Search

Toxoplasmosis is a serious health problem in humans and animals resulting from obligatory intracellular invasion of reticuloendothelial tissue by Toxoplasma gondii. The profound pathologic effect of toxoplasmosis is confined to nervous tissue, but many other organs, including the liver and spleen, are insulted. Many molecules like caspase-3, CD3, and CD138 are implicated in the tissue immune response in a trial to alleviate hazardous toxoplasmosis impact. This study aimed to investigate the effect of chronic toxoplasmosis on the liver and spleen tissues of mice using biochemical and histopathological techniques and to detect the activity and level of expression of caspase-3, CD3, and CD138 in these tissues using immunohistochemical labeling. Compared with normal control, altered normal histological features accompanied by inflammatory reaction were recorded in hepatosplenic reticuloendothelial tissues in chronically infected mice. The biochemical profile of the liver has been changed in the form of increased liver enzymes, and oxidative stress has been evidenced by elevated nitric oxide (NO) concentration in liver homogenate. The levels of caspase3, CD3, and CD138 were markedly expressed in the liver and spleen of infected mice. Our findings revealed the persistent effect of latent toxoplasmosis on the host’s histological architecture, metabolic, and immunological profile, creating a continued challenging host-parasite relationship.

Chronic kidney disease (CKD) imposes a strong and independent risk for peripheral artery disease (PAD). While solutes retained in CKD patients (uremic solutes) inflict vascular damage, their role in PAD remains elusive. Here, we show that the dietary tryptophan-derived uremic solutes including indoxyl sulfate (IS) and kynurenine (Kyn) at concentrations corresponding to those in CKD patients suppress β-catenin in several cell types, including microvascular endothelial cells (ECs), inhibiting Wnt activity and proangiogenic Wnt targets in ECs. Mechanistic probing revealed that these uremic solutes downregulated β-catenin in a manner dependent on serine 33 in its degron motif and through the aryl hydrocarbon receptor (AHR). Hindlimb ischemia in adenine-induced CKD and IS solute–specific mouse models showed diminished β-catenin and VEGF-A in the capillaries and reduced capillary density, which correlated inversely with blood levels of IS and Kyn and AHR activity in ECs. An AHR inhibitor treatment normalized postischemic angiogenic response in CKD mice to a non-CKD level. In a prospective cohort of PAD patients, plasma levels of tryptophan metabolites and plasma’s AHR-inducing activity in ECs significantly increased the risk of future adverse limb events. This work uncovers the tryptophan metabolite/AHR/β-catenin axis as a mediator of microvascular rarefaction in CKD patients and demonstrates its targetability for PAD in CKD models.

Background: Corticosteroids play a significant role in managing the vast majority of inflammatory and immunologic conditions. To date, population-based studies on knowledge and attitudes concerning corticosteroids are scarce. This study aims to comprehensively assess knowledge, perception, experience and phobia toward corticosteroid use among the general population in the era of COVID-19. Methods: A cross-sectional self-administrated questionnaire was used to collect the data from 6 countries. Knowledge and corticophobia scores, descriptive statistics and logistic regression were computed. Results: A total of 2354 participants were enrolled in this study; the majority were females (61.6%) with an average age of 30. Around 61.9% had been infected previously with COVID-19, and about one-third of the participants had experience with corticosteroid use. The mean knowledge score was relatively satisfactory (8.7 ± 4.5 out of 14), and Corticophobia ranked a high score in all countries. Age, female gender, and history of COVID-19 were positively correlated with developing corticophobia. Conclusion: Our study highlights that the general knowledge about steroids was satisfactory. However, the phobia toward its use upon indication is high. Therefore, enhancing awareness and providing essential counseling regarding the rational use of corticosteroids may reduce corticophobia.

Obesity might adversely affect the health and well-being of children and their families. Childhood obesity has crucial implications for health, both during childhood and as they age. It is highly associated with many acute problems and is commonly present during childhood, making visits and hospital admissions polarized in this group of children. The problems that may affect these children can be medical, such as asthma, chronic inflammation, orthopedic abnormalities, liver disease, diabetes mellitus or dyslipidemia. Long-term consequences of cardiovascular risk factors, the persistence of obesity and premature mortality are common among adults who had obesity during their early lives. Additionally, they could also suffer from psychological issues, such as low self-esteem, which puts them at risk of a much more serious psychosocial problem that may lead to depression, as well as a disruption in educational achievements and social relationships. A healthy diet, physical activity, adequate sleep, and limited screen time are all preventive measures that should be implemented at the family and community levels, preferably through well-structured programs. Furthermore, pharmacological management of childhood obesity is limited and only used after non-pharmacological interventions have failed or in the late stages of obesity. However, recent guidelines advocate the early use of medical interventions. Approved pharmacotherapeutic options include orlistat, phentermine/topiramate combination and liraglutide. There are several other options approved primarily for other specific forms of obesity or for other indications, including setmelanotide, metformin, lisdexamfetamine, zonisamide and fluoxetine. Bariatric surgery is a safe and effective option in cases with extreme obesity and comorbidities considering the need for long-term monitoring and support for cases and their families post-surgery. This review aims to discuss and highlight the recent evidence regarding risk factors, clinical consequences, prevention, and treatment of childhood obesity.

This study evaluated the treatments, mortality rate and patient-related factors associated with mortality. This is a retrospective study involving hospitalised patients with infections caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) in a tertiary hospital in Malaysia from January 2018 to June 2020. A clinical pharmacist reviewed patients’ electronic records and collected the data according to a pre-designed form. Data were analysed using both descriptive and inferential tests. The study included 145 patients with CR-GNB infections including 77, 40 and 28 Acinetobacter baumannii, enterobacteriaceae and Pseudomonas aeruginosa, respectively. The mean age was 57.9 ± 15.8 years. Pneumonia (40.7%) and bacteremia (25.5%) were the most common infections. Meropenem (24.7%) and piperacillin-tazobactam (20.4%) were the most commonly used empiric antibiotics while colistin (63.3%) and amikacin (8.3%) were the most common definitive antibiotics. The mean duration before active antibiotics was 4.6 ± 3.3 days. Overall, the in-hospital mortality rate was 41.4%. Multivariate logistic regression analysis showed that intensive care unit (ICU) admission (adjusted odds ratio (AOR): 5.201; 95% confidence interval (CI): 1.603–16.872; p = 0.006), sepsis/septic shock (AOR: 3.430; 95% CI: 1.021–11.522; p = 0.049) and elevated serum creatinine (AOR: 2.752; 95% CI: 1.005–7.536; p = 0.049) were independently associated with mortality. The mortality rate among patients with CR-GNB infection is high. A high rate of inappropriate antibiotic use was observed, including combination antibiotic therapy and delays in starting active antibiotics. Mortality was significantly associated with ICU admission, sepsis/septic shock and elevated serum creatinine.

Second- and third-line treatments of patients with antibiotic-resistant infections can have serious side effects, such as organ failure with prolonged care and recovery. As clinical practices such as cancer therapies, chronic disease treatment, and organ transplantation rely on the ability of available antibiotics to fight infection, the increased resistance of microbial pathogens presents a multifaceted, serious public health concern worldwide. The pipeline of traditional antibiotics is exhausted and unable to overcome the continuously developing multi-drug resistance. To that end, the widely observed limitation of clinically utilized antibiotics has prompted researchers to find a clinically relevant alternate antimicrobial strategy. In recent decades, the discovery of antimicrobial peptides (AMPs) as an excellent candidate to overcome antibiotic resistance has received further attention, particularly from scientists, health professionals, and the pharmaceutical industry. Effective AMPs are characterized by a broad spectrum of antimicrobial activities, high pathogen specificity, and low toxicity. In addition to their antimicrobial activity, AMPs have been found to be involved in a variety of biological functions, including immune regulation, angiogenesis, wound healing, and antitumor activity. This review provides a current overview of the structure, molecular action, and therapeutic potential of AMPs.

Endogenous nitro-fatty acids (NFA) are potent electrophilic lipid mediators that exert biological effects in vitro and in vivo via selective covalent modification of thiol-containing target proteins. The cytoprotective, anti-inflammatory, and anti-tumorigenic effects of NFA in animal models of disease caused by targeted protein nitroalkylation are a valuable basis for the development of future anti-phlogistic and anti-neoplastic drugs. Considering the complexity of diseases and accompanying comorbidities there is an urgent need for clinically effective multifunctional drugs. NFA are composed of a fatty acid backbone containing a nitroalkene moiety triggering Michael addition reactions. However, less is known about the target-specific structure–activity relationships and selectivities comparing different NFA targets. Therefore, we analyzed 15 NFA derivatives and compared them with the lead structure 9-nitro-oleic acid (9NOA) in terms of their effect on NF-κB (nuclear factor kappa B) signaling inhibition, induction of Nrf-2 (nuclear factor erythroid 2-related factor 2) gene expression, sEH (soluble epoxide hydrolase), LO (lipoxygenase), and COX-2 (cyclooxygenase-2) inhibition, and their cytotoxic effects on colorectal cancer cells. Minor modifications of the Michael acceptor position and variation of the chain length led to drugs showing increased target preference or enhanced multi-targeting, partly with higher potency than 9NOA. This study is a significant step forward to better understanding the biology of NFA and their enormous potential as scaffolds for designing future anti-inflammatory drugs.

Aim To study clinical, electrophysiological, and laboratory properties of peripheral neuropathy (PN) in systemic lupus erythematosus (SLE) and their association with disease activity. Patients and methods A total of 30 patients who met the American College of Rheumatology case definition criteria for SLE-PN and 30 age-matched and sex-matched patients with SLE without PN were selected from the Main Alexandria University Hospital Physical Medicine, Rheumatology and Rehabilitation clinic. Demographic data, SLE-related clinical, laboratory data, Systemic Lupus Activity Measure (SLAM) index, and nerve conduction studies were done. This case–control study compared clinical and SLE-related features, laboratory, and SLAM index in patients with SLE with PN versus those without neuropathy. Results The results showed that the most common PN subtype was sensorimotor polyneuropathy which occurred in 18 (60%) patients; the most common PN pathology was axonal degeneration, which occurred 19 (63.3%) patients; and the most common associated nerve entrapment was carpal tunnel syndrome in 10 (33.3%) patients. In comparison between group I (SLE with PN) and group II (SLE without PN), there was no statistically significant difference between the two groups regarding demographic data, disease duration, and lupus clinical features, except malar rash and lupus nephritis, which showed significant increase in patients with SLE with PN compared with patients with SLE without PN (P=0.003 and P

Objective To evaluate whether serum matrix metalloproteinase-9 (MMP-9) is associated with peripheral neuropathy (PN) in patients with systemic lupus erythematosus (SLE) and to determine the relationship between MMP-9 serum level and SLE disease activity, lupus manifestations, and laboratory markers. Patients and methods A total of 30 patients with SLE with PN, 30 patients with SLE without PN, and 20 healthy controls were included in this study. SLE clinical manifestations, Systemic Lupus Activity Measure (SLAM) index, and laboratory markers were evaluated. All the data were compared and correlated with serum MMP-9 level. Results MMP-9 showed a significant increase in frequency in SLE with PN group compared with SLE without PN group (P1=0.037), SLE with PN group compared with control group (P2

Plants especially in their natural habitat are considered part of a rich ecosystem that includes many various microorganisms in the soil. The current study aimed to identify the bacterial profile of agriculture-related soil samples using the metabarcoding technique to compare and explore relevant rhizosphere bacteria associated with plant cultivations in newly reclaimed land and habitual cultivated ones. The total environmental DNA was extracted from rhizosphere and noncultivated samples derived from three land types in Egypt. The bacterial 16S rDNA was amplified and sequenced by NGS technology to profile each sample. The microbial profile was characterized by statistical and literature-based methods. Among all samples, the most identified phyla were Actinobacteriota (28%), followed by Proteobacteriota (26%), Firmicutes (14%), Acidobacteriota and Chloroflexi (7%), Gemmatimonadota (5%), Bacteriodota and Crenarchaeota (3%), and Myxococcota (2%), in addition to 37 other phyla with

Cooperative non-orthogonal multiple access (NOMA) is a technology that addresses many challenges in future wireless generation networks by delivering a large amount of connectivity and huge system capacity. The aim of this paper is to design the varied distances and power location coefficients for far users. In addition, this paper aims to evaluate the outage probability (OP) performance against a signal-to-noise ratio (SNR) for a 6G downlink (DL) NOMA power domain (PD) and DL cooperative NOMA PD networks. We combine a DL cooperative NOMA with a 16 × 16, a 32 × 23, and a 64 × 64 multiple-input multiple-output (MIMO) and a 128 × 128, a 256 × 256, and a 512 × 512 massive MIMO in an innovative method to enhance OP performance rate and mitigate the power location coefficient’s effect for remote users. The results were obtained from Rayleigh fading channels using the MATLAB simulation software program. According to the outcomes, increasing the power location coefficients for the far user from 0.6 to 0.8 reduces the OP rate because increasing the power location coefficient for the far user decreases the power location coefficient for the near user, which results in less interference between them. In terms of the OP performance rate, the DL cooperative NOMA outperforms the NOMA. According to the findings, the DL cooperative NOMA OP rate outperforms the DL NOMA by a rate of 10−0.5. Whereas the 16 × 16 MIMO enhances the OP for the far user by 78.0 × 10−4, the 32 × 32 MIMO increases the OP for the far user by 19.0 × 10−4, and the 64 × 64 MIMO decreases the OP rate for the far user by 5.0 × 10−5. At a SNR of 10 dB, the 128 × 128 massive MIMO improves the OP for the far user by 1.0 × 10−5. The 256 × 256 massive MIMO decreases the OP for the far user by 43.0 × 10−5, and the 512 × 512 massive MIMO enhances the OP for the far user by 8.0 × 10−6. The MIMO techniques improve the OP performance, while the massive MIMO technology enhances the OP performance dramatically.

Background: Pain after laparoscopic cholecystectomy remains a major challenge. Ondansetron blocks sodium channels and may have local anesthetic properties. Aims: To investigate the effect of intraperitoneal administration of ondansetron for postoperative pain management as an adjuvant to intravenous acetaminophen in patients undergoing laparoscopic cholecystectomy. Methods: Patients scheduled for elective laparoscopic cholecystectomy were randomized into two groups (n = 25 each) to receive either intraperitoneal ondansetron or saline injected in the gall bladder bed at the end of the procedure. The primary outcome was the difference in pain from baseline to 24-h post-operative assessed by comparing the area under the curve of visual analog score between the two groups. Results: The derived area under response curve of visual analog scores in the ondansetron group (735.8 ± 418.3) was 33.97% lower than (p = 0.005) that calculated for the control group (1114.4 ± 423.9). The need for rescue analgesia was significantly lower in the ondansetron (16%) versus in the control group (54.17%) (p = 0.005), indicating better pain control. The correlation between the time for unassisted mobilization and the area under response curve of visual analog scores signified the positive analgesic influence of ondansetron (rs =0.315, p = 0.028). The frequency of nausea and vomiting was significantly lower in patients who received ondansetron than that reported in the control group (p = 0.023 (8 h), and 0.016 (24 h) respectively). Conclusions: The added positive impact of ondansetron on postoperative pain control alongside its anti-emetic effect made it a unique novel option for patients undergoing laparoscopic cholecystectomy.

Background and Aims: COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and “lockdown” measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic.Design: Cross-sectional survey.Setting: Worldwide.Participants: Starting on April 4, 2020 during a 5-week period, the survey received 185 responses from 77 countries.Measurements: To assess addiction medicine professionals' perceived changes in drug and alcohol supply, price, use pattern, and related complications during the COVID-19 pandemic.Findings: Participants reported (among who answered “decreased” or “increased”) a decrease in drug supply (69.0%) and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported, while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall.Conclusions: The global report on changes in the availability, use patterns, and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to people with SUD.

In this study, a deep learning bidirectional long short-term memory (BiLSTM) recurrent neural network-based channel state information estimator is proposed for 5G orthogonal frequency-division multiplexing systems. The proposed estimator is a pilot-dependent estimator and follows the online learning approach in the training phase and the offline approach in the practical implementation phase. The estimator does not deal with complete a priori certainty for channels’ statistics and attains superior performance in the presence of a limited number of pilots. A comparative study is conducted using three classification layers that use loss functions: mean absolute error, cross entropy function for kth mutually exclusive classes and sum of squared of the errors. The Adam, RMSProp, SGdm, and Adadelat optimisation algorithms are used to evaluate the performance of the proposed estimator using each classification layer. In terms of symbol error rate and accuracy metrics, the proposed estimator outperforms long short-term memory (LSTM) neural network-based channel state information, least squares and minimum mean square error estimators under different simulation conditions. The computational and training time complexities for deep learning BiLSTM- and LSTM-based estimators are provided. Given that the proposed estimator relies on the deep learning neural network approach, where it can analyse massive data, recognise statistical dependencies and characteristics, develop relationships between features and generalise the accrued knowledge for new datasets that it has not seen before, the approach is promising for any 5G and beyond communication system.

Objective: The surgical resection of pulmonary metastases is associated with a survival benefit in selected patients. The use of laser devices for pulmonary metastasectomy (PM) is believed to facilitate the complete resection of metastases while preserving a maximum of healthy parenchyma. This is a prospective study to evaluate surgical outcome including the changes of lung function after laser–assisted surgery (LAS).Methods: A total of 77 operations in 61 patients in which PM was carried out in a curative intent were analyzed. A 1.320 nm diode-pumped Nd: YAG-Laser was used for resection of the metastases. Surgical and clinical data were collected using a standardized form and postoperative lung function changes 3 and 6 months after surgery were assessed using whole body plethysmography and diffusion capacity for carbon monoxide (DLCO). Size and distance of metastases to the pleural surface were measured radiologically.Results: A median of two metastases were resected per operation (range 1–13). The median duration of postoperative air leak was 1 day (range 0–11). LAS associated postoperative minor and major complications were observed in 4 (5%) cases and 1 (1%) case, respectively; there were no mortalities. The analysis of perioperative lung function showed that mean VC 3 months after surgery was reduced by 11 %, FEV1 by 11% and median DLCO by 11% (all p < 0.0001). There was almost no recovery of lung function between 3 and 6 months in the whole cohort. Patients with two or less metastases showed a recovery of lung function after 3 months regarding DLCO (p = 0.003). Decline of DLCO in the whole cohort correlated with the number of resected metastases at 3 months (r = 0.45, p = 0.006) and at 6 months (r = 0.42, p = 0.02) as well as depth of metastases in the parenchyma at 6 months (r = 0.48, p = 0.001).Conclusions: LAS is a safe and effective method for PM even for higher numbers of metastases, with short duration of postoperative air leak and little morbidity. Number and depth, but not size of metastases affect lung function changes after resection.

A greenhouse experiment was conducted during the seasons of 2016 - 2017 to compare the impact of foliar amino acids binding (0.5, 1 and 2 g.L-1) and yeast extract ( 2.5, 5 and 10 g.L-1) on certain development and physiological parameters of hot pepper (Capsicum annuum L.). The results cleared that foliar application of amino acid (2 g.L-1) or yeast (10 g.L-1) increased development parameters of hot pepper compared to control in both first and second seasons. Amino acids foliar implementation with (2 g.L-1) gave higher content of anthocyanins, ascorbic acid, lycopene and íŸ- carotene contents as compared with the control. Also, 10 g.L-1 foliar application of yeast extract showed the best results as compared to control in both first and second seasons. Foliar application of amino acids contents increased phenol and flavonoid contents of hot pepper fruits. Maximum increase was observed at 2 g.L-1 amino acids in both seasons. While 1,1-Diphenyl-2-picrylhydrazyl (DPPH) and lipid peroxidation contents increased with 2 g.L-1 amino acids and 10 g.L-1 yeast foliar application. The HPLC analysis of ethanolic extract of hot pepper fruits has shown fifteen phenolic compounds. Phenolic compounds were increased by increasing the concentration of amino acid and yeast extract foliar application in the both two seasons. In conclusion it is recommended to use amino acid (2 g.L-1) and yeast extract (10 g.L-1) foliar application as they play a key role in productivity , also in protecting the environment as eco-friendly and cost-effective inputs for the farmers.

Background Data: Brown tumor is a lytic bone tumor and has variable symptoms according to the affected site. It is called brown because of its characteristic brown color believed to have occurred after accumulation of blood, fibrous tissue, and hemosiderin. Hyperparathyroidism can result in a brown tumor whether it is primary or secondary, but this case is much rarer in primary hyperparathyroidism. It rarely affects the spine, while it is extremely rare to compromise the spinal canal. Purpose: To report a rare case of lumbar spinal brown tumor with primary hyperparathyroidism. Study Design: A case report of brown tumor of the lumbar spine (5th lumbar vertebrae). Patients and Methods: Our case was a forty-year-old female patient presenting with persistent dull aching low back pain. There was no history of any chronic illness. She had a 5-month history of slowly progressive left lower limb radicular pain and not associated with sphincter disturbance. Magnetic resonance imaging of the spine demonstrated lesion affecting the 5th lumbar vertebrae invading the left pedicle and compressing the spinal canal. Results: Team did neural decompression, biopsy harvesting, and partial corpectomy with reconstruction of the affected lumbar vertebra (L5) followed by fixation by rods and screws. The patient showed relief of the radicular pain and back pain on VAS. Histopathological analysis of the biopsy showed evidence of giant-cell tumor (brown tumor). Parathyroid survey was done and showed normal calcium levels. By revising the literature, we claim that this present study is reporting the 10th case of brown tumor of lumbar spine in patient with primary hyperparathyroidism. Conclusion: The diagnosis of brown tumor of spine could be considered in patients with lytic spine lesions. (2019ESJ192)

The present work was undertaken with the aim of studying the microstructural changes as well as variations in the tensile properties of 413.0 alloy. The ultimate tensile strength (UTS), elastic limit (YS) and elongation to fracture (%El) resulting from the addition of alloying elements – strontium (Sr), magnesium (Mg), copper (Cu), silver (Ag), nickel (Ni), zinc (Zn), cerium (Ce) and lanthanum (La) to the base alloy, and heat treatment were measured. Furthermore, the effect of the addition of phosphorus (P) as well as heat treatment on the microstructure and properties of the base alloy 413.0 modified with Sr was studied from the point of view of the interaction between phosphorus and strontium during the solidification process. The findings revealed that the addition of Mg, Cu, Ag, Ni, Zn, and Sr cause an increase in the values of UTS and YS coupled with a decrease in the values of %El of the base alloy 413.0 following the heat treatment. The hardening effect produced by the addition of ∼0.4% Mg is more or less equal to that obtained from the addition of ∼3% Cu. Alloys modified with Sr show high tensile properties. In addition, the results demonstrate that alloys modified with Sr in which P was added possess ductility values of the order of 4–12%, which is much higher compared to the 2% obtained for the non-modified 413.0 base alloy. Keywords: Aluminum alloys, Heat treatment, Alloying elements, Q-charts, Tensile properties, P–Sr interaction

Background. Eptifibatide achieves high local concentration via direct intracoronary (I/V) injection as it promotes clot disaggregation, but it remains unclear if it is of superior benefit than the routine intravenous (I/V) administration. Aim. The current study aimed to examine the safety and efficacy of I/C vs I/V bolus regimen dose of eptifibatide during primary percutaneous coronary intervention (PPCI).Material and methods. Prospective, controlled, randomized study enrolled 100 patients with acute anterior ST-segment elevation myocardial infarction (STEMI) eligible for PPCI equally divided into 2 groups (group A received bolus I/C eptifibatide and group B received it I/V) followed by 12-hour continuous I/V infusion. Features related to of myocardial salvage in the form of TIMI flow grade 3, myocardial blush grade 3, ST segment resolution and left ventricular systolic function were evaluated with short-term follow up for 1 month.Results. Mean age of the study population was 50.95±8.45years, there was statistically insignificant difference between both groups regarding baseline characteristics in age (p=0.062), gender (p=0.488), coronary artery disease risk factors (p>0.05), time from onset of pain to admission (p=0.86) or door to balloon (p=0.12). Group A achieved statistically significant better myocardial blush grade 3 (42% vs 10%, p=0.005), ejection faction 30 days after PPCI (46.11±7.81% vs 40.88±6.26%, p=0.005) but statistically insignificant TIMI flow grade 3 (p=0.29) and ST resolution (p=0.34). Incidence of complications in the hospital and 30 days after discharge was statistically insignificant (p>0.05).Conclusion. Both regimens were safe and effective in STEMI patients undergoing PPCI and regimen of I/C bolus eptifibatide achieved better myocardial blush grade and systolic function.

Abstract Forty-two bacterial isolates were collected from soft-rotted potato tubers originating from four governorates in Egypt. Their phenotypic and genetic characteristics were studied. The phenotypic identification resulted in grouping the studied isolates into five different species and/or genera including Pectobacterium sp., Bacillus sp., Dickeya sp., Pseudomonas sp. (1), and Pseudomonas sp. (2). The molecular identification of the 10 isolates of them were pathogenic to potato tubers and other hosts. More specific identification of the later 10 isolates, using two specific primers for P. carotovorum subsp. carotovorum (Pcc) and the reference strain PccY46 (Acc. No. KP187511.1), revealed that all these isolates had yielded 220–272-bp DNA fragments identical to the 16S rRNA gene of PccY46. Phylogenetic analysis showed sequence similarity ranging from 87 to 98%, which confirmed the genetic variation among the 10 tested strains of Pcc. The isolates were distributed in four major clusters, each subdivided into a few sub-clusters. In another experiment, two different essential oils (peppermint and clove oils) plus a nano-Cu-based fungicide (Tango®), in comparison to the two different antibiotics and the two copper fungicides, were evaluated for their potential management on the three most severe bacterial isolates (Pcc1, Pcc5, and Pcc10). Results of in vivo experiment showed that clove oil was the most effective, where it caused a reduction of disease severity (0.0%) on potato tubers, 4 days post artificial inoculation.

Abstract Background The term minimal hepatic encephalopathy (MHE) is defined as encephalopathy that does not lead to clinically overt cognitive dysfunction but can have an impact on quality of life, risk of involvement in road traffic accidents, and ability to function in daily life. Objective To identify the incidence of minimal hepatic encephalopathy in patients actively involved in a road traffic accident and its role in the increased incidence of road traffic accidents. Patients and methods We included 74 patients presented in road traffic accidents (drivers, history of fall, pedestrians whom accidents occur during crossing the road) with clinically proven hepatic cirrhosis, without clinical manifestation of hepatic encephalopathy (HE). Thorough history taking, clinical examinations, routine laboratory investigations, serum IL-6 and ammonia in blood were done. Diagnosis of MHE is based on psychometric hepatic encephalopathy score (PHES) which includes digit symbol test (DST), number connection test-A (NCT-A), number connection test-B (NCT-B), serial dotting test (SDT), and line drawing test (LDT). Results The mean age was 52.0 ± 7.47 in MHE patients. Most of the MHE patients were males. Most of the patients with MHE were working other jobs and were not drivers (63.2% vs 36.8%). MHE was observed in 19 patients (25.7%). Albumin, interleukin-6 (IL-6), and ammonia were statistically significantly different between both groups. Conclusion Minimal hepatic encephalopathy (MHE) was observed in 25.7% of patients which points that we must give attention in the screening of MHE as road traffic accident is considered the main cause of mortality in our community with high incidence of liver disease.

(1) Objectives: Clinical pharmacists are now playing a significant role in hospitals aiming to reduce medication errors, adverse drug reactions, and healthcare costs. Therefore, the main objective of this study was to assess the interventions provided by a clinical pharmacist in the intensive care unit at the King Faisal Hospital in Taif city. (2) Methods: For this single-center retrospective study, patients were included from December 2021 to May 2022. In the present study, all the interventions of clinical pharmacists made over six months were included. The Intensive care unit (ICU) ward was covered by three clinical pharmacists, and the interventions made were categorized into four groups: (1) interventions related to indications; (2) interventions regarding safety; (3) interventions regarding dosing, and (4) miscellaneous. Descriptive statistics was applied to evaluate the results in the form of frequencies and percentages. Analysis was performed using the statistical package SPSS 20.0. (3) Results: Overall, a total of 404 interventions were recommended for 165 patients during the six- month period of study. Among them, 370 interventions (91.5%) were accepted by physicians. Among all the interventions, the majority were suggested regarding ‘indication’ (45.7%), including the addition of drugs, drugs with no indications, and duplication. The acceptance rate of clinical pharmacist intervention was 98.5%. (4) Conclusions: This retrospective study shows that clinical pharmacists played a critical role in optimizing drug therapy which could subsequently help to prevent drug-related issues and lower drug costs. More research is needed to do a thorough cost-benefit analysis.

The integration of multiple-input multiple-output (MIMO) and non-orthogonal multiple access (NOMA) technologies is a hybrid technology that overcomes a myriad of problems in the 5G cellular system and beyond, including massive connectivity, low latency, and high dependability. The goal of this paper is to improve and reassess the bit error rate (BER), spectrum efficiency (SE) of the downlink (DL), average capacity rate, and outage probability (OP) of the uplink (UL) in a 5G network using MIMO. The proposed model utilizes QPSK modulation, four users with different power location coefficients, SNR, transmit power, and two contrasting bandwidths 80 and 200 MHz under selective frequency Rayleigh fading channels. The proposed model’s performance is evaluated using the MATLAB software program. The DL results found that the BER and SE against transmitted power showed the MIMO-NOMA enhanced the BER performance for the best user U4 from 10−1.7 to 10−5.2 at 80 MHz bandwidth (BW), and from 10−1.5 to 10−5 at 200 MHz for transmitting power of 40 dBm. In contrast, the SE performance for the best user U4 is enhanced from 24 × 10−3 to 25 × 10−3 bits/second/Hz at 80 MHz BW and from 19.8 × 10−3 to 20 × 10−3 bps/Hz at 200 MHz BW. Although the outcomes for the UL were obtained in terms of average capacity rate and OP versus SNR at 80, and 200 MHz BW, the MIMO-NOMA result showed that the average capacity rate for the best user U4 performance improves by 12 bps/Hz for 1 dB SNR and the OP is reduced by 15 × 10−3 for 80 MHz BW and by 12 × 10−3 for 200 MHz BW at an SNR of 0.17 dB. As the BW increased the BER, the average capacity rate increased while the SE and OP decreased. For both DL/UL NOMA with and without MIMO, closed-form expressions for BER, SE, average capacity rate, and OP were obtained. All users’ performance, even those whose connections were affected by interference or Rayleigh fading channels significantly improved, when MIMO-NOMA was implemented.

Fusarium toxins are the largest group of mycotoxins, which contain more than 140 known secondary metabolites of fungi. Deoxynivalenol (DON) is one of the most important compounds of this class due to its high toxicity and its potential to harm mankind and animals and a widespread contaminant of agricultural commodities, such as wheat, corn, barley, oats, bread, and biscuits. Herein, a hybridoma cell 8G2 secreting mAb against DON was produced by fusing the splenocytes with a tumor cell line Sp2/0. The obtained mAb had a high affinity (2.39 × 109 L/mol) to DON. An indirect competitive Enzyme-Linked Immunosorbent Assay (ic-ELISA) showed that the linear range for DON detection was 3.125–25 μg/mL, and the minimum inhibitory concentration (IC50) was 18.125 μg/mL with a limit of detection (LOD) of 7.875 μg/mL. A colloidal gold nanoparticle (AuNP) with 20 nm in diameter was synthesized for on-site detection of DON within 10 min with vLOD of 20 μg/mL. To improve the limit of detection, the gold nanoflower (AuNF) with a larger size (75 nm) was used to develop the AuNF-based strip with vLOD of 6.67 μg/mL. Compared to the vLOD of a convectional AuNP-based strip, the AuNF-based strip was three times lower. Herein, three immunoassay methods (ic-ELISA and AuNP/AuNF-based strips) were successfully developed, and these methods could be applied for the DON detection in agricultural products.

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic.Methods: One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups.Results: Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted.Conclusions: Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.

Purpose This study investigated pharmacy students’ perceptions of various aspects of virtual objective structured clinical examinations (vOSCEs) conducted during the coronavirus disease 2019 pandemic in Malaysia. Methods This cross-sectional study involved third- and fourth-year pharmacy students at the International Islamic University Malaysia. A validated self-administered questionnaire was distributed to students who had taken a vOSCE a week before. Results Out of the 253 students who were approached, 231 (91.3%) completed the questionnaire. More than 75% of the participants agreed that the instructions and preparations were clear and helpful in familiarizing them with the vOSCE flow. It was found that 53.2% of the respondents were satisfied with the flow and conduct of the vOSCE. However, only approximately one-third of the respondents believed that the tasks provided in the vOSCE were more convenient, less stressful, and easier to perform than those in the conventional OSCE. Furthermore, 49.7% of the students favored not having a vOSCE in the future when conducting a conventional OSCE becomes feasible again. Internet connection was reported as a problem hindering the performance of the vOSCE by 51.9% of the participants. Students who were interested in clinical pharmacy courses were more satisfied than other students with the preparation and operation of the vOSCE, the faculty support, and the allocated time. Conclusion Students were satisfied with the organization and operation of the vOSCE. However, they still preferred the conventional OSCE over the vOSCE. These findings might indicate a further need to expose students to telehealthcare models.

Soil salinity is significant abiotic stress that severely limits global crop production. Chickpea (Cicer arietinum L.) is an important grain legume that plays a substantial role in nutritional food security, especially in the developing world. This study used a chickpea population collected from the International Center for Agricultural Research in the Dry Area (ICARDA) genebank using the focused identification of germplasm strategy. The germplasm included 186 genotypes with broad Asian and African origins and genotyped with 1856 DArTseq markers. We conducted phenotyping for salinity in the field (Arish, Sinai, Egypt) and greenhouse hydroponic experiments at 100 mM NaCl concentration. Based on the performance in both hydroponic and field experiments, we identified seven genotypes from Azerbaijan and Pakistan (IGs: 70782, 70430, 70764, 117703, 6057, 8447, and 70249) as potential sources for high salinity tolerance. Multi-trait genome-wide association analysis (mtGWAS) detected one locus on chromosome Ca4 at 10618070 bp associated with salinity tolerance under hydroponic and field conditions. In addition, we located another locus specific to the hydroponic system on chromosome Ca2 at 30537619 bp. Gene annotation analysis revealed the location of rs5825813 within the Embryogenesis-associated protein (EMB8-like), while the location of rs5825939 is within the Ribosomal Protein Large P0 (RPLP0). Utilizing such markers in practical breeding programs can effectively improve the adaptability of current chickpea cultivars in saline soil. Moreover, researchers can use our markers to facilitate the incorporation of new genes into commercial cultivars.

IntroductionEnd-stage kidney disease (ESKD) patients are at a high risk for Coronavirus Disease 2019 (COVID-19). In this study, we compared characteristics and outcomes of ESKD and non-ESKD patients admitted with COVID-19 to a large safety-net hospital.MethodsWe evaluated 759 adults (45 with ESKD) hospitalized with COVID-19 in Spring of 2020. We examined clinical characteristics, laboratory measures and clinical outcomes. Logistic regression analyses were performed to investigate the associations between ESKD status and outcomes.Results73% of ESKD and 47% of non-ESKD patients identified as Black (p = 0.002). ESKD patients were older and had higher rates of comorbidities. Admission ferritin was approximately 6-fold higher in ESKD patients. During hospitalization, the rise in white blood cell count, lactate dehydrogenase, ferritin and C-reactive protein, and the decrease in platelet count and serum albumin were all significantly greater in ESKD patients. The in-hospital mortality was higher for ESKD [18% vs. 10%; multivariable adjusted odds ratio 1.5 (95% CI, 0.48-4.70)], but this did not reach statistical significance.ConclusionsAmong hospitalized COVID-19 patients, ESKD patients had more co-morbidities and more robust inflammatory response than non-ESKD patients. The odds ratio point estimate for death was higher in ESKD patients, but the difference did not reach statistical significance.

We compared the results of absorbed dose measurements made using the TRS-398, TG-51, and DIN protocols and their associated uncertainties to reduce discrepancies in measurement results made using the three protocols. This experiment was carried out on two Varian Medical linear accelerators with 4, 6, 10, and 20 MV photon energies using FC65-G and CC15 (cylindrical) and NACP-02-type (plane-parallel) ion chambers in water phantoms. The radiation beam quality index (Q) was determined from the measurement of percentage depth dose. It was used to determine the photon beam quality factor required with the ionization chamber calibration factor to convert the ion chamber reading into the absorbed dose to water. For the same beam quality, the TRS-398/TG-51 varied from 0.01% to 1.8%, whereas the ratio for TRS-398/DIN 6800-2 varied from 0.1% to 0.88%. The chamber-to-chamber variation was 0.09% in TRS-398/TG-51, 0.03% in TRS-398/DIN, and 0.02% in TG-51/DIN 6800-2. The expanded uncertainties (k = 1) were 1.24 and 1.25 when using TRS-398 and DIN 6800-2, respectively. Using the aforementioned three protocols, the results showed little chamber-to-chamber variation and uncertainty in absorbed dose measurements. The estimated uncertainties when using cylindrical ion chambers were slightly lower than those measured using plane-parallel chambers. The results are important in facilitating comparisons of absorbed dose measurements when using the three protocols.

This study reports a simple new technique for the preparation of novel hexagonal-shaped mixed metal oxides (MMO) nanorods using Zn/Al-layered double hydroxide (LDH) as a precursor for dye-sensitized solar cell (DSSC) application. The effect of the Zn to Al molar ratio demonstrated a sound correlation between the obtained nanorods’ diameter and the fabricated DSSCs efficiency. Additionally, the optical behavior of the fabricated MMO film as well as the absorption enhancement due to the utilized dye are also demonstrated; a cut-off phenomenon at around 376 nm corresponds to the attained hexagonal nanorods. The open-circuit voltage augmented noticeably from 0.6 to 0.64 V alongside an increase in the diameter of nanorods from 64 to 80 nm. The results indicated that an increment in the diameter of the nanorods is desirable due to the enhanced surface area through which a higher amount of dye N719 was loaded (0.35 mM/cm2). This, in turn, expedited the transport of electrons within the MMO matrix resulting in an advanced short-circuit current. Of the devices fabricated, ZA-8 exhibited the highest fill factor and efficiency of 0.37% and 0.69%, respectively, because of its boosted short-circuit current and open-circuit voltage.

We study the transmission and reflection properties of a single-photon pulse in a one-dimensional waveguide side coupled with a Jaynes-Cummings system, namely, a multi-cavity with an embedded Rydberg atom. A Single-photon pulse is applied to tune the atoms energy spectrum, and varying it can bring the atomic qubit transition on or off-resonance for the cavity. The transmission and reflection behavior are systematically explored by a real-space model Hamiltonian and we find that the coupling strength between the waveguide and the side optical cavity exerts a tremendous impact on it. The influence of cavity and atomic dissipations and the incident pulse width on the transport properties of the single-photon is also investigated simultaneously. Based on these phenomena, we point out the possibility of utilizing this system as a single-photon transport in practice and has potential applications in quantum information.

Cet article propose une stratégie de couplage entre deux processus, le pronostic et le diagnostic, basée sur le modèle OSA-CBM et appliquée au cas des générateurs photovoltaïques. Dans un premier temps, les principales méthodes de couplage : Watch Dog, PEDS, SIMP et OSA-CBM sont décrites. Puis, les avantages de la stratégie OSA-CBM en particulier ses sept couches spécialisées permettant l'interopérabilité des processus sont mis en avant. Suivant cette architecture, un système de monitoring fournissant les indicateurs de performance des GPV est mis en œuvre et les résultats sont utilisés pour l'aide à la prise de décision de maintenance. Enfin, l'évolution de l'indicateur de dégradation CPR et surtout de son taux de réduction (Rd), est utilisée pour le contrôle du couplage entre les processus. Cette approche est validée en utilisant des données expérimentales issues de quatre installations photovoltaïques (projet IEA PVPS Task13).

Purpose: We systematically reviewed the literature to compare the clinical and radiologic outcomes and retear rates of superior capsular reconstruction (SCR) using fascia lata autograft (FLA) versus human dermal allograft (HDA) in cases of massive irreparable rotator cuff tears. Methods: Searches of Pub Med and Cochrane Library identified clinical studies addressing SCR using FLA and HDA. Two reviewers independently screened the titles, abstracts and full texts to extract data from eligible studies. Reported outcome measures were descriptively analyzed. Results: A total of 6 studies with 2 study groups satisfied the inclusion criteria. The number of shoulders in the HDA group was 155, and in the FLA group, the number was 140 shoulders. The mean age at time of surgery for the HDA group and the FLA group was 60.49 years and 65.8 years, respectively, and the mean follow-up was 15.2 months and 44.6 months, respectively. Active elevation improved from of 121°-130° to 158°-160° in the HDA group and from 74.8°-133° to 130.4°-146° in the FLA group. Active external rotation improved from 36°-45° in the HDA group and from 13°-28° to 30°-43° in the FLA group. The Visual Analog Scale for pain improved from 4-6.25 to 0.38-1.7 points in the HDA group, whereas in the FLA group, it improved from 6-2.5 points. In the HDA group, American Shoulder and Elbow Surgeons scores improved from 42-52 to 77.5-86.5, whereas in the FLA group scores improved from 35-54.4 to 73.7-94.3. The acromiohumeral distance improved in both groups. The retear rate was 3.4%-55% in the HDA group and 4.5%-29% % in the FLA group. Conclusions: Arthroscopic SCR for massive, irreparable rotator cuff tears using both fascia lata allograft and human dermal allograft leads to improvement in clinical outcomes and radiologic outcomes. There is a lower retear rate in fascia lata allografts. The current literature is heterogeneous and has low levels of evidence. Level of Evidence: Level IV, systematic review of level IV studies.

Introduction Objective of the ‘German hyperthermic intrathoracic chemotherapy (HITOC) study’ is to evaluate the HITOC as additional treatment after surgical cytoreduction for malignant pleural tumours. Even though HITOC is applied with increasing frequency, there is no standardised therapy protocol concerning the technique of HITOC, the selection as well as dosage of chemotherapeutic agents and perioperative management in order to provide a safe and comparable, standardised treatment regime.Methods and analysis This trial is a retrospective, multicentre observational study, which is funded by the German Research Foundation. Approximately 300 patients will be included. Four departments of thoracic surgery, which are performing the most HITOC procedures in Germany, are contributing to this study: Center for Thoracic Surgery at the University Hospital Regensburg, Thoracic Clinic Heidelberg of the University of Heidelberg, Center for Thoracic Surgery of the Hospital University of Munich and the Department of Thoracic Surgery at the University Hospital Freiburg. All patients who underwent surgical cytoreduction and subsequent HITOC at one of the four centres between starting the HITOC programme in 2008 and December 2019 will be included. Information on the performed HITOC will be obtained, focusing on the technique as well as the applied perfusion solution including the chemotherapeutic agent. Furthermore, parameters of the patient’s postoperative recovery will be analysed to determine 30-day morbidity and mortality.Ethics and dissemination The approvals by the local ethics committee of the respective clinic and the three participating clinics have been obtained. The results will be presented in conferences and published in a peer-reviewed journal.Trial registration number German Clinical Trials Registry (DRKS00015012; Pre-results).

There has been a steady rise in the number of patients treated with cardiac implantable electrical devices. Remote monitoring and remote follow-up have proven superior to conventional care in the follow-up of these patients and represent the new standard of care. With the widespread availability of smartphones and with more people using them for health queries, app-based remote care offers a promising new digital health solution promoting the shift of follow-up to exception-based assessments. It focuses on patients’ enablement and has shown promising results, but also highlights the need to increase the system’s automaticity to achieve acceptable follow-up adherence rates. MyCareLink Heart is a fully automated app-based system that represents the next generation of app-based monitoring and is currently being evaluated in an international study with promising initial results.

Ochratoxins were important secondary metabolites secreted by fungi, and OTA and OTB are mainly significant mycotoxin, having toxic effects on humans and animals. Therefore, it is important to establish a rapid, sensitive, and precise method for ochratoxins detection and quantification in real samples. In this study, a stable monoclonal antibody (mAb) that recognizing both OTA and OTB toxins was employed for the establishment of indirect competitive ELISA (ic-ELISA), colloidal gold nanoparticles (CGNs), and nanoflowers gold strips (AuNFs) for detection of ochratoxins in real samples. A 6E5 hybridoma cell line stable secreting mAb against both OTA and OTB toxins was obtained by fusion of splenocytes with myeloma SP2/0 cells. The 6E5 mAb had a high affinity (3.7 × 108 L/mol) to OTA, and also showed similar binding activity to OTB. The optimized ic-ELISA resulted in a linear range of 0.06–0.6 ng/mL for ochratoxins (OTA and OTB) detection. The IC50 was 0.2 ng/mL and the limit of detection (LOD) was 0.03 ng/mL. The mean recovery rate from the spiked samples was 89.315 ± 2.257%, with a coefficient variation of 2.182%. The result from lateral flow immunoassays indicated that the LOD of CGNs and AuNFs were 5 and 1 μg/mL, respectively. All these results indicated that the developed ic-ELISA, CGNs, and AuNFs in this study could be used for the analysis of the residual of ochratoxins (OTA and OTB) in food and agricultural products.

BackgroundWestern dietary habits, coupled with a sedentary lifestyle, are potential contributors to the prevalence and rapid increase in the incidence of obesity in Saudi Arabia. This study aimed to investigate the association between students' weight status and their eating behaviors and practices. Another aim was to assess students' awareness of the health risks associated with obesity.MethodsA cross-sectional survey was conducted among a sample of 416 (53% male and 47% female) undergraduate students, aged 18-26 years old, between January 6 and April 6, 2019, from colleges of Health Sciences at Jazan University in the Kingdom of Saudi Arabia (K.S.A). Students completed a self-administered questionnaire and recorded their measured anthropometric parameters.ResultsThe prevalence of overweight (20.4%) and obesity (14.9%) were relatively high among the participants. There were statistically significant associations between Body Mass Index (BMI) and the different settings of food consumption (i.e., dining on a table (or) in the Islamic way: squatting on the ground) (pConclusionThe prevalence of obesity and overweight were reasonably high in our study sample and were affected by several factors related to students' eating behaviors and practices. This warrants the need for rigorous and frequent health education interventions on healthy eating behaviors, dietary practices, with an emphasis on the importance of adopting an active, healthy lifestyle.

The outstanding evidence of phthalimide pharmacophore in securing enhanced biological activities had encouraged further research and development into phthalimide-based derivatives as potential new drugs. In this study, phthalimide core was hybridized with aldehydes giving integrated imines displaying different types of functionalities and at alternating positions. The resulting compounds, therefore, provide an innovative window to explore possible differential biological effects as antioxidants and anticancer agents. A total of sixteen compounds were synthesized, and each was verified by FT-IR, H NMR, C NMR, and MS characterization. Herein, a facile single-step synthesis method was employed substituting the conventional two-step chemical production routes. Among the sixteen tested compounds, the H7 compound with hydroxyl phenolic group has shown an eminent antioxidant activity with a 19.52% decrease to the IC50 value compared to that of the control standard BHT antioxidant. On the other hand, the halogenated H6 Schiff base structure was successful in securing effective cancer inhibition to both colon and breast cancer cell lines, while maintaining selective action toward normal tissues. Results have collectively indicated the importance and impactful effects of functional groups position and types within similar basic structures, in directing different biological outcomes.

Introduction. Lupus nephritis (LN) affects almost two-thirds of systemic lupus erythematosus (SLE) patients. Despite initial aggressive therapy, up to 25% of patients with LN will progress to permanent renal damage. Conventional serum markers for LN lack the sensitivity of an ideal biomarker. Urinary neutrophil gelatinase-associated lipocalin (UNGAL) is an excellent biomarker for early diagnosis of acute kidney injury and predicting renal outcomes. Objective. To measure UNGAL among LN patients to correlate its levels with renal disease activity and to investigate its predictive performance in response to induction therapy. Patients and Methods. 40 SLE patients with biopsy-proven LN class III, IV, or V were randomly selected. The study was conducted in the internal medicine department and outpatient clinic in Ain Shams University Hospitals and completed after six months. UNGAL was measured at baseline, three-month follow-up, and after complete induction therapy. Results. In LN patients at baseline, the mean serum creatinine was 2.57 ± 0.96 mg/dL and the mean UNGAL was 33.50 ± 18.34 ng/dL. Mean UNGAL levels of complete response, partial response, and nonresponse groups were 14.48 ± 2.99 ng/mL, 34.49 ± 4.09 ng/mL, and 62.07 ± 14.44 ng/mL, respectively. Based on the ROC curve, we found a better performance of baseline UNGAL to discriminate the complete response group from partial and nonresponse groups to predict response to induction, outperforming conventional biomarkers. The area under the curve was 0.943, and the best cutoff level was 26.5 ng/mL (92.31% sensitivity and 88.89% specificity). Conclusion. UNGAL performed better than conventional biomarkers in predicting response to treatment of active LN.

Epigenetic mechanisms are fundamentally important for cancer initiation and development. However, a survey of the literature reveals that, to date, they appear less comprehensively investigated in melanoma than in many other cancers, e.g., prostate, breast, and colon carcinoma. The aim of this review is to provide a short summary of epigenetic aspects of functional relevance for melanoma pathogenesis. In addition, some new perspectives from epigenetic research in other cancers with potential for melanoma diagnosis and therapy are introduced. For example, the PrimeEpiHit hypothesis in urothelial carcinoma, which, similarly to malignant melanoma, can also be triggered by a single exogenous noxa, states that one of the first steps for cancer initiation could be epigenetic changes in key genes of one-carbon metabolism. The application of such insights may contribute to further progress in the diagnosis and therapy of melanoma, a deadly type of cancer.

In this article, an in-depth optical investigation of Zn(Al)O-mixed metal oxide (MMO) film using Zn/Al-layered double hydroxide (LDH) was elucidated through co-precipitation and spin coating techniques. The field emission scanning electron microscopy (FE-SEM) analysis revealed the occurrence of a vertically aligned sheet-like structure with a thickness of 60 nm for pristine LDH, which further reduced to 45 nm after calcination at 300 °C. Additionally, pristine LDH showed multiple optical bandgaps of 5.18, 3.6, and 3.2 eV. Moreover, a good agreement of the obtained optical bandgaps was attained between both utilized methods, ultraviolet-visible light (UV-Vis), and photoluminescence (PL) spectroscopies. The optical bandgap decreased at higher calcination temperatures, which indicates the active role of the applied post-fabrication process on the optical profile of the deposited MMO film/s. The demonstrated transmittance spectra of the deposited MMO films exhibited a transparency between 85% and 95%; this indicates the usefulness and consistency of the proposed film for transparent conductive oxide (TCO) based optoelectronic applications.

Background: Fractional flow reserve (FFR) is the reference standard for the assessment of the functional significance of coronary artery stenoses, but remains underutilized. Our aims were to study whether FFR changed the decision for treatment of intermediate coronary lesions and to assess the clinical outcome in the deferred and intervention groups. Methods: In this retrospective study, coronary angiograms of patients with moderately stenotic lesions (40–70%) for which FFR was performed were re-analyzed by three experienced interventional cardiologists (blinded to FFR results) to determine its angiographic significance and whether to defer or perform an intervention. Results: We revised 156 equivocal lesions of 151 patients. The clinical presentation were stable angina (65.6%) and acute coronary syndrome in (34.4%). All reviewers had concordant agreement to do PCI in 59 (37.8%) lesions based on angiographic assessment. Interestingly 23 (39%) of these lesions were functionally non-significant by FFR. The reviewers agreed to defer 97 (62.2%) lesions, however, 32 (33%) of these lesions were functionally significant by FFR and necessitated PCI. MACE were similar in both groups (1.5% vs 2.4%, p = 1.0). Conclusion: Mismatches between visually- and FFR- estimated significance of intermediate coronary stenosis are frequently encountered across a wide spectrum of clinical presentations. FFR leads to a change in decision for coronary intervention. The clinical and cost implications of such changes-in areas with limited resources- needs further evaluation. Keywords: Fractional flow reserve, Visual assessment, Intermediate coronary artery lesion

Objectives: Curriculum analysis is an essential process in exploring the validity of assumptions behind the curriculum and judging its perspectives, goals, and objectives. This study analysed the curriculum of the Internal Medicine Residency Programme at the Sudan Medical Specialisation Board, exploring the programme’s strengths, weaknesses, and areas for improvement. Materials and Methods: A qualitative descriptive analysis method using Harden Ten Questions framework was used, implemented through document analysis. Thematic analysis was used to categorise the findings following the Harden Ten Questions framework. Results: The analysis of this curriculum using Harden Ten Questions framework revealed that it is built on needs assessment, with clear objectives and contents, good organisation of the contents and a precise management process. However, there is a need to improve the areas related to training strategies, training methods, assessment methods and the learning environment. Conclusions: This study showed that the curriculum is built to meet the needs of the Sudanese community. The contents fit for internal medicine clinical residency and the methods of training are likely to foster long-life learning. The curriculum needs some improvement particularly in the following areas such as clinical teaching, trainee assessments, and learning environments. Harden Ten Questions framework for curricula was practical to some degree in analysing the postgraduate curriculum. However, some suggestions have been made regarding the original framework to make it more adaptable to curriculum analysis at postgraduate level. The systematic analysis is transferable to the analysis of other undergraduate or postgraduate medical curricula in Sudan.

Ras Abda Area is located in the north part of the Eastern desert, and is characterized by a rugged topography and high relief. The main exposed rock units in the area comprise older granites, younger gabbros and granites as well as several types of post granite dykes (rhyolite, basic and microgranite dykes). Radiometric measurements indicated that the microgranite samples are characterized by anomalous concentrations of the radioelements which mean that the rocks originated from radioelements-bearing magma and may be subjected to epigenetic processes of leachability and migration of uranium. The stream sediments samples show low levels of radioactivity where eU ranges from 4.0 to 7.0 ppm with an average of 5.3 ppm, and eTh ranges from 6.0 to 18.0 ppm with an average of 10.65 ppm. The eTh/eU ratio ranges from 1.2 to 3.6 where the samples distal from the microgranite dykes are characterized by the highest eTh/eU ratio (3.6) while those close to the dykes have the lower eTh/eU ratios. Generally, the average eTh/eU ratio (∼2.08) is lower than the world ratio (3.5) implying that uranium probably enriched from an adjacent source may be the microgranite dykes. The calculated factors of equilibrium (P and D) indicated disequilibrium state for both rocks types (microgranite and stream sediments) and referred to incomplete U-decay series. Mineralogical studies revealed that the heavy minerals could be classified into: a) radioactive minerals comprising uranophane, kasolite, sklodowskite, thorite and uranothorite, and b) radioelements-bearing minerals comprising columbite, fergusonite, samarskite, pyrochlore, allanite, monazite, zircon and fluorite. The heavy minerals are mostly concentrated upstream rather than downstream; meandering portions of the stream may act as natural traps for the heavy minerals. Keywords: Ras abda, North eastern desert, Egypt, Microgranite dyke, Radioactivity, Mineralogy

ZnO tetrapods have been grown by an environmental microwave evaporation approach in air atmosphere without any use of organic solvents or precursors. The synthesized powder was characterized using X-ray diffractometry (XRD) and Field emission Scanning Electron Microscopy (FE-SEM). The grown ZnO tetrapods exhibited a noteworthy microstructure and phase formation of crystalline and pure structure. ZnO tetrapods were deposited on Pt electrode to be employed as ZnO tetrapods structure-based sensors, then, they were investigated at room temperature in the relative humidity ranging from 0.0 to 96.0%. The sensors have shown a significant response towards relative humidity starting from 30%. Cross-sensitivity was investigated with respect to N2O (150 ppm in helium) and methane (1000 ppm in helium). The ZnO tetrapods-based sensors were insensitive towards the interfering gases, indicating a potential applicability for humidity sensing purposes.

Introduction: Methotrexate (MTX) could provoke a renal dysfunction. However, beneficial extra-hematopoietic effect of erythropoietin might guard against MTX-induced nephrotoxicity. Objectives: Determination of renoprotective erythropoietin’s role against MTX-induced nephrotoxicity through elucidating its renofunctional and renomorphological effects in adult male albino rats. Materials and Methods: The study was performed on 60 adult male Albino rats, equally divided into three groups; group 1 (control): treated with intraperitoneal injections of normal saline at a dosage of 0.5 mg/kg BW twice weekly for 9 weeks. group 2: injected with MTX hydrate intraperitoneal twice weekly at a dosage of 0.5 mg/kg BW for 9 weeks; and group 3: intraperitoneal injected with MTX hydrate in a similar dosage and duration like group 2 concomitant with subcutaneous injection of 100 IU/kg recombinant human erythropoietin once weekly for 9 weeks. At the study end, serum urea and creatinine together with albuminuria were measured, rats were sacrificed and renal sections were prepared for histopathological examination. Results: Significantly increased values of renal function analyzed substances with deteriorated histopathological renal changes were detected in the MTX-treated group compared to either the control or to the MTX and erythropoietin co-treated group. The later displayed statistically significant decreased levels of the substances accompanied by remarkably ameliorated microscopic renal changes. Additionally, insignificant statistical biochemical and morphological renal differences were noticed between the third and control groups. Conclusion: This study concluded valuable and efficient defense against MTX-induced nephrotoxicity in adult male Albino rats when co-treated with erythropoietin.

Abstract Urothelial carcinoma (UC), the most common cancer of the urinary bladder causes severe morbidity and mortality, e.g. about 40.000 deaths in the EU annually, and incurs considerable costs for the health system due to the need for prolonged treatments and long-term monitoring. Extensive aberrant DNA methylation is described to prevail in urothelial carcinoma and is thought to contribute to genetic instability, altered gene expression and tumor progression. However, it is unknown how this epigenetic alteration arises during carcinogenesis. Intact methyl group metabolism is required to ensure maintenance of cell-type specific methylomes and thereby genetic integrity and proper cellular function. Here, using two independent techniques for detecting DNA methylation, we observed DNA hypermethylation of the 5′-regulatory regions of the key methyl group metabolism genes ODC1, AHCY and MTHFR in early urothelial carcinoma. These hypermethylation events are associated with genome-wide DNA hypomethylation which is commonly associated with genetic instability. We therefore infer that hypermethylation of methyl group metabolism genes acts in a feed-forward cycle to promote additional DNA methylation changes and suggest a new hypothesis on the molecular etiology of urothelial carcinoma.