Principal component analysis confirmed the two-dimensional structure of the questionnaire. The scores of the questionnaire were associated with duration of illness, patient-reported dyspnea, quality of life related to respiratory problems, mood, and fatigue (p < 0.05)., Conclusions: According to our results, the 12-item Turkish BBQ-SSc is a reliable and valid tool to assess dyspnea-related kinesiophobia in SSc patients. Key Points • There are no structured tools available for assessing dyspnea-related kinesiophobia in patients with systemic sclerosis (SSc) • The 12-item Turkish Breathlessness Beliefs Questionnaire for SSc (BBQ-SSc) is a reliable and valid tool to assess dyspnea-related kinesiophobia in SSc patients., (© 2022. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Previous studies have shown that serum estradiol (E2) levels can predict mortality in intensive care unit patients. Our study investigated the predictive role of admission estradiol level on patient mortality and development of acute kidney injury in medical intensive care unit patients with a wide range of diagnoses. We conducted a prospective cohort study using serum samples from hospitalized patients in medical, cardiac, and pulmonary intensive care units at the Ege University Hospital within 6 months. Serum estradiol levels from 118 adult patients were collected within 48 h of hospitalization. Receiver operating curves and multiple logistic regression analyses were performed to investigate its relationship with acute kidney injury development and mortality. Serum estradiol levels were significantly higher in non-survivor patients than in survivor patients [85 (19-560) pg/mL vs. 32 (3-262) pg/mL, p < 0.001]. Admission estradiol levels were significantly higher in patients with AKI on admission than in patients with chronic kidney disease (p = 0.002) and normal renal function (p = 0.017). Serum E2 levels were higher in patients with renal deterioration during follow-up than patients with stable renal functions [62 (11-560) pg/mL vs. 38 (3-456) pg/mL, p = 0.004]. An admission estradiol level of 52.5 pg/mL predicted follow-up renal deterioration with 63% sensitivity and 74% specificity. A combined (APACHE II-E) score using APACHE II and serum estradiol level predicted overall mortality with 66% sensitivity and 82% specificity. Admission estradiol level is a good marker to predict the development of acute kidney injury and mortality in medical intensive care unit patients., (© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)

Aim: The study's aim was to investigate the relationship of grip strength and endurance with clinical characteristics, upper extremity functional disability, and quality of life in rheumatoid arthritis (RA) patients., Method: We included 45 RA patients and 37 healthy controls in this cross-sectional study. All participants were evaluated using the maximal gripping test, static and dynamic grip endurance test, the Disability of Arm, Shoulder Hand Questionnaire, and Short Form-36, and sociodemographic and clinical characteristics were recorded., Results: Moderate to strong correlations were found between functional disability and all of the grip-related variables. Physical, emotional, and social function sub-scores were correlated with grip strength on both sides and dynamic endurance on the dominant side., Conclusion: The study highlights grip-related variables associated with disability of the upper extremity. The grip strength was related to hand-wrist pain but not other clinical characteristics. Furthermore, grip strength on both sides and dynamic grip endurance on the dominant side were associated with some quality of life sub-scores. While therapists create a rehabilitation plan for RA patients, based on our findings, it may be beneficial to maximize therapeutic benefits on daily life and quality of life., (© 2022 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)