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Thrombocytopaenia in antiphospholipid syndrome: a free radical perspective
Get PDFThrombosis associated with thrombocytopaenia is an apparent paradox that is present across a wide spectrum of disorders. While thrombocytopaenia has been a controversial clinical classification criterion for APS, as initial reports failed to demonstrate a relation between low platelet count with other clinical or laboratory manifestations of the syndrome, recent data highlight the association between mild-moderate thrombocytopaenia and the risk of thrombosis. Although aPL antibodies may induce platelet activation in vitro, additional stimuli may contribute to their activation in vivo, among which are reactive oxygen and nitrogen species and lipid peroxidation products, which are elevated in patients with APS; an excess of the same stimuli may induce megakaryocyte and platelet apoptosis that leads to decreased platelet production and increased destruction, resulting ultimately in thrombocytopaenia. Herein we provide a novel plausible framework involving free radicals that could add to the understanding of the thrombocytopaenia-thrombosis paradox in APS. © 2022 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved
Hematological manifestations of antiphospholipid syndrome: Going beyond thrombosis
Get PDFThrombotic complications are a hallmark of antiphospholipid syndrome (APS). These vascular – arterial, venous, and/or small vessel – complications are well described and known to hematologists and healthcare providers caring for patients with this disease. In this review, we shed light on other hematological manifestations of the disease, including bleeding, thrombocytopenia, autoimmune hemolytic anemia, and thrombotic microangiopathy syndromes. While these manifestations are not bona fide clinical criteria for the diagnosis of APS, they frequently interact and contribute to the complexity of clinical management of APS. © 2022 Elsevier Lt
Development and validation of the Socioeconomic Status Composite Scale (SES-C)
Get PDFBackground: Socioeconomic status (SES) is a critical multifactorial determinant of health and plays a significant role in shaping an individual’s health outcomes. While a composite scale has been proposed to measure SES in children, to our knowledge, limited composite scales were developed for adults in different contexts, highlighting the need for a comprehensive and valid SES measure to elucidate the relationship between SES and health in this population. Objective: This study aimed to develop and validate a composite scale that measures the socioeconomic status in Lebanon and assess its correlates in a socioeconomic crisis context. Methods: An online study was carried out between October and November 2022 across all Lebanese regions. Snowball sampling was used to enroll 448 adults living in Lebanon through a questionnaire created on Google Forms and shared by WhatsApp to a first sample from all geographic areas. Results: The developed composite scale (SES-C) was found to be reliable and valid. It was based on several aspects of socioeconomic status, i.e., participant education level, family head education level, perceived social class, not being in debt, not receiving financial help, crowding index, participant work status, family head work status, monthly household income, and financial well-being. Furthermore, high SES was significantly associated with married status, older age, alcohol consumption, the absence of chronic disease, easy access to healthcare, private insurance coverage, and the number of rooms in the house in the bivariate analysis. In the multivariable analysis, high SES was significantly associated with age (ORa-1.13; p = 0.011) and easy access to healthcare (ORa = 7.81; p = 0.001) and inversely associated with chronic disease (ORa = 0.17; p = 0.002). Similar results with lower magnitude were found for moderate SES. Conclusion: The study successfully developed and validated a composite scale (SES-C) for measuring the socioeconomic status in Lebanon, taking into account the complexities of the Lebanese context. The scale was found to be reliable and valid, and its results showed significant correlations with various factors such as older age, lower risk of chronic disease, and easy access to healthcare. © 2023, BioMed Central Ltd., part of Springer Nature
Using the SLIPTA checklist to assess laboratory readiness for Joint Commission International accreditation
Get PDFBackground: The Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) helps prepare laboratories in low- and middle-income countries to achieve international accreditation aligned with the ISO 15189:2012 standards. Accreditation by the Joint Commission International (JCI) is among the highest sought by hospitals worldwide. While the readiness of laboratories with a five-star SLIPTA score to undergo ISO 15189:2012 accreditation was recently assessed, the compliance of the SLIPTA checklist with JCI is still unknown. Objective: The study evaluated the SLIPTA checklist's utility in assessing laboratories to meet the JCI standards. Methods: We conducted a detailed gap analysis between SLIPTA and JCI laboratory standards from January 2021 to January 2022. We cross-matched the JCI standard requirements to SLIPTA clauses and categorised each standard into 'met', 'partially met', and 'not met'. We highlighted similarities, discrepancies, and improvement areas. Results: A total of 109 JCI standards were included. The SLIPTA checklist completely met 61 standards, partially met four, but did not meet 44. The unmet JCI standards focused on the quality planning, control, and improvement sections. Healthcare organisation management and quality control processes, including selecting an accredited reference laboratory, collecting quality management data, creating of post-analytical policies and procedures, and validating monitoring systems, constitute the basis of this preparation. Conclusion: The SLIPTA checklist covers major quality management system elements of the JCI standards for laboratories. However, some components should be addressed to assure readiness for JCI accreditation. © 2023. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License
EXAMINING THE CINEMATIC REPRESENTATION OF KUWAIT’S BIDOON: A LOOK AT SHARQ AND KA3BOOL
Get PDFThe Bidoon are a stateless and marginalized community in Kuwait, their status owing to Kuwaiti law that restricts the granting of citizenship only to those born to Kuwaiti fathers. While the Bidoon have consistently fought against their statelessness, they have done so to little avail, as the Kuwaiti government, along with the mass media, have advanced exclusionary narratives that solidify their status. This research presents a deeper look at the social exclusion of Bidoon, focusing on two short films, Sharq and Ka3bool, the first of which addresses the sociologic dichotomy between the hadar, the urban elite, and the badu, those who come from nomadic backgrounds. The second film focuses on the struggles of a Bidoon main character, highlighting the exclusionary policies that he must confront. Taken together, the films challenge the idea of a collective Kuwaiti identity, though not always successfully, as Sharq falls short in its attempt to convey the inequitable reality that characterizes hadar and badu existence. Meanwhile, Ka3bool is arguably more successful in this regard, as it defies typical representative boundaries of the Bidoon and humanizes its character, even though, owing to its online presence, it did not receive as much attention as its counterpart
Enhancing sustainability and resilience of elderly dwellings: Optimized refurbishing parameters and air conditioning operation
Get PDFRefurbishing buildings to minimize lifecycle costs and increase reliance on natural ventilation may reduce building resilience to extreme weather. This is critical for elderly whose health is affected by exposure to thermally stressful conditions. This study proposes a novel approach for refurbishing elderly houses to enhance their sustainability and heatwave resilience with the aim of supporting low-income groups. This approach involves using multi-objective optimization to identify refurbishment parameters and an autonomous control strategy to provide thermoneutral indoor conditions at a low cost. The optimization procedure and control strategy were applied to a case study for a representative apartment in the Mediterranean climate using a validated building model. The strategy led to substantial reduction (61%) in cooling energy, while the optimization yielded Pareto solutions that showed trade-offs between lifecycle cost and resilience. A selected solution resulted in reduced electrical usage for heating (37%) and cooling (45%) and decreased indoor overheating during heatwaves. The study recommends design features for cost-effective and resilient elderly housing in the Mediterranean climate, such as limited window area, enhanced thermal properties, and a modest air conditioning system for low-income populations. Larger windows and AC systems are recommended for high income populations seeking reduced operational expenses and improved sustainability. © 2023 Elsevier B.V
The efficacy of honey or olive oil on the severity of oral mucositis and pain compared to placebo (standard care) in children with leukemia receiving intensive chemotherapy: A randomized controlled trial (RCT)
Get PDFBackground: Oral mucositis (OM) is a significant complication occurring in approximately 40 to 80% of patients receiving chemotherapy regimens. Although a wide variety of agents have been tested to prevent OM or reduce its severity, none have provided conclusive evidence. Objectives: To determine the efficacy of honey or olive oil on the severity and OM pain in children with leukemia and suffering from OM compared to placebo (standard care) and, to assess which of the two interventions is more beneficial. Methods: A single blind randomized controlled study (RCT) was used to evaluate the effect of Manuka honey or olive oil, in the treatment of chemotherapy-related OM in 42 children with leukemia. The primary outcome was the severity of mucositis, using the World Health Organization (WHO) scale and the secondary outcome was the pain assessed using the Visual analogue scale (VAS). Results: Children who received the honey had less severe OM (assessed on the (WHO) scale), p = 0.00 and less pain (assessed on the VAS scale), p = 0.00, compared to the control group. Children who received the olive oil had less pain than the control group, p = 0.00), although not lower than the honey group. Conclusion: Manuka honey or olive oil can be used as alternative therapies by nurses to children with leukemia and suffering from OM, especially in low and middle-income countries where more expensive therapies may not be available or economical. Practice implications: Pediatric nurses may recommend Manuka honey to treat OM in children with leukemia as it is safe and inexpensive compared to other treatment modalities. © 2023 Elsevier Inc
Assessing Drug Administration Techniques in Zebrafish Models of Neurological Disease
Get PDFNeurological diseases, including neurodegenerative and neurodevelopmental disorders, affect nearly one in six of the world’s population. The burden of the resulting deaths and disability is set to rise during the next few decades as a consequence of an aging population. To address this, zebrafish have become increasingly prominent as a model for studying human neurological diseases and exploring potential therapies. Zebrafish offer numerous benefits, such as genetic homology and brain similarities, complementing traditional mammalian models and serving as a valuable tool for genetic screening and drug discovery. In this comprehensive review, we highlight various drug delivery techniques and systems employed for therapeutic interventions of neurological diseases in zebrafish, and evaluate their suitability. We also discuss the challenges encountered during this process and present potential advancements in innovative techniques. © 2023 by the authors
Effect of EBV on Inflammatory Processes in a Type 1 Diabetes Mellitus Mouse Model
No full textThe Epstein-Barr virus (EBV), also referred to as Human herpes virus 4 (HHV-4), is a double-stranded virus that belongs to the Herpesviridae family of viruses. It is estimated that this ubiquitous virus has infected more than 90% of the world’s adult population and persists for the lifetime of an individual whereby it undergoes latency in infected memory B cells. EBV has been implicated in several autoimmune diseases notably multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosus. Therefore, a study conducted by our lab examined the effects of the DNA of EBV on the expression levels of several cytokines. Results revealed higher Interleukin 17A (IL-17A) levels 3,6- and 9 days post-EBV DNA administration to mice. IL-17A is an autoimmune-associated cytokine. With Type 1 Diabetes Mellitus (T1DM) being a chronic autoimmune disease affecting millions worldwide, we aimed at assessing the roles EBV may play in the pathogenesis of T1DM.
C57BL/6J male mice were intraperitoneally administered with 144 x 103 EBV particles or DNA on day 0. The induction of T1D was obtained via the intraperitoneal injection of 150 mg/kg streptozotocin (STZ) seven days later. Afterwards, mice were monitored for four weeks for body weight changes and blood glucose levels. The relative concentrations of pancreatic IL-17A and IFN-γ were determined by ELISA. The length of the excised colon was measured. Sections of the colon, pancreas and the liver were stained with H&E and then examined for signs of inflammation and infiltration in addition to histological damage grading.
We observed significantly higher average blood glucose levels in week four in EBV-treated STZ-induced diabetic mice compared to the STZ-treated mice. Moreover, the former group had fluctuating average body weights for four weeks. Following week 3, mice in this group continued to exhibit decreased body weights as compared to the group administered with STZ alone. IL-17A and IFN-γ levels were higher in pancreatic tissues from mice treated with EBV followed by STZ compared to those administered with STZ alone. No significant enhancement of colon, pancreas or liver tissue damage was observed in the groups treated with viral elements and STZ compared to the group treated only with STZ.
Therefore, our research demonstrates that EBV rather than EBV DNA is exacerbating T1DM pathogenesis. A better understanding of the factors involved in the development of T1D and the involvement of EBV in this disease may aid in developing therapeutic interventions that target pro-diabetogenic mediators triggered by this virus
A Guide to Flow Cytometry: Components, Basic Principles, Experimental Design, and Cancer Research Applications
No full textFlow cytometry (FCM) is a state-of-the-art technique for the qualitative and quantitative assessment of cells and other particles’ physical and biological properties. These cells are suspended within a high-velocity fluid stream and pass through a laser beam in single file. The main principle of the FCM instrument is the light scattering and fluorescence emission upon the interaction of the fluorescent particle with the laser beam. It also allows for the physical sorting of particles depending on different parameters. A flow cytometer comprises different components, including fluidic, optics, and electronics systems. This article briefly explains the mechanism of all components of a flow cytometer to clarify the FCM technique's general principles, provides some useful guidelines for the proper design of FCM panels, and highlights some general applications and important applications in cancer research. © 2023 Wiley Periodicals LLC. © 2023 Wiley Periodicals LLC