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Abstract Background Children with hearing impairment (HI) face communication challenges during dental procedures due to hearing loss. Studies suggest that distraction techniques, like virtual reality (VR), can effectively divert their focus from stressful stimuli, resulting in a more comfortable dental experience. The present study aims to assess the effectiveness of distracting children with moderate to severe (HI) with virtual reality glasses that show cartoons in sign language during pulpotomy treatment compared to conventional management techniques. Methods Forty children aged five to seven participated in a randomized controlled parallel two-arm clinical trial—the type of behavioral management employed determined which two groups children were randomly placed into. Group I (Study group) used virtual reality glasses as a diversion, while Group II (Control group) used the conventional behavior management approach. Local anesthesia was administrated, and a pulpotomy procedure was performed on the selected tooth, followed by stainless steel crown restoration (SSC). There were three methods used to assess dental anxiety before and after the procedure: the physiological method, which used heart rate (HR); the objective measure, which used the Venham Clinical Anxiety Scale (VCAS); and the subjective measure, which used the modified Facial Affective Scale (FAS). An independent t-test was employed for HR analysis of the difference between the groups as a continuous variable. The Pearson Chi-square test assessed differences between groups for categorical variables, such as (VCAS) (FAS). Results No significant differences were found in mean (HR) or (VCAS) between the two groups throughout the procedures: during local anesthesia (p = 0.659, 0.282), pulpotomy (p = 0.482, 0.451), and stainless steel crown preparation (p = 0.090, 0.284). Anxiety levels by (FAS) remained statistically comparable between the two groups before and after the procedures (p = 0.507, 0.749), respectively. Conclusions The use of VR glasses revealed no significant advantages in managing children with HI during the dental visit compared to the conventional method of child behavior management. Trial registration The trial was prospectively enrolled on 11/11/2023 under the identification number NCT06153823 on ClinicalTrials.gov.

Abstract Introduction The use of focal therapies for prostate cancer (PCa) has soared, as it controls disease and is associated with minimal side effects. Bibliometric analysis examines the global research landscape on any topic to identify gaps in the research and areas for improvement and prioritize future research efforts. This study aims to examine the research outputs and trends and collaboration landscape in the field of focal therapy for PCa on a global scale. Methods We searched Medline, PubMed and Scopus for peer‐reviewed publications on our research topic using controlled keywords. Search results were limited to the period between 1980 and 2022, screened for duplicates and then included in our study based on prespecified eligibility criteria. The Bibliometrix Package was used for comprehensive science mapping analysis of co‐authorship, co‐citation and co‐occurrence analysis of countries, institutions, authors, references and keywords in this field. Results This analysis included 2578 research articles. The annual scientific production increased from one article in 1982 to 143 in 2022 (13.21%). The average citation per year was incrementally increasing, and these documents were cited around 32.52 times. The documents included in this analysis were published in 633 sources. The international collaboration index was 22.7. In total, 6280 author keywords were identified. The most used keywords were ‘prostate cancer’, ‘focal therapy’, ‘prostate’ and ‘photodynamic therapy’. Conclusion This bibliometric analysis has provided a comprehensive review of focal therapy in PCa research, highlighting both the significant growth in the field and the existing gaps that require further exploration. The study points to the need for more diverse international collaboration and exploration of various treatment modalities within the context of focal therapy.

The burden of noncommunicable chronic diseases has relevant and negative consequences to persons, health care systems, and economies worldwide. Chronic diseases are the leading cause of disability and mortality and are responsible for 90% of health care expenditure. The most common chronic diseases are diabetes mellitus (DM), cardiovascular disease, and cerebrovascular disease (stroke and vascular cognitive impairment). Modifiable risk factors (MRFs) for these conditions include hypertension, hyperlipidemia, smoking, poor diet, and low-physical activity; with hypertension being the most prevalent MRF. Most MRFs can be successfully targeted through lifestyle medicine (LSM), which is a medical specialty that addresses the root causes of chronic diseases through its primary, secondary, and tertiary preventative approaches. Lifestyle medicine comprises 6 pillars (nutrition, physical activity, sleep health, stress reduction, social connections, and substance use) which through various behavioral approaches, focus on regular physical activity, healthy eating, good quality and quantity sleep, and meaningful social connections coupled with the reduction of stress and substance use. This paper will briefly review the evidence and promise of individual LSM pillars in addressing the underlying MRFs of DM, cardiovascular and cerebrovascular disease (specifically stroke and vascular cognitive impairment). Lifestyle medicine holds a great promise for comprehensive and much improved population health. However, the adoption of LSM at the societal scale requires a multifaceted approach and widespread integration would galvanize a paradigm shift to prevent, treat or reverse chronic diseases from the root causes and achieve health equity.

Introduction Stroke and vascular cognitive impairment (VCI) are major global public health pandemics. The increased incidence of stroke and VCI is in part due to modifiable risk factors (MRFs), with hypertension (HTN) being the strongest single MRF. Even though the underlying causes of HTN are multifactorial, lifestyle choices (eg, poor diet, physical inactivity, alcohol consumption) are chief contributors. Lifestyle medicine (LSM) is a medical and evidence-based discipline that is a promising approach for preventing stroke and cognitive impairment, including VCI. The empirical evidence from systematic reviews, meta-analyses and large population-based studies has reported on the effectiveness of LSM interventions. However, the evaluation of such complex, social and behavioural interventions warrants more information to allow its successful implementation into innovative clinical care models. More importantly, we need to understand how such interventions work, who it works for and under what circumstances to successfully manage HTN and other MRFs (eg, hyperlipidaemia, smoking, alcohol use and diet).Methods and analysis This realist review will follow the Realist and Meta-narrative Evidence Synthesis: Evolving Standards. The review will comprise four stages: (1) clarify the scope, (2) search for the evidence, (3) critically appraise primary studies and extract data focusing on the context, mechanism and outcome configuration and (4) synthesise evidence and draw conclusions.Ethics and dissemination Research ethics board approval is not required for this review. The primary output of this review will be an evidence-based programme theory for LSM interventions for the management of HTN and other MRFs to reduce the risk of stroke and VCI. Findings from this review will be disseminated at three levels: micro (eg, patients, caregivers, clinicians, non-research partners), meso (eg, public, national not-for-profit organisations, professional associations and centres) and macro (eg, policymakers and government partners).PROSPERO registration number CRD42024511566.

IntroductionThe 21-point Brain Care Score (BCS) is a novel tool designed to motivate individuals and care providers to take action to reduce the risk of stroke and dementia by encouraging lifestyle changes. Given that late-life depression is increasingly recognized to share risk factors with stroke and dementia, and is an important clinical endpoint for brain health, we tested the hypothesis that a higher BCS is associated with a reduced incidence of future depression. Additionally, we examined its association with a brain health composite outcome comprising stroke, dementia, and late-life depression.MethodsThe BCS was derived from the United Kingdom Biobank baseline evaluation in participants with complete data on BCS items. Associations of BCS with the risk of subsequent incident late-life depression and the composite brain health outcome were estimated using multivariable Cox proportional hazard models. These models were adjusted for age at baseline and sex assigned at birth.ResultsA total of 363,323 participants were included in this analysis, with a median BCS at baseline of 12 (IQR: 11-14). There were 6,628 incident cases of late-life depression during a median follow-up period of 13 years. Each five-point increase in baseline BCS was associated with a 33% lower risk of incident late-life depression (95% CI: 29%-36%) and a 27% lower risk of the incident composite outcome (95% CI: 24%-30%).DiscussionThese data further demonstrate the shared risk factors across depression, dementia, and stroke. The findings suggest that a higher BCS, indicative of healthier lifestyle choices, is significantly associated with a lower incidence of late-life depression and a composite brain health outcome. Additional validation of the BCS is warranted to assess the weighting of its components, its motivational aspects, and its acceptability and adaptability in routine clinical care worldwide.

In this study, a silver nanoparticle (AgNPs) was created using a biological technique from an extract of the fungus Metarhizium anisopliae. The characteristics of the prepared AgNPs were identified by utilizing the optical, ultraviolet, and infrared absorbance spectroscopy. The shape, size, and charge distribution on the particles were determined by using scanning electron microscopy and zeta voltage analysis. The analysis of biological activity of the silver nanoparticles showed its effectiveness in treating pollutants, as confirmed by the reduction of higher than 93% weight of crude oil in contaminated water samples. The crude oil mass was effectively transformed into the gelatinous mass that lacks consistency and emulsification. The chemical analysis of NP-treated and untreated crude oil- contaminated water samples was performed using gas chromatography mass spectrometry (GC MASS). The results displayed the emergence of 55 graphic peaks, each of them indicating a chemical compound, in the control sample, while in the study sample, about 51 of these peaks disappeared and the area of the remaining 4 peaks was reduced. The silver nanoparticles' capability to maintain their effectiveness under cryogenic storage conditions for six months was tested and compared to that of the fungal isolation before the production of the silver nanoparticles. The results showed no significant changes in the shape, size, and efficiency of the silver nanoparticles in the treatment of oil pollutants in water. The results indicated the higher efficiency of the silver nanoparticles, as compared to chemicals, in treating petroleum pollutants as well as enhancing the solubility, emulsification, and degradation of hydrocarbons. In addition, the AgNPs are characterized by the availability of inexpensive, easy, fast to produce, and environmentally friendly production materials, as compared to the usage of chemical products that are highly toxic to aquatic organisms, expensive to produce, and highly accumulative in the ecosystem, i.e. environmentally unsafe.

BackgroundStroke incidence among young adults of working age (under 65 years of age) has significantly increased in the past decade, with major individual, social, and economic implications. There is a paucity of research exploring the needs of this patient population. This study assessed: (1) young adult stroke patients' physical, psychological, and occupational functioning and health-related quality of life (HRQoL); and (2) post-stroke care preferences using patient-reported outcome measures (PROMs), with attention to gender differences.MethodsA cross-sectional pilot study was conducted. Sociodemographic and clinical characteristics were collected through chart review and data on occupational function, physical, psychological, and social wellbeing >90 days post-stroke through a self-reported survey. Descriptive statistics, gender-based, and regression analyses were conducted.ResultsThe sample included 85 participants. Participants reported impairments in both, occupational functioning, with 58.7% not returned to work (RTW), and HRQoL, specifically with social activities (37%), anxiety (34%), and cognitive function (34%). Women had significantly (p < 0.05) worse physical symptoms (sleep disturbance and fatigue), emotional health (depression, stigma, emotional dyscontrol) scores, and sense of self-identify post-stroke. Over 70% of participants preferred in-person post-stroke care led by health care providers and felt they would have benefited from receiving information on physical health (71.4%), emotional and psychological health (56.0%), RTW (38.1%), and self-identity (26.2%) post-stroke. Women preferred cognitive behavioral therapy (p = 0.018) and mindfulness-based stress reduction therapy (p = 0.016), while men preferred pharmacotherapy (p = 0.02) for psychological symptoms.ConclusionThis is the first study to report impaired HRQoL, psychological and occupational functioning using PROMs, with significant gender differences and preferences for post-stroke care delivery among young adult stroke patients at >90 days after stroke. The findings highlight the importance of needs, gender, and age-specific post-stroke education and interventions.

Background: The level of awareness of peripheral artery disease (PAD) in Saudi Arabia, especially among populations at high risk, is not currently well known. Therefore, our objective was to assess the existing level of awareness among patients who are at high risk of PAD, as well as their comprehension of the disease. Method: An interview-based cross-sectional study included 1035 participants with risk factors for PAD and collected data on demographics and knowledge domains related to PAD. Results: The statistical analysis was performed using t-tests and ANOVA. Overall, participants exhibited poor knowledge, with a mean score of 5.7 out of 26. The highest scores were observed in the risk factor and preventive measure domains, with means of 1.8 out of 7 and 1.8 out of 6, respectively. The factors associated with higher knowledge scores included older age, male gender, higher education, healthcare profession, interviews in vascular settings, previous awareness of PAD, and prior cardio-cerebrovascular interventions. Conclusion: This study underscores the inadequate knowledge of PAD among high-risk individuals. Targeted educational initiatives are essential to bridge this knowledge gap, potentially reducing the burden of PAD-related complications and improving patient outcomes. Efforts should focus on raising awareness about PAD, particularly among high-risk populations.

الملخص: يتزايد التهديد العالمي للأمراض غير المعدية (NCDs) بشكل مثير للقلق. العبء الصحي والاقتصادي لاختيارات نمط الحياة غير الصحي هائل. ثبت أن الحد من عوامل الخطر القابلة للتعديل يمنع الأمراض المزمنة بشكل كبير. في هذا الوقت الحرج ، تلقى طب نمط الحياة (LM) اعترافًا جديدًا كمجال طبي قائم على الأدلة. من بين الأدوات المختلفة المستخدمة في طب نمط الحياة ، تأتي المقابلات التحفيزية (MI) كنهج استشاري تشاركي يركز على المريض. في هذه المقالة المستندة إلى الأدلة ، حاولنا إلقاء الضوء على الأدبيات الحديثة حول تطبيق MI على ركائز LM الستة التي حددتها الجمعية البريطانية لـطب نمط الحياة(LM (BSLM): الأكل الصحي ، والرفاهية العقلية ، والعلاقات الصحية ، والنشاط البدني ، التقليل من المواد الضارة والنوم الصحي. يساعد نهج (MI) في تقوية الجوانب التحفيزية للمرضى لمحاربة المشاكل الصحية المتأثرة بالسلوك ، وتحسين الالتزام بالعلاج ، وتحسين التدخلات الطبية. تحقق تدخلات MI الصحيحة من الناحية الفنية والمتطابقة نظريًا والسليمة من الناحية النفسية نتائج مرضية وتساعد على تحسين نوعية حياة المرضى. غالبًا ما يكون تغيير نمط الحياة عملية تدريجية تنطوي على جهود ونكسات متعددة. يعمل نهج MI على أساس أن التغيير عملية وليس حدثًا. الأدلة الأدبية حول فوائد نهج MI واسعة ، والبحث حول تطبيق MI يكتسب اهتمامًا عبر جميع ركائز طب نمط الحياة. تخدم MI الأشخاص لتغيير أفكارهم ومشاعرهم حول إجراء تغيير من خلال التعرف على ما يمنعهم من بدء عملية التغيير. حتى التدخلات ذات المدة الأقصر أثبتت قدرتها على تحقيق نتائج أفضل. يجب أن يتعلم المتخصصون في الرعاية الصحية أهمية وارتباط MI في الممارسة السريرية. Abstract: The global threat of noncommunicable diseases (NCDs) is alarmingly increasing. The health and economic burden of improper lifestyle choices is immense. Reducing modifiable risk factors has been demonstrated to significantly prevent chronic diseases. At this crucial time, lifestyle medicine (LM) has been recognized as an evidence-based medical domain applicable to NCDs. Among the tools used in LM, motivational interviewing (MI) is a patient-centered, collaborative counseling approach. In this evidence-based review article, we discuss recent literature on the application of MI in the six LM pillars defined by the British Society of LM (BSLM): healthy eating, mental wellbeing, healthy relationships, physical activity, minimizing harmful substances, and sleep. MI helps strengthen patients’ motivation to ameliorate behaviorally influenced health problems, improve treatment adherence, and optimize medical interventions. Technically correct, theoretically congruent, and psychometrically sound MI interventions yield satisfactory outcomes and help improve patient quality of life. Lifestyle change is often a gradual process involving multiple efforts and setbacks. MI is based on the idea that change is a process rather than an event. Extensive literature evidence supports the benefits of MI treatment, and interest in research on MI application is increasing across all BSLM pillars. MI helps people alter their thoughts and feelings about making changes by recognizing obstacles to change. Even interventions of short duration have been reported to yield better outcomes. Healthcare professionals must understand the relevance and importance of MI in clinical practice.

The inflammatory reaction is induced by several factors like stimulation of different enzymes, oxidative stress, and production of various proinflammatory mediators. Here, we elucidated the phytochemical profile of Euphorbia milii ethanol extract (EMEE) then, we studied its anti-inflammatory potential using a carrageenan-induced paw edema model in rats. It was found that the average paw edoema weight substantially declined (p

Background and Objectives: Screening for type 2 diabetes mellitus (DM2) aims to identify asymptomatic individuals who may be at a higher risk, allowing proactive interventions. The objective of this study was to predict the incidence of DM2 and prediabetes in the Saudi population over the next five years. Materials and Methods: The study was conducted in the Aseer region through August 2023 using a cross-sectional survey for data collection. A multistage stratified random sampling technique was adopted, and data were collected through face-to-face interviews using the validated Arabic version of the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). Results: In total, 652 individuals were included in the study. Their mean age was 32.0 ± 12.0 years; 53.8% were male, 89.6% were from urban areas, and 55.8% were single. There were statistically significant differences between males and females in AUSDRISK items, including age, history of high blood glucose, use of medications for high blood pressure, smoking, physical activity, and measurements of waist circumference (p < 0.05). Based on AUSDRISK scores, 46.2% of the included participants were predicted to develop impaired glucose tolerance within the coming five years (65.8% among females vs. 23.6%), and 21.9% were predicted to develop DM2 (35.6% among males vs. 6.0% among females); this difference was statistically significant (p = 0.0001). Conclusions: Urgent public health action is required to prevent the increasing epidemic of DM2 in Saudi Arabia.

The increasing rates of morbidity and mortality owing to bacterial infections, particularly Staphylococcus aureus have necessitated finding solutions to face this issue. Thus, we elucidated the phytochemical constituents and antibacterial potential of Cleome droserifolia extract (CDE). Using LC-ESI-MS/MS, the main phytoconstituents of CDE were explored, which were kaempferol-3,7-O-bis-alpha-L-rhamnoside, isorhamnetin, cyanidin-3-glucoside, kaempferide, kaempferol-3-O-alpha-L-rhamnoside, caffeic acid, isoquercitrin, quinic acid, isocitrate, mannitol, apigenin, acacetin, and naringenin. The CDE exerted an antibacterial action on S. aureus isolates with minimum inhibitory concentrations ranging from 128 to 512 µg/mL. Also, CDE exhibited antibiofilm action using a crystal violet assay. A scanning electron microscope was employed to illuminate the effect of CDE on biofilm formation, and it considerably diminished S. aureus cell number in the biofilm. Moreover, qRT-PCR was performed to study the effect of CDE on biofilm gene expression (cna, fnbA, and icaA). The CDE revealed a downregulating effect on the studied biofilm genes in 43.48% of S. aureus isolates. Regarding the in vivo model, CDE significantly decreased the S. aureus burden in the liver and spleen of CDE-treated mice. Also, it significantly improved the mice’s survival and substantially decreased the inflammatory markers (interleukin one beta and interleukin six) in the studied tissues. Furthermore, CDE has improved the histology and tumor necrosis factor alpha immunohistochemistry in the liver and spleen of the CDE-treated group. Thus, CDE could be considered a promising candidate for future antimicrobial drug discovery studies.

Doxorubicin (DOX)-induced cardiotoxicity (DIC) is a life-threatening clinical issue with limited preventive approaches, posing a substantial challenge to cancer survivors. The anthraquinone diacerein (DCN) exhibits significant anti-inflammatory, anti-proliferative, and antioxidant actions. Its beneficial effects on DIC have yet to be clarified. Therefore, this study investigated DCN’s cardioprotective potency and its conceivable molecular targets against DIC. Twenty-eight Wister rats were assigned to CON, DOX, DCN-L/DOX, and DCN-H/DOX groups. Serum cardiac damage indices, iron assay, oxidative stress, inflammation, endoplasmic reticulum (ER) stress, apoptosis, ferritinophagy, and ferroptosis-related biomarkers were estimated. Nuclear factor E2-related factor 2 (NRF2) DNA-binding activity and phospho-p53 immunoreactivity were assessed. DCN administration effectively ameliorated DOX-induced cardiac cytomorphological abnormalities. Additionally, DCN profoundly combated the DOX-induced labile iron pool expansion alongside its consequent lethal lipid peroxide overproduction, whereas it counteracted ferritinophagy and enhanced iron storage. Indeed, DCN valuably reinforced the cardiomyocytes’ resistance to ferroptosis, mainly by restoring the NRF2/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) signaling axis. Furthermore, DCN abrogated the cardiac oxidative damage, inflammatory response, ER stress, and cardiomyocyte apoptosis elicited by DOX. In conclusion, for the first time, our findings validated DCN’s cardioprotective potency against DIC based on its antioxidant, anti-inflammatory, anti-ferroptotic, and anti-apoptotic imprint, chiefly mediated by the NRF2/SLC7A11/GPX4 axis. Accordingly, DCN could represent a promising therapeutic avenue for patients under DOX-dependent chemotherapy.

IntroductionThe 21-point Brain Care Score (BCS) was developed through a modified Delphi process in partnership with practitioners and patients to promote behavior changes and lifestyle choices in order to sustainably reduce the risk of dementia and stroke. We aimed to assess the associations of the BCS with risk of incident dementia and stroke.MethodsThe BCS was derived from the United Kingdom Biobank (UKB) baseline evaluation for participants aged 40–69 years, recruited between 2006–2010. Associations of BCS and risk of subsequent incident dementia and stroke were estimated using Cox proportional hazard regressions, adjusted for sex assigned at birth and stratified by age groups at baseline.ResultsThe BCS (median: 12; IQR:11–14) was derived for 398,990 UKB participants (mean age: 57; females: 54%). There were 5,354 incident cases of dementia and 7,259 incident cases of stroke recorded during a median follow-up of 12.5 years. A five-point higher BCS at baseline was associated with a 59% (95%CI: 40-72%) lower risk of dementia among participants aged 59 years. A five-point higher BCS was associated with a 48% (95%CI: 39-56%) lower risk of stroke among participants aged 59.DiscussionThe BCS has clinically relevant and statistically significant associations with risk of dementia and stroke in approximately 0.4 million UK people. Future research includes investigating the feasibility, adaptability and implementation of the BCS for patients and providers worldwide.

Background and objective: Asthma is a common disease that has a significant influence on patients’ quality of life. Although Arabic tools for assessing symptom control and quality of life in individuals with asthma are available, no sufficient studies have evaluated the validity of these tools. Therefore, the aim of the current study was to validate the Arabic version of these tools. Methods: Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted on the Arabic versions of the Asthma Control Test (ACT) and Mini Asthma Quality of Life Questionnaire (Mini AQLQ). Results: A total of 314 participants (70.1 % females) were enrolled in the current study. The mean age of the participants was 51.47 (±16.37). EFA suggested a three-factor model for Mini AQLQ and a one-factor model for ACT, which was confirmed by CFA analyses. High correlations were found between spirometric values and ACT and Mini AQLQ scores, indicating good concurrent validity. The area under the curve produced by the Roc curve was 0.861 (p

Zingiber and Alpinia species (family: Zingiberaceae) are popularly used in food as spices and flavoring agents and in ethnomedicine to heal numerous diseases, including immune-related disorders. However, their ethnomedicinal uses have not been sufficiently supported by scientific investigations. Numerous studies on the modulating effects of plants and their bioactive compounds on the different steps of the immune system have been documented. This review aimed to highlight up-to-date research findings and critically analyze the modulatory effects and mechanisms of the extracts and secondary compounds of several Zingiber and Alpinia species, namely, Zingiber officinale Roscoe, Z. cassumunar Roxb., Z. zerumbet (L.) Roscoe ex Sm., Alpinia galanga Linn., A. conchigera Griff, A. katsumadai Hayata, A. oxyphylla Miq., A. officinarum Hance, A. zerumbet (Pers.) Burtt. et Smith, and A. purpurata (Viell.) K. Schum. on the immune system, particularly via the inflammation-related signaling pathways. The immunomodulating activities of the crude extracts of the plants have been reported, but the constituents contributing to the activities have mostly not been identified. Among the extracts, Z. officinale extracts were the most investigated for their in vitro, in vivo, and clinical effects on the immune system. Among the bioactive metabolites, 6-, 8-, and 10-gingerols, 6-shogaol, and zerumbone from Zingiber species and cardamomin, 1′-acetoxychavicol acetate, yakuchinone, rutin, 1,8-cineole, and lectin from Alpinia species have demonstrated strong immunomodulating effects. More experimental studies using cell and animal models of immune-related disorders are necessary to further understand the underlying mechanisms, together with elaborate preclinical pharmacokinetics, pharmacodynamics, bioavailability, and toxicity studies. Many of these extracts and secondary metabolites are potential candidates for clinical development in immunomodulating agents or functional foods to prevent and treat chronic inflammatory disorders.

Owing to the spread of resistance between pathogenic bacteria, searching for novel compounds with antibacterial activity is essential. Here, we investigated the potential antibacterial activity of Greek clover or Trigonella foenum-graecum herb extract on Salmonella typhimurium clinical isolates. The chemical profile of the herb was initially determined using LC-ESI-MS/MS, which explored 36 different compounds. Interestingly, the fenugreek extract possessed antibacterial action in vitro with minimum inhibitory concentrations of 64 to 512 µg/mL. The potential mechanism of action was studied by elucidating the effect of the fenugreek extract on the membrane properties of S. typhimurium bacteria, including the inner and outer membrane permeability and membrane integrity. Remarkably, the fenugreek extract had detrimental effects on the membrane properties in 40–60% of the isolates. Moreover, the in vivo antibacterial action was studied using a gastrointestinal infection model with S. typhimurium bacteria. Interestingly, the fenugreek extract (200 mg/kg) improved the infection outcomes in the tested mice. This was represented by the noteworthy decrease (p < 0.05) in the bacterial count in the small intestine and caecum tissues. The survival rate of the fenugreek-extract-treated mice significantly increased compared to the S. typhimurium-infected group. Additionally, there was an improvement in the histological and immunohistochemical features of tumor necrosis factor-alpha. In addition, using an ELISA and qRT-PCR, there was an improvement in the proinflammatory and oxidative stress markers in the fenugreek-extract-treated group. Consequently, fenugreek extract should be investigated further on other food pathogens.

Background: The Syrian crisis has resulted in one of the worst humanitarian disasters in modern history. Inadequate access to and use of sexual and reproductive health services is a prevailing issue among adolescent girls and young refugee women in humanitarian settings. Objectives: This article aimed to explore and describe the perceived extent of implementation of the different objectives and activities outlined within the minimum initial service package for reproductive health in crisis services in Lebanon, from the perspectives of a diverse set of stakeholders from leading organizations (public, private, primary health centers, nongovernmental organizations) that were directly engaged with the Syrian refugee crisis response. Design: This study is a cross-sectional survey conducted using a standardized and validated questionnaire. Methods: Centers that provided sexual and reproductive health services to Syrian refugees in Lebanon were mapped. The study was based on a purposive sampling approach, retrieving 52 eligible organizations to cover most areas in the country. A total of 43 centers accepted to take part in the study. The head of the center was then asked to identify one person in their center who holds adequate knowledge of the explained objectives of the survey. Accordingly, the identified person was asked to fill out the survey. Results: A considerable portion of the respondents had limited knowledge about the specific minimum initial service package objectives and related sexual and reproductive health services. The study found the presence of a leading reproductive health agency, the Lebanese MoPH, as an essential facilitating factor for sexual and reproductive health service provision in Lebanon and has helped in overseeing the overall sexual and reproductive health coordination response for Syrian refugees (76.74% of all respondents). The identified challenges impeding adequate sexual and reproductive health services provision for Syrian refugees included (1) insufficient supplies (46.51%); (2) insufficient funds (39.53%); and (3) shortage of staff (39.53%). Conclusion: The recommendations for improved sexual and reproductive health service provision include the need for (1) enforcing the lead minimum initial service package agency for adequate and effective coordination, reporting, and accountability and (2) increasing funding for training staff and healthcare workers, as well as improving the overall quality of services available with the inclusion of family planning services, purchasing the necessary commodities, supplies and equipment, and covering fees associated with the different sexual and reproductive health services.

Abstract Background Infant and young child feeding practices (IYCF) impact the early and later health status of the population. Limited data is available regarding IYCF in the United Arab Emirates (UAE). This study aimed to evaluate the nutritional status and adequacy of feeding practices, energy, food, and nutrient intakes of UAE infants and toddlers ages 0-23.9 months. Methods This study is a population-based cross-sectional survey of 276 infants and toddlers aged 0-23.9 months of which 180 were nationals and 96 were Arab non-nationals living in the UAE. Data were collected from the three major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometry was collected and assessed using WHO Anthro-Survey Analyzer, and a multicomponent age-specific questionnaire was used to evaluate IYCF and sociodemographic characteristics. Usual intake of energy, micronutrients, and macronutrients, including supplements, were collected using multiple-pass 24-h dietary recall and analyzed using the PC-side software. IYCF practices were assessed using the WHO indicators. Results Overall, 4% of children were malnourished, 8% wasted, 15% stunted, 18% at risk of overweight, and 7% overweight and obese. 95% of infants were ever breastfed and 37% exclusively breastfed at 6 months. Around 98% of infants had a timely introduction of complementary food. Macronutrient intake exceeded AMDR for fat, carbohydrates, and protein for 27%, 8% and 2% of toddlers respectively. As for the percentage of those exceeding the ESPGHAN cut-off for free sugars set at 5% of energy intake, 28.6% had excessive intakes overall, 10% in 0-5.9, 21.9% in 6-11.9 and 56.7% in 12-23.9 month. Usual iron intake was below the Estimated Average Requirement (EAR) in 47% of infants 6-11.9 months. Above 12 months, the usual intake of iron and vitamin D were below EAR in 11% and 49% of toddlers respectively. Usual intake exceeded the tolerable upper intake levels (UL) for vitamin A (14 to 18%) and zinc (11 to 22%) across all ages. Approximately 93% of toddlers ages 12–23.9 months did not meet food groups’ recommendations for vegetables, 87% for fruits, 48% for milk/dairy, 54% for lean meat and beans, and 33% for grains. Conclusions This study revealed that a high percentage of infants and toddlers aged 0-23.9 m suffer from a double burden of malnutrition, which is the coexistence of both undernutrition, and overweight and obesity in the same population. In addition to suboptimal feeding practices and inadequate/overconsumption of various nutrients. The findings highlight the need for the development of culturally specific programs aiming to improve the nutritional status of infants and toddlers in the UAE.

Background and Aim. The chronicity of type 1 diabetes (T1D) and the demanding nature of care needed to maintain adequate glycemic control expose adolescents with T1D to various psychosocial disorders including depression. We aimed to study the frequency and risk factors of depressive symptoms in adolescents with T1D in Jordan. Methods. The study was conducted by distributing the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to adolescents with T1D seen at Jordan University Hospital between February 2019 and February 2020. Demographic, clinical, and socioeconomic data were collected using electronic clinical charts. Possible predictors of depression were assessed using logistic regression analysis. Results. A total of 108 children were enrolled in the study with mean age of 13.7±2.3 years. Fifty-eight children (53.7%) had a CES depression score less than 15, and 50 children (46.3%) had a depression score of 15 or more. The number of diabetes-related hospital admissions and the frequency of self-monitoring of blood glucose (SMBG) were significantly different between the two groups. In the multivariable analysis, both gender and SMBG frequency were statistically significant. Girls were more likely to have a depression score≥15 (OR=3.41, p=0.025) than boys. Patients who were rarely testing blood glucose levels were more likely to have a depression score≥15 compared to those who were testing regularly (OR=36.57, p=0.002). Conclusion. The prevalence of depressive symptoms is relatively high in adolescents with T1D, especially in those living in developing countries. Longer diabetes duration, higher glycated hemoglobin level, and less frequent blood glucose monitoring are associated with higher depression scores.

The COVID-19 pandemic affected public health, economy, social life, and the environment. It infected and killed millions of people around the world. Most of the recent literature has focused on the medications to combat this virus, including antivirals and vaccines, but studies about its effect on the environment are still rare, particularly on the water sector. Most of the studies concentrate on the effect of water availability on COVID-19, the effect of the used medications on the water, and the probability of transmission of SARS-CoV-2 through water. Herein, we have summarized the effects of COVID-19 on the water sector from many perspectives. We show different methods to detect the effect of the pandemic on water and also methods to investigate the presence of the virus or its RNA in the water. We also show the different effects of its presence in the wastewater, the probability of transmission, the detection of different variants, and the prediction of new waves. We also show the disadvantages and advantages of the pandemic in the water sector. We finally suggest some recommendations to face this pandemic and the future pandemics for the governments and water policymakers, water treatment plants, general population, and researchers. The aim of this review is to show the different aspects of the pandemic in order to give a general idea about what must be done in order to minimize its effect and any probable pandemic in the future.

Palestine, since 1948, has endured frequent military occupations and uprisings, intifadas, in a limited geographic area that has resulted in one of the worst humanitarian crises. The prolonged nature of this military occupation has created a biosphere of war that is uninhabitable, whereby Palestinians suffer from physical, psychological, and social wounds. Israel also imposed restrictive measures in Gaza, making it difficult for Palestinians to obtain permits to work and travel throughout Palestine. Israel continued to intensify the restrictions on Gaza, reaching a blockade on the Gaza Strip, which cut off Palestinians from Jerusalem, where hospitals, banks, and vital services are found. This form of permanent siege resulted in a surge in the unemployment rate, poverty, and poor nutritional and wellbeing status. The siege also resulted in the largest open-air prison, as people became stuck between an incomplete life and the absence of total death. The major challenge is that humanitarian interventions, in the case of Gaza, are ineffective, as they are part of the siege framework. This is because any humanitarian aid meant for Gaza needs to be approved by Israel. Thus, when the emergency becomes chronic and humanitarian interventions become part of the siege framework, how can Gaza rebuild its health capacity in a permanent emergency, and to what extent can the humanitarian sector make a change?

BackgroundThe COVID-19 pandemic has strained health systems world wide. In our region, surging numbers of critically ill adult patients demanded urgent system-wide responses. During the peak of the pandemic, our Pediatric Intensive Care Unit (PICU) team redesigned the existing educational resources and processes of care to ensure for adult patients for the first time in the hospital’s history.AimDescribe the experiences and impacts of the rapidly initiated Adult COVID-19 Program on health care providers (HCP) and family members. Havelock’s Theory of Change framed the examination of Adult COVID-19 Program participant experiences and surfaced lessons learned.Materials and MethodsA quality improvement review was employed to collect feedback about the program experience from the health care team and patient’s family members. HCP completed a questionnaire 10 months following the implementation of the program and feedback from family members was provided during the program was obtained. Havelock’s Theory of Change was used to explore trends and frame participants’ experiences.ResultsPediatric Intensive Care Unit bedside team members and clinical leaders (n = 17), adult hospital partners (n = 3), and family members (n = 8) participated. HCP describe; motivation and readiness; concern for personal safety and uncertainty experienced in the early program phases; the importance of supports and resources; use of relationships and collaboration to facilitate change; the emotional impacts of this unique experience; and opportunities for individual and team growth. An overarching theme of ‘doing our part to help’ emerged. Family members described the positive impacts of family-centered interventions offered, individualized care, and shock at their family member’s illness.ConclusionThe PICU team rapidly adapted to provide care for adults at the peak of the pandemic. Family members expressed feeling grateful for the care their loved ones received in the pediatric setting. The experience of caring for adult patients with COVID-19 was a source of tension, personal growth, and meaning for the pediatric intensive care team.

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in clinical practice and is a common comorbidity in hemodialysis patients. AF contributes to cardiovascular complications; therefore, it is recommended to screen for AF in high-risk patients to prevent serious complications. As we currently lack a handy AF screening tool, the aim of this study was to assess the accuracy of a modified BP monitor (Omron M6), in detecting AF in hemodialysis patients. In a cross-sectional analysis conducted from October 2018 to February 2019, we enrolled all the hemodialysis patients, older than 18 years and maintained on hemodialysis for at least 3 months in four hemodialysis centers in Jordan. Logistic regression was used to predict the accuracy, while the R package (epiR) was used to determine the sensitivity and specificity of the Omron M6 in screening AF. A total of 227 patients participated in the study, with a median age of 57 years (42.8-67.3); among these, 44.5% were female. Of all the participants, 18 were detected with AF, which was confirmed by a 12-lead ECG. The prevalence of AF in our study was 7.9%, while the sensitivity, specificity and accuracy of the Omron M6 in detecting AF were calculated as 83.0% (95% CI, 59.0-96.0), 94.0% (95% CI, 90.0-97.0) and 93.4% (95% CI, 88.0-95.0) respectively. We concluded that Omron M6 has high sensitivity, specificity, and accuracy in screening AF among hemodialysis patients. However, further studies are required to ascertain and firmly establish this preliminary finding.

Background: The concept of Healthy City has been widely accepted globally and has been established in all six World Health Organization (WHO) regions. Community involvement, empowerment, and leadership are embedded core principles in the Healthy Cities initiative and pillars to achieve the health and health-related sustainable development goals. This article aimed to present the findings of the recent evaluation of eleven healthy cities in the WHO Eastern Mediterranean Region (EMR). Methods: The evaluation was based on the 80 indicators of a WHO/EMRO Healthy City. It included eleven cities (Al-Dariyah, Jalajil, Al-Jamoum, Unaiza, Riyadh Alkhubra, Sharoura, Al-Madina, Al-Taif, and Al-Mundaq in Kingdom of Saudi Arabia; Al-Yarmouk in Kuwait, and Manama in Bahrain). Results: The findings revealed that eleven cities were peculiar in demonstrating community involvement, empowerment, and leadership in real terms. All had proper mechanisms for their communities to voice themselves and participate in decision-making, assessing the needs, setting priorities, planning better for their cities, and monitoring. Their community engagement was based on voluntarism with a high sense of loyalty. This feature has been well demonstrated in their community organizations, such as women and youth groups, health volunteers, community-based organizations, etc. Conclusion: Although community participation and empowerment remain at the heart of the healthy cities initiative, to be more meaningful, the government-related sectors must foresee this as an integral part of long-term strategic development. Moreover, a paradigm shift towards a more integrated approach to promote health and well-being would accelerate the achievement of health-related sustainable development goals and reduce health inequities in urban settings which would require multi-stakeholder collaboration, including public, private, and community civil societies.

Abstract Background Sugars and triglycerides are common carbon sources for microorganisms. Nonetheless, a systematic comparative interpretation of metabolic changes upon vegetable oil or glucose as sole carbon source is still lacking. Selected fungi that can grow in acidic mineral salt media (MSM) with vegetable oil had been identified recently. Hence, this study aimed to investigate the overall metabolite changes of an omnipotent fungus and to reveal changes at central carbon metabolism corresponding to both carbon sources. Results Targeted and non-targeted metabolomics for both polar and semi-polar metabolites of Phialemonium curvatum AWO2 (DSM 23903) cultivated in MSM with palm oil (MSM-P) or glucose (MSM-G) as carbon sources were obtained. Targeted metabolomics on central carbon metabolism of tricarboxylic acid (TCA) cycle and glyoxylate cycle were analysed using LC–MS/MS-TripleQ and GC–MS, while untargeted metabolite profiling was performed using LC–MS/MS-QTOF followed by multivariate analysis. Targeted metabolomics analysis showed that glyoxylate pathway and TCA cycle were recruited at central carbon metabolism for triglyceride and glucose catabolism, respectively. Significant differences in organic acids concentration of about 4- to 8-fold were observed for citric acid, succinic acid, malic acid, and oxaloacetic acid. Correlation of organic acids concentration and key enzymes involved in the central carbon metabolism was further determined by enzymatic assays. On the other hand, the untargeted profiling revealed seven metabolites undergoing significant changes between MSM-P and MSM-G cultures. Conclusions Overall, this study has provided insights on the understanding on the effect of triglycerides and sugar as carbon source in fungi global metabolic pathway, which might become important for future optimization of carbon flux engineering in fungi to improve organic acids production when vegetable oil is applied as the sole carbon source.

Abstract Background Atrial fibrillation (AF) is the most prevalent sustained arrhythmia worldwide and it aggravates cardiovascular morbidity and mortality; however, this is largely under-diagnosed. Moreover, among end-stage renal disease patients on haemodialysis, AF is substantially more common and serious. The researchers conducted this study to assess the prevalence of, and the factors correlated with AF in Jordanian haemodialysis patients. Methods In a cross-sectional analysis conducted from October 2018 to February 2019 in four tertiary hospitals, the researchers enrolled all consenting patients aged 18 years or older who were on haemodialysis for at least three months prior to the study. We screened for AF clinically by pulse palpation, precordial auscultation, by an automated blood pressure monitor and an electrocardiogram. The researchers reported qualitative variables as counts and frequencies, while continuous variables were summarised using the mean or median where necessary. We used multiple logistic regression with backward selection to identify independent risk factors of AF. Results A total of 231 patients were enrolled; mean age was 54.8 ± 15.6 years (from 20 to 86), and 44.3% of them were women. The prevalence of AF was found to be 7.8% (95% CI, 4.8–12.2), with no gender disparity. Age (adjusted odds ratio [AOR] = 1.05; 95% CI, 1.01–1.10; p = 0.031), history of ischaemic heart disease (AOR = 3.74; 95% CI, 1.09–12.34; p = 0.033), history of smoking (AOR = 0.15; 95% CI, 0.02–0.60; p = 0.019), and low interdialytic weight gain (AOR = 0.50: 95% CI, 0.25–0.91; p = 0.031) were independently correlated to AF. Conclusions The prevalence of AF among patients on maintenance haemodialysis is high, but largely undiagnosed. AF is generally associated with advancing age, history of ischaemic heart disease, lower interdialytic weight gain, and history of smoking. We suggest routine check-up of AF in this high-risk group of patients as anticoagulant therapy if indicated may prevent serious complications. However, there is a need for large-scale cohort studies and for the creation of regional chronic kidney disease and dialysis registries in the Middle East region.

Background Depigmentation represents a final alternative for patients with widespread vitiligo, failing to attain satisfactory pigmentation and having a compromised quality of life. Monobenzyl ether of hydroquinone (MBEH) is the most widely used depigmenting agent, but little is known regarding specific features of its utilization. Objective To evaluate and compare two concentrations of MBEH cream (20 and 40%) regarding their effectiveness, tolerability, and effect on patients’ quality of life. Patients and methods In a double-blind randomized study, 40 patients indicated for depigmentation were equally divided into MBEH 20 and 40% groups. Patients’ responses were assessed bimonthly over 1 year or till complete depigmentation was attained through photography, point counting, and colorimetric assessment. Baseline and final evaluations by dermatology life quality index and visual analog scale were performed. Patients were followed up for 6 months. The study was registered under number ‘PACTR201808699550182.’ Results A total of 39 patients completed the study. Significant color dilution, reduction of point counting and melanin indices, and improvement of dermatology life quality index and visual analog scale scores were obtained in both groups. The number of patients who achieved complete depigmentation and the degree of skin irritation was higher in MBEH 40% group, but no significant difference was found regarding the efficacy, adverse effects, or relapse between groups. Conclusion MBEH 20 and 40% concentrations proved to be effective in depigmentation; however, MBEH 20% is more suitable for face in terms of safety profile, whereas MBEH 40% can be employed for resistant cases as well as for hands and areas of thick skin.

Objectives: The activity and productivity of the honey bee colony depend upon many factors operating simultaneously and reacts to some environmental conditions. We aimed to study the morphometric characteristics and glands development of nurse and forager of hybrid Carniolan honey bee (Apis mellifera carnica Pollmann) workers in relation to activities of the colony during the different seasons. Methods: The study was conducted during spring, summer, fall, then winter in 2020/2021. Ten colonies of hybrid Carniolan honey bees, every colony with about 14,000 bees, were utilizedz. The seasonal variations of foraging activity, hoarded pollen area, and sealed brood area were determined. Also, the body weight, some morphometric characteristics, and development of glands of nurses and foragers bees were measured. Results and conclusions: The highest numbers of foragers and pollen foragers/colony/min., stored pollen area, and worker sealed brood area were recorded in May. Measurements of nurses reared during spring were larger than nurses and foragers of other seasons for body weight, mandibular and hypopharyngeal glands (HPGs), length and width of the 2nd wax mirror. The highest proboscis and corbicula lengths were found in foragers reared during spring, without significant differences between worker castes. It can be concluded that the performance of the colony, morphometric characteristics, and development of glands were dependent on the time of the year. Beekeepers in Kafrelsheikh province and similar environmental condition areas should provide the colonies with pollen substitutes or supplements during April, June, and October to February to maintain the strength of the colonies.

Objective:Adequate glycemic control in children with type 1 diabetes reduces the risk of future complications. Identifying factors affecting haemoglobin A1c (HbA1c) is crucial to management of metabolic control. We aimed to identify possible socioeconomic predictors of poor metabolic control this patient group in Jordan, a developing country with limited resources.Methods:Medical charts of children with type 1 diabetes attending the pediatric endocrine clinics in two major diabetes centers were reviewed. HbA1c ≥7.5% (58 mmol/mol) was considered to reflect poor metabolic control. Logistic regression analysis was performed to identify predictors of poor glycemic control. The association between socioeconomic characteristics and metabolic control was evaluated using multiple correspondence analysis (MCA).Results:Two hundred and fifty-nine children were enrolled in the study. One fifth of the patients (20.5%) achieved HbA1c

Objective: Scientific findings regarding the prevalence of celiac disease (CD) in pediatric patients with type 1 diabetes (T1D) in the Arab world are scarce. We aimed to determine the prevalence of biopsy-proven celiac disease (BPCD) among pediatric patients with T1D from Jordan. We also assessed the possible predictors for developing CD in this cohort of patients and we compared T1D patients who developed BPCD with those who had positive CD serology but negative histology and/or fluctuating C D serology. Methods: Celiac serology and duodenal biopsy results from 2012 to 2017 were collected from patients with T1D. The outcome of positive celiac serology and the risk factors for CD in T1D patients were investigated. Results: A total of 538 children of which 278 boys (51.7%) were included in the study. The prevalence of positive serology and the diagnosis of BPCD in this cohort of T1D patients were 16.6 and 9.1% respectively. Eighty percent of those with BPCD were asymptomatic and 47% were diagnosed with CD at onset of T1D. Spontaneous normalization of celiac serology occurred in 23.6% of those with positive serology. Conclusion: CD is prevalent in T1D pediatric patients from Jordan (9.1%). It is often asymptomatic and the majority of cases were diagnosed at onset or within 5 years of T1D diagnosis. Spontaneous normalization of CD serology occurred in some patients with T1D. Hence, a watchful follow-up is recommended in such patients.

Proteomics is often hindered by the lack of protein sequence database particularly for non-model species such as Persicaria minor herbs. An integrative approach called proteomics informed by transcriptomics is possible [1], in which translated transcriptome sequence database is used as the protein sequence database. In this current study, the proteome profile were profiled using SWATH-MS technology complemented with documented transcriptome profiling [2], the first such report in this tropical herb. The plant was also elicited using a phytohormone, methyl jasmonate (MeJA) and protein changes were elucidated using label-free quantification of SWATH-MS to understand the role of such signal molecule in this herbal species. The mass spectrometry proteomics data was deposited to the ProteomeXchange Consortium via the PRIDE partner repository with the dataset identifier PXD005749. This data article refers to the article entitled “Proteomics (SWATH-MS)-informed by transcriptomics approach of Persicaria minor leaves upon methyl jasmonate elicitation” [3].

Background. Achieving adequate metabolic control in children with type 1 diabetes is important in slowing the progression of future microvascular and macrovascular complications, but still it is a universal challenge. We aim to investigate possible factors associated with poor metabolic outcomes in Jordan as an example of a country with limited resources. Methods. This is a retrospective chart review study of children with type 1 diabetes. Several clinical and personal characteristics were tested for association with metabolic control reflected by HbA1c levels. Linear logistic regression analysis was used to evaluate possible predictors of metabolic control. One-way ANOVA analysis was used to detect significant differences in HbA1c between categories. Results. Significant predictors of metabolic control were found. A one-year increase in age led to an increase in HbA1c by 0.053% (P=0.044). A decline in HbA1c levels was predicted in children who have precise amount of carbohydrates or who are receiving insulin at school (-0.46% (P=0.014) and -0.82% (P=0.004), respectively). When family members other than mothers decided the insulin dose, the HbA1c level increased by 0.74% (P=0.005). Conclusion. Poor metabolic control was associated with age, dietary noncompliance, not receiving insulin at school, and absence of direct mother care. Our study is one of the few studies from Middle East evaluating predictors of metabolic control. Global research studies help in giving universal insight towards developing more effective multidisciplinary team approach for diabetes care and education.

Background Jasmonic acid (JA) and its derivative, methyl JA (MeJA) are hormonal cues released by plants that signal defense response to curb damages from biotic and abiotic stresses. To study such response, a tropical herbal plant, Persicaria minor, which possesses pungent smell and various bioactivities including antimicrobial and anticancer, was treated with MeJA. Such elicitation has been performed in hairy root cultures and plants such as Arabidopsis and rice, yet how MeJA influenced the proteome of an herbal species like P. minor is unknown. Method In this study, P. minor plants were exogenously elicited with MeJA and leaf samples were subjected to SWATH-MS proteomics analysis. A previously published translated transcriptome database was used as a reference proteome database for a comprehensive protein sequence catalogue and to compare their differential expression. Results From this proteomics informed by transcriptomics approach, we have successfully profiled 751 proteins of which 40 proteins were significantly different between control and MeJA-treated samples. Furthermore, a correlation analysis between both proteome and the transcriptome data sets suggests that significantly upregulated proteins were positively correlated with their cognate transcripts (Pearson’s r = 0.677) while a weak correlation was observed for downregulated proteins (r = 0.147). Discussion MeJA treatment induced the upregulation of proteins involved in various biochemical pathways including stress response mechanism, lipid metabolism, secondary metabolite production, DNA degradation and cell wall degradation. Conversely, proteins involved in energy expensive reactions such as photosynthesis, protein synthesis and structure were significantly downregulated upon MeJA elicitation. Overall protein-transcript correlation was also weak (r = 0.341) suggesting the existence of post-transcriptional regulation during such stress. In conclusion, proteomics analysis using SWATH-MS analysis supplemented by the transcriptome database allows comprehensive protein profiling of this non-model herbal species upon MeJA treatment.

Reactive oxygen species and other radicals potentially cause oxidative damage to proteins, lipids, and DNA which may ultimately lead to various complications including mutations, carcinogenesis, neurodegeneration, cardiovascular disease, aging, and inflammatory disease. Recent reports demonstrate that Streptomyces bacteria produce metabolites with potent antioxidant activity that may be developed into therapeutic drugs to combat oxidative stress. This study shows that Streptomyces sp. MUM212 which was isolated from mangrove soil in Kuala Selangor, Malaysia, could be a potential source of antioxidants. Strain MUM212 was characterized and determined as belonging to the genus Streptomyces using 16S rRNA gene phylogenetic analysis. The MUM212 extract demonstrated significant antioxidant activity through DPPH, ABTS and superoxide radical scavenging assays and also metal-chelating activity of 22.03 ± 3.01%, 61.52 ± 3.13%, 37.47 ± 1.79%, and 41.98 ± 0.73% at 4 mg/mL, respectively. Moreover, MUM212 extract was demonstrated to inhibit lipid peroxidation up to 16.72 ± 2.64% at 4 mg/mL and restore survival of Vero cells from H2O2-induced oxidative damages. The antioxidant activities from the MUM212 extract correlated well with its total phenolic contents; and this in turn was in keeping with the gas chromatography–mass spectrometry analysis which revealed the presence of phenolic compounds that could be responsible for the antioxidant properties of the extract. Other chemical constituents detected included hydrocarbons, alcohols and cyclic dipeptides which may have contributed to the overall antioxidant capacity of MUM212 extract. As a whole, strain MUM212 seems to have potential as a promising source of novel molecules for future development of antioxidative therapeutic agents against oxidative stress-related diseases.

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