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Abstract This contribution presents a two‐step hybrid diagnostic approach, combining k‐means clustering for subset formation, followed by subset analysis conducted by human experts. As the feature input vector has a significant influence on the performance of unsupervised machine learning algorithms, seven feature input vectors derived from traditional methods, including Duval pentagon method, Rogers ratio method, three ratios technique, Denkyoken method, ensemble gas characteristics method, Duval triangle method, and Gouda triangle method were explored for the subset formation stage. The seven proposed individual methods, corresponding to the seven feature input vectors, were implemented using a dataset of 595 DGA samples and tested on an additional 254 DGA samples. Furthermore, a combined technique based on a support vector machine was introduced, utilising the diagnostic results of the individual methods as input features. From training and testing, with diagnostic outcomes of 91.09% and 90.94%, the combined technique demonstrated the highest overall diagnostic accuracies. Using the IEC TC10 database, the diagnosis accuracies of the proposed diagnostic methods were compared to existing methods of literature. From the results obtained, the combined technique outperformed the proposed individual methods and existing methods used for comparison.

Abstract Objective In Morocco, there was a lack of data related to the epidemiology of epilepsy. This data serves as a useful basis for the development of any national intervention or action program against epilepsy in Morocco. Through this study, we aimed to estimate the active and lifetime prevalence of epilepsy in Morocco. Methods We collected data from eight out of 12 Moroccan regions in two steps: In the screening step, we first used a nationwide telephone diagnosis questionnaire and in the second stage, a team of physicians under the direction of an epileptologist conducted a confirmative survey for suspected cases. We fixed the confidence interval at α = 5% and the precision at 0.02. Results Up to 3184 responded positively to our invitation to participate in this study and were able to answer the questions of the first diagnostic questionnaire. In the diagnostic phase, physicians in neurology reinterviewed all 86 suspected cases using a confirmative diagnosis questionnaire, and 63 persons were confirmed as having lifetime epilepsy and 56 with active epilepsy. The mean age (Mean ± SD) of persons with epilepsy was 35.53 years (±21.36). The prevalence of lifetime and active epilepsy were 19.8 (19.6–20.0) and 17.6 (17.5–17.8) per 1000 (95% confidence interval), respectively. Significance This is the first study to estimate the active and lifetime prevalence of epilepsy in Morocco according to the international recommendations of the ILAE. The prevalence of lifetime and active epilepsy were 19.8 (15–24.6) and 17.6 (13.3–22.8) per 1000, respectively. We included both children and elderly subjects. The rates of active and lifetime population epilepsy prevalence in Morocco ranged between Asian and sub‐Saharan Africa low‐ and middle‐income countries.

Building materials can enable the recycling of sewage sludge from tannery wastewater treatment by infiltration/percolation over coal and clay waste. The process avoids energy-intensive operations and yields a stable and environmentally friendly product. The sludge under study is mainly composed of SiO2, CaO, Al2O3, and Fe2O3, which is convenient to replace the mortar in cement. Different mortars were made by substituting a variable amount of sludge, from 0 to 30%, into the standard cement. The microstructure and mechanical properties of the mortar specimens were characterized after curing for 7 days and 28 days. The best properties were obtained with 15% sludge. Above 15%, the strength decreases at an early stage, as confirmed by SEM and XRD analysis, with more voids and ettringites at larger sludge content. The leaching tests of the mortar confirm that the cumulative values of heavy metals are far below the Deutsch regulatory limits (NEN 7043), justifying retention of the metals in the matrix. Radiological assessment of the sludge mortars also confirms their safety with the values of naturally occurring radioactive materials, surface radon exhalation and annual effective dose far below the required limits. The study suggests that 15% sludge can be used to sustainably replace cement and meet building safety requirement standards.

Overheating in school buildings can negatively affect the cognitive learning performance of particularly young students whose thermoregulation systems are still developing. However, currently, in schools, issues related to overheating have been addressed by limiting the exposure time to thermal discomfort. In this paper, the development of a general procedure that combines building and bioheat simulations to evaluate overheating risk in schools and generate health-based overheating limit criteria that may be applied in Canadian schools is described. General school building models, having either old or new constructions, were created based on a primary school building and successfully calibrated using field measurements of indoor temperature and humidity and published building energy use intensity data. Three sets of two limit criteria (exposure duration and severity of overheating) that account for the personal exposure conditions of students in primary, middle, and secondary schools were developed by limiting the body dehydration of students during extreme overheating events. Comparing the proposed limit criteria with the hour of exceedance criterion revealed interesting relationships between them, suggesting the proposed limit criteria as a benchmark for the comfort-based criteria, particularly for the more vulnerable primary and middle schools. The proposed procedure with the obtained overheating limit criteria is intended to be applied in any field or simulation study to assess the risk of overheating in similar school buildings under any local prevailing climate.

Abstract Background Silver orthophosphate (Ag3PO4) has received enormous attention over the past few years for its higher visible light photocatalytic performance as well as for various organic pollutants degradation in aqueous media. Therefore, considerable efforts have been made to the synthesis of Ag3PO4 with high catalytic efficiency, long lifetime, and using low-cost inorganic precursors. Results This article describes our efforts to develop a novel approach to synthesize of nanostructured silver phosphate (Ag3PO4) using phosphate rock as alternative and natural source of PO4 3− precursor ions. The catalytic experimental studies showed that the nanostructured Ag3PO4 exhibited excellent catalytic activity for reduction of p-nitrophenol in the presence of NaBH4 at room temperature. Furthermore, the antibacterial studies revealed that the obtained Ag3PO4 possess significant effect against E. Coli and S. Aureus bacteria. Conclusion The obtained results make the nanostructured Ag3PO4 prepared from natural phosphate as a highly promising candidate to be used as efficient catalyst and antibacterial agent. Graphic Abstract

Objectif. L’objectif de notre étude est d’évaluer l’expression du HER 2 dans le carcinome urothélial de la vessie sur 30 cas sélectionnés parmi une série de 361 cas colligée au service d’anatomie pathologie du CHU de Batna et de comparer nos résultats aux données de la littérature. Matériels et méthodes. Dans notre étude, nous avons évalué la surexpression de l’HER2 par technique immunohistochimique sur 30 cas, en utilisant les mêmes critères d’interprétation que pour le cancer du sein. Les résultats ont été évalués en utilisant le score d’interprétation de l’American Society of Clinical Oncology (l’ASCO), basé sur le pourcentage de cellules marquées, et l'intensité du marquage dans la perspective d'un traitement par le Trastuzumab (Herceptine). Dans notre étude, seul le score 3 + est considéré comme positif. Résultats et discussion. Nous avons constaté qu’aucun cas de tumeurs à faible potentiel de malignité (TFPM) n’a exprimé le HER2, et que 40 % des carcinomes de haut grade (HG) ont exprimé un marquage intense. Une surexpression de HER2 a été retrouvée dans 23,33% de nos échantillons tumoraux. Ce taux est proche de ceux décrits dans la littérature, allant de 23% à 80% avec d’importants écarts qui pourraient être expliqué par plusieurs hypothèses. Les résultats discordants rapportés dans la littérature nécessitent la standardisation des méthodes des laboratoires. Les différentes études démontrent que les décisions et l’algorithme actuellement utilisés dans les cancers du sein sont également adaptables dans les cancers de la vessie. Conclusion. Malgré la taille réduite de notre échantillon, l’expression de l’HER2 est présente surtout dans les carcinomes de haut grade ce qui concorde avec les données de la littérature des grandes séries. Ces résultats peuvent avoir des implications cliniques sur la prise en charge des tumeurs HER2-positifs localement avancées et/ou métastatiques. Ces patients sont donc des candidats potentiels pour la thérapie ciblée anti HER 2 (Herceptine)

Climate heat waves occurring in urban centers are a serious threat to public health and wellbeing. Historically, most heat-related mortalities have arisen from excessive overheating of building interiors housing older occupants. This paper developed an approach that combines the results from building simulation and bioheat models to generate health-based limit criteria for overheating in long-term care homes (LTCHs) by which the body dehydration and core temperature of older residents are capped during overheating events. The models of the LTCHs were created for buildings representative of old and current construction practices for selected Canadian locations. The models were calibrated using measurements of indoor temperature and humidity acquired from monitoring the building interiors and the use of published building energy use intensity data. A general procedure to identify overheating events and quantify their attributes in terms of duration, intensity, and severity was developed and applied to LTCHs to generate the limit criteria. Comparing the limit criteria from the proposed and comfort-based methods showed evident differences. The proposed method predicted the overheating risk consistent with the overall thermal comfort during overheating events in contrast to the comfort-based methods. The new limit criteria are intended to be used in any study to evaluate overheating risk in similar buildings.

As digitalization increasingly gains attention in the agriculture sector, many African youths are seizing the opportunity provided by digital technologies to engage in agriculture. While prior studies have started examining the intricacies of digitalization in agriculture, they have paid less attention to its implications for fostering institutions and inter-organizational synergies that can support and sustain the businesses of youth enterprises engaging with Africa’s agriculture. Against this backdrop, we undertook a qualitative case study to shed light on the development of a community of practice comprising youth enterprises engaging in agriculture through digitalization. Thus, we studied Africa Goes Digital (AFGD), a consortium of young African enterprises that rely on digital technologies and solutions to provide services to farmers across the African continent. The results showed that: (1) the Technical Centre for Agricultural and Rural Cooperation ACP-EU (CTA) played a pioneering role as a development agency in supporting enterprises with drones and training for agriculture, which led to the formation of AFGD; (2) two prevalent themes characterized the services offered by AFGD members; (3) AFGD brings members under one platform where they leverage WhatsApp for communication and knowledge sharing and Twitter to showcase success stories and form partnerships with each other to execute certain development projects with governments and development agencies; (4) the lack of regulations or the restrictive regulations on the use of drones are still problems that some members face, and the high costs of sensors and related drones are challenges for the members. Building on the results, we discuss the implications of digitalization for supporting African governments in meeting sustainability goals and conclude by describing the theoretical contribution of our study and promising future research directions.

The PMV index forms the basis of international thermal comfort standards. PMV was developed based on empirical relationships between the metabolic rate of activity and the body mean skin temperature and evaporative heat loss under the comfort conditions. However, many recent studies have questioned the accuracy and reliability of the PMV predictions, particularly for the discomfort range. This paper develops a general formulation of PMV that does not involve the mean skin temperature and evaporative heat loss. The new metabolic-based predicted mean vote (MPMV) index is expressed as the difference between the metabolic rate of activity and the metabolic rate required to achieve a comfort state under the imposed environment conditions. The comfort metabolic rate is found to vary linearly with the metabolic rate required to maintain the body core and mean skin temperatures at the resting thermo-neutral state. The model constants are determined using public experimental data on thermal sensation votes of young and older people. The new formulation accounts for body core cooling to achieve comfort under hot exposures; it also addresses the overlooked non-shivering thermogenesis in the body heat balance at the comfort state and covers comfort requirements for young and older people in wakeful and sleep states.

Canada is warming at double the rate of the global average caused in part to a fast-growing population and large land transformations, where urban surfaces contribute significantly to the urban heat island (UHI) phenomenon. The federal government released the strengthened climate plan in 2020, which emphasizes using nature-based solutions (NBSs) to combat the effects of UHI phenomenon. Here, the effects of two NBSs techniques are reviewed and analysed: increasing surface greenery/vegetation (ISG) and increasing surface reflectivity (ISR). Policymakers have the challenge of selecting appropriate NBSs to meet a wide range of objectives within the urban environment and Canadian-specific knowledge of how NBSs can perform at various scales is lacking. As such, this state-of-the-art review intends to provide a snapshot of the current understanding of the benefits and risks associated with the implantation of NBSs in urban spaces as well as a review of the current techniques used to model, and evaluate the potential effectiveness of UHI under evolving climate conditions. Thus, if NBSs are to be adopted to mitigate UHI effects and extreme summertime temperatures in Canadian municipalities, an integrated, comprehensive analysis of their contributions is needed. As such, developing methods to quantify and evaluate NBSs’ performance and tools for the effective implementation of NBSs are required.

Nowadays, new information technologies produce new methodological approaches attempting to extract not just valid and reliable information, but more generally a particular technical and professional expertise to support the decision making. A Bayesian network was developed for fault assessment of an electrical motor. By inference, this model made it possible to calculate the probability of rotor fault of the induction motor, while defining the weakest branch in the structure of the Bayesian network that leads to failure by determining the probabilities of intermediate events. The most likely faults were then defined and the information system consolidated, as well as the decision-making process. The article ends with an application that shows the methodology developed and gives some results illustrated by figures. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Nanocellulose (NC) were extracted from the Moroccan Alfa plant (Stipa tenacissima L.) and characterised. These Alfa cellulosic nanoparticles were used as reinforcing phase to prepare bionanocomposite films using carboxymethyl cellulose as matrix. These films were obtained by the casting/evaporation method. The crystallinity of NC was analysed by X-ray diffraction, the dimension of NC by atomic force microscopy, molecular interactions due to incorporation of NC in carboxymethyl cellulose (CMC) matrix were supported by Fourier transforms infrared (FTIR) spectroscopy. The properties of the ensuing bionanocomposite films were investigated using tensile tests, water vapour permeability (WVP) study and thermogravimetric analysis. With the progress of purification treatment of cellulose, the crystallinity is improved compared to the untreated fibres; this can be explained by the disappearance of the amorphous areas in cellulose chain of the plant. Consequently, the tensile modulus and tensile strength of CMC film increased by 60 and 47%, respectively, in the bionanocomposite films with 10 wt% of NC, and decrease by 8.6% for WVP with the same content of NC. The NC obtained from the Moroccan Alfa fibres can be used as a reinforcing agent for the preparation of bionanocomposites, and they have a high potential for the development of completely biodegradable food packaging materials.

Dissolved gas analysis of transformer insulating oil is considered the best indicator of a transformer’s overall condition and is most widely used. In this study, a Bayesian network was developed to predict failures of electrical transformers. The Duval triangle method was used to develop the Bayesian model. The proposed prediction model represents a transformer fault prediction, possible faulty behaviors produced by this transformer (symptoms), along with results of possible dissolved gas analysis. The model essentially captures how possible faults of a transformer can manifest themselves by symptoms (gas proportions). Using our model, it is possible to produce a list of the most likely faults and a list of the most informative gas analysis. Also, the proposed approach helps to eliminate the uncertainty that could exist, regarding the fault nature due to gases trapped in the transformer, or faults that result in more simultaneous gas percentages. The model accurately provides transformer fault diagnosis and prediction ability by calculating the probability of released gases. Furthermore, it predicts failures based on their relationships in the Bayesian network. Finally, we show how the approach works for five distinct electrical transformers of a power plant, by describing the advantages of having available a Bayesian network model based on the Duval triangle method for the fault prediction tasks.

Building retrofitting plays a key-role in energy saving and a growing interest is focused on insulating materials that allow a reduction in heat loss from envelopes with low thickness, by a process of reducing heating and cooling demand. In this context, a complete characterization of the physical properties of Moroccan natural gypsum materials was carried out. Basic information on the mineralogical, microstructure, thermal, mechanical, and acoustic characteristics of the rocks sampled from two Moroccan regions is provided. It was found that mineralogy, porosity, and water content are the main factors governing the development of the structure and the strength of the samples. The measured values of the porosity were 8.94%, the water content varied between 2.5−3.0% for the two studied typologies, coming from Agadir and Safi, respectively. Gypsum powder was used for fabricating samples, which were investigated in terms of thermal and acoustic performance. Thermal properties were measured by means of a hot disk apparatus and values of conductivity of 0.18 W/mK and 0.13 W/mK were obtained for Agadir and Safi Gypsum, respectively. The acoustic performance was evaluated in terms of absorption coefficient and sound insulation, measured by means of a Kundt’s Tube (ISO 10534-2). The absorption coefficients were slightly higher than the ones of conventional plasters with similar thickness. A good sound insulation performance was confirmed, especially for Safi Gypsum, with a transmission loss-value up to about 50 dB at high frequency.

A sustainable Knoevenagel condensation of a series of aldehydes with malononitrile and ethyl cyanoacetate is described. The process is based on the combination of microwave activation and hydroxyapatite catalysis under solvent-free conditions. Products are obtained in and high yields after short reaction times. The effects of the specific surface of porous calcium hydroxyapatite and microwave activation are discussed.

The possible role of viruses in breast cancer etiology remains an unresolved question. We hypothesized that if some viruses are involved, it may be in a subgroup of breast cancers only. Epidemiological arguments drove our interest in breast cancer subgroups that are more frequent in Africa, namely inflammatory breast cancer (IBC) and triple-negative breast cancer. We tested whether viral prevalence was significantly higher in these subgroups.One hundred fifty-five paraffin-embedded malignant breast tumors were randomly selected at the pathology laboratory of the University Hospital of Annaba (Algeria) to include one third of IBC and two thirds of non-IBC. They were tested for the presence of DNA from 61 viral agents (46 human papillomaviruses, 10 polyomaviruses, and 5 herpesviruses) using type-specific multiplex genotyping assays, which combine multiplex PCR and bead-based Luminex technology.Viral DNA was found in 22 (17.9%) of 123 tumors. The most prevalent viruses were EBV1 and HPV16. IBC tumors carried significantly more viruses (any type) than non-IBC tumors (30% vs. 13%, p

A porous hydroxyapatite (p-HAp) was prepared and employed for the removal of lead(II) ions at different concentrations from aqueous solution to determine the adsorption properties of p-HAp and compare them with those of a commercial hydroxyapatite (CAp) sample. The kinetic data obtained indicated that the adsorption performances of the adsorbents depended both on their specific surface area and crystallinity. Complexation of the Pb(II) ion on the adsorbent surface favoured the dissolution of hydroxyapatites characterized by a Ca/Pb molar ratio in the 0.85–1.5 range. The maximum adsorption capacity of p-Hap for Pb(II) ions at 30 ± 2°C was 2.30 mmol/g relative to 1.38 mmol/g for the commercial compound Cap at the same temperature. The higher capacity of p-HAp was explained in terms of its porosity and crystallinity. The Pb(II) ions sorption results could be modelled by the Langmuir and Freundlich isotherms.

Background: Colon cancer is one of the leading causes of cancer-related deaths worldwide. The increased incidence of comorbid diseases in elderly patients above 70 leads to the need of less aggressive strategies to be used in the adjuvant setting of stage III colon cancer., Method: Our prospective cohort study was performed in the period from April 2017 to March 2020. Seventy-five patients with newly diagnosed stage III colon cancer received adjuvant chemotherapy after surgery. Patients who either received adjuvant chemotherapy less than 3 months due to intolerability or toxicity from medications or who have more than one type of cancers or metastatic disease from the start were excluded from the study. Patients' clinicopathological characteristics in relation to oxaliplatin- and non-oxaliplatin-based chemotherapeutic regimens were analyzed with survival assessment., Results: In our study, patients above 70 had better overall survival (OS) in the non-oxaliplatin chemotherapy group (p-value = 0.032) in contrast to OS in patients under 70 which was better in the oxaliplatin group (p-value < 0.001). By comparing the OS between the two age groups, the OS was better in patients < 70 years (p-value = 0.001). Additionally, we found that the DFS in patients above 70 was better in oxaliplatin-based regimens than in the non-oxaliplatin group (p-value = 0.011) with better survival rates (81.8% vs 15.7%), and markedly high DFS in patients under 70 for oxaliplatin based regimens (p-value < 0.001), with survival rates (31.1% vs 0%). By comparing the DFS between the two age groups, the DFS was better in patients < 70 years (p-value < 0.001). The disease recurrence was in favor of the non-oxaliplatin group with significant p-value = 0.003, while mortality occurred more in the oxaliplatin group (p-value < 0.001)., Conclusions: The appropriate selection of a personalized strategy for treatment of stage III colon cancer plays an important role in the outcome of the disease. Our findings supported the use of oxaliplatin-based chemotherapy as a standard treatment option in the adjuvant management of stage III colon cancer patients in all age groups. The benefit of non-oxaliplatin-based chemotherapy was limited to patients above 70 which might be an effective option for elderly patients., (© 2021. Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Despite the presence of a prognostic risk stratification sco-ring system for Hodgkin lymphoma (HL), the lymphocyte-to-monocyte ratio (LMR) is a simple and low-cost test that has been investigated as a prognostic marker to evaluate the clinical course and survival outcomes., Material and Methods: We prospectively enrolled 92 patients with classical HL (CHL), who were diagnosed and treated in the period from April 2017 to April 2020. Lymphocyte monocyte ratio cut-off values were estimated using receiver operating characteristic curves., Results: We found that patients with LMR < 1.4 at the time of diagnosis had poorer progression-free survival (PFS) and overall survival (OS) than those with LMR > 1.4. Patients with increased LMR values after the first 2 cycles of chemotherapy had better PFS and OS; meanwhile, patients who had low LMR after the end of chemotherapy had poorer PFS and OS in comparison to patients who gained higher value after the completion of all cycles of chemotherapy., Conclusions: A rise of LMR value indicated better outcome and better survival rate, so it can be an independent prognostic factor for survival and to predict outcome in patients with CHL., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Termedia.)

Introduction: Cytokeratin 19 (CK19) is highly expressed in epithelial tumours such as breast cancer (BC). Octamer-binding transcription factor 4 (OCT4), a transcription factor of the POU (Pit-Oct-UNC) family, plays a criti-cal role in the self-renewal and maintenance of pluripotency of embryonic stem cells; therefore, it has been used as a promising CSC marker., Material and Methods: CK19 was assessed in peripheral blood using flow-cytometric analysis while OCT4 was evaluated in breast tissue samples by immunohistochemistry from 70 patients (non-metastatic BC, meta-static BC, and non-malignant breast tumours)., Results: CK19 and OCT4 were significantly associated with BC patients compared to control ( p < 0.001). CK19 was detected in 38 patients with BC (62.2%); meanwhile, OCT4 was positive in 37 BC patients (60.6%). CK19 was positively associated with grade ( p = 0.002), HER2 ( p = 0.009), metastasis ( p = 0.026), molecular subtypes and LN ( p < 0.001), and stage ( p = 0.001) while OCT4 expression was positively associated with BMI ( p < 0.023), aggressive molecular subtype ( p < 0.019), ER expression ( p = 0.025), presence of LN metastases ( p < 0.017), and distant metastasis ( p < 0.018). A non-significant relation was found between the expression of CK19 and OCT ( p = 0.291). The positive expression of CK19 and OCT4 was significantly and inversely associated with both 3-year OS and 3-year PFS., Conclusions: CK19 and OCT4 are associated with BC, so they can be considered as prognostic and predictive markers for poor OS and PFS in non-metastatic as well as metastatic BC patients., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Termedia.)

Background: Colorectal carcinoma (CRC) is the third most common human cancer. Twist, a basic helix-loop-helix (bHLH) transcription factor, is an epithelial-mesenchymal transition ((EMT) inducer that has been involved in carcinogenesis and chemoresistance. Also, the enhancer of Zeste homolologue2 (EZH2), a member of the polycomb group of genes, had been associated with poor prognosis in several malignancies., Objective: To evaluate the expression of Twist1 and EZH2 in colon carcinoma in Egyptian patients and its relation to clinicopathological parameters, prognosis, and survival., Methods: Twist1 and EZH2 expressions were evaluated immunohistochemically in 50 cases of colorectal tumors (12 colon adenomas and 38 colon carcinomas) and 20 samples from normal colonic mucosa., Results: The expression of Twist1 and EZH2 was significantly higher in colon adenoma and carcinoma than that in normal colonic mucosa (P < 0.05). Twist1 and EZH2 expressions were associated with decreased tumor differentiation, advanced stage, and lymph node metastasis. Twist1 and EZH2 expressions were significantly related to 3-year disease-free survival (P = 0.005 and 0.002 respectively) and 3-year overall survival (P = 0.045 and 0.039, respectively)., Conclusions: Twist1 and EZH2 may serve as prognostic predictors for colon carcinoma and may have a potential role as therapeutic targets in patients with colon carcinoma in the future.

Introduction: Forkhead box M1 (FOXM1) is considered as a novel anti-cancer target, because it has many essential functions such as mitosis regulation, cell cycle transition, and other carcinogenesis signaling pathways. Dachshund homolog 1 (DACH1) is a member of the Sno/Ski co-repressor family., Material and Methods: Expression of DACH1 has been detected in many cancers. Patients and pathologic specimens: 50 patients with endometrial cancer (EC) were included in the study: ten specimens of normal endometrium and twenty specimens of endometrial hyperplasia. All samples underwent processing to investigate FOXM1 and DACH1 expression using immunohistochemistry., Results: FOXM1 expression was detected in EC tissues more than normal endometrium and endometrial hyperplasia tissues ( p = 0.001) and 0.01. Increased FOXM1 expression was positively associated with larger tumor size ( p = 0.002), high grade ( p = 0.004), myometrial invasion, presence of lymph node metastases, higher Federation of Gynecology and Obstetrics (FIGO) stage ( p < 0.001), and worse progression-free survival (PFS) and overall survival (OS) rates. The expression of DACH1 was lower in EC cells than normal endometrium and endometrial hyperplasia tissues ( p = 0.071) and 0.252. Low DACH1 expression was associated with high grade ( p = 0.001), presence of lymph node metastases ( p = 0.49), higher FIGO stage ( p = 0.022), and unfavorable PFS and OS rates ( p = 0.037). We found an inverse association between expression of FOXM1 and DACH1 in EC tissues and in non-neoplastic endometrial tissues ( p = 0.007)., Conclusions: FOXM1 over-expression and DACH1 down-regulation in EC were related to poor clinical and pathological parameters and unfavorable prognosis., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Termedia.)

Papillary thyroid carcinoma (PTC) is considered the most prevalent thyroid malignancy. The association between Hashimoto's thyroiditis (HT) and PTC is still unclear. We aimed to examine the clinicopathological impact of immunohistochemical staining of FOXP3 and Cytokeratin 19 in PTC and concomitant HT and their correlation with patients' outcome and survival. Eighty thyroid biopsies obtained from patients with PTC were immunostained by FOXP3 and CK19.The patients were treated by radioactive iodine (I 131 ) and followed up. FOXP3 and CK19 expression were detected in 45% and 80% studied cases of PTC respectively. 16.7% of PTC with associated HT showed FOXP3+ lymphocytes in lymphocytic infiltrate of HT, while most of PTC associated HT express cytoplasmic CK19 positive Hurtle cells. FOXP3 was more expressed in PTC female patients more than 45 years with higher stage, lymph node, and distant metastasis, extracapsular extension, number of I 131 doses, and cumulative radioiodine doses with a highly statistically significant difference (p < 0.001). The relation was significant between CK19 immunostaining as regard 10-year Overall Survival and death (p value = 0.027 and 0.036, respectively). HT represents a step in the process of autoimmune inflammatory disease ending by the evolution of PTC with better prognosis, therefore appropriate follow up of these cases is needed. FOXP3 tends to be more expressed in PTC cases with worse prognostic variables and is predictable to become a recent prognostic and targeted therapy for PTC. There was a significant relation between CK19 immunostaining and 10 year overall survival.

Introduction: Sunitinib is a standard of care first line treatment for patients with metastatic renal cell carcinoma (RCC). Sunitinib standard dose is 50 mg once daily for 4 consecutive weeks followed by 2 weeks' off (4/2 schedule). Long-term and high exposure to this medication lead to severe adverse events (AEs); therefore, this trial was done to find the best schedule which gives the best outcome with minimal toxicity., Materials and Methods: Seventy patients were randomly assigned into 2 groups, then received 50 mg/day of sunitinib. Group 1 (40 patients) received sunitinib for 4 consecutive weeks followed by 2 weeks off (4/2 schedule) while 30 patients were admitted to group 2 with 2 weeks on and 1 week off (2/1 schedule)., Results: All patients (100%) had significantly higher AEs on schedule 4/2 vs. 73.3% on schedule 2/1 ( p = 0.001). Furthermore, the grade 3 AEs on schedule 2/1 were significantly lower than those on schedule 4/2 (26.7% vs. 82.5%) respectively ( p = 0.001), such as fatigue, diarrhea, hypertension, hand foot syndrome (HFS) and mucositis. Progression-free survival (PFS) rate was significantly higher in 2/1 schedule (60.9% vs. 38.6%) than in 4/2 schedule ( p < 0.008). Multivariate analysis suggested that: age > 60 years, poor International Metastatic RCC Database Consortium (IMDC) risk category, tumor size > 10 cm and treatment schedule (group 1) were poor prognostic factors of PFS., Conclusions: Our study supported the use of 2/1 schedule of sunitinib in patients with metastatic RCC because of lower toxicity profile and better efficacy with improved PFS in comparison to 4/2 schedule., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Termedia.)

Rectal cancer involves one-third of colorectal cancers (CRCs). Recently, data supported that DNA methylation have a role in CRC pathogenesis. In the present study we aimed to analyze the methylation status of MGMT and ERCC1 promoter regions in blood and tissue of patients with benign and malignant rectal tumors. We also studied the methylated MGMT and ERCC1 genes and their relations with clinicopathological features. Furthermore, we suggested that methylation may play a critical function in the regulation of MGMT and ERCC1 expression. Fifty patients with non-metastatic cancer rectum and 43 patients with benign rectal lesions were involved in the study. DNA extraction from blood and rectal specimens was done to analyze the methylation status of MGMT and ERCC1 genes by methylation-specific PCR method. RNA was extracted also to determine the expression levels of these genes by real time-PCR. The frequency of MGMT and ERCC1 methylation was significantly higher in rectum cancers than in benign tumors both for the tissue and the blood (p<0.001). There was no relation between MGMT or ERCC1 methylation and clinicopathological features; while they were correlated with the response to therapy. An interesting finding that the agreement of the methylation levels in the blood and rectal tissue was classified as good (κ=0.78) for MGMT gene and as very good (κ=0.85) for ERCC1. Lastly, the MGMT and ERCC1 genes methylation was associated with down-regulation of their mRNA expression when compared with the non-methylated status. Our findings provided evidence that both blood and tumor tissue MGMT and ERCC1 methylation were associated with cancer rectum. MGMT or ERCC1 methylation in blood could be suitable non-invasive biomarkers differentiating benign and malignant rectal tumors. Furthermore, the methylation of the MGMT and ERCC1 promoter regions was associated with down-regulation of their mRNA expression., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background. The most common malignant tumor of the urinary bladder is transitional cell carcinoma (TCC). Neural precursor cell-expressed developmentally downregulated protein 9 (NEDD9) is found to be a cell adhesion mediator. P38 Mitogen-Activated Protein Kinase is a serine/threonine kinases member which can mediate carcinogenesis through intracellular signaling. Methods. To assess their prognostic role; NEDD9 and p38 protein were evaluated in sections from 50 paraffin blocks of TCC. Results. The high expressions of NEDD9 and p38 protein were significantly associated with grade, stage, distant metastasis ( p < 0.001), number of tumors, lymph node metastasis, and tumor size ( p < 0.001, 0.002; 0.018, <0.001; and 0.004, 0.007, respectively). High NEDD9 and p38 detection had a worse 3-year OS ( p = 0.041 and <0.001, respectively). By multivariate analysis the NEDD9 and p38 protein expression levels and various clinicopathological criteria including gender, grade, stage of the tumor, and regional lymph node involvement were independent prognostic parameters of TCC of the urinary bladder patients' outcome. Conclusion. NEDD9 and p38 protein expressions were poor prognostic markers of TCC., Competing Interests: Conflict of interests relevant to this article was not reported.

Venous thromboembolism (VTE) represents one of the most important causes of morbidity and mortality in cancer patients. This investigation was undertaken to investigate the natural history of VTE in the oncology center in a tertiary care hospital. We did a retrospective study on cancer patients who presented to King Abdullah Medical city in Holly capital; a tertiary care hospital; from May 2011 to June 2013. Follow up period was calculated from time of VTE diagnosis till the last clinical visit or till patient death. Among 1,678 cancer patients, 132 (7.87 %) were diagnosed with VTE. The median patient age was 53.5 years, with female to male ratio 1.3/1. Thirty one patients (23.5 %) were diagnosed with VTE and cancer simultaneously, seventy four patients (56.1 %) were on chemotherapy and twenty eight patients (21.2 %) were on best supportive care.VTE were symptomatic in 110 patients (83.3 %) and asymptomatic in 22 patients (16.7 %). Lower limbs were the commonest site (42.4 %) with the highest incidence in patients with advanced stages (93 %). Forty nine (37 %) patients were receiving LMWH as prophylaxis. Median survival in months for patients with VTE prophylaxis versus without prophylactic, and asymptomatic versus symptomatic were (12.6 vs 6.3; p 0.12 and 9.8 vs 12.4; p 0.885, respectively). There is underutilization of thromboprophylaxis in our region, which needs more effort to reduce VTE burden. Also we need large prospective studies to clarify the impact of VTE symptoms and presentation on patient's survival.

Synovial chondromatosis (SC) of temporomandibular joint is rare proliferative disorder featured by the formation of cartilaginous nodules in synovium and joint space. Transforming growth factor beta 3 (TGF-β3) is closely related to chondrogenic differentiation, and might participate in pathogenesis of SC. We discovered that increased quantity of synoviocytes and blood vessels were observed in SC synovium. The vessel wall and sublining fibroblasts were stained positively by the antibodies against TGF-β3, fibroblast growth factor 2 (FGF-2), and CD34. In loose bodies (LBs), TGF-β3 was mainly expressed in chondrocytes and FGF-2 was expressed in chondrocytes, fibroblasts, and vessel walls. Expressions of TGF-β1, TGF-β3, FGF-2, Sox9, Wnt-4, Foxc2, and VEGF-A mRNA were significantly higher in SC synovium. Stimulation of TGF-β3 on synoviocytes increased alkaline phosphatase (ALP) activity and expressions of chondrogenic genes (Sox9, Col2α1, Aggrecan, Wnt-4, and Wnt-11), osteogenic genes (Runx2, Foxc2, osteocalcin, and Col1α1), and VEGF-A, but failed to influence FGF-2 expression. However, the addition of FGF-2 increased TGF-β3 expression. In conclusion, TGF-β3 existed in synovium and LBs of SC, and was responsible for the pathogenesis of SC.

Microsporidia are emerging opportunistic parasites. Preservation of the biological properties of microsporidian spores is often required in research work. The present study compared two preservatives; zinc polyvinyl alcohol (zinc PVA) and potassium dichromate solutions for preservation of microsporidian spores separated from human faecal samples. After 0, 1, 2 and 4 months of storage, morphological features and staining characters of the spores were assessed by light microscopy in modified trichrome-stained smears and their viability percentages were calculated using acridine orange/ethidium bromide mixture. Also, spore infectivity was evaluated by faecal spore shedding and intestinal spore load in mice orally inoculated with the preserved spores. Results revealed that morphological features, staining characters and viability of the spores were maintained in both solutions throughout the study period. Spore infectivity was completely preserved in zinc PVA solution but showed significant reduction in potassium dichromate solution at the fourth month of the preservation duration.