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This study was conducted to evaluate the quality of frozen chicken meat received at government hos-pitals in Assiut city, Egypt, during hot and cold seasons. A total of 308 chicken meat samples were collected randomly and subjected to sensory, chemical, physical and microbiological testing. The findings showed that frozen chicken meat samples examined during the cold season had a better sen-sory evaluation than those examined during the hot season. The mean values of the physical quality tests, which included pH, drip loss, and water-holding capacity (WHC), were 6.12±0.017, 4.13±2.8, and 63.60±0.55 in the hot season and 5.9±0.013, 3.32±3.09, and 81.28±0.48 in the cold season, re-spectively. The total bacterial count, psychrotrophic count, total yeast and mould counts were 6.9×105±8.7×104, 1.1×106±1.0×105, 3.9×104±3.8×103, and 7.4×104±2.7×103 CFU/g in the hot season and 4.4×104±2.2×103, 1.9×105±1.6×104, 1.4×104±2.0×103, and 3.8×104±3.1×103 CFU/g in the cold season, respectively. These findings indicate that temperature has a significant impact on meat quality; the frozen chicken meat samples examined in the cold season were in better condition than those examined in the hot season. It is necessary to maintain sanitary hygienic conditions during handling, packaging, storage and distribution particularly in the hot season.

Introduction Individuals with co-occurring mental and physical health issues have worse health outcomes in both domains. Integration improves outcomes and aligns with patient preference, but health services tend to be siloed. The Mental Health in Medicine Clinic (MHiM) supports patients receiving inpatient or outpatient medical or surgical care at a tertiary academic hospital in Toronto, Canada. The predominantly virtual clinic has an interdisciplinary team offering services via stepped care, matching patient need with service intensity. Measurement-based care (MBC), the systematic evaluation of patient reported outcomes, was not initially used routinely in the clinic, but its implementation may improve treatment decision-making and may be useful in allocating patients within a stepped care model. Objectives 1) To describe the stepped care model, referral patterns, diagnoses, and level of care provided since implementation of stepped care. 2) To conduct a quality improvement initiative to implement MBC in the clinic, with a goal of 50% of patients completing at the time of first assessment and prior to discharge from the clinic. Methods We reviewed the electronic medical record for referral source, diagnoses, and level of stepped care within the clinic. We conducted semi-structured interviews with stakeholders (clinicians, administrative staff, patients) to explore barriers to implementation of MBC. Interviews were analyzed for themes around barriers and facilitators to MBC. Plan, Do, Study, Act cycles were carried out around change concepts informed by stakeholder interviews and relevant literature. Results The MHiM clinic began operations in August 2020. The clinic operated on a physician-only model until March 2022 and then shifted to a stepped care model with an interdisciplinary team. The most frequent referral sources were internal medicine, COVID19 clinics, consultation-liaison psychiatry, red blood cell disorders clinic and cardiology. Since the implementation of stepped care, 250 referrals were assessed. 58% of new referrals were assessed by the psychiatrist, 42% were managed by the NP, and 25% consulted with the social worker. Referrals consisted of trauma and stress-related disorders (32%), depression (21%) or anxiety disorders (20%). Personality, substance use, and psychotic disorders accounted for less than 10% of referrals combined. Some patients did not have any diagnosis (6%). Results from the quality improvement initiative to implement MBC will also be presented. Conclusions The MHiM clinic provides an integrated care pathway addressing comorbid mental and physical health conditions. We describe a novel stepped care model and the implementation of MBC. Future directions include ongoing quality improvement of MBC and its integration within the clinic to assess and re-assess service intensity. Disclosure of Interest None Declared

Abstract Background The current experiment was done during the 2018 and 2019 seasons on ‘Ewais’ mango trees (Mangifera indica) grown in Research Station, El-Nubaria district, Egypt, to study the impact of spraying ammonium nitrate (NH4NO3) and irrigation time on vegetative growth, yield and fruit quality. All experimental plants have been received the same care, i.e. control of pests & weeds, fertilization, and irrigation until the 1st week of October. The irrigation was adapted to apply 5m3/feddan (4200 m2)/week to control leaves damage due to low temperature after this period and the treatments included: (T1) Water spraying at 1st week of November + start normal irrigation program at the same time after four weeks of adapted irrigation as 5m3/feddan (4200 m2)/week (Control). (T2) Spraying with NH4NO3 2% at 1st week of November + start normal irrigation program at the same time after four weeks of adapted irrigation as 5m3/feddan /week. (T3) Spraying NH4NO3 2% at 1st week of November + start normal irrigation program at 1st week of December after eight weeks of adapted irrigation as 5m3/feddan/week. (T4) Spraying NH4NO3 2% at 1st week of November + start normal irrigation program at 1st week of January after twelve weeks of adapted irrigation as 5m3/feddan/week. All treatments received the same quantity of irrigation water, approximately 4000 m3/feddan/year. Results All treatments (T2, T3 & T4) had a significant influence on vegetative growth, fruiting behavior (fruit set % & the yield), and the fruit quality compared with the control (T1). The significant was not only the fruit physical characteristics (weight, dimensions, volume, and specific gravity) but also the fruit chemical characteristics (total soluble solids % (T.S.S.), acidity %, T.S.S / acid ratio and vitamin C (L- ascorbic acid)). Conclusion Spraying NH4NO3 2% at 1st week of November plus start normal irrigation program at 1st week of November or December or January after 4 or 8 or 12 weeks of adapted irrigation as 5m3/feddan (4200 m2)/week (T2, T3, and T4) increased the vegetative growth, i.e. length of terminal shoots, No. leaves / terminal shoots & leaf area as well as the fruiting behavior such as fruit set percentage, No. fruits per tree & the tree production (kg/tree) and improved the fruit characteristics not only the fruit physical parameters but also the chemical properties in comparing with the untreated trees. During the two seasons, spraying NH4NO3 2% at 1st week of November plus start normal irrigation program at 1st week of January after 12 weeks of adapted irrigation as 5m3/feddan/week (T4) is recommended since; it is the only treatment with the superiority effect on studied parameters.

Phengite is known to be an important mineral in the transport of alkalis and water to upper mantle depths. Since ammonium (NH4+) can substitute for K+ in K-bearing minerals, phengite is thus a potential host to transport nitrogen into the mantle. However, the temperature and pressure conditions at which devolatilisation of NH4-bearing phengite occurs are not well constrained. In this study, NH4-phengite (NH4)(Mg0.5Al1.5)(Al0.5Si3.5)O10(OH)2 was synthesised in piston-cylinder experiments at 700 ∘C and 4.0 GPa. Its devolatilisation behaviour was studied by means of in situ micro-FTIR (Fourier transform infrared) spectroscopy under low and high temperatures from −180 up to 600 ∘C at ambient pressure using a Linkam cooling–heating stage and pressures up to 42 GPa at ambient temperature in diamond anvil cell (DAC) experiments. In addition to these short-term in situ experiments, we performed quenched experiments where the samples were annealed for 24 h at certain temperatures and analysed at room conditions by micro-FTIR spectroscopy. Our results can be summarised as follows: (1) an order–disorder process of the NH4+ molecule takes place with temperature variation at ambient pressure; (2) NH4+ is still retained in the phengite structure up to 600 ∘C, and the expansion of the NH4+ molecule with heating is reversible for short-term experiments; (3) kinetic effects partly control the destabilisation of NH4+ in phengite; (4) ammonium loss occurs at temperatures near dehydration; (5) NH4+ in phengite is apparently distorted above 8.6 GPa at ambient temperature; and (6) the local symmetry of the NH4+ molecule is lowered/descended/reduced by increasing pressure (P) or decreasing temperature (T), and the type and mechanism of this lowered symmetry is different in both cases. The current study confirms the wide stability range of phengite and its volatiles and thus has important implications for the recycling of nitrogen and hydrogen into the deep Earth. Moreover, it is considered as a first step in the crystallographic determination of the orientation of the NH4+ molecule in the phengite structure.

Abstract Background Cardiovascular diseases are the leading cause of death in Lebanon and Qatar. When lifestyle modifications prove insufficient, medication becomes a cornerstone in controlling such diseases and saving lives. Price, availability, and affordability hinder the equitable access to medicines. The study aimed to assess prices, availability, and affordability of essential cardiovascular disease medicines in relation to pricing strategies in Qatar and Lebanon. Methods A cross-sectional survey using a variant of the World Health Organization and Health Action International (WHO/HAI) methodology as outlined in “Measuring medicine prices, availability, affordability and price components” (2008), second edition, was adopted. Prices and availability of 27 cardiovascular medicines were collected from public and private dispensing outlets. For international comparison, prices were adjusted to purchasing power parity. Data was analyzed across multiple sectors, within and across countries. Results A total of 15 public and private outlets were surveyed in each country. Prices were more uniform in Qatar than in Lebanon. In the public sector, medicines were free-of-charge in Lebanon and priced lower than the international reference prices in Qatar. The ratio of medicine unit price to international reference price in the private sectors surveyed are significantly higher than the acceptable threshold of 4. This ratio of originator brands and lowest priced generics in Qatar were up to two and five times those in Lebanon, respectively, even after adjusting for purchasing power parity. However, prices of lowest priced generics in the private sector were at least 35% cheaper in Qatar and 65% cheaper in Lebanon than their comparative originator brands. Medicines were more available in the private sector in Lebanon than in Qatar, but only the originator brand availability in the public sector in Qatar exceeded the WHO target of more than 80%. While affordable in the public sector in Qatar, four out of thirteen medicines exceeded the threshold in all private sectors covered. Hence, only the public sector in Qatar had a satisfying level of availability and affordability. Conclusions Except for the Qatari public sector, medicine prices, availability, and affordability are falling short from targets. Key policy decisions should be implemented to improve access to medicines.

Abstract Background This experiment was carried out during 2015 and 2016 seasons to investigate the effect of strand thinning treatments by removing 15 and 30% of the total number of strands from the bunch center after 8 weeks from pollination (kimri stage) on productivity and fruit quality of Khadrawi date palm cultivar compared to the control (without thinning). Results The present results indicated that strand thinning by removing 30% of the total number of strands gave the lowest bunch weight and yield per palm compared to thinning 15% and control treatments during the two seasons of study. Also, removing 30% of the total number of strands improved some physical properties, i.e., fruit weight, flesh weight, fruit length, and fruit diameter than control in both seasons. All strand thinning treatments improved some chemical properties such as TSS %, total sugars %, and reducing sugars % than control (without thinning). However, both 15 and 30% strand thinning treatments had no significant effect on nonreducing sugars %, total acidity %, and tannins content in the two studied seasons. Conclusion From the obtained results, it was revealed that application of thinning treatment by removing 15 or 30% of the total number of strands from bunch center improved some physical and chemical properties of Khadrawi date palm fruits although there are no significant differences found between strand thinning at 15% and control during the second season.

Bacterial endophytic ubiquitously colonize the internal tissues of the plant. The purpose of this study was to isolate and identify the endophytic bacteria from sugarcane stalks which have antagonistic activity against Sporisorium scitamineum, the causal pathogen of sugarcane smut disease, and to study their activity to produce some secondary metabolites i.e. enzymes and growth-promoters. Sugarcane samples were collected from five governorates in Upper-Egypt namely, Giza, Beni-Suef, Sohag, Qena, and Luxor. A total of 240 isolates of endophytic bacteria were isolated from 160 samples of healthy sugarcane stalks (variety GT-54-9). Isolated endophytes were screened for its antagonistic activity against S. scitamineum, in vitro, using dual culture method. Only, 62 isolates showed different degrees of antagonistic activity. Ten isolates of endophytic bacteria were selected to study their potential to produce enzymes (chitinase, β 1,3 glucanase, phenylalanine ammonia lyase) and growth-promoters (siderophores, indole acetic acid (IAA), salicylic acid (SA)). These isolates were pre-identified using the morphological and physiological properties according to Bergy's manual as Pseudomonas sp., Serratia sp., Enterobacteria sp., Herbaspirillium sp., Gluconacetobacter sp. Anabaenopsis sp. and Azospirillumsp. All endophetic bacteria produced β 1,3gluconase and indole acetic acid (IAA), while Pseudomonas sp. produced salicylic acid and phenylalanine ammonia lyase, Ana baenopsis sp. produced phenylalanine ammonia lyase, Gluconacetobacter sp. produced chitinase and Herbaspirillium sp. produced siderophore. Meanwhile, isolates of Anabaenopsis sp. and Pseudomonas sp. were the most effective to produce β 1,3glucanase and indole acetic acid compared with other entophytic bacteria.

Wady El Natroun high way (Beer Hooker Area) in a private orchard in a sandy soil under drip irrigation system with saline water. in 2015 and 2016 seasons. Chinese tangerine (Citrus tangerine) transplant were budded on three rootstocks namely sour orange (Citrus aurantum, mion), volkamer lemon (Citrus volkameriana, Tem) and X639 hybrid between (Cleopatra mandarin × Ponicurus trifoliata) grown under saline conditions to study the effect of foliar application of antioxidants namely ascorbic and salicylic acid on vegetative growth and leaf mineral contents. Results showed that, Volkamer lemon rootstock surpassed sour orange and x639 rootstocks under saline conditions, the highest incremental percentage young tree height, stem diameter, number of leaves per shoot and leaf area were registered by Chinese tangarine scion budded on Volkamer lemon rootstock. Among selected antioxidants ascorbic acid at the concentrations of 800 ppm recorded the highest significant values for vegetative growth parameters and surpassed salicylic acid. Also Chinese mandarin scion budded on volkamer lemon accumulated the highest concentrations of nitrogen (N), phosphorus(P), magnesium(Mg), and chloride (Cl-) and the lowest concentration of sodium (Na+). Chinese mandarin scion budded on sour orange rootstock accumulated the highest concentrations of potassium (K) while Chinese tangerine scion budded on x639 accumulated the highest concentrations of sodium (Na).

This investigation was carried out during two successive seasons 2013 and 2014 on fruits of Washington Navel orange (Citrus sinensis L.). The experiment was conducted to evaluate the influence of some environmentally safe matural products to improve the storability of Navel orange (citrus sinensis) fruits during 2013 and 2014 seasons, Jojoba oil (1,3,5)%, castor oil (0.5, 1,2)%, yeast (1,2,3)%, seaweed (1,2,3)%, hot water (45ᵒC and commercial wax were used for proposed study, After the application of the treatments on the fruits, fruits were stored at a temperature of 5°±1 C and 90%±5 of relative humidity for 60 days, physical characteristics (weight loss%, decay% and the peel's thickness of the crust) and chemical properties (total phenols) were determined. Results indicated that, castor oil (2 and 1)% and jojoba oil 5% reduced the deterioration in weight loss%, decay%, peel thickness, and phenols content, compared to the content was obtained in control. So the results show that, coating orange fruits with castor oil (1, 2)% and jojoba oil (5)% had the most effective in improve the storability of orange fruits Navel Orange (Citrus sinensis L.).

This experiment was carried out during 2015 and 2016 experimental seasons to investigate the effect of spraying with moringa extract at 3%, garlic extract at 3% or ascorbic acid at 300 ppm on fruit set, yield and fruit quality of Khadrawi date palm cultivar. Anyhow, bunches were sprayed at three times (3 hours before pollination then 4 and 8 weeks after pollination). The present results indicated that spraying date palm bunches with moringa extract or garlic extract recorded the highest initial fruit set in the first and second seasons, respectively. As well as, moringa extract gave the highest fruit retention and yield in both seasons. In addition, all treatments improved some fruit physical characteristics i.e. fruit weight, flesh weight, fruit volume and fruit length compared to the control treatment in the two studied seasons. Also, results showed that moringa extract or ascorbic acid increased TSS%, total sugars % and reducing sugars % in both seasons compared to the control. Meanwhile, the lowest fibers % was obtained by garlic extract in the two seasons. Also, all treatments had no significant effect on total acidity % and tannins content in both seasons.

Depo-medroxy progesterone acetate (DMPA, Depo-Provera®) is used in morethan 80 countries as a long-acting contraceptive administered as a single intramuscular(i.m) injection of 150 mg/3 months. The present study was set up to investigate theeffects of DMPA on 80 average Egyptian women classified into four groups comprisingthose using the drug for one, two, three and four years, respectively, compared to acontrol group (N = 20) of married non-hormonally – treated women of similar ages. Thedrug showed a transient significant elevation of alanine aminotransferase activity (ALT)without an apparent effect on other liver indices, namely total bilirubin (T.Bil) level,aspartate aminotransferase (AST) and alkaline phosphatase (ALP) activities. Only thelow density/high density lipoproteins cholesterol ratio (LDLC/HDLC) was gradually andnon-significantly (ns) increased in comparison to control group, however, neither totalcholesterol (TC) nor triglycerides (TG) were affected by the drug. The lipid peroxideproduct malondialdehyde (MDA) was significantly elevated in an gradual manner with acorresponding decrease in reduced glutathione (GSH), without any change in blood nitricoxide (NO) levels. It can be concluded that DMPA may be considered as a safecontraceptive medication for the studied group of women, but that special care should beexercised for cardiovascular, hepatic and other patients more sensitive to the harmfuleffects of free radicals. Alternatively, supportive medications are advisable for eachexposed case to secure against the possible irreversible adverse effects of the drug by continuous use. In addition, annual re-evaluation is much more advisable despite the proven safety of the drug.

Thrombotic Thrombocytopenic Purpura (TTP) is a rare hematologic emergency, congenital or acquired, characterized by ischemic damage of various organs because of platelet aggregation. It is the common name for adults with microangiopathic hemolytic anemia, thrombocytopenia, with or without neurologic or renal abnormalities, and without another etiology; children without renal failure are also described as TTP. Plasma exchange (PE) is the main stay of treatment in combination with steroids and immunosuppressive therapies. The monoclonal antibody against CD20 Rituximab decreases the production of antibodies from B lymphocytes and it is used for antibodies-mediated diseases including TTP. We present our data on retrospective analysis of rituximab in treatment of TTP at University of Cincinnati in a series of 22 patients from 1997 to 2009. Our results showed that PE with immunosuppressive therapy resulted in decreased duration of PE, relapse rate, and increased duration of remission in patients with TTP.

Vitamin B12 deficiency can present with various hematological, gastrointestinal and neurological manifestations. We report a case of elderly female who presented with neuropathy and vitamin B12 deficiency where the final work-up revealed polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS). This case suggests that, although POEMS syndrome is a rare entity, it can present with vitamin-B12 deficiency and thus specific work up for early diagnosis of POEMS should be considered in patients with B12 deficiency unresponsive to therapy.

We report a case of a 29-year-old male who presented with paraesthesia and skin lesions with excessive bleeding after skin biopsy leading to hematology consultation. He was found to have prolonged partial thromboplastin time (PTT) and monoclonal gammopathy on serum protein electrophoresis (SPEP). He experienced excessive bleeding leading to hospitalization after bone marrow biopsy and required blood transfusion. He was diagnosed with Waldenstrom's Macroglobulinemia (WM), based on the presence of IgM-κ type monoclonal (M) protein and infiltration of lymphoplasmacytic cells identified in bone marrow aspirates. He was noticed to have features of peripheral neuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS syndrome). This is a very rare case of WM with POEMS syndrome which responded to chemotherapy using bortezomib, steroids, and rituximab.

Background: Cryptosporidium parvum is a protozoan parasite of medical and veterinary importance that causes neonatal diarrhea in many vertebrate hosts. In this study, we evaluated the efficacy of an affinity-purified antigen as a C. parvum vaccine candidate using ileal and liver tissues of experimentally infected neonatal mice by immunohistochemical profiling and immune scoring of CD4+, CD8+, Caspase-3, and nuclear factor kappa B (NF-κB). This vaccine was prepared from the C. parvum oocysts antigen using immune affinity chromatography with cyanogen bromide-activated Sepharose-4B beads. Methods: Thirty neonatal mice were divided into three groups (10 mice/group): (1) non-immunized non-infected, (2) non-immunized infected (using gastric tubes with a single dose of 1 × 105 of C. parvum oocysts in 250 µl PBS solution 1 h before a meal) and (3) immunized (twice with 40 µg/kg of purified C. parvum antigen at 2-week intervals and then infected with 1 × 105 C. parvum oocysts simultaneously with the second group). After euthanizing the animals on the 10th day, post-infection, their ileal and liver tissues were collected and prepared for immunohistochemistry (IHC) staining to detect CD4+, CD8+, Caspase-3, and NF-κB levels, which are indicators for T helper cells, cytotoxic T cells, apoptosis, and inflammation, respectively. Results: The IHC results showed that CD4+, CD8+, Caspase-3, and NF-κB expression varied significantly (P < 0.001) in both organs in all the groups. We also recorded high CD4+ levels and low CD8+ expression in the non-immunized non-infected mice tissues, while the opposite was observed in the non-immunized infected mice tissues. In the immunized infected mice, the CD4+ level was higher than CD8 + in both organs. While the Caspase-3 levels were higher in the ileal tissue of non-immunized infected than immunized infected mice ileal tissues, the reverse was seen in the liver tissues of both groups. Furthermore, NF-κB expression was higher in the liver tissues of non-immunized infected mice than in immunized infected mice tissues. Therefore, the IHC results and immune-scoring program revealed a significant difference (P < 0.001) in the CD4+, CD8+, Caspase-3, and NF-κB expression levels in both ileal and liver tissues of all mice groups, which might be necessary for immunomodulation in these tissues. Conclusions: The improvement observed in the immunized infected mice suggests that this vaccine candidate might protect against cryptosporidiosis. [ABSTRACT FROM AUTHOR]

Heavy metal toxicity is an important issue owing to its harmful influence on fish. Hence, this study is a pioneer attempt to verify the in vitro and in vivo efficacy of a magnetite (Fe3O4) nanogel (MNG) in mitigating waterborne lead (Pb) toxicity in African catfish. Fish (n = 160) were assigned into four groups for 45 days. The first (control) and second (MNG) groups were exposed to 0 and 1.2 mg L−1 of MNG in water. The third (Pb) and fourth (MNG + Pb) groups were exposed to 0 and 1.2 mg L−1 of MNG in water and 69.30 mg L−1 of Pb. In vitro, the MNG caused a dramatic drop in the Pb level within 120 h. The Pb-exposed group showed the lowest survival (57.5%) among the groups, with substantial elevations in hepato-renal function and lipid peroxide (MDA). Moreover, Pb exposure caused a remarkable decline in the protein-immune parameters and hepatic antioxidants, along with higher Pb residual deposition in muscles and obvious histopathological changes in the liver and kidney. Interestingly, adding aqueous MNG to Pb-exposed fish relieved these alterations and increased survivability. Thus, MNG is a novel antitoxic agent against Pb toxicity to maintain the health of C. gariepinus. [ABSTRACT FROM AUTHOR]