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Abstract Hospital plate waste poses a major challenge facing the present food systems, as providing meals that meet the nutritional requirements and expectations of the patients remains complex for hospital food services. This study aimed to assess the magnitude of plate waste in Lebanese hospitals, evaluate the patients’ satisfaction levels, and identify the determinants of plate waste in participating hospitals. A cross-sectional study was conducted between April 2023 and September 2023, involving 155 in-patients from cardiovascular, gastrointestinal, obstetrics-gynecology, and surgical wards across 16 hospitals in different Lebanese governorates. Plate waste was measured, and patient satisfaction was assessed using a questionnaire. Plate waste represented 31.4% of the total food served, equivalent to 366 tonnes annually in the 16 participating hospitals. Waste was higher in hospitals located in rural areas (p-value = 0.771). The highest waste levels were observed in the obstetrics-gynecology ward and during lunchtime. Vegetables were the most wasted food group. The majority of participants were satisfied with the food service, and low appetite was the main reason for not consuming hospital meals. Food quality (β= −0.17, p-value = 0.049) and governorate (β= −0.18, p-value = 0.019) were determinants of plate waste. The hospital sector is as unique and challenging as other sectors regarding plate waste, which warrants further research to gain deeper insights into waste generation.

Abstract Background Total joint arthroplasty (TJA) is an effective treatment for end-stage osteoarthritis, but postoperative pain has been poorly managed. The purpose of this study was to (1) assess how much narcotic medication was prescribed after TJA; (2) assess if patients were satisfied with their pain management; (3) compare these same data between total hip arthroplasty (THA)/total knee arthroplasty (TKA); (4) compare these same data between preoperative opioid users/opioid-naïve patients. Methods An IRB-approved prospective study was conducted at a US academic joint replacement practice. Patients were evaluated by an independent observer at three weeks, three months, and six months postoperatively using the Detroit Interventional Pain Assessment (DIPA) scale. Patients verbally rated their pain with their current medication regimen as 0 (no pain), 1 (tolerable pain), or 2 (intolerable pain) on the DIPA scale. Narcotic usage was verified by the Michigan Automated Prescription System (MAPS). Patients were divided into THA, TKA, previously on opioids, and opioid-naïve groups. Provider efficiency scores reflected pain management satisfaction and were calculated as the percentage of patients reporting no pain or tolerable pain. Results Out of 200 patients, the percentage of patients using narcotics and their daily usage (MMEs) significantly decreased from 75.5% (27.5 MMEs) at three weeks to 42.9% (5.3 MMEs) at six months (P

Abstract Corn-based breakfast cereals, known as cornflakes, have become a common breakfast choice worldwide, recognized for their convenience and versatility. However, mycotoxins can contaminate these products, adversely affecting human health. This study assessed the occurrence of major mycotoxins (AFB1, OTA, DON, ZEA, and FUM) in cornflake stock-keeping units (SKUs) marketed in the United Arab Emirates (UAE). It also evaluated the effect of different independent variables (country of origin, temperature on the production day, storage time, presence of chocolate, bran, and nut ingredients) and estimated the exposure levels of the UAE population to these mycotoxins and the associated risk factors. Seventy-six distinct cornflake SKUs were identified through a market screening and tested for mycotoxins using the Enzyme-Linked Immunosorbent Assay (ELISA) technique. AFB1, OTA, ZEA, FUM, and DON were detected in 23.7, 48.7, 27.6, 9.2 and 88.2% of the samples, respectively. The mean concentrations among positive samples were 2.0, 1.0, 10.14, 584.9, and 90.6 μg/kg, respectively. Except for AFB1, the average mycotoxin levels in samples were below the established limits by the European Union (EU). Among positive samples, none exceeded the US FDA limits for all mycotoxins, and only one exceeded the CODEX limit for FUM. On the other hand, four (5.3%), one (1.3%), one (1.3%), and one (1.3%) SKU exceeded EU limits for AFB1, OTA, FUM, and ZEA, respectively. The country of origin (developing vs. developed countries) exhibited a significant effect on AFB1 presence (p

Abstract Owning pets offers various potential health benefits; however, it can be associated with gastrointestinal illnesses due to poor food safety knowledge and practices. This study aimed to evaluate the level of food safety knowledge and practices among pet owners in Lebanon, exploring the association between their knowledge/practices and socio-demographic characteristics. The participants included 300 pet owners, representing various genders, ages, educational levels, educational backgrounds, and incomes. They completed a questionnaire of 72 food handling practices and knowledge questions related to preparation, cross-contamination, storage and hygiene. In parallel, 300 non-pet owners with comparable sociodemographic characteristics to pet owners (control group) completed the questionnaire. On average, food safety knowledge scores were 62.1 ± 14.9% and 58.7 ± 15.5% among pet and non-pet owners, respectively, and the difference was significant (p = 0.05). On the other hand, mean food safety practice scores were 41.3 ± 14.8% and 40.4 ± 15.3% among pet and non-pet owners, respectively, and the difference was not significant (p = 0.41). In the food safety knowledge part, non-pet owners who were young, high income, university graduate, and from health-related majors scored significantly (p

Background: Lebanese bread plays a significant role in the Lebanese diet and presents a promising opportunity for fortification with vitamin D. However, there is currently no evidence of such fortification being implemented. This study was conducted to assess the knowledge, attitudes, and perceptions of the Lebanese population toward vitamin D-fortified bread and to evaluate the impact of vitamin D on the sensory characteristics of bread. Materials and Methods: A cross-sectional study was performed on respondents (n = 300) who were randomly selected from different age groups and different districts in Lebanon via an online questionnaire from May to June 2022. For the fortification of the bread dough, a premix containing 100,000 IU/ml vitamin D3 (New Bridge Pharmaceuticals) was used. Three different concentrations of vitamin D were used, starting with 1000 IU/50 g, 1250 IU/50 g, and 1500 IU/50 g of bread. The dough samples were baked at 600 °C. The samples produced were stored inside nylon bags in a refrigerator. A pilot study was conducted for bread tasting and sample evaluation. Statistical analysis was carried out via the Statistical Package for Social Sciences (version 21.0) for Windows SPSS, Inc. Figures were created using Origin Lab Software. Results: A total of 300 respondents (188 females, 112 males) answered the questionnaire, with a mean age ranging from 20 to 30 years. Nearly half of them (48.3 %) had either vitamin D insufficiency or deficiency, and their daily vitamin D intake ranged between 0 and 7 µg/day. With respect to knowledge of vitamin D, 88.6 % correctly identified sunlight as the main source of vitamin D, and 73 % were aware that vitamin D preserves bone health. Half of the respondents (51.75 %) had daily sunlight exposure, and 82.6 % consumed bread on a daily basis. Those interested in increasing their vitamin D intake constituted 97.6 % of the respondents. With respect to their willingness to consume vitamin D-fortified bread, only 39 % of the participants reported that they would consume it. A considerable proportion (63.5 %) did not know whether fortification with vitamin D can affect bread shelf-life, taste, or texture. For the evaluation of the sensory properties of the bread, the panelists reported that the overall acceptability reached 62.26 %. No significant correlation was detected between vitamin D content and bread sensory characteristics (p value >0.05). Conclusions: The findings of this pioneering study reveal that the concept of fortifying Lebanese bread with vitamin D was positively received by respondents, marking a significant step forward in the use of this staple food as a novel vehicle to increase vitamin D intake in the Lebanese population. As the first study of its kind, it underscores the importance of integrating bread backing with fortification strategies to achieve broader acceptance. Future research should build on this foundation by investigating the impact of fortification on the sensory attributes of bread, as well as conducting detailed physiochemical analyses to determine the retention of vitamin D after baking, fermentation, and storage.

The number of individuals purchasing gluten-free products is increasing worldwide for various reasons, including celiac disease, gluten intolerance, or following food trends. Our objective was to conduct a review regarding the consumers’ perception on the availability, price, quality, and knowledge about gluten free products. This narrative review screened the databases and identified 26 published research articles on the topic. These articles were analyzed to examine associated parameters, such as availability, price, quality, and consumer knowledge on gluten-free products. The findings highlight the ongoing challenges faced by consumers of gluten-free products, including limited availability, higher prices, issues with product quality, and gaps in knowledge. Addressing these challenges is essential to improve the overall experience of individuals with gluten-related concerns.

Background: Olive oil consumption and production are evident among Lebanese households, yet little is known about the knowledge, perceptions, and practices of Lebanese consumers of olive oil. Methods: A total of 610 adolescents and adults who consume olive oil were surveyed using a semi-qualitative questionnaire comprising 47 questions between August 2022 and May 2023. Descriptive analyses of knowledge, perceptions, and practices were conducted in addition to a regression analysis of the predictors of higher knowledge. Results: 610 participants were included (61.0 % aged

Bostonite rocks are widely spread in the Central Eastern Desert (CED) of Egypt, they are found in the form of sills or dykes injected in the Precambrian rocks. Postgeosynclinal (Hammamat) sediments were intruded by Postorogenic bostonites. The study of this area, using ground geophysical methods, aimed at tracking the radioactive mineralization under the surface, based on the possible association of this radioactive mineralization with some other mineralizations such as sulphides. The application of the self-potential survey shows that the highest negative anomalies are associated with the South El-Atshan bostonite sill and its contact zones. The depths to the centres of some selected anomalies range from 5.7 m to 24 m, half-widths oscillate from 6 to 32 m, with shallow dips towards the west and east directions. The horizontal-loop electromagnetic (HLEM) survey, which was conducted using four frequencies, revealed the presence of two conductive bodies. These conductive bodies possess narrow widths and depths, ranging from 25 m to 27 m, dipping towards the west direction with shallow angles of 25° and 40°, respectively. In addition, the induced polarization (IP) profile shows high chargeability values reaching more than 7.9 mV/V at depths starting from about 10 m to about 35 m. This zone corresponds to a high-resistance zone that may reflect a subsurface disseminated mineralization. The integration of the results obtained using the three techniques makes it possible to determine the most appropriate zones for the development of exploration in the area of investigation.

Hydrolyzed collagen (HC) consists of many small and low-molecular-weight amino acid chains (3–6 kDa) that can be produced either in basic or acidic media through enzymatic activity. This review details the sources of hydrolyzed collagen, its biosynthesis and its uses in the food industry, as well as its production process and beneficial health effects. HC can be extracted from a variety of sources, during which acetic acid is used for the extraction of collagen type I from bovine, porcine, marine, chicken, and fish cartilage. An enzymatic treatment combined with an acidic treatment has shown more efficient extraction results. Because of its properties, it is frequently employed in the food industry since it improves sensorial qualities, as well as in the cosmetic industry as a functional component in face and body cream because of its moisturizing properties. It is also used in the pharmaceutical development of antioxidant supplements often combined with hyaluronic acid and vitamin C. HC has an excellent therapeutic effect on osteoporosis and osteoarthritis, where a daily dose of 12 g enhances pain symptoms and contributes to bone health. It also increases mineral density and protects articular cartilage. This review presents the structure and properties of hydrolyzed collagen, which mainly consists of the amino acids glycine, proline and hydroxyproline in a triple helix, its extraction process and its sources, as well as its applications. In particular, the creation of Enzymatic Membrane Reactor allows the production of HC with different molecular weight distributions, allowing wider application.

Background: This study examines the health security of both Lebanese citizens and Syrian refugees in Lebanon. It also assesses the readiness and resilience of the healthcare system in response to the multi-layered crisis that began in late 2019. Methods: A qualitative case study design was employed, utilizing 2 unstructured interviews with health experts/hospital staff, semi-structured interviews with 20 Lebanese participants and a document review. Thematic analysis was used to analyze the data. Results: The study found that Syrian refugees have access to health services under terms, conditions and restrictions including out-of-pocket (OOP) payment. In contrast, Lebanese citizens find traditional health guarantor systems largely ineffective, leading to high OOP costs for most healthcare services, with few exceptions. This study reveals a paradox in healthcare access within Lebanon’s fragile environment. Syrian refugees have greater access to health services, with minimal out-of-pocket (OOP) costs to a certain extent, compared to Lebanese citizens themselves who remain entrenched in inadequate health support services and poor public administration. Conclusion: To address this, targeted interventions and policies are crucial for policymakers and stakeholders, including the private and public sectors, local non-governmental organizations (NGOs), and the international community. Reforms are needed, spearheaded by the Ministry of Public Health (MoPH), other relevant ministries, and government payers, to refinance the traditional guarantor system and restore Lebanese citizens’ health security. Additionally, unifying health coverage across all government payers is vital.

Background: Assessing food waste management in hospitals is crucial for establishing a baseline model of the impact of waste reduction strategies and monitoring progress. Limited data exists on measuring and managing food waste in hospitals, emphasizing the need for comprehensive assessment in the country. Aims: This study sought to assess the food waste management protocols in different types of food services at Lebanese hospitals. Methods: This observational, descriptive, cross-sectional study sampled 32 dietitians in Lebanese Hospitals using a convenience sampling technique, who were interviewed to complete a questionnaire. Frequencies and percentages were obtained through simple statistics. Results: Study findings showed that, in Lebanese hospitals, 81.3% of food waste was obtained from patient's tray, 66.7% from expired prepackaged food, 58.1% from hospital cafeterias, and 48.4% from expired-unconsumed cafeteria food. The aforementioned food waste obtained is mixed with general waste. None incorporates composting or anaerobic digestion due to financial issues, but 18 hospitals are open to considering these methods. About 85% of hospitals adopt different approaches for managing food waste from isolated patients. Only 18.8% had external contractors for waste management, among which 9.4% mentioned food waste management in the contract. Conclusion: Lebanese hospitals rely on garbage disposal as a food waste management technique, lacking effective strategies, such as composting or anaerobic digestion. This underscores the urgent need for comprehensive and improved food waste management measures in the country. This study is a wake-up call for policymakers to adopt a robust approach in formulating hospital food waste management policies.

The widespread destruction and the devastating humanitarian toll caused by the ongoing war on Gaza have transformed this besieged Strip into a place of death and despair. This review will explore the implications of this war for food security, focusing on Sustainable Development Goal (SDG) 2, which seeks to fight malnutrition and food insecurity and achieve zero hunger by 2030. This work is based on a review of grey literature, such as reports from government and non-governmental agencies, as well as recent scientific journal publications. Our results show that the ongoing war on Gaza has exacerbated the already acute food insecurity that Gazans have been struggling with since the blockade was imposed in 2007. Restless bombardment and ground operations have damaged or even razed agricultural land and all food production infrastructure (such as bakeries, mills, and food processing facilities), destroying Gaza’s food system. Facing catastrophic levels of hunger, some families, especially in northern Gaza have recently been resorting to eating animal feed and weeds to survive. With the starvation of civilians being used as a method of warfare, many experts and human rights organizations argue that Gaza is now the world’s worst hunger crisis and its population is on the verge of famine, if not already there. Moreover, this unprecedented humanitarian crisis in Gaza could have significant consequences on global food security in its six pillars, jeopardizing the implementation of SDG 2. While international organizations are making efforts to mitigate the catastrophic food shortage and famine, more comprehensive and sustainable solutions are needed to address the root causes of food insecurity in Gaza and ensure that all residents have access to an adequate and nutritious diet.

Examining the microbiological characteristics of pet food is imperative to safeguard the health and well-being of companion animals, pet owners, and the surrounding environment. Domestic animals, known for carrying harmful microorganisms, pose a significant health risk, especially in close proximity to people and children. Notably, no studies have previously investigated pet food quality in the Gulf Cooperation Council countries, in particular, the United Arab Emirates (UAE). This study examined the microbiological quality of all stock keeping units (SKUs) of pet foods marketed in UAE (n = 118). Parameters assessed include Total Aerobic Microbial Count (TAMC), Enterobacteriaceae, Total Yeast and Mold Count (TYMC), Salmonella, Listeria monocytogenes, and Clostridium species. Among the 118 samples, 33 (28%) exceeded the acceptable TAMC limit of 106 CFU/g, highlighting significant variations based on manufacturers and ingredients. Eight samples (7%) surpassed the maximum Enterobacteriaceae limit of 3 × 102 CFU/g. TYMC levels exhibited variation, with 33 (28%) exceeding the limit of 104 CFU/g. L. monocytogenes was identified in 44 (37%) of the samples, while Salmonella was not detected. Clostridium contamination was observed in 28 (24%) of the samples. Statistical analyses revealed associations between pet food characteristics and microbial quality, underscoring the imperative for international standards to ensure the safety of pet food. These findings carry significant implications for pet owners, regulatory bodies, and the pet food industry, emphasizing the need for ongoing efforts to enhance the overall quality and safety of pet food products.

This study aimed to examine the features of the mesonephric system in fourteen (14) dromedary camel fetuses. Standard anatomical, histological, histochemical and scanning electron microscopic procedures were applied to investigate the role of the camel's mesonephros as a secretory system and hematopoietic center. In early development, the mesonephros occupied a large field of the abdominal cavity, expanded by lateral symmetry from the diaphragm to the pelvic cavity in the dorso-sublumbar regions. At 112 days of gestation, the mesonephros regressed at the cranial extremities. In the early stages of development, the mesonephros was enclosed by a thin capsule of mesenchymal connective tissue; irregular mesonephric tubules with large lumens lined with simple cuboidal cells interspersed with tiny blood vessels; and a few hemopoietic cells were discovered near the periphery of the mesonephros. With advanced development, giant glomeruli with a parietal layer lined with a simple columnar epithelium were seen in the ventral and associated boundary between the mesonephros and the developing gonads. Glycogen and alkaline phosphatase elicited an intense response in the capsule, the mesonephric tubule epithelium, renal tubule system, blood vessels, and hemopoietic cells, which was expected and contributed to water conservation and urine concentration. Scanning electron microscopy revealed that the outer surface of the mesonephros had an oval-brain shape. Based on the findings, the camel’s mesonephric system had a secretory function and served as a hematopoietic center. The morphology and development of the camel’s mesonephric system were comparable to those of other mammalian species, however, with unique traits and characteristics.

Background and Aim: Campylobacter spp. are Gram-negative bacilli that are widely recognized as a primary cause of bacterial gastroenteritis worldwide. Campylobacteriosis is the disease caused by this pathogen. Recently, greater attention has been given to the prevalence of campylobacteriosis in different animals, including pets. These animals are considered to be significant reservoirs for this zoonosis. In Lebanon, the occurrence of Campylobacter infection is high. Our first-of-its-kind pilot study in Lebanon aimed to estimate the fecal prevalence of Campylobacter species in house dogs. Materials and Methods: Thirty-five rectal swabs were collected from male and female house dogs of different ages, both with or without diarrhea. Samples obtained from the dogs were subjected to qualitative microbiological culture testing and molecular diagnosis by polymerase chain reaction assays after bacterial DNA extraction. Results: Fecal prevalence of Campylobacter spp. in house dogs in this study was 17%. There was a relatively higher prevalence among young females and a significant difference between healthy dogs and those suffering from diarrhea. Conclusion: Campylobacteriosis was found to be prevalent among house dogs in Lebanon, making them potential carriers of Campylobacter species.

Abstract Cornflakes are a popular and convenient breakfast cereal made from corn and widely consumed worldwide, including in Lebanon. However, they are susceptible to mycotoxin contamination, which can have harmful effects on human health. Our study evaluated the occurrence of five mycotoxins (AFB1, OTA, FUM, ZEA, DON) levels in packed cornflakes marketed in Lebanon. A market screening identified 35 different cornflake stock-keeping units (SKU) in the Lebanese market, originating from 10 different brands and having different tastes and shapes. SKUs were collected and tested for five mycotoxins in triplicates using enzyme-linked immunosorbent assay technique. The results showed the presence of the five mycotoxins in the samples. The average levels of AFB1, OTA, ZEA and FUM among positive samples (above limit of detection) were 1.58, 1.2, 15.1 and 774.1 μg/kg, respectively, and were below the EU limits. On the other hand, the average level of DON was 1206.7 μg/kg, exceeding the EU limit. Furthermore, out of the positive samples, 60%, 17%, 9%, 14%, and 6% exceeded the EU limits for DON, OTA, AFB1, FUM, and ZEA, respectively. Notably, SKUs made in Lebanon had significantly (p 0.05) effect on the levels of the five mycotoxins detected in the samples. AFB1, FUM and ZEA levels differed significantly among SKUs (p > 0.05). Considering these findings, further studies should be conducted to assess the exposure to mycotoxins from the consumption of cornflakes in Lebanon, especially among children.

Abstract Abundance of data on the role of inflammatory immune responses in the progression or inhibition of hepatocellular carcinoma (HCC) has failed to offer a curative immunotherapy for HCC. This is largely because of focusing on detailed specific cell types and missing the collective function of the hepatic immune system. To discover the collective immune function, we take systems immunology approach by performing high-throughput analysis of snRNAseq data collected from the liver of DIAMOND mice during the progression of nonalcoholic fatty liver disease (NAFLD) to HCC. We report that mutual signaling interactions of the hepatic immune cells in a dominant-subdominant manner, as well as their interaction with structural cells shape the immunological pattern manifesting a collective function beyond the function of the cellular constituents. Such pattern discovery approach recognized direct role of the innate immune cells in the progression of NASH and HCC. These data suggest that discovery of the immune pattern not only detects the immunological mechanism of HCC in spite of dynamic changes in immune cells during the course of disease but also offers immune modulatory interventions for the treatment of NAFLD and HCC.

Background: Hospital food wastage has been identified as a significant issue within the foodservice sector. Numerous studies have shed the light on the amount of food waste in hospitals, along with its financial and environmental implications. Consequently, reducing food waste in hospitals has become a priority for the foodservice management sector in the Eastern Mediterranean Region (EMR). Aims: This review aims to examine studies on food waste in the hospitals of the EMR countries, and highlight research gaps in quantification, management, and assessment strategies in this region. Methods: PubMed and Google Scholar databases were searched between January 6 and September 1, 2023, to identify relevant articles published up to 2023 in the EMR. Results: Six studies were included in this review. Among EMR countries, only Iran, Saudi Arabia, and Qatar have assessed food waste at hospitals. The average food waste in the EMR represents 25.4 % of total food served. Factors contributing to food waste include clinical issues, food preferences, meal timing, and ward sections. Patient's plate waste reduce dietary intake, affects patient's nutritional status and predispose to malnutrition. While some strategies to reduce plate waste have been proposed in many countries, there is a notable lack of food and food-related waste management policies and programs in hospitals food services in the EMR. Conclusion: This review summarizes the hospital's food-related waste assessment, quantifications, and management used by hospitals in the EMR. This review is a benchmark for the EMR's hospitals to work on adopting proactive measures as a general strategy to move toward food and food-related waste reduction.

The safety and quality of foods of animal origin are of great importance to the human health and economy. Food can contain different hazards, including antibiotic residues. In both low and middle-income countries, such as the case of the majority of the Arab countries, the use of antibiotics is not under control, in addition to the poor monitoring of imported foodstuffs. This has been causing antimicrobial resistance (AMR) that is in turn threatening the safety of both animals and humans. The presence of antibiotic residues in food commodities, such as dairy and meat products, in addition to honey, is a public health concern. In this review, literature review from the Arab countries on antibiotic residues in foods was done and a total of 40 published articles were found and analyzed. The findings of these articles in terms of most used antibiotics, exposure levels, detection methods, in addition to understanding the factors that increase their presence in food samples are presented in this review.

Background: The COVID-19 pandemic has interrupted economies and food systems globally, leading to substantial consequences on food waste, which is also influenced by political and economic factors. To date, information on the attitudes and behaviors of households regarding food waste generation in developing countries like Lebanon, witnessing a multifaceted economic and COVID-19 crisis, is scarce. Previous studies reported that around one third of the food produced in Lebanon gets lost or wasted. This study aims to update the attitudes and behaviors determining household food waste in Lebanon in light of the COVID-19 pandemic and unprecedented economic crisis. Methods: Participants (n = 1251) from the five governorates of the country filled out a structured questionnaire composed of 3 sections and 31 questions. The variable “eat everything prepared” was used as a proxy for food waste. The effects of different socio-behavioral and demographic characteristics on household food waste generation in the country were estimated using a Logistic regression on STATA. Results: Most participants (69%) reported that the economic crisis had a greater impact on their food shopping and eating behaviors compared to the COVID-19 pandemic. In comparison, 65% reported that their household food waste generation did not change because of the COVID-19 pandemic, and 47% reported that their household food waste generation decreased because of the economic crisis. Employment status, income, educational level, and the number of householders did not affect food waste generation. Feelings of guilt, thinking of ways to use leftovers, and frequent preparation of more dishes were negatively associated with food waste generation while eating out and buying special offers showed the opposite effect. Conclusion: Our findings provide a better understanding of more effective community-based food waste-related interventions in Lebanon. Future research is still needed to explain the medium and long-term effects of COVID-19 and the economic crisis on food waste-related behaviors in the country since the behavioral changes uncovered in the current study might be temporary during the pandemic and the economic crisis and not permanent. This issue should be verified in the future using longitudinal surveys.

IntroductionThis study aimed to explore how veterinarians (vets) rationalized their prescribing decisions for antimicrobial (AM) uses, the barriers they perceived to implement proper farm management in Lebanon, and the consecutive threats that might arise concerning the emergent spread of antimicrobial resistance in animals and the population.MethodsAmid the COVID-19 pandemic, phone call interviews were conducted with 34 veterinarians working in different demographic regions across the country. Data were analyzed qualitatively using an inductive thematic analysis.Results and discussionThe majority of veterinarians called for responsible antibiotic use. The prescribing decision of veterinarians was based mainly on suspected disease from field examination, farmer’s reports via phone calls, and the ability of the farmer to cover antibiotic costs. Very few veterinarians referred to laboratory diagnosis before prescribing a specific AM due to many obstacles. This study uncovered the absence of a trust relationship between veterinarians and farmers in Lebanon. Veterinarians provided different insights into farming practices, reflecting that farmers, in general, lack proper knowledge and implementation of farm management and that they mainly treat the herd on their own, especially in light of the current unprecedented economic crisis that Lebanon has been facing in the last three years. Above all, veterinarians revealed that AM resistance in Lebanon is markedly spreading, which calls for a serious and instantaneous set of governmental policies and regulations.

Background and Aim: Great attention has been given recently to the prevalence of different Campylobacter spp. in poultry since the latter are considered the major contributing reservoir of human campylobacteriosis. In Lebanon, the occurrence of campylobacteriosis in humans is high. The aim of our first-of-its-kind study in the country was to estimate the prevalence of Campylobacter spp. in broilers from a convenient sample of farms in North Lebanon. Materials and Methods: One hundred twenty-five fecal samples were collected from 25 broiler farms, which were selected, examined, and classified according to their biosecurity level and rearing system. All samples were subjected to qualitative microbiological culture testing and polymerase chain reaction (PCR) assays to detect Campylobacter spp. Results: Despite the reported use of antibiotics, cell culture and PCR were positive for 44% and 88%, respectively. This implies that this bacterium is resistant to antibiotics used on the farms. Furthermore, Campylobacter infection rate was higher in open (92%) than in closed (85%) system farms. All farms with poor biosecurity measures, and 82% of farms with good biosecurity measures had Campylobacter infections, and the difference was significant (p < 0.05). Conclusion: Our results show that campylobacteriosis was found prevalent among broilers in North Lebanon, making them potential carriers of Campylobacter spp. Future studies should include antibiotic susceptibility testing to check the susceptibility pattern of isolates.

In the present study, 30 lactic acid bacteria (LAB) strains were isolated from Anbaris, a traditional fermented dairy product manufactured in rural villages of Lebanon from goat milk with a distinct sharp taste, and identified as members of the Lactobacillus genus. Among these strains, twelve showed potential probiotic characteristics with acid and bile tolerance, angiotensin-converting enzyme (ACE) inhibitory activity, and antimicrobial capacity against Staphylococcus aureus, but not against E-coli. Pooled isolates have displayed a very high ACE inhibitory activity (>70%). These isolates also had a high tolerance to all pH values between 3.0 and 5.0, making Anbaris contain probiotic LAB that can cross saliva, upper and lower stomach, and the intestines. The isolates were also characterized using pulse-field gel electrophoresis (PFGE). The obtained results are the first to be collected on Anbaris. This increases the marketability of this product as a source of probiotics, nutritional, economical, and empowering women cooperatives in rural areas.

Background: Primary total knee arthroplasty (TKA) has been historically associated with considerable blood loss. Allogenic transfusions, the standard of care for blood loss following TKA, carry inherent risks. With the expanding use of robotic technology in TKA, one theoretical advantage is decreased blood loss and postoperative blood transfusions requirements. The purpose of this study was to compare postoperative hemoglobin levels and the percentage of patients requiring a transfusion of allogenic packed red blood cells after conventional TKA (CTKA) vs robot-assisted TKA (RATKA). Methods: This is a retrospective review of 486 consecutive patients undergoing either CTKA or RATKA between October 30, 2018, and June 25, 2020, by a single fellowship-trained arthroplasty surgeon. Mako SmartRobotics (Stryker, Kalamazoo, MI) was used for RATKA cases. Primary outcomes included preoperative vs postoperative hemoglobin values and postoperative blood transfusion rates between the 2 groups. Results: The mean hemoglobin on postoperative day 1 was 10.7 gm/dl (±1.3) in the CTKA group and 10.9 gm/dl (±1.3) in the RATKA group, P = .24. The largest decline in hemoglobin from preoperative to within 2 days postoperatively was 3.1 gm/dl (±1.1) in the CTKA group and 3.1 gm/dl (±1.1) in the RATKA group, P = .92. The percentage of patients requiring a blood transfusion was 1.1% in the CTKA group and 1.3% in the RATKA group, P = .79. Conclusions: RATKA and CTKA groups did not have significant differences in postoperative hemoglobin changes or the need for postoperative blood transfusions.

Background and Objectives: Orthopedic surgeons commonly prescribe opioids, surpassing all medical specialties. Our objective was to develop a pain management scale that captures medication use, patient-reported pain scores, and helps orthopedic surgeons evaluate their post-operative prescribing practice. Materials and Methods: An IRB-approved prospective study followed 502 post-operative orthopedic surgery patients over a six-month period. All patients were surveyed in an orthopedic clinic at a Level 1 US Trauma Center, during a routine follow-up. Patient pain satisfaction was assessed using the validated Interventional Pain Assessment (IPA) scale, which uses three categories: 0 (no pain), 1 (tolerable pain), and 2 (intolerable pain). Daily narcotic use was translated to morphine milligram equivalents (MMEs) using the Michigan Automated Prescription System (MAPS) narcotics registry. When patient pain satisfaction and narcotic usage were combined, this scale was called the Detroit Interventional Pain Assessment (DIPA) scale. Results: The five classes based on common prescription and usage of narcotics in this cohort include the following: A (no pain medication), B (over-the-counter medication), C (occasional use of short-acting narcotics 1–30 MMEs), D (consistent/regular use of short-acting narcotics 31–79 MMEs), and E (long-duration or stronger short-acting narcotics 80+ MMEs). Patients were most satisfied with their pain management at six weeks (80.5%) and three months (75.65%), and least satisfied at two weeks (62.5%) and six months (60.9%). Additional information displayed on the DIPA graph revealed there was a significant decrease in the percentage of patients on narcotics at two weeks (65.2%) to six months (32.6%) at p < 0.001. Conclusions: The DIPA pain scale shows the relationship between patient pain perception and opioid prescription/usage, while also tracking prescriber tendencies. Providers were able to visualize their post-operative pain management progression at each designated clinic visit with corresponding alphabetical daily MME categories. In this study, results suggest that surgeons were not effective at managing the pain of patients at two weeks post-operative, which is attributed to an inadequate number of pain pills prescribed upon discharge. Overall, the DIPA graph signaled that better pain management interventions are necessitated in periods with lower efficiency scores.

Background: Food allergy is a life-threatening medical condition of public health concern. The aim of our study was to characterize food allergies, in terms of sources, symptoms, severity, and history, as well as to assess the knowledge, practices, and attitudes towards food allergens and allergies, in addition to food allergen labeling, in Lebanon. Methods: For this, 1100 participants filled over the phone a comprehensive valid questionnaire composed of 41 questions. Results: Fruits were reported as top food allergens (29.6%), while itching and rash were the most reported symptoms (9.6% and 8.0%, respectively). In terms of knowledge, participants scored on average 67.9 ± 16.2%. Participants who identified as females, below 35 years, highly educated, and from health backgrounds had a significantly higher score (p 0.05). Participants who are medically diagnosed with allergies and those with health background were found to check the ingredients list and read nutritional claims significantly more frequently than those from a non-health background and who are non-medically diagnosed, respectively, while females were found to check ingredients list and read nutritional claims significantly more frequently (p

IntroductionFood waste is a global issue of primary concern due to its repercussions on the environment, food security, and the economy. Our study aimed to explore the impact of religion and religiosity on food waste generation among restaurant clienteles in Lebanon, a religiously diverse country.MethodsA convenient sample of 927 restaurant patrons dining out in Greater Beirut was interviewed face-to-face, and leftovers at each table were collected and weighed.ResultsChristian diners were found to waste significantly less (p < 0.05) than Druze and Muslim patrons in restaurants serving Lebanese and non-Lebanese food. Individuals (19.1% of respondents) from both religions who reported that their relationship with God is the priority in life waste similarly compared to those who claimed to have other priorities. The higher the religiosity score among both Christians and Muslims/Druze groups was, the lower the food waste quantity got, highlighting the reduced wasteful behavior among highly religious people.DiscussionBased on these findings, including religious cues in consumer-based interventions to reduce food waste can be more effective. This can be achieved through marketing campaigns that communicate religious-based messages to trigger religious beliefs that reduce food waste, using physical spaces and rituals of mosques and churches.

Our study aimed to examine the practices and knowledge of food handling and safety among 1534 university students in Bangladesh (mean age 22.09 ± 1.78), as well as the relationship between these factors and their academic and demographic backgrounds. Participants in this study were undergraduate and graduate students from four public universities in Bangladesh from different religions, income levels, years and majors of study, residential areas, living alone or not, and whose mothers are working or non-working. The questionnaire included 14 questions on food handling practices and 16 on knowledge. Questions were related to food preparation, hygiene, cross-contamination, and storage. The overall mean score for food handling practices was 34.9% (SD = 13.7), while that of knowledge was 41.8% (SD = 16.5). Female students, those from food-related majors, and those engaged in cooking activities scored significantly higher in the knowledge and practice sections (p < 0.05). Students who lived with their families performed significantly better on the knowledge parts, while those who shared a home with roommates in mess performed significantly better on the practice part (p < 0.05). Students having housewife mothers, personal poisoning experience, and continuous involvement in food purchasing scored significantly higher (p < 0.05) in the practices section but not in the knowledge one. On the other hand, students living in urban areas scored significantly higher (p < 0.05) in the knowledge section but not in the practices one. Our results highlight the importance of educational interventions and initiatives to enhance food safety awareness among Bangladeshi university students.

Coffee is considered among the most popular beverages and is classified as the second most exported item worldwide. The presence of pesticides in this staple commodity is a challenge to import and export activities, in addition to the fact that pesticides are toxins of public health concern. Even if pesticides are applied properly and their residues are within the acceptable range, it is important to know the fate of these pesticides prior to their ingestion. A plethora of research has been done to optimize methods and thus to have valid procedures to test for the presence of pesticides in coffee. In this review, the analytical methods used in these articles to detect and quantify the pesticides in coffee beans, roasted coffee, and coffee infusion were identified. This review highlights as well the main factors that play a key role in having good separation, identification, and recovery of pesticide residues in the aforementioned items. In addition, the review explains the effect of pesticides on human health and the mitigation techniques for pesticide exposure.

Factors such as aging, an unhealthy lifestyle with decreased physical activity, snacking, a standard Western diet, and smoking contribute to raising blood pressure to a dangerous level, increasing the risk of coronary artery disease and heart failure. Atherosclerosis, or aging of the blood vessels, is a physiological process that has accelerated in the last decades by the overconsumption of carbohydrates as the primary sources of caloric intake, resulting in increased triglycerides and VLDL-cholesterol and insulin spikes. Classically, medications ranging from beta blockers to angiotensin II blockers and even calcium channel blockers were used alone or in combination with lifestyle modifications as management tools in modern medicine to control arterial blood pressure. However, it is not easy to control blood pressure or the associated complications. A low-carbohydrate, high-fat (LCHF) diet can reduce glucose and insulin spikes, improve insulin sensitivity, and lessen atherosclerosis risk factors. We reviewed articles describing the etiology of insulin resistance (IR) and its impact on arterial blood pressure from databases including PubMed, PubMed Central, and Google Scholar. We discuss how the LCHF diet is beneficial to maintaining arterial blood pressure at normal levels, slowing down the progression of atherosclerosis, and reducing the use of antihypertensive medications. The mechanisms involved in IR associated with hypertension are also highlighted.

Estimating the microbiological quality of pet food is essential in providing healthy and safe foods to pets. The aim of this study was to assess the microbiological safety of pet food marketed in Lebanon, namely cat and dog products. To the best of our knowledge, no studies have been conducted in Lebanon nor the Middle East region with reference to pet food quality. Lebanese market was screened and a total of 165 dry and canned pet food products were identified, collected and analyzed for their load of total aerobic microbial count, Enterobacteriaceae species, yeasts and molds, and for the presence of Salmonella and Listeria species. Dry pet food products had higher contamination level compared to canned ones. In terms of non-conformity to the European commission regulations, out of the 165 brands, 11 (7%) had a total aerobic microbial count above 106 cfu/g, and 27 (16%) exceeded 3 × 102 cfu/g as a maximum limit of presumptive Enterobacteriaceae. Among the dry brands, 8 out of 66 (12%) had a contamination level of yeasts and molds above 104 cfu/g. Presumptive Salmonella spp. was detected in 68 (41%) and presumptive Listeria spp. in 106 (64%) of brands. These alarming results necessitates setting and monitoring microbiological standards for pet food in Lebanon. This study contributes as well to the building of a database for knowledge development regarding the potential contamination of pet food by the abovementioned microorganisms.

Background and Aim: Transfer of antibiotics from raw milk to derived products is directly related to the processes involved in the manufacturing of dairy products, including East Mediterranean cheeses, since these have particular flow diagrams of production. The aim of this study was to assess the effects of skimming, pasteurization, curding, pressing, salting, cheese boiling, and whey acidification/heating on two widely used antibiotics in Lebanon, oxytetracycline (OTC) and tylosin (TYL), in the manufacture of commonly consumed cheeses in the East Mediterranean. Materials and Methods: Four hundred and fifty kilograms of full-fat bovine milk were spiked with OTC and TYL, then skimmed and pasteurized using holder and high-temperature short-time (HTST) methods. Milk was then processed to make cheeses (23 kg Baladi, 20 kg Akkawi, 20 kg Halloum, and 18 kg Double Cream). Liquid chromatography–mass-spectrometry was used to measure antibiotics. Analysis was performed using Statistical Package for the Social Sciences v25. Results: Skimming significantly (p=0.015) decreased TYL concentration by 68.6%. OTC degradation during holder (41- 54%) proved to be significant (p=0.015). HTST had a significant (p=0.012) effect on TYL with 32% degradation. Curding step in making Baladi had a significant (p=0.028) effect on OTC only with the concentration increasing by 1.5-fold. Acidification and heating of whey to produce Double Cream decreased significantly (p=0.037) OTC concentration (14.7- 46.3%), while TYL concentration increased significantly (p=0.000) by 300%. Pressing and salting in making Akkawi did not have any significant effect, while cheese boiling in making Halloum significantly decreased both antibiotics. Conclusion: OTC is transferred to Baladi and Akkawi (curd based) mainly, while double cream (whey based) has a high level of TYL transfer. Hence, people who consume these cheeses excessively could be exposed to high amounts of both antibiotics and thus be prone to their detrimental effect on health.

Tea is a worldwide consumed beverage that is known for its variety of flavors and aroma, in addition to its antioxidant, antimicrobial, anti-carcinogenic, and anti-inflammatory properties. Tea is produced from drying the tender leaves of the plant Camellia sinensis. However, the use of pesticides for protection against pests renders tea a potential health hazard, especially when consumed in large amounts. The greater surface area per unit weight of the tea leaf compared to other crops, in addition to the short time interval between pesticide application and harvest, increases the probability for human exposure to pesticides. For this reason, a multitude of research has been directed towards the analysis of pesticides in tea and their transfer to humans, along with their health consequences. In this review, we summarize the analytical methods used to detect and quantify pesticides in tea.

Magnetic and ground penetrating radar (GPR) techniques are perhaps the most convenient and popular geophysical survey techniques for detecting the buried archaeological targets, because of their high speed and quality of information. The results of the two used techniques have been integrated in Dawwar Jabal, Fayoum Governorate, Egypt to detect the buried archaeological remains and their depths.The magnetic survey shows various high positive magnetic anomalies, some of these anomalies are related to the possible archaeological targets and the others are due to the mudstones which may include iron minerals. The results of the GPR survey after processing shows scattering and strong reflection of the subsurface oscillations along some profiles, which may reflect the existence of the possible buried objects. Meanwhile, no evidence of scattering or clear reflection for the signals are recorded along the other profiles which suggest that there is not any possibility of archaeological targets.The integration of the obtained results from the two used techniques indicates that there is some agreement in mapping the locations of the possible buried archaeological targets and their depths (1–7.5 m) for most of the detected targets. However, few targets are observed only on the data of one of the used techniques and disappeared along the other. This is related to the limitation of each technique. Therefore, such combination of the two mentioned techniques to detect the archaeological targets yields more information about the locations and depths of the buried targets than is obtain if each technique is used individually.

Abstract Background Although breast cancer mortality is a result of distant recurrences associated with the establishment of tumor dormancy, current clinical practice guidelines recommend a wait and watch approach for tumor recurrences. This is because of our limited understanding of tumor dormancy and insufficient evidence in support of immunological control of tumor dormancy. Methods We used FVBN202 transgenic mice expressing rat neu oncogene in the mammary glands, and their parental FVB strain lacking neu expression. These models allowed the detection of tumor dormancy at distant sites using the rat neu protein as a tumor marker. We also used Ki67 for the detection of the indolent and quiescent types of tumor dormancy. Multicolor flow cytometry was used to detect dormant tumor cells and T cell subsets. Co-culture studies were performed to determine the role of T cells in preventing regrowth of dormant cells. Results We demonstrated that dormant tumor cells were present at the site of primary breast cancer and at distant sites in the lungs and in the liver very early in the course of early stage breast cancer when no distant metastasis was evident. Dormant tumor cells were characterized as neu expressing Ki67− and Ki67low fractions associated with the induction of local immune responses predominated by CD4+ and CD8+ T effector cell subsets. The presence of neu-autoreactive T cells from FVBN202 mice only prevented regrowth of dormant cells. On the other hand, presence of neu-alloreactive anti-tumor T cells in FVB mice prior to tumor challenge resulted in the protection of mice from the dissemination of dormant tumor cells to distant organs. Conclusion Our results suggest that immunotherapeutic targeting of semi-allogeneic mutant neoantigens during tumor dormancy might prevent distant recurrence of the disease.

Introduction: Appropriate dose adjustments of glucocorticoids replacement therapy for adrenal insufficiency (AI) is vital. Objective: We sought to scope physicians’ perceptions, and practices regarding Ramadan fasting (RF) impact on the management of AI. Methods: A web-based survey of a convenience sample of endocrinologists . Results: Nearly two-thirds of 145 respondents (64.1%) were adult endocr inologists and almost half (49%) saw more than 10 hypoadrenal patients per yea r. Most respondents (78.6%) prescribed hydrocortisone, while the minority prescribed other preparations. The glucocorticoid doses were reportedly divided twice daily by 70.8% and thrice daily by 22.2% of respondents. Respondents recognized RF as having po tential consequences in adrenal insufficiency patients included causing hypoglycaemia, undue tiredness, and fatigue, hypotension, feeling dizzy, and light-headedness. Symptoms of under-replacement were thought to happen in the late afternoon by 59. 3% of respondents. Almost half (45.5%) of respondents thought that RF has some pro bable or definite impact on glucocorticoid therapy that certainly warrants specifi c concern and possible action. Three quarters (76.4%) of respondents confirmed providin g specific management recommendations during RF. The most frequently reported recomme ndation was taking in the usual morning dose of hydrocortisone just before pre-daw n meal (Suhor) (57.8%). A third switch patients from hydrocortisone to prednisolone/pre dnisone. Half reported providing patients with specific recommendations regarding breaking their fast and/or seeking help if hypoadrenal symptoms occur. Conclusions: There is a remarkable variation in the physicians’ perceptions and practices regarding the management of AI during Ramadan. This warrants pr ofessional effort to increase the awareness and dissemination of evidence-based guid elines.

The primary purpose of this research is to move a 5-DoF Aideepen ROT3U robotic arm in real-time based on the surface Electromyography (sEMG) signal obtained from a wireless Myo gesture armband to distinguish seven hand movements. The pattern recognition system is employed to analyze these gestures and consists of three main parts: segmentation, feature extraction, and classification. Overlap technique is chosen for segmenting portion of the signal. Six-time domain features, namely, Mean Absolute Value (MAV), Waveform Length (WL), Root Mean Square (RMS), Autoregressive Coefficients (AR), Zero Crossings (ZC), Slope Sign Changes (SSC) are extracted from each segment. While the Support Vector Machines (SVM), Linear Discriminant Analysis (LDA), and K-Nearest Neighbor (K-NN) classifiers are employed in the classification of the seven hand movements. Moreover, a comparison between their performance is carried out to obtain optimum accuracy. The proposed system is tested on datasets extracted from six healthy subjects and the results showed that the SVM achieved higher system accuracy with 95.26% compared to LDA with an accuracy of 92.58%, and 86.41% accuracy achieved by K-NN.

Objectives: We sought to determine the prevalence of inborn errors of metabolism (IEM) in children with unexplained developmental delay and their types. Methods: We conducted a cross-sectional study in Misan, Iraq, over a period of one year. A total of 112 infants with unexplained developmental delay were included in the study, and the required information was taken from their parents by direct interview. Tandem mass spectrometry (MS/MS) was done in collaboration with MedLabs’ Referral Laboratory in Amman, Jordan. Results: Twenty (17.9%) cases had abnormal MS/MS. Disorders of amino acid metabolism represented the majority of IEM (10 cases) in which phenylketonuria and maple syrup urine disease were the most common (found in five cases each). Organic and fatty acid metabolisms were found in five and two cases, respectively. Most cases of IEM had a positive family history and consanguinity, however, family history was the only significant factor (p < 0.001). Conclusions: A high rate of IEM was detected in children with unexplained developmental delay in Misan. A high clinical suspicion with positive family history and consanguinity supported by the MS/MS results played an essential role in the diagnosis. However, implementation of newborn screening is essential for early diagnosis and to determine appropriate therapy in newborns with IEM in Iraq generally and in Misan in particular.

Background and Aim: The safety and quality of dairy products are considered to be of significant importance to human health. Although antimicrobial drugs are essential for disease treatment in modern medicine, the use of these drugs can have undesired consequences for human and animal health. This study aimed to investigate the presence of tetracycline and penicillin residues in raw, pasteurized, and UHT cow's milk of different fat contents, as well as in the dairy products yogurt and labneh, a traditional Lebanese product. Materials and Methods: A total of 44 samples, 4 raw, 9 UHT, 9 pasteurized milk, 10 yogurt, and 12 labneh samples from common local brands available in the Lebanese market were collected from Keserwan regions in May 2016. Tetracycline and penicillin residues were determined using a competitive enzyme-linked immunosorbent assay (ELISA) technique. Results: The mean values for tetracycline and penicillin were all below the limit of detection (LOD) of the ELISA kit of a maximum standard concentration of 1.80 μg/kg and 4.00 μg/kg, respectively. All samples tested positive for antibiotic residues. The detection rate for tetracycline in milk (n=22) samples was 86.4% with a mean residues value of 1.16±0.70 μg/kg. The detection rate of tetracycline in labneh (n=12) and yogurt (n=10) samples was 50% for each with a mean value of 1.76±0.40 μg/kg and 0.63±0.12 μg/kg, respectively. As for penicillin residues, 90.9% of the milk (n=22) samples tested positive with a mean value of 0.52±0.25 μg/kg. The detection rate in labneh (n=12) and yogurt (n=10) samples was 0% for penicillin residues, where mean values were all below the LOD (

Background: Gait recognition has been applied in the prediction of the probability of elderly flat ground fall, functional evaluation during rehabilitation, and the training of patients with lower extremity motor dysfunction. Gait distinguishing between seemingly similar kinematic patterns associated with different pathological entities is a challenge for the clinician. How to realize automatic identification and judgment of abnormal gait is a significant challenge in clinical practice. The long-term goal of our study is to develop a gait recognition computer vision system using artificial intelligence (AI) and machine learning (ML) computing. This study aims to find an optimal ML algorithm using computer vision techniques and measure variables from lower limbs to classify gait patterns in healthy people. The purpose of this study is to determine the feasibility of computer vision and machine learning (ML) computing in discriminating different gait patterns associated with flat-ground falls. Methods: We used the Kinect® Motion system to capture the spatiotemporal gait data from seven healthy subjects in three walking trials, including normal gait, pelvic-obliquity-gait, and knee-hyperextension-gait walking. Four different classification methods including convolutional neural network (CNN), support vector machine (SVM), K-nearest neighbors (KNN), and long short-term memory (LSTM) neural networks were used to automatically classify three gait patterns. Overall, 750 sets of data were collected, and the dataset was divided into 80% for algorithm training and 20% for evaluation. Results: The SVM and KNN had a higher accuracy than CNN and LSTM. The SVM (94.9 ± 3.36%) had the highest accuracy in the classification of gait patterns, followed by KNN (94.0 ± 4.22%). The accuracy of CNN was 87.6 ± 7.50% and that of LSTM 83.6 ± 5.35%. Conclusions: This study revealed that the proposed AI machine learning (ML) techniques can be used to design gait biometric systems and machine vision for gait pattern recognition. Potentially, this method can be used to remotely evaluate elderly patients and help clinicians make decisions regarding disposition, follow-up, and treatment.

Our study aims to determine the effects of different processes (skimming, pasteurizing, curding, pressing, boiling and salting) on enrofloxacin during the making of commonly consumed Middle Eastern products (Baladi, Akkawi, Halloum, Double Cream), which have flow diagrams of production that are particular to them. This was done by spiking milk with the antibiotic, skimming, and then processing it to cheeses. Liquid chromatography–mass spectrometry was used to measure enrofloxacin. Pasteurization (both holder and high temperature short time) significantly (p

This study aimed at evaluating the incidence of aflatoxin B1 (AFB1) and ochratoxin A (OTA) in thyme and thyme-based products, related dietary exposure, and cancer risk for regular and high consumption. A total of 160 samples were collected, and 32 composite samples were analyzed. AFB1 and OTA were respectively found in 84% (27/32) and 38% (12/32) of the samples. AFB1 exceeded the limits in 41% (13/32) and 25% (8/32) of the samples according to the Lebanese and European standards, respectively. OTA was unacceptable in only 6% (2/32) and 3% (1/32) of the samples according to the Lebanese and European standards, respectively. AFB1 and OTA daily exposure was shown to be 4.270 and 1.345 ng/kg bw/day, respectively. AFB1 was shown to be associated with 0.41 and 0.35 additional cancer cases per 100,000 persons per year for regular consumption, respectively; while for high consumption, an increase of 0.911 and 0.639 cancer cases per 100,000 person per year was noted, respectively. The margin of exposure (MOE) for OTA was >10,000 for the non-neoplastic effect and >200 for the neoplastic effect, representing no toxicological concerns for consumers.

Background: The aim of our study was to assess the knowledge, practices, and attitudes towards food allergens and allergies among diagnosed food allergic individuals in Lebanon. Methods: Seventy diagnosed participants were recruited after reaching out to all the allergists of the country. They completed in person or over the phone a comprehensive valid questionnaire composed of 49 questions. Results: Wheat was reported as top food allergen (15.7%), while itchy skin and rash were the most reported symptoms (71.4% and 68.6%, respectively). Only 34 (48.6%) of participants indicated they carry medications, 58 (70.7%) were diagnosed using blood test, and 22 (31.4%) stated that they are very knowledgeable on the topic. In terms of knowledge, participants scored on average 84.2 ± 11.5%. In terms of best practices, participants scored on average 47.8 ± 28.3%. Having a health related educational background increased significantly (p

Objectives: The current work was designed to study the effect of dehydroepiandrosterone (DHEA) on glucose homeostasis, liver functions and hemostatic disturbances in a rat model of bilateral orchidectomy (ORCH). Methods: 32 male rats (n = 8) were randomly assigned into 4 groups; (i) control (sham operated) group; were normal rats in which all surgical procedures were done without ORCH, (ii) Control + DHEA group: as control group but rats were treated with DHEA for 12 weeks, (iii) orchiectomized (ORCH) group: rats had bilateral orchidectomy and (iv) ORCH + DHEA group: orchiectomized rats treated with DHEA for 12 weeks. Four weeks after ORCH, DHEA treatment began and lasted for twelve weeks. By the end of the experiment, the parameters of glucose homeostasis, lipid profile, liver enzymes, bleeding and clotting times (B.T. and C.T.), prothrombin time (P.T.), activated partial thromboplastin time (aPTT), platelet count and aggregation, von-Willebrand factor (vWF), fibrinogen, plasminogen activator inhibitor (PAI-1), fibrin degradation products (FDP), intercellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1), endothelin-1 were measured. Results: ORCH caused significant deteriorations in the parameters of glucose homeostasis, lipid profile, and liver functions (p < 0.05). In addition, lower androgenicity-induced by ORCH caused a significant rise in PAI-1, fibrinogen, FDPs, ET-1 (p < 0.01) with significant shortening of bleeding and clotting times. DHEA replacement therapy significantly decreased glucose, insulin, PAI-1, fibrinogen, ICAM-1, and VCAM-1 when compared to ORCH rats. Conclusion: DHEA ameliorated the metabolic, hepatic, hypercoagulable, and hypofibrinolysis disturbances induced by ORCH.

Abdel Naser Zaid,1 Nihal Zohud,1 Bushra E’layan,1 Tasneem Aburadi,1 Nidal Jaradat,1 Iyad Ali,2 Fatima Hussein,1 Mashhour Ghanem,3 Aiman Qaddomi,3 Yara Abu Zaaror4 1Department of Pharmacy, 2Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 3Department of Regulatory, Pharmacare PLC, 4Department of Research and Development Pharmacare PLC, Ramallah, Palestine Background: Orlistat is an irreversible inhibitor of the lipase enzyme that prevents trigylcerides from being digested, thereby inhibiting triglyceride hydrolysis and absorption. The resultant reduced calorie uptake enables a positive effect on weight control. Systemic absorption of the drug is, therefore, not necessary for its mode of action. An alternative in vitro study (pharmacodynamic) has been introduced for this drug, as in vivo bioavailability studies are irrelevant with regard to the achievement of the product’s intended purposes.Objectives: To develop a new validated high-performance liquid chromatography (HPLC) method for the analysis of orlistat and to assess the potency and equivalence of three orlistat formulations using the pharmacodynamic method as a surrogate indicator of pharmaceutical interchangeability.Methods: A new HPLC method was developed for the analysis and for the dissolution studies of orlistat in capsules. Pancreatic lipase activity was measured for three different capsule products: Orlislim®, Slimcare®, and Xenical®, G1, G2, and the brand, respectively. Porcine pancreatic lipase and p-nitrophenyl butyrate (PNPB) were placed in a pH 7.4 reaction buffer at 37°C, and substrate hydrolysis was monitored by measuring absorbance changes at 410 nm; this was repeated on six capsules of each product. The inhibition was expressed by the concentration of product, which inhibited 50% of the activity of pancreatic lipase (IC50).Results: The new analytical method was suitable for orlistat analysis. Values of IC50 from regression lines and equations were 6.14, 8.43, and 7.80 µg/mL for Orlislim®, Xenical®, and Slimcare®, respectively.Conclusion: Pharmacodynamic studies of lipase inhibition could be used to support in vitro dissolution, which demonstrates interchangeability between generic and branded orlistat capsules. Moreover, it could be suggested as an alternative tool to bioequivalence studies for orlistat oral products. Keywords: Orlistat, therapeutic equivalence, validation, pancreatic lipase

The research deals the evaluation of buckling behavior for 5056-H18 Al alloy columns under variable loads and studies the effect of initial deflection on the critical buckling load. Seven samples were used for the purpose of testing the buckling of the column. The critical deflection of the column can be determined by measuring a length multiplied by 0.01 and this is the critical load of the columns. For the purpose of measuring the critical deviation of the column, a digital dial gauge has been applied and it set at 0.7 distance from the length of the column from the fixed condition. The experimental results were compared with the Perry - Robertson formula, Euler's theory for long columns and with the values calculated from the ANSYS 17 program. It has been observed that the Euler formula showed good compatibility with the practical results with safety factor 1.5. The ANSYS results showed well agreement taking a 1.5 factor of safety. While the Perry-Robertson formula needs a 1.4 safety factor to be safe results compared with experimental results.

Type 2 diabetes mellitus (T2DM) is known to be associated with an increased risk of dementia, specifically Alzheimer’s disease and vascular dementia. Intermittent fasting (IF) has been proposed to produce neuroprotective effects through the activation of several signaling pathways. In this study, we investigated the effect of IF on rat behavior in type 2 diabetic rats. Forty male Wistar Kyoto rats were divided into four groups (n = 10 for each): the ad libitum (Ad) group, the intermittent fasting group (IF), the streptozotocin-induced diabetic 2 group (T2DM) fed a high-fat diet for 4 weeks followed by a single intraperitoneal (i.p.) injection of streptozotocin (STZ) 25 mg kg−1, and the diabetic group with intermittent fasting (T2DM+IF). We evaluated the impact of 3 months of IF (16 h of food deprivation daily) on the levels of brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT3), serotonin, dopamine, and glutamate in the hippocampus, and rat behavior was assessed by the forced swim test and elevated plus maze. IF for 12 weeks significantly increased (p < 0.05) the levels of NT3 and BDNF in both control and T2DM rats. Additionally, it increased serotonin, dopamine, and glutamic acid in diabetic rats. Moreover, IF modulated glucose homeostasis parameters, with a significant decrease (p < 0.05) in insulin resistance and downregulation of serum corticosterone level. Interestingly, T2DM rats showed a significant increase in anxiety and depression behaviors, which were ameliorated by IF. These findings suggest that IF could produce a potentially protective effect by increasing the levels of BDNF and NT3 in both control and T2DM rats. IF could be considered as an additional therapy for depression, anxiety, and neurodegenerative diseases.