Reduction of Hepato-Metabolic Changes in Rat Model of Metabolic Syndrome by Metformin and Atorvastatin Combination: submitted: Apr 18, 2018 Accepted: Jun 29, 2018 Published online: Aug 30, 2018

Metabolic syndrome (MetS) and the commonly associated nonalcoholic fatty liver disease (NAFLD) is an increasing health concern and hot topic in medical research. Together with lifestyle modification, metformin (MET) and statins are among drugs with potential therapeutic beneft. The aim of this study is to investigate the potential of synergistic combination of MET and atorvastatin (ATR) in rat model of MetS. Methods. Rats were fed on high-carbohydrate, highfat (HCHF) diet for 16 weeks and either of MET, ATR, or their combination were administered from the beginning of the 9th week to the end of the study. Body weight, insulin resistance, plasma lipids, serum transaminases, TNF-α, leptin and adiponectin as well as liver histopathology were assessed. Results. Both MET and ATR worked synergistically to reverse the biochemical and histological abnormalities of MetS and ameliorated steatohepatitis more than their individual effects. Conclusion. The present study clearly demonstrates a synergistic effect of MET an ATR combination to reverse hepato-metabolic abnormalities of MetS/NAFLD in rat model and calls for pursuing subsequent clinical studies to consolidate data at han

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Subtitling for Intercultural Communication in Foreign Language Learning/Teaching: the case of "Dhat", an Egyptian Series Subtitled in Spanish

El objetivo de este trabajo es presentar un nuevo recurso para la enseñanza del árabe como lengua extranjera. El trabajo se desarrolla dentro del marco de las actividades del proyecto E-LENGUA financiado por el programa europeo de Erasmus+. El objetivo del proyecto es desarrollar nuevos recursos y compartir buenas prácticas para la enseñanza de lenguas extranjeras aplicando las tecnologías de información y comunicación. El recurso presentado aquí consiste en la subtitulación de un conjunto de 10 capítulos de una serie egipcia contemporánea titulada, Dhat. La serie refleja la historia egipcia contemporánea desde los cincuenta hasta la revolución del 2011 a través de la vida de la protagonista, Dhat, una chica egipcia de la clase media, nacida en El Cairo. El artículo consiste en cuatro partes. La introducción presenta el marco teórico. La segunda parte explica la metodología y el alcance de la tarea planteada. La tercera parte presenta las actividades desarrolladas utilizando este recurso y su evaluación en el aula. Finalmente en la última parte se resumen las conclusiones y los futuros trabajos.The objective of this paper is to present a teaching resource for Arabic as a foreign language, developed within the context of the European project ELENGUA. E-LENGUA is funded by Erasmus+ programme and it aims at developing new resources and sharing good practices in foreign language teaching using modern information and communication technologies. The resource consists of subtitling a set of ten episodes of the Egyptian TV series, Dhat. The subtitles are in Spanish and the series depicts the evolution of the Egyptian society, from the fifties until the Egyptian Revolution in 2011 through the biography of Dhat, an Egyptian middle class girl born in the fifties in Cairo. The paper is divided into four sections. The first is an introduction covering the theoretical framework. The second presents the methodology and the scope of work. The learning activities and its evaluation are addressed in the third section. Finally, the conclusions and future work are presente

Acaricidal and Antioxidant Activities of Anise Oil (<i>Pimpinella anisum</i>) and the Oil’s Effect on Protease and Acetylcholinesterase in the Two-Spotted Spider Mite (<i>Tetranychus urticae</i> Koch)

The two-spotted spider mite, Tetranychus urticae, also known as the red spider, is one of the most harmful pests in agriculture and causes large losses of many crops. These mites have rapidly developed a resistance to many chemical pesticides in recent years. In this study, the essential oil of seeds of the anise plant (Pimpinella anisum) was extracted by hydrodistillation, and the chemical composition of the oil was analyzed. The antioxidant activity of the volatile oil was determined by the DPPH radical scavenging assay. The acaricidal activity of the anise oil, a natural acaricide, was evaluated for its ability to protect green bean plants from mite injury. The two-spotted spiders were spread on green bean seedlings for 1 week; then, different plants were sprayed with different concentrations of anise oil (10, 20, 30, or 40 µL/L). Our results revealed that anethole was the major component of anise oil, at 53.23%. The acaricidal effect of the various concentrations on T. urticae was recorded after 24, 48, and 72 h of treatment. Our findings suggest that anise oil showed significant acaricidal activity against T. urticae in a dose- and time-dependent manner. Anise oil at a concentration of 40 µL/L killed 96.0% of the red spiders after 72 h. Also, all concentrations of anise oil inhibited acetylcholinesterase, and the spiders’ protease activity declined when the plants were treated with 30 or 40 µL/L of anise oil. The concentrations of 10 and 20 µL/L did not significantly affect the protease activity of T. urticae mites. We can conclude that anise oil exhibited acaricidal activity against T. urticae and that this was highly correlated with the inhibition of acetylcholinesterase and protease activities in the mites

Role of Signaling Molecules Sodium Nitroprusside and Arginine in Alleviating Salt-Induced Oxidative Stress in Wheat

Nitric oxide (NO) is a well-accepted signaling molecule that has regulatory effects on plants under various stresses. Salinity is a major issue that adversely affects plant growth and productivity. The current study was carried out to investigate changes in the growth, biochemical parameters, and yield of wheat plants in response to NO donors, namely sodium nitroprusside (SNP) (2.5 and 5.0 mM) and arginine (10 and 20 mM), under two salinity levels (1.2 mM and 85.5 mM NaCl). Salinity stress significantly decreased the lengths and weights of plant parts (shoot, tiller, and root) and reduced the flag leaf area, photosynthetic pigments, indole acetic acid (IAA), and yield and its components. Moreover, salt stress induced a significant accumulation of some osmoprotectants (total soluble sugars (TSS) and amino acids, especially proline) and triggered the accumulation of hydrogen peroxide (H2O2) and lipid peroxidation in wheat leaves. In contrast, arginine and SNP treatments significantly mitigated the negative impacts of salinity on growth and productivity via enhancing photosynthetic pigments, nitrate reductase, phenolic compounds, IAA, TSS, free amino acids, and proline. In addition, SNP and arginine potentially reduced oxidative damage by decreasing H2O2 and lipid peroxidation through the induction of antioxidant enzymes. The individual amino acid composition of wheat grains under the interactive effect of salinity and NO sources has been scarcely documented until now. In this study, the NO sources restrained the reduction in essential amino acids (isoleucine and lysine) of wheat grains under salinity stress and further stimulated the contents of non-essential and total aromatic amino acids. Interestingly, the applied protectants recovered the decrease in arginine and serine induced by salinity stress. Thus, SNP or arginine at the levels of 5.0 and 20 mM, respectively, had a profound effect on modulating the salt stress of wheat throughout the life cycle

Mirtazapine, an atypical antidepressant, mitigates lung fibrosis by suppressing NLPR3 inflammasome and fibrosis-related mediators in endotracheal bleomycin rat model

Idiopathic pulmonary fibrosis (IPF) is a progressive and irreversible lung disease with a poor prognosis. There is currently no definitive cure for IPF. The present study establishes a platform for the development of a novel therapeutic approach for the treatment of PF using the atypical antidepressant, mirtazapine. In the endotracheal bleomycin rat model, mirtazapine interfered with the activation of NLRP3 inflammasome via downregulating the NLRP3 on the gene and protein expression levels. Accordingly, the downstream mediators IL-1β and IL-18 were repressed. Such observation is potentially a direct result of the reported improvement in oxidative stress. Additionally, mirtazapine corrected the bleomycin-induced disparities in the levels of the fibrogenic mediators TGF-β, PDGF-BB, and TIMP-1, in consequence, the lung content of hydroxyproline and the expression of α-SMA were reduced. Besides, mirtazapine curbed the ICAM-1 and the chemotactic cytokines MCP-1 and CXCL4. This protective property of mirtazapine resulted in improving the BALF total and differential cell counts, diminishing LDH activity, and reducing the BALF total protein. Moreover, the inflammation and fibrosis scores were accordingly lower. To conclude, we reveal for the first time the efficacy of mirtazapine as a potential treatment for PF. The combination of social isolation, sleep problems, breathing difficulties, and fear of death can lead to psychological distress and depression in patients with IPF. Hence, mirtazapine is a promising treatment option that may improve the prognosis for IPF patients due to its antifibrotic effects, as well as its ability to alleviate depressive episodes

Insights into the Antimicrobial, Antioxidant, Anti-SARS-CoV-2 and Cytotoxic Activities of Pistacia lentiscus Bark and Phytochemical Profile; In Silico and In Vitro Study

Foodborne infections and antibiotic resistance pose a serious threat to public health and must be addressed urgently. Pistacia lentiscus is a wild-growing shrub and has been utilized for medicinal applications as well as for culinary purposes. The antibacterial and antioxidant activities of P. lentiscus bark in vitro, as well as the phytochemical composition, are the focus of this inquiry. The bark extract of P. lentiscus showed significant antimicrobial activity in experiments on bacteria and yeast isolated from human and food sources. The exposure time for the complete inhibition of cell viability of P. aeruginosa in the extracts was found to be 5% at 15 min. Phytochemical inquiry of the methanol extract demonstrates the existence of carbohydrates, flavonoids, tannins, coumarins, triterpenes, and alkaloids. Deep phytochemical exploration led to the identification of methyl gallate, gallic acid, kaempferol, quercetin, kaempferol 3-O-&alpha;-rhamnoside, kaempferol 3-O-&beta;-glucoside, and Quercetin-3-O-&beta;-glucoside. When tested using the DPPH assay, the methanol extracts of P. lentiscus bark demonstrated a high free radical scavenging efficiency. Further, we have performed a molecular modelling study which revealed that the extract of P. lentiscus bark could be a beneficial source for novel flavonoid glycosides inhibitors against SARS-CoV-2 infection. Taken together, this study highlights the Pistacia lentiscus bark methanol extract as a promising antimicrobial and antiviral agent

Prospective multicentre study in intensive care units in five cities from the Kingdom of Saudi Arabia: Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on rates of central line-associated bloodstream infection

OBJECTIVE: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in five intensive care units (ICUs) from October 2013 to September 2015. DESIGN: Prospective, before-after surveillance study of 3769 patients hospitalised in four adult ICUs and one paediatric ICU in five hospitals in five cities. During baseline, we performed outcome and process surveillance of CLABSI applying CDC/NHSN definitions. During intervention, we implemented IMA and ISOS, which included: (1) a bundle of infection prevention practice interventions; (2) education; (3) outcome surveillance; (4) process surveillance; (5) feedback on CLABSI rates and consequences; and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed. RESULTS: During baseline, 4468 central line (CL) days and 31 CLABSIs were recorded, accounting for 6.9 CLABSIs per 1000 CL-days. During intervention, 12,027 CL-days and 37 CLABSIs were recorded, accounting for 3.1 CLABSIs per 1000 CL-days. The CLABSI rate was reduced by 56% (incidence-density rate, 0.44; 95% confidence interval, 0.28–0.72; P = 0.001). CONCLUSIONS: Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in the ICUs of Saudi Arabia

Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia

To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and use of INICC Surveillance Online System (ISOS) on ventilator-associated pneumonia (VAP) rates in Saudi Arabia from September 2013 to February 2017. A multicenter, prospective, before–after surveillance study on 14,961 patients in 37 intensive care units (ICUs) of 22 hospitals. During baseline, we performed outcome surveillance of VAP applying the definitions of the CDC/NHSN. During intervention, we implemented the IMA and the ISOS, which included: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on VAP rates and consequences and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using generalized linear mixed models to estimate the effect of intervention. The baseline rate of 7.84 VAPs per 1000 mechanical-ventilator (MV)-days―with 20,927 MV-days and 164 VAPs―, was reduced to 4.74 VAPs per 1000 MV-days―with 118,929 MV-days and 771 VAPs―, accounting for a 39% rate reduction (IDR 0.61; 95% CI 0.5–0.7; P 0.001). Implementing the IMA was associated with significant reductions in VAP rates in ICUs of Saudi Arabia