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Background The present study presents a 3-D numerical simulation of a direct injection diesel engine powered by base diesel oil and soybean biodiesel fuel at different load conditions. The modeling was performed using commercial computational fluid dynamics (CFD) software linked to a chemical solver. A chemical kinetic reaction mechanism was developed to simulate the combustion and fuel spray processes. Base diesel oil results were verified using a single-cylinder, 4-stroke diesel engine. Results The study showed that the usage of the soybean biodiesel fuel caused a reduction in carbon monoxide (CO) and hydrocarbon (HC) emissions by about 42.38% and 41.35%, compared with base diesel and an increase in nitrogen oxides (NOx) and carbon dioxide (CO2) emissions of about 21.8% and 11.2%, respectively. Exhaust gas temperature (EGT) is reduced by an average value of 9.4%, the brake-specific fuel consumption (BSFC) is increased by an average value of 11.8% and the brake thermal efficiency (BTE) is dropped by an average value of 11.3% for soybean biodiesel fuel. Conclusions The CFD model showed the effect of the unsaturated fatty acid methyl esters present in soybean biodiesel on the spatial distributed values of NOx, oxygen and temperature during the combustion in engine cylinder. It was observed that the combustion of soybean biodiesel began about 3.89 CAD earlier than base diesel, and the in-cylinder peak pressure was dropped by 8.25%. Soybean biodiesel fuel was optimized by performing four starts of injection (SOI) at timings of − 18, − 16, − 15 and − 13,5 bTDC, and it was found that the combustion characteristics of soybean biodiesel are optimum at SOI = − 15 bTDC. These results indicate that the biodiesel fuel can be used as an alternative and environmentally friendly fuel in the engine without any modifications.

Some studies suggest that thyroid hormones and disorders can influence breast (BC) and ovarian (OC) cancers risks. However, studies regarding their effect on these tumors progression are limited. Thyroid-stimulating hormone (TSH), T4, free T4 (FT4), T3, and free T3 (FT3) were detected in patients with BC, OC, benign breast and ovary diseases, and healthy controls using highly sensitive chemiluminescence assay. In contrast to OC, hypothyroidism prevalence was associated with BC late stage (11/24 vs. 2/46), high grade (11/23 vs. 4/47), lymph node invasion (11/42 vs. 0/28), positive distant metastasis (11/25 vs. 1/45), and large tumor size (14/25 vs. 1/45) compared to tumor early stages, low grades, negative lymph node, and distant metastasis and small size, respectively. Patients with late stage, high grade, large tumor size, positive lymph nodes, or positive distant metastasis were significantly (P < 0.05) associated with elevated levels of TSH and decreased levels of T4, FT4, T3, and FT3. There were both significant positive correlation of serum TSH and significant inverse correlation of T4, FT4, T3, and FT3 with these tumor worse outcomes. In conclusion, our results identify hypothyroidism as potentially important prognostic factor in BC not in OC that is associated with poor outcomes of BC patients.

Background Impact of interleukin 28B (IL28B) rs12979860 polymorphism on response to direct-acting antivirals agents in HCV genotype 4-infected patients is under investigation. Zinc may have an advantage in improvement of liver damage and treatment outcome. We aimed to evaluate IL28B polymorphism and zinc administration impact on patient response to treatment and amelioration of liver fibrosis. Results Three hundred patients on anti-HCV treatments were equally categorized into patients treated with dual therapy (sofosbuvir/ribavirin) for 24 weeks, triple therapy (sofosbuvir/ribavirin+pegylated interferon-alpha) for 12 weeks, dual therapy plus oral zinc and with triple therapy plus oral zinc. All patients were genotyped for IL28B. Sustained virologic response (SVR) was achieved in 100% of patients with CC genotypes while 15.5% of CT/TT carriers did not attain SVR. After treatment, patients with CC genotype showed improvement in liver-related parameters compared with CT/TT genotypes. Zinc supplementation was associated with improved SVR in CT/TT genotypes and liver parameters in both CC and CT/TT genotypes. Hepatic fibrosis was improved in higher percent of CC genotype (16.7%) compared with CT/TT genotypes (5.8%). Interestingly with zinc administration, improved fibrosis increased to 60.9% in CC genotype vs. 15.4% in CT/TT genotypes. Conclusion Absolute SVR rates in patients with IL28B CC genotype support their selection for shorter treatment duration and therefore associated with high economic value. IL28B polymorphism is associated with improvement of hepatic functions and fibrosis after antiviral treatments. Zinc is powerful supplement not only to increase SVR in non-responders but also to improve hepatic functions and fibrosis.

Background: Hand fractures represent a considerable burden upon society in terms of medical costs and reduced workplace productivity. Fractures of the metacarpals and phalanges are the most common fractures of the upper extremity. Outcome of conservative treatment in displaced, irreducible, unstable and rotational fractures is poor. Objective: To assess the outcome of fixation of oblique and spiral fractures of phalanges and metacarpals of the hand by interfragmentary mini screws and to evaluate the rate of complications. Patients and methods: A study included 18 patients with oblique and spiral fractures, 6 metacarpals and 12 phalangeal fractures. Patients were managed by open reduction and internal fixation using mini Interfragmentary screws with lag technique at Zagazig University Hospital and Zagazig General Hospital. Results: Four weeks postoperative, the mean total active motion (TAM) score was 83.22 ± 13.26. Early range of motion assessment revealed one (5.6%) poor, two (11.1%) fair, five (27.8%) good and ten (55.6%) excellent results. The end results by measuring grip strength of affected hand for metacarpals was excellent in two patients (40%), good in two patients (40%) and fair in one patients (20%). The mean grip strength for metacarpals was 85.8 ± 7.5. While the grip strength of affected hand for phalanges was excellent in eight patients (61.5%), good in four patients (30.7%) and fair in one patients (7.7%). The mean grip strength for phalanges was 90.07 ± 7.3. Conclusion: Inter-fragmentary mini lag screws fixation represents an effective method for managing such rotationally unstable fractures as oblique and spiral hand fractures. Younger patients with hand fractures revealed better results of range of motion and hand function.

This study aims to investigate the effects of piston bowl shape and biodiesel fuel on combustion and emissions of a direct injection (DI) diesel engine. Three configurations of piston bowl geometry are modeled: hemispherical, toroidal, and rectangular. Biodiesel fuel derived from soybean oil is being considered. An experimental work was conducted on a diesel engine with a hemispherical piston bowl, and a better validity was attained. The study showed that, diesel engine with toroidal piston bowl delivered the largest power than other shapes, where turbulent regions are formed inside the toroidal piston bowl with higher intensity, which resulted in better combustion characteristics and lower emission concentrations. It is observed from the combustion of biodiesel fuel that, the rapid combustion stage began earlier than conventional diesel fuel by about 5o CA, heat release rate (HRR) decreased by 18.88%, emissions of carbon monoxide (CO), and unburnt hydrocarbon (UHC) reduced but nitric oxide (NO) emission increased by about 17.78% at 55o CA, as compared to diesel fuel. During the injection process, the jet core of biodiesel fuel appeared thicker and longer than conventional diesel fuel. For optimization, preheating with exhaust gas recirculation (EGR) of biodiesel fuel contributes to reduce the emissions of nitrogen oxides (NOx) and improve the atomization rate.

In chronic hepatitis C (CHC), Toxoplasma gondii infection can lead to more severe diseases and is capable of changing the disease course. Former studies were concerning anti-T. gondii IgG/IgM seroprevalence in CHC patients regardless the antigenic proteins that are associated with active infection. Therefore, this study aimed to evaluate association between prevalence of 36-KDa T. gondii antigen (TAg) and both CHC progression and liver and viral biochemical parameters. One hundred-twenty five CHC patients (65 with fibrosis and 60 with cirrhosis) and forty healthy controls constituted this study. Demographics and clinical data were collected. Both TAg and HCV-NS4 were identified using ELISA. In contrast to healthy controls (0%), both seropositivity (P = 0.043) and mean serum level (P = 0.025) of TAg were higher in cirrhotic patients (43.3 %; 1.2 ± 0.2 ng/mL) compared to fibrotic patients (26.2 %; 0.7 ± 0.1 ng/mL). T. gondii infection was significantly (P

Chronic hepatitis C (CHC) leads eventually to liver fibrosis, advanced hepatic disease and related deaths. Therefore, it is very important to assess clinical risk factors associated with rapid CHC and hepatic fibrosis progression. Former studies reported diabetes mellitus synergistic interactions with other host factors to fibrosis progression. Here, we aimed to evaluate the association between elevated blood glucose levels and CHC progression according to METAVIR system in patients chronically infected with HCV-genotype 4 and to evaluate the correlation between elevated glucose levels and liver- and viral-related biochemical parameters. A total of 160 patients with CHC (80 with liver fibrosis and 80 with cirrhosis) and 40 healthy volunteers, negative for HCV, were included. Our results revealed that cirrhotic patients had high (

BackgroundThe implementation and continuous improvement of patient safety learning systems (PSLS) is a principal strategy for mitigating preventable harm to patients. Although substantial efforts have sought to improve these systems, there is a need to more comprehensively understand critical success factors. This study aims to summarise the barriers and facilitators perceived by hospital staff and physicians to influence the reporting, analysis, learning and feedback within PSLS in hospitals.MethodsWe performed a systematic review and meta-synthesis by searching MEDLINE (Ovid), EMBASE (Ovid), CINAHL, Scopus and Web of Science. We included English-language manuscripts of qualitative studies evaluating effectiveness of the PSLS and excluded studies evaluating specific individual adverse events, such as systems for tracking only medication side effects, for example. We followed the Joanna Briggs Institute methodology for qualitative systematic reviews.ResultsWe extracted data from 22 studies, after screening 2475 for inclusion/exclusion criteria. The included studies focused on reporting aspects of the PSLS, however, there were important barriers and facilitators across the analysis, learning and feedback phases. We identified the following barriers for effective use of PSLS: inadequate organisational support with shortage of resources, lack of training, weak safety culture, lack of accountability, defective policies, blame and a punitive environment, complex system, lack of experience and lack of feedback. We identified the following enabling factors: continuous training, a balance between accountability and responsibility, leaders as role models, anonymous reporting, user-friendly systems, well-structured analysis teams, tangible improvement.ConclusionMultiple barriers and facilitators to uptake of PSLS exist. These factors should be considered by decision makers seeking to enhance the impact of PSLS.Ethics and disseminationNo formal ethical approval or consent were required as no primary data were collected.

Background: Distal radius fractures are the most common fractures of the upper extremity, representing approximately one-sixth of all fractures treated in the emergency room. Various classification systems are used to classify distal radius fractures. There are different methods for treatment of this type of fractures.Objective: This study aimed to evaluate the best procedure in management of comminuted distal radial fractures and attainment of better outcomes.Patient and methods: This study involved 30 patients with distal radial fractures who divided equally into: 15 patients performed volar plate in group (A) and other 15 patients applied external fixation augmented by K-wires group (B). The follow-up in was six months.Results: The mean operation time was 54.00 ± 12.28 minutes in volar plating group, in comparison with 36.33 ± 5.16 minutes in external fixation group. There was statistically clinical significance between the two groups. Patients treated with volar plating had flexion range of 10-85, radial deviation range of 5-30 and ulnar deviation range of 20-40, while patients treated with external fixation augmented by k-wires had flexion range of 60-85, radial deviation range of 10-28 and ulnar deviation range of 20-35. Patients treated with external fixation augmented by k-wires had extension range of 45-85 better than those treated with volar plating (10-85). Patients treated with external fixation augmented by k-wires had grip strength range of 15-27, while patients treated with volar plating had grip strength range (8-27).Conclusion: Volar plating had better functional outcomes when compared to external fixation. Whereas grip strength and ROM data were similar between the two groups.

Halocnemum strobilaceum halophyte occupies tidal and coastal environments in Egypt. Endophytes have the potential to yield novel and important natural products. Herein we evaluate the effect of changing media on the production of secondary metabolites by Halocnemum strobilaceum endophytes. Endophytic fungal ethyl acetate extracts of different culturing media; corn “Zea mays” (CGA), rice “Oryza sativa” media (M1), cowpea “Vigna unguiculata” (M2), painted pony “Phaseolus vulgaris” (M3) and broad bean “Vicia faba”(M4), were screened to evaluate their cytotoxic and antimicrobial activities. Media showing the highest antibacterial activities of fungal metabolites were riceculture media with Penicillium citrinum E-346 and broad bean media with Aspergillus flavus RF-03with MIC (Minimum inhibitory concentration) value of 0.94 µg/mL for both against Bacillus subtilis (ATCC-6633). No antifungal activities against Candida albicans or Aspergillus niger were noticed with any of the tested fungal strains. The cytotoxicity assays using the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) method against the breast cancer cell line (MCF-7) manifested a good safety index with all media. This evaluation aims to select the best growth conditions for the isolated endophytic fungi to direct further studies toward the best media for chemical investigation of their antimicrobial metabolites.

Halocnemum strobilaceum halophyte occupies tidal and coastal environments in Egypt. Endophytes have the potential to yield novel and important natural products. Herein we evaluate the effect of changing media on the production of secondary metabolites by Halocnemum strobilaceum endophytes. Endophytic fungal ethyl acetate extracts of different culturing media; corn “Zea mays” (CGA), rice “Oryza sativa” media (M1), cowpea “Vigna unguiculata” (M2), painted pony “Phaseolus vulgaris” (M3) and broad bean “Vicia faba”(M4), were screened to evaluate their cytotoxic and antimicrobial activities. Media showing the highest antibacterial activities of fungal metabolites were riceculture media with Penicillium citrinum E-346 and broad bean media with Aspergillus flavus RF-03with MIC (Minimum inhibitory concentration) value of 0.94 µg/mL for both against Bacillus subtilis (ATCC-6633). No antifungal activities against Candida albicans or Aspergillus niger were noticed with any of the tested fungal strains. The cytotoxicity assays using the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) method against the breast cancer cell line (MCF-7) manifested a good safety index with all media. This evaluation aims to select the best growth conditions for the isolated endophytic fungi to direct further studies toward the best media for chemical investigation of their antimicrobial metabolites.

Lymphangiomas are rare benign lesions resulting from abnormal proliferation and sequestration of lymphatic tissues that are disconnected from the rest of the lymphatic system. This is a case of a 50-year-old woman with an unusually large mediastinal lymphangioma complicated by hemorrhage. The substantial mass effect and unstable clinical status necessitated urgent operative management. The use of preoperative multimodality radiologic assessment, including CT and MRI, is illustrated throughout this case. Keywords: CT, MR Imaging, Thorax, Lung © RSNA, 2022

This paper discusses the impact of British colonialism on the legal system of Egypt and its development. During the height of British imperialism, Egypt was at a crossroads transferring from one empire to another; this concluded with the British occupation of 1882. This forced occupation has had many implications, but the one that can still be felt the most is the legal changes that occurred. Before the occupation, Egypt was facing tremendous debt and understood that it would be a matter of time before they are occupied by one of their creditors. Egypt thus began a legal reform process, which led to the adoption of a new legal code based on the Napoleonic code. This work combines events and resources in order to demonstrate the relationship between British colonialism and the development of the Egyptian legal system. This work shows that the way imperialism affected the development of the legal system was somewhat unique, as Egypt did wind up with a European system, the government did so at their own will, rather than by coercion from the imperial forces. Egypt shows that codification, and legal reform, although deemed as tools of imperialism, could be used to counteract even further interference. Key Words: Egypt, Colonialism, Independence, Legal codes, Judicial System, British Empire, Nationalism

Early accurate breast cancer (BC) diagnosis is critical in disease management. Mammography has been widely used. However, its radiation, and high false-negative and -positive results have always been a concern. We evaluated combined detection of human epididymal protein 4 (HE4) and trefoil factor 3 (TFF3) as substitute method to enhance BC diagnosis.HE4 and TFF3 blood levels were determined by ELISA in sera of 120 BC patients and 80 women (40 healthy and 40 benign breast disease) as controls. Receiver-operating characteristic curve was applied for evaluation diagnostic power of each biomarker and their combination.In BC patients, serum HE4 [5 (2-11.9) vs. 3.1 (1.8-5.4) and 1 (1-3.5); P = 0.022] and TFF3 [5.3 (4.5-6.7) vs. 4.7 (4-4.8) and 3.9 (3-4.4); P = 0.027] were significantly higher than that in benign and healthy groups, respectively. Both HE4 (AUC = 0.783; P 0.0001) and TFF3 (AUC = 0.759; P 0.0001) had superior BC diagnostic ability compared to CEA and CA-15.3. Logistic regression analysis revealed simplified index BC-DETECT = HE4 + TFF3, and its values were significantly (P = 0.0132) elevated in BC (10.9 (8.4-17.2) compared to benign (7.2 (5.4-10.1)) and healthy (5.1 (4-6.3)) controls. AUC of BC-DETECT for BC prediction was (AUC = 0.850; P 0.0001) with sensitivity, specificity, and positive and negative predictive values and accuracy of 84.2%, 70%, 80.8%, 74.7%, and 78.5%, respectively. High BC-DETECT levels were associated with tumor non-luminal subtypes, late stage, high grade, large size, lymph-node invasion, and multiple lesions.BC-DETECT is inexpensive, rapid, and easy to perform and reliably guides BC early detection. Moreover, the association between elevated BC-DETECT values and disease severity may propose its potential role as prognostic marker.

This study aims at using pictorial art through educating art to develop some elements of environmental enlightenment among primary school students. The researchers have prepared a list of the dimensions of environmental enlightenment that should be included in the curriculum based upon the enlightenment environmental dimensions developed by the former researchers in this field. The researchers have prepared a proposal to the curriculum of art education in the light of those dimensions. A group of students (50 students) has been divided into two groups: experimental and adjustment. The research tools included a corrective test of environmental knowledge, a measure of environmental trends and a measure of the skill of solving environmental problems applied to the two groups; the experimental and that has been controlled in advance. The experimental group has studied four units of the proposal where the research tools (Environmental Knowledge Test, Environmental Trends and Environmental Problem Solving) have been re-applied to the experimental and control groups (afterwards). Where the study reached the following results: There is a statistically significant difference between the mean of the experimental group and the control group in the environmental knowledge test at (0.001) after teaching the proposed scenario for the experimental group in the remote application. There is a statistically significant difference between the mean scores of the experimental group and the control group in the environmental trends scale at (0.001) after teaching the proposed scenario for the benefit of the experimental group in the remote application. There is a statistically significant difference between the mean scores of the experimental group and the control group in the scale of environmental problem solving skill at (0.001) after teaching the proposed scenario for the benefit of the experimental group in the remote application.

Aim: Improvement of breast cancer (BrCa) control will be markedly supported by early detection. Owing to limitations of current diagnostic tools like mammography and ultrasound and lack of existing confirmed BrCa biomarkers, this study concerned the evaluation of some potential biomarkers and their combination in BrCa detection. Methods: Three hundred participant women; 200 with BrCa patients, 50 with benign breast diseases, and 50 healthy individuals were enrolled in this study. Serum levels of nuclear matrix protein-52 (NMP-52), collagen III, and matrix metalloproteinase-1 (MMP-1) were determined by ELISA. Results: Mean levels of NMP-52 (9.83±1.1 μg/ml), collagen III (22.6±3.2 μg/mL) and MMP-1 (3.6±0.3 μg/mL) in BrCa patients were significantly higher (P 2cm). Diagnostic scores combined these markers revealed valuable power (AUC=0.83, 78% sensitivity, 75% specificity) in BrCa diagnosis. This power is not markedly influenced in the detection of early tumor stages (Tis-T2), low grade (G1-G2), lesser tumor size ≤2 cm, and negative lymph nodes status (AUC=0.79, 0.74, 0.74, and 0.85, respectively). Conclusions: Combined use of NMP-52, collagen III, and MMP-1 can serve as a potential biomarker for BrCa diagnosis. This combination is likely to improve the clinical early tumor diagnosis.

Background: Currently, blood markers are noninvasive methods for the diagnosis of patients with colorectal cancer (CRC). We evaluated four biomarkers (Carcinoembryonic antigen (CEA), carbohydrate antigen 19.9 (CA19.9), collagen III, and metalloproteinase 1 (MMP-1)) and their combination as a substitute method to enhance diagnosis of CRC. Subjects and methods: one hundred ninety-five patients who had undergone colonoscopy examination were included in the study (135 CRC and 60 benign growths). Also, 45 healthy individuals were included. Multivariate discriminant analysis (MDA) and area under the receiver operating characteristic curve (AUC) were applied for evaluating the diagnostic power of single and their combination. Results: levels of collagen III, CEA, and CA 19.9 increased while MMP-1 decreased with the progression of CRC (stages, positive lymph node invasion, distant organ metastasis, and high grades) with a significant difference (P P < 0.0001). Combination of MMP-1, CEA, CA 19-9, and Collagen III yielded MC3 index had diagnostic power greater than every single marker could achieve alone. When differentiating colon cancer from benign growth, the AUC of MC3 index was 0.91 yielded 85.2% sensitivity and 86.7% specificity. Moreover, the MC3 index for patients with late stages, lymph node invasion, organ metastasis, and high-grade had AUC = 0.81, 0.82, 0.80, and 0.80 higher than CEA and CA19.9.Conclusion: MC3 index is can be used as an effective index for early detection of CRC.

Avian influenza (AI) has become a disease of great importance for human and animal health. Beside adverse side effects, there is resistance mutation for about all the conventional drugs that target viral proteins. This study aimed to evaluate antiviral activity of silver nanoparticles combined with epigallocatechingallate (EGCG-AgNPs) and co-administered with zinc sulphate (Zn+2) as alternative treatment strategy to control AI H9N2. EGCG conjugated silver nanoparticles (EGCG-AgNPs) were synthesized. Virus propagation was performed using embryonated Specific-Pathogen-Free (SPF) hen's eggs. Viral EID50 titers were determined before and after treatments. The antiviral activity was determined as Log virucidal reduction. A commercial tetrazolium MTS assay kit was used to determine cytotoxicity. Results showed that 50 μM EGCG was the most significant concentration reduced the logEID50/mL of AI H9N2. Co-treatment with zinc sulphate (1.3 mg/mL) increased the EGCG antiviral effect. The most effective antiviral activity was obtained when combined EGCG-AgNPs with zinc sulphate with the greatest virucidal log reduction. No cytotoxic effect in Vero cells was observed among all of these forms at concentrations of interest used in this study. In conclusion, the topical application of EGCG-AgNPs/ZnSO4 demands additional antiviral strategies against H9N2 AI. This combination may prevent virus transmission, inhibit virus replication within neighboring cells and inhibit microbial resistance by making microbial adaptability very difficult.

Background Data: Lumbar degenerative disorders may result in low back pain, leg pain and limitation of walking distance that can disturb the patients’ life. Several surgical procedures have been used to treat spinal canal stenosis ranging from minimal invasive to extensive decompression and fusion. However, recurrence of symptoms or instability may occur postoperatively. Purpose: To evaluate efficacy and safety of sublaminar decompression and fusion in the management of lumbar degenerative disorders. Study Design: Prospective clinical case study. Patients and Methods: Twenty patients including; 7 central canal stenosis, 5 degenerative disc disease, 4 foraminal and central stenosis, and 4 central stenosis and spondylolisthesis patients were enrolled in this study. All were treated with sublaminar decompression and fusion. Pre- and post-operative clinical evaluation included Visual Analogue scale (VAS) for back and leg pain, Oswestry Disability Index (ODI). Pre- and post-operative measurement of anteroposterior thecal diameter, thecal cross-sectional area, right and left foraminal height were obtained using MRI and CT-scan. The mean follow up duration was 13.85±8.30 (Range, 8-33) months. Results: VAS of leg pain improved from 7.3±1.4 to 2.4±0.9, VAS of the back pain improved from 7.4±0.9 to 2.3±0.5. ODI improved from 76±7.5 to 29.5±8.3. Anteroposterior thecal diameter changed from 10.4±1.4 mm to 14.1±1.1mm. Thecal sac cross sectional area improved from 134.2±19.6 mm2 to 184±20.4 mm2. Right foraminal height changed from 4.4±0.5 mm to 5.4±0.5 mm and left foraminal height changed from 4.2±0.5 mm to 5.2±0.5 mm. The mean time to achieve bone fusion in our series was 8.1 months and the fusion rate was 95%. Conclusion: Sublaminar decompression and fusion is safe and effective procedure in treatment of stenotic degenerative spinal disorders. It achieves high fusion rate without serious complications. (2018ESJ166)

INTRODUCTION AND AIM The correlation between interleukin-28B (IL-28B) polymorphisms and chronic hepatitis C (CHC) progression is debatable. Here, we aimed to evaluate the relation between IL-28B C/T genotypes and the development of cirrhotic liver. Extracellular matrix (ECM) proteins, FibroScan and model for end-stage liver disease (MELD) were used to substantiate the severity of liver disease. MATERIAL AND METHODS IL-28B rs12979860, liver stiffness and ECM proteins were assessed in 272 CHC patients. RESULTS Cirrhosis percentage increased to 10%, 52% and 96% with the increasing number of T alleles (CC, CT and TT, respectively). Also, elevated ECM proteins levels were correlated with the increasing number of T alleles. Interestingly, among cirrhotic patients, liver stiffness, MELD and ECM proteins were significantly (P < 0.0001) higher in patients with TT more than CT genotype. FibroScan, hyaluronic acid, Laminin, Collagen IV and the N-terminal pro-peptide of collagen type III have high accuracy to differentiate liver status in CC from TT genotype. Area under receiver-operating characteristic curve (95% CI) were 1.0 (1.0-1.0), 0.97 (0.96- 1.0), 0.93 (0.85-1.0), 0.98 (0.97-1.0) and 0.93 (0.91-0.97), respectively. CONCLUSION This study suggests that IL-28B T allele affects the natural course of CHC type 4 and also suggests that carriage of the IL-28B C allele protects from unfavorable clinical outcomes in CHC as coexistence of C allele with T allele reduced cirrhosis severity.

Due to the increasing complexity in systems development as well the highly competitive environment, it has become apparent that new ways of reducing system development time, minimize cost, enhance organizational efficiency, increase customer satisfaction, and improve the quality of the final systems are required. The Transdisciplinary Quality System development lifecycle (TQSDL) Model is one of the new systematic approaches models used as a design management tool for developing the complex systems based on scientific principles. This model is applied across the whole systems development lifecycle. The model processes are based on the Axiomatic Design (AD) and Quality Function Deployment (QFD) tool. One of the factors that influence the quality and the cost of the final systems is the supply chain. Also, one of the largest difficulties during the development of complex systems is tracking and expecting the changes in development cost due to changes in customer needs or function requirements.In this paper, the TQSDL model is extended to cover the supply chain process by adding a new domain to TQSDL domains. This new domain is introduced to manage the relationships between system components and all suppliers by using the QFD tool. As well as, Dependency Structure Matrix (DSM) will be integrated into the TQSDL process to improve information management and to address the interdependency between the system components and the interrelation between activities during systems development. Moreover, DSM with a new characteristic vector will aid to capture the changes in the development cost due to the changes in customer needs or function requirements. The enhancement in TQSDL model aims to provide a complete framework and systematic thinking to the designers and technical managers during the whole system development lifecycle. Moreover, it will also support the decision makers on whether or not to implement changes to a design.

The present study aimed to investigate cyberbullying among normal and attention deficit hyperactivity disorder (ADHD) university students based on some variables. Its population comprised (1312) students at Saudi universities and disability centers and covered a sample of (148) normal and ADHD students encountering cyberbullying. Two clinical case studies were conducted. The study adopted the descriptive and analytical method, as well as the clinical approach. It utilized the cyberbullying scale, interview form, and Thematic Apperception Test. Results revealed the proliferation of some cyberbullying types among normal and ADHD university students. The cultural nature of the community affected the type of cyberbullying. Furthermore, there were differences in cyberbullying between normal and ADHD university students in favor of the ADHD students and between males and females, favoring the males. Such differences were caused by psychological and cultural variables .

A single nucleotide polymorphism (SNP) in the interleukin 28B (IL28B) gene may alter the trajectory of hepatitis C virus (HCV) chronic infection. Several studies have sought to determine a link between IL28B rs12979860 SNP and the development of HCV-related hepatocellular carcinoma (HCC), but with variable results, and consensus is awaited. We hypothesised that IL28B rs12979860 SNP is linked to HCC in patients with HCV type 4.IL28B genotyping of 300 patients with HCV-related fibrosis (n = 100), cirrhosis (n = 100) and HCC (n = 100) was carried out and the results were analysed to determine the association between the IL28B genotype and clinical outcome.In IL28B TT genotype carriers, the proportions of moderate/severe fibrosis, advanced cirrhosis (Child B-C) and HCC (50%, 84% and 60.2%, respectively) were higher (p 0.05) than in CC/CT (4.3%, 46% and 23%, respectively). IL-28B SNP was linked significantly (p 0.05) with cirrhosis progression and HCC advanced stages. Moreover, HCC advanced Child, Okuda and CLIP stages were associated with T allele carriage (73.9%, 82.6% and 78.3% vs. 44.2%, 50.6% and 46.8% in CC/CT). The percentage of large tumour size ( 3cm) increased (p = 0.028) in TT genotype carriers (81.8% vs.52.6% in CC/CT).IL-28B rs12979860 TT genotype is more prevalent in patients with advanced fibrosis, cirrhosis and HCC stages. Thus, it seems to be associated with poor outcomes in chronic HCV patients and to augment the risk of developing HCC.

Perinatal exposure to hepatitis C virus (HCV) antigens during pregnancy may affect the developing immune system in the fetus. We aimed to study the perinatal transmission of HCV structural and non-structural antigens.Sera from 402 pregnant mothers were tested for anti-HCV antibody and HCV RNA. HCV antigens were determined in sera from 101 HCV-infected mothers and their cord blood.In both serum and cord blood samples, HCV NS4 (non-structural 4) at 27 kDa, E1 (envelope 1) at 38 kDa and E2 (envelope 2) at 40 kDa were identified, purified and quantified using western blotting, electroelution and ELISA. Maternal sera and neonate cord blood samples had similar detection rates for NS4 (94.1%), E1 (90.1%) and E2 (90.1%). The mean maternal serum levels (optical density, OD) of HCV NS4 (0.87 ± 0.01), E1 (0.86 ± 0.01) and E2 (0.85 ± 0.01) did not differ significantly (p0.05) from those of neonatal cord blood (0.83 ± 0.01, 0.87 ± 0.01 and 0.85 ± 0.01, respectively). Also, strong correlations (p0.0001) were shown between sera and cord blood sample levels of HCV NS4, r = 0.77; E1, r = 0.76 and E2, r = 0.80. The vertical transmission of these antigens in vaginal delivery did not differ significantly (p0.05) from those in caesarean section.These findings indicate that vertical transmission of HCV NS4, E1 and E2 antigens was very high. Thus, exposure to these antigens may influence the developing immune responses to natural infection or future vaccination.

Hepatitis C virus (HCV) has the lymphotropic feature that is supposed to be the reason of related extrahepatic manifestation. HCV viral oncoproteins may participate in the regulation of some gene expression that has been implicated in tumorigenesis. Our aim is to evaluate the HCV-NS4 circulating levels in breast cancer (BC) and to investigate its relation with BC tumor aggressiveness. This study was performed among 158 Egyptian women (120 with BC and 38 with benign breast diseases). ELISA was used for detection of anti-HCV antibodies, HCV-NS4, fibronectin, and CA 15-3. No association between HCV detection in this group of BC patients (27.5% in BC vs. 23.7% in breast benign diseases, P = 0.687). Among HCV-infected patients, the mean HCV-NS4 serum level in BC was significantly higher than benign group (61.7 μg/mL vs. 33.9 μg/mL, P = 0.0005). Fibronectin levels were higher (P = 0.014) in patients infected with HCV than noninfected BC patients. Elevated HCV-NS4 levels were associated with tumor severity features like large size, late stages, high grades, and infiltrated lymph nodes. The elevated levels of HCV-NS4 (> 40 μg/mL) yielded an estimated odds ratio (95% confidence intervals) of 2.5 (0.98–6.36), 1.2 (0.44–3.33), 1.9 (0.53–7.00), and 2.5 (0.87–7.33) for developing large size, late stages, high grades, and infiltrated lymph nodes, respectively. Interestingly, HCV-NS4 levels significantly correlated with other BC tumor marker like CA15-3 (r = 0.535; P = 0.0009) and fibronectin (r = 0.432; P

Hepatocellular carcinoma (HCC) is a multistage process resulting from various genetic changes. We aimed to determine nuclear phosphoprotein c-Myc and cellular phosphoprotein p53 expression and to evaluate their importance in HCC diagnosis.One hundred and twenty chronic hepatitis C (CHC) patients (60 non-HCC CHC patients and 60 HCC patients who had a single small (5 cm) tumour) were recruited. The gene products of c-Myc and p53 were identified in liver tissues and serum samples using immunostaining, western blot and ELISA.Immunohistochemical detection of c-Myc and p53 with monospecific antibodies revealed intense and diffuse cytoplasmic staining patterns. Accumulated mutant proteins, released from tumour cells into the extracellular serum, were detected at 62 KDa, for c-Myc, and 53 KDa, for p53, using western blotting. In contrast to alpha feto-protein, there was a significant increase (p 0.0001) in the positivity rate of c-Myc (86.7% vs. 6.7%) and p53 (78.3% vs. 8.3%) in the malignant vs. non-malignant patients. The parallel combination of c-Myc and p53 reach the absolute sensitivity (100%), for more accurate and reliable HCC detection (specificity was 87%).c-Myc and p53 are potential HCC diagnostic biomarkers, and convenient combinations of them could improve diagnostic accuracy of HCC.

Left ventricular noncompaction (LVNC) is a cardiomyopathy with hypertrabeculation of the LV, often complicated by heart failure, arrhythmia and thromboembolic events. The features of LVNC are still incompletely characterized due to its late recognition as clinically relevant condition. The aims of this study were to describe echocardiographic and electrophysiologic characteristics of LVNC patients and to assess the effects of chronic β-blocker treatment. Study patients (n = 20; 42.5 [36.3; 52.5] years; 12 men) exhibited reduced LV ejection fraction (median LVEF = 32 %) and an increased LV mass of 210 g. Sinus rhythm was present in 19 patients, whereas one patient was in atrial fibrillation. Baseline heart rate was 77.5 beats per minute. Left bundle branch block was detected in five cases. In a subgroup of patients receiving β-blocker therapy (n = 17), LV mass was reduced from 226 [178; 306] g to 220 [169; 254] g (p = 0.007) at 13 ± 6 months follow-up. By contrast, a subgroup of three patients that were not treated with an anti-β-adrenergic agent showed LV mass increase from 180 [169; 197] g to 199 [185; 213] g (p = 0.023). LVEF and electrocardiographic parameters were not significantly modulated during chronic β-blocker treatment. There was no sustained symptomatic ventricular tachyarrhythmia, thromboembolic event or death in either group. In conclusion, this study reveals reduction of LV mass among LVNC patients during β-blocker therapy. Effects of β-blocker treatment in LVNC require validation in prospective controlled studies.

Hepatitis C virus (HCV)-RNA amplification is a costly procedure in terms of time and reagents. Consequently, the search for more a cost-effective specific HCV diagnostic method is of great interest. Capillary zone electrophoresis (CZE) methods that detect HCV in serum, plasma, whole blood, and ascites without the need for sample pretreatment are not currently available. Here, a CZE method was developed that detects a larger specific peak in serum and other body fluids of HCV-infected patients than that found in healthy or hepatitis B virus (HBV)-infected individuals. The nature of the HCV peak was investigated using biochemical treatments, including RNase, DNase, and chymotrypsin enzymes. Electroeluted HCV peak was applied to transmission electron microscopy; electron micrographs showed that the HCV peak was attributed to virus-like particles with diameter and morphological properties similar to non-enveloped HCV nucleocapsids. The determination of CZE-HCV and HCV-RNA levels using quantitative real-time reverse transcriptase-polymerase chain reaction (qRT-PCR) in 258 subjects revealed that these two tests were highly correlated (r = 0.92, p < 0.0001). One important issue of HCV testing is the storage conditions of serum to obtain reliable results. Serum samples at −20 °C showed the best preservation of the HCV peak up to one year. In conclusion, we detected HCV using CZE in a microliters volume from different body fluids. Besides the stability of samples in maintaining their peak height, the HCV-CZE test is rapid (