Integrating social determinants of health in medical education: a bibliometric analysis study

OBJECTIVES

Social determinants of health (SDH) are the prevalent enablers of health among populations, and integrating them in medical education will advance clinical care by integrating social and economic risk data into medical diagnosis and treatment. Despite the numerous publications on SDH and medical education, the publication trends are not known. The study aims to analyse publication trends in integrating SDH into medical education and the corresponding thematic areas.

STUDY DESIGN

This was a bibliometric analysis study.

METHODS

Bibliometric was used. Data from Scopus databases from January 2006 to June 2023 were retrieved with no language restriction. VOSviewer software was used for analysis. Bibliographic coupling was used to identify the clusters of published literature on the integration of SDH into medical education, followed by the analysis of annual distribution and growth trends, authors and co-author relationships and collaborations.

RESULTS

A total of 1047 articles were retrieved. The annual research publication exhibited a swift surge in the studies conducted during the reviewed period. Five clusters of information were derived: relating to curriculum development, community engagement and service-learning, stakeholder collaborations, development of assessment methods and tools for SDH, and the impact of integrating SDH into medical education.

CONCLUSION

Bibliometric analysis has revealed a growing trend in the field of integrating SDH into medical education, and the study has highlighted the research impact through bibliographic coupling by identifying the five thematic areas. This study lays a foundation for advancing knowledge on what has been published and possible areas for improvement in the integration of SDH into medical education.

Boswellic acids ameliorate neurodegeneration induced by AlCl3: the implication of Wnt/β-catenin pathway

Alzheimer's disease (AD) is a neurodegenerative disease (ND) that represents the principal cause of dementia. Effective treatment is still lacking. Without prevention, Alzheimer's disease (AD) incidence is expected to triple within 30 years. The risk increases in highly polluted areas and is positively linked to chronic aluminum (Al) exposure. Canonical Wingless-Int (Wnt)/β-catenin pathway has been found to play a considerable role in ND pathogenesis. Resins of Boswellia serrata (frankincense) have been used traditionally for their psychoactive activity, in addition to their memory-boosting effects. Boswellic acids (BA) are pentacyclic triterpenes. They have antioxidant, anti-inflammatory, antinociceptive, and immunomodulatory activities. This study aimed to elucidate the role of the Wnt/β-catenin pathway in BA protective activity against aluminum-induced Alzheimer's disease. For 6 weeks, rats were treated daily with AlCl3 (100 mg/kg/i.p.) either alone or with BA (125 or 250 mg/kg PO). Results indicated that BA significantly improved learning and memory impairments induced by AlCl3 treatment. Moreover, BA treatment significantly decreased acetylcholinesterase levels and reduced amyloid-beta (Aβ) expression. In addition, BA ameliorated the increased expression of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β), inhibited lipid peroxidation, and increased total antioxidants in the brain. Indeed, BA significantly suppressed AlCl3-induced decrease of brain-derived neurotrophic factor, pGSK-3β (Ser 9), and β-catenin. BA (250 mg/kg) showed a significant protective effect compared to a lower dose. The results conclude that BA administration modulated the expression of Wnt/β-catenin pathway-related parameters, contributing to BA's role against Al-induced Alzheimer's disease. Effect of Boswellic acids on AlCl3-induced neurodegenerative changes. ChE cholinesterase, Ach acetylcholine, BDNF brain-derived neurotrophic factor, IL-1β interleukin-1β, TNF-α tumor necrosis factor-α.

Highly Efficient and Durable Electrocatalysis by a Molecular Catalyst with Long Alkoxyl Chains Immobilized on a Carbon Electrode for Water Oxidation

A dinuclear Ru complex, proximal,proximal-[Ru₂L(C₈Otpy)₂(OH)(OH₂)]³⁺ (C₈Otpy = 4'-octyloxy-2,2'; 6',2″-terpyridine) (1) with long alkoxyl chains, was synthesized to be immobilized on a carbon paper (CP) electrode via hydrophobic interactions between the long alkoxyl chains and the CP surface. The 1/CP electrode demonstrated efficient electrocatalytic water oxidation with a low overpotential (η_onset) of 0.26 V (based on the onset potential for water oxidation) in an aqueous medium at pH 7.0, which is compared advantageously with those of hitherto-reported molecular anodes for water oxidation. The active species of Ru^IIIRu^III(μ-OO) with a μ-OO bridge was involved in water oxidation at 0.95 V versus Ag/AgCl. As the applied potential increased to 1.40 V, water oxidation was promoted by participation of the more active species of Ru^IIIRu^IV(μ-OO), and very durable electrocatalysis was gained for more than 35 h without elution of 1 into the electrolyte solution. The introduced long alkoxyl chains act as a dual role of the linker of 1 on the CP surface and decrease the η value. Theoretical investigation provides insights into the O-O bond formation mechanism and the activity difference between Ru^IIIRu^III(μ-OO) and Ru^IIIRu^IV(μ-OO) for electrocatalytic water oxidation.

Mechanical Properties of Bisacryl-, Composite-, and Ceramic-resin Restorative Materials

OBJECTIVE

Resin-based materials used in restorative dentistry are introduced at a fast pace with limited knowledge about their properties. Comparing properties of these materials from different restorative categories is lacking but can help the clinician in material selection. This study aimed to compare mechanical properties and wear resistance of bis-acryl-, composite-, and ceramic-resin restorative materials.

METHODS AND MATERIALS

Bisacryl-resin (Bis-R, LuxaCrown, DMG), composite-resin (Com-R, Filtek Supreme Ultra, 3M Oral Care), and ceramic-resin (Cer-R, Enamic, VITA Zahnfabrik) specimens were prepared for mechanical tests: fracture toughness (FT) with and without initial thermomechanical loading using a mastication simulator, flexural strength (FS), and flexural modulus (FM), compressive strength (CS), and volumetric wear loss measurement. The datasets for FT and wear resistance were each analyzed using two-way ANOVA followed by pairwise comparisons or Tukey testing as appropriate. The datasets for FS, FM, and CS were analyzed using one-way ANOVA followed by the Tukey test.

RESULTS

Analysis of FS, FM, and CS showed significant differences between materials, with all pairwise comparisons between materials showing significance. Analysis of FT resulted in a significant interaction between the material and treatment, with analysis of wear loss showing a significant interaction between the material and the number of cycles.

CONCLUSIONS

Cer-R demonstrated superior FT, CS, and wear resistance compared to Bis-R and Comp-R materials. Fracture toughness of Bis-R increased after thermomechanical loading.

Further insights for the role of Morin in mRTBI: Implication of non-canonical Wnt/PKC-α and JAK-2/STAT-3 signaling pathways

The slightly available data about the pathogenesis process of mild repetitive traumatic brain injury (mRTBI) indicates to the necessity of further exploration of mRTBI consequences. Several cellular changes are believed to contribute to the cognitive disabilities, and neurodegenerative changes observed later in persons subjected to mRTBI. We investigated glial fibrillary acidic protein (GFAP), the important severity related biomarker, where it showed further increase after multiple trauma compared to single one. To authenticate our aim, Morin (10 mg/kg loading dose, then twice daily 5 mg/kg for 7 days), MK-801 (1 mg/kg; i.p) and their combination were used. The results obtained has shown that all the chosen regimens opposed the upregulated dementia markers (Aβ1-40,p(Thr231)Tau) and inflammatory protein contents/expression of p(Ser53s6)NF-κBp65, TNF-α, IL-6,and IL-1β and the elevated GFAP in immune stained cortex sections. Additionally, they exerted anti-apoptotic activity by decreasing caspase-3 activity and increasing Bcl-2 contents. Saving brain tissues was evident after these therapeutic agents via upregulating the non-canonical Wnt-1/PKC-α cue and IL-10/p(Tyr(1007/1008))JAK-2/p(Tyr705)STAT-3 signaling pathway to confirm enhancement of survival pathways on the molecular level. Such results were imitated by correcting the injury dependent deviated behavior, where Morin alone or in combination enhanced behavior outcome. On one side, our study refers to the implication of two survival signaling pathways; viz.,the non-canonical Wnt-1/PKC-α and p(Tyr(1007/1008))JAK-2/p(Tyr705)STAT-3 in single and repetitive mRTBI along with distorted dementia markers, inflammation and apoptotic process that finally disrupted behavior. On the other side, intervention through affecting all these targets by Morin alone or with MK-801 affords a promising neuroprotective effect.

Facile Fabrication of a Highly Crystalline and Well-Interconnected Hematite Nanoparticle Photoanode for Efficient Visible-Light-Driven Water Oxidation

Facile and scalable fabrication of α-Fe₂O₃ photoanodes using a precursor solution containing Fe^III ions and 1-ethylimidazole (EIm) in methanol was demonstrated to afford a rigidly adhered α-Fe₂O₃ film with a controllable thickness on a fluorine-doped tin oxide (FTO) substrate. EIm ligation to Fe^III ions in the precursor solution brought about high crystallinity of three-dimensionally well-interconnected nanoparticles of α-Fe₂O₃ upon sintering. This is responsible for the 13.6 times higher photocurrent density (at 1.23 V vs reference hydrogen electrode (RHE)) for photoelectrochemical (PEC) water oxidation on the α-Fe₂O₃ (w-α-Fe₂O₃) photoanode prepared with EIm compared with that (w/o-α-Fe₂O₃) prepared without EIm. The w-α-Fe₂O₃ photoanode provided the highest charge separation efficiency (η_sep) value of 27% among the state-of-the-art pristine α-Fe₂O₃ photoanodes, providing incident photon-to-current conversion efficiency (IPCE) of 13% at 420 nm and 1.23 V vs RHE. The superior η_sep for the w-α-Fe₂O₃ photoanode is attributed to the decreased recombination of the photogenerated charge carriers at the grain boundary between nanoparticles, in addition to the higher number of the catalytically active sites and the efficient bulk charge transport in the film, compared with w/o-α-Fe₂O₃.

Sesame oil mitigates memory impairment, oxidative stress, and neurodegeneration in a rat model of Alzheimer's disease. A pivotal role of NF-κB/p38MAPK/BDNF/PPAR-γ pathways

ETHNOPHARMACOLOGICAL RELEVANCE

Sesame (Sesamum indicum, L., Family: Pedaliaceae) is a notable folk medicine in Middle East, Asia and Africa. Many traditional and pharmacological studies have documented the unique nature of sesame oil (SO). SO has been reported to have many pharmacological effects related to the anti-inflammatory and antioxidant capacity of its components. Neuroinflammation and oxidative stress have been the predominant pathogenic events in Alzheimer's disease (AD) which is one of the most common neurodegenerative diseases.

AIM OF STUDY

we aimed to explore the neuroprotective effect and the probable mechanisms of SO against aluminium chloride (AlCl3)-induced AD symptoms.

MATERIALS AND METHODS

Rats were treated daily with AlCl3 (100 mg/kg/i.p.) either alone or with SO (two different doses) for six weeks. Behavioral (Open-field and Morris water maze tests), histopathological, and biochemical examinations were used to evaluate the neuroprotective effect and the underlying mechanisms of SO against AlCl3-induced AD symptoms.

RESULTS

Our results indicated that SO significantly improved learning and memory impairments induced by AlCl3. Indeed, SO treatment significantly restored the elevated level of acetylcholinesterase (AChE) and amyloid beta (Aβ) overexpression. Moreover, AlCl3 treatment afforded histopathological changes, increase the expression of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) in addition to mitigation of oxidative stress status in the brain. SO abolished all these abnormalities. Meanwhile, AlCl3 induced activation of p38 mitogen-activated protein kinase (p38MAPK) and decreased brain-derived neurotrophic factor (BDNF) which were inhibited by SO. Furthermore, SO administration modulated the expression of the peroxisome proliferator-activated receptor gamma (PPAR-γ) and nuclear factor kappa B (NF-κB).

CONCLUSIONS

In conclusion, the neuroprotective effect of SO involved the modulation of different mechanisms targeting oxidative stress, neuroinflammation, and cognitive functions. SO may modulate different molecular targets involved in AD pathogenesis by alterations of NF-κB/p38MAPK/BDNF/PPAR-γ signalling and this may be attributed to the synergistic effect of their active components.

Cardioprotective effect of pioglitazone and curcumin against diabetic cardiomyopathy in type 1 diabetes mellitus: impact on CaMKII/NF-κB/TGF-β1 and PPAR-γ signaling pathway

Diabetic cardiomyopathy (DCM) is a leading cause of death in diabetic patients, which is currently without available specific treatment. This study aimed to investigate the potential protective effects of pioglitazone (Pio) and curcumin (Cur) against DCM in type 1 diabetes mellitus (T1DM), with pointing to their role on Ca+2/calmodulin-dependent protein kinase II (CaMKII) and peroxisome proliferator-activated receptor gamma (PPAR-γ) expression. Diabetes was induced in adult male Sprague Dawley rats by administration of single intraperitoneal injection of streptozotocin (STZ) (52.5 mg/kg). Diabetic rats were administered either Pio (20 mg/kg/day) or Cur (100 mg/kg/day) orally for 6 weeks. Treatment with Pio and/or Cur markedly reduced serum cardiac injury markers and lipid profile markers in diabetic animals. Additionally, Pio and/or Cur treatment mitigated oxidative stress and fibrosis in diabetic rats as evident from the significant suppression in myocardial lipid peroxidation and tumor growth factor beta 1 (TGF-β1) level, with concomitant significant elevation in total antioxidant capacity (TAC) and improvement in histopathological architecture of heart tissue. Pio/Cur treatment protocol accomplished its cardioprotective effect by depressing cardiac CaMKII/NF-κB signaling accompanied by enhancement in PPAR-γ expression. Conclusively, these findings demonstrated the therapeutic potential of Pio/Cur regimen in alleviating DCM in T1DM through modulation of CaMKII and PPAR-γ expression. Graphical Abstract.

Multi-potential-step chronocoulospectrometry for electrocatalytic water oxidation by a mononuclear ruthenium aquo complex immobilized on a mesoporous ITO electrode

A new mononuclear Ru aquo complex [Ru(C₈Otpy)(H₂dcbpy)(OH₂)]²⁺ with 4,4'-dicarboxy-2,2'-bipyridine (H₂dcbpy) and 4'-octyloxy-2,2':6',2''-terpyridine (C₈Otpy) ligands was synthesized to investigate electrocatalytic water oxidation by the complex immobilized on a mesoporous indium-doped tin oxide (meso-ITO) electrode using a multi-potential-step chronocoulospectrometric (MPSCCS) technique. UV-visible absorption spectroscopic data indicated that [Ru(C₈Otpy)(dcbpy)(OH₂)] (RuOH₂) is deprotonated to [Ru(C₈Otpy)(dcbpy)(OH)]^- (RuOH) on the meso-ITO surface even at pH 5.9 of the electrolyte solution. The cyclic voltammogram (CV) of the RuOH/meso-ITO electrode showed a pH-independent redox response at E_1/2 = 0.80 V vs. Ag/AgCl in the pH range of 5-12, being assigned to a non-proton-coupled 1e^- redox process of Ru^IIOH/Ru^IIIOH. The MPSCCS measurement of the RuOH/meso-ITO electrode between 0.2 and 1.5 V vs. Ag/AgCl showed that Ru^IV species (tentatively Ru^IVO) exist in a steady state of the electrocatalysis in the initial stage. This suggests that the electrochemical oxidation from Ru^IVO to Ru^VO could compete with the water nucleophilic attack for O-O bond formation involved in the rate-determining step under the employed conditions. The possibility that the water nucleophilic attack on Ru^IVO could also compete with the electrochemical oxidation of Ru^IVO to Ru^VO was suggested by the electrocatalytic water oxidation at a low applied potential of 1.4 V prior to the formation potential of Ru^VO. The MPSCCS measurement at 1.4 V for 1 h showed that RuOH is gradually transformed into an alternative catalyst (most likely RuO_x nanoparticles) on the electrode. The MPSCCS technique is promising to reveal the redox reactions and catalytic aspects of molecular catalysts immobilized on an electrode for water oxidation.

Dimethyl fumarate and curcumin attenuate hepatic ischemia/reperfusion injury via Nrf2/HO-1 activation and anti-inflammatory properties

BACKGROUND

Hepatic ischemia/reperfusion (I/R) injury occurs in different clinical settings as hepatic transplantation, and different types of shock. I/R injury is the main cause of hepatic damage and failure due to the production of reactive oxygen species (ROS) and inflammatory cytokines. Dimethyl fumarate (DMF), an immunomodulatory drug, activates cellularantioxidantsignaling pathways exerting cytoprotective properties. Curcumin (CUR), a natural phenolic compound, possesses antioxidant and anti-inflammatory properties.

METHOD

To study potential protective effects of DMF with CUR against hepatic I/R injury in rats, animals were randomly allocated into seven groups as follows: (1) Sham; (2) DMF (25 mg/Kg, p.o); (3) CUR (400 mg/Kg, p.o.); (4) I/R; (5) DMF + I/R; (6) CUR + I/R; and combination (COM) therapy + I/R. Drugs were given for 14 days before I/R.

RESULTS

Compared with I/R group, COM group showed the best amelioration in hepatic injury induced by I/R insult. This was confirmed by a significant reduction in serum ALT and AST activity with improved histopathological results when compared to every single treatment. Hepatic protection afforded by DMF was mediated by activating Nrf2/HO-1 signaling and increasing GSH and TAC contents. CUR treatment improved the inflammatory markers (TNF-α, IL-1β, Il-6 and iNOS) as well as neutrophilic infiltration assessed as MPO. Moreover, CUR potentiated Nrf2/HO-1 signaling induced by DMF with significant suppression in lipid peroxidation.

CONCLUSION

We concluded that combining DMF and CUR has more efficient hepatoprotective effects against hepatic-induced IRI via potentiating antioxidant and anti-inflammatory properties mediated by Nrf2/HO-1 pathway.

Critical Hammett Electron-Donating Ability of Substituent Groups for Efficient Water Oxidation Catalysis by Mononuclear Ruthenium Aquo Complexes

[Ru(Rtpy)(bpy)(H₂O)]²⁺ (1R; bpy = 2,2'-bipyridine, and Rtpy = 2,2':6',2″-terpyridine derivatives) complexes with a variety of 4'-substituent groups on Rtpy were synthesized and characterized to reveal the effects of substituents on their structures, physicochemical properties, and catalytic activities for water oxidation. The geometric structures of 1R are not considerably influenced by the electron-donating ability of the 4'-substituent groups on Rtpy. Similar multistep proton-coupled electron transfer reactions were observed for 1R, and the redox potentials for each oxidation step tended to decrease with an increase in the electron-donating ability of the substituent, which is explained by the increased electron density on the Ru center by electron-donating groups, stabilizing the positive charge that builds up upon oxidation. This is consistent with the red-shift of the absorption bands around 480 nm assigned to the metal-to-ligand charge transfer transition for 1R due to the increased d orbital energy level of the Ru center. The turnover frequency (k_O2) of 1R for water oxidation catalysis, however, depended greatly on the Rtpy ligands, varying from 0.05 × 10^-2 to 44 × 10^-2 s^-1 (as the highest k_O2 was observed for R = ethoxy) by a factor of 880. A critical electron-donating ability of the 4'-substituent groups with a narrow range of Hammett constants (σ_p = -0.27 to -0.24) found for the highest k_O2 values is valuable for understanding the great difficulty in the search for efficient water oxidation catalysts. On another front, the k_O2 values increased with a decrease in the redox potentials of Ru^IV═O/Ru^V═O for 1R, indicating that the potential of formation of Ru^V═O species for 1R is crucial for water oxidation catalysis under the employed conditions.

Recent Advances in the Development of Molecular Catalyst-Based Anodes for Water Oxidation toward Artificial Photosynthesis

Catalytic water oxidation represents a bottleneck for developing artificial photosynthetic systems that store solar energy as renewable fuels. A variety of molecular water oxidation catalysts (WOCs) have been reported over the last two decades. In view of their applications in artificial photosynthesis devices, it is essential to immobilize molecular catalysts onto the surfaces of conducting/semiconducting supports for fabricating efficient and stable water oxidation anodes/photoanodes. Molecular WOC-based anodes are essential for developing photovoltaic artificial photosynthesis devices and, moreover, the performance of molecular WOC on anodes will provide important insight into designing extended molecular WOC-based photoanodes for photoelectrochemical (PEC) water oxidation. This Review concerns recent progress in the development of molecular WOC-based anodes over the last two decades and looks at the prospects for using such anodes in artificial photosynthesis.

Protective effect of irbesartan against doxorubicin-induced nephrotoxicity in rats: implication of AMPK, PI3K/Akt, and mTOR signaling pathways

Nephrotoxicity is one of the serious undesirable effects related to doxorubicin (DOX). Herein, we have investigated the potential protective effect of irbesartan (IRB) against chronic nephrotoxicity induced by DOX, and the implication of different mechanistic pathways underlying these effects. Rats were treated with either DOX (2.5 mg/kg i.p., 3 times/week) for 2 weeks, and (or) IRB (40 mg/kg, daily) for 3 weeks. IRB prohibited nephrotoxicity induced by DOX, which was evident by the increase in blood urea nitrogen and creatinine levels and histopathological changes. IRB improved DOX-induced alterations in oxidative status by diminishing lipid peroxidation and upregulating the antioxidant enzymes. Also, upon DOX treatment, the renal expression of tumor necrosis factor-α, interleukin-6, and caspase-3 were significantly increased; IRB diminished DOX-induced alterations in these parameters. Moreover, DOX significantly decreased the expression level of AMP-activated protein kinase (AMPK). Meanwhile, DOX induced activation of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt/PKB) and mammalian target of rapamycin (mTOR) pathways that cross talked with AMPK. On the contrary, IRB successfully counterbalanced all these effects. Collectively, these outcomes suggest that the modulation of AMPK, PI3K, Akt, and mTOR pathways plays a critical role in conferring the protective effects of IRB against DOX nephrotoxicity.

Cross-talk between apelin and vasopressin in response to different osmotic stimuli in type 2 diabetic rats

Apelin, a peptide hormone that has been linked to insulin resistance, obesity and glucose metabolism, coexists with arginine vasopressin (AVP) in hypothalamic magnocellular neurons that control body fluid homeostasis. The significant correlation between serum glucose and serum osmolarity in uncontrolled DM indicates the need for adequate compensation, but how apelin and AVP contribute to this is still unsettled. This study aims to investigate the interaction between apelin and AVP in osmotic regulation in type 2 diabetes mellitus (T2DM), and to explore the underlying mechanism. Forty-eight adult male albino rats were divided into six groups: control (isotonic, ip 0.9% NaCl; hypotonic, ip distilled water; hypertonic, ip 2% NaCl) groups and T2DM (isotonic, hypotonic, hypertonic) groups. Serum levels of AVP, apelin, Na, glucose, serum and urine osmolarity were measured; kidney samples were taken for Aquaporin 2 channels (AQP2) and epithelial sodium channel gamma subunit (ENaCγ) gene expression. Hypothalamic tissue sections were used for immunohistochemical staining of apelin and AVP. Both in control and diabetic groups serum apelin, showed a significant negative correlation with serum AVP (r=-0.533, p≤ 0.001). Serum apelin and AVP were inversely proportional to their hypothalamic protein expression. Serum apelin and AVP were significantly higher in diabetic rats (P= 0.001) yet their percentage change in response to hypo and hyper-osmotic stimuli (1.5±0.7, -0.34±0.15 and -0.38±0.13, 1.95±0.36, respectively) was less pronounced when compared to control rats (3.28±0.52, -0.59±0.12 and -0.45±0.13, 2.58±0.93, respectively). Na and ENaCγ levels significantly increased in hypertonic rats, while AQP2 gene expression significantly increased in hypotonic rats. Both apelin and AVP reacted to osmotic stimuli in T2DM but with less sensitivity than in control rats. In spite of its abnormal increased levels in diabetic rats, apelin maintained its role through counteracting AVP action.

Role of Morphometry and Matrix Metalloproteinase-9 Expression in Differentiating between Atypical Endometrial Hyperplasia and Low Grade Endometrial Adenocarcinoma

Background: Endometrial carcinomas are common gynecologic malignancies worldwide. In Egypt they represent 2.6 %. We evaluated the role of morphometry and MMP-9 immunohistochemical expression to differentiate atypical endometrial hyperplasia from low grade endometrial adenocarcinoma. Methods: 60 cases of endometrial lesions that included 25 cases of complex endometrial hyperplasia with atypia, 25 cases of low grade endometrioid adenocarcinoma, in addition to 10 cases of proliferative endometrium as a control group. Morphometric measurements and D-score were evaluated. MMP9 was performed using streptavidin –biotin immunoperoxidase system. Results: D score was more than 1 in 100% of cases of proliferative endometrium. In atypical hyperplasia 28 % of cases had a D-score more than 1, 44% less than 0 and 28% of cases had a D score between 0 and 1 with uncertain prognosis. All carcinoma cases had D-score less than 0. MMP9 was positive in all cases of the study but differ in its degree of expression; proliferative endometrium with low expression. Atypical hyperplasia divided as 52% low expression and 48% high expression. Most of the Endometrial adenocarcinoma cases (92%) showed high expression. There was significant difference in expression of MMP9 in atypical endometrial hyperplasia and endometrial adenocarcinoma (p> 0.001). Conclusion: The relation between MMP9 expression and D-score value in cases of atypical endometrial hyperplasia was highly significant P>0.001Thus, incorporating both MMP9 immunoexpression and D-score value would increase the accuracy of diagnosis of atypical endometrial hyperplasia and low grade endometrial adenocarcinoma.

Efficacy of kinesiotape on functional disability of women with postnatal back pain: A randomized controlled trial

BACKGROUND

Postpartum low back pain harmfully affects all parts of women's life.

OBJECTIVE

To investigate the effect of kinesiotape on women with postnatal backache.

METHODS

Thirty participants were randomly allocated to either group (A; n= 15), treated by kinesiotape with exercise program, or the group (B; n= 15), treated by exercise program. Visual analogue scale (VAS) and Back Pain Function Scale (BPFS) were evaluated.at baseline and after 2 weeks of intervention.

RESULTS

There were no statistically significant changes between group A and group B for baseline characteristics (p> 0.05). After two-week intervention, within group analyses revealed that VAS decreased (p< 0.05), with significant increase in BPFS (p> 0.05) in the two groups. Between group analyses showed that there was significant reduction of VAS (p< 0.05) and significant increase of BPFS (p< 0.05) in favor to group A than group B.

CONCLUSIONS

Kinesiotape and postural correction exercises can be recommended as effective treatment methods for women's postnatal back pain with better effect of kinesiotape and postural correction exercises than exercise alone.

N-acetylcysteine versus progesterone on the cisplatin-induced peripheral neurotoxicity

BACKGROUND

Cisplatin-induced peripheral nerve neurotoxicity (CIPN) is the main obstacle in cisplatin treatment. The aim of this study was to compare the modulatory effects of N-acetylcysteine (NAC) and progesterone on CIPN, because there are scarce literature data on the protective effect of the proge-sterone on the CIPN.

MATERIALS AND METHODS

Twenty-four rats were divided into four groups: control, cisplatin-treated, concomitant cisplatin-treated and NAC-treated, and concomitant cisplatin-treated and progesterone-treated. Electron microscopic, immunohistochemical, real time polymerase chain reaction and histomorphome-tric analysis; oxidative/antioxidative markers (MDA/GSH and SOD), neurotoxic/ neuroprotective markers (iNOS/nNOS), inflammatory mediators (TNF-a and NF-kB) and BAX were done.

RESULTS

The myelin sheath in the cisplatin-treated group elucidated infolding. The myelin was disfigured, degenerated, and extensively split with areas of focal loss. The axoplasm was atrophic. Ballooning and vacuolations of the mitochon-dria with alterations of Remak bundles structures were observed. Fewer of these changes were noted in the NAC and progesterone-treated groups. Decrease of the antioxidant SOD and GSH (81% and 64%) and increase of the oxidant MDA (9 folds), increment of the neurotoxic iNOS (1.9 folds) and decrement of the neuroprotective nNOS (64%) and elevation of the inflammatory mediators' TNF-a and NF-kB (8.3 and 11 folds) in the cisplatin-treated group. Increase of the antioxidant SOD (1.3 and 2.5 folds) and GSH (120% and 79%) and decrease of the oxidant MDA (69% and 88%), decrement of the neurotoxic iNOS (56% and 68%) and increment of the neuroprotective nNOS (1.6 and one folds) and elevation of the inflammatory mediators' TNF-a and NF-kB were observed in the NAC and progesterone-treated groups, respectively.

CONCLUSIONS

The toxic effect of CIPN might be attributed to either oxidative or severe inflammatory stress. Progesterone is efficient in ameliorating these effects; however, NAC is better. (Folia Morphol 2018; 77, 2: 234-245).

Efficient electrocatalytic CO2 reduction with a molecular cofacial iron porphyrin dimer

A cofacial iron tetraphenyl porphyrin dimer, , bio-inspired by the Ni-Fe containing metalloenzyme, carbon monoxide dehydrogenase (CODH), efficiently and selectively catalyses the electrochemical reduction of CO2 to CO in DMF/10% H2O solution at the electro-generated Fe(0)(por) species with high Faradic efficiency (95%) and TOF (4300 s(-1)) at a moderate overpotential, η = 0.66 V.

Solar drying of whole mint plant under natural and forced convection

Two identical prototype solar dryers (direct and indirect) having the same dimensions were used to dry whole mint. Both prototypes were operated under natural and forced convection modes. In the case of the later one the ambient air was entered the dryer with the velocity of 4.2 m s⁻¹. The effect of flow mode and the type of solar dryers on the drying kinetics of whole mint were investigated. Ten empirical models were used to fit the drying curves; nine of them represented well the solar drying behavior of mint. The results indicated that drying of mint under different operating conditions occurred in the falling rate period, where no constant rate period of drying was observed. Also, the obtained data revealed that the drying rate of mint under forced convection was higher than that of mint under natural convection, especially during first hours of drying (first day). The values of the effective diffusivity coefficient for the mint drying ranged between 1.2 × 10⁻¹¹ and 1.33 × 10⁻¹¹ m² s⁻¹.

Vascular endothelial growth factor A polymorphism and risk of Kaposi's sarcoma herpesvirus viremia in kidney allograft recipients

BACKGROUND

Kaposi's sarcoma herpesvirus (KSHV) causes Kaposi's sarcoma (KS), primary effusion lymphoma, and multicentric Castleman's disease in immunocompromised patients including allograft recipients. Detection of KSHV DNA in blood, as well as host genetic polymorphisms has been found to be associated with an increased risk for KS. We investigated an association between single nucleotide polymorphisms (SNPs) in vascular endothelial growth factor A (VEGFA) gene region and KSHV viremia in kidney transplant recipients (KTR) in Saudi Arabia.

METHODS

In total, 152 KTR who have survived kidney transplantation for at least 6 months were included in the study. KSHV viremia was determined by real-time polymerase chain reaction (PCR). Genotyping of SNPs in the VEGFA region was performed by PCR and direct sequencing, as well as by restriction fragment length polymorphism.

RESULTS

KSHV DNA was detected in 28.9% (n = 44) of the study population. The A-allele at position C172A VEGFA gene promoter region was found to be associated with KSHV viremia (odd ratio [OR] = 4.8, P = 0.005). In addition, the G-allele at position C+405G in the 5'-untranslated region was associated with KSHV viremia in women, but not in men (OR = 3.98, P = 0.004).

CONCLUSIONS

Our results suggest an association of VEGFA polymorphisms with KSHV viremia among KTR in this study population. A limitation of our study is that the results can only be predicated for patients 6 months after kidney transplantation and should be validated in another cohort with larger sample size.

Metabolomic profiling and antioxidant activity of some Acacia species

Metabolomic profiling of different parts (leaves, flowers and pods) of Acacia species (Acacia nilotica, Acacia seyal and Acacia laeta) was evaluated. The multivariate data analyses such as principal component analysis (PCA) and partial least square-discriminant analysis (PLS-DA) were used to differentiate the distribution of plant metabolites among different species or different organs of the same species. A. nilotica was characterized with a high content of saponins and A. seyal was characterized with high contents of proteins, phenolics, flavonoids and anthocyanins. A. laeta had a higher content of carbohydrates than A. nilotica and A. seyal. On the basis of these results, total antioxidant capacity, DPPH free radical scavenging activity and reducing power of the methanolic extracts of studied parts were evaluated. A. nilotica and A. seyal extracts showed less inhibitory concentration 50 (IC50) compared to A. laeta extracts which means that these two species have the strongest radical scavenging activity whereas A. laeta extracts have the lowest radical scavenging activity. A positive correlation between saponins and flavonoids with total antioxidant capacity and DPPH radical scavenging activity was observed. Based on these results, the potentiality of these plants as antioxidants was discussed.

Microbial control of the cotton leafworm Spodoptera littoralis (Boisd.) by Egyptian Bacillus thuringiensis isolates

Four local Bacillus thuringiensis (Bt) isolates that had been serologically identified as Bt var. kurstaki (Btk2, Btk3, and Btk66) and Bt var. mexicanensis (Btm27), in addition to two reference strains (4D20 and 4AC1), were laboratory assayed as microbial control agents against the Egyptian cotton leafworm Spodoptera littoralis (Boisd.). Polymerase chain reaction (PCR) amplification analysis revealed that each of the six experimental strains carries, at least, a cry1 type gene which expresses a protein toxin active against lepidopterous insects. Additionally, PCR amplification results demonstrated that 4D20 and Btk66 contain the Lepidoptera- and Diptera-active cry2 type gene and that Btk66 contains Coleoptera-active cry7 and cry8 genes. Among the six strains, Btk66 and Btm27 were the most promising microbial control agents against S. littoralis. The present findings were the first to report that Btm27 (classified as B. thuringiensis var. mexicanensis) is a very potent microbial control agent against S. littoralis-tested larvae. For more characterization of these two isolates, the sspO gene was investigated as a molecular chronometer. The DNA sequencing results proved that Btk66 and Btm27 carry sspO open reading frames with identical nucleotide sequences, suggesting a strong phylogenetic relationship between the two strains.

Interleukin-18 Gene Polymorphisms in Egyptian Patients with Allergic Diseases

Background

Allergic diseases, such as allergic rhinitis (AR) and atopic dermatitis (AD), affect a large proportion of people worldwide. Both have environmental and genetic predisposing factors. Single nucleotide polymorphisms (SNPs) in interleukin (IL)-18, may play a direct role in the disease pathogenesis. This study was designed to investigate the association of the IL-18 gene SNPs (-137 G/C [rs187238], and −140 C/G [rs360721]) with AR and AD, as well as their relations to the diseases’ severity.

Methods

Seventy-five individuals were enrolled in the study including, 25 AD children, 25 AR patients, and 25 unrelated healthy adult volunteers who served as controls. Genotyping was performed by polymerase chain reaction and restriction fragment length polymorphism analysis.

Results

AR and AD patients showed no significant differences in the genotype distribution and allele frequencies of −137 G/C and −140 C/G SNPs when compared independently with the control group. However, the −140 GG genotype and the −140 G allele were more often associated with severe AD compared with mild and moderate phenotypes (p = 0.01 and 0.001, respectively; odds ratios [ORs], 14.25 [95% CI, 1.48–143.2] and 16 [95% CI, 2.8–90.46], respectively). Moreover, the −137 G allele was associated with moderate/severe AR (p = 0.019; OR, 6.1 [95% CI, 1.34–28.1]).

Conclusion

This preliminary study indicates that the studied polymorphisms do not confer susceptibility to allergy in Egyptian patients but may be related to the disease phenotype. However, the role of IL-18 in allergy may be too complex to be reflected in a simple association study.

Impact of an educational programme on knowledge, beliefs, practices and expectations about care among adolescent glaucoma patients in Cairo

Glaucoma is a leading cause of blindness worldwide. The aim of the current study was to evaluate the impact of an educational programme on knowledge, beliefs, practices and expectations towards glaucoma and eye care among adolescent patients with glaucoma. A purposive sample of 50 patients with glaucoma aged 12-18 years, attending ophthalmology outpatient clinics in Cairo, Egypt, were given an educational programme focusing on information about glaucoma, correcting patients' incorrect beliefs and expectations, and demonstrations and retraining about eye care. A range of tools was used to assess patients before and after the programme: questionnaire, observation checklist, physical assessment sheet, childrens' depression scale, children manifest anxiety scale, self-esteem inventory and patients' expectations scale. The programme significantly improved patients' knowledge and beliefs about glaucoma and their practices and expectations concerning eye care. Innovative educational programmes about eye diseases are needed to improve patients' knowledge and practices.

Capacitation status of stored boar spermatozoa is related to litter size of sows

Semen parameters can be considered useful predictors of sperm fertility. The objective of this study was to address the question of whether differences in in vivo fertility after the use of different ejaculates could be predicted using sperm kinematics, capacitation status, and sperm penetration ability under commercial pig production conditions. The percentage of capacitated sperm, as assessed by chlortetracycline (CTC) staining, was positively correlated with litter size (p<0.01). Our data suggest that litter size increases in proportion to the number of capacitated spermatozoa. When all semen parameters (kinematics, sperm capacitation status, and sperm penetration ability) and litter size were included in a multiple linear regression analysis, significant associations were found between the percentage of capacitated sperm (B-type), the sperm fertility index as assessed by a sperm penetration assay (SPA), and litter size. This relationship between capacitated sperm and litter size, however, was more predictive for smaller litter groups than larger ones. We found that the percentage of B-type sperm was significantly correlated with historic average litter size. However, there was no significant correlation between the percentage of B-type sperm and historic farrowing rates. To determine the normal range for B-type sperm, the lower limits were established as 30% for small litters (<8 piglets) and 35% for large litters. The overall accuracy of the assay was 92% and 83% for small and large litters, respectively. These results indicate that capacitation status as measured by CTC staining is a useful predictor of sperm fertility, equivalent to SPA. Moreover, original capacitation status exhibited better predictive ability for small litters than for large ones. Therefore, subfertile boars can be identified primarily by capacitation status.

Study of the relationship between electrical and magnetic properties and Jahn-Teller distortion in R(0.7)Ca(0.3)Mn(0.95)Fe(0.05)O(3) perovskites

In this work structural, magnetic and electrical properties of R(0.7)Ca(0.3)Mn(0.95)Fe(0.05)O(3) (R = Pr and Nd) perovskite manganites are presented. Structural characterization of these compounds shows that both have orthorhombic (Pbnm) phase. The Mössbauer spectra show clear evidence of the local structural distortion of the Mn(Fe)O(6) octahedron on the basis of non-zero nuclear quadrupole interactions for high-spin Fe(3+) ions. It was found that the local structural distortion decreases significantly on replacing Pr(3+) by Nd(3+). This replacement dependence of the Jahn-Teller coupling strength estimated from the Mössbauer results was found to be consistent with the electrical and magnetic properties.