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Abstract In patients with relapsed DLBCL in complete remission (CR), autologous hematopoietic cell transplantation (auto-HCT) and CAR-T therapy are both effective, but it is unknown which modality provides superior outcomes. We compared the efficacy of auto-HCT vs. CAR-T in patients with DLBCL in a CR. A retrospective observational study comparing auto-HCT (2015–2021) vs. CAR-T (2018–2021) using the Center for International Blood & Marrow Transplant Research registry. Median follow-up was 49.7 months for the auto-HCT and 24.7 months for the CAR-T cohort. Patients ages 18 and 75 with a diagnosis of DLBCL were included if they received auto-HCT (n = 281) or commercial CAR-T (n = 79) while in a CR. Patients undergoing auto-HCT with only one prior therapy line and CAR-T patients with a previous history of auto-HCT treatment were excluded. Endpoints included Progression-free survival (PFS), relapse rate, non-relapse mortality (NRM) and overall survival (OS). In univariate analysis, treatment with auto-HCT was associated with a higher rate of 2-year PFS (66.2% vs. 47.8%; p

Single agent immune checkpoint inhibitors have been ineffective for patients with advanced stage and recurrent high grade serous ovarian cancer (HGSOC). Using pre-clinical models of HGSOC, we evaluated the anti-tumor and immune stimulatory effects of an oncolytic adenovirus, MEM-288. This conditionally replicative virus encodes a modified membrane stable CD40L and IFNβ. We demonstrated this virus successfully infects HGSOC cell lines and primary human ascites samples in vitro. We evaluated the anti-tumor and immunostimulatory activity in vivo in immune competent mouse models. Intraperitoneal delivery of MEM-288 decreased ascites and solid tumor burden compared to controls, and treatment generated a systemic anti-tumor immune response. The tumor microenvironment had a higher proportion of anti-tumor macrophages and decreased markers of angiogenesis. MEM-288 is a promising immunotherapy agent in HGSOC, with further pre-clinical studies required to understand the mechanism of action in the peritoneal microenvironment and clinical activity in combination with other therapies.

Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only curative treatment for myelofibrosis. However, the optimal conditioning regimen either with reduced-intensity conditioning (RIC) or myeloablative conditioning (MAC) is not well known. Using the Center for International Blood and Marrow Transplant Research database, we identified adults aged ≥18 years with myelofibrosis undergoing allo-HCT between 2008-2019 and analyzed the outcomes separately in the RIC and MAC cohorts based on the conditioning regimens used. Among 872 eligible patients, 493 underwent allo-HCT using RIC (fludarabine/ busulfan n=166, fludarabine/melphalan n=327) and 379 using MAC (fludarabine/busulfan n=247, busulfan/cyclophosphamide n=132). In multivariable analysis with RIC, fludarabine/melphalan was associated with inferior overall survival (hazard ratio [HR]=1.80; 95% confidenec interval [CI]: 1.15-2.81; P=0.009), higher early non-relapse mortality (HR=1.81; 95% CI: 1.12-2.91; P=0.01) and higher acute graft-versus-host disease (GvHD) (grade 2-4 HR=1.45; 95% CI: 1.03-2.03; P=0.03; grade 3-4 HR=2.21; 95%CI: 1.28-3.83; P=0.004) compared to fludarabine/busulfan. In the MAC setting, busulfan/cyclophosphamide was associated with a higher acute GvHD (grade 2-4 HR=2.33; 95% CI: 1.67-3.25; P

Summary: Background: Better understanding of the association between characteristics of patients hospitalized with coronavirus disease 2019 (COVID-19) and outcome is needed to further improve upon patient management. Methods: Immunophenotyping Assessment in a COVID-19 Cohort (IMPACC) is a prospective, observational study of 1164 patients from 20 hospitals across the United States. Disease severity was assessed using a 7-point ordinal scale based on degree of respiratory illness. Patients were prospectively surveyed for 1 year after discharge for post-acute sequalae of COVID-19 (PASC) through quarterly surveys. Demographics, comorbidities, radiographic findings, clinical laboratory values, SARS-CoV-2 PCR and serology were captured over a 28-day period. Multivariable logistic regression was performed. Findings: The median age was 59 years (interquartile range [IQR] 20); 711 (61%) were men; overall mortality was 14%, and 228 (20%) required invasive mechanical ventilation. Unsupervised clustering of ordinal score over time revealed distinct disease course trajectories. Risk factors associated with prolonged hospitalization or death by day 28 included age ≥ 65 years (odds ratio [OR], 2.01; 95% CI 1.28–3.17), Hispanic ethnicity (OR, 1.71; 95% CI 1.13–2.57), elevated baseline creatinine (OR 2.80; 95% CI 1.63– 4.80) or troponin (OR 1.89; 95% 1.03–3.47), baseline lymphopenia (OR 2.19; 95% CI 1.61–2.97), presence of infiltrate by chest imaging (OR 3.16; 95% CI 1.96–5.10), and high SARS-CoV2 viral load (OR 1.53; 95% CI 1.17–2.00). Fatal cases had the lowest ratio of SARS-CoV-2 antibody to viral load levels compared to other trajectories over time (p=0.001). 589 survivors (51%) completed at least one survey at follow-up with 305 (52%) having at least one symptom consistent with PASC, most commonly dyspnea (56% among symptomatic patients). Female sex was the only associated risk factor for PASC. Interpretation: Integration of PCR cycle threshold, and antibody values with demographics, comorbidities, and laboratory/radiographic findings identified risk factors for 28-day outcome severity, though only female sex was associated with PASC. Longitudinal clinical phenotyping offers important insights, and provides a framework for immunophenotyping for acute and long COVID-19. Funding: NIH.

Anthyllis henoniana stems were harvested in two seasons: winter and spring (February and May 2021). In this study, we investigated the antioxidant (DPPH, ABTS, FRAP and TAC) and antimicrobial activities, total phenolic contents and total flavonoid contents of the obtained extracts (hexane, ethyl acetate and methanol). The results showed that ethyl acetate extract from stems harvested in winter exhibited the highest antioxidant activity, while ethyl acetate extract from the stems harvested in spring showed the most potent antibacterial and antifungal activities. To explain these differences, we investigated the phytochemical composition of these two extracts using liquid chromatography coupled with mass spectrometry. Therefore, 45 compounds were detected, from which we identified 20 compounds (flavonoids, triterpenoids, chalcones and phenolic acids); some were specific to the harvest month while others were common for both periods. Some of the major compounds detected in ethyl acetate (spring) were dihydrochalcone (Kanzonol Y, 8.2%) and flavanone (sophoraflavanone G, 5.9%), previously recognized for their antimicrobial effects. We therefore concluded that the difference in activities observed for the two harvest periods depends on the chemical composition of the extracts and the relative abundance of each compound.

Somatic mutations are recognized as an important prognostic factor in chronic myelomonocytic leukemia (CMML). However, limited data are available regarding their impact on outcomes after allogeneic hematopoietic cell transplantation (HCT). In this registry analysis conducted in collaboration with the Center for International Blood and Marrow Transplantation Registry database/sample repository, we identified 313 adult patients with CMML (median age: 64 years, range, 28- 77) who underwent allogeneic HCT during 2001-2017 and had an available biospecimen in the form of a peripheral blood sample obtained prior to the start of conditioning. In multivariate analysis, a CMML-specific prognostic scoring system (CPSS) score of intermediate-2 (HR=1.46, P=0.049) or high (HR=3.22, P=0.0004) correlated significantly with overall survival. When the molecularly informed CPSS-Mol prognostic model was applied, a high CPSS-Mol score (HR=2 P=0.0079) correlated significantly with overall survival. The most common somatic mutations were in ASXL1 (62%), TET2 (35%), KRAS/NRAS (33% combined), and SRSF2 (31%). DNMT3A and TP53 mutations were associated with decreased overall survival (HR=1.70 [95% CI: 1.11-2.60], P=0.0147 and HR=2.72 [95% CI: 1.37-5.39], P=0.0042, respectively) while DNMT3A, JAK2, and TP53 mutations were associated with decreased disease-free survival (HR=1.66 [95% CI: 1.11-2.49], P=0.0138, HR=1.79 [95% CI: 1.06-3.03], P=0.0293, and HR=2.94 [95% CI: 1.50-5.79], P=0.0018, respectively). The only mutation associated with increased relapse was TP53 (HR=2.94, P=0.0201). Nonetheless, the impact of TP53 mutations specifically should be interpreted cautiously given their rarity in CMML. We calculated the goodness of fit measured by Harrell’s C-index for both the CPSS and CPSS-Mol, which were very similar. In summary, via registry data we have determined the mutational landscape in patients with CMML who underwent allogeneic HCT, and demonstrated an association between CPSS-Mol and transplant outcomes although without major improvement in the risk prediction beyond that provided by the CPSS.

Abstract: Allogeneic bone marrow transplantation (BMT) is curative therapy for the treatment of patients with severe aplastic anemia (SAA). However, several conditioning regimens can be used for BMT. We evaluated transplant conditioning regimens for BMT in SAA after HLA-matched sibling and unrelated donor BMT. For recipients of HLA-matched sibling donor transplantation (n = 955), fludarabine (Flu)/cyclophosphamide (Cy)/antithymocyte globulin (ATG) or Cy/ATG led to the best survival. The 5-year probabilities of survival with Flu/Cy/ATG, Cy/ATG, Cy ± Flu, and busulfan/Cy were 91%, 91%, 80%, and 84%, respectively (P = .001). For recipients of 8/8 and 7/8 HLA allele-matched unrelated donor transplantation (n = 409), there were no differences in survival between regimens. The 5-year probabilities of survival with Cy/ATG/total body irradiation 200 cGy, Flu/Cy/ATG/total body irradiation 200 cGy, Flu/Cy/ATG, and Cy/ATG were 77%, 80%, 75%, and 72%, respectively (P = .61). Rabbit-derived ATG compared with equine-derived ATG was associated with a lower risk of grade II to IV acute graft-versus-host disease (GVHD) (hazard ratio [HR], 0.39; P < .001) but not chronic GVHD. Independent of conditioning regimen, survival was lower in patients aged >30 years after HLA-matched sibling (HR, 2.74; P < .001) or unrelated donor (HR, 1.98; P = .001) transplantation. These data support Flu/Cy/ATG and Cy/ATG as optimal regimens for HLA-matched sibling BMT. Although survival after an unrelated donor BMT did not differ between regimens, use of rabbit-derived ATG may be preferred because of lower risks of acute GVHD.

We sought to study whether survival after haploidentical transplantation is comparable to that after matched unrelated donor transplantation for 822 patients aged 50-75 years with acute myeloid leukemia in first or second complete remission. One hundred and ninety-two patients received grafts from haploidentical donors (sibling 25%; offspring 75%) and 631 patients from matched unrelated donors aged 18-40 years. Patients’ and disease characteristics of the two groups were similar except that recipients of matched unrelated donor transplantation were more likely to have poor risk cytogenetics and more likely to receive myeloablative conditioning regimens. Time from documented remission to transplant did not differ by donor type. Five-year overall survival was 32% and 42% after haploidentical and matched unrelated donor transplant, respectively (P=0.04). Multivariable analysis showed higher mortality (hazard ratio 1.27, P=0.04) and relapse (hazard ratio 1.32, P=0.04) after haploidentical transplantation, with similar non-relapse mortality risks. Chronic graft-versus-host disease was higher after matched unrelated donor compared to haploidentical transplantation when bone marrow was the graft (hazard ratio 3.12, P

Aeonium is a genus of succulents belonging to the Crassulaceae family. Their importance in traditional medicine has stimulated both pharmacological and chemical research. In this study, we optimized extraction, separation, and analytical conditions using a high performance liquid chromatographic method coupled with electrospray ionization mass spectrometry by the negative mode (HPLC-ESI-MS) in order to, for the first time, determine thirty-four compounds from Aeonium arboreum leaves. Twenty-one of them are assigned among which are sixteen flavonoids and five phenolic acids. FRAP, TAC, DPPH, and ABTS•+ radical scavenging were used to evaluate antioxidant activity. The obtained IC50 values ranged from 0.031 to 0.043 mg.mL−1 for DPPH and between 0.048 and 0.09 mg·mL−1 for ABTS•+. Antimicrobial activity was also assessed. The obtained minimum inhibitory concentrations (MIC) of these extracts ranged from 12.5 to 50 µg·mL−1 against Micrococcus luteus, Listeria ivanovii, Staphylococcus aureus, Salmonella enterica, Escherichia coli, Pseudomonas aeruginosa, Aspergillus niger, and Fusarium oxysporum, and from 25 to 50 µg·mL−1 against Candida albicans. Therefore, these extracts can be considered as a potential source of biological active compounds.

Allogeneic hematopoietic stem cell transplant is an established treatment modality for hematologic and non-hematologic diseases. However, it is associated with acute and long-term sequelae which can translate into mortality. Graft-versus-host disease (GVHD) remains a glaring obstacle, especially with the advent of reduced-intensity conditioning. Serotherapy capitalizes on antibodies which target T cells and other immune cells to mitigate this effect. This article focuses on the utility of two such agents: anti-thymocyte globulin (ATG) and alemtuzumab. ATG has demonstrated benefit in prophylaxis against GVHD, especially in the chronic presentation. However, there is limited impact of ATG on overall survival and it has little utility in the treatment context. There may be an initial improvement, particularly in skin manifestations, but no substantial benefit has been elicited. Alemtuzumab has shown benefit in both prophylaxis and treatment of GVHD, but at the consequence of a more profound immunosuppressive phase, mandating aggressive viral prophylaxis. There remains heterogeneity in the doses and regimens of the agents, with no standardized protocol in place. Furthermore, it seems that once steroid-refractory GVHD has been established, there is little that can be offered to offset the ultimately dismal outcome. Here we present a systematic overview of ATG- or alemtuzumab-based serotherapy in the prophylaxis and management of GVHD.

Abstract Background Autologous hematopoietic stem-cell transplantation (HSCT) is the standard of care in many relapsed and refractory lymphoid malignancy, neuroblastoma, and multiple myeloma (MM). This study was conducted to describe the epidemiology of early infections that occurred within the first 100 days among patients who received HSCT for MM, Hodgkin (HL), and non-Hodgkin lymphoma (NHL) in Palestine. Methods This study was conducted in a retrospective cohort design in the only autologous HSCT in Palestine in the period between 2014 and 2021. The medical records of the patients were reviewed to identify and collect demographic, clinical, and microbiological data on bacterial, viral, fungal, and parasitic infections as diagnosed by cultures, polymerase chain reaction, and fluorescent antibody testing. Results A total of 145 patients were included in this study (median age = 44.0 [28.0, 53.5] years). Of those, 8 (5.5%) were younger than 18 years, 69 (47.6%) had MM, 53 (36.6%) had HL, and 23 (15.9%) had NHL. The source of fever had no focus in the majority of the cases 82 (56.6%), 12 (8.3%) had bloodstream infections, 8 (5.5%) had colitis, and 7.6 (5.0%) had pneumonia. Patients from whom gram-negative bacteria were isolated stayed in the hospital for longer duration compared to the other patients (median = 21.0 [19.0, 25.0] vs. 18.0 [15.0, 22.0] days, p-value = 0.043, respectively). The cumulative incidence of death in the first 100 days after infusion of stem cells was 3.4%. The cumulative incidence of death in the first 100 days post-transplantation was higher for patients with NHL compared to those with HL and MM (p-value = 0.017). Gram-negative and fungal infections were strong predictors of mortality. Conclusion Bacterial gram-positive and gram-negative infections were the most common early infections among patients who underwent autologous HSCT for hematological malignancies (HM) in the only center in Palestine. The findings of this study are informative to healthcare providers and planners of care for patients who are scheduled to receive autologous HSCT for HM.

This paper aims to investigate the rotatory dynamical motion of a charged symmetric gyrostat when its center of mass is slightly displaced from the axis of dynamic symmetry as a novel case. A uniform electromagnetic field, due to the presence of point charge located on the axis of symmetry, and a gyrostatic moment are acted on the gyrostatic motion. Equations of motion are derived and solved analytically using the small parameter method of Poincaré for irrational frequencies’ case of the examined motion of the gyrostat. The approximate formulas of the rotating Euler’s angles of the gyrostat are obtained. The time histories of the achieved results and the Euler’s ones are graphed to display the excellent influence of the chosen parameters of the gyrostat on the motion. Moreover, the phase plane diagrams of these results are graphed also to reveal the stability of the gyrostatic motion at any time. The attained results can be used to improve the dynamical behavior of several engineering applications, particularly those that employ the gyroscopic theory such as satellites, submarines, compasses, and automatic pilots on aircraft and ships.

This paper studies the vibrational motion of a dynamical system connected to an electromagnetic device, which is one of the energy harvesting (EH) devices that transform the vibrational motion into electric energy. This system has three degrees-of-freedom (DOF) and consists of two linked parts attached together; one is a nonlinear Duffing oscillator, and the other is a nonlinear damping spring pendulum. The regulating equations of motion (EOM) are achieved utilizing Lagrange’s equations and solved analytically applying the approach of multiple scales (AMS) till the third order of approximation. The accuracy of the attained solutions has been examined by comparing them with the numerical ones of the EOM. The time histories of the solutions and the nonlinear stability analysis of the modulation equations are represented graphically in various plots. The Poincaré maps and phase portraits diagrams displayed the stable behavior of the studied dynamical system. In addition, the different ranges of the stabilities are examined and discussed. In the electromagnetic device, the output power and current time series are depicted as a function of different values of the damping coefficients, excitation amplitudes, and load resistance. It is noted that the output current and power are dropped when the damping coefficient is raised. On the other hand, the increment of the excitation has a positive effect on the electrical generation and produces increment of the output power and current. Furthermore, the output power grows when the total resistance increases to accommodate the applied load. The EH device generates high output current and power at low-frequency values. The significance of this work is limited to the numerous uses of its outcomes in everyday life, such as powering medical devices, serving as a power supply for sensors, and serving as a backup energy source for some electronic devices.

Lipoprotein(a) (Lp(a)) represents a unique subclass of circulating lipoprotein particles and consists of an apolipoprotein(a) (apo(a)) molecule covalently bound to apolipoprotein B-100. The metabolism of Lp(a) particles is distinct from that of low-density lipoprotein (LDL) cholesterol, and currently approved lipid-lowering drugs do not provide substantial reductions in Lp(a), a causal risk factor for cardiovascular disease. Somatic genome editing has the potential to be a one-time therapy for individuals with extremely high Lp(a). We generated an LPA transgenic mouse model expressing apo(a) of physiologically relevant size. Adeno-associated virus (AAV) vector delivery of CRISPR-Cas9 was used to disrupt the LPA transgene in the liver. AAV-CRISPR nearly completely eliminated apo(a) from the circulation within a week. We performed genome-wide off-target assays to determine the specificity of CRISPR-Cas9 editing within the context of the human genome. Interestingly, we identified intrachromosomal rearrangements within the LPA cDNA in the transgenic mice as well as in the LPA gene in HEK293T cells, due to the repetitive sequences within LPA itself and neighboring pseudogenes. This proof-of-concept study establishes the feasibility of using CRISPR-Cas9 to disrupt LPA in vivo, and highlights the importance of examining the diverse consequences of CRISPR cutting within repetitive loci and in the genome globally.

IL-10 receptor (IL-10R) deficiency is a rare immune dysregulation disorder that is characterized by early-onset and life-threatening inflammatory bowel disease (IBD). Activation of the IL-10R inhibits the release of pro-inflammatory cytokines resulting in decreased inflammation. Herein, we present a case of novel homozygous IL-10RA mutation (c.243T>A; p.Y81*) resulting in early-onset Crohn's disease and failure to thrive who was treated with anakinra (IL-1 blocker). His disease course was complicated with IgA nephropathy while anakinra was held for the treatment of osteomyelitis and improved when anakinra was restarted. A year later, he developed inflammatory brain disease and Hemophagocytic Lymphohistiocytosis (HLH), which was treated with high dose steroid and hematopoietic stem cell transplant (HSCT). This case highlights IgA nephropathy, CNS autoinflammation, and HLH as possible extraintestinal manifestations of IL-10 receptor deficiency, especially in the setting of delayed stem cell transplantation.

Biphasic release bio-composite films of the low water-soluble drug, linezolid (LNZ), were formulated using the solvent casting technique. Different polymers and plasticizers (gelatin, Tween 80, polyethylene glycol 400, and glycerol) were assessed for the preparation of bio-composite films. An I-optimal design was applied for the optimization and to study the impact of polymer concentration (X1), plasticizer concentration (X2), polymer type (X3), and plasticizer type (X4) on different LNZ-loaded bio-composite films. The film thickness, moisture content, mechanical properties, swelling index, and percentage of drug release at fixed times opted as dependent variables. Results demonstrated a significant effect of all independent variables on the drug release from the prepared bio-composite films. The plasticizer concentration significantly increased the thickness, moisture content, elongation at break, swelling index, and in vitro drug release and significantly reduced the tensile strength. The optimized LNZ-loaded bio-composite film comprised of 15% Tween 80 and 30% PEG 400 was highly swellable, elastic, acceptable tensile properties, safe, maintained a moist environment, and indicated great antimicrobial activity against both Staphylococcus aureus (ATCC® 25922) and methicillin-resistant Staphylococcus aureus (MRSA), which are common wound infectious bacteria. The present study concludes that the optimized LNZ-loaded bio-composite film was successfully designed with fast drug release kinetics and it could be regarded as a promising novel antimicrobial wound dressing formulation.

Background Emergence delirium (ED) is a common complication after general anesthesia in pediatrics, as reported by pediatric anesthesiologists. Multiple drugs have been suggested to prevent the incidence of this problem. Herein, we compared dexmedetomidine and propofol in the prevention of ED in pediatric patients undergoing cataract surgery under general anesthesia.Patients and methods: This prospective study included 80 children who were randomly allocated into two groups; the Dex group, which received dexmedetomidine, and the Pro group, which received propofol. All operations were performed under general anesthesia, and both drugs were administered 20 minutes before the end of surgery. Our primary outcome was to compare between the incidence of ED in both groups, while secondary outcomes included hemodynamic changes, pain scores, and other complications.Results Age, gender, and the duration of PACU stay showed no significant difference between the two groups. ED was encountered in 5% and 27.5% of patients in the Dex and Pro groups, respectively, with a significant decline in association with dexmedetomidine. Delirium and pain scores were significantly decreased in the Dex group throughout all times of measurement. The same group expressed a significant decrease in most heart rate and arterial pressure measurements. Hypotension was encountered in 15% of patients in the Dex group versus no cases in the Pro group.Conclusion Dexmedetomidine is superior to propofol in the prevention of ED in pediatrics. It is also associated with better post-operative pain scores.

Abstract Background Thromboembolic events are a common complicated health problem. Although anticoagulants have several positive effects on these conditions, they also have several characteristics that strongly affect compliance and satisfaction. The purpose of this investigation is to explore the association between treatment satisfaction and self-efficacy in a sample of patients using anticoagulation therapy and determine the influence of sociodemographic and clinical factors on both aspects. Methods This was a cross-sectional exploratory study carried out in Palestine. The Arabic version of the Anti-Coagulant Treatment Satisfaction Scale (ACTS) assessed treatment satisfaction. In addition, the Arabic version of the 6-Item Self-Efficacy for Managing Chronic Diseases (SES6C) was used to assess self-efficacy. Results A total of 300 patients using anticoagulants (average age 51.95 and SD 17.98) were included. There is a modest correlation between treatment satisfaction and self-efficacy (r = 0.345; p

Hydrogen (H2) is a clean fuel and key enabler of energy transition into green renewable sources and a method of achieving net-zero emissions by 2050. Underground H2storage (UHS) is a prominent method offering a permanent solution for a low-carbon economy to meet the global energy demand. However, UHS is a complex procedure where containment security, pore-scale scattering, and large-scale storage capacity can be influenced by H2contamination due to mixing with cushion gases and reservoir fluids. The literature lacks comprehensive investigations of existing thermodynamic models in calculating the accurate transport properties of H2-blend mixtures essential to the efficient design of various H2storage processes. This work benchmarks cubic equations of state (EoSs), namely Peng–Robinson (PR) and Soave Redlich–Kwong (SRK) and their modifications by Boston–Mathias (PR-BM) and Schwartzentruber–Renon (SR-RK), for their reliability in predicting the thermophysical properties of binary and ternary H2-blend mixtures, including CH4, C2H6, C3H8, H2S, H2O, CO2, CO, and N2, in addition to Helmholtz-energy-based EoSs (i.e., PC-SAFT and GERG2008). The benchmarked models are regressed against the experimental data for vapor–liquid equilibrium (VLE) that covers a wide range of pressures (0.01 to 101 MPa), temperatures (92 K to 367 K), and mole fractions (0.001 to 0.90) of H2. The novelty of this work is in benchmarking and optimizing the parameters of the mentioned EoSs to study VLE envelopes, densities, and other critical transport properties, such as heat capacity and the Joule–Thomson coefficient of H2mixtures in a wide range of associated conditions. The results highlight the significant effect of the temperature-dependent binary interaction parameters on the calculations of thermophysical properties. The SR-RK EoS demonstrated the highest agreement with VLE data among the cubic EoSs with a low root mean square error and absolute average deviation. The PC-SAFT VLE models demonstrated results comparable to the SR-RK. The sensitivity analysis highlighted the high influence of impurity on changing the thermophysical behavior of H2-blend streams during the H2storage process.

Adopting unsustainable farming strategies and practices in Egypt led to several socio-economic and environmental problems that are strongly reflected in human health and lifestyle. An example of these problems in the livestock sector is insufficient meat production leading to the dependence on imported meat or cattle. This is in addition to the pollution caused by the unprocessed and wasted cattle manure. To develop the livestock sector in Egypt researchers must introduce new energy solutions to farmers and smallholders. This paper aims to economically compare Photovoltaic (PV) to Anaerobic Digestion (AD) projects’ benefits within the livestock sector in Egypt, considering their Life Cycle Costs (LCC) and other parameters using systems components available in the local market. The study proves that the electricity load is the main reason for using either PV or AD. A real case study of a livestock farm is considered to determine its energy profile. Later on, an optimization procedure is implemented for hybrid PV/AD power supplies to optimize the Cost of Energy (CoE) and guarantee a continuous power supply depending on the best use of land and cattle number covered within the comparison. The results show that the CoE produced from renewables is still higher than the CoE from the grid. Furthermore, the rated tariff set by the government to buy electricity from investors will never attract farmers and smallholders to invest in renewables in case of consistent grid power. In other words, farmers under these conditions would only invest in renewables in case a power outage threatens their businesses.

The energy sector is the most greenhouse gas (GHG) emitting sector which is transitioning away to using less carbon-intensive fuels. The highlights the complexity of energy systems as well as the uncertainty surrounding the transition path, as governments must ensure not only environmental issues but also energy security and affordability. The energy transition away from oil and gas has implications for Egypt, which recently declared intentions to become a liquefied natural gas (LNG) export hub.Under these goals, the analysis of the existing status of global natural gas markets by focusing on natural gas importer countries in the European and the Asian markets by investigating natural gas demand in the context of the energy transition. The study investigates the links between economic growth, carbon emissions, and energy intensity to highlight the dependency of the economy on carbon-intensive energies to enhance the economic growth in Egypt, Europe, and Asia along with global energy pathways forecast the global and regional demand of natural gas. According to the findings, Egypt is expected to face difficulties in boosting its export share in the European market while the most promising destinations for future Egyptian natural gas exports are Asian countries. The study contextualizes the framework, which suggests the ways to reduce emissions in the gas upstream sector in Egypt by three actions; reducing flaring and venting operations, improving well integrity management, and regulating the abandonment of old wells.

Abstract One of the tomato’s acutely devastating diseases is Alternaria leaf spot, lowering worldwide tomato production. In this study, one fungal isolate was isolated from tomatoes and was assigned to Alternaria alternata TAA-05 upon morphological and molecular analysis of the ITS region and 18SrRNA, endoPG, Alt a1, and gapdh genes. Also, Urtica dioica and Dodonaea viscosa methanol leaf extracts (MLEs) were utilized as antifungal agents in vitro and compared to Ridomil, a reference chemical fungicide. The in vitro antifungal activity results revealed that Ridomil (2000 µg/mL) showed the highest fungal growth inhibition (FGI) against A. alternata (96.29%). Moderate activity was found against A. alternata by D. viscosa and U. dioica MLEs (2000 µg/mL), with an FGI value of 56.67 and 54.81%, respectively. The abundance of flavonoid and phenolic components were identified by HPLC analysis in the two plant extracts. The flavonoid compounds, including hesperidin, quercetin, and rutin were identified using HPLC in D. viscosa MLE with concentrations of 11.56, 10.04, and 5.14 µg/mL of extract and in U. dioica MLE with concentrations of 12.45, 9.21, and 5.23 µg/mL, respectively. α-Tocopherol and syringic acid, were also identified in D. viscosa MLE with concentrations of 26.13 and 13.69 µg/mL, and in U. dioica MLE, with values of 21.12 and 18.33 µg/mL, respectively. Finally, the bioactivity of plant extracts suggests that they play a crucial role as antifungal agents against A. alternata. Some phenolic chemicals, including coumaric acid, caffeic acid, ferulic acid, and α-tocopherol, have shown that they may be utilized as environmentally friendly fungicidal compounds.

Abstract Background Laterality in breast cancer means an increased frequency of left-sided breast cancers compared to right-sided breast cancers ranging between 1.05 and 1.26. It was first described in 1935 by Fellenberg, Sweden. The explanation of this phenomenon is not clear, but the association with other factors was found. This study aimed to explore the laterality of breast cancer in Bahrain as a model for Arabian countries. The association of laterality with the clinicopathological characteristics of the tumor was also analyzed to explore any applied clinical value. Methods This is a cross-sectional, retrospective review of a particular ethnic population to study laterality of breast cancer versus a number of clinicopathological factors, as well as prognosis. The study analyzed 228 breast cancer patients treated in Arabian Gulf University facilities in Bahrain between 1999 and 2020. Three bilateral breast cancer and two malignant phyllodes patients were excluded. The following variables were analyzed: laterality ratio (Lt/Rt) and the association between laterality and clinicopathological characteristics (age at diagnosis, family history of malignancy, size of the tumor, tumor grade, histological type, hormonal receptors and HER2, axillary lymph node status, tumor stage, five-year survival rate, nulliparity, and multifocality). Results The laterality ratio (Lt/Rt) was 1.06 and was 0.97 for patients below 50 years of age, and 1.19 for patients 50 years of age and above. Analysis of our data showed a statistically significant association between laterality and tumor stage (p. value =0.025) at presentation, and laterality and family history of malignancy (p. value =0.052). Right-sided breast cancer was associated with a higher positive family history of malignancy and an increased ratio of locally advanced and metastatic disease, and a reduced 5-year survival in relation to size and stage. Left-sided breast cancer was associated with higher early tumor stage. Conclusion This is the first study exploring the issue of breast cancer laterality in a defined Arabian population. The laterality ratio in this study was 1.06, which is consistent with the globally published range (1.05 to 1.26) and is increasing with increasing age. The association between breast cancer laterality, and the hormonal and HER2 is still not widely addressed in the available literature, although other clinicopathological characteristics were extensively analyzed.

Abstract Cancer is a major health concern and accounts for one of the main causes of death worldwide. Innovative strategies are needed to aid in the diagnosis and treatment of different types of cancers. Recently, there has been an evolving interest in utilizing nanobodies of camel origin as therapeutic tools against cancer. Nanotechnology uses nanobodies an emerging attractive field that provides promises to researchers in advancing different scientific sectors including medicine and oncology. Nanobodies are characteristically small-sized biologics featured with the ability for deep tissue penetration and dissemination and harbour high stability at high pH and temperatures. The current review highlights the potential use of nanobodies that are naturally secreted in camels’ biological fluids, both milk and urine, in the development of nanotechnology-based therapy for treating different typesQuery of cancers and other diseases. Moreover, the role of nano proteomics in the invention of novel therapeutic agents specifically used for cancer intervention is also illustrated.

Abstract Background Acute kidney injury (AKI) was common in the first two waves of the SARS-COV-2 pandemic in critically ill patients. A high percentage of these patients required renal replacement therapy and died in the hospital. Methods The present study examines the clinical presentation, laboratory parameters and therapeutic interventions in critically ill patients with AKI admitted to the ICU in two centres, one each in India and Pakistan. Patient and outcome details of all critically ill COVID 19 patients admitted to the ICU requiring renal replacement therapy were collected. Data was analysed to detect patient variables associated with mortality. Results A total of 1,714 critically ill patients were admitted to the ICUs of the two centres. Of these 393 (22.9%) had severe acute kidney injury (AKIN stage 3) requiring dialysis. Of them, 60.5% were men and the mean (± SD) age was 58.78 (± 14.4) years. At the time of initiation of dialysis, 346 patients (88%) were oligo-anuric. The most frequent dialysis modality in these patients was intermittent hemodialysis (48.1%) followed by slow low efficiency dialysis (44.5%). Two hundred and six (52.4%) patients died. The mortality was higher among the Indian cohort (68.1%) than the Pakistani cohort (43.4%). Older age (age > 50 years), low serum albumin altered sensorium, need for slower forms of renal replacement therapy and ventilatory support were independently associated with mortality. Conclusion There was a very high mortality in patients with COVID-19 associated AKI undergoing RRT in the ICUs in this cohort from the Indian sub-continent.

The present study aims to metaphorically represent the semantic layer of the sub-worlds in the concept of worlds in the Text Worlds Theory proposed by Werth in 1999. In this study, the nature of Shirko Bikas's poetic landscapes was studied linguistically, and it was determined the type of his perspective and point of view. The methodological nature of this qualitative study is descriptive-analytical, and the data were collected by a library method from the book titled chair written by Shirko Bikas. This study also showed how the poetic landscapes of Sherko Bikas's poetry were the means of expressing his thoughts and mentality at the beginning of the chair. Thus, relying on the concept of metaphor in Text Worlds theory, the Kurdish poet's metaphorical worlds were deciphered at the beginning of the chair to discover the attitude based onwhich this work was created. The results showed that the external underlying mega-metaphor as internal mega-metaphor is represented through the surface structural micro-metaphor of wind, poetry, story, and play all of which are considered as human.

Abstract Background Heart failure (HF) is considered one of the main causes of morbidity and death among chronic diseases worldwide. Patients have increasingly reported chronic pain in long-standing heart failure as a disturbing symptom. Its unknown etiology and mechanism, in addition to its insidious progressive nature, made both the doctor and the patient not notice it until it affects the quality of life (QoL) and general health status. The primary objective of this study is to find the prevalence of pain in chronic heart failure patients and its impact on their QoL. The secondary objective is to determine the predictors of QoL in HF patients. Methods A multicenter cross-sectional design was used. The European Quality of Life scale five dimensions scale and the Brief Pain Inventory were adopted to evaluate QoL and pain, respectively. The Statistical Package for the Social Sciences version 25 was applied to present the data. The Mann-Whitney U, Kruskal-Wallis, and Cronbach alpha tests were used. Results The final study had a total of 142 individuals. The prevalence of pain among HF patients was 84.5%. Knee pain was the main complaint among patients. Our patients' median pain severity score was 18 [5.00–25.00], while the median pain interference score was 39 [24.75–53.00]. They had a median EQ-5D score of 0.34 [0.0–0.6] and an EQ-VAS score of 50 [30–70]. Pain severity (p = 0.004 and p

Abstract Background To our knowledge, there is currently no psychometrically validated Hungarian scale to evaluate nurses’ knowledge about infection prevention and control (IPC) practices. Thus, we aim in this study to assess the validity and reliability of the infection control standardized questionnaire Hungarian version (ICSQ-H). Methods A cross-sectional, multisite study was conducted among 591 nurses in Hungary. The original ICSQ included 25 questions. First, the questionnaire was translated into Hungarian. Then, content validity was assessed by a committee of four specialists. This was done by calculating the item content validity index and scale content validity index. Afterward, structural validity was evaluated in a two-step process using principal component analysis and confirmatory factor analysis. The goodness of fit for the model was measured through fit indices. Convergent validity was assessed by calculating the average variance extracted. Additionally, discriminant validity was evaluated by computing the Spearman correlation coefficient between the factors. Finally, the interitem correlations, the corrected item-total correlations, and the internal consistency were calculated. Results The content validity of the questionnaire was established with 23 items. The final four-factor ICSQ-H including 10 items showed a good fit model. Convergent validity was met except for the alcohol-based hand rub (ABHR) factor, while discriminant validity was met for all factors. The interitem correlations and the corrected item-total correlations were met for all factors, but the internal consistency of ABHR was unsatisfactory due to the low number of items. Conclusions The results did not support the original three-factor structure of the ICSQ. However, the four-factor ICSQ-H demonstrated an adequate degree of good fit and was found to be reliable. Based on our findings, we believe that the ICSQ-H could pave the way for more research regarding nurses’ IPC knowledge to be conducted in Hungary. Nevertheless, its validation among other healthcare workers is important to tailor effective interventions to enhance knowledge and awareness.

Abstract Background We evaluated the sensitivity, specificity and accuracy of fluorine-18-fluorodeoxyglucose with positron emission tomography/computed tomography (18F-FDG-PET/CT) in a group of patients with suspicion of ovarian cancer recurrence. It is considered a diagnostic dilemma, particularly in the 2 years following first-line therapy. CA125 serum levels computed tomography (CT) and other modalities are used during routine follow-up. These traditional modalities could provide a significant number of false-negative or equivocal results even in the presence of elevated CA125 levels. So the performance of 18F-FDG-PET/CT is essential for the optimal diagnosis of recurrence and treatment planning. Results Studying PET/CT behaviour in the detection of ovarian cancer recurrence, 18F-FDG-PET/CT had an accuracy of 98% with sensitivity and specificity of 98% and 100%, respectively. 18F-FDG-PET/CT had a PPV of 100% and NPV of 83%. While studying the CA125 level (> 35 U/ml) to detect the ovarian cancer recurrence during patient follow-up, the CA125 level had an accuracy of 50% with a sensitivity ratio and specificity ratio of 47% and 80%, respectively. CA-125 level had a PPV of 95% and NPV of 14%. In comparison between conventional CT and PET/CT studies, the PET/CT diagnosed local tumor recurrence in 16 patients (32%), while CT scan diagnosed local tumor recurrence in only 3 patients (6%), and PET/CT detected peritoneal recurrence in 34 patients (68%). CT scan found peritoneal deposits in 11 patients (22%), also the PET/CT showed suspicious abdominal LNS in 22 patients (44%) while, CT scan showed suspicious abdominal LNS in 4 patients (8%), and PET/CT showed suspicious pelvic LNS in 16 patients (32%). CT scan showed suspicious pelvic LNS in 7 patients (14%). PET/CT detected distant organ metastases in 18 patients (36%). CT scan detected distant organ metastasis in only 8 patients (16%). Comparison between CT and PET/CT in 32 follow-up cases for the detection of local tumor recurrence, peritoneal deposits, suspicious abdominal/pelvic LNs and distant organ metastasis. There was a statistically significant difference between CT and PET/CT the end results (p

We explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases–International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (~5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%−90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs’ implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted.

This article explores the planar motion of a novel dynamical system of three degrees of freedom (DOF) triple pendulum, consisting of a double rigid pendulum attached to an un-stretched one, in which its suspension point is considered to be fixed. Applying Lagrange's equations, the controlling system of the equations of motion (EOM) is derived. The multiple scales method (MSM) is used to achieve the analytic solutions of these equations up to higher order of approximation as novel approximate solutions. The accuracy of these solutions is demonstrated by comparing them with the numerical results of the EOM. The system's resonance cases are characterized, and its modulation equations are established. In light of solvability conditions, the steady-state solutions are analyzed. A graphic depiction of the dynamical behavior regarding the motion’s time histories and resonance curves is presented. The stability zones are discussed by analyzing their graphs to evaluate the positive effect of different parameters on the dynamic behavior. The importance of the studied dynamical system is evident from its many applications in various fields such as engineering and physics. However, the vibrational motion can be taken into account in engineering applications like shipbuilding and ships motion, structure vibration, automotive devices, designing robots, and human walking analysis.

This study was designed for infection with T. gondii by using specific IgG and IgM by VIDAS technique to indicate T. gondii. The experiment was distributed into three groups: (A) (N=30) kidney failure patients group, (B) (N=30) patients with kidney failure patients and COV-19, (C) (N=30) patients with covid- 19 + kidney failure and T.gondii infected. The criteria were studied Blood Urea (B.U.) mg\dl, Serum Creatinine (S.Cr.) mg\dl, Albumin serum (ALB) mg\dl, Total serum protein (T.S.P) and phosphate test (PO4) mg\dl. The examination of the parameters mentioned above was performed using a spectrophotometer device by wavelength 490-540 nm. It was seen that the amounts of creatinine, PO4, and blood urea were significantly higher (P < 0.05) in COVID-19-infected patients with renal failure than in the control group of patients with renal failure. However, it was noted that patients with COVID-19 and kidney failure, as well as T. gondii infection, demonstrated a return to normal blood urea levels. Creatinine and phosphorous oxyhydroxide levels were not different between those with COVID-19 + renal failure and those with T.gondii infection (P > 0.05).

Abstract A serious global public health emergency emerged late November 2019 in Wuhan City, China, by a new highly pathogenic virus, SARS-CoV-2. The virus evolution spread has been tracked by three developing databases: GISAID, Nextstrain and PANGO to understand its circulating variants. In this study, 110 diagnosed positive COVID-19 patient’s samples, were collected from Kasr Al-Aini Hospital and the Children Cancer Hospital Egypt 57357 between May 2020 and January 2021, with clinical severity ranging from mild to severe. The viral genomes were sequenced by next generation sequencing, and phylogenetic analysis was performed to understand viral transmission dynamics. According to Nextstrain clades, most of our sequenced samples belonged to clades 20A and 20D, which in addition to clade 20B were present from the beginning of sample collection in May 2020. Clades 19A and 19B, on the other hand, appeared in the mid and late 2020 respectively, followed by the disappearance of clade 20B at the end of 2020. We identified a relatively high prevalence of the D614G spike protein variant and novel patterns of mutations associated together and with different clades. We also identified four mutations, spike H49Y, ORF3a H78Y, ORF8 E64stop and nucleocapsid E378V, associated with higher disease severity. Altogether, our study contributes genetic, phylogenetic, and clinical correlation data about the spread of the SARS-CoV-2 pandemic in Egypt.

Abstract Background The eggplant suffers from many biotic stresses that cause severe damage to crop production. One of the most destructive eggplant pathogens is Alternaria solani, which causes early blight disease. A pot experiment was conducted to evaluate the role of fungal endophytes in protecting eggplant against early blight as well as in improving its growth performance. Results Endophytic Aspergillus terreus was isolated from Ocimum basilicum leaves and identified morphologically and genetically. In vitro, crude extract of endophytic A. terreus exhibited promising antifungal activity against A. solani where minimum inhibitory concentration (MIC) was 1.25 mg/ml. Severity of the disease and rate of protection from the disease were recorded. Vegetative growth indices, physiological resistance signs (photosynthetic pigments, carbohydrates, proteins, phenols, proline, malondialdehyde (MDA), antioxidant enzymes), and isozymes were estimated. Alternaria solani caused a highly disease severity (87.5%) and a noticeable decreasing in growth characteristics and photosynthetic pigments except for carotenoids. Also, infection with A. solani caused significant decreases in the contents of carbohydrate and protein by 29.94% and 10.52%, respectively. Infection with A. solani caused enhancement in phenolics (77.21%), free proline (30.56%), malondialdehyde (30.26%), superoxide dismutase (SOD) (125.47%), catalase (CAT) (125.93%), peroxidase (POD) (25.07%) and polyphenol oxidase (PPO) (125.37%) compared to healthy plants. In contrast, the use of A. terreus on infected plants succeeded in recovering eggplants from the disease, as the disease severity was recorded (caused protection by 66.67%). Application of A. terreus either on healthy or infected eggplants showed several responses in number and density of peroxidase (POD) and polyphenol oxidase (PPO) isozymes. Conclusion It is necessary for us to address the remarkable improvement in the photosynthetic pigments, protein, carbohydrates, and enzymatic activity compared to infected control, which opens the way for more studies on the use of biocides as safe alternatives against fungal diseases.

Background: Understanding the profile of antibody responses following acute COVID-19 infection is required. Aim: to describe the pattern of IgG anti-COVID-19 antibody production in patients with acute infection using the LABScreen COVID Plus assay. Results: The overall seropositivity was 69/73(94.5%). Anti-Spike, Spike 1 and spike S2 subunits were positive in 78.1%, while anti spike receptor binding domain (RBD) was detected in 68.4% and anti nucleocapsid protein in 61.6%. The overall positivity of the assay reached 100.0% during the second week post symptoms. The mean fluorescent intensities (MFI) of anti-Spike S1 was higher in the second week than the first week, p < /em>=0.03. MFI of anti-Spike S2 was significantly higher in PCR positive patients in comparison with the negative ones, p < /em>=0.006. When compared to the RT-PCR results; the overall antibodies positivity, anti-Spike, and anti-Spike2 antibodies had sensitivities (100% and 84.7%) and specificities (28.6% and 50.0%) and accuracies (86.3% and 78.1%). Patients' outcome correlated significantly with the time of hospital admission, p < /em>=0.001. Conclusion: COVID-19 IgG antibodies are detectable with considerable frequencies during the first two weeks post infection. Anti S2 antibodies correlates well with the RT-PCR results. The LABScreen COVID Plus is a sensitive assay for the detection of post-acute COVID-19 infection antibody responses. Background: Understanding the profile of antibody responses following acute COVID-19 infection is required. Aim: to describe the pattern of IgG anti-COVID-19 antibody production in patients with acute infection using the LABScreen COVID Plus assay. Results: The overall seropositivity was 69/73(94.5%). Anti-Spike, Spike 1 and spike S2 subunits were positive in 78.1%, while anti spike receptor binding domain (RBD) was detected in 68.4% and anti nucleocapsid protein in 61.6%. The overall positivity of the assay reached 100.0% during the second week post symptoms. The mean fluorescent intensities (MFI) of anti-Spike S1 was higher in the second week than the first week, p < /em>=0.03. MFI of anti-Spike S2 was significantly higher in PCR positive patients in comparison with the negative ones, p < /em>=0.006. When compared to the RT-PCR results; the overall antibodies positivity, anti-Spike, and anti-Spike2 antibodies had sensitivities (100% and 84.7%) and specificities (28.6% and 50.0%) and accuracies (86.3% and 78.1%). Patients' outcome correlated significantly with the time of hospital admission, p < /em>=0.001. Conclusion: COVID-19 IgG antibodies are detectable with considerable frequencies during the first two weeks post infection. Anti S2 antibodies correlates well with the RT-PCR results. The LABScreen COVID Plus is a sensitive assay for the detection of post-acute COVID-19 infection antibody responses.

Background:This study aimed at analyzing the microbiological profile of neonatal sepsis in Egypt and to determine the antibiotic susceptibility patterns of the isolated microorganisms. Methods: Two thousand and four hundred blood samples were collected from neonates showing symptoms suggestive of septicemia, inoculated into BACT/ALERT culture bottles. Positive blood culture samples were identified and tested for antimicrobial susceptibility. Results: Among the neonates included in our study, 457 (19%) neonates were positively diagnosed with sepsis. early onset neonatal sepsis (EOS) was detected in 181 (39.6%), while late-onset neonatal sepsis (LOS) in 276 (60.4%) cases. Klebsiella pneumoniae was the most commonly isolated microorganism. Staphylococcus aureus and Enterococcus spp. were the most common isolated Gram-positive bacteria. Candida spp. was more encountered in LOS.An alarming feature of the present study is the high incidence of multidrug resistant microorganisms (65%). Among Gram negative isolates (56%) of were extended spectrum beta-lactamase (ESBL) producers and (70.5%) were carbapenem resistant. In Gram positive bacteria, resistance to methicillin in S. aureus and coagulase negative staphylococci were detected in (50%) and (41%) of isolates respectively. Additionally, 17% of Enterococcus isolates were vancomycin resistant. Coclusion: Our bacteriological profile of neonatal sepsis showed that Gram negative bacteria represented the majority of isolates. Klebsiella pneumoniae was the predominant isolate. In our study, both EOS & LOS share a nosocomial infection profile, as high antimicrobial resistance was observed among our isolates. The susceptibility profiles of the isolates may urge for the change of the current used empirical therapies.

The Mishrif Formation is among southern Iraq's most important reservoirs, which contains a third of the oil in the Cretaceous reservoirs, which is a broad carbonaceous succession in Iraq and the surrounding area. For detecting differences in the geochemical characteristics of crude oil, three crude oil samples were obtained from the Mishrif carbonate reservoir intervals in the Cretaceous at the Zubair, Halfaya and Buzurgan oilfields in southern Iraq. Analyses utilize API gravity, sulfur concentration, Gc, Gc/MS, and bulk carbon isotope compositions. The low API (23 to 28) and high sulfur content (4.45 to 5.36 wt%) of the oils studied can be linked to the deposition of a marine carbonate environment under sulfate-reducing environments. The anoxic, non-biodegradation, organic matter type II-S, marine carbonate depositional was indicated by the pristane/ nC17 (0.16 to 0.26), phytane/ nC18 (0.29 to 0.31), narrow Pr/Ph ratio range from 0.76 to 0.78, high C29/C30 hopane ratios of 1.01–1.71, and low C26/C25 tricyclic terpene ratios in the related source-rock. TAS3 (CR) ratios of 0.33 to 0.36, C27 Ts of 0.18 to 0.22, and 29 sterane 20S/20R sterane ratios all refer to early maturity. Biomarker parameters and bulk carbon isotope values in the oil analysis match those found in the Sulaiy and Yamama sources of the Late Jurassic-Early Cretaceous.

Abstract Myelodysplastic syndromes (MDS) are a heterogeneous clonal disease of myeloid neoplasms characterized by ineffective hematopoiesis, variable degree of cytopenias, and an increased risk of progression to acute myeloid leukemia (AML). Molecular and genetic characterization of MDS has led to a better understanding of the disease pathophysiology and is leading to the development of novel therapies. Targeted and immune therapies have shown promising results in different hematologic malignancies. However, their potential use in MDS is yet to be fully defined. Here, we review the most recent advances in therapeutic approaches in MDS, focusing on higher-risk disease. Allogeneic hematopoietic cell transplantation is beyond the scope of this article.

Familial Mediterranean fever (FMF) is a rare autoinflammatory disorder. Ocular involvement is rare. The full spectrum and response to treatment is poorly understood. An 18-year-old girl previously diagnosed with FMF presented with sudden loss of vision in the left eye (LE). Best-corrected visual acuity (BCVA) in the LE was finger counting at 1.5 meters. Angiitis with mild “frosting,” hemi-central retinal vein occlusion (HCRVO), and acute outer retina rupture (ORR) were observed in the LE. Systemic steroids were initiated immediately. The ORR was sealed 2 weeks later while vision improved to 6/15 (near vision: J2) 5 months later. No recurrences were observed over 5 years of follow-up. We report a rare manifestation of frosted branch angiitis with concomitant HCRVO and ORR in a young patient with FMF. Closure of ORR was attained and vision recovered after treatment with high-dose steroids.

Background: With the rapid development of the genomic sequence data for the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants Delta (B.1.617.2) and Omicron (B.1.1.529), it is vital to successfully identify mutations within the genome. Objective: The main objective of the study is to investigate the full-length genome mutation analysis of 157 SARS-CoV-2 and its variant Delta and Omicron isolates. This study also provides possible effects at the structural level to understand the role of mutations and new insights into the evolution of COVID-19 and evaluates the differential level analysis in viral genome sequence among different nations. We have also tried to offer a mutation snapshot for these differences that could help in vaccine formulation. This study utilizes a unique and efficient method of targeting the stable genes for the drug discovery approach. Methods: Complete genome sequence information of SARS-CoV-2, Delta, and Omicron from online resources were used to predict structure domain identification, data mining, and screening; employing different bioinformatics tools. BioEdit software was used to perform their genomic alignments across countries and a phylogenetic tree as per the confidence of 500 bootstrapping values was constructed. Heterozygosity ratios were determined in-silico. A minimum spanning network (MSN) of selected populations was determined by Bruvo's distance role-based framework. Results: Out of all 157 different strains of SARS-CoV-2 and its variants, and their complete genome sequences from different countries, Corona nucleoca and DUF5515 were observed to be the most conserved domains. All genomes obtained changes in comparison to the Wuhan-Hu-1 strain, mainly in the TRS region (CUAAAC or ACGAAC). We discovered 596 mutations in all genes, with the highest number (321) found in ORF1ab (QHD43415.1), or TRS site mutations found only in ORF7a (1) and ORF10 (2). The Omicron variant has 30 mutations in the Spike protein and has a higher alpha-helix shape (23.46%) than the Delta version (22.03%). T478 was also discovered to be a prevalent polymorphism in Delta and Omicron variations, as well as genomic gaps ranging from 45 to 65aa. All 157 sequences contained variations and conformed to Nei's Genetic distance. We discovered heterozygosity (Hs) 0.01, mean anticipated Hs 0.32, the genetic diversity index (GDI) 0.01943989, and GD within population 0.01266951. The Hedrick value was 0.52324978, the GD coefficient was 0.52324978, the average Hs was 0.01371452, and the GD coefficient was 0.52324978. Among other countries, Brazil has the highest standard error (SE) rate (1.398), whereas Japan has the highest ratio of Nei's gene diversity (0.01). Conclusions: The study's findings will assist in comprehending the shape and kind of complete genome, their streaming genomic sequences, and mutations in various additions of SARS-CoV-2, as well as its different variant strains like Omicron. These results will provide a scientific basis to design the vaccines and understand the genomic study of these viruses.

Abstract Background Egypt has agreed and ratified international regulations that strict child labor. However, the country still struggles with high prevalence of child labor and the associated negative social and health effects. The objective of this study was to identify the prevalence and determinants of work-related injuries among working children in Egypt. Methods This study involved a secondary data analysis of the National Child Labor Survey (NCLS) conducted in 2010 by The Central Agency for Public Mobilization and Statistics (CAPMAS) in Egypt with technical and financial support from the ILO’s International Program on the Elimination of Child Labor (IPEC) through its Statistical Information and Monitoring Program on Child Labor (SIMPOC). The total number of working children who responded to questions of work-related injuries in the NCLS child questionnaire was 7485 children. Results The prevalence of work-related injuries among working children in Egypt was estimated as 24.1% (95% CI: 22.0%—26.2%), of whom the majority were superficial wounds (87.3%). Among children who reported work-related injuries, 57.9% did not stop work or schooling because of the most serious injury, while 39.6% had stopped temporarily and 2.6% had stopped completely. The main determinants of work-related injuries among working children in the study sample were gender (boys), age of starting work (5–11 years), type of main economic activity (industry and services), type of main workplace (plantation, farms, or garden), the average work hours per week (28 h or more), and exposure to ergonomic and safety, and chemical hazards at work. Conclusions The estimated high prevalence of work-related injuries among working children aged 5–17 years in Egypt raises the health risks concerns associated with child labor. Findings of this study on the determinants of work-related injuries could guide policies and interventions to combat child labor and the associated health risks, including work-related injuries.

This study was prepared to investigate the performance and behavior of concrete thrust blocks supporting pipe fittings. In the water distribution networks, it is always necessary to change the path of the pipes at different degrees or to create new branches. In these regions, an unbalanced force called the thrust force is generated. In order to counter this force, these regions are supported with concrete blocks. In this article, the system components (soil, pipe with its bend and thrust blocks) have been numerically modeled and simulated by the ABAQUS CAE/2019 software program in order to study the behavior and stability of the thrust block with different burial conditions (several burial depths) by the soil under the influence of the thrust force. Accordingly, 45° bend angles were studied with a specified pipe diameter placed on soil with known properties under the influence of internal hydrostatic test pressure. The obtained results that were relied upon to describe the behavior and stability of the block are (the lateral displacement of the block in the direction of the thrust force, as well as the vertical displacement of the block in addition to the Von Mises stresses transmitted by the block to the soil). It was concluded that the case in which the block is fully supported from its back side represents the optimum state of the block as it provides marginal sliding of the block and the least transmitted stress to the soil. It was also concluded that the transition from the first case (thrust block without soil behind it) to the second case (a quarter of the block is supported by soil), in which the maximum change in the performance of the concrete block was recorded, but after shifting to the other cases, the effect was reduced gradually.

Formaldehyde-free hair-straightening products are hair-smoothening solutions widely used by professional beauty salons. Formaldehyde-free hair straighteners do not technically contain formaldehyde; however, they contain other chemicals such as glyoxyloyl carbocysteine which releases formaldehyde upon contact with heat. Moreover, its by-product glyoxylate may convert to oxalate; both compounds have potential nephrotoxic effect. Here, we report a case of a 41-year-old woman who presented to the emergency room with weakness, nausea, vomiting, and stage 3 acute kidney injury (AKI) according to Kidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury staging shortly after exposure to formaldehyde-free hair-straightening product; other causes of AKI were excluded such as preceding acute illness, drug history, or other nephrotoxic agent exposure. On physical examination, the patient was pale, and her vital signs were normal. The urine microscopy and serologic workup were not indicative. Kidney core biopsy revealed interstitial edema, acute interstitial nephritis, and oxalate crystal nephropathy. Kidney function completely recovered after a short course of steroid therapy. In this case, AKI was a complication caused by exposure to hair-straightening products branded as formaldehyde free but actually containing other chemical products which release formaldehyde and other toxic chemicals when heated during the straightening procedure and may cause systemic toxicity, particularly kidney injury. Different cosmetic products are widely in use, but not all are under tight regulation, and therefore, it is important to raise the awareness among both medical teams and consumers of possible adverse health effects of different cosmetic products.

Abstract Background This study aimed to evaluate the GIT manifestation in Autistic children and relate it to the degree of autism to demonstrate the possible connection between celiac disease and autism. An observational cross-sectional study with analytic component was carried out on 114 children with autism spectrum disorder above 3 years who visited to Phoniatric Unit, Mansoura University Hospitals and were separated into three groups according to DSM-V each of them contained 38 children, group I (children with level I ASD), group II (children with level II ASD), and group III (children with level III ASD). Results Fifty percent of ASD children in the studied groups showed at least one GIT symptom. Constipation was the most common symptom. The existence of gastrointestinal signs was shown to have a substantial link with the severity of autism. None of the youngsters had celiac disease. Conclusion Gastrointestinal issues are frequent in ASD children and may lead to ASD behavioral symptoms. It is possible that children with more severe autism are more prone to suffer from gastrointestinal issues, and the other way around. This research found no evidence to demonstrate a connection between autism spectrum disorder and celiac illness.

Abstract In this paper, a new design of a non-isolated high-voltage gain DC/DC converter that operates at a reasonable duty cycle, by merging the dual boost converter with the switched inductor structure, is presented as a solution for the high-conversion ratio requirement. The proposed converter operates in discontinuous-current mode (DCM) with zero current switching for all switches and diodes. Wide duty cycle range operation, high output voltage gain, low switching stress, small switching losses, and high efficiency are achieved efficiently. Operating the converter in DCM can support a wide range of the duty cycle operation, maintain lower voltage stress of all devices, ensure the same current sharing among inductors, make it easy to control, provide more stability, and require a smaller inductor which reduces size and weight of the proposed converter. Moreover, the converter operates with a continuous input current. These features make the converter a good choice for many applications such as photovoltaic, x-ray, fuel cells, etc. To prove the converter’s effectiveness, theoretical analysis, project specifications, and operation principles are presented and studied. Experimental results in an open and closed-loop, and a comparison with other recent converters are also introduced to confirm the validity of the proposed converter.

Background: Polycystic ovarian syndrome (PCOS) is one of the most prevalent endocrine and metabolic conditions in premenopausal women. Objectives: The goal of this study was to see the efficacy of Letrozole in conjunction with clomiphene citrate versus Letrozole alone in inducing ovulation in PCOS patients. Patients and methods: This was a randomized clinical trial (RCT) done on a total of 200 patients who came to South Valley University, Obstetrics and Gynecology clinics, after receiving the ethical committee permission and signed informed consent from all participants. Results: Regarding all treatment outcomes, there were no statistically substantial difference among the two groups as regards the following parameters: ovulation, mature follicle number, endometrial thickness, OHSS, single pregnancy, clinical pregnancy, multiple pregnancy and miscarriage, P>0.05. Conclusion: this research showed that in terms of infertility therapy in women with PCOS, the combination of letrozole and CC was linked to"Although there is absolute difference between the two groups in favor of the combined use of letrozole plus clomiphene citrate, this difference is not statistically significant". These new findings indicate that this combined therapy might be a low-risk, low-cost infertility treatments.

With the spread of the use of liquefied petroleum gas (LPG) in developing countries for use in domestic cooking with the increase in the expansion and distribution of gas pipelines for residential buildings, the 2002 World Summit focused on sustainable development in clean energy for natural gas (NG) and LPG. The research aims to focus on the important aspects of design sustainability from an environmental point of view to reduce gas leakage, accidents, and explosions that occur socially to expand the distribution of LPG and motivate the consumers to use it instead of natural gas and other fuels, and from an economic point of view to take into account the annual cost and aesthetic impact of maintaining on the view of the building and the design of the pipes in ways that do not distort the public view. The study area was a building in a residential complex in Baghdad and the gas pipelines were connected to the building completely for studying. The axes of sustainability were applied to the building in an analysis method using the goals achievement matrix, which is divided into main goals and secondary goals. The results showed that the environmental and aesthetic sustainability were well applied to the building, but from a social point of view, in the dissemination of safety instructions to the consumer, and from a financial point of view, there were shortcomings in them, and this could lead to long-term damage to the building.

This experimental study demonstrates the gable-reinforced concrete beams’ behavior with several number of openings (six and eight) and posts’ inclination, aimed to find the strength reduction in this type of beam. The major results found are: for the openings extending over similar beam length it is better to increase the number of posts (openings), i.e., increasing opening number led to decrease in opening area, which allows us to transmit stresses and act as lever arms between the upper and the lower chords. Also, findings revealed that the inclined posts have larger loading at the mid-point relative to vertical ones. For gables with vertical posts having six and eight openings, the ultimate strength reduction was 31.5 and 25.6%, whereas it was 29 and 17.3% for those with inclined posts, respectively.

The malignant peripheral nerve sheath tumor is one of the rare sarcomas that have a challenging diagnosis. It occurs independently with neurofibromatosis type 1. Some studies referred that malignant peripheral nerve sheath tumor attains a worse prognosis when it occurs in the head and neck region. In the reported case, a male patient with neurofibromatosis type 1 manifestations presented with a large mass in the temporal region. Based on the clinical history, histopathology, and immunohistochemical findings, the lesion was diagnosed as a low-grade malignant peripheral nerve sheath tumor with rhabdoid features. Surgical resection followed by intensity-modulated radiotherapy was the treatment of choice.

Recent studies have indicated that microRNA and VEGF are considered to be genetic modifiers and are associated with elevated levels of fetal haemoglobin HbF, and thus they reduce the clinical impact of sickle haemoglobin (HbS) patients. This cross-sectional study was performed on clinical confirmed subjects of SCD cases. miR-423-rs6505162 C>T and VEGF-2578 C>A genotyping was conducted by ARMS-PCR in SCD and healthy controls. A strong clinical significance was reported while comparing the association of miR-423 C>T genotypes between SCD patients and controls (p = 0.031). The microRNA-423 AA genotype was associated with an increased severity of SCD in codominant model with odd ratio (OR = 2.36, 95% CI, (1.15–4.84), p = 0.018) and similarly a significant association was observed in recessive inheritance model for microRNA-423 AA vs (CC+CA) genotypes (OR = 2.19, 95% CI, (1.32–3.62), p < 0.002). The A allele was associated with SCD severity (OR = 1.57, 95% CI, (1.13–2.19), p < 0.007). The distribution of VEGF-2578 C>A genotypes between SCD patients and healthy controls was significant (p < 0.013). Our results indicated that in the codominant model, the VEGF-2578-CA genotype was strongly associated with increased SCD severity with OR = 2.56, 95% CI, (1.36–4.82), p < 0.003. The higher expression of HbA1 (65.9%), HbA2 (4.40%), was reported in SCD patients carrying miR-423-AA genotype than miR-423 CA genotype in SCD patients carrying miR-423 CA genotype HbA1 (59.98%), HbA2 (3.74%) whereas SCD patients carrying miR-423 CA genotype has higher expression of HbF (0.98%) and HbS (38.1%) than in the patients carrying AA genotype HbF (0.60%), HbS (36.1%). ARMS-PCR has been proven to be rapid, inexpensive and is highly applicable to gene mutation screening in laboratories and clinical practices. This research highlights the significance of elucidating genetic determinants that play roles in the amelioration of the HbF levels that is used as an indicator of severity of clinical complications of the monogenic disease. Further well-designed studies with larger sample sizes are necessary to confirm our findings.