Search

OBJECTIVE Meningiomas close to the optic pathway are commonly candidates for microsurgical decompression, more so if they are large perioptic meningiomas. However, microsurgery itself imposes risk to vision, and the larger the tumor, the more the risk and the lower the possibility of postoperative visual recovery. Fractionated stereotactic radiotherapy is usually reserved for such cases. The purpose of this study was to assess the long-term efficacy and safety of single-session stereotactic radiosurgery (SRS) for large (≥ 10 cm3) perioptic intracranial benign meningiomas. METHODS This retrospective study included 175 patients with large perioptic benign meningiomas (≥ 10 cm3) who were treated by single-session SRS. Perioptic meningiomas were defined as meningiomas touching, compressing, or within 3 mm of the optic pathway. The median tumor volume was 15 cm3 (range 10–57.3 cm3, IQR 8.4 cm3). The median prescription dose was 12 Gy (range 9–14 Gy, IQR 1 Gy). RESULTS The median follow-up period was 72 months (range 13–217 months, IQR 65 months). The tumor control rate was 92%. The progression-free survival rates at 5 and 10 years were 97% and 80%, respectively. Favorable (better/stable) visual outcome was reported in 169 patients (97%) and unfavorable (worse) outcome in 6 patients (3%). Temporary adverse radiation effects were observed in 21 patients (12%), but only 7 patients (4%) were symptomatic. Sixty-three patients had a blind/nonuseful eye according to the pretreatment visual field examination. Visual improvement was observed in the blind/nonuseful eye in 17 patients (27%), while vision remained unchanged in 46 patients (73%). Ocular nerve palsy improved in 36 patients (61%). Tumor shrinkage was not a prerequisite for cranial nerve improvement. CONCLUSIONS SRS provides an effective and safe treatment option for large perioptic meningiomas.

تهدف هذه الدراسة إلى التعرف على مستوى الرضا لأسر مساكن ذوي الدخل المحدود في إمارة دبي من حيث معايير توفر الخدمات، ومعايير الاستدامة البيئة، والاستدامة الاجتماعية. ولتحقيق أهداف الدراسة تم تصميم استبانة طبقت على عينة عشوائية قوامها 100 مستفيد ومستفيدة من مساكن مؤسسة محمد بن راشد للإسكان. وتم استخدام الاحصاء الوصفي والتحليلي (التكرارات، النسب المئوية، المتوسط الحسابي، الانحراف المعياري ومعامل الانحدار المتعدد) لمعرفة الخصائص الديموغرافية والاجتماعية للمبحوثين، وتحليل بيانات الدراسة المتعلقة بمستوى الرضا لأسر مساكن ذوي المدخل المحدود وعلاقته بمعايير الاستدامة. وكشفت نتائج التحليل الإحصائي عدم وجود علاقة ذات دلالة إحصائية ما بين المتغيرات المستقلة (جنس صاحب المسكن، الحالة الاجتماعية، عمر الزوج، عمر الزوجة، الحالة المهنية للزوج، الحالة المهنية للزوجة، المستوى التعليمي للزوج، المستوى التعليمي للزوجة، متوسط دخل الأسرة الشهري من جميع المصادر، مدة السكن) ومقياس القرب من توفر الخدمات، معايير الاستدامة البيئية، والاستدامة الاجتماعية من جهة أخرى.

Background: Malignant mixed corticomedullary adrenal tumors (MCMTs) are extremely rare, with limited cases reported in the literature. The pathophysiology of malignant MCMTs is not well understood; the most prevailing theories are that it is a composite tumor of embryologically derived mesodermal (adrenal cortex) and neural crest (medulla) origin, perpetuating as two distinct cell lines forming a singular mass. Clinical features and laboratory diagnosis are associated with hypersecretions of the adrenal cortex and medulla. Surgical resection is curative in an isolated tumor. We reviewed and compared cases in the literature highlighting the pathogenesis and genetics of benign and malignant MCMT. Methods: Comprehensive literature analysis was conducted on PubMed and all the cases of mixed corticomedullary adrenal tumor published in English were included. Results: Most patients were female (73.1%) with a median age of 49 in women and 50 in men. Surgery was performed in all patients, and in four patients with malignant disease, chemotherapy was used as well. Clinically, most patients presented with hypertension (69%) followed by Cushing syndrome (42%) and diabetes (19%). Tumors often produced cortisol (74%), catecholamines (50%), and adrenocorticotrophic hormone (ACTH) (38%), with lower incidence of aldosterone- (7%) or dopamine (4%)-producing tumors. Immunohistochemical staining of 96% of cases showed Chromogranin-A (73%) and Synaptophysin (62%), followed by Inhibin-α (50%), Melan-A (31%), and S-100 (23%). Of the reported four cases with malignant disease, three showed a Ki-67 index of 40–50% with one showing less than 5%. Conclusion: Mixed corticomedullary adrenal tumors rarely present as a malignant disease requiring chemotherapy. Most MCMTs confer a good prognosis and respond well to surgical resection, though their pathogenesis is largely up to speculation because of limited data. Current theories regarding MCMT pathogenesis should be investigated further with genetic testing. Future research on MCMT may provide ways to guide physician diagnosis and subsequent treatment for refractory cases.

To evaluate the results of a new plate system using anterior approaches in the management of acetabular fractures.Retrospective case-note review.Pelvic and acetabular tertiary center.A consecutive series of acetabular fractures treated using only anterior approach and anatomical plates, at one tertiary specialist unit, were reviewed. The fracture patterns, incisions used, intraoperative and postoperative complications, reduction achieved (measured on postoperative radiographs and computed tomography scans), and early postoperative results (minimum 1-year follow-up) were recorded.Postoperative reduction (measured by postoperative plain radiographs and computed tomography).Thirty-three patients (mean age, 57 years) underwent reconstruction with the anatomical plates using anterior approaches. Associated both columns and anterior column posterior hemitransverse represented most of the patients (85%). The fracture pattern was complex with quadrilateral plate involvement in 79% of cases. Overall, anatomic reduction was seen in 82% on plain radiographs and CT scan evaluation. Increasing age was a statistically significant variable in obtaining anatomical reduction with an age cutoff value of 70 years ( P 0.012). Associated both column fractures were associated with a lower incidence of anatomical reduction ( P = 0.038). Complication rates were comparable with the literature. 22 patients (71%) were symptom free, with 20 patients (62.5%) having excellent radiographic outcomes at the latest follow-up.The results suggested that using approach-specific instruments and anatomical plates through anterior approaches in a specialized unit led to anatomical reconstruction in 82% with patients demonstrating satisfactory early radiological and functional outcomes at 1 year.Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Programmed death-ligand (PD-L) 1 and 2 are ligands of programmed cell death 1 (PD-1) receptor. They are members of the B7/CD28 ligand-receptor family and the most investigated inhibitory immune checkpoints at present. PD-L1 is the main effector in PD-1-reliant immunosuppression, as the PD-1/PD-L pathway is a key regulator for T-cell activation. Activation of T-cells warrants the upregulation of PD-1 and production of cytokines which also upregulate PD-L1 expression, creating a positive feedback mechanism that has an important role in the prevention of tissue destruction and development of autoimmunity. In the context of inadequate immune response, the prolonged antigen stimulation leads to chronic PD-1 upregulation and T-cell exhaustion. In lung cancer patients, PD-L1 expression levels have been of special interest since patients with non-small cell lung cancer (NSCLC) demonstrate higher levels of expression and tend to respond more favorably to the evolving PD-1 and PD-L1 inhibitors. The Food and Drug Administration (FDA) has approved the PD-1 inhibitor, pembrolizumab, alone as front-line single-agent therapy instead of chemotherapy in patients with NSCLC and PD-L1 ≥1% expression and chemoimmunotherapy regimens are available for lower stage disease. The National Comprehensive Cancer Network (NCCN) guidelines also delineate treatment by low and high expression of PD-L1 in NSCLC. Thus, studying PD-L1 overexpression levels in the different histological subtypes of lung cancer can affect our approach to treating these patients. There is an evolving role of immunotherapy in the other sub-types of lung cancer, especially small cell lung cancer (SCLC). In addition, within the NSCLC category, squamous cell carcinomas and non-G12C KRAS mutant NSCLC have no specific targetable therapies to date. Therefore, assessment of the PD-L1 expression level among these subtypes of lung cancer is required, since lung cancer is one of the few malignances wherein PD-L1 expression levels is so crucial in determining the role of immunotherapy. In this study, we compared PD-L1 expression in lung cancer according to the histological subtype of the tumor.

Lung cancer is the leading cause of cancer-related deaths. Surgery remains the best option to treat lung cancer when feasible. However, many cases are diagnosed beyond the initial stages. There has been tremendous progress in the treatment of lung cancer over the last few years. Studies have shown that biomarker-driven targeted therapies lead to better outcomes. Due to the technical difficulties and significant procedural risk associated with repeated tissue biopsies, analysis of tumor constituents circulating in the blood, such as circulating tumor DNA (ctDNA) and various proteins, is becoming more widely recognized as an alternative method of tumor sampling, i.e., liquid biopsy. Liquid biopsy is superior to tissue biopsy, as it is minimally invasive and easily repeatable. Given the recent data on changes in mutations as the disease progresses or responds to treatment, liquid biopsies can help monitor the changes and guide us in giving targeted drugs. Here we present a case of advanced NSCLC who was initially started on Alectinib based on positivity for ALK gene rearrangement found in the FISH study. At the time of progression, molecular profiling liquid biopsy was obtained, which revealed KRAS-p.G12C mutation. Thus, the patient’s therapy was later on changed to sotorasib after the FDA approved a KRAS-p.G12C mutation inhibitor.

OBJECTIVE Resection of meningiomas in direct contact with the anterior optic apparatus carries risk of injury to the visual pathway. Stereotactic radiosurgery (SRS) offers a minimally invasive alternative. However, its use is limited owing to the risk of radiation-induced optic neuropathy. Few SRS studies have specifically assessed the risks and benefits of treating meningiomas in direct contact with the optic nerve, chiasm, or optic tract. The authors hypothesized that SRS is safe for select patients with meningiomas in direct contact with the anterior optic apparatus. METHODS The authors performed an international multicenter retrospective analysis of 328 patients across 11 institutions. All patients had meningiomas in direct contract with the optic apparatus. Patients were followed for a median duration of 56 months after SRS. Neurological examinations, including visual function evaluations, were performed at follow-up visits. Clinical and treatment variables were collected at each site according to protocol. Tumor volumes were assessed with serial MR imaging. Variables predictive of visual deficit were identified using univariable and multivariable logistic regression. RESULTS SRS was the initial treatment modality for 64.6% of patients, and 93% of patients received SRS as a single fraction. Visual information was available for 302 patients. Of these patients, visual decline occurred in 29 patients (9.6%), of whom 12 (41.4%) had evidence of tumor progression. Visual decline in the remaining 17 patients (5.6%) was not associated with tumor progression. Pre-SRS Karnofsky Performance Status predicted visual decline in adjusted analysis (adjusted OR 0.9, 95% CI 0.9–1.0, p < 0.01). Follow-up imaging data were available for 322 patients. Of these patients, 294 patients (91.3%) had radiographic evidence of stability or tumor regression at last follow up. Symptom duration was associated with tumor progression in adjusted analysis (adjusted OR 1.01, adjusted 95% CI 1.0–1.02, adjusted p = 0.02). CONCLUSIONS In this international multicenter study, the vast majority of patients exhibited tumor control and preservation of visual function when SRS was used to treat meningioma in direct contact with the anterior optic pathways. SRS is a relatively safe treatment modality for select patients with perioptic meningiomas in direct contact with the optic apparatus.

Background: Primary lung cancer is the most common cause of cancer-related mortality in the United States (US). Approximately 90% of lung cancers are associated with smoking and the use of other tobacco products. Based on histology, lung cancers are divided into small-cell lung carcinomas (SCLCs) and non-small-cell lung carcinomas (NSCLCs). Most SCLCs are of the pure subtype, while the rare combined SCLCs contain elements of both small-cell and non-small-cell morphologies. This study sought to evaluate the demographics, clinical factors, molecular abnormalities, treatment approaches, and survival outcomes with combined SCLC and NSCLCs. Materials and Methods: Data on 2126 combined SCLC patients was extracted from the Surveillance Epidemiology and End Result (SEER) database from 2000 to 2018. Data extracted for analyses included age, sex, race, tumor size, tumor location, metastasis status, stage at diagnosis, treatment received, and treatment outcomes. Multivariate analysis was performed using Statistical Product and Service Solutions (SPSS) software. Results: The patients had a median age of 68 years; 43.9% of the patients were female and 56.1% were male; 84.5% were White and 11.7% were African Americans. The majority of patients had a poorly differentiated disease at 29.6%; 17% were undifferentiated, 3.2% were moderately differentiated, and 0.8% were well differentiated. Chemotherapy was the most common treatment modality (45.3%); 17% underwent surgery only, 10.3% underwent surgery followed by adjuvant chemotherapy, and 10% underwent radiation after surgery. Five-year cancer-specific survival was 15.2% with surgery alone, and combined surgery and chemotherapy provided the highest percentages (38.3% and 34.7%, respectively). Females had significantly higher 1- and 5-year cancer-specific survival rates compared to males (59.3% and 29.9% vs. 48.0% and 23.7, respectively; p < 0.001). Well-differentiated tumors had significantly higher survival compared to other gradings (p < 0.001). Survival decreased as tumor staging moved distally from localized to regional to distant (p < 0.001). Metastasis to bone, liver, brain, and lung significantly decreased survival in comparison to patients who did not have any metastasis (p < 0.001). Females had significantly shorter survival compared to their counterparts when metastasis was to the bone, brain, or liver (p < 0.001). Multivariate analysis identified male sex (Hazard Ratio (HR) = 1.2), undifferentiated grade (HR = 1.9), regional extent of disease (HR = 1.7), distant extent of disease (HR = 3.7), and metastasis to liver (HR = 3.5) as variables associated with worse survival. Conclusion: Combined SCLC is overall very rare. However, the frequency of presentation with combined SCLC is on the rise, in part due to improvements in diagnostic techniques. Despite advances in therapies, treating combined SCLC is challenging, and novel therapies are not utilized, owing to low rates of targetable mutations. Combined SCLC has higher survival rates if well differentiated.

The current research aims to verify the effect of (leader-member exchange) as an independent variable in psychological capital as a responding variable, in the departments of the Ministry of Education headquarters, and to try to come up with a set of recommendations that contribute to enhancing the practice and adoption of variables in the organizations under study. Based on the importance of the subject of the research to the community, and to the researched organizations and their individuals, the researcher adopted the descriptive analytical approach in completing this research, with choosing the headquarters of the Ministry of Education as a place of application, while the research sample was represented (and heads of departments and officials of the people at the level of the ministry and its departments) as a random stratified sample of the research community. In the general directorates at the headquarters of the Ministry of Education, as the researcher distributed (169) questionnaires of the research sample, then collected data from (154) respondents from the surveyed community by adopting the questionnaire, which included (45) paragraphs, and providing it with personal interviews and field observations as tools to help in strengthening it. The research adopted the program (Amos V.25, SPSS v25) with the adoption of descriptive and inferential statistics methods (normal distribution test, confirmatory factor analysis, building models of variables, arithmetic mean, percentages, standard deviation, relative importance, coefficient of variation, Pearson correlation coefficient, simple regression coefficient, path analysis, Sobel test) to test its hypotheses. As for the most prominent results of the research, it was represented by the presence of a clear positive effect of the exchange (leader-member) in the psychological capital through the presence of supportive and supportive leadership for human resources and for excellence and creativity that is provided by human resources, and therefore this support has contributed positively to achieving good levels of Selfefficacy, confidence and flexibility in performance among the research sample.

Aims: As conservation agriculture have been proposed as an option to limit conventional agriculture impact and to ensure sustainability and food security. This study examined the effect of conventional tillage (CT) and no tillage (NT) on mycorrhization rate, mineral elements uptake, total phenolic content (TPC) and total flavonoid content (TFC) of oat during tillering. Study Design: Split-plot design was applied for this study. Place and Duration of Study: The experiment was conducted at the referential farm for direct drilling (Krib, Siliana) situated in northwestern Tunisia during 2015/2016 cultivation year. Methodology: Mycorrhization rate (MR), mineral elements uptake, total phenolic content (TPC) and total flavonoid content (TFC) of oat were studied as affected by conventional tillage (CT) and no tillage (NT) during tillering stage. Results: The results showed that tillage practices (T) had no significant effect on mycorrhization rate, mineral uptake, total phenolic content and total flavonoids content under rainfed conditions. Even if NT had no significant effect on MR, higher rates were noted for NT compared to CT. Conclusion: This study extends our knowledge on oat mycorrhization, mineral elements uptake, TPC and TFC as affected by tillage practices to advance results helping decision makers for no tillage adoption upscaling in Tunisia under rainfed conditions.

Trichoderma harzianum S7113 as an efficient fungal isolate for laccase production was identified using the 18S rRNA sequencing. T. harzianum S7113 attained its maximal laccase production level on the 14th day of static incubation at 28 °C and pH 5.0 using the inoculum size of 5 discs (14 mm), according to the one factor per time (OFT) method. The most appropriate carbon, organic and inorganic nitrogen sources to promote maximal laccase synthesis were glucose (15 g/L), beef extract (5 g/L), and ammonium chloride (4 g/L), respectively. Results of Response Surface Methodology (RSM) revealed that glucose, meat extract, and ammonium chloride concentrations of 17.54, 7.17, and 4.36 g/L respectively, at a pH value of 6.74 are the favorite conditions for high titer production. The ANOVA analysis highlighted an excellent match between the actual experimental results and the model predicted laccase production levels. The biodegradation of hydroquinone (HQ) by T. harzianum S7113 laccase was most efficient in the pH range of 5.0 to 6.5. The increase in laccase concentration led to a significant increase in the HQ conversion to get a biodegradation rate of 92 ± 2.6% with a laccase concentration of 0.75 U/mL after 3 h of reaction.

AIM To study the incidence, extent and fate of uterine ischaemia as one of the forms of non-target embolisation following uterine artery embolisation (UAE), as detected on immediate post-embolisation and contrast-enhanced magnetic resonance imaging (MRI) examinations at the 3-month follow-up. MATERIALS AND METHODS A retrospective study was undertaken comprising 43 women (mean age: 44.8 ± 3.79 years). MRI was performed before, immediately after (within 6 h), and 3 months after successful UAE. Areas of uterine ischaemia were identified on immediate post-embolisation MRI as regions of newly developed (compared to pre-embolisation MRI) absent enhancement within the uterus not corresponding to the location of the leiomyoma. The volume of the ischaemic region was calculated using the formula (height × length × width × 0.523). RESULTS Uterine ischaemia was encountered in 29 patients (67.44%). The mean volume of the ischaemic region immediately after UAE was 29.29 ± 19.15 ml (range: 7.36–87.71 ml). At 3-month follow-up, it was 0.35 ± 0.95 ml (range: 0–3.5 ml) with 25 (86%) patients showing complete resolution of the ischaemia. The mean reduction in the volume of the ischaemic region at the 3-month follow-up was 98.24 ± 5.72% (range: 72–100%). This volume reduction was statistically significant (p CONCLUSION Uterine ischaemia as a form of non-target embolisation following UAE might be encountered in up to two thirds of patients. These ischaemic areas are significantly reduced at the 3-month follow-up with up to 86% of cases showing complete reversibility of the ischaemia.

Aims/Introduction To study the epidemiology, genetic landscape and causes of childhood diabetes mellitus in the State of Qatar. Materials and methods All patients (aged 0–18 years) with diabetes mellitus underwent biochemical, immunological and genetic testing. American Diabetes Association guidelines were used to classify types of diabetes mellitus. The incidence and prevalence of all the different types of diabetes mellitus were calculated. Results Total number of children with diabetes mellitus was 1,325 (type 1 n = 1,096, ≥1 antibody; type 2 n = 104, type 1B n = 53; maturity onset diabetes of the young n = 20; monogenic autoimmune n = 4; neonatal diabetes mellitus n = 10;, syndromic diabetes mellitus n = 23; and double diabetes mellitus n = 15). The incidence and prevalence of type 1 diabetes were 38.05 and 249.73 per 100,000, respectively, and for type 2 were 2.51 and 23.7 per 100,000, respectively. The incidence of neonatal diabetes mellitus was 34.4 per 1,000,000 live births, and in indigenous Qataris the incidence was 43.6 per 1,000,000 live births. The prevalence of type 1 diabetes and type 2 diabetes in Qatari children was double compared with other nationalities. The prevalence of maturity onset diabetes of the young in Qatar was 4.56 per 100,000. Conclusions This is the first prospective and comprehensive study to document the epidemiology and genetic landscape of childhood diabetes mellitus in this region. Qatar has the fourth highest incidence of type 1 diabetes mellitus, with the incidence and prevalence being higher in Qatari compared with non‐Qatari. The prevalence of type 2 diabetes mellitus is also higher in Qatar than in Western countries. The incidence of neonatal diabetes mellitus is the second highest in the world. GCK is the most common form of maturity onset diabetes of the young, and a large number of patients have type 1B diabetes mellitus., This is the first comprehensive, prospective study from the Middle East North Africa region to systematically study the causes of diabetes in every child in the State of Qatar. The State of Qatar has the fourth highest incidence of type 1 diabetes in the world. The incidence of type 2 diabetes is much higher in Qatar than in Western countries. Both type 1 and type 2 diabetes are more common in the Qatari population than the non‐Qatari population. Mutations in GCK were the most common cause of maturity onset diabetes of the young, and mutations in the PTF1A and INS genes were the most common cause of neonatal diabetes in this population.

The objective of the research was to build a battery for testing the compatibility abilities of football players for the ages of 13-15 years. The descriptive method was used in the survey and correlation method. The sample consisted of (104) players from the Mosul Sports Academy. They were chosen in a deliberate manner. To determine the components of the compatibility capabilities and their tests, which reached to 22 tests. The tests were performed and the results of the analysis were reached. The following conclusions were reached: The results of the analysis were conducted on (22) measuring tests 7 factors reached 7 factors were all accepted In the light of the conditions laid down for its acceptance it has been interpreted and called first factor harmonic power of the body second factor steering the spatial and temporal third factor ability of the diverse fourth factor precision kinetic ability of the ability to deal with different Renderings Factor 5th ability to make the appropriate voltage factor 6th and change the direction the ability of balance and agility factor 7th rhythmic ability.

Mediastinal lymph node assessment is a crucial step in non-small cell lung cancer staging. Positron emission tomography (PET) has been the gold standard for the assessment of mediastinal lymphadenopathy, though it has limited specificity. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is quick, accurate, and a less invasive method for obtaining a diagnostic sample in contrast to mediastinoscopy. We performed a retrospective chart analysis of 171 patients to assess the adequacy of tissue obtained by EBUS for diagnosis and molecular profiling as well as the assessment of staging and lymph node (LN) stations diagnostic yield, in correlation to PET scan and the operator’s level of experience. A significantly increased tissue adequacy was observed based on the operators’ experience, with the highest adequacy noted in trained Interventional Pulmonologist (IP) (100%), followed by >5 years of experience (93.33%), and 88.89% adequacy with

Shiga toxin-producing E. coli (STEC) are an important cause of foodborne illness in humans with infections ranging from mild non-bloody diarrhea to bloody diarrhea (BD) and hemolytic uremic syndrome (HUS). This study aimed to investigate the distribution of STEC in shellfish from coastal shores of Lake Timsah in Ismailia Governorate, Egypt and its probable hazard to seafood consumers. Samples from the external surface and tissues of shrimp (n = 45), crabs (n = 45), and oysters (n = 45) batches were examined bacteriologically for the presence of STEC and tested for their antibiotic sensitivity. Moreover, occurrence of virulence genes was determined via detection of stx1, stx2 and eaeA genes using PCR. Overall, E. coli and presumptive STEC isolates (from CHROMagar) were identified from the surface (55.6 and 5.9%) and tissues (42.2 and 8.9%) of the examined shellfish batches, respectively. Five STEC isolates had been confirmed and found belonging to O26:H11, O125:H6, O146:H21, and O159 serogroups, those were 4 isolates from tissues of the three shellfish species and one isolate from the crab surface. The STEC isolates were multi-drug resistant, showing complete resistance to; penicillins, amoxycillin/clavulanic acid, colistin, fosfomycin, ceftriaxone, ciprofloxacin, and tetracycline, however, they were sensitive to gentamycin except O159 serogroup. The current study revealed low level of contamination of shellfish from coastal shores of Lake Timsah with STEC, however, it also highlights the extreme level of antimicrobial resistance exhibited by the presumptive and confirmed STEC isolates which is very hazardous for seafood consumers in the study area.

The study area was chosen in the field of the College of Agriculture of Al-Qasim Green University, confined between longitudes 22.6° 22° 044° to 00.9° 24° 0.44° east and between latitudes 19.3° 21° 32° to 21.7° 24° 32° N, and the study area was interlocked and identified The coordinates were obtained by GPS, as samples were obtained from 40 sites of cultivated soils. For two surface depths 0-30 cm and sub-surface 30-60 cm and 40 sites for leftover soils of two depths as well, The volumetric analysis results showed that the variability of the microorganisms in the soil was that the Azotobacter bacteria were the most heterogeneous compared to the Bacillus bacteria, and that the content of Azotobacter was higher in the soil than the Bacillus bacteria, and the agricultural use had an effect on the presence of these microorganisms and their heterogeneity.

The aim of the research is to structure tests for the compatibility abilities of football players for ages (13-15) years and to find their standard grades. The descriptive method was used in the survey method to achieve the research goals. The research community is one of the football players of 13-15 years of football academies in Mosul. The study sample included 104 players from the Mosul Sports Club Academy and the Andalus Academy. They were selected in a deliberate manner. The researchers used the analysis of sources, research and questionnaire to determine the compatibility abilities. A set of behavioral attitudes were designed as proposed tests. A number of experiments were conducted to determine the validity of the tests. The aim was to determine the scientific basis for the tests. The most important results were that the proposed tests enjoy scientific transactions of honesty, consistency, objectivity and suitability, indicating that the design of the tests was done in accordance with sound scientific methods of construction Standard scores for final tests were found.

Upon Seeking natural and safe alternatives for synthetic medicines to treat many chronic diseases, seaweeds have offered a promising resource to produce numerous bioactive secondary metabolites. Th...

In 1991, Stewart launched the theory of economic value added (EVA) as a modern measure of financial performance assuring its ability in analyzing and improving the firm performance. Later on, in 2009, he introduced the economic value added momentum (EVA Momentum) as the single best firm financial performance measurement tool. Therefore, this study has the purpose of investigating the impact of EVA and EVA Momentum on firm financial performance indicators; return on assets (ROA) and return on equity (ROE) using Generalized Least Squares (GLS) regression. This paper is also aiming to contribute into announcing the economic value added measure with the highest explanatory power relevant to firm financial performance via conducting relative information content analysis along with Stepwise regression. Data were collected for companies listed in the Egyptian Stock Exchange over the period 2010-2019 excluding the financial sector. Statistical techniques are conducted using the statistical package of EViews-version 10. The results showed significant impact for both economic values added on firm financial performance, except for EVA with ROE. In addition, it was found that EVA Momentum could be considered as the most effective economic measure in improving and explaining the financial performance.

Anterior capsular contraction syndrome (ACCS) describes the progressive fibrotic phimosis of the anterior capsular bag that usually occurs a few months after cataract surgery. YAG laser anterior capsulotomy (YAGAC) is the most common treatment option due to the low-risk profile of this intervention.In this series, we evaluated the outcomes of an advanced nurse practitioner (ANP) in conducting this laser intervention, comparing the results with those of ophthalmologists.Our study represents a single-centre, retrospective, continuous case series of 108 eyes that underwent YAGAC due to ACCS between January 2017 and July 2020 at the Birmingham and Midland Eye Centre, the second largest tertiary referral centre in the United Kingdom.The groups treated by ANPs and ophthalmologists were similar in respect to age, gender, and laterality of the laser procedure. Eyes treated by ophthalmologists had significantly more ocular comorbidities (p.001), the most common of which was glaucoma. Although the complication rate was higher in the ophthalmologist group, it did not reach statistical significance. However, there was a trend toward significance in the retreatment rate, with 8.6% (7/81) of eyes lasered by ophthalmologists requiring further YAGAC, and no repeat procedure was needed in the ANP group.YAGAC leads to good visual outcomes and a low complication rate in both ophthalmologist and ANP groups.Advanced nurse practitioners can deliver results that are comparable with those of experienced ophthalmologists.

Purpose: We report our experience with transperitoneal laparoscopic nephrectomy (LN) for giant hydronephrosis (GH) and compare the outcome data with open nephrectomy (ON). Patients and methods: The retrospective data of 88 patients (52 males and 36 females) who underwent LN or ON for treatment of GH in the period between October 2015 and December 2019 were investigated. LN was performed in 38 patients, while 50 patients underwent ON. We compared the two groups for success, operative time, and intraoperative and postoperative complications. Results: The mean age of the patients in the LN group was 45.8 ± 11.4 years, and it was 44.7 ± 10.8 years in the ON group. The mean operative time in the LN group was statistically significantly longer when compared with the ON group195 ± 18 min versus 127 ± 22 min ( p = 0.01).The estimated blood loss was significantly greater in the ON group ( p = 0.01). However, no patients required blood transfusions in either group. The visual analog pain (VAP) scores were significantly higher on both day 1 and day 2 in the ON group 3.6 ± 0.9 and 2 ± 0.7 versus 2.7 ± 0.6 and 1.4 ± 0.5 in LN group, ( p = 0.01). Conclusion: LN for GH is feasible, safe, and efficacious. Compared to open surgery, the laparoscopic approach resulted in significantly shorter hospital stays, decreased morbidity, and quicker recovery. Some tips and tricks could help to do it in an easier way and reduce the operative time.

Background Salmonella is one of the most common and economically important zoonotic pathogens. This study aimed to determine the occurrence of Salmonella serovars in sheep and goats and their probable zoonotic risk to humans in Suez Canal area in Egypt. A total of 320 fecal samples from sheep (n = 120), goats (n = 100), and humans (n = 100) were collected and examined for the presence of Salmonella based on cultural and biochemical characteristics, and serological analysis. Moreover, the virulence of the identified Salmonella isolates was assessed by molecular screening for invA, stn, spvC, and sopB virulence genes using PCR. Results Overall, the occurrence of Salmonella in sheep feces (23.3%) was higher than that in goat feces (7%) and human stool (13%) in the study area. The identified isolates belonged to 12 serotypes; ten, five, and eight from sheep, goats, and humans, respectively. The most frequently identified serotypes were S. Typhimurium from sheep feces, and S. Enteritidis from both goat feces and human stool, with four serotypes; S. Typhimurium, S. Enteritidis, S. Dublin and S. Saintpaul, were mutually shared between all of them. Demographic data revealed that diarrheic sheep (85.7%) and goats (25%) had a higher risk for Salmonella fecal carriage than non-diarrheic ones (19.5% and 6.25%, respectively). The prevalence of Salmonella infection in humans in contact with sheep and goats (28%) was significantly higher than its prevalence in people having a history of contact with animals other than sheep and goats (10%) and those having no history of animal contact (7.3%) (χ2 = 6.728, P ˂ 0.05). The stn, spvC, and sopB genes were detected in 98.1% of the isolates, with a significant, very strong positive correlation for their mutual presence (P invA gene had a non-significant, very weak positive correlation with other virulence genes. The most common genotypic virulence profile for all isolates was stn, spvC, and sopB; however, invA, stn, spvC, and sopB was the frequent virulotype for S. Typhimurium, S. Tsevie, S. Apeyeme, and S. Infantis. Conclusions The present study highlights the role of apparently healthy and diarrheic sheep and goats as reservoirs and sources of human infection with virulent Salmonella serovars in the Suez Canal area.

Objective Approximately 30% of lung cancer patients develop central airway obstruction (CAO) that remarkably shortens survival. There is little data about the benefits of stenting within this heterogeneous patient group. Our objective was to review their overall survival (OS) and their risk of hospitalization versus patients who did not have lesions requiring stent placement. Methods We retrospectively reviewed charts of 171 non-small cell lung cancer (NSCLC) patients who underwent bronchoscopy in the University of Cincinnati Cancer Center from the year 2011 to 2013. Twenty-five patients with advanced lung cancer were evaluated by interventional pulmonology service for endobronchial stent placement for CAO. Eight patients did not require placement of a stent and 17 had obstructive lesions that required stenting by interventional pulmonology. Results Demographical parameters such as age and gender did not have a significant impact on the risk of hospitalization or OS of both groups of patients, however, those whose lesions did not mandate stent placement had significantly lower odds of hospitalization compared to patients with CAO requiring a stent (OR: 15.913, 95% CI: 1.211-209.068, P = 0.0352). Patients with advanced NSCLC and CAO that required stent placement had an OS of 13.9 m [3.9-19.9 m] compared to an OS of 23.9 m for patients with CAO not requiring a stent. We found out that patients with less severe CAO have lower odds of hospitalization and better OS compared to patients with CAO mandating stent placement. Conclusion CAO patients with interventional pulmonology (IP) evaluation and management in addition, may have improved OS suggesting that IP consultation might offer both improvement in quality of life and overall survival to patients with advanced NSCLC and CAO. .

Background: Three-dimensional (3D) visualization systems, also known as heads-up systems, are now available for eye surgery and as with every new device there is need for a specific evaluation. Objectives: The aim of this study was to compare the efficiency, surgical comfort, and safety of a 3D visualization system to a standard binocular microscope (BM) in routine ophthalmologic procedures. Method: After a 4-week training period, a 3D visualization system (Ngenuity, Alcon®) available in one of the Robert Debré Hospital Ophthalmology Departments’ operating rooms was compared to a standard BM (OPMI LUMIRA 700, Zeiss®), in the process of a call for new device evaluation. From December 2017 to March 2018, 5 surgeons and their respective residents were asked to fill in a questionnaire for all procedures. Before the surgery, the surgeon recorded: (i) the type of surgery (cataract [PK], retinal detachment [RD], epiretinal membrane peeling [ERM], macular hole, vitreous haemorrhage [VH]), (ii) the type of visualization system chosen (3D or BM), and (iii) the estimated surgical risk (low, intermediate, or high grade). At the end of the procedure, the primary surgeon recorded the remaining parameters, including: (i) surgery duration, (ii) intraoperative complications, (iii) percentage of endoillumination for posterior segment surgeries, (iv) status of the operator (senior or resident) and operator switch if necessary (senior only, resident only, or resident with help of the senior), and rated: (i) the visual comfort (low, normal, excellent), (ii) the operative fluency (low, normal, excellent), (iii) backaches (none, low, moderate, important), and (iv) headaches (range from 0 to 10). Age and sex were collected retrospectively. The procedures performed with 3D and BM were subsequently compared using univariate (χ2, Fisher, Wilcoxon) and multivariate analysis (generalized linear model), allowing us to identify parameters independently associated with PK surgery duration. Results: A total of 102 valid questionnaires, relative to 73 PK and 29 vitreoretinal procedures, respectively, were analysed. As regards PK (3D, n = 25 vs. BM, n = 48), the mean age, sex ratio, surgical risk, intraoperative complications (1/25 vs. 4/48), visual comfort, backaches, and headaches were similar between the two systems. The use of 3D allowed faster PK surgeries (16.44 ± 4.36 vs. 21.44 ± 7.50 min; p = 0.007) and slightly enhanced the operative fluency. In vitreoretinal surgeries (3D, n = 14 vs. BM, n = 15), no obvious differences between the two visualization systems were observed, although the use of the 3D system was found to slightly decrease the operative fluency. Parameters independently associated with PK surgery duration were 3D visualization (β = –4.4 ± 1.4; p = 0.002), high preoperative surgical risk (β = 6.2 ± 2.4; p = 0.012), intraoperative complications (β = 8.7 ± 2.6; p = 0.001), and surgeon status (β = –4.4 ± 1.3; p = 0.001) in univariate and multivariate analysis. Conclusions: 3D visualization can be safely used in routine practice. It slightly improves the operative fluency, allowing faster PK surgery.

Background Autophagy is a catabolic process, utilized constitutionally by body cells to recycle nutrients and to remove unwanted/damaged intracellular constituents. It is enhanced during periods of stress, such as starvation and hypoxia, aiding in cell survival and it is linked to major cellular processes, such as apoptosis and antigen expression. The process has been extensively studied in vitro models or tumor tissue samples with rare application on human subjects. Methods Plasma samples from 24 advanced solid tumor patients were collected at different time points before and after chemotherapy. Their exosomes were isolate and blotted for microtubule-associated protein-1 light chain-3 (LC-3B) protein as a marker for autophagy. All the subjects received a standard chemotherapy regimen of carboplatin- gemcitabine with chloroquine (CQ)/ hydroxychloroquine (HCQ) in chronic doses throughout their treatment period as an autophagy modulator. CQ/HCQ was given in 50 mg increments as guided by their tolerability to treatment. Results A total of 267 plasma samples were obtained for the 24 patients and processed. Each sample corresponds to a single time point. The first group included 6 patients, all received 50 mg of CQ with chemotherapy. LC-3B I was detected in their isolated exosomes, while LC3-BII was not detected in their samples. The second cohort of patients included 3 subjects who re-ceived 100mg of HCQ. They demonstrated both LC3-BI and II on day 15 after chemotherapy in one patient, and on third cycle after 24 hours in the second patient. The third cohort included 3 subjects who received 150 mg of HCQ. All cases demonstrated LC3-BI and II on first cycle of treatment after less than 24 hours. The last cohort included 8 subjects, who received a fixed dose of 100 mg of HCQ with treatment. In this cohort, we were able to detect both LC3-B isoforms on advanced time points of second and third cycles. Conclusion Detection of autophagy protein LC3-B in exosomes serves as a dynamic method to monitor autophagy. It can be utilized to study the effects of anti-neoplastic agents on autophagy and mechanisms of drug resistance, however, to standardize our results a larger specimen of patients should be included.

OBJECTIVERecurrent or residual adenomas are frequently treated with Gamma Knife radiosurgery (GKRS). The most common complication after GKRS for pituitary adenomas is hypopituitarism. In the current study, the authors detail the timing and types of hypopituitarism in a multicenter, international cohort of pituitary adenoma patients treated with GKRS.METHODSSeventeen institutions pooled clinical data obtained from pituitary adenoma patients who were treated with GKRS from 1988 to 2016. Patients who had undergone prior radiotherapy were excluded. A total of 1023 patients met the study inclusion criteria. The treated lesions included 410 nonfunctioning pituitary adenomas (NFPAs), 262 cases of Cushing’s disease (CD), and 251 cases of acromegaly. The median follow-up was 51 months (range 6–246 months). Statistical analysis was performed using a Cox proportional hazards model to evaluate factors associated with the development of new-onset hypopituitarism.RESULTSAt last follow-up, 248 patients had developed new pituitary hormone deficiency (86 with NFPA, 66 with CD, and 96 with acromegaly). Among these patients, 150 (60.5%) had single and 98 (39.5%) had multiple hormone deficiencies. New hormonal changes included 82 cortisol (21.6%), 135 thyrotropin (35.6%), 92 gonadotropin (24.3%), 59 growth hormone (15.6%), and 11 vasopressin (2.9%) deficiencies. The actuarial 1-year, 3-year, 5-year, 7-year, and 10-year rates of hypopituitarism were 7.8%, 16.2%, 22.4%, 27.5%, and 31.3%, respectively. The median time to hypopituitarism onset was 39 months.In univariate analyses, an increased rate of new-onset hypopituitarism was significantly associated with a lower isodose line (p = 0.006, HR = 8.695), whole sellar targeting (p = 0.033, HR = 1.452), and treatment of a functional pituitary adenoma as compared with an NFPA (p = 0.008, HR = 1.510). In multivariate analyses, only a lower isodose line was found to be an independent predictor of new-onset hypopituitarism (p = 0.001, HR = 1.38).CONCLUSIONSHypopituitarism remains the most common unintended effect of GKRS for a pituitary adenoma. Treating the target volume at an isodose line of 50% or greater and avoiding whole-sellar radiosurgery, unless necessary, will likely mitigate the risk of post-GKRS hypopituitarism. Follow-up of these patients is required to detect and treat latent endocrinopathies.

Pectin extracted from sugar beet pulp using enzymatic or acid hydrolysis was evaluated as corrosion inhibitor for mild steel under acidic conditions. Effect of pectin concentration on corrosion rate and efficiency was studied via weight loss and electrochemical measurements. The effect of temperature on corrosion inhibition was studied in temperature range from 298 to 333 K. The thermodynamic parameters of corrosion process such as activation energy, equilibrium constant of adsorption (Kads), and standard free energy of adsorption (ΔGads) were also calculated. Scanning electron microscopy (SEM) coupled with Energy Dispersive X-Ray analysis (EDX) was used to examine the surface of mild steel after corrosion test. The results showed dependence of corrosion efficiency on method of pectin extraction. Enzymatic-extracted pectin showed moderately higher inhibition efficiency than the acid-extracted pectin. Polarization curves indicated that both types of pectin acted as mixed-type inhibitors with predominant inhibition at the cathodic site.

Background Atrial fibrillation represents a common complication after coronary artery bypass and valvular surgery, although it is a benign arrhythmia it may contribute to the morbidity, high cost and prolonged ICU stay. Objectives The purpose of this study is to investigate and analyze the incidence and risk factors associated with postoperative atrial fibrillation (POAF) and its impact on intensive care unit (ICU) and postoperative hospital stay in patients undergoing coronary artery bypass graft surgeries (CABG) at Ain Shams University hospitals using the medical records of patients who underwent(CABG) surgeries from July 2018 to July 2019. Patients and Methods Our study was conducted in Ain Shams University hospitals from July 2018 to July 2019. This study was a retrospective non randomized on total 660 patients who undergone isolated Coronary artery bypass graft surgeries (CABG) during this period, of them we targeted 100 cases who developed POAF after surgery. Results Our results show that age, history of hypertension,smoking,history of renal impairment and recent myocardial infarction were all predictors of atrial fibrillation after cardiac surgery. POAF developed more frequent in patients who had larger left atrium diameter and lower ejection fraction. Our present results indicate that there is significant association between longer bypass and cross clamping time and development of POAF. We also found that patients who had postoperative lower serum potassium experienced more frequent POAF than who had normal potassium levels. In our study, we found that use of preoperative beta blocking drugs reduces risk of developing POAF. Early electrocardiographic ischemic postop. changes was also associated with high risk to develop POAF. No significant relation between use of intra-aortic balloon pump and development of POAF. Also, no significant relation between POAF and development of stroke or thromboembolic manifestations as POAF is usually self limiting,transient and resolves spontaneously in most of cases. Conclusion The current study found that low ejection fraction, dilated left atrium, hypertension, smoking, old age, male gender, prolonged bypass time, prolonged cross clamping time, renal impairment, previous myocardial infarction, ungrafted dominant right coronary artery, low temperatures on bypass, early ischemic changes postoperative, hypokalemia, use of adrenaline and nor adrenaline, all of these factors were a significant predictors for development of atrial fibrillation after cardiac surgery.

Aims Cereals contaminated with type B trichothecene nivalenol (NIV) and its acetylated derivative 4-acetyl-nivalenol (4-AcNIV) are a global mycotoxicological problem threatening the health of humans and livestock. Toxicological studies, quantitative determinations and screening for biodegrading micro-organisms require massive amounts of pure toxins. However, the low yield from fungal cultures and high prices of NIV and 4-AcNIV limit research progress in these areas. This work aimed to select Fusarium asiaticum mutant strains with enhanced production of NIV and 4-AcNIV. Methods and Results A total of 62 NIV-producing F. asiaticum strains were isolated and compared regarding their ability to produce NIV. Strain RR108 had the highest yield of NIV among 62 field isolates surveyed and was then genetically modified for higher production. Targeted deletion of the FaFlbA gene, encoding a regulator of G protein signalling protein, resulted in a significant increase in NIV and 4-AcNIV production in the FaFlbA deletion mutant ΔFaFlbA. The expression of three TRI genes involved in the trichothecene biosynthetic pathway was upregulated in ΔFaFlbA. ΔFaFlbA produced the highest amount of NIV and 4-AcNIV when cultured in brown long-grain rice for 21 days, and the yields were 2.07 and 2.84 g kg−1, respectively. The mutant showed reduced fitness, including reduced conidiation, loss of perithecial development and decreased virulence on wheat heads, which makes it biologically safe for large-scale preparation and purification of NIV and 4-AcNIV. Conclusions The F. asiaticum mutant strain ΔFaFlbA presented improved production of NIV and 4-AcNIV with reduced fitness and virulence in plants. Significance and Impact of the Study Targeted deletion of the FaFlbA gene resulted in increased NIV and 4-AcNIV production. Our results provide a practical approach using genetic modification for large-scale mycotoxin production.

We report a new 3D nanocomposite cryogel combines the advantages of cationic starch (Cs), nanofibrillated cellulose (NFC) and silver nanoparticles (Ag NPs). Cs was the main component of the cryogel while NFC was used as a filling agent to enhance the mechanical properties of the produced cryogel. Both Cs and NFC endow the cryogel with adsorption properties while Ag NPs enhances its antibacterial properties. Ag NPs was green synthesized with the aid of microwave radiation using NFC as reducing and stabilizing agent. The prepared Ag particles were free of impurities with sizes10 nm and good stability in solution. Two different concentrations of the prepared Ag NPs were added to a mixture of Cs and NFC and subjected to freeze drying to get porous cryogel (3D microstructure). The Ag NPs free cryogel has highly porosity smooth surface with large surface area. Adding Ag NPs decreased these features and increased the 3D roughness. Optimum adsorption of reactive blue 49 was observed after 30 min of contact with 1.5 g/L of the cryogel at pH 1. The adsorption kinetics and isotherm were best described by the pseudo-first-order and Freundlich equations, respectively. All prepared cryogels have notable antibacterial properties that were significantly improved by adding Ag NPs. Overall, the new 3D composite cryogel can efficiently remove dyes and bacteria from wastewater.

Overcoming the existing environmental issues and the gradual depletion of energy sources is a priority at global level, biohydrogen can provide a sustainable and reliable energy reserve. However, the process instability and low biohydrogen yields are still hindering the adoption of biohydrogen production plants at industrial scale. In this context, membrane-based biohydrogen production technologies, and in particular fermentative membrane bioreactors (MBRs) and microbial electrolysis cells (MECs), as well as downstream membrane-based technologies such as electrodialysis (ED), are suitable options to achieve high-rate biohydrogen production. We have shed the light on the research efforts towards the development of membrane-based technologies for biohydrogen production from organic waste, with special emphasis to the reactor design and materials. Besides, techno-economic analyses have been traced to ensure the suitability of such technologies in bio-H

Chlorpromazine (CPZ) is an antipsychotic phenothiazine which is still commonly prescribed though it causes idiosyncratic toxicity such as cholestasis. CPZ toxicity mechanisms involve oxidative stre...

In order to apply the most accurate and efficient locoregional techniques, the knowledge of the anatomical characteristics of the oro-maxilo-facial territory becomes imperatively necessary, without which the installation and the effect of the locoregional anaesthetics may be poor. Due to the many advantages it presents, locoregional anaesthesia is considered as a current use method during routine dental care. A good local or locoregional anaesthetic must be harmless to the tissues, must have no local or general toxicity, must lead to a high quality and durable anaesthetic, must not cause lesions to nerve endings, to be subject to dental surgery or of oral surgery, can be satisfactorily solved by using locoregional anaesthesia techniques, which are used successfully in patients with balanced psychic, who are calm and cooperative. A good anaesthesia suppresses pain, prevents pain-induced shock, and allows the dentist to work in optimal conditions. Although modern anaesthesia techniques have greatly changed the working environment in dental surgeries or outpatient facilities of oral and maxillo-facial surgery, emotion and anxiety, fears continue to exist in patients who will have to undergo care treatments. In order to apply the most accurate and effective locoregional anaesthetic techniques, the knowledge of the anatomical characteristics of oro-maxilo-facial territory becomes imperatively necessary, without which the location and effect of locoregional anaesthetics may be poor. The study includes 114 patients studied in the period 2015-2017 on which we used Stabident system intraosseous anaesthesia of company Fairfax under two available systems: Stabident Regular and Stabident Alternative. Intraosseous anaesthesia reduces the amount of injected anaesthesia, thus reducing the toxicity of anaesthetic procedures; this technique allows the use of vasoconstrictors for the immediate delivery of anaesthesia to the teeth affected by pulpitis without the risk of necrosis. Intraosseous anaesthesia is an anaesthesia technique similar to the ideal anaesthesia technique.

Cobalt oxide layers was formed on a stainless steel type 304 surface after annealing heat treatment (400 oC / 10 hr) of the previously electrodeposited pure cobalt coating. The influence of heat treatment on surface morphology of pure cobalt films deposited has been studied. Crystallite structure transformation from hexagonal system to cubic system occurs. The coating layer morphology change from nano platelets to nano flecks was observed. SEM and EDAX are used for monitoring the gradually changes in the coated surface and nanostructure formation behavior. The degree of crystallitey and crystallite size changes, due to annealing at 400 oC/10 hrs, was measured by using XRD device. The optical properties were investigated by using UV-IR Spectrometry to study the effect of the formed surface coating at different electrodeposition conditions on the solar energy absorption behavior. The optimal solar absorptance was 98% at visible light wavelength range (400- 750 nm) for the films after annealing heat treatment.

This study examined, to what extent the structure of spousal relationship in United Arab Emirati' (UAE) family has been changed from rigidity to flexibility among a sample of 168 pairs of daughters and mothers (N=336). Three propositions were derived from Coser's theory "functions of social conflict" to measure the structural flexibility: releasing the antagonistic claims, interdependency and reproducing of consensual agreements. Findings revealed that daughters and mothers reported a low level of structural flexibility in terms of the three propositions, however, daughters reported more flexibility than their mothers. This result indicates that the rapid and comprehensive change of the infrastructures didn’t lead to a parallel change in the nontangible elements of UAE culture which are highly rooted in a composition of social traditions and Islamic values.

Objectives: Numerous studies addressed the effect of statin on cancer patients. The aim of this study is to define the effect of statin administration with chemotherapy on the patients’ outcomes. Methods: We retrospectively researched the database of the University of Cincinnati cancer to identify lung cancer patients who received statins (S+, n=41) during their treatment in our institute. We also, retrieved data for contemporaneously treated patients who did not receive statins (S-, n=159) as a control arm. Clinico-demographical data and overall survival (OS) were analyzed using Pearson’s Chi-square (χ2) test and Kaplan-Meier survival curves with Log-rank test. Adjustment using Cox proportional hazard ratios (HR) were done based on (age, gender, race and stage) to identify effect of statins on their outcomes. Results: The median age for S+ was 64y (IQR; 55-69) and 71.2% of the patients were white. Histopathology was 55.4% and 31.7% for adenocarcinoma and squamous cell carcinoma, respectively. Fifty-six percent were stage IV in each study arm and the median OS was14.9 m. Median OS was insignificantly lower in S–ve arm (13.7 vs 15.6 months; P=0.652, HR=0.91, 95%CI 0.52-1.57). Our results show that after different types of adjustments, S+ did not show survival advantage (P>0.05) compared to the control arm. Conclusion: While showing an increase in overall survival in patients with advanced lung cancer, the results of this study did not reach statistical significance. This could be due for the small sample size of this retrospective study.