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PurposeAs the world began to witness an unprecedented rate of environmental destruction, economists and international institutions have been toiling away for decades, making every effort to dissect the dynamics of the relationship between the environment and the economy. Many claims have preached that there is a trade-off between environmental wellbeing and economic prosperity, where economic growth would be hindered by environmental protection. As we continue to neglect nature, will the world be capable of maintaining infinitely growing economies without falling into a deficit of natural resources? The foundation of all forms of economic growth springs from nature. Therefore, this study aims to explore the true impact of environmental protection policies on economic performance, and claims that well-designated environmental policies would only strengthen economies.Design/methodology/approachThis study aims to investigate the impact of environmental protection policies on gross domestic product (GDP) growth utilizing a selected sample of 18 OECD countries. Fixed effects panel regression was conducted for the sample from 1998 to 2015.FindingsFindings suggest that an increase in the environmental protection stringency is associated with an increase in GDP in the long-run. Whereas in the short run, more stringent environmental policies have been shown to have a questionable impact on GDP, brought to light by the mixed results portrayed in the short-run data.Research limitations/implicationsWhile it is true that this study has utilized data from the The Organisation for Economic Co-operation and Development (OECD), the findings could be applicable to countries of the MENA region. This is due to the fact that GDP levels of OECD countries and Middle East and North African (MENA) countries have been converging over the past few decades. The convergence suggests that both regions seem to be following similar trends since the year 1990, with an increasing similarity in trend over the years.Originality/valueThis paper empirically proves that the protection of nature is necessary for the sustenance of long-term economic growth. This study also provides an approximate time range of when the economic gains of environmental protection would be realized, specifically in the beginning of a green growth transition. This makes the study findings accurately relevant to Arab countries, where providing a time range is necessary to alleviate some the uncertainty of policymakers in the MENA region towards environmental policies.

Introduction: The role of DNA methylation in metabolic dysregulation is emerging. However, the functional role of methylation in obesity and metabolic dysregulation is poorly understood. Aim: The aim of this study was to compare DNA methyltransferase-3A (DNMT3A) and ten-eleven translocase-2 (TET2) levels in children and adolescents with obesity to normal-weighed children and adolescents and to correlate them to various metabolic parameters. Methods: Fifty children and adolescents with obesity were compared to 50 matched normal-weighed children and adolescents. Participants underwent assessment for anthropometric measurements, Tanner staging, acanthosis nigricans, and mean blood pressure percentile on three different occasions. TET2, DNMT3A, fasting lipids, and insulin were measured with calculation of the homeostatic model assessment insulin resistance (HOMA-IR). Results: The median BMI SDS of the studied children and adolescents with obesity was 3.40, their mean TET2 was 178.40 ng/mL, and their mean DNMT3A was 2.18 ng/mL. TET2 is significantly lower (p = 0.009), while DNMT3A is significantly higher (p < 0.001) in children and adolescents with obesity than controls. Children and adolescents with obesity and insulin resistance have significantly lower TET2 (p = 0.012) and significantly higher DNMT3A (p = 0.013) than those without insulin resistance. Diastolic blood pressure percentile and HOMA-IR are positively correlated to DNMT3A (p < 0.001) and negatively correlated to TET-2 (p < 0.001). Multivariate logistic regression analysis revealed that TET2 and DNMT3A are independently associated with diastolic blood pressure percentile (p = 0.03 and p = 0.014, respectively) and HOMA-IR (p = 0.003 and p = 0.001, respectively). Conclusions: Children and adolescents with obesity have significantly higher DNMT3A and significantly lower TET2 than controls. This is more evident in those having insulin resistance than those without. DNMT3A and TET2 are independently associated with systemic hypertension and insulin resistance in children with obesity.

Background: A decrease in eosinophil levels was found in Corona Virus Disease-19 [COVID-19] patients [eosinopenia]. However, recent research on eosinopenia and disease severity has yielded conflicting results.Objectives: To investigate the relationship between interleukin [IL]-5 and IL-6 levels, COVID-19 severity, and eosinophil count in Egyptian patients.Patients and Methods: Eighty-three COVID-19 patients were enrolled. At hospital admission, patients' medical records were reviewed for sociodemographic, clinical, and laboratory data. IL-5 and IL-6 levels in pretreatment serum samples were measured by enzyme linked immunosorbent assay [ELISA].Results: Severe disease patients had significantly lower eosinophil levels than non-severe patients [0.0 ×103/μL [0.0-0.4] vs. 0.2×103/μL [0.0-0.4]; P ≤ 0.001]. On the other hand, levels of IL-5 [180.0 pg/ml [10.0-960.0] vs. 300.0 pg/ml [170.0-690]; P=0.013] and IL-6 [110.0 pg/ml [20.0-600.0] vs. 45.0 pg/ml [20.0-120.0]; P ≤ 0.001] were significantly higher. Additionally, eosinophils were significantly negatively correlated with biomarkers of coagulation dysfunction [D-dimer; P=0.016], inflammation [C-reactive Protein [CRP]; P=0.037 and ferritin; P=0.049] and cytokine storm [IL-6; P=0.018], but there was no significant correlation between eosinophils and IL-5 [P=0.931]. In addition, eosinophil count showed little diagnostic significance in distinguishing between severe and non-severe COVID, with an area under the curve [AUC] of 0.174.Conclusion: Anti-COVID-19 immunotherapy could target IL-5, IL-6, and eosinophils. IL-6 levels outperformed IL-5 levels and the peripheral eosinophil count in predicting COVID-19 development. Despite its weak predictive potential, eosinopenia has been related to severe COVID-19 infection and a higher risk of in-hospital death.

The current study was carried out to evaluate eco-friendly extracts of an invasive weed; Eichhornia crassipes (Mart.) Solms (Pontederiaceae) for controlling Agrotis ipsilon (Hufn.) (Lepidotera: Noctuidae). The insecticidal and biological activities of the whole plant extracts with different polarity solvents (petroleum ether, acetone, and absolute ethanol) were investigated. The extracts were evaluated against the 2nd larval instars of A. ipsilon. The results revealed that acetone fraction extract was the most effective extract with the lowest LC50 value (240 mg/L). The larval mortality percentage increased by elevating concentrations of all tested extracts. Pupation and adult emergence percentages were inversely proportional with the concentration of all tested extracts. There was a disturbance in both the adult malformation and sex ratios. Furthermore, the spectrophotometric testing of the most promising extracts (acetone and ethanol fractions) on some biochemical parameters (total body metabolites, acid and alkaline phosphatases, aminotransferase activities, and kidney function) in the serum of albino rats showed non-toxic effects on mammals. Therefore, acetone and ethanol fraction extracts of E. crassipes were considered promising eco-friendly insecticidal alternatives in (Integrated Pest Management) IPM programs to control A. ipsilon worldwide.

Oral mucosa considered as one of defensive mechanism of oral cavity, it is important in oral functions as eating, swallowing and even talking. Any wound or discontinuity effects on these functions so speeding the healing process with less inflammatory reactions is crucial, many herbs were used at different eras to reach this goal one of these herbs is Acacia plant. The aim of this study is to evaluate the effect of acacia oral gel extract on the wound healing. In materials and method This study include (twenty-one) male rabbits, (seven) for each group used for this study, two incisions of one centimeter length were made on buccal oral mucosa bilaterally one is treated by acacia oral gel while other left for normal healing, the follow up of the wound at twenty-four hours, three days and seven days clinically and histopathological examination were done. In result of this study, The study shows decrease in inflammatory reaction after seventy-two hours of the wound and increase in re-epithelialization rate in wound healing of acacia nilotica gel group, So it is concluded from this study that the acacia plant gel extract has anti-inflammatory effect and accelerate the wound healing of oral mucosa in rabbits.

Objective: The purpose of this study was to investigate the influence of various factors on the outcome of intrauterine insemination (IUI) as a trial for improving the quality of health care provided for women with infertility problems as well as infertility center outcomes. Methods: Cohort study conducted over two years between December 2016 and December 2018 in IVFICSI center. Two hundred forty-nine couples diagnosed with different infertility etiologies underwent 487 cycles of IUI were enrolled. Ultrasound follicular measurements were recorded around time of ovulation as well as different factors were col- lected and compared between pregnant and non-pregnant groups. Main outcome measures were clinical pregnancy rate and risk of OHSS ac- cording to the woman’s age, BMI, infertility type, different etiology of female infertility, the ovulation drug used and the quantity and size of ovarian follicles before hCG injection. Setting: Department of Obstetrics and Gynecology, Suez Canal Uni- versity Hospitals, Ismailia. Results:Pregnancy was achieved in 21.4% of cycles enrolled in the anal- ysis being significantly higher in women with mean follicular diameter of leading follicle of (19.8 +/- 1.97mm) in women with shorter infertility duration. The highest pregnancy rate was achieved in third IUI cycle. Conclusion: Leading follicle mean diameter of 19.8 mm was the op- timum diameter to trigger the ovulation and to have pregnancy. Early treatment of infertility is recommended as the success rate of IUI seems to get less with longer duration of infertility.

ZusammenfassungIn Deutschland wurde der erste Patient mit SARS-Cov-2 Virus Infektion am 27. Januar 2020 in München bestätigt. Für uns als Plastische Chirurgen und Handchirurgen ist es von zentralerBedeutung, dass wir uns als verantwortungsbewusste Menschen und Ärzte dafür einsetzen, die Übertragung von Viren zu verringern und die Ressourcen zur Behandlung von Patienten, die an der Krankheit schwer erkrankt sind, frei geben. Die vorliegende Arbeit gibt einer Übersicht zu aktuellen Entwicklungen und Erkenntnissen für das Fachgebiet Plastische Chirurgie und für die Handchirurgie.Gleichzeitig müssen wir über unsere Fachgesellschaften aktiv Kriterien und Regularien zur Versorgung von an COVID-19 erkrankten Patienten mitgestalten, den Erhalt unserer Notfallversorgung sichern und sinnvolle Exit-Strategien erarbeiten. Naturgemäß kann dabei gerade bei der rasanten Entwicklung der Erkenntnisse in der aktuellen Pandemie nur eine Momentaufnahme gegeben werden.

In the last three decades, significant advances have been made in the care of children requiring renal replacement therapy (RRT). The move from the use of only hemodialysis and peritoneal dialysis to continuous venovenous hemofiltration with or without dialysis (continuous renal replacement therapy, CRRT) has become a mainstay in many intensive care units. The move to CRRT is the result of greater clinical experience as well as advances in equipment, solutions, vascular access, and anticoagulation. CRRT is the mainstay of dialysis in pediatric intensive care unit (PICU) for critically ill children who often have hemodynamic compromise. The advantages of this modality include the ability to promote both solute and fluid clearance in a slow continuous manner. Though data exist suggesting that approximately 25% of children in any PICU may have some degree of renal insufficiency, the true need for RRT is approximately 4% of PICU admissions. This article will review the history as well as the progress being made in the provision of this care in children.

Objective: To compare the early recovery after surgery (ERAS) pprotocol with the conventional one in women undergoing elective CS.Patients and Methods: The study included 96 women undergoing elective cesarean section for different reasons. They were randomly divided into two groups 48 patients each, Group (A) received the ERAS regimen and Group (B) was managed with the conventional care. Women with major medical or obstetric disorders were excluded.Results: Cases' age ranged between 18- 35 years without significant difference between groups. Also, gestational age, haemoglobin concentration and platelet count were comparable between groups. Intra and post-operative nausea and vomiting were significantly higher (p value

Environmental problems have always received immense attention from scientists. Toxicants pollution is a critical environmental concern that has posed serious threats to human health and agricultural production. Heavy metals and pesticides are top of the list of environmental toxicants endangering nature. This review focuses on the toxic effect of heavy metals (cadmium (Cd), lead (Pb), copper (Cu), and zinc (Zn)) and pesticides (insecticides, herbicides, and fungicides) adversely influencing the agricultural ecosystem (plant and soil) and human health. Furthermore, heavy metals accumulation and pesticide residues in soils and plants have been discussed in detail. In addition, the characteristics of contaminated soil and plant physiological parameters have been reviewed. Moreover, human diseases caused by exposure to heavy metals and pesticides were also reported. The bioaccumulation, mechanism of action, and transmission pathways of both heavy metals and pesticides are emphasized. In addition, the bioavailability in soil and plant uptake of these contaminants has also been considered. Meanwhile, the synergistic and antagonistic interactions between heavy metals and pesticides and their combined toxic effects have been discussed. Previous relevant studies are included to cover all aspects of this review. The information in this review provides deep insights into the understanding of environmental toxicants and their hazardous effects.

The first case of a SARS-Cov-2 virus infection was confirmed on January 27th in Munich. For both, plastic and hand surgeons it is crucial to act responsible, minimize the transmission of the virus and aid in reasonable and adequate allocation of resources for the treatment of affected patients during this pandemia. This article aims to provide an overview over the latest developments and insights that affect plastic and hand surgeons. At the same time plastic and hand surgeons are required to participate actively in the discussion of new regulatory measures that on one hand aim to ensure a proper medical care of COVID-19 patients and on the other hand need to guarantee coverage of all other patients. Furthermore exit - strategies after the pandemia need to be discussed by our societies. Naturally, this manuscript provides insight into the current situation, which might undergo changes due to the swift progression of the pandemia.In Deutschland wurde der erste Patient mit SARS-Cov-2 Virus Infektion am 27. Januar 2020 in München bestätigt. Für uns als Plastische Chirurgen und Handchirurgen ist es von zentralerBedeutung, dass wir uns als verantwortungsbewusste Menschen und Ärzte dafür einsetzen, die Übertragung von Viren zu verringern und die Ressourcen zur Behandlung von Patienten, die an der Krankheit schwer erkrankt sind, frei geben. Die vorliegende Arbeit gibt einer Übersicht zu aktuellen Entwicklungen und Erkenntnissen für das Fachgebiet Plastische Chirurgie und für die Handchirurgie.Gleichzeitig müssen wir über unsere Fachgesellschaften aktiv Kriterien und Regularien zur Versorgung von an COVID-19 erkrankten Patienten mitgestalten, den Erhalt unserer Notfallversorgung sichern und sinnvolle Exit-Strategien erarbeiten. Naturgemäß kann dabei gerade bei der rasanten Entwicklung der Erkenntnisse in der aktuellen Pandemie nur eine Momentaufnahme gegeben werden.

The application of liposuctioned white adipose tissue (L-WAT) and adipose-derived stem cells (ADSCs) as a novel immunomodulatory treatment option is the currently subject of various clinical trials. Because it is crucial to understand the underlying therapeutic mechanisms, the latest studies focused on the immunomodulatory functions of L-WAT or ADSCs. However, studies that examine the specific transcriptional adaptation of these treatment options to an extrinsic inflammatory stimulus in an unbiased manner are scarce. The aim of this study was to compare the gene expression profile of L-WAT and ADSCs, when subjected to tumor necrosis factor alpha (TNF&alpha, ), and to identify key factors that might be therapeutically relevant when using L-WAT or ADSCs as an immuno-modulator. Fat tissue was harvested by liposuction from five human donors. ADSCs were isolated from the same donors and shortly subjected to expansion culture. L-WAT and ADSCs were treated with human recombinant TNF&alpha, to trigger a strong inflammatory response. Subsequently, an mRNA deep nextgeneration sequencing was performed to evaluate the different inflammatory responses of L-WAT and ADSCs. We found significant gene expression changes in both experimental groups after TNF&alpha, incubation. However, ADSCs showed a more homogenous gene expression profile by predominantly expressing genes involved in immunomodulatory processes such as CCL19, CCL5, TNFSF15 and IL1b when compared to L-WAT, which reacted rather heterogeneously. As RNA sequencing between L-WAT and ADSCS treated with TNF&alpha, revealed that L-WAT responded very heterogeneously to TNF&alpha, treatment, we therefore conclude that ADSCs are more reliable and predictable when used therapeutically. Our study furthermore yields insight into potential biological processes regarding immune system response, inflammatory response, and cell activation. Our results can help to better understand the different immunomodulatory effects of L-WAT and ADSCs.

Human mesenchymal stromal cells (hMSCs) are the cellular source of new bone formation and an essential component of autologous bone grafts. Autologous bone graft harvesting is routinely conducted at the iliac crest, although alternative donor sites with lower complication rates are available. Thus, the aim of this study was to compare hMSCs harvested from the iliac crest and the proximal tibia regarding their proliferative and osteogenic differentiation capacity. Furthermore, we investigated the influence of donor age on these biological properties. HMSCs were isolated from iliac crest or proximal tibia bone grafts of 46 patients. Proliferative capacity was assessed by cumulative population doublings, population doubling time, colony forming units and cell proliferation assays. Osteogenic capacity was assessed by quantification of extracellular calcium deposition and marker gene expression levels. The number of hMSCs per gram harvested tissue was determined. Furthermore, the adipogenic and chondrogenic differentiation capacity were quantified using BODIPY and Safranin Orange staining, respectively. Additional analyses were carried out after grouping young (18-49 years) and aged (≥50 years) donors. HMSCs derived from the proximal tibia featured a comparable proliferative and osteogenic differentiation capacity. No significant differences were found for any analysis conducted, when compared to hMSCs obtained from the iliac crest. Furthermore, no significant differences could be revealed when comparing young and aged donors. This was equally true for hMSCs from both donor sites after comparison within the same age group. Our study demonstrates comparable biological properties of hMSCs derived from both donor sites, the iliac crest and the proximal tibia. Furthermore, aging does not alter proliferative and osteogenic differentiation capacity. Consequently, the proximal tibia should be considered more closely as an alternative donor site in patients of all age groups.

A simple portable spectrophotometer was constructed and used to perform analytical experiments. The developed model uses available tools and materials such as light emitting diode lamps, compact discs, plastic and cardboard boxes and a cell phone camera to build a design that illustrates the major components of spectrophotometers. The spectra of serial concentrations of KMnO4 (50‒600 μM) were recorded and the values of absorbance were extracted at λmax to build the calibration curve. A linear relationship between the concentration and absorbance was obtained with the coefficient of determination 0.994. The model was also utilized to study the spectra of KMnO4, phenolphthalein and bromothymol blue in comparison with a Shimadzu UV-1800 spectrophotometer as a reference instrument. In spite of the differences in the observed spectra, the recorded λmax were almost identical to those measured by the developed model. The model was successfully used to determine the concentration of sodium alendronate through ligand-exchange complexation with ferric salicylate.

Summary Background Adipose-derived stem/progenitor cells (ADSPCs) are under investigation in many clinical applications for their regenerative potential in a variety of autoimmune, degenerative, and inflammatory diseases. Adipose tissue, which is mainly harvested by manual liposuction, is the main source of these ADSPCs. Objective In the past years, a variety of different liposuction devices have been commercialized. To ensure a high quality of obtained ADSPCs, it is crucial to show the advantages and disadvantages of frequently used liposuction methods. For this reason, the objective of this study was to compare ADSPCs harvested by either the suction-assisted LipiVage200-5 or the water-assisted Body-Jet system. Methods The proliferation potential of ADSPCs, harvested from 20 patients, was assessed by cumulative population doublings (cumPD), population doubling time (PDT), colony-forming units (CFU), and cell metabolism assays. To prove the multipotency of the primary isolated cells, ADSPCs were induced to differentiate into adipogenic, osteogenic, and chondrogenic lineages. Results Our data show a significantly higher cumPD, as well as a significantly lower PDT for cells obtained by the Body-Jet system. No significant differences were found regarding the CFU efficiency and the cell metabolism. Furthermore, we showed that the adipogenic, osteogenic, and chondrogenic potential of ADSPCs is similar in both groups. Discussion/conclusion In our study, we provide evidence that the cell characteristics and the functional properties of ADSPCs isolated after liposuction with different techniques are largely similar. However, we observed a significantly higher cumPD and a slightly higher adipogenic potential in cells isolated after liposuction with the Body-Jet system. Different cannula sizes and sheer stresses in the used methods might play a role here.

Background Hirsutism is a common clinical condition encountered in day-to-day practice. The androgenic causes account for more than 80% of these patients and include polycystic ovary syndrome (PCOS), which affects about 70%-80% of hirsute women. The second most common cause is idiopathic hirsutism. Omentin-1 is an adipokine mainly produced by visceral adipose tissue. Aim The current study aimed at evaluating omentin-1 levels in hirsute females with PCOS and in idiopathic hirsutism. Patients and methods Eighty-five females were included in this study. They were classified into three groups: thirty hirsute patients with PCOS, thirty females with idiopathic hirsutism, and twenty-five healthy control females. The participants were subjected to history taking, physical and dermatological examination. A gynecological history and radiological examination of the ovary also were done. Serum testosterone and omentin-1 were measured by ELISA. Results Serum testosterone was statistically elevated in PCOS than other groups. Serum omentin-1 in females with idiopathic hirsutism was statistically significantly higher than control and PCOS. There was a significant inverse correlation between serum testosterone level and serum omentin-1 level. Conclusion Omentin-1 may be involved in the pathogenic process of hirsutism.

Objectives: To evaluate Doppler ultrasound and platelet indices for the prediction of preeclampsia (PE).Design: Prospective observational study.Methods: The study included 270 normal pregnancy prim...

Background.Catha edulisForsk. (Khat) is used for its psychoactive effects among people in Africa and the Arabian Peninsula, although its utilization is illegal in some countries such as Saudi Arabia. This study examined the pattern of Khat use and assessed the applicability of the Drug Abuse Screening Test-10 (DAST-10) to measure Khat dependence.Methods. A pretested questionnaire was used to gather data from 603 respondents. Variables included demographic characteristics, pattern of use, reasons for Khat chewing, and DAST-10. Stepwise-logistic regression was used to explore predictors of Khat dependence.Results. The majority of the respondents were married, had a secondary school level of education, were employed, were younger than 35 years old, and were living in rural areas. Many chewers gave more than one reason for using Khat. It was mainly used to increase mental capacity, physical strength, and social entertainment, as well as enhance cheerfulness and orgasms. Statistical modeling of Khat dependence suggested that the most significant predictors were residence (OR = 1.67,P<0.02), frequency of Khat chewing (OR = 4.8,P<0.01), age of starting Khat chewing (OR = 1.15,P<0.01), and time of Khat effect (OR = 1.15,P<0.04).Conclusion. Our study provides important information on the pattern of Khat use and its potential to cause dependence.