Clinical phenotypes and constipation severity in Parkinson’s disease: Relation to Prevotella species

Background: The gut microbiome is speculated to play a crucial role in its pathogenesis of Parkinson’s disease as a triggering factor. Recent hypotheses suggested that Prevotella species regulate gut permeability, exert a neuroprotective effect, and interestingly, has been suspected to be deficient in PD patients, and so may play a role in this disease. Aim: This study was designed to compare between PD patients and their healthy controls as regards relative Prevotella abundance, prevalence of Prevotella-dominant Enterotype, and constipation severity. Also, to correlate Prevotella changes with the clinical phenotypes and  severity of motor and non-motor symptoms of PD. Methods: Twenty-five PD cases were enrolled in this study and cross-matched to 25 healthy subjects representing the control group. Overall NMS severity was assessed using the Non-Motor Symptoms Scale (NMSS). Quantitative SYBR green Real Time PCR was performed for the identification and quantitation of Prevotella in stool. Results: Prevotella relative abundance was 4-fold decreased in cases when compared to controls with PIGD phenotype showing the lowest abundance, however the difference was not statistically significance. Prevotella-dominant Enterotype was less presented in cases compared to controls, the result was statistically significant. Severe and very severe constipation grades presented 64% of cases group Vs 12% of control group. There was statistically significant positive correlation between total constipation score and UPDRS total score and motor symptoms phenotypes. Conclusion: Relative low Prevotella abundance in PD patients appears to be related to severe phenotypes of the disease; PIGD and mixed phenotypes. Severe constipation was more presented in PD cases which may be considered  as a preclinical biomarker for PD

Edge Computing for Real-Time Inference in Internet of Things Environments: Challenges and Solutions

The role that the real-time inference model plays in the Internet of Things environment and the applications that correspond to it are demonstrated by this project. In order to provide an all-encompassing picture of networking technologies, the section on the literature review has provided a description of the research that came before this project as well as an evaluation of its overall quality. In this section, the methodology component of the evolution of computing techniques in the environment of IOT is also examined. As a result, the technique of edge computing is utilised to produce many answers to the difficulties presented by the Internet of Things environment. In this section, the thematic analysis is carried out by making use of real-time applications and examples that are connected to networking applications. Last but not least, the project session comes to a close with the inclusion of research recommendations for the development of IOT and further work in this research

Optimal Timing of the Sugar Beet Juice Season as an Intelligent Adaptation Strategy to Climate Change in Egypt

Agricultural production, especially beet sugar production, is expected to face climate change-induced challenges, which require adaptation using innovative techniques and strategies. Therefore, this work was conducted in the rural area of Abnoub, Asyut governorate, Egypt, during the 2020–2021 working season and in laboratories of Delta Sugar Company, Kafr El-Sheikh governorate, as well as in laboratories of Food Science and Technology Department, Faculty of Agriculture, New Valley University, Egypt. The aim of this study was to investigate the effects of juicing season timing on quantitative and qualitative indices of beetroot. The obtained results indicated that juice season timing exhibited a significant effect on quantitative indices of beetroots, including root yield, gross sugar, recoverable sugar, and sugar loss (t/ha) as well as qualitative indices of beetroots, including total soluble solids, purity, sugar recovery, sugar loss% to molasses, non-sucrose substances, quality index, moisture, pol, total sugars, reducing sugars, total nitrogen content, total lipids, marc, ash%, impurities: α-amino N, and Na content. The early juice season, beginning in mid-February, proved to be the best time for sugar beet manufacturing and can be suggested as smart sugar manufacturing in Egypt to combat climate change. However, under the study conditions, the timing of the late juice season in mid-June is unfavorable for sugar manufacturing

Comparison of Muscle Energy Techniques and Myofascial Release in Premenopausal Women with Fibromyalgia

Background and Purpose Fibromyalgia is characterized by idiopathic long-lasting pain that negatively impacts patients’ quality of life. Although many therapeutic interventions are available; treatment is still challenging due to the condition’s complexity. Therefore, comparative researches are required to decide which treatment is better to produce the best clinical decision for fibromyalgia. The purpose of this study was to compare the effect of ‘muscle energy technique and myofascial release’ on fibromyalgia patients. Materials and Methods In this randomized controlled trial, seventy-four women aged 30 to 45, with a body mass index ranging from 25 - 34.9 kg/m², were participated. They were assigned to either the ‘muscle energy technique or myofascial release’ group. Each treatment was conducted over four weeks, with three weekly sessions lasting 25 minutes each. Meanwhile, the ‘myofascial release’ group received treatment for 20 minutes, three times per week for the same duration. Outcome measures included ‘pain levels assessed via a visual analog scale, range of motion evaluated with a universal goniometer, and quality of life determined through the fibromyalgia impact questionnaire’. Results ‘Muscle energy technique and myofascial release’ showed a significant decrease (p<0.001) in cervical pain, low back pain, and fibromyalgia impact questionnaire score, and a significant increase (p<0.001) in cervical and trunk range of motion after treatment. The myofascial release group showed more significant decrease in cervical pain (p=0.002), low back pain (p=0.003), fibromyalgia impact questionnaire score (p=0.001), cervical left bending (p=0.007), and trunk extension (p=0.003), right bending (p=0.014), left bending (p=0.007), right rotation (p=0.009), and left rotation (p=0.007) than muscle energy technique group. Conclusion ‘Muscle energy technique and myofascial release’ is beneficial methods for fibromyalgia patients. However, myofascial release was more effective than muscle energy technique in improving pain, quality of life, and trunk range of motion

Enhanced therapeutic efficacy of SERCA2a gene-modified adipose-derived mesenchymal stem cell exosomes in doxorubicin-induced cardiomyopathy in male albino rats

Background: Worldwide, cancer is still the primary cause of death, and one of the most widely used anthracyclines for treating cancer is doxorubicin (DOX). But a major worry is DOX-induced cardiomyopathy, which is primarily resulted from an excess of reactive oxygen species. Heart sarcoplasmic reticulum calcium ion ATPase2a (SERCA2a) controls the amount of calcium ions stored in the sarcoplasmic reticulum (SR). This study aims to evaluate and compare the efficacy of SERCA2a gene modified adipose mesenchymal stem cell-derived exosomes (AMSCs-dE) to nontransfected AMSCs-dE, in DOX induced cardiomyopathy in adult male albino rat. Materials and methods: Thirty one adult male albino rats were randomly divided into control group and DOX group that further subdivided into three DOX, AMSCs-dE and SERCA2a AMSCs-dE subgroups. AMSCs-dE were administered intravenously (IV). The levels of serum creatine kinase MB (CK-MB) were assessed after DOX injection and before sacrifice. Cardiac muscle samples were taken for histological analysis using Masson’s trichrome and hematoxylin and eosin stains two months after the experiment. Proliferating cell nuclear antigen (PCNA) and connexin 43 were stained using immunohistochemistry. The expression of TNF and SERCA2a genes and proteins was measured by real-time polymerase chain reaction (PCR) and Western blot (Wb) analysis, respectively. Fluorescent microscopy demonstrated non-transfected and transfected exosomes labeled with PKH26 and GFP, respectively, in culture and cardiac muscle. Results: DOX induced myocarditis progressing to degenerative and fibrotic changes in cardiac muscle that regressed in response to AMSCs-dE therapy. However, SERCA2a gene modified AMSCs-dE treatment reversed the mentioned parameters to nearly its normal level. Conclusions: These findings suggest that SERCA2a gene modification enhances the therapeutic efficacy of AMSCs-dE in treating DOX-induced cardiomyopathy

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Menstrual changes after COVID-19 vaccination and/or SARS-CoV-2 infection and their demographic, mood, and lifestyle determinants in Arab women of childbearing age, 2021

BackgroundBy September 2, 2021, over 30,000 COVID-19-vaccinated females had reported menstrual changes to the MHRA's Yellow Card surveillance system. As a result, the National Institutes of Health (NIH) is urging researchers to investigate the COVID-19 vaccine's effects on menstruation. Therefore, this study was conducted to explore the menstrual changes after COVID-19 vaccination and/or SARS-CoV-2 infection and their interrelations with demographic, mood, and lifestyle factors in Arab women of childbearing age (CBA).MethodologyA cross-sectional study was conducted during October 2021 using an Arabic validated and self-administrated questionnaire. In total, 1,254 Women of CBA in the Arabic Population (15–50 y) with regular menstrual cycles were randomly selected from five countries (Saudi Arabia, Egypt, Syria, Libya, and Sudan).ResultsThe mean (SD) age of the 1,254 studied females was 29.6 (8.5) years old. In total, 634 (50%) were married, 1,104 (88.0%) had a University education or above, 1,064 (84.4%) lived in urban areas, and 573 (45.7%) had normal body weight. Moreover, 524 (41.8%) were COVID-19 cases and 98 women (18.7%) reported menstrual changes (MCs). The 1,044 (83.5%) vaccinated females reported 418 (38.5%) MCs after being vaccinated, and these MCs resolved in 194 women (55.1%) after more than 9 months. Statistically significant relationships were observed between the reported MCs and the following variables: age, marital status, level of education, nationality, residence, and BMI. MCs were reported at 293(80.6) after the 2nd dose, and were mainly reported after 482 (46.1) Pfizer, 254 (24.3) Astrazenica, and 92 (8.8) Senopharm.ConclusionMCs among women of CBA after COVID-19 infection and vaccination are prevalent and complex problems, and had many determinates

Chitosan edible coating: a potential control of toxic biogenic amines and enhancing the quality and shelf life of chilled tuna filets

Edible films and coatings offer great potential to support sustainable food production by lowering packaging waste, extending product shelf life, and actively preserving food quality. Using edible coatings containing plant extracts with antioxidant and antibacterial characteristics could help to enhance the quality and shelf life of fish products. In this study, the combination effect of chitosan with beetroot, curcumin, and garlic extracts on biogenic amines (BAs) reduction, biochemical quality [pH, thiobarbituric acid index (TBA), trimethylamine (TMA), and total volatile base (TVB)], shelf life and sensory characteristics of tuna filets was investigated over 14 days of refrigerated storage compared to control (uncoated) samples. The results showed that the coated samples experienced a lower increase in BAs levels than the control samples. Among the treated samples, chitosan incorporated with curcumin (CH-C) showed the highest reduction in BAs formation (1.45 – 19.33, 0.81 – 4.45, and 1.04 – 8.14 mg/kg), followed by chitosan with garlic (CH-G) (1.54 – 21.74, 0.83 – 5.77, and 1.08 – 8.84 mg/kg), chitosan with beetroot extract (CH-B) (1.56 – 31.70, 0.84 – 6.79, and 1.07 – 10.82 mg/kg), and chitosan without extract addition (CH) (1.62 – 33.83, 0.71 – 7.82 and 1.12 – 12.66 mg/kg) compared to control samples (1.62 – 59.45, 0.80 – 11.96, and 1.14 – 20.34 mg/kg) for histamine, cadaverine, and putrescine, respectively. In addition, the rate of increase in pH, TBA, TMA, and TVB of all coated treatments was lower than in the control samples. Sensory evaluation results revealed that chitosan-treated samples incorporated with beetroot, garlic, and curcumin extracts showed good quality and acceptability characteristics. Overall, chitosan edible coatings incorporated with beetroot, garlic, and curcumin extracts reduced the formation of biogenic amine, delayed biochemical deterioration, and extended the shelf life of tuna filets. Among the treated samples, CH-C demonstrated a remarkable superiority in all the studied parameters. Therefore, this study provides a promising strategy for the incorporation of active compounds in edible coatings to improve the quality and safety of foods during storage

Safety of COVID-19 Vaccination in Patients with Rheumatic and Musculoskeletal Diseases: A Cross-sectional Study in Egypt

Objectives: To investigate the incidence and associated risk factors of adverse events following COVID-19 vaccination in patients with inflammatory and non-inflammatory rheumatic and musculoskeletal diseases (I-RMD and NI-RMD, respectively). Methods: The Egyptian College of Rheumatology COVID-19 Study Group investigated physician-reported data (ECR-VaXurvey3) of RMD patients vaccinated against COVID-19 from December 2021 to June 2022, including their demographics, vaccination type, RMD diagnosis, treatments, post-vaccine flares, and other adverse events. The control group consisted of healthy, vaccinated individuals. Results: The ECR-VaXurvey3 included 890 vaccinated RMD patients, predominantly women (73.3%) with a mean age of 44.4 ± 12.1 years, and 172 controls. The RMD group comprised 816 (91.7%) with I-RMD and 74 (8.3%) with NI-RMD. The frequency of adverse events was comparable between the RMD and control groups. In RMD patients, injection site pain (59.9%) was the most reported adverse event. Post-vaccination COVID-19 infections and disease flares were reported in 2.9% and 12.1% of I-RMD patients and in 8.1% and 9.5% of NI-RMD patients (p =0.018 and p =0.497, respectively). The severity of prior COVID-19 infection (odds ratio (OR) = 2.4, 95% CI: 1.0–5.8; p =0.040) and azathioprine use (OR = 2.6, 95% CI: 1.1–5.9; p =0.024) were associated with higher post-vaccine adverse events, while biologic use was associated with fewer adverse events (OR = 0.5, 95% CI: 0.3–0.8; p =0.010). Conclusions: Adverse events following COVID-19 vaccinations in patients with RMD are comparable to controls

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions