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Beef carcass evaluation is generally the basis for judging the commercial value of the livestock and is consequently one of the most common quality control tests carried out in the meat industry. In the current study, sixty swabs were taken from the outer surface of neck and groin (30 of each) of freshly dressed beef carcasses taken from three local slaughterhouses located in El-Bagour, El-May and El-Shohadaa provinces of Menoufia governorate, Egypt. Swabs were microbiologically examined; the results revealed that groin samples had significantly (P≤0.05) lower contamination levels than that of neck samples. In addition, samples that were collected from El-May’s abattoir revealed the highest bacterial counts, followed by El-Bagour and El-Shohadaa, respectively. Regarding to detection of some pathogenic bacteria in the examined swab samples, S. aureus was the most detected bacteria, followed by Salmonella spp. and E. coli with total incidence 23.3, 18.3 and 15.0, respectively. However, equal number of S. aureus isolates was obtained from neck and groin samples, groin samples showed higher incidence of Salmonella and E. coli than those of neck samples. In addition, staphylococcal enterotoxins were investigated in the contaminated samples. Results revealed that all of the examined samples had enterotoxin type A only. Moreover, E. coli isolates were serotyped into O103:H2, O146:H21 and O117:H4; out of which, three strains were molecularly examined for their Shiga toxin types 1 (stx-1) and 2 (stx-2) genes; where, stx-1 was detected in 66.7% of the examined strains, while stx-2 was not detected in any of the examined isolates. On the other hand, Salmonella strains were serotyped into S. Enteritidis, S. Montevideo, S. Tsevie, S. Typhimurium and S. Shangani were the detected serotypes. Salmonella Typhimurium was detected in higher incidence than the other detected strains. So, regular monitoring of beef carcasses microbiological evaluation, and application of strict hygienic measures are recommended. [ABSTRACT FROM AUTHOR]

Background: Freezing of embryos and gametes is considered one of the corner stones of ART. Its application increases both IVF safety and efficiency. Aim and objectives: the aim of the present study is to compare cleaved embryo and blastocyst freezing to determine the optimal time for embryo cryopreservation, Subjects and methods: A randomized clinical trial, it was involved 300 cases of infertile patients who will undergo ICSI cycles and embryo freezing at the assisted reproduction unit, Qena University hospital, South Valley University, Egypt after complete infertility evaluation. Population was divided into two groups: Group 1 (n =150), underwent embryo freezing at day 3 then will undergo FET (Cleaved embryo). Group 2 (n =150), will underwent embryo freezing at day 5 then will undergo FET (Blastocyst) The duration of the study had been from 6 to 12 months, Results: the results revealed that there is high significant difference between the studied groups as regard Total number of survival more survival was observed in blastocyst group, while there is no significant difference between the studied groups as regard completed transfer. Conclusion: The maintenance of embryo culture until day 5 may be a more sensible approach for the correct identification of best quality embryos with the highest probability of success for both transfer and freezing.

The purpose of this work is to evaluate DCE MRI parameters for monitoring acute response in the muscular tissues of the head and neck (HN) and relate kinetics to post-RT measured swallowing dysfunction via DIGEST, a video fluoroscopy-based grading system. 88 HN cancer (HNC) patients who received definitive RT were enrolled in the prospective study following IRB approval and study-specific informed consent prior to imaging. MRI acquisitions performed at baseline (pre-RT), 3 weeks after treatment start date (Mid-RT), and 3 months post-RT. DIGEST (grade 0-4) assessments for dysphagia were collected between end of RT to 6 months post-RT. 17 swallowing structures were auto segmented on T2W images taken during the same acquisition using atlases on commercial software. These structures were then registered onto the parametric maps to extract median intensity estimations for each parameter, K trans , K ep , V e , and V P - generated with the extended-Tofts model. Mann-Whitney U (p < 0.05) was used to compare delta changes from baseline between groups based on DIGEST score relative to a set threshold. Wilcoxon Signed Rank Test (p < 0.05) was used to generate statistical evidence for each timepoint-DIGEST group change from baseline. Analysis was repeated for varying DIGEST score binarization thresholds. Of the 88 HNC patients, 77 male and 11 female, with 69 (78%) having primary tumors originating from the oropharynx, 9 (10%) had the primary tumor in the oral cavity, 7 (8%) with unknown primary tumor and 3 (3.4%) had primary tumor in the parotid gland. Sixty-three patients (72%) were treated with IMRT/VMAT and 25 (28%) were treated with IMPT. At Mid-RT there were statistically significant increases in ΔK ep found in 12/17 (70.6%) of structures in patients binarized into more severe dysphagia group, but at post-RT, this drops to 3/17 (17.6%) exhibited statistically significant increases. ΔV e exhibited statistically significant differences at post-RT in 1/17 (5.8%) of structures. In ΔK trans and ΔV p, we did not observe any statistically significant changes between the groups based on DIGEST status. Evaluating timepoints relative to the baseline within each patient using the matched-pair Wilcoxon demonstrated robust changes from baseline with stronger evidence for ΔK trans and ΔK ep in the higher DIGEST group – in concordance with statistical findings when comparing between groups. Our findings demonstrate that acute vascular changes in the muscle tissues of the HN during radiotherapy assessed by DCE MRI provide highly informative monitoring information. This strongly supports further investigation for use as a monitoring biomarker for muscle toxicity to evaluate radiation dose association and additional clinical variables of interest to improve prediction and treatment of dysphagia in HNC patients. [ABSTRACT FROM AUTHOR]

Chemical additives were found to be the most widely used and least expensive flavouring and preservatives for meat products, but they must be used within safe-permissible levels to protect customers from any negative effects. With reference to the most recent updates of the Egyptian standards, this study examines the levels of nitrite, phosphate, ascorbic acid, and monosodium glutamate as examples of chemical additives in one hundred and sixty random samples of raw minced meat, beef burgers, sausages, and frankfurters (40 of each), which were collected from different supermarkets located in Shibin Elkom city, Menoufia governorate, Egypt. While nitrite was not found in the minced meat samples, out of the analyzed samples, 92.5%, 97.5, and 100% of the tested sausage, burger, and frankfurter samples, respectively, were within the permitted limits (PL) (≤ 100 ppm) regarding their nitrite level. Furthermore, when it came to ascorbic acid PL (≤ 500 ppm), 72.5%, 100%, 87.5%, and 100% of the minced beef, sausage, burger, and frankfurter samples were within PL, respectively. Additionally, 100%, 90%, 95.0%, and 97.5% of the analyzed minced beef, sausage, burger, and frankfurter samples fell below the acceptable range for monosodium glutamate level (≤ 5000 ppm), respectively. Furthermore, the tested minced beef and sausage samples had no phosphate, whereas 72.5% of the investigated frankfurter samples were within the PL, and all of the studied burger samples were outside the PL (≤ 0.3%). So, it is advised to continuously monitor the meat production market and carefully enforce the safety requirement [ABSTRACT FROM AUTHOR]

Fish is considered the main source of protein in Egypt, especially due to the shortage of red meat. In this study, one hundred random samples of Nile fish represented by Clarias lazera (C. lazera) and Oreochromis niloticus (O. niloticus) (25 of each fish species) and marine fish represented by Sardina pilchardus (S. pilchardus) and Mullus barbatus (M. barbatus) (25 of each fish species) were collected at different periods of time from various fish markets in Shibin Elkom city, Egypt. The samples had been analyzed using an atomic absorption spectrophotometer for the detection of mercury (Hg), lead (Pb), cadmium (Cd), and arsenic (As). In addition to Lactobacillus rhamnosus (L. rhamnosus ) used in decontamination of artificially inoculated fish fillet with different heavy metals. The mean values of Hg were 1.44 ± 0.03 of 1.13 ± 0.01, 0.81± 0.02 and 0.59± 0.01 mg/kg in C. lazera, O. niloticus, S. pilchardus and M. barbatus, respectively. Also, for Pb values were 0.78 ± 0.01, 0.61 ± 0.01, 0.39 ± 0.02 and 0.08 to 0.53 mg /kg C. lazera, O. niloticus, S. pilchardus and M.barbatus, respectively. The mean values of Cd were 0.43± 0.01, 0.26± 0.01, 0.04 to 0.49 and 0.05± 0.01mg/ kg in examined C. lazera, O. niloticus, S. pilchardus and M.barbatus, respectively. Meanwhile, as residues were 0.29± 0.01 and 0.16 ± 0.01 mg/kg in C. lazera and O. niloticus only. The L. Rhamnosus can reduce Hg, Pb, Cd and as experimentally inoculated to fish fillets with percentages 67.7%, 76.3%, 75% and 59%, respectively. [ABSTRACT FROM AUTHOR]

Physico-chemical and microbiological quality of meat products are the main acceptability issue to the consumers. So, the current study aimed to determine the acceptability and fitness of four restructured meat products for human consumption based on their sensory, keeping quality and bacteriological quality trough examination of one-hundred and sixty random samples of minced meat, sausage, beef burger and frankfurter (40 of each), which were collected from different supermarkets located in Menoufia governorate, Egypt, and were examined according to standard guidelines. Results revealed that the examined burger and frankfurter samples revealed higher acceptability scores than those of minced meat and sausage samples. In addition, although it revealed lower pH values, minced meat samples had the lowest keeping quality with significantly higher TVN and TBA values than the recorded results of the other examined samples. Moreover, the bacteriological examinations revealed detection of Salmonella and E. coli were detected in 20% and 25%; 17.5% and 20%; 12.5% and 12.5%; 5.0% and 7.5% for the examined minced meat, sausage, burger, and frankfurter samples, respectively. In addition, S. aureus was counted (CFU/g) in the examined samples with mean values of 1.98 ×10³, 9.64×10², 5.03 ×10² and 2.16 ×10² CFU/g for the same examined samples, respectively. Furthermore, minced meat was the most contaminated samples with Pseudomonas and Aeromonas spp., where P. fluorescens and A. sorbia were the most isolated strains in the examined samples. Meat and meat product safety and acceptability are of a major concern as commercial foods. Minced meat showed lower acceptability levels than the other examined samples, with higher contamination levels. So, monitoring of the chemical and bacteriological quality of restructured meat products is significantly helping in its improvement. [ABSTRACT FROM AUTHOR]

The study was carried out to determine the prevalence of hydatidosis among the sheep carcasses at Al-Ahsa region, Saudi Arabia. The study included also histopathological tissue evaluation. The results of the present study showed that the prevalence of hydatidosis among sheep carcasses was 6.60 % (98/1485); meanwhile among the native sheep breed was 7.70 %, and 5.8 % among the imported ones. Concerning the effect of age, the prevalence of hydatidosis increased significantly (p≤ 0.0001) in old aged sheep. On the other hand, the prevalence in liver, lung, heart and muscles was 66.3%, 23.4%, 7.1% and 3.0%, respectively. Regarding the cyst state in sheep, the percentages of viable, non-viable, sterile and calcified one were 24.4 %, 12.2 %, 7.14 % and 56.1 %, respectively. Meanwhile, results of histopathological examination had shown that most of hydatid cysts in sheep were fertile. [ABSTRACT FROM AUTHOR]

The identification of the biologically radioresistant subvolumes within the primary tumor volumes is an essential step towards biologically guided radiation therapy (RT) dose painting application. Therefore, the aim of our study is to assess the radioresistant subvolumes using quantitative MRI-guided characterization of the patterns of failure in head and neck cancer patients. Forty patients with head and neck cancer who have developed local and/ or regional recurrence were included. The recurrence diagnostic CT (rCT) was co-registered with the planning CT (pCT) using a validated deformable image registration software. Subsequently, pCTs were co-registered with baseline DWI. The manually segmented recurrent gross disease (rGTV) was then propagated to the co-registered pCTs and baseline DWI. For the pCTs, the mapped rGTVs were assessed dosimetrically concerning the planned dose and spatially in relation to planning target volumes. Failures were classified based on combined spatial/dosimetric criteria into categories A (central high-dose), B (peripheral high-dose), C (central intermediate/low-dose), D (peripheral intermediate/low-dose), and E (extraneous-dose). The center of mass of the rGTVDWI was generated as a surrogate of tumor recurrence origin and apparent diffusion coefficient (ADC) values were extracted for both the centroid and the whole rGTV volumes and compared to the baseline GTV. The mean age of the patients included in the study was 60.3 years, with the oropharynx being the most common site for the primary tumor. Approximately one-third of the patients (n = 14, 35%) were diagnosed with stage IVa disease at the time of initial diagnosis. Type A failure was the most prevalent (n = 30, 71.4%). The mean ADC values for baseline GTV, rGTV, and centroid volume were 1.27, 1.35, and 1.23, respectively. For type A failure, the mean ADC values for baseline GTV, rGTV, and centroid volume were 1.30, 1.40, and 1.24, respectively. For type B failure, the mean ADC values for baseline GTV, rGTV, and centroid volume were 0.94, 1.40, and 1.40, respectively. For type C failure, the mean ADC values for baseline GTV, rGTV, and centroid volume were 1.00, 0.85, and 0.82, respectively. For type D failure, the mean ADC values for baseline GTV, rGTV, and centroid volume were 1.30, 1.60, and 1.70, respectively. For type E failure, the mean ADC values for baseline GTV, rGTV, and centroid volume were 1.36, 1.26, and 1.12, respectively. The most frequent type of failure observed was central local failure. There were no significant differences detected between baseline ADC values and the baseline GTV, rGTV, or centroid volume. Similarly, no significant correlations were found between baseline ADC values and the different types of failures. Further studies with larger cohorts and multi-institutional data are needed for validation of ADC as a model for prediction of type of failure after definitive RT in head and neck cancer patients. [ABSTRACT FROM AUTHOR]

Heat stress causes economic losses via decreasing feed intake, nutrient digestion, weight gain, feed conversion, immunity, carcass quality and increasing mortality in broilers. The aim of the study was to assess the ability of dietary additive combinations to ameliorate the detrimental effect caused by chronic heat stress (32 ± 2ºC for 24 h per d) on performance, carcass traits, metabolic status and economic efficiency of broiler chickens. A total of 420, one-day old Cobb-500 broiler chicks were assigned into seven treatment groups (n=60) of five replicates. Each replicate contained 12 unsexed chicks. The control groups did not receive any supplementation to the basal diet (thermoneutral control (TNC) and heat stress control (HSC) groups). The other groups received control diet supplemented with 1 % cumin plus 1 % turmeric powders (T1); 1.5 g/kg potassium chloride plus 2 g/kg sodium bicarbonate (T2); 1000 ppm propolis plus 15000 IU vitamin A (T3); 1200 ppb chromium plus 500 ppm vitamin C (T4) ; 1200 ppm betaine plus 500 ppm vitamin E (T5). The results indicated that at 42 d of age, all dietary additive combinations improved the growth performance indices, carcass traits, concentrations of serum antioxidant enzyme biomarkers, stress biomarkers and economic efficiency in comparison to HSC group. Based on the obtained results, it could be concluded that dietary supplementation with betaine and vitamin E followed by chromium and vitamin C combinations offers a good management practice for alleviating heat stress related depression in the performance of broiler chickens. [ABSTRACT FROM AUTHOR]

Accurate diagnosis of urinary tract infections (UTIs) is important as early diagnosis increases treatment rates, reduces the risk of infection and disease spread, and prevents deaths. This study aims to evaluate various parameters of existing and developing techniques for the diagnosis of UTIs, the majority of which are approved by the FDA, and rank them according to their performance levels. The study includes 16 UTI tests, and the fuzzy preference ranking organization method was used to analyze the parameters such as analytical efficiency, result time, specificity, sensitivity, positive predictive value, and negative predictive value. Our findings show that the biosensor test was the most indicative of expected test performance for UTIs, with a net flow of 0.0063. This was followed by real-time microscopy systems, catalase, and combined LE and nitrite, which were ranked second, third, and fourth with net flows of 0.003, 0.0026, and 0.0025, respectively. Sequence-based diagnostics was the least favourable alternative with a net flow of -0.0048. The F-PROMETHEE method can aid decision makers in making decisions on the most suitable UTI tests to support the outcomes of each country or patient based on specific conditions and priorities.

Objectives: We aim to characterize the serial quantitative apparent diffusion coefficient (ADC) changes of the target disease volume using diffusion-weighted imaging (DWI) acquired weekly during radiation therapy (RT) on a 1.5T MR-Linac and correlate these changes with tumor response and oncologic outcomes for head and neck squamous cell carcinoma (HNSCC) patients as part of a programmatic R-IDEAL biomarker characterization effort., Methods: Thirty patients with pathologically confirmed HNSCC who received curative-intent RT at the University of Texas MD Anderson Cancer Center, were included in this prospective study. Baseline and weekly Magnetic resonance imaging (MRI) (weeks 1-6) were obtained, and various ADC parameters (mean, 5 th , 10 th , 20 th , 30 th , 40 th , 50 th , 60 th , 70 th , 80 th , 90 th and 95 th percentile) were extracted from the target regions of interest (ROIs). Baseline and weekly ADC parameters were correlated with response during RT, loco-regional control, and the development of recurrence using the Mann-Whitney U test. The Wilcoxon signed-rank test was used to compare the weekly ADC versus baseline values. Weekly volumetric changes (Δvolume) for each ROI were correlated with ΔADC using Spearman's Rho test. Recursive partitioning analysis (RPA) was performed to identify the optimal ΔADC threshold associated with different oncologic outcomes., Results: There was an overall significant rise in all ADC parameters during different time points of RT compared to baseline values for both gross primary disease volume (GTV-P) and gross nodal disease volumes (GTV-N). The increased ADC values for GTV-P were statistically significant only for primary tumors achieving complete remission (CR) during RT. RPA identified GTV-P ΔADC 5 th percentile >13% at the 3 rd week of RT as the most significant parameter associated with CR for primary tumor during RT (p <0.001). Baseline ADC parameters for GTV-P and GTV-N didn't significantly correlate with response to RT or other oncologic outcomes. There was a significant decrease in residual volume of both GTV-P & GTV-N throughout the course of RT. Additionally, a significant negative correlation between mean ΔADC and Δvolume for GTV-P at the 3 rd and 4 th week of RT was detected (r = -0.39, p = 0.044 & r = -0.45, p = 0.019, respectively)., Conclusion: Assessment of ADC kinetics at regular intervals throughout RT seems to be correlated with RT response. Further studies with larger cohorts and multi-institutional data are needed for validation of ΔADC as a model for prediction of response to RT.

This paper presents an overview of the third edition of the HEad and neCK TumOR segmentation and outcome prediction (HECKTOR) challenge, organized as a satellite event of the 25th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) 2022. The challenge comprises two tasks related to the automatic analysis of FDG-PET/CT images for patients with Head and Neck cancer (H&N), focusing on the oropharynx region. Task 1 is the fully automatic segmentation of H&N primary Gross Tumor Volume (GTVp) and metastatic lymph nodes (GTVn) from FDG-PET/CT images. Task 2 is the fully automatic prediction of Recurrence-Free Survival (RFS) from the same FDG-PET/CT and clinical data. The data were collected from nine centers for a total of 883 cases consisting of FDG-PET/CT images and clinical information, split into 524 training and 359 test cases. The best methods obtained an aggregated Dice Similarity Coefficient ( DSC agg ) of 0.788 in Task 1, and a Concordance index (C-index) of 0.682 in Task 2., Competing Interests: No conflict of interest applies. Fundings are specified in the acknowledgments. Only the organizers had access to the test cases’ ground truth contours.

Background: Quick magnetic resonance imaging (MRI) scans with low contrast-to-noise ratio are typically acquired for daily MRI-guided radiotherapy setup. However, for patients with head and neck (HN) cancer, these images are often insufficient for discriminating target volumes and organs at risk (OARs). In this study, we investigated a deep learning (DL) approach to generate high-quality synthetic images from low-quality images., Methods: We used 108 unique HN image sets of paired 2-minute T2-weighted scans (2mMRI) and 6-minute T2-weighted scans (6mMRI). 90 image sets (~20,000 slices) were used to train a 2-dimensional generative adversarial DL model that utilized 2mMRI as input and 6mMRI as output. Eighteen image sets were used to test model performance. Similarity metrics, including the mean squared error (MSE), structural similarity index (SSIM), and peak signal-to-noise ratio (PSNR) were calculated between normalized synthetic 6mMRI and ground-truth 6mMRI for all test cases. In addition, a previously trained OAR DL auto-segmentation model was used to segment the right parotid gland, left parotid gland, and mandible on all test case images. Dice similarity coefficients (DSC) were calculated between 2mMRI and either ground-truth 6mMRI or synthetic 6mMRI for each OAR; two one-sided t-tests were applied between the ground-truth and synthetic 6mMRI to determine equivalence. Finally, a visual Turing test using paired ground-truth and synthetic 6mMRI was performed using three clinician observers; the percentage of images that were correctly identified was compared to random chance using proportion equivalence tests., Results: The median similarity metrics across the whole images were 0.19, 0.93, and 33.14 for MSE, SSIM, and PSNR, respectively. The median of DSCs comparing ground-truth vs. synthetic 6mMRI auto-segmented OARs were 0.86 vs. 0.85, 0.84 vs. 0.84, and 0.82 vs. 0.85 for the right parotid gland, left parotid gland, and mandible, respectively (equivalence p<0.05 for all OARs). The percent of images correctly identified was equivalent to chance (p<0.05 for all observers)., Conclusions: Using 2mMRI inputs, we demonstrate that DL-generated synthetic 6mMRI outputs have high similarity to ground-truth 6mMRI, but further improvements can be made. Our study facilitates the clinical incorporation of synthetic MRI in MRI-guided radiotherapy., Competing Interests: CF has received direct industry grant support, speaking honoraria, and travel funding from Elekta AB. JX, NO’C, DT, NC, and JC are employees of Elekta AB. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wahid, Xu, El-Habashy, Khamis, Abobakr, McDonald, O’ Connell, Thill, Ahmed, Sharafi, Preston, Salzillo, Mohamed, He, Cho, Christodouleas, Fuller and Naser.)

The accurate determination of sarcopenia is critical for disease management in patients with head and neck cancer (HNC). Quantitative determination of sarcopenia is currently dependent on manually-generated segmentations of skeletal muscle derived from computed tomography (CT) cross-sectional imaging. This has prompted the increasing utilization of machine learning models for automated sarcopenia determination. However, extant datasets currently do not provide the necessary manually-generated skeletal muscle segmentations at the C3 vertebral level needed for building these models. In this data descriptor, a set of 394 HNC patients were selected from The Cancer Imaging Archive, and their skeletal muscle and adipose tissue was manually segmented at the C3 vertebral level using sliceOmatic. Subsequently, using publicly disseminated Python scripts, we generated corresponding segmentations files in Neuroimaging Informatics Technology Initiative format. In addition to segmentation data, additional clinical demographic data germane to body composition analysis have been retrospectively collected for these patients. These data are a valuable resource for studying sarcopenia and body composition analysis in patients with HNC., (© 2022. The Author(s).)

Background/purpose: Sarcopenia is a prognostic factor in patients with head and neck cancer (HNC). Sarcopenia can be determined using the skeletal muscle index (SMI) calculated from cervical neck skeletal muscle (SM) segmentations. However, SM segmentation requires manual input, which is time-consuming and variable. Therefore, we developed a fully-automated approach to segment cervical vertebra SM., Materials/methods: 390 HNC patients with contrast-enhanced CT scans were utilized (300-training, 90-testing). Ground-truth single-slice SM segmentations at the C3 vertebra were manually generated. A multi-stage deep learning pipeline was developed, where a 3D ResUNet auto-segmented the C3 section (33 mm window), the middle slice of the section was auto-selected, and a 2D ResUNet auto-segmented the auto-selected slice. Both the 3D and 2D approaches trained five sub-models (5-fold cross-validation) and combined sub-model predictions on the test set using majority vote ensembling. Model performance was primarily determined using the Dice similarity coefficient (DSC). Predicted SMI was calculated using the auto-segmented SM cross-sectional area. Finally, using established SMI cutoffs, we performed a Kaplan-Meier analysis to determine associations with overall survival., Results: Mean test set DSC of the 3D and 2D models were 0.96 and 0.95, respectively. Predicted SMI had high correlation to the ground-truth SMI in males and females (r>0.96). Predicted SMI stratified patients for overall survival in males (log-rank p = 0.01) but not females (log-rank p = 0.07), consistent with ground-truth SMI., Conclusion: We developed a high-performance, multi-stage, fully-automated approach to segment cervical vertebra SM. Our study is an essential step towards fully-automated sarcopenia-related decision-making in patients with HNC., Competing Interests: CF has received direct industry grant support, speaking honoraria, and travel funding from Elekta AB. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Naser, Wahid, Grossberg, Olson, Jain, El-Habashy, Dede, Salama, Abobakr, Mohamed, He, Jaskari, Sahlsten, Kaski and Fuller.)

Background: Human immunodeficiency virus (HIV) can be transmitted from mothers to their babies during pregnancy, delivery through vaginal fluids or breastfeeding. As false positivity anti-HIV results due to pregnancy could be detected and no relevant study have been reported in Northern Cyprus so far, we aimed to estimate the false anti-HIV positivity rate in pregnant women., Methods: A total of 11.977 women admitted to Near East University Hospital between 2015 and 2018 were involved. The fourth generation anti-HIV-1/2 ELISA test was carried out by chemiluminescence enzyme immunoassay. Positive results were confirmed by real-time polymerase chain reaction (rt-PCR). SPSS (Statistical Package for the Social Sciences) Demo Ver 22 program was used for statistical analysis and significance (p<0.05) was measured by Person Chi-Square and Fisher's Exact tests., Results: Anti-HIV-1/2 ELISA test was positive in 7 (0.3%) of pregnant and 11 (0.1%) of non-pregnant women. HIV RNA was not detected in any pregnant however, was detected in 2 (0.02%) of non pregnant. S/Co titer of pregnant and non pregnant who have positive anti-HIV-test without viral load was x̄=2.68±1.64 (1.34-5.20) and x̄=8.63±7.68 (1.56-20.98) respectively. False positivity was significantly higher in pregnants compared to non-pregnants (p=0.033)., Conclusion: False positivity can be encountered during pregnancy therefore, positive anti-HIV-1/2 ELISA results should be confirmed with molecular techniques before initiating antiretroviral treatment., Competing Interests: The authors declare that they have no conflicts of interest regarding the publication of this article., (Copyright © 2022 Emrah Güler et al.)

Objective: Some patients who had chronic coronary syndrome (CCS) and were recognized as low risk, however, developed cardiovascular events, whereas others who were categorized as high risk did not develop any cardiovascular events. Invasive coronary angiography is the gold standard tool for the assessment of coronary artery disease (CAD) severity. The SYNTAX score (SS) was recently recognized as an invasive angiographic-guided scoring system used in risk stratification of patients who have more than one-vessel CAD and undergoing revascularization with percutaneous cardiovascular intervention. It has a good predictive value of adverse cardiovascular events. Exploration for unique noninvasive modalities that may help in a better way for risk stratification of CCS patients by predicting the severity of CAD (as reflected by SS) would be of a paramount value. Tei index is a promising modality for that objective, which is a Doppler-derived time interval index that combines both systolic and diastolic cardiac performance., Methods: We examined the relationship between the severity of CAD as assessed by the SS and Tei index in 100 patients with CCS and normal left ventricular systolic function., Results: All the studied 100 patients had a normal ejection fraction with mean = 58.92 ± 7.88; the mean value of Tei index was 0.84 ± 0.26. There was a statistically significant positive association between Tei index and SS ( P = 0.0001); moreover, there was a correlation between left anterior descending (LAD) affection and Tei index ( P = 0.0001).The cutoff point of Tei index to detect SS above 22 was >0.93 (with specificity of 86.5% and sensitivity of 42.4%)., Conclusion: Tei index significantly correlates with SS and LAD affection. Moreover, it is a cheap, radiation-free, noninvasive technique and may be used as a further risk stratification modality beyond others., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Cardiovascular Echography.)

Objective: We compared protocolized weaning versus nonprotocolized weaning practice from nasal high flow therapy (nHFT) in preterm infants., Study Design: A before-and- after observational study., Methods: The study was conducted in three phases; Phase 1: infants were weaned according to usual practice for 6 months (nonprotocolized), Phase 2: education and training physicians and nursing staff for the protocol for 1 month, and Phase 3: protocol of weaning from nHFT was applied for the following 6 months with specified criteria for readiness to wean, weaning failure and weaning technique. The primary outcome was failure to wean off nHFT., Results: One hundred and four preterm infants were enrolled, 51 preterm infants in the protocol group and 53 in the nonprotocol group. The groups were similar in demographic and clinical characteristics at baseline. There were significantly lower number of patients who failed weaning from nHFT in the protocol group compared to nonprotocol group (4 [7.8%] versus 15 [28.3%], p = .007]. There was shorter time to reach full enteral feeding in the protocol group compared with nonprotocol group (p = .03). There were no significant differences between groups regarding other outcomes including total durations of respiratory support, nHFT and oxygen therapy, duration of nHFT after decision of weaning, and neonatal mortality and morbidity., Conclusion: Implementation of a standardized protocol for weaning from nHFT in preterm infants reduced weaning failure and reduced the time to full feeds. Larger trials are recommended to detect the impact of weaning protocols on other outcomes., (© 2020 Wiley Periodicals LLC.)