Spatial congruency or discrepancy? Exploring the spatiotemporal dynamics of built-up expansion patterns and flood risk

Most coastal cities have been experiencing unprecedented urbanization-induced flood risk, climatic events, and haphazard anthropogenic activities, jeopardizing residents' lives and building environments. Despite mounting flood-related studies, analyzing the correlation between the spatiotemporal dynamics of Built-up Expansion patterns (BE) and flood risk remains unknown and holds divergent perspectives. In this context, the coastal city of Alexandria, Egypt, characterized by multiple urban patterns and experiencing heavy rainfall annually, was selected as a testbed. Our method defined the spatiotemporal rates of BE from 1995 to 2023, quantified flood risk spatially, and finally investigated the correlation between BE and flood risk through spatial and statistical analysis. Our results show the built-up area occupied 30.32 % of the total city area till 2023, and the infilling pattern dominated the BE growth by 45.21 % of the total built-up area, followed by leapfrogging and edge expansion by 33.25 % and 21.55 %, respectively. The unplanned-infilling pattern is predominantly highly correlated with the flood-vulnerable peaks (correlation coefficient (rk) = 0.975, p-value < 0.05) and lowers dramatically towards planned-infilling regions with flood protections. Meanwhile, a spatial mismatch exists between high-risk peaks and leapfrogging and edge expansion (rk = 0.118 and 0.662, respectively, with a p-value < 0.01), indicating that controlling the built-up amount is inadequate for mitigating flood risk. Porosity-based urban configuration and spatial distribution of built-up patches in harmony with nature-based solutions are recommended for shaping flood-resilient and effective urban planning.

Mapping COVID-19's potential infection risk based on land use characteristics: A case study of commercial activities in two Egyptian cities

The contagious COVID-19 has recently emerged and evolved into a world-threatening pandemic outbreak. After pursuing rigorous prophylactic measures two years ago, most activities globally reopened despite the emergence of lethal genetic strains. In this context, assessing and mapping activity characteristics-based hot spot regions facilitating infectious transmission is essential. Hence, our research question is: How can the potential hotspots of COVID-19 risk be defined intra-cities based on the spatial planning of commercial activity in particular? In our research, Zayed and October cities, Egypt, characterized by various commercial activities, were selected as testbeds. First, we analyzed each activity's spatial and morphological characteristics and potential infection risk based on the Centre for Disease Control and Prevention (CDCP) criteria and the Kriging Interpolation method. Then, using Google Mobility, previous reports, and semi-structured interviews, points of interest and population flow were defined and combined with the last step as interrelated horizontal layers for determining hotspots. A validation study compared the generated activity risk map, spatial COVID-19 cases, and land use distribution using logistic regression (LR) and Pearson coefficients (rxy). Through visual analytics, our findings indicate the central areas of both cities, including incompatible and concentrated commercial activities, have high-risk peaks (LR = 0.903, rxy = 0.78) despite the medium urban density of districts, indicating that urban density alone is insufficient for public health risk reduction. Health perspective-based spatial configuration of activities is advised as a risk assessment tool along with urban density for appropriate decision-making in shaping pandemic-resilient cities.

Assessing the effectiveness of nature-based solutions-strengthened urban planning mechanisms in forming flood-resilient cities

Cities have experienced rapid urbanization-induced harsh climatic events, especially flooding, inevitably resulting in negative and irreversible consequences for urban resilience and endangering residents' lives. Numerous studies have analyzed the effects of anthropogenic practices (land use changes and urbanization) on flood forecasting. However, non-structural mitigation's effectiveness, like Nature-Based Solutions (NBS), has yet to receive adequate attention, particularly in the Middle East and North Africa (MENA) region, which have become increasingly significant and indispensable for operationalizing cities efficiently. Therefore, our study investigated the predictive influence of incorporating one of the most common NBS strategies called low-impact development tools (LID) (such as rain gardens, bio-retention cells, green roofs, infiltration trenches, permeable pavement, and vegetative swale) during the urban planning of Alexandria, Egypt, which experiences the harshest rainfall annually and includes various urban patterns. City characteristics-dependent 14 LID scenarios were simulated with recurrence intervals ranging from 2 to 100 years using the LID Treatment Train Tool (LID TTT), depending on calibrated data from 2015 to 2020, by the Nash-Sutcliffe efficiency index and deterministic coefficient, and root-mean-square error with values of 0.97, 0.91, and 0.31, respectively. Our findings confirmed the significant effectiveness of combined LID tools on total flood runoff volume reduction by 73.7%, revealing that different urban patterns can be used in flood-prone cities, provided LID tools are considered in city planning besides grey infrastructure to achieve optimal mitigation. These results, which combined multiple disciplines and were not explicitly mentioned in similar studies in developing countries, may assist municipalities' policymakers in planning flood-resistant, sustainable cities.

Phytochemical Screening, Antioxidant Potential, and LC-ESI-MS Profiling of Ephedra alata and Ephedra altissima Seeds Naturally Growing in Tunisia

Most Ephedra species are adapted to arid and desert conditions and are widely used in folk medicine to treat several disorders. The design of the current study was to determine the functional properties of seeds of two Ephedra species (E. alata and E. altissima) naturally growing in Tunisian arid zones by evaluating their mineral contents and bioactive compounds. The flame atomic absorption spectrometry revealed that seeds contained remarkable amounts of sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), copper (Cu), zinc (Zn), and iron (Fe). The colorimetric investigation revealed high total polyphenol, flavonoid, and condensed tannin contents. Furthermore, by utilizing high-performance liquid chromatography-electrospray ionization-mass spectrometry method (HPLC-ESI/MS), a total of 11 phenolics were identified and quantified including 7 flavonoid compounds and 4 phenolic acids that were mostly predominated by gallic acid and quercetrin. Results so far have been very encouraging and proved that Ephedra seeds are a valuable source of natural bioactive compounds and minerals which could potentially be used for industrial and pharmaceutical purposes.

Phytochemical profile, antioxidant properties and protein contents of Astragalus tenuifoliosus seeds

Fabaceae seeds are reported to be used for varying medicinal and pharmaceutical purposes. However, knowledge of the nutritive value of Astragalus tenuifoliosus seeds is largely based on very limited data and remains unexplored, we report here the protein content, phenolics as well as the antioxidant potential of plant seeds to give adequate information on its suitability as a new source of natural bioactive compounds. The protein content was determined using the Kjeldahl and Bradford assays. The phytochemical contents were evaluated, and the extracts were further subjected to high-performance liquid chromatography-electrospray ionization – mass spectrometry (HPLC-ESI-MS) analysis. The antioxidant potential was evaluated using the total antioxidant capacity and the free DPPH radical scavenging activity. The results obtained from the protein analysis showed that the total content was 59.43 % of the dry matter basis. The globulins constituted the dominant fraction and followed by albumins, glutelins, and prolamins. The phytochemical investigation showed considerable amounts of polyphenol, flavonoid and condensed tannin amounts. The LC-ESI/MS analysis revealed the presence of 18 phenolics including 8 phenolic acids and 10 flavonoids mostly predominated by quinic acid (255.4 µg g-1 DW), p-coumaric acid (65.39 µg g-1 DW), quercetin (97.21 µg g-1 DW), and cirsiliol (29 µg g-1 DW). The seeds possessed strong antioxidant potential evidenced by their DPPH radical scavenging activities and total antioxidant capacity. The obtained findings contribute to the limited bibliographic information concerning A. tenuifoliosus seeds and represent a starting point to evaluate its potential as a valuable source of proteins, natural antioxidants, and safe bioactive compounds.   Resumen. Las semillas de las Fabaceae se utilizan para diversos fines medicinales y farmacéuticos. Sin embargo, el conocimiento del valor nutritivo de las semillas de Astragalus tenuifoliosus se basa en gran medida en datos muy limitados y sigue sin explorarse. Aquí se reporta el contenido de proteínas, fenoles y el potencial antioxidante de las semillas de plantas para brindar información adecuada sobre su idoneidad como nueva fuente de compuestos bioactivos naturales. El contenido de proteína se determinó utilizando los ensayos de Kjeldahl y Bradford. Se evaluaron los contenidos fitoquímicos y los extractos se sometieron a análisis de cromatografía líquida de alto rendimiento, ionización por electropulverización y espectrometría de masas (HPLC-ESI-MS). El potencial antioxidante se evaluó utilizando la capacidad antioxidante total y la actividad de captación de radicales libres DPPH. Los resultados obtenidos del análisis de proteína mostraron que el contenido total fue de 59.43% con base en el peso seco. Las globulinas constituyeron la fracción dominante, seguidas por las albúminas, las glutelinas y las prolaminas. La investigación fitoquímica mostró cantidades considerables de polifenoles, flavonoides y taninos condensados. El análisis medinate LC-ESI/MS reveló la presencia de 18 fenoles, incluidos 7 ácidos fenólicos y 11 flavonoides, predominando en su mayoría el ácido quínico (255.4 µg g-1 DW), el ácido p-cumárico (65.39 µg g-1 DW), la quercetina (97.21 µg g-1 DW), y el cirsiliol (29 µg g-1 DW). Las semillas poseen un fuerte potencial antioxidante, evidenciado por sus actividades de eliminación de radicales DPPH y su capacidad antioxidante total. Los hallazgos obtenidos contribuyen a la limitada información bibliográfica sobre las semillas de A. tenuifoliosus y representan un punto de partida para evaluar su potencial como fuente valiosa de proteínas, antioxidantes naturales y compuestos bioactivos seguros.

Assessment of the risks of copper- and zinc oxide-based nanoparticles used in Vigna radiata L. culture on food quality, human nutrition and health

The present article aims to assess the phytotoxic effects of copper and zinc oxide nanoparticles (Cu NPs, ZnO NPs) on mung bean (Vigna radiata L.) and their possible risk on food quality and safety. We also study the molecular mechanisms underlying the toxicity of nanosized Cu and ZnO. Seeds of mung bean were germinated under increasing concentrations of Cu NPs and ZnO NPs (10, 100, 1000, 2000 mg/L). We analyzed levels of free amino acids, total soluble sugars, minerals, polyphenols and antioxidant capacity. Our results showed that depending on the concentrations used of Cu NPs and ZnO NPs, the physiology of seed germination and embryo growth were modified. Both free metal ions and nanoparticles themselves may impact plant cellular and physiological processes. At 10 mg/L, an improvement of the nutritive properties, in terms of content in free amino acids, total soluble sugars, essential minerals, antioxidant polyphenols and flavonoids, was shown. However, higher concentrations (100-2000 mg/L) caused an alteration in the nutritional balance, which was revealed by the decrease in contents and quality of phenolic compounds, macronutrients (Na, Mg, Ca) and micronutrients (Cu, Fe, Mn, Zn, K). The overall effects of Cu and ZnO nanoparticles seem to interfere with the bioavailability of mineral and organic nutrients and alter the beneficial properties of the antioxidant phytochemicals, mineral compounds, phenolic acids and flavonoids. This may result in a potential hazard to human food and health, at some critical doses of nanofertilizers. This study may contribute in the guidelines to the safe use of nanofertilizers or nanosafety, for more health benefit and less potential risks.

Development of active edible coatings based on fish gelatin enriched with Moringa oleifera extract: Application in fish ( Mustelus mustelus ) fillet preservation

An edible coating was developed using gelatin extracted from the skin of gray triggerfish (Balistes capriscus) and applied to the fillet of the smooth‐hound shark (Mustelus mustelus). Moringa oleifera leaf extract was added to gelatin coating solution to improve its preservative properties. The phenolic profiles and antioxidant and antibacterial activities of M. oleifera extracts were determined. Phenolic acids constituted the largest group representing more than 77% of the total compounds identified in the ethanol/water (MOE/W) extract, among which the quinic acid was found to be the major one (31.48 mg/g extract). The MOE/W extract presented the highest DPPH• scavenging activity (IC₅₀ = 0.53 ± 0.02 mg/ml) and reducing (Fe³⁺) power (EC_0.5 = 0.57 ± 0.02 mg/ml), as well as interesting inhibition zones (20–35 mm) for the most tested strains. Coating by 3% of gelatin solution significantly reduced most deterioration indices during chilled storage, such as malondialdehyde (MDA), total volatile basic nitrogen (TVB‐N), weight loss, pH, and mesophilic, psychrophilic, lactic, and H₂S‐producing bacterial counts. Interestingly, coating with gelatin solution containing MOE/W extract at 20 μg/ml was more effective than gelatin applied alone. Compared with the uncoated sample, gelatin‐MOE/W coating reduced the weight loss and MDA content by 26% and 70% after 6 days of storage, respectively. Texture analysis showed that the strength of uncoated fillet increased by 46%, while the strength of fillet coated with gelatin‐MOE/W only increased by 12% after 6 days of storage. Fish fillet coated with gelatin‐MOE/W had the highest sensory scores in terms of odor, color, and overall acceptability throughout the study period.

Diagnosis and treatment of uncommon ileal endometriosis: a case report and literature review

Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. It is a common finding in premenopausal women and commonly affects the gastrointestinal tract, especially the rectosigmoid tract. Small bowel involvement is rare and usually asymptomatic making diagnosis difficult. Here we report an uncommon case of exophytic ileal endometriosis surgically treated. Detailed pre-operative counselling on the risk of ileal surgery should always be considered in all cases with endometriosis requiring surgery. We also present a review of the literature regarding the clinical presentation, diagnosis, and treatment of this challenging condition.

Limoniastrum guyonianum behavior under seasonal conditions fluctuations of Sabkha Aïn Maïder (Tunisia)

In Sabkha biotope, several environmental factors (i.e., salinity, drought, temperature, etc.) especially during dry season affect halophytes developments. To cope with these harmful conditions, halophytes use multiple mechanisms of adaptations. In this study, we focused on the effect of environmental condition changes over a year in the Sabkha of Aïn Maïder (Medenine - Tunisia) on the physiological and biochemical behavior of Limoniastrum guyonianum using a modeling approach. Our study showed that the model depicted well (R² > 0.75) the monthly fluctuations of the studied parameters in this habitat. During the dry period (June to September), the salinity of the soil increased remarkably (high level of EC and Na⁺ content), resulting in high Na⁺ content in the aerial parts followed by a nutrient deficiency in K⁺, Ca²⁺, and Mg²⁺. As a result of this disruption, L. guyonianum decreased its water potential to more negative values to maintain osmotic potential using inorganic osmolytes (i.e., Na⁺) and organic osmolytes (i.e., sugars: sucrose, fructose, glucose, and xylitol, and organic acids: citric and malic acids). In addition, CO₂ assimilation rate, stomatal conductance, transpiration rate, and photosynthetic pigments decreased significantly with increasing salinity. The phenolic compounds contents and the antioxidant activity increased significantly in the dry period as a result of increased levels of H₂O₂ and lipid peroxidation. This increase was highly correlated with soil salinity and air temperature. The maintenance of tissue hydration (i.e., moderate decrease of relative water content), the accumulation of sugars and organic acids, the enhancement of phenolic compounds amounts, and the increase of antioxidant activity during the dry period suggest that L. guyonianum possesses an efficient tolerance mechanism that allows the plant to withstand the seasonal fluctuations of climatic conditions in its natural biotope.

Effects of lead, cadmium, copper and zinc levels on the male reproductive function

This study aimed to investigate the effects of heavy metals on measures of male fertility. One hundred and two infertile men with occupational exposure and thirty fertile men were included in this study. Blood and urinary levels of lead, cadmium, zinc and copper were measured by atomic absorption spectrophotometry. Semen parameters and a motile sperm organelle morphology examination were also performed. Measures of hormonal levels, oxidation-reduction potential, DNA fragmentation index and chromatin condensation were assessed for all participants. Heavy metals levels, oxidative stress and DNA quality were significantly higher in the infertile group compared to controls. FSH and testosterone levels were lower in the infertile group. A urinary cadmium level was positively associated with abnormal sperm morphology (r = .225, p < .05). Normal morphology was inversely correlated with the duration of the exposure (r = -.227, p = .022). The blood lead level was positively related to the level of testosterone (r = .223, p = .031). Cadmium and lead blood levels were positively correlated with the level of chromatin decondensation (r = .528, p < .001; r = .280, p = .017). Our study showed that occupational exposure to heavy metals is very harmful to reproductive health. DNA quality and oxidative stress investigations must be recommended for reprotoxic exposed patients prior to in vitro fertilisation treatment.

Moringa oleifera leaves: could solvent and extraction method affect phenolic composition and bioactivities?

This study was carried out to evaluate the effect of extraction methods (direct maceration (DM) and successive maceration (SM)) and solvents (dichloromethane (DCM), ethyl acetate (EAc), butanol (But), and aqueous extraction (Aqu)) on the phenolic composition and biological activities of Moringa oleifera leaves cultivated for the first time in Tunisia. Total polyphenol content (TPC), total flavonoid content (TFC) and LC-MS analysis were performed for all extracts. Antioxidant potential by DPPH, metal chelating, and FRAP assays, antibacterial activity against Staphylococcus aureus (ATCC 29213) and Escherichia coli (ATCC 25922) by the minimum inhibitory concentration method (MIC) and cytotoxic properties against lung cancer cells (A549), were determined. Phenolic compounds and biological activities of M. oleifera leaves depend on the method and the solvent used for the extraction of these bioactive substances. The But extract prepared by SM method exhibited the highest amounts of TPC (103.06 ± 0.5 mg GAE/g DE) and showed the strongest potential antioxidant (CI₅₀ = 0.26 mg/mL on DPPH test), antibacterial (MIC = 250 µg/mL) and cytotoxic activities (GI₅₀ = 69.9 µg/mL). LC-MS analysis showed that 28 phenolic compounds of 33 tested standards were found in M. oleifera leaves. The But extract obtained by SM method exhibited the highest amounts of rutin, quercetin and syringic acid.

Characterization of lipids, proteins, and bioactive compounds in the seeds of three Astragalus species

Despite the interest of legumes for food and feed purposes, the phytochemicals of Astragalus armatus (AA), A. caprinus (AC), and A. gombiformis (AG) have not been reported in-depth yet. Thus, the lipid contents, fatty acids composition, proteins, and bioactive compounds in the seeds of these species were investigated. Total lipids were ranged from 12.2 (AG) to 36.5 g 100 g^-1 DW (AC) and consisted of oleic acid, linoleic acid, α-linolenic acid, and palmitic acid. The crude protein contents were in the range from 52.2 (AG) to 54.7 g 100 g^-1 DW (AA). Globulin and albumin were the predominant soluble protein fractions. The seeds consisted significantly of different contents of total polyphenols (3.4-6.5 mg GAEg^-1 DW), total flavonoids (1.24-5.15 mg QEg^-1 DW), and total condensed tannins (12-23.2 mg CEg^-1 DW). The extracts mainly consisted of quinic acid, p-coumaric acid, and cirsiliol. All these findings can be assets for functional foods and/or food ingredients.

High-Density SNP-Based Association Mapping of Seed Traits in Fenugreek Reveals Homology with Clover

Fenugreek as a self-pollinated plant is ideal for genome-wide association mapping where traits can be marked by their association with natural mutations. However, fenugreek is poorly investigated at the genomic level due to the lack of information regarding its genome. To fill this gap, we genotyped a collection of 112 genotypes with 153,881 SNPs using double digest restriction site-associated DNA sequencing. We used 38,142 polymorphic SNPs to prove the suitability of the population for association mapping. One significant SNP was associated with both seed length and seed width, and another SNP was associated with seed color. Due to the lack of a comprehensive genetic map, it is neither possible to align the newly developed markers to chromosomes nor to predict the underlying genes. Therefore, systematic targeting of those markers to homologous genomes of other legumes can overcome those problems. A BLAST search using the genomic fenugreek sequence flanking the identified SNPs showed high homology with several members of the Trifolieae tribe indicating the potential of translational approaches to improving our understanding of the fenugreek genome. Using such a comprehensively-genotyped fenugreek population is the first step towards identifying genes underlying complex traits and to underpin fenugreek marker-assisted breeding programs.

Thermoprotective properties of Opuntia ficus-indica f. inermis cladodes and mesocarps on sheep lymphocytes

This study aims to investigate the thermoprotective properties of Opuntia ficus-indica f. inermis. Extracts were prepared from cladodes (CE) and mesocarps (ME), then subjected to a spectrophotometric and LC-MS analyses. Lymphocytes were isolated from peripheral blood of non-stressed sheep, supplemented with CE, ME, betanin or α-tocopherol, and subjected to two thermal treatments: 40 and 41 °C, for 6 h. Viable lymphocytes and H₂O₂ production were evaluated. The antioxidant activity of ME was 3.43 folds higher than CE. The LC-MS analysis of CE and ME allowed identifying 11 phenolic acids, 2 flavanones, 6 flavones, 3 flavonols and 1 betanin type betacyanin. Lymphocytes mortality increased linearly as function of the severity and the duration of heat stress. This mortality was correlated with H₂O₂ production. At 41 °C, only ME allowed maintaining lymphocytes viability. Moreover, ME was more efficient than CE in reducing H₂O₂ production. This thermoprotection was ensured by betaxanthin and betacyanin pigments. Interestingly, betanin was more efficient than α-tocopherol in preventing hyperthermia-induced lymphocytes' mortality. We report here for the first time the thermoprotective properties of cladodes and mesocarps of Opuntia ficus-indica f. inermis. Betanin was able to maintain lymphocyte viability through reducing H₂O₂ production, and therefore the oxidative-induced heat stress.

Modulatory Role of Vitamins A and E on Memory and Motor Functions of Cyanide Induced Neurotoxicity in Adult Swiss Mice

Cyanide is a potent neurotoxic substance that can initiate series of intracellular reactions leading to oxidativestress. To evaluate effect of sublethal administration of potassium cyanide (KCN) on sensorimotor functions and long termvisuo-spatial learning and memory in adult Swiss mice and possible ameliorative role of vitamins A and E. These vitaminsA and E (dietary) are antioxidants that have scavenging properties against free radicals and reactive oxygen species as aresult of oxidative stress induced by cyanide. Thirty-five mice weighing between 18-22 g were used for the study. Theanimals were randomly divided into five groups (n = 7) and exposed to sublethal concentration of potassium cyanide (10%LD50; 1.5 mg/kg). KCN was administered orally while vitamin A (25 mg/kg) and vitamin E (50 mg/kg) were administeredintra-peritoneal (IP) once daily for 28 days. Potassium cyanide (KCN) was first administered and after 10 minutes intervals,followed by vitamin A and then E after 5 minutes, vitamin E were administered across the different treatment groups. Micewere examined for signs of toxicity. Vitamins pre-treatment ameliorated toxic signs. In the dynamics of wire grid, coathanger and stationary beam test, the latency to fall in weeks 2 and 4 were statistically significant. In acquisition and retention,using elevated plus maze (EPM), KCN treated group recorded high transfer latencies in seconds (50.40±1.72 secs) and(57.60±0.93 secs) as compared to group IV (29.40±0.68 secs; 5.60±0.60 secs). Cyanide is a neurotoxin that affects motorfunctions with progressive decline in motor strength and coordination. KCN affects acquisition and retention memory whilepre-treatment with antioxidant vitamins A and E ameliorated these deficits.

Pelvic floor muscle assessment on three- and four-dimensional transperineal ultrasound in women with ovarian endometriosis with or without retroperitoneal infiltration: a step towards complete functional assessment

OBJECTIVES

Previous studies comparing women with deep infiltrating endometriosis (DIE) and healthy controls have underlined an association between pelvic floor muscle (PFM) hypertonic dysfunction and deep lesions. The aim of this study was to compare the morphometry of PFM in women affected by ovarian endometriosis with DIE vs those without DIE in order to assess the impact of retroperitoneal infiltration by the disease on PFM function.

METHODS

This was a prospective study conducted between March 2015 and December 2016 on symptomatic women with a clinical and sonographic diagnosis of ovarian endometriosis with or without DIE, scheduled for laparoscopic surgery. We excluded patients with current or previous pregnancy, previous surgery for deep endometriosis, other causes of chronic pelvic pain or congenital or acquired abnormalities of pelvic floor anatomy. Three- and four-dimensional transperineal ultrasound was performed to evaluate PFM morphometry and assess levator hiatal area (LHA) and diameters at rest, during PFM contraction and during Valsalva maneuver. All volumes were analyzed offline by an investigator blinded to the clinical data.

RESULTS

One hundred and fourteen patients with ovarian endometriosis were enrolled in the study, 75 with DIE and 39 without DIE. The diagnosis of endometriosis was confirmed by histological examination in all patients. Compared with women without DIE, women with DIE showed a smaller LHA at rest, during contraction and during Valsalva maneuver (P = 0.03, P = 0.03 and P = 0.02, respectively) and a smaller reduction in LHA during PFM contraction (P = 0.04).

CONCLUSIONS

Women with ovarian endometriosis who were affected by DIE showed smaller hiatal dimensions than did women without DIE. Considering that PFM dysfunction in patients with DIE could cause pain symptoms and pelvic organ dysfunction, transperineal ultrasound could allow a more complete functional assessment and tailored therapy. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Pelvic floor muscle dysfunction on 3D/4D transperineal ultrasound in patients with deep infiltrating endometriosis: a pilot study

OBJECTIVE

Pelvic floor muscle (PFM) dysfunction seems to play an important role in the pathophysiology of pelvic pain, including that associated with deep infiltrating endometriosis (DIE). The aim of this study was to evaluate the static and dynamic morphometry of the PFM using three-dimensional (3D) and four-dimensional (4D) transperineal ultrasound in women with DIE compared with asymptomatic healthy women.

METHODS

This was a pilot, prospective study conducted at our tertiary center between March and November 2015. Fifty nulliparous women with DIE (study group) and 35 nulliparous asymptomatic healthy women (control group) were included. 3D/4D transperineal ultrasound examination of the PFM was performed in both groups. Levator hiatal area (LHA) and anteroposterior and left-right transverse diameters were evaluated at rest, on maximum PFM contraction and on maximum Valsalva maneuver. Persistent levator ani muscle (LAM) coactivation during Valsalva maneuver was investigated.

RESULTS

Compared with the control group, women with DIE had a smaller LHA at rest (P = 0.03) and during Valsalva maneuver (P < 0.01). Furthermore, reduction in LHA during PFM contraction (P < 0.001) and enlargement in LHA during Valsalva maneuver (P = 0.01) were significantly less marked. In comparison with controls, women with DIE presented a higher frequency of LAM coactivation during Valsalva maneuver, although this difference did not reach statistical significance (P = 0.05).

CONCLUSIONS

3D and 4D transperineal ultrasound is an objective and non-invasive method for PFM morphometry and may have a role in detecting PFM dysfunction in women with DIE. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Blind testing cross-linking/mass spectrometry under the auspices of the 11th critical assessment of methods of protein structure prediction (CASP11)

Determining the structure of a protein by any method requires various contributions from experimental and computational sides. In a recent study, high-density cross-linking/mass spectrometry (HD-CLMS) data in combination with ab initio structure prediction determined the structure of human serum albumin (HSA) domains, with an RMSD to X-ray structure of up to 2.5 Å, or 3.4 Å in the context of blood serum. This paper reports the blind test on the readiness of this technology through the help of Critical Assessment of protein Structure Prediction (CASP). We identified between 201-381 unique residue pairs at an estimated 5% FDR (at link level albeit with missing site assignment precision evaluation), for four target proteins. HD-CLMS proved reliable once crystal structures were released. However, improvements in structure prediction using cross-link data were slight. We identified two reasons for this. Spread of cross-links along the protein sequence and the tightness of the spatial constraints must be improved. However, for the selected targets even ideal contact data derived from crystal structures did not allow modellers to arrive at the observed structure. Consequently, the progress of HD-CLMS in conjunction with computational modeling methods as a structure determination method, depends on advances on both arms of this hybrid approach.

Therapeutic outcome of 6198 interferon-naïve Egyptian patients with chronic hepatitis C: a real-life experience and lessons to be learned in DAAs' era

Antiviral therapy for HCV infection has been validated in randomized controlled clinical trials, but its value in the real world is less well studied. There is relatively little data on real-world responses to interferon-based therapies for patients with genotype 4 infection. We aimed to examine experience with large-scale access to antiviral therapy in chronic HCV in a real-life clinical setting in Egypt. Detailed pretreatment data of 6198 IFN-naïve chronic HCV patients who had received PEG-IFN/RBV therapy at Cairo-Fatemic Hospital, Egypt, between 2009 and 2012 were obtained from the HCV database. At week 12, 95.7% of patients had undetectable HCV RNA, and by week 24 and 48, breakthrough was 6% and 4%, respectively. However, 43.7% of patients discontinued treatment prematurely, and intent to treat end of treatment response was 44.6% (79.3% per protocol). Sustai-ned response data were available from only 1281 patients and was 84.9%. Haematological abnormalities were comparable in patients who did or did not comply with therapy. This is the first real-world, large-scale experience of antiviral therapy in chronic HCV in Egypt. Suboptimal response in HCV predominantly genotype 4 was mainly driven by noncompliance as well as gaps in the healthcare system leading to treatment discontinuation. These results need to be considered in the era of all oral antiviral regimes.

Analysis of free modeling predictions by RBO aleph in CASP11

The CASP experiment is a biannual benchmark for assessing protein structure prediction methods. In CASP11, RBO Aleph ranked as one of the top-performing automated servers in the free modeling category. This category consists of targets for which structural templates are not easily retrievable. We analyze the performance of RBO Aleph and show that its success in CASP was a result of its ab initio structure prediction protocol. A detailed analysis of this protocol demonstrates that two components unique to our method greatly contributed to prediction quality: residue-residue contact prediction by EPC-map and contact-guided conformational space search by model-based search (MBS). Interestingly, our analysis also points to a possible fundamental problem in evaluating the performance of protein structure prediction methods: Improvements in components of the method do not necessarily lead to improvements of the entire method. This points to the fact that these components interact in ways that are poorly understood. This problem, if indeed true, represents a significant obstacle to community-wide progress. Proteins 2016; 84(Suppl 1):87-104. © 2015 Wiley Periodicals, Inc.

RBO Aleph: leveraging novel information sources for protein structure prediction

RBO Aleph is a novel protein structure prediction web server for template-based modeling, protein contact prediction and ab initio structure prediction. The server has a strong emphasis on modeling difficult protein targets for which templates cannot be detected. RBO Aleph's unique features are (i) the use of combined evolutionary and physicochemical information to perform residue–residue contact prediction and (ii) leveraging this contact information effectively in conformational space search. RBO Aleph emerged as one of the leading approaches to ab initio protein structure prediction and contact prediction during the most recent Critical Assessment of Protein Structure Prediction experiment (CASP11, 2014). In addition to RBO Aleph's main focus on ab initio modeling, the server also provides state-of-the-art template-based modeling services. Based on template availability, RBO Aleph switches automatically between template-based modeling and ab initio prediction based on the target protein sequence, facilitating use especially for non-expert users. The RBO Aleph web server offers a range of tools for visualization and data analysis, such as the visualization of predicted models, predicted contacts and the estimated prediction error along the model's backbone. The server is accessible at http://compbio.robotics.tu-berlin.de/rbo_aleph/.

Segmental bowel resection for colorectal endometriosis: is there a correlation between histological pattern and clinical outcomes?

BACKGROUND

Laparoscopic segmental resection as a treatment for intestinal endometriosis can be supported by favorable clinical outcomes, but carries a high risk of major complications. The purpose of this study is to evaluate histopathological patterns of colorectal endometriosis and investigate potential relationships between histological findings and clinical data.

METHODS

We consecutively included 47 patients treated with laparoscopic segmental resection because of symptomatic colorectal endometriosis. All patients underwent follow-up for a median of 18 months (range: 6-35). We examined the histological patterns of colorectal endometriosis and evaluated the relationships between histological findings (satellite lesions, positive margins and vertical infiltration) and clinical outcomes (incidence of recurrence, quality of life and symptom improvement). Moreover, we observed if satellite lesions could influence preoperative scores of the short form-36 health survey (SF-36) questionnaire and visual analogue score (VAS) for pain symptoms.

RESULTS

There were no statistically significant differences in terms of anatomical and pain recurrences, pain symptoms and quality of life improvement among patients with or without positive margins, satellite lesions and different degrees of vertical infiltration (P > 0.05). Furthermore, women with or without satellite lesions were no different in terms of preoperative VAS of pain symptoms and SF-36 scores (P > 0.05).

CONCLUSIONS

The presence of satellite lesions or positive resection margins does not seem to influence clinical outcomes of segmental colorectal resection. Similarly, satellite lesions do not appear to have a major role in determining preoperative clinical presentation. These results may be useful to reconsider the surgical strategy for bowel endometriosis.

Comparison of transvaginal sonography and double-contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment

OBJECTIVES

To compare the diagnostic accuracy of transvaginal sonography (TVS) and double-contrast barium enema (DCBE) in the preoperative detection of deep infiltrating endometriosis (DIE) of the posterior compartment.

METHODS

This was a prospective study of 69 consecutive patients with results of pelvic examination or symptoms suggestive of DIE of the posterior compartment. TVS and DCBE were performed before surgery by two groups of physicians specialized in endometriosis, each blinded to the results of the other technique. Imaging data were compared with histopathologic analysis of the resected specimen (gold standard). Sensitivity, specificity, positive and negative predictive values and test accuracies were calculated for both imaging modalities.

RESULTS

Sixty seven of the 69 women had a nodule of DIE confirmed at laparoscopy and histopathologic examination. TVS diagnosed DIE in 57 (85%) of these patients, while DCBE revealed the presence of the lesion in 24 (36%) women. For the diagnosis of posterior DIE, TVS and DCBE had, respectively, a sensitivity of 85% and 36%, specificity of 100% and 100%, positive predictive value of 100% and 100%, negative predictive value of 17% and 4% and accuracy of 85.5% and 38%. In patients with pure bowel DIE the sensitivity was 91% and 43%, specificity was 100% and 100%, positive predictive value was 100% and 100%, negative predictive value was 29% and 6% and accuracy was 91% and 45%, respectively.

CONCLUSIONS

TVS has a much higher sensitivity than does DCBE in detecting the presence of posterior DIE and should thus be regarded as the imaging modality of choice when there is clinical suspicion of the disease.

[Laparoscopic surgery for endometrial cancer in overweight women]

AIM

The aim of this study was to investigate the feasibility and safety of laparoscopic staging of overweight women with endometrial cancer and to compare the surgical outcomes among these patients with those managed by laparotomy.

METHODS

This was a retrospective analysis (Canadian Task-force Classification II-3). We reviewed operative and hospital records of 70 patients with a body mass index >25 kg/m2 who underwent surgical treatment for endometrial cancer between 2001 and 2008. Thirty-five patients treated laparoscopically were compared to an equivalent group of patients treated by laparotomy. Operative and postoperative variables were afterwards assessed.

RESULTS

Women in laparoscopic group had a significantly lower blood loss (median, 25th-75th percentiles: 1.2, 0.8-2.0 in laparoscopic versus 1.8, 1.0-2.8 in laparotomic group, P<0.05). No differences between both group in terms of operative time (median, 25th-75th percentiles: 165 min, 130-183 in laparoscopic versus 135 min, 110-170 in laparotomic; P>0.05) and mean number of pelvic and para-aortic lymph nodes removed (22 ± 8.4 versus 24 ± 6.2 and 9.2 ± 2.5 versus 9.3 ± 5 respectively; P>0.05). Length of urethral catheter and hospital stay were statistically higher in laparotomic group (two days versus three days; four days versus seven days respectively; P<0.05).

CONCLUSION

Laparoscopic surgery in overweight women with endometrial cancer had equivalent surgical staging than women operated by laparotomy. With regard to postsurgical variables, overweight women who underwent laparoscopic surgery had better results than those treated by laparotomy.

One-Step Laparoscopic Management of a Female Adnexal Tumor of Wolffian Origin

We report a case of female adnexal tumor of Wolffian origin (FATWO), a rare neoplasm arising from the mesonephric ducts. A 48-year-old woman came first to our center for a recent discovery of a pelvic mass. Transvaginal ultrasonographic findings suggested a solid right para-ovarian mass suspected to be malignant. After thorough counseling, the patient underwent operative laparoscopy for excision of the para-ovarian mass with frozen section (FS) examination resulting in the diagnosis of a poorly differentiated adenocarcinoma. In this case, FS results allowed performing a comprehensive oncological staging, through a totally laparoscopic extrafascial hysterectomy, bilateral adnexectomy, total omentectomy, pelvic wall peritonectomy, and pelvic, parasacral and para-aortic lymphadenectomy. Final pathological and immunohistochemical results confirmed the diagnosis of FATWO. To our knowledge, this is the first case of FATWO managed entirely by a minimally invasive laparoscopic approach in a single surgical session.

Diagnostic accuracy and potential limitations of transvaginal sonography for bladder endometriosis

OBJECTIVES

To evaluate the accuracy and the potential limitations of transvaginal sonography (TVS) in the preoperative evaluation of women with clinically suspected bladder endometriosis and to describe the sonographic features of the pathological condition in cases in which it was confirmed.

METHODS

In the period between 2001 and 2006, we operated on 490 patients with clinically/sonographically suspected endometriosis. In 41 cases, bladder endometriosis was diagnosed at surgery and confirmed at histopathological examination. All patients underwent TVS in a standardized manner not more than 1 month before surgery. Findings at preoperative TVS were described and compared with those at laparoscopy in order to evaluate the sensitivity, specificity, and positive and negative predictive values of TVS.

RESULTS

Bladder endometriosis was correctly identified at TVS in 18/41 cases (43.9%) while 23/41 (56.1%) patients had a negative preoperative sonogram. The sensitivity, specificity and positive and negative predictive values of TVS for bladder endometriosis were 44% (18/41), 100% (449/449), 100% (18/18) and 95% (449/472), respectively, and the total accuracy was 95% (467/490). The detection rate was strongly related to mean lesion diameter as measured by the pathologist (mean +/- SD, 42.5 +/- 22.1 mm in the nodules detected vs. 28.9 +/- 14.8 mm in the nodules missed; P = 0.029) and to a history of previous surgery for endometriosis (70.6% vs. 25.0%; P = 0.005). At TVS, the nodule was hypoechogenic, its morphology was either elongated ('comma-shaped': 12/18, 66.7%) or spherical (6/18, 33.3%), and the site involved was the dome (11/18, 61.1%) or the base (7/18, 38.9%) of the bladder. Small anechogenic cystic areas within the nodule were seen in five of the 18 patients (27.8%) and a bright hyperechogenic rim was seen in 10 (55.6%).

CONCLUSIONS

The detection rate of bladder endometriosis by TVS depends on the size of the endometriotic nodules, with detected nodules being larger than those that were missed. A history of previous surgery for endometriosis increases the likelihood of bladder endometriosis being detected on ultrasound examination.