Molecular Characterization of VIM Carbapenemases in the Arabian Peninsula

The emergence and global spread of carbapenem resistant Enterobacteriaceae is alarming world-wide phenomenon that also affects the Middle East due to limited treatment options for such infections and their common association with high level of fatality. The most important mechanism of such resistance is caused by the production of various carbapenemase enzymes. In the Arabian Peninsula, so far, NDM and OXA48-like carbapenemases have been reported, while elsewhere other enzymes, e.g. VIM, IMP and KPC are also commonly found. Our aim was to systematically look for the VIM-type carbapenemases among local isolates and to characterize their genetic background. Initially, screening isolates from Abu Dhabi hospitals, we identified a single Enterobacter cloaceae strain carrying the VIM-4 allele. This was the first such isolate ever reported from the peninsula. Subsequently, investigating isolates from Kuwait, Saudi Arabia, Oman and the UAE, we identified a further 11 isolates, one E. cloaceae from Saudi Arabia, two from Oman, one from Kuwait and also one Escherichia coli from this country. Besides these, the latter country also provided six Klebsiella pneumonia isolates. All strains produiced the VIM-4 variant of the enzyme as determined by the sequencing of their genes. In all cases, the gene was located on plasmids of varying sizes, either non-typable or belonging to the IncA/C group; most of them were conjugative and they commonly harbored other Β-lactamase genes, such as CTX-M or CMY-4. In all strains the VIM-4 gene was located within a class I integrin – with some variations between the gene casettes present – similar to strains previously identified in North Africa and Italy, suggesting the possibility of spread. Clonal typing revealed that the relatively high incidence of VIM-producer Enterobacteriaceae encountered in Kuwait was not due to the spread of a particular clone, but most probably was the result of the transfer of an IncA/C plasmid, co-harboring blaVIM-4 and blaCMY-4, into Klebsiella pneumonia and E. coli. Our data show that, beyond NDM and OXA-48-like, VIM type carbapenemases are the third most common isolates in the Arabian Peninsula. Further investigation is needed to monitor the spread of clones and genes in the region

THE RELATIONSHIP BETWEEN CAFFEINE ADDICTION AND STRESS AMONG LEBANESE MEDICAL STUDENTS IN LEBANON

Stress and behavioral addiction are becoming major health problems growing in strength and prevalence. They are often associated with a large array of debilitating diseases and conditions including psychosocial impairments. Medical students remain a vulnerable territory for developing stress and addiction mainly relating to caffeine consumption. Methods: A cross-sectional design was utilized in this study. Results: The study revealed that academic and learning issues are the most stressful and alarming levels of caffeine dependence. Conclusions: This showed a high impact of academic issues on medical students stress and performance, which mandates thorough actions to be considered by both medical institutions and medical students to fight this stress and maintain a healthier life and academic development

Assessing the Psychometric Properties of the Internet Addiction Test (IAT) Among Lebanese College Students

Internet addiction is an emergent problem; yet, both a strong conception of the factors precipitating challenging activities and a gold standard tool for evaluating symptoms are deficient. The aim of this study was to carry out a psychometric analysis using the most commonly employed screening tool, the young Internet Addiction Test (IAT), comprising a sample of Lebanese University medical students. Two hundred and fifty-six undergraduate medical students from a university in Beirut, Lebanon were included in our IAT. Exploratory factor analysis was employed, and four factors were extracted. These four factors were named as Lack of Control, Social Withdrawal and Emotional Conflict, Time Management Problems, and Concealing Problematic Behavior. Furthermore, the selected factors explained 56.5% of the total variance. Cronbach's alpha coefficient for the internal reliability of the scale was found to be 0.91. For each subscale, the internal consistency score was approximated and detected as 0.76, 0.74, 0.69, and 0.63 for the first through fourth factor, respectively. Item total correlations were calculated and had a value range from 0.37 to 0.63 for the 20 items. IAT is a proper tool for evaluating internet addiction in Lebanese college students

Impact of supragingival therapy on subgingival microbial profile in smokers versus non-smokers with severe chronic periodontitis

The aim of this study was to assess subgingival microbiological changes in smokers versus non-smokers presenting severe chronic periodontitis after supragingival periodontal therapy (ST).Non-smokers (n=10) and smokers (n=10) presenting at least nine teeth with probing pocket depth (PPD) (≥5 mm), bleeding on probing (BoP), and no history of periodontal treatment in the last 6 months were selected. Clinical parameters assessed were plaque index (PI), BoP, PPD, relative gingival margin position (rGMP) and relative clinical attachment level (rCAL). Subgingival biofilm was collected before and 21 days after ST. DNA was extracted and the 16S rRNA gene was amplified with the universal primer pair, 27F and 1492R. Amplified genes were cloned, sequenced, and identified by comparison with known 16S rRNA sequences. Statistical analysis was performed by Student's t and Chi-Square tests (α=5%).Clinically, ST promoted a significant reduction in PI and PPD, and gain of rCAL for both groups, with no significant intergroup difference. Microbiologically, at baseline, data analysis demonstrated that smokers harbored a higher proportion of Porphyromonas endodontalis, Bacteroidetes sp., Fusobacterium sp. and Tannerella forsythia and a lower number of cultivated phylotypes (p<0.05). Furthermore, non-smokers featured significant reductions in key phylotypes associated with periodontitis, whereas smokers presented more modest changes.Within the limits of the present study, ST promoted comparable clinical improvements in smokers and non-smokers with severe chronic periodontitis. However, in smokers, ST only slightly affected the subgingival biofilm biodiversity, as compared with non-smokers

Psychometric Comparisons of Benevolent and Corrective Humor across 22 Countries: The Virtue Gap in Humor Goes International

Recently, two forms of virtue-related humor, benevolent and corrective, have been introduced. Benevolent humor treats human weaknesses and wrongdoings benevolently, while corrective humor aims at correcting and bettering them. Twelve marker items for benevolent and corrective humor (the BenCor) were developed, and it was demonstrated that they fill the gap between humor as temperament and virtue. The present study investigates responses to the BenCor from 25 samples in 22 countries (overall N = 7,226). The psychometric properties of the BenCor were found to be sufficient in most of the samples, including internal consistency, unidimensionality, and factorial validity. Importantly, benevolent and corrective humor were clearly established as two positively related, yet distinct dimensions of virtue-related humor. Metric measurement invariance was supported across the 25 samples, and scalar invariance was supported across six age groups (from 18 to 50+ years) and across gender. Comparisons of samples within and between four countries (Malaysia, Switzerland, Turkey, and the UK) showed that the item profiles were more similar within than between countries, though some evidence for regional differences was also found. This study thus supported, for the first time, the suitability of the 12 marker items of benevolent and corrective humor in different countries, enabling a cumulative cross-cultural research and eventually applications of humor aiming at the good

The Immunomodulatory and Anti-Inflammatory Role of Polyphenols

This review offers a systematic understanding about how polyphenols target multiple inflammatory components and lead to anti-inflammatory mechanisms. It provides a clear understanding of the molecular mechanisms of action of phenolic compounds. Polyphenols regulate immunity by interfering with immune cell regulation, proinflammatory cytokines’ synthesis, and gene expression. They inactivate NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) and modulate mitogen-activated protein Kinase (MAPk) and arachidonic acids pathways. Polyphenolic compounds inhibit phosphatidylinositide 3-kinases/protein kinase B (PI3K/AkT), inhibitor of kappa kinase/c-Jun amino-terminal kinases (IKK/JNK), mammalian target of rapamycin complex 1 (mTORC1) which is a protein complex that controls protein synthesis, and JAK/STAT. They can suppress toll-like receptor (TLR) and pro-inflammatory genes’ expression. Their antioxidant activity and ability to inhibit enzymes involved in the production of eicosanoids contribute as well to their anti-inflammation properties. They inhibit certain enzymes involved in reactive oxygen species ROS production like xanthine oxidase and NADPH oxidase (NOX) while they upregulate other endogenous antioxidant enzymes like superoxide dismutase (SOD), catalase, and glutathione (GSH) peroxidase (Px). Furthermore, they inhibit phospholipase A2 (PLA2), cyclooxygenase (COX) and lipoxygenase (LOX) leading to a reduction in the production of prostaglandins (PGs) and leukotrienes (LTs) and inflammation antagonism. The effects of these biologically active compounds on the immune system are associated with extended health benefits for different chronic inflammatory diseases. Studies of plant extracts and compounds show that polyphenols can play a beneficial role in the prevention and the progress of chronic diseases related to inflammation such as diabetes, obesity, neurodegeneration, cancers, and cardiovascular diseases, among other conditions

Place du médecin généraliste dans le suivi des patients porteurs d'assistance cardiaque gauche type Heartmate II rentrés à domicile (enquête téléphonique auprès des médecins concernés)

Chaque année dans le monde, plus de 6000 patients en insuffisance cardiaque terminale bénéficient de l implantation d une assistance ventriculaire gauche de type Heartmate II. Ce dispositif devient incontournable devant le manque de thérapie médicamenteuse efficace à leur stade. Ils ont à cœur de rentrer à domicile mais leur médecin traitant est-il prêt à les suivre? Notre étude téléphonique concerne les généralistes de dix patients implantés à l hôpital Louis Pradel de Lyon et rentrés à domicile entre 2011 et 2013. 40% déclarent connaître l Heartmate II et ce grâce à un travail personnel; aucun n a bénéficié de formation spécifique. Un seul savait que ce type d assistance permettait au malade de quitter l hôpital. 70% révèlent ne pas intervenir dans la prescription des examens complémentaires et laisser faire le cardiologue. Avec une amélioration de leur capacité fonctionnelle rapide et durable, les médecins généralistes sont satisfaits de la prise en charge globale de leur patient, mais ne s en sentent pas forcément acteurs. Il serait intéressant d étendre ce travail à d autres centres afin de comparer les pratiques.BORDEAUX1-Bib.electronique (335229901) / SudocSudocFranceF

A Self-Stabilizing Distributed Branch-and-Bound Algorithm

: The Branch-and-Bound algorithm is fundamental for a variety of applications in Combinatorial Optimization. Known distributed algorithms for this problem do not tolerate faults. This paper presents the first distributed self-stabilizing branch-and-Bound algorithm. This algorithm is inherently tolerant to transient faults and can recover from transmission errors between nodes. Key-words: Branch-and-Bound method, parallel and distributed algorithms, selfstabilization, fault-tolerance. (R'esum'e : tsvp) z Email : [email protected] Laboratoire PRiSM Universit e de Versailles - Saint Quentin en Yvelines 78035 Versailles Cedex, FRANCE. T el ephone/Phone : (33 1) 39 25 40 56 -- T el ecopie/Fax : (33 1) 39 25 40 Un Algorithme Branch-and-Bound Distribu'e Auto-Stabilisant R'esum'e : L'algorithme Branch-and-Bound est fondamental pour une vari'et'e d'applications dans le domaine de l'Optimisation Combinatoire. Les algorithmes connus de ce type ne sont pas tol`erants aux pannes. Ce papier pr'..

The Immunomodulatory and Anti-Inflammatory Role of Polyphenols

This review offers a systematic understanding about how polyphenols target multiple inflammatory components and lead to anti-inflammatory mechanisms. It provides a clear understanding of the molecular mechanisms of action of phenolic compounds. Polyphenols regulate immunity by interfering with immune cell regulation, proinflammatory cytokines’ synthesis, and gene expression. They inactivate NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) and modulate mitogen-activated protein Kinase (MAPk) and arachidonic acids pathways. Polyphenolic compounds inhibit phosphatidylinositide 3-kinases/protein kinase B (PI3K/AkT), inhibitor of kappa kinase/c-Jun amino-terminal kinases (IKK/JNK), mammalian target of rapamycin complex 1 (mTORC1) which is a protein complex that controls protein synthesis, and JAK/STAT. They can suppress toll-like receptor (TLR) and pro-inflammatory genes’ expression. Their antioxidant activity and ability to inhibit enzymes involved in the production of eicosanoids contribute as well to their anti-inflammation properties. They inhibit certain enzymes involved in reactive oxygen species ROS production like xanthine oxidase and NADPH oxidase (NOX) while they upregulate other endogenous antioxidant enzymes like superoxide dismutase (SOD), catalase, and glutathione (GSH) peroxidase (Px). Furthermore, they inhibit phospholipase A2 (PLA2), cyclooxygenase (COX) and lipoxygenase (LOX) leading to a reduction in the production of prostaglandins (PGs) and leukotrienes (LTs) and inflammation antagonism. The effects of these biologically active compounds on the immune system are associated with extended health benefits for different chronic inflammatory diseases. Studies of plant extracts and compounds show that polyphenols can play a beneficial role in the prevention and the progress of chronic diseases related to inflammation such as diabetes, obesity, neurodegeneration, cancers, and cardiovascular diseases, among other conditions

Knowledge, Attitude and Practices of Lebanese Married Women towards Food Safety

Objectives: To determine the knowledge, attitude, and practices of Lebanese married women toward food safety and to assess the correlation of these factors with socio-demographic characteristics. Methods: The evaluation forms of the “Five Keys to Safer Food Manual” of the WHO (World Health Organization) were administered to 516 Lebanese married women living in Beirut and Mount Lebanon between December 2017 and May 2018. The questionnaire is divided into three sections: food safety knowledge (11 questions), attitude (10 questions), and practices (10 questions). A score was calculated for each section with one point for every correct answer. Findings: The mean of knowledge score was 8.23 ± 1.59 over 11, the attitude score was 7.43 ± 1.82 over 10, and the behavior score was 6.69 ± 2.32 over 10. The relationship between the knowledge score and other scores was weak (with behavior score r = 0.222 and attitude score r = 0.260; p-value <0.005). Knowledge and attitude scores were higher than practices score. Food safety knowledge, attitude and practices did not differ with age nor the number of kids. Years of marriage and employment only influenced practices. Frequency of cooking influenced knowledge and behavior. The main food safety problems were found in separating raw from cooked food, cooking food to the right temperature and keeping food at safe temperature whether hot-holding or thawing. Conclusions: Knowledge of food safety measures might not reflect good food safety practices. Therefore, there is a need to highlight the importance of safe practices and prevention of foodborne illnesses