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Venous thromboembolism (VTE) is one of the major causes of pregnancy-related mortality and morbidity. This study aimed to determine the frequency of factor V Leiden (FVL) and prothrombin G20210A polymorphisms and measure the plasma levels of protein C (PC), protein S (PS) and antithrombin (AT) in pregnant women with VTE and healthy pregnant women. This prospective case-control study determined the frequencies of FVL G1691A and prothrombin G20210A polymorphisms and measured the plasma levels of PC, PS and AT in 198 pregnant women with VTE and 198 healthy pregnant women. Allele-specific polymerase chain reaction (ASPCR) was used to detect the FVL G1691A polymorphisms and prothrombin G20210A gene mutations. The FVL G1691A polymorphism and prothrombin G20210A gene mutations were detected only in pregnant women with VTE, with frequencies of 4.0 and 0.5%, respectively. The highest frequency of FVL G1691A polymorphism was observed in patients with deep vein thrombosis (DVT) and positively associated with contraceptive use and termination. Pregnant women with VTE had significantly lower levels of PC, PS and AT than those of controls. In conclusion, among the VTE cases, FVL G1691A polymorphism and PC, PS and AT deficiencies were the most common findings in patients presenting with DVT. Antithrombin deficiency was more common than PC and PS deficiencies. Contraceptive use, high body mass index (BMI) and termination correlated strongly with FVL G1691A polymorphism and PC and PS deficiencies in patients with VTE.

Ezeldine K Abdalhabib,1 Denise E Jackson,2 Badr Alzahrani,1 Elyasa M Elfaki,1 Alneil Hamza,1 Fehaid Alanazi,1 Elryah I Ali,3 Abdulrahman Algarni,3 Ibrahim Khider Ibrahim,4 Muhammad Saboor5,6 1Department of Clinical Laboratory Sciences, College of Applied Medical Sciences-Al Qurayyat, Jouf University, Sakaka, Saudi Arabia; 2Thrombosis and Vascular Diseases Laboratory, School of Health and Biomedical Sciences, RMIT University, Victoria, Australia; 3Department of Medical Laboratory Technology, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia; 4Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan; 5Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 6Medical Research Center (MRC), Jazan University, Jazan, Saudi ArabiaCorrespondence: Muhammad SaboorDepartment of Medical Laboratory Technology, Faculty of Applied Medical Science, Jazan University, Jazan, Saudi ArabiaTel +966 54 495 9029Email msaboor@jazanu.edu.saPurpose: Glutathione S-transferases (GSTT1 and GSTM1) are instrumental in detoxification process of activated carcinogens. Nucleotide excision repair is carried out by DNA helicase encoded by xeroderma pigmentosum group D (XPD) genes and aberrations in the XPD gene predisposes to increased risk of cancer. The present study aimed to investigate GSTT1, GSTM1 and XPD polymorphisms in newly diagnosed chronic myeloid leukemia (CML) patients and to examine the association of these polymorphisms with the risk of developing CML.Patients and Methods: This case–control study was carried out from June 2019 to August 2021 involving 150 newly diagnosed patients with CML and an equal number of randomly selected age- and sex-matched healthy individuals. A multiplex-PCR assay was used to genotype GSTT1 null and GSTM1 null polymorphisms. XPD gene polymorphism was detected by PCR-RFLP using predesigned gene-specific primers.Results: GSTT1 and GSTM1 null polymorphisms were detected in 42.7% and 61.3% of cases, respectively, compared to 18% and 35.3% for controls. The combination of both GST null polymorphisms revealed a significant association with CML. Frequencies of XPD Lys751Gln genotypes in cases were 62.7% heterozygous Lys/Gln, 24% homozygous Lys/Lys and 13.3% homozygous Gln/Gln, while in the controls were 74.7%, 20%, and 5.3%, respectively. Significant differences were also noted regarding the combination of GSTT1/GSTM1 null with XPD Lys/Lys, and GSTM1 null with XPD Lys/Lys.Conclusion: In conclusion, GSTT1 null, GSTM1 null and XPD polymorphisms showed positive association with the risk of development of CML. Furthermore, age and gender did not exhibit any association with the studied polymorphisms, while CML phases were associated with GSTT1 null polymorphism.Keywords: GSTT1 null polymorphism, GSTM1, XPD, chronic myeloid leukemia

In this research, a combined cooling system of heating and electricity is proposed and a complete thermodynamic analysis is presented. The system includes a gas turbine, a heat cooling system, a cogeneration system and a hot water heat exchanger. The basis of the work is that by using the recovery of waste gases in the gas turbine can be generated by a steam turbine and, with the help of an absorption chiller, can recover the waste heat in the steam turbine and provide the required cooling. The cogeneration system saves energy consumption, and reduces environmental pollution. In this study, we have tried to increase the economic justification of using the cogeneration system under study by using up-to-date cost functions. The energy efficiency and exergy efficiency of the studied system are 20 and 21%, respectively, which is a reasonable amount. The results of the economic analysis show that with a total cost of $ 93.56 per second and a total investment and maintenance cost of $ 1732 per second, the proposed system is highly economical and profitable in practice. This may provide a new way to increase the efficiency and effectiveness of thermodynamic performance of cogeneration systems.

Abstract A 70‐day experiment was carried out to evaluate biofloc system operation with no carbon addition by manipulating dietary protein and lipid levels for Nile tilapia (Oreochromis niloticus) cultivation. Three treatments were conducted; Control treatment (C; fed on a 30% crude protein [CP] diet supplemented with 3% vegetable oil [VO] + addition of external carbon source [ECS] in rearing tank), low protein–low lipid treatment (LPLL; fed on 23% CP diet supplemented with 3% (VO) + no addition of ECS) and low protein–high lipid treatment (LPHL; fed on 23% CP diet supplemented with 9% VO + no addition of ECS). The C treatment recorded the highest values (p

This study aims to explore the characteristics of tangent hyperbolic fluid flow along a stretching sheet. The sheet has suction or injection influences and is located inside a porous medium. The research inspects the flow and heat transfer (FHT) properties, taking into account the presence of a velocity slip condition. The flow of non-Newtonian magnetohydrodynamic fluid caused by a porous stretching sheet, taking into account thermal radiation and heat generation, has a wide range of engineering applications. These applications involve chemical reactors, energy distribution, storage of solar energy, and filtration processes. Mathematically, the flow problem is expressed as a collection of nonlinear partial differential equations. To numerically solve the resulting ODEs, the finite difference approach (FDM) is successfully used. Tables and graphs are used to display the various output values related to the hyperbolic tangent fluid. Among the different output values that appear are velocity and temperature. Significant observations from the study indicate that an increase in the power-law index, slip velocity parameter, porosity parameter, and magnetic number results in a decrease in the fluid's velocity and an increase in temperature. The completed comparison analysis shows a sizable degree of agreement with the earlier investigation.

Background: Chemotherapy inducing nausea and vomiting (CINV) is one of the significant side effects of anti-cancer treatment, and its full prevention is a potential challenge. This study was done to specify the effect of olanzapine in this setting. Methods: In this randomized, double-blind, clinical trial study, olanzapine was compared with a placebo in combination with dexamethasone and granisetrone in patients with cancer. Patients in the intervention group received dexamethasone , granisetron and olanzapine. Patients in the control group received a placebo instead of olanzapine. Overall, acute nausea and vomiting prevention were the primary and secondary end points; complete response (no nausea,no vomiting) in the delayed period of chemotherapy was the third end point. Response to treatment was evaluated by the Functional Living Index Emesis (FLIE) questionnaire completion in the first, the third and the fifth of chemotherapy. Results: Percentage reduction in mean±SD nausea and vomiting in the overall phase (0-120 hours) of intervention group compared to the control group respectively were 29.94±2.06, 69.75±2.32 [(57.93% reduction (p

Extended AbstractAbstract The present study examines the effects of consumer-based commercial branding of private banking brands on customers' emotional commitment. The results were obtained by examining the customer opinions of six private banks: Pasargad, Parsian, Eghtesad Novin, Karafarin, Saman and Sarmayeh. The research method was descriptive which was performed by survey method. The sample size of the research was 384 people, which was obtained by means of Cochran's formula based on an unknown statistical population. Sampling method was available. Data analysis was performed based on standard questionnaires. The validity of the questionnaires was evaluated based on content validity using experts' opinions, formally based on the views of a number of statistical and structural communities by factor analysis method, and validity was confirmed. The reliability of the questionnaires was estimated by Crunbach Alpha, respectively branding was 0.849, consumer behavior was 0.851 and emotional commitment was 0.733. Data analysis was performed at two levels of descriptive statistics and inferential statistics including structural equation modeling. The results showed that bank branding had an effect on consumer behavior with an impact factor of 0.67, consumer behavior had an effect on customer emotional commitment with an impact factor of 0.76, bank branding had an impact on customer emotional commitment with an impact factor of 0.48. On the other hand, bank branding indirectly had an effect on the customer emotional commitment with an impact factor of 0.50. In other words, consumer behavior has played a mediating role in the impact of bank branding on customer emotional commitment. Ultimately, it can be said that the dimensions of branding according to the power of effect on the consumer behavior are: perceived value, brand loyalty, brand image, brand performance, brand trust, brand compatibility.IntroductionThe globalization of the service industry and the free international economy have forced service companies and institutions to continuously upgrade and improve their competitiveness (Shokoohyar & et al, 2017), hence service companies such as financial and credit institutions have recently put more attention to customers on their agenda in order to improve these capabilities (Nadaf & et al, 2016). Financial experts believe that brand can create more value than usual, and the value of a branded product is higher than a non-branded one (Bozorg Khoo & et al, 2018). On one hand, because of the presence of competitors, new comer's threat, bargaining power and increasing level of consumer expectations, increasing technology upgrades, the use of new methods of production and service delivery have made the competition field of business more sophisticated than before. Therefore, in order to increase the awareness and provide productions to the customers and ultimately expand the market field; the organizations are bond to use new approaches (Roosta & et al, 2018). Branding is one of the ways to achieve this goal and brands play a special role in the development of cultures, business and individual decisions (Shirkavand & et al, 2017). Branding is a set of methods that give identity to a brand and distinguish it from other competitors. A successful brand is often synonymous with credibility and possesses significant intangible value. The results of brand modeling show that the perception of a brand leadership is actually more important than its uniqueness (Park, 2014). Emotional commitment to the brand has been described as the relative strength of the consumer's positive feelings toward a brand. In the marketing science, emotional commitment to brand is the continuous tendency of consumer to follow the relationship with the brand in such a way that the consumers normally like to establish a close emotional connection with the brand in which it has created a sense of joy and happiness (Momen & et al, 2015). The importance of emotional commitment is considered both to maintain and to develop relationships, because it creates a positive interaction between the company and the company's customers (Shahtahmasbi & Mazarei, 2020). As it is obvious, one of the characteristics of the Iranian banking industry is the great similarity of services provided by different banks. Banks have almost the same service portfolio so that the customer is not able to completely discriminate between banking services. Innovation in one bank is quickly applied in other banks. This intensity of new services by other banks has reached even less than a week. In such a situation, mental perceptions and attitudes strongly affect the way information interpretation and the type of behavior explanation towards a bank's marketing plans. (Abbaszadeh & etal, 2019) Therefore, the main issue of the present study is to examine the factors affecting and recent branding in the banking industry and the answer to the question that what effect branding of private banks with a focus on consumer behavior has on customers' emotional commitment?Theoretical literaturebrandingBranding is adding the power of a brand to products and services. The product of the branding process is the creation of distinctions. Branding shapes the mental structures of consumers and helps them to organize information about products and services in a way that Have a clear purchase decision and be valuable to the company (Karimian & eyal, 2019).Customer emotional commitmentEmotional commitment to the brand is derived from the customer's feelings, which indicates the customer's emotional relationship with the brand, and consists of the customer's judgment and mentality about the board, regardless of its functional and instrumental features; and when the customer intends to repeat the purchase, evaluation plays a special role (Khodabandeh & Lindh, 2021). Emotional commitment also refers to attachment along with people's desire and then includes loving the relationship. When customers are emotionally committed to the provider of products and services, they, in fact, love the service provider psychologically and it is considered desirable for them in relation to him (Sharma & et al, 2020).Mohajer (2021) conducted a study entitled Luxury Hotel Branding focusing on consumer behavior and brand equity. The statistical population was tourists staying in luxury hotels in Macau. Survey method and sampling method were available. The results showed that all four CBBE elements had a positive relationship with brand attitude and three of them directly on the willingness to buy. The tendency to buy is the interface between the four elements of CBBE and the intention to buy, and brand performance moderates the relationship between the brand attitude and the intention to buy.Norouzi & et al (2021) conducted a study entitled assessing the effective factors on branding in Saipa Automotive Company using meta-analysis research method. The statistical sample included Saipa Automotive Company experts who were selected by available sampling method. Based on meta-analysis findings among brand personality outcomes, best variables of brand impact; customer satisfaction, communication quality, brand development, perceived value, brand loyalty, customer lifetime value and brand equity had the greatest effect.Baghaienia & et al (2021) conducted a study entitled Analysis of effective factors in the internal branding of hotels in Yazd with a qualitative approach. The statistical sample was the executives of hotels in Yazd who were selected by purposive sampling. The results showed that the set of effective factors in domestic branding from the perspective of hotel executives includes training, monitoring, effective communication, effective meetings, customer orientation, leadership, selection and employment, compensation of services and quality of working life.MethodologyThe present study is applicable in terms of purpose, and descriptive correlative (structural equation modeling) in terms of data analysis. The statistical population of the present study consisted of all customers of six private banks of Pasargad, Parsian, Eghtesad Novin, Karafarin, Saman and Sarmayeh. Considering that the statistical population of the present study is unlimited, the statistical sample size of the research was 384 based on Morgan table. In this study, 384 questionnaires were distributed among customers using available sampling method. The standard branding questionnaire (Wahyuni ​​& et al, 2019) was used to collect data. This questionnaire included 19 items and six components of brand loyalty, brand compatibility, perceived value, brand performance, brand trust and brand image. Consumer behavior variable was analyzed according to the standard questionnaire of Mothersbaugh & et al, (2020). This variable included 6 items and two components of tendency to change the brand and verbal recommendations. The variable of customer emotional commitment was analyzed by the Masternd questionnaire (Iglesias & et al, 2019), which includes 6 items.Discussion and ResultsIn this research, the structural equation model has been used to brand private banks with a focus on consumer behavior and emotional commitment. The results of the first hypothesis showed that the power of the bank's branding effect on consumer behavior was equal to (0.67) which shows that the correlation is favorable. Significance statistic of the test was obtained 7.65, which is more than the critical value of t at the error level of 5% (1.96) and shows that the observed correlation is significant. The second hypothesis showed that the strength of the effect of consumer behavior on customer emotional commitment is equal to (0.76), which shows that the correlation is desirable. Significance statistic of the test was obtained (8.74), which is more than the critical value of t at the error level of 5% (1.96) and shows that the observed correlation is significant. The third hypothesis showed that the strength of the effect of bank branding on customer emotional commitment is equal to (0.48) which shows that the correlation is favorable. Significance statistic of the test was obtained (5.46), which is more than the critical value of t at the error level of 5% (1.96) and shows that the observed correlation is significant. The fourth hypothesis showed that the power of direct impact of bank branding on customer emotional commitment was equal to (0.48). Significance test was also obtained (5.46). The power of indirect effect of bank branding on customer emotional commitment was calculated equal to (0.50). Considering that the power of indirect path is more than direct path, so the variable of consumer behavior has a mediating role in this regard.ConclusionThe power of indirect effect of bank branding on customer emotional commitment was calculated equal to (0.50). Considering that the power of indirect path is more than direct path, so the variable of consumer behavior has a mediating role in this regard. Strong brands, always in the direction of promotion, strive for a deep relationship with consumers (Park & ​​Kim, 2016). Maintaining a deep commitment to repeat purchases or reuse of services and continuously changing customer behavior in the future leads to change in customer behavior (Oliver, 2014) Loyalty is recognized as a strong commitment of repurchasing a superior product or service in the future (Buttle & Malkan, 2015) so that the same brand is purchased despite the potential marketing efforts and effects of competitors. From a relational perspective, the extension of customer retention leads to their loyalty and emotional commitment (Heding & et al, 2015). These results are consistent with the findings Mazraeh & et al (2021), and Yousf & Khurshid (2021).In addition to tangible assets, bank managers must have a comprehensive plan for branding as intangible assets. According to the research results, brand performance has been identified as an improving point for banks in terms of branding; therefore, factors such as modern equipment and innovation in banking services and bank compatibility with customer conditions should be paid more attention. Banks also try to provide plans that guarantee the interests of customers and also provide services to them in the shortest possible time; therefore, to improve this index, bank managers in the field of branding should pay serious attention to financial and non-financial factors of customer value. The results show that managers should pay special attention to the dimensions of consumer behavior; including high-level advising others has a significant importance. Due to the obstacles and limitations of any research, the main limitation in the present study was the coordination with the managers and experts of the banking network to distribute the questionnaire and its time-consuming process. In the present study, branding in the banking network is with a consumer behavior approach. Therefore, future researchers are advised to study branding with social approaches as a focal point in social interactions; and also, obtain the dimensions of branding through interviews with key customers in order to achieve these factors from the perspective of these customers.

Abstract Obesity is a global public health concern associated with increased risk of several comorbidities. Due to the limited effectiveness of current therapies, new treatment strategies are needed. Our aim was to examine the effect of adipose-derived mesenchymal stem cells (AD-MSCs) on obesity and its associated diseases in a diet-induced obese (DIO) animal model. C57BL6 mice were fed with either high fat diet (HFD) or CHOW diet for 15 weeks. Obese and lean mice were then subjected to two doses of AD-MSCs intraperitoneally. Mice body weight and composition; food intake; blood glucose levels; glycated hemoglobin (HbA1c), intraperitoneal glucose tolerance test and atherogenic index of plasma (AIP) were measured. Pro-inflammatory cytokines, tumor necrosis factor-α and interleukin-6, were also determined. AD-MSCs treatment reduced blood glucose levels, HbA1c and AIP as well as improved glucose tolerance in DIO mice. In addition, MSCs caused significant attenuation in the levels of inflammatory mediators in HFD-fed mice. Taken together, AD-MSCs were effective in treating obesity-associated diabetes in an animal model as well as protective against cardiovascular diseases as shown by AIP, which might be partly due to the attenuation of inflammatory mediators. Thus, AD-MSCs may offer a promising therapeutic potential in counteracting obesity-related diseases in patients.

Background: The aim was to describe, evaluate and document the prevention of medication errors by clinical pharmacologist consultations in patients with cancer. Methods: We assessed the effect of clinical pharmacologist consultation by the acceptance of interventions recommended due to dosage, frequency, duration of therapy errors and drug-drug interactions (DDIs). All medication errors detected by clinical pharmacologist were reported in the format of medical consultation. A documentation template was designed to collect the patient’s data (sex, age, and diagnosis), prescriptions written, and drug-specific recommendations. For the descriptive analysis of medication errors, the unit of analysis was the number and percentage of errors. Results: A total of 296 patients included in this study with a median age of 48.67±19.76 years of which 47.30% were females. 936 prescribing errors were detected and recommended for their correction. The specialist physicians accepted 897 of prescribed errors. DDIs that were detected in 66.22% of patients, were the most errors in this group of errors (47%). Improper dose (17.41%) wrong frequency (16.67%) and drug-food interaction (10.26%) were after that. Conclusion: Pharmacological consultation in the hematology-oncology ward revealed many medication errors. The trust of physicians in the views of the clinical pharmacologist led to a large part of these errors being accepted and resolved.

We have previously characterized the role of p16/Rb in coordinating the early events in UVB-irradiated skin. As an extension to this work, normal melanocytes and mutant p16-inducible melanoma cell models were employed to elucidate further the coordinated molecular mechanisms occurring during early UVB exposure. Our results showed that melanocytes expressed p16 only at a high UVB dose, with undetectable p53. The Bax/Bcl2 ratio increased at higher dose, indicating that the cells had selected apoptosis program. In the wt-p16 melanoma cells, while low UVB dose upregulated p16, the high dose suppressed it, and further abrogated Cdk6 but not Cdk4. Interestingly, while induction of mutant-p16 increased Cdk4, cdk6 and pRb proteins, UVB exposure did not affect this increase. More interestingly, p16 mutant cells increased their resistance to apoptosis at high UVB-dose, associated with decreased Bax and increased Bcl2 expression. Thus, mutant-p16 appears to dictate a deregulation of cell cycle and increased resistance to apoptosis in melanoma cells. Together, the data indicate a deregulation of p16INK4/Rb pathway as an early event in UVB-induced melanomagenesis.

We recently reported that carnosol induces ROS-dependent autophagy and apoptosis in breast cancer cells. We also reported that carnosol inhibits breast cancer cell migration, invasion, and in ovo tumor growth, as well as targets STAT3, PCAF, and p300 to proteasome degradation. Here, we investigated the molecular mechanisms underlying its anti-malignant activity in breast cancer. We report that carnosol induces a ROS-dependent type I and type II programmed cell death (PCD-I or PCD-II, respectively), which occurred independently of each other. Indeed, chemical inhibition of autophagy had no effect on the induction of apoptosis, evident by the absence of cleaved PARP. Electron microscopy revealed that carnosol-treated cells exhibited enlarged endoplasmic reticulum, characteristic of ER stress. Markers of the three unfolded protein response pathways (PERK, IRE-1 α, and ATF6), namely ATF4, CHOP, phospho-IRE-1α, XBP1S, and cleaved ATF6 were upregulated in a ROS-dependent manner. In addition, carnosol induced a ROS-dependent activation of p38MAPK, increased the overall level of protein polyubiquitination, and targeted mTOR protein to proteasome degradation. Interestingly, inhibition of p38MAPK, by SB202190 and 203580, reduced cell death, selectively blocked the induction of IRE-1α and ATF6 UPR sensors and inhibited autophagy. In addition, inhibition of p38 reduced the carnosol-induced polyubiquitination and rescued mTOR, PCAF, and STAT3 from proteasomal degradation. Importantly, activation of PERK sensors and induction of apoptosis occurred independently of p38 activation. Taken together, our results suggest that ROS-dependent induced-ER stress contributes to carnosol-induced apoptotic and autophagic cell death in breast cancer cells, and further confirm that carnosol is a promising agent for breast cancer therapy.

عنى البحث في هذا المقام بأهمية التجارة الخارجية التي تعد الحل لمعضلة عجز الدول عن القيام بمفردها بتحقيق الاكتفاء الذاتي من السلع والخدمات لعدم قدرتها على انتاج هذه السلع، إما لأسباب تعود لطبيعة السلع أو عدم توافر رؤوس الأموال أو التكنولوجيات أو الإدارة الحديثة لدى بعض الدول لإنتاجها بتكلفة أقل. ويهدف البحث إلى بيان دور التجارة الخارجية في رفد الاقتصاد المحلي وتطويره ودعمه بالعملات الأجنبية ومعرفة اهم أساليب هذه التجارة. وخلص البحث الى أن التجارة الخارجية جاءت استجابة لما يحدث من تبدلات بالغة في الاقتصاد الدولي و ما واجهته الدول النامية من تحديات على الصعيد الاقتصادي تتمثل بمحاولة الدول الصناعية الرأسمالية بأحكام سيطرتها على الأسواق الدولية وفرض هيمنتها على بلدان العالم النامي تحقيقا لمصالحها على حساب مصالح الشعوب الأخرى.

Since its emergence in China in December 2019, COVID-19 has quickly spread around the globe causing a pandemic. Vaccination or the development of herd immunity seems the only way to slow down the spread of the virus; however, both are not achievable in the near future. Therefore, effective treatments to mitigate the burden of this pandemic and reduce mortality rates are urgently needed. Preclinical and clinical studies of potential antiviral and immunomodulatory compounds and molecules to identify safe and efficacious therapeutics for COVID-19 are ongoing. Two compounds, remdesivir, and dexamethasone have been so far shown to reduce COVID-19–associated death. Here, we provide a review of the potential therapeutic agents being considered for the treatment and management of COVID-19 patients.

مقدمه: بيماري‌هاي Myeloproliferative مزمن يك عنوان کلی برای بيماري‌هاي كلونال هماتوپوئتيك است و در نتيجه‌ی تغيير شکل سلول‌هاي اجدادي خون‌ساز چند استعداده به وجود مي‌آيد كه در نهایت، منجر به افزايش توليد در يك يا چند رده‌ی سلول خوني می‌گردد. شناسایی جهش نقطه‌ای JAK2 V617F یک کشف مهم در زمينه‌ی نئوپلاسم‌هاي Myeloproliferative مزمن است. این مطالعه به منظور تعیین فراوانی این جهش در افراد مبتلا به بيماري‌هاي Myeloproliferative مزمن ABL-BCR منفی در استان آذربایجان غربی انجام شد. روش‌ها: در این مطالعه، 43 نفر از بیماران با تشخیص نئوپلاسم‌هاي Myeloproliferative مزمن ABL-BCR منفی مشارکت داشتند. از روش‌های Amplification-refractory mutation system-polymerase chain reaction (ARMS-PCR) و Allele-specific oligonucleotide-real time-PCR (ASO-RT-PCR) برای تعیین جهش مورد نظر استفاده شد. یافته‌ها: در این مطالعه، جهش اکتسابی تیروزین کیناز JAK2 V617F در 33 نمونه (74/76 درصد) از بیماران مبتلا به نئوپلاسم‌هاي Myeloproliferative مزمن ABL-BCR منفی یافت شد. در این بررسی، جهش اکتسابی تیروزین کیناز JAK2 V617F درکل نمونه‌ها، توسط هر دو روش تعیین شد. نتیجه‌گیری: جهش اکتسابی تیروزین کیناز JAK2 V617F در طیف وسیعی از بیماران مبتلا به نئوپلاسم‌هاي Myeloproliferative مزمن ABL-BCR منفی در استان آذربایجان غربی دیده می‌شود. تعیین جهش اکتسابی تیروزین کیناز JAK2 V617F از طریق روش‌های مولکولی ARMS-PCR وASO-RT-PCR برای تأیید تشخیص بالینی بیماری و مدیریت بیماران و روش‌های درمانی، با هزینه‌های پایین در مدت زمان اندک مؤثر می‌باشد.

Photovoltaic (PV) systems have become one of the most promising alternative energy sources, as they transform the sun’s energy into electricity. This can frequently be achieved without causing any potential harm to the environment. Although their usage in residential places and building sectors has notably increased, PV systems are regarded as unpredictable, changeable, and irregular power sources. This is because, in line with the system’s geographic region, the power output depends to a certain extent on the atmospheric environment, which can vary drastically. Therefore, artificial intelligence (AI)-based approaches are extensively employed to examine the effects of climate change on solar power. Then, the most optimal AI algorithm is used to predict the generated power. In this study, we used machine learning (ML)-based algorithms to predict the generated power of a PV system for residential buildings. Using a PV system, Pyranometers, and weather station data amassed from a station at King Khalid University, Abha (Saudi Arabia) with a residential setting, we conducted several experiments to evaluate the predictability of various well-known ML algorithms from the generated power. A backward feature-elimination technique was applied to find the most relevant set of features. Among all the ML prediction models used in the work, the deep-learning-based model provided the minimum errors with the minimum set of features (approximately seven features). When the feature set is greater than ten features, the polynomial regression model shows the best prediction, with minimal errors. Comparing all the prediction models, the highest errors were associated with the linear regression model. In general, it was observed that with a small number of features, the prediction models could minimize the generated power prediction’s mean squared error value to approximately 0.15.

Saffron is the most expensive agricultural and pharmaceutical product in the world. It is significant for several reasons such as having high water productivity compared to other crops. It is providing rural employment and preventing their migration, having high medicinal and spice values, ease of maintenance and transportation. Most importantly, it is producing a high revenue compared to other agricultural products. On this basis, due to the suitability of some parts of Iran to saffron production and the role of this product in the livelihood of rural households, assessment of the sustenance impacts of saffron production in the active villages seems absolutely necessary. Therefore, the aim of the present study is to assess the status of saffron production and its role in the livelihood of rural households of the Roshtkhar Rural District. This research was done based on a descriptive-analytic approach. In this regard, the role of saffron cultivation in 355 households living in 13 villages with over 100 households in the study rural district was investigated. To this goal, after conducting documentary studies and initial field visits, a wide range of measures proportional to the circumstances of the study villages were adopted. Then, data collection was performed based on the selected indices and questionnaires were distributed to be filled by villagers and households... To analyze the data, the relevant statistical and spatial analyses were done through the application of Expert choice, SPSS, and ArcGIS software packages. The research findings indicated that the annual revenues derived from saffron production in 43.9% of the households under study were more than they obtained from other sources of income. Through the analysis of the study data, it can be concluded that saffron production has a significant effect on the improvement of the residents’ livelihood in the Roshtkhar Rural District and this fact has reinforced the households’ motivation to stay in the rural district.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

A new approach for the synthesis of nanopowders and thin films of CuInGaSe2 (CIGS) chalcopyrite material doped with different amounts of Cr is presented. The chalcopyrite material CuInxGa1 − xSe2 was doped using Cr to form a new doped chalcopyrite with the structure CuInxCryGa1 − x − ySe2, where x = 0.4 and y = 0.0, 0.1, 0.2, or 0.3. The electrical properties of CuInx CryGa1 − x − ySe2 are highly dependent on the Cr content and results show these materials as promising dopants for the fabrication thin film solar cells. The CIGS nano-precursor powder was initially synthesized via an autoclave method, and then converted into thin films over transparent substrates. Both crystalline precursor powders and thin films deposited onto ITO substrates following a spin-coating process were subsequently characterized using XRD, SEM, HR-TEM, UV–visible and electrochemical impedance spectroscopy (EIS). EIS measurement was performed to evaluate the dc-conductivity of these novel materials as conductive films to be applied in solar cells.

In this study, a novel and simple synthetic sol-gel procedure was established to directly prepare spherical lead titanate powders without prior synthesis/usage of spherical templates such as TiO2 particles. Isotropic submicron particles with a mean diameter of 1–4 μm were prepared in this way. This synthetic process takes advantage of acetone as a stabilizing ligand and autogenous pressure generated in the autoclave during the reaction. The influence of various experimental factors (nature of the ligand, thermal treatment mode, and post-calcining temperature) as well as the formation mechanism were studied. Scanning electron microscopy and transmission electron microscopy were used to explore the particle morphology. The crystalline phases were explored and identified by X-ray diffraction analysis.

Consumer’s personality traits, as one of the most important aspects of human psychological tendency, may influence people towards different brands. Therefore, the owners of most well-known brands also try to learn more about people’s personal characteristics to gain more market shares. The purpose of this paper is to find out more about consumer personality, which creates motivation in consumer’s mind and to learn more about the effect of this image on consumer’s interest on purchasing products. The population of this survey includes all people in city of Tehran, Iran who own one of Apple’s products. The results of the survey have indicated that neuroticism, extroversion, openness, compatibility, loyalty and brand love, as the main characteristics of brand personality, maintained positive impacts on brand love.

Background: Candida glabrata is one of the most common Candida species which is able to get resistant to antifungals. So, the rapid identification of it, seems to be necessary for early treatment of infections. The conventional methods for detection of Candida species are time-consuming and difficult. Today, using of nanoparticles with unique properties has been expanded. The purpose of this study was rapid identification of Candida glabrata using colorimetric assay based on gold nanoparticles. Methods: Candida glabrata was cultured in yeast extract peptone dextrose broth medium and DNA was extracted. The gene specific sequence (CAGL0M05005g) was determined from the Candida genetic information bank. For polymerase chain reaction (PCR), the primers and probe were designed via Oligo 7 software. The PCR product and probe was affected by denaturation and optimized binding temperatures. The gold nanoparticles were added and changed the color to be visual; by using ultraviolet-visible (UV-vis) spectrophotometer and transmission electron microscopy (TEM), they were confirmed. To evaluate the sensitivity of new method, different concentrations of PCR product were used and the results were analyzed using gel electrophoresis. Findings: The optimum temperatures of the primer binding to the DNA template and hybridization the probe was determined. After adding gold nanoparticles, the mixture solution color was changed from red to purple. The results were confirmed via spectroscopy and electron microscopy. Conclusion: The results indicated that in detection of Candida glabrata, the new method is faster than conventional methods and more sensitive than gel electrophoresis.

Parelasmopus setiger has been widely described from tropical to subtropical regions from Philippine Islands, Sulu Sea, Indonesia, Australia, north Indian Ocean and the Seychelles by several authors. The present study provides detailed descriptions of Parelasmopus setiger Chevreux, 1901 (Crustacea: Amphipoda) based on newly collected specimens from Pulau Hantu, Singapore. Morphological characters of the specimens closely resemble those of Parelasmopus setiger and Parelasmopus siamensis Wongkamhaeng, Coleman & Pholpunthin, 2013. The specimens of both the species were quite similar to the Singapore specimens, although the shapes of appendages vary with growth and locality; therefore, P. siamensis is synonymized with P. setiger. The following species characteristics for P. setiger are indicated: 1) antenna 1 peduncle with 2 setae; 2) male gnathopod 2 propodus palm transverse; 3) Pereopods 5 to 7 posterior margins with long slender setae; and 4) dorsal carina pattern for pereonite 7 and pleonites 1 to 3.

Traumatic brain injury (TBI) can result in persistent cognitive, behavioral and emotional deficits. However, the vast majority of patients are not chronically hospitalized; rather they have to manage their disabilities once they are discharged to home. Promoting recovery to pre-injury level is important from a patient care as well as a societal perspective. Electrical neuromodulation is one approach that has shown promise in alleviating symptoms associated with neurological disorders such as in Parkinson’s disease and epilepsy. Consistent with this perspective, both animal and clinical studies have revealed that TBI alters physiological oscillatory rhythms. More recently several studies demonstrated that low frequency stimulation improves cognitive outcome in models of TBI. Specifically, stimulation of the septohippocampal circuit in the theta frequency entrained oscillations and improved spatial learning following traumatic brain injury. In order to evaluate the potential of electrical deep brain stimulation for clinical translation we review the basic neurophysiology of oscillations, their role in cognition and how they are changed post-TBI. Furthermore, we highlight several factors for future pre-clinical and clinical studies to consider, with the hope that it will promote a hypothesis driven approach to subsequent experimental designs and ultimately successful translation to improve outcome in patients with TBI.

Carcinoid tumors of the bile duct are rare. Despite cholangiocarcinoma, they grow more slowly and generally occur in younger patients and females. These tumors have a better prognosis and more disease-free survival. We present the case of a 25-year-old male with common bile duct (CBD) carcinoid tumor misdiagnosed ascholangiocarcinoma.

Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract that occur predominantly in adults. These tumors originated from Cajal cells have positive mutations for KIT (CD117) or platelet-derived growth factor receptor (PDGFRA). GIST especially multiple GISTs are very rare in children and lacking mutations in KIT. We present a previously healthy 13 year- old girl with history of hematemesis and melena for two months which has caused severe anemia requiring ICU admission with final diagnosis of KIT positive multiple GISTs in stomach.

Introduction & Objective: Tuberculosis is an ancient disease that will affect human health in the future. Tuberculosis is a systemic disease and more body systems are affected such as hematologic system. This study was conducted to determine peripheral blood changes in pulmonary tuberculosis detecting by H3 technicon in Urmia hospitals in the west of Iran. Materials & Methods: In this study 85 patients with active pulmonary tuberculosis were evaluated for peripheral blood manifestation before and after anti tuberculosis chemotherapy. Subjects were diagnosed as active pulmonary tuberculosis with two sputum smears positive for acid fast bacillus or one smear plus one positive culture. Peripheral blood count and indices were determined by H3 technicon system and peripheral blood smear. Data were analyzed with SPSS. Win software and using Mac Nemar and Paired – Sample t-test. Results: According to the result of this study 60 percent of our patients were male. Prevalence of anemia at the time of presentation was 53 percent, in 18 patients (21.2 percent), anemia was severe. In the post-treatment phase, anemia was significantly lower than pretreatment phase (P=0.001). Leukocytosis was found in 31 percent and eosinophilia in 12.9 percent that was 3.5 and 2.3 percent respectively in post-treatment period. Thrombocythopenia was seen in 23.5 percent of our patients before treatment and 16.4 after it. Conclusion: Considering these results, prevalence of anemia among patients that were diagnosed as suffering active pulmonary tuberculosis was very high. Anemia in these patients was contributed to anemia of chronic disease and was not closely evaluated. After successful treatment some of anemic patients were still anemic. Anemia in presentation of tuberculosis has to be adequately evaluated and managed.

In the processing of subject-verb agreement, non-subject plural nouns following a singular subject sometimes attract the agreement with the verb, despite not being grammatically licensed to do so. This phenomenon generates agreement errors in production and an increased tendency to fail to notice such errors in comprehension, thereby providing a window into the representation of grammatical number in working memory during sentence processing. Research in this topic, however, is primarily done in related languages with similar agreement systems. In order to increase the cross-linguistic coverage of the processing of agreement, we conducted a self-paced reading study in Modern Standard Arabic. We report robust agreement attraction errors in relative clauses, a configuration not particularly conducive to the generation of such errors for all possible lexicalizations. In particular, we examined the speed with which readers retrieve a subject controller for both grammatical and ungrammatical agreeing verbs in sentences where verbs are preceded by two NPs, one of which is a local non-subject NP that can act as a distractor for the successful resolution of subject-verb agreement. Our results suggest that the frequency of errors is modulated by the kind of plural formation strategy used on the attractor noun: nouns which form plurals by suffixation condition high rates of attraction, whereas nouns which form their plurals by internal vowel change (ablaut) generate lower rates of errors and reading-time attraction effects of smaller magnitudes. Furthermore, we show some evidence that these agreement attraction effects are mostly contained in the right tail of reaction time distributions. We also present modeling data in the ACT-R framework which supports a view of these ablauting patterns wherein they are differentially specified for number and evaluate the consequences of possible representations for theories of grammar and parsing.

Malignant tumors of the spermatic cord are rare. There are a few case reports on spermatic cord metastasis from colonic, gastric, pancreas, and prostatic cancer. Here, we report a 36-year-old man with brucellosis presenting with spermatic cord metastasis as early manifestation of small bowel adenocarcinoma.

BACKGROUND:In this study we investigated the in vitro and in vivo anticancer effect of carnosol, a naturally occurring polyphenol, in triple negative breast cancer. RESULTS:We found that carnosol significantly inhibited the viability and colony growth induced G2 arrest in the triple negative MDA-MB-231. Blockade of the cell cycle was associated with increased p21/WAF1 expression and downregulation of p27. Interestingly, carnosol was found to induce beclin1-independent autophagy and apoptosis in MDA-MB-231 cells. The coexistence of both events, autophagy and apoptosis, was confirmed by electron micrography. Induction of autophagy was found to be an early event, detected within 3 h post-treatment, which subsequently led to apoptosis. Carnosol treatment also caused a dose-dependent increase in the levels of phosphorylated extracellular signal-regulated kinase 1 and 2 (pERK1/2). Moreover, we show that carnosol induced DNA damage, reduced the mitochondrial potential and triggered the activation of the intrinsic and extrinsic apoptotic pathway. Furthermore, we found that carnosol induced a dose-dependent generation of reactive oxygen species (ROS) and inhibition of ROS by tiron, a ROS scavenger, blocked the induction of autophagy and apoptosis and attenuated DNA damage. To our knowledge, this is the first report to identify the induction of autophagy by carnosol. CONCLUSION:In conclusion our findings provide strong evidence that carnosol may be an alternative therapeutic candidate against the aggressive form of breast cancer and hence deserves more exploration.

BACKGROUND: In the present study, we investigated the effect of Origanum majorana ethanolic extract on the survival of the highly proliferative and invasive triple-negative p53 mutant breast cancer cell line MDA-MB-231. RESULTS: We found that O. majorana extract (OME) was able to inhibit the viability of the MDA-MB-231 cells in a time- and concentration-dependent manner. The effect of OME on cellular viability was further confirmed by the inhibition of colony growth. We showed, depending on the concentration used, that OME elicited different effects on the MDA-MB 231 cells. Concentrations of 150 and 300 µg/mL induced an accumulation of apoptotic-resistant population of cells arrested in mitotis and overexpressing the cyclin-dependent kinase inhibitor, p21 and the inhibitor of apoptosis, survivin. On the other hand, higher concentrations of OME (450 and 600 µg/mL) triggered a massive apoptosis through the extrinsic pathway, including the activation of tumor necrosis factor-α (TNF-α), caspase 8, caspase 3, and cleavage of PARP, downregulation of survivin as well as depletion of the mutant p53 in MDA-MB-231 cells. Furthermore, OME induced an upregulation of γ-H2AX, a marker of double strand DNA breaks and an overall histone H3 and H4 hyperacetylation. CONCLUSION: Our findings provide strong evidence that O. majorana may be a promising chemopreventive and therapeutic candidate against cancer especially for highly invasive triple negative p53 mutant breast cancer; thus validating its complementary and alternative medicinal use.

BACKGROUND: We have recently reported that Origanummajorana exhibits anticancer activity by promoting cell cycle arrest and apoptosis of the metastatic MDA-MB-231 breast cancer cell line. Here, we extended our study by investigating the effect of O. majorana on the migration, invasion and tumor growth of these cells. RESULTS: We demonstrate that non-cytotoxic concentrations of O. majorana significantly inhibited the migration and invasion of the MDA-MB-231 cells as shown by wound-healing and matrigel invasion assays. We also show that O. majorana induce homotypic aggregation of MDA-MB-231 associated with an upregulation of E-cadherin protein and promoter activity. Furthermore, we show that O. majorana decrease the adhesion of MDA-MB-231 to HUVECs and inhibits transendothelial migration of MDA-MB-231 through TNF-α-activated HUVECs. Gelatin zymography assay shows that O. majorana suppresses the activities of matrix metalloproteinase-2 and -9 (MMP-2 and MMP-9). ELISA, RT-PCR and Western blot results revealed that O. majorana decreases the expression of MMP-2, MMP-9, urokinase plasminogen activator receptor (uPAR), ICAM-1 and VEGF. Further investigation revealed that O. majorana suppresses the phosphorylation of IκB, downregulates the nuclear level of NFκB and reduces Nitric Oxide (NO) production in MDA-MB-231 cells. Most importantly, by using chick embryo tumor growth assay, we also show that O. majorana promotes inhibition of tumor growth and metastasis in vivo. CONCLUSION: Our findings identify Origanummajorana as a promising chemopreventive and therapeutic candidate that modulate breast cancer growth and metastasis.

Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract that occur predominantly in adults. These tumors originated from Cajal cells have positive mutations for KIT (CD117) or platelet-derived growth factor receptor (PDGFRA). GIST especially multiple GISTs are very rare in children and lacking mutations in KIT. We present a previously healthy 13 year- old girl with history of hematemesis and melena for two months which has caused severe anemia requiring ICU admission with final diagnosis of KIT positive multiple GISTs in stomach.

Inflammatory myopathy is a paraneoplastic syndrome. Inflammatory myopathy may be the first manifestation of underlying malignancy. It was reported in patients with colon cancer, breast cancer, ovarian cancer, lung cancer and non-Hodgkin lymphoma. There are few reports regarding inflammatory myopathy in patients with gastric cancer. We want to present inflammatory myopathy as early manifestation of gastric cancer in a 65 y/o Asian male.

IntroductionDeveloping organic herbal crops provides chemical-free herbs to support environmentally friendly and sustainable farming. One way in agricultural biotechnology to grow herbal organic crops is to use rhizobacteria. The herbal plant used in this study is the Javanese ginseng plant (Talinum paniculatum), which contains phytochemicals that increase stamina.MethodsThe study used four rhizobacteria to enhance the growth and phytochemistry of T. paniculatum leaves; the target phytochemical compounds analyzed in Javanese ginseng leaves were total flavonoids, total phenols, and antioxidants (IC50%). The four selected rhizobacteria can produce indole-3-acetic acid (IAA), fix nitrogen, and dissolve phosphate. Thus, high-quality T. paniculatum leaves were obtained as herbal tea ingredients. The pattern used is a random group pattern in the greenhouse.ResultsThe results of the study showed that the use of rhizobacteria at 2% concentrations had a real effect on plant growth parameters such as plant height, leaf area, root length, wet weight and dry weight of the plant, and phytochemical content like total flavonoids, total phenols, IC50%, total chlorophyll, content of T. paniculatum leave plant when compared to the control. The four rhizobacteria used can produce the IAA, fix nitrogen, and dissolve phosphorus.DiscussionThe four rhizobacteria can also colonize the root of the T. paniculatum plant. The four Rhizobzcteria used significantly affected the growth and phytochemical content of T. paniculatum leaves as an ingredient in herbal tea at a concentration of 2% compared to controls. The four rhizobacteria can produce IAA hormones, fix nitrogen, and dissolve phosphorus. All four rhizobacteria can colonize the roots of T. paniculatum plants. These four rhizobacteria can be used as alternative methods in developing organic farming systems and can also be used practically in the field by farmers. It is necessary to research the application of rhizobacteria to other crops to support sustainable agriculture.

Inflammatory myopathy is a paraneoplastic syndrome. Inflammatory myopathy may be the first manifestation of underlying malignancy. It was reported in patients with colon cancer, breast cancer, ovarian cancer, lung cancer and non-Hodgkin lymphoma. There are few reports regarding inflammatory myopathy in patients with gastric cancer. We want to present inflammatory myopathy as early manifestation of gastric cancer in a 65 y/o Asian male.

The study examines the utility of AMACR, ERG, and AR immunostains in diagnosing prostatic adenocarcinoma (PCa) and assessing prognosis in comparison to the Gleason score and new WHO grading groups. Seventeen PCa biopsies and five benign prostatic hyperplasia (BPH) biopsies were analyzed. Immunoreactivity, scored from 1 to 3 based on percentage of positive cells and intensity of expression, was assessed, revealing 76.47% positivity for AMACR, 35.29% for ERG, and 94.12% for AR in PCa cases, with variable scores and intensity among markers and grade groups. AMACR sensitivity and ERG specificity were noted. Higher-grade PCa exhibited increased positivity for both markers, indicating prognostic significance. In BPH cases, AMACR showed positivity in 2 cases, ERG in 1, and AR in all cases, albeit with lower expression. Differential expression was observed among immunomarkers and grade groups of malignancy. AMACR and ERG stains serve as sensitive and specific markers for PCa diagnosis and prognosis. Their increasing positivity with higher-grade groups underscores prognostic value. These findings highlight the importance of immunostains in refining PCa diagnosis and prognostication.

A new optical sensor was developed for the rapid sensing of total phenolic content, which is simple, cheap, and sensitive, using the Eu(III)-(NTA) 2 -(Phen) complex [NTA = 1-(2-naphthoyl)-3,3,3-trifluoroacetone and Phen = 1,10 phenanthroline] as a luminescent probe at pH 7.5 using PIPES buffer. This method was based on luminescence quenching. The type of quenching during the reaction between the Eu(III)-(NTA) 2 -(Phen) complex and the phenolic compounds is dynamic quenching; the binding site is close to 1, and the reaction is endothermic, spontaneous, and involves hydrophobic attraction forces. The calibration curves were plotted using a sigmoidal fit giving an LOD of 0.01 μg mL -1 , and the correlation coefficients are more than 0.99. For the first time, the time-resolved fluorescence technique was utilized in microtiter plates to enable the determination of 96 samples within two minutes with high sensitivity and selectivity. The proposed method was applied to three industrial wastewater samples and compared with the standard method for phenolic content determination, yielding high recoveries. This is the first luminescence method based on lanthanide complexes as probes for determining the total phenolic content in water samples.

Deep vein thrombosis (DVT) is a critical condition and a potential cause of mortality and morbidity in Africa and worldwide with a high recurrence rate. The study was designed to assess the roles of natural anticoagulants and fibrinolytic regulatory factors in the development of DVT in Sudanese patients. A case-control study was conducted in Omdurman Teaching Hospital, Khartoum State over a period of 1 year. The study enrolled 200 patients diagnosed with DVT and 200 age-matched and gender-matched controls. Demographic data and data on acquired risk factors were collected using a semi-structured questionnaire. Protein C (PC), protein S (PS), antithrombin III (AT-III), thrombin-activable fibrinolysis inhibitor (TAFI), and plasminogen activator inhibitor-1 (PAI-1) were measured in patients and controls. Among the patients with DVT, 5.5% had PC deficiency, 8.5% had PS deficiency, and 3% had AT-III deficiency. Elevated TAFI and PAI-1 levels were demonstrated in 1.5 and 0.5% of patients, respectively. Risk factors for DVT (overweight, surgical history, and family history of DVT) were remarkably higher in patients than in controls. Among the female participants, pregnancy and usage of oral contraceptive pills were the highest associated risk factors for DVT. The findings concluded that the early assessment of risk factors, including the measurements of natural inhibitors, can predict the occurrence of DVT before it is actually detected in patients., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Reducing maternal mortality ratios (MMRs) remain an important public health issue in Egypt. The three delays model distinguished three phases of delay to be associated with maternal mortality: 1) first phase delay is delay in deciding to seek care; 2) second phase delay is delay in reaching health facilities; and 3) third phase delay is delay in receiving care in health facilities. Increased health services' coverage is thought to be associated with a paradigm shift from first and second phase delays to third phase delay as main factor contributing to MMR. This study aims to examine the contribution of the three delays in relation to maternal deaths., Methods: During a 10 year period (2008-2017) 207 maternal deaths were identified in a tertiary hospital in Minia governorate, Egypt. Data were obtained through reviewing medical records and verbal autopsy for each case. Then data analysis was done in the context of the three delays model., Results: From 2008 to 2017 MMR in this hospital was 186/100.000 live births. Most frequent causes of maternal mortality were postpartum hemorrhage, hypertensive disorders of pregnancy and sepsis. Third phase delay occurred in 184 deaths (88.9%), second phase delay was observed in 104 deaths (50%), always together with other phases of delay. First phase delay alone was observed in 13 deaths (6.3%) and in 82 deaths (40%) with other phases of delay. One fifth of the women had experienced all three phases of delay together. Major causes of third phase delay were delayed referral from district hospitals, non-availability of skilled staff, lack of blood transfusion facilities and shortage of drugs., Conclusions: There is a paradigm shift from first and second phases of delay to the third phase of delay as a major contributor to maternal mortality. Reduction of maternal mortality can be achieved through improving logistics, infrastructure and health care providers' training., Trial Registration: This study is a retrospective study registered locally and approved by the ethical committee of the Department of Obstetrics and Gynaecology, Minia University Hospital on 1/4/2016 (Registration number: MUEOB0002).