Ashwagandha (ASH), a vital herb in Ayurvedic medicine, demonstrated potent preclinical hepato- and neuroprotective effects. However, its efficacy is limited due to low oral bioavailability. Accordingly, we encapsulated ASH extract in chitosan-alginate bipolymeric nanocapsules (ASH-BPNCs) to enhance its physical stability and therapeutic effectiveness in the gastrointestinal tract. ASH-BPNC was prepared by emulsification followed by sonication. The NCs showed small particle size (< 220 nm), zeta-potential of 25.2 mV, relatively high entrapment efficiency (79%), physical stability at acidic and neutral pH, and in vitro release profile that extended over 48 h. ASH-BPNC was then investigated in a thioacetamide-induced hepatic encephalopathy (HE) rat model. Compared with free ASH, ASH-BPNC improved survival, neurological score, general motor activity, and cognitive task-performance. ASH-BPNC restored ALT, AST and ammonia serum levels, and maintained hepatic and brain architecture. ASH-BPNC also restored GSH, MDA, and glutathione synthetase levels, and Nrf2 and MAPK signaling pathways in liver and brain tissues. Moreover, ASH-BPNC downregulated hepatic NF-κB immunohistochemical expression. Moreover, the in vivo biodistribution studies demonstrated that most of the administered ASH-BPNC is accumulated in the brain and hepatic tissues. In conclusion, chitosan-alginate BPNCs enhanced the hepatoprotective and neuroprotective effects of ASH, thus providing a promising therapeutic approach for HE.

Assessing environmentally sensitive areas (ESA) to desertification and understanding their primary drivers are necessary for applying targeted management practices to combat land degradation at the basin scale. We have developed the MEditerranean Desertification And Land Use framework in the Google Earth Engine cloud platform (MEDALUS-GEE) to map and assess the ESA index at 300 m grids in the Blue Nile Basin (BNB). The ESA index was derived from elaborating 19 key indicators representing soil, climate, vegetation, and management through the geometric mean of their sensitivity scores. The results showed that 43.4%, 28.8%, and 70.4% of the entire BNB, Upper BNB, and Lower BNB, respectively, are highly susceptible to desertification, indicating appropriate land and water management measures should be urgently implemented. Our findings also showed that the main land degradation drivers are moderate to intensive cultivation across the BNB, high slope gradient and water erosion in the Upper BNB, and low soil organic matter and vegetation cover in the Lower BNB. The study presented an integrated monitoring and assessment framework for understanding desertification processes to help achieve land-related sustainable development goals.

BACKGROUND: Diabetes control without developing hypoglycemia is challenging in Type 1 diabetes (T1D) management with few studies evaluating the effect of insulin glargine timing on glucoregulation.

OBJECTIVES: The aim is to compare glycemic control using Continuous Glucose Monitoring (CGM) in children with T1D receiving bedtime versus morning glargine and to assess CGM effect on glycemia.

METHODS: This cross-sectional observational study was conducted on 30 pediatric patients with T1D receiving glargine (19 at bedtime and 11 in the morning). CGM sensor was applied for 3-5 days using I-Pro2 Blood Glucose sensor.

RESULTS: Total daily dose of glargine showed a significant correlation with HbA1C (p=0.006) and percent of glucose readings within average (p=0.039). HbA1C correlated significantly with time in range (TIR) (p=0.049). Nocturnal hypoglycemia was significantly higher in the bedtime glargine group than in the morning one (p=0.016). Morning glargine group showed better control in terms of lower HbA1C and higher TIR but these didn't reach statistical significance. Follow up after 3 months revealed significant improvement in percent of hyperglycemia, BG readings within average as well as HbA1c (p:0.001).

CONCLUSIONS: Bedtime glargine administration was associated with higher frequency of occurrence of nocturnal hypoglycemia. No statistically significant difference regarding glycemic control between both groups. CGM use improved glycemic control.

BACKGROUND: E-cadherin is a classic cadherin that mediates keratinocyte adhesion.

AIMS: To assess the tissue expression of E-cadherin and its proteolytic serum fragment (soluble E-cadherin) in pemphigus vulgaris (PV) before and after clinical remission compared with controls.

PATIENTS: Thirty-seven PV patients and thirty controls were enrolled. Pemphigus disease area index (PDAI) was calculated for patients at baseline and after remission. Punch biopsy specimens were taken from patients before, and after remission, and from controls for assessment of tissue E-cadherin by immunofluorescence. Similarly, serum samples were collected for assessment of serum soluble E-cadherin by ELISA.

RESULTS: Presence, intensity, and mean intensity of tissue E-cadherin were significantly reduced in PV patients before treatment compared with controls (p < 0.001). Detected E-cadherin showed mainly a basal and suprabasal distribution with cell surface and a cytoplasmic expression. Serum E-cadherin was significantly higher in patients before treatment compared with controls (p = 0.006). With remission, tissue E-cadherin presence, intensity, mean intensity, and serum E-cadherin showed statistically significant improvement (p = 0.003, <0.001, <0.001, and 0.003 respectively). Tissue E-cadherin presence and serum E-cadherin level reached values equivalent to the controls (p = 0.49 and 0.44, respectively).

CONCLUSIONS: Disruption of tissue E-cadherin and upregulation of serum soluble E-cadherin can contribute to the pathogenesis of PV. Clinical remission of PV is associated with normalization of tissue and serum E-cadherin.

Purpose Blastocystis is a common enteric human parasite of non-conclusive pathogenicity which may be determined by subtype (ST) variation. Colorectal cancer (CRC) is considered one of the primary causes of cancer mortality. Blastocystis ST7 has been shown to reduce benefcial intestinal microbiota and may exacerbate CRC. This study assessed the possible association between Blastocystis STs and CRC in comparison to non-cancer patients.

Material and Methods A total of 200 fecal samples were obtained from CRC (100) and non-CRC (100) individuals attending Beni-Suef University Hospital, Egypt. Blastocystis was searched for in all samples using microscopy and culturing. Positive subculture samples were genetically sequenced and subtyped using conventional polymerase chain reaction (PCR). Blastocystis STs were determined by sequencing and a phylogenetic tree was created. Related patient characteristics and tumor stages were analyzed for association with presence of Blastocystis.

Results Blastocystis was identifed in 52% and 42% of CRC and non-cancer individuals, respectively. ST1, 2, and 3 were isolated from both cancer and non-cancer individuals; however, for the frst time, ST7 was only isolated from CRC stool samples with signifcant association. Associated patient characteristics were evaluated as predictors.

Conclusion Blastocystosis is highly prevalent in CRC patients, predominantly in the latest CRC grades and stages. To the best of our knowledge, this is the frst study to report the identifcation of Blastocystis ST7 in CRC patients. To determine whether certain STs of Blastocystis are associated with CRC would require further research, including the role played by
gut microbiota.

Keywords Blastocystis · Subtypes · Colorectal cancer · Egypt