Search

Rania Abd El-Hamid El-Kady,1,2 Dania Waggas,2 Ahmed AkL3,4 1Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt; 2Department of Pathological Sciences, Fakeeh College for Medical Sciences, Jeddah, Kingdom of Saudi Arabia; 3Department of Nephrology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt; 4Department of Internal Medicine/Adult Nephrology, Dr. Soliman Fakeeh Hospital, Jeddah, Kingdom of Saudi ArabiaCorrespondence: Rania Abd El-Hamid El-KadyDepartment of Pathological Sciences, Fakeeh College for Medical Sciences, Jeddah, 2537, Kingdom of Saudi ArabiaTel +966 569849897Email raniael_kady@yahoo.comBackground: Albeit growing technical advances in the design of hemodialysis catheters, intravascular catheter-related bloodstream infection (CRBSI) still represents an utmost clinical challenge to the health-care workers (HCWs). Data regarding the influence of the culprit organism on the scenario of CRBSI in the literature are extremely lacking. Thereby, this research was carried out.Methods: We undertook a retrospective cohort study over an interval of 2 years, involving patients who underwent regular hemodialysis via catheters in the Renal Dialysis Unit (RDU) of Dr. Soliman Fakeeh Hospital (DSFH), Jeddah, Kingdom of Saudi Arabia (KSA). The study enrolled 139 patients (56.8% females and 43.2% males), with mean age of 60.79 ± 11.45 years.Results: The aggregate rate of CRBSI was 5.1/1000 catheter days. Amongst the 139 study candidates confirmed of having CRBSI, while 69.8% of CRBSIs were ascribed to Gram-positive cocci, about one-third of the infectious episodes were secondary to Gram-negative bacilli. Interestingly, fever was the most common presentation of S. aureus CRBSI compared to CoNS and Gram-negative bacilli CRBSIs (20.9% versus 12.9% versus 6.5%, p= 0.0001), whereas CRBSIs due to CoNS were presented mainly with rigors (19.4%). Of note, CRBSIs caused by Gram-negative bacilli had a tendency to manifest with unusual symptoms such as vomiting or hypotension. Besides, they were more prone to involve hospitalization or ICU admission. In this study, no mortality was attributed to CRBSIs.Conclusion: Our study disclosed that the illicit organism has a repercussion on the clinical presentation as well as the fate of CRBSI among hemodialysis patients. This highlights the worth of identifying the infected cases in a periodic manner, to avoid the occurrence of devastating complications. A large body of work from various hemodialysis centers should take place in the near future so as to provide more insight in this perspective.Keywords: hemodialysis, catheter, ESRD, CRBSI, susceptibility

This paper addresses the analysis of textured images using the symmetric positive semi-definite matrix. In particular, a field of symmetric positive semi-definite matrices is used to estimate the structural information represented by the local orientation and the degree of anisotropy in structured and sinusoid-like textured images. In order to ensure faithful local structure estimation, an adaptive algorithm for the regularization of the extent of gradient fields smoothing is proposed. Results obtained on different texture samples show the strength of the proposed method in accurately representing the local variation of orientations in the underlying textured images, which paves the way towards an accurate analysis of the texture structures.

Abstract In this research, we reported the synthesis of effective sulphonated sugarcane bagasse (SCB@SA) biosorbent based on agriculture waste materials via a simple diazotization strategy for the removal of methylene blue (MB) and Bismarck Brown R(BB) dyes from waste water samples. First, the sugarcane bagasse (SCB) waste was collected, grinded, and sieved to obtain the desired size. Secondly, the SCB powder is modified with sulfanilinic acid (SA) via the formation of its diazonium salt to introduce sulfonic groups on the SCB surface. Different advanced techniques were applied to characterize the prepared materials before and after the adsorption process viz. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Energy-dispersive X-ray spectroscopy (EDS) and Thermogravimetric analysis (TGA). Different parameters affecting the adsorption process of both MB and BB were studied. Because of the higher correlation coefficient (R2 ≥ 0.999) and lower error functions, the equilibrium MB and BB adsorption isotherms for a single-dye system fit Langmuir with maximum adsorption capacity reaching to 127.48 and 166.75 mg/g for MB and BB, respectively. Moreover, the RL values obtained for both dyes lie between 0 and 1, indicating that MB and BB adsorption by SCB@SA is a favorable process. Besides, the error functions’ values of the pseudo-2nd-order are significantly lower than those of the pseudo-1st-order, implying that the adsorption MB and BB onto SCB@SA biosorbent fitted the pseudo-2nd-order kinetic model in a chemosorption manner. In the thermodynamic studies, the adsorption process is spontaneous, exothermic, and has less randomness. In addition, the SCB@SA biosorbent could be reused in five cycles maintaining on suitable adsorption efficiency. Finally, the MB and BB dyes could be adsorbed on the SCB@SA biosorbent via three mechanisms including π-π stacking, columbic attraction, and hydrogen bonding.

Abstract Background A recommendation by the World Health Organization (WHO) was issued about the use of chest imaging to monitor pulmonary sequelae following recovery from COVID-19. This qualitative study aimed to explore the perspective of key stakeholders to understand their valuation of the outcome of the proposition, preferences for the modalities of chest imaging, acceptability, feasibility, impact on equity and practical considerations influencing the implementation of using chest imaging. Methods A qualitative descriptive design using in-depth interviews approach. Key stakeholders included adult patients who recovered from the acute illness of COVID-19, and providers caring for those patients. The Evidence to Decision (EtD) conceptual framework was used to guide data collection of contextual and practical factors related to monitoring using imaging. Data analysis was based on the framework thematic analysis approach. Results 33 respondents, including providers and patients, were recruited from 15 different countries. Participants highly valued the ability to monitor progression and resolution of long-term sequelae but recommended the avoidance of overuse of imaging. Their preferences for the imaging modalities were recorded along with pros and cons. Equity concerns were reported across countries (e.g., access to resources) and within countries (e.g., disadvantaged groups lacked access to insurance). Both providers and patients accepted the use of imaging, some patients were concerned about affordability of the test. Facilitators included post- recovery units and protocols. Barriers to feasibility included low number of specialists in some countries, access to imaging tests among elderly living in nursing homes, experience of poor coordination of care, emotional exhaustion, and transportation challenges driving to a monitoring site. Conclusion We were able to demonstrate that there is a high value and acceptability using imaging but there were factors influencing feasibility, equity and some practical considerations associated with implementation. We had a few suggestions to be considered by the expert panel in the formulation of the guideline to facilitate its implementation such as using validated risk score predictive tools for lung complications to recommend the appropriate imaging modality and complementary pulmonary function test.

Abstract Coronary artery disease (CAD) is the leading cause of death among adults worldwide. Accurate risk stratification can support optimal lifetime prevention. Current methods lack the ability to incorporate new information throughout the life course or to combine innate genetic risk factors with acquired lifetime risk. We designed a general multistate model (MSGene) to estimate age-specific transitions across 10 cardiometabolic states, dependent on clinical covariates and a CAD polygenic risk score. This model is designed to handle longitudinal data over the lifetime to address this unmet need and support clinical decision-making. We analyze longitudinal data from 480,638 UK Biobank participants and compared predicted lifetime risk with the 30-year Framingham risk score. MSGene improves discrimination (C-index 0.71 vs 0.66), age of high-risk detection (C-index 0.73 vs 0.52), and overall prediction (RMSE 1.1% vs 10.9%), in held-out data. We also use MSGene to refine estimates of lifetime absolute risk reduction from statin initiation. Our findings underscore our multistate model’s potential public health value for accurate lifetime CAD risk estimation using clinical factors and increasingly available genetics toward earlier more effective prevention.

Abstract Background Hepatocellular carcinoma (HCC) is the first cause of cancer in Egypt. Recently, HCC developed post direct-acting antivirals (DAAs) differ in some characteristics from those developed without DAAs exposure regarding the biological features and behavior of HCC. We aimed to assess the epidemiological, clinical, laboratory, and radiological findings besides the biological behavior of HCC patients post DAAs in comparison to HCC not exposed to DAAs. An analytic cross-sectional research was performed at the National Liver Institute which is a tertiary multidisciplinary HCC center. Subjects included hepatitis C virus patients and were allocated into two groups: group I included 2036 HCC cases post-DAA treatment and group II included 6338 HCC cases who did not receive DAAs. Subjects were examined to evaluate clinical, laboratory, and radiological findings. Tumor staging was done using the BCLC staging system. Results Group II showed a more advanced Child–Pugh score, FIB-4 index, and MELD score than Group I (P = 0.001). The multiplicity of hepatic focal lesions was elevated in group I than in group II (P = 0.033). AFP level was significantly elevated in group I than in group II (p = 0.012). Portal vein invasion was significantly elevated in group I than in group II patients (P = 0.001). Extrahepatic spread of HCC was significantly elevated in group I than in group II (P = 0.001). Infiltrative lesions were significantly elevated in group I than in group II (P = 0.002). Conclusion Our study detected that the behavior in HCC post DAAs treatment is more aggressive in respect of the number of lesions, PV invasion; local and distant metastasis, and serum AFP level than in patients unexposed to DAAs. Strict surveillance in cirrhotic patients treated with DAA should be followed according to the international guidelines for early diagnosis and treatment of HCC.

This work investigates the compositional dependence and thermal annealing of the morphological properties, electrical conductivity mechanisms and Mott's parameters of sprayed MoxW1-xO3 (x = 0, 0.05, 0.10 and 0,20) thin films. The prepared thin films were examined using field emission scanning electron microscopy (FE-SEM), energy dispersive X-ray analysis (EDX) and Fourier transform infrared spectroscopy (FTIR) techniques. In addition, the two-point probe method was used to calculate the electrical properties of MoxW1-xO3 thin films. The FTIR results revealed that; the tungsten hydroxyl bond (W-OH) and the surface hydroxyl group vibrated within the ranges of 1558.62–1645.56 cm−1 and, 3296.76 and 3424.34 cm−1, respectively. Furthermore, a prominent band in the spectrum spanning from 850 to 650 cm−1 represents the W-O-W bridge mode. The FE-SEM investigations found that the molybdenum (Mo) dopant caused significant changes in the surface morphology of the films. The EDX results showed that the percentages of the isotropic elements MoxW1-xO3 agreed well with those obtained by atomic weight. Studies of the conduction mechanism indicate that the transition temperature was approximately 393K. Corresponding to Mott's model, the conduction mechanism below this temperature was across the variable hopping conduction band near the Fermi level. The mechanism exhibited a cycle of localised states through activated thermionic emission above 393K. Mott parameters were also estimated in addition to barrier potential energies, trapping state energies, local state densities, and other variables. The results revealed that both temperature areas had a rise in ρo and ρ1 values during and after annealing. The ΔEo and ΔE1 values in each temperature area decreased as the Mo-ion concentration increased. Furthermore, the conversion temperature gradually reduced as Mo was added. Based on these properties, the study's overall findings indicate that MoxW1-xO3 is suitable for future photonic devices and optoelectronic applications.

Background: Peanut meal (seeds waste with the red skin) contains antioxidants and anti-inflammatory compounds, which protect cells from oxidative stress and inflammation. Hypothesis: This byproduct can be used to produce nutraceutical and functional food items that may become popular. Methods: Ultrasound-assisted extraction was used to prepare peanut meal extracts at various times and with different solvents of 90 % (acetone, ethanol, methanol, and acetic acid ethyl ester). Acetone peanut meal extracting (for 20 min ) demonstrated the highest total phenolic content (83.78 mg GAE/g meal) and DPPH scavenging activity (95.83 %). Acetone peanut meal extract (PME) was analyzed by HPLC and encapsulated using sodium alginate via the co-extrusion technique. The alginate/PME microbeads were studied for their morphology and release of phenolic compounds. Results: The results of the molecular docking demonstrated a strong binding affinity, implying that the identified compounds in PME may inhibit acetylcholinesterase. Through the in vivo study, it was revealed that PME and PME microbeads demonstrated antioxidant and anti-inflammatory effects in AlCl3-treated rats. Additionally, PME and PME microbeads reduced the acetylcholinesterase activity while elevating the levels of dopamine and serotonin compared to the AlCl3-treated rats. Conclusion: This work provided valuable contributions towards the valorization of peanut byproducts, highlighting their potential neuroprotective effect against aluminum-induced Alzheimer's disease.

Cell-cell interactions in the central nervous system play important roles in neurologic diseases. However, little is known about the specific molecular pathways involved, and methods for their systematic identification are limited. Here, we developed a forward genetic screening platform that combines CRISPR-Cas9 perturbations, cell coculture in picoliter droplets, and microfluidic-based fluorescence-activated droplet sorting to identify mechanisms of cell-cell communication. We used SPEAC-seq (systematic perturbation of encapsulated associated cells followed by sequencing), in combination with in vivo genetic perturbations, to identify microglia-produced amphiregulin as a suppressor of disease-promoting astrocyte responses in multiple sclerosis preclinical models and clinical samples. Thus, SPEAC-seq enables the high-throughput systematic identification of cell-cell communication mechanisms.

ObjectiveTo provide evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases (RMDs).MethodsThis guideline follows American College of Rheumatology (ACR) policy guiding management of conflicts of interest and disclosures and the ACR guideline development process, which includes the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. It also adheres to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. A core leadership team consisting of adult and pediatric rheumatologists and a guideline methodologist drafted clinical population, intervention, comparator, outcomes (PICO) questions. A review team performed a systematic literature review for the PICO questions, graded the quality of evidence, and produced an evidence report. An expert Voting Panel reviewed the evidence and formulated recommendations. The panel included adult and pediatric rheumatology providers, infectious diseases specialists, and patient representatives. Consensus required ≥70% agreement on both the direction and strength of each recommendation.ResultsThis guideline includes expanded indications for some vaccines in patients with RMDs, as well as guidance on whether to hold immunosuppressive medications or delay vaccination to maximize vaccine immunogenicity and efficacy. Safe approaches to the use of live attenuated vaccines in patients taking immunosuppressive medications are also addressed. Most recommendations are conditional and had low quality of supporting evidence.ConclusionApplication of these recommendations should consider patients' individual risk for vaccine-preventable illness and for disease flares, particularly if immunosuppressive medications are held for vaccination. Shared decision-making with patients is encouraged in clinical settings.

Multiple sclerosis is a chronic inflammatory disease of the central nervous system1. Astrocytes are heterogeneous glial cells that are resident in the central nervous system and participate in the pathogenesis of multiple sclerosis and its model experimental autoimmune encephalomyelitis2,3. However, few unique surface markers are available for the isolation of astrocyte subsets, preventing their analysis and the identification of candidate therapeutic targets; these limitations are further amplified by the rarity of pathogenic astrocytes. Here, to address these challenges, we developed focused interrogation of cells by nucleic acid detection and sequencing (FIND-seq), a high-throughput microfluidic cytometry method that combines encapsulation of cells in droplets, PCR-based detection of target nucleic acids and droplet sorting to enable in-depth transcriptomic analyses of cells of interest at single-cell resolution. We applied FIND-seq to study the regulation of astrocytes characterized by the splicing-driven activation of the transcription factor XBP1, which promotes disease pathology in multiple sclerosis and experimental autoimmune encephalomyelitis4. Using FIND-seq in combination with conditional-knockout mice, in vivo CRISPR-Cas9-driven genetic perturbation studies and bulk and single-cell RNA sequencing analyses of samples from mouse experimental autoimmune encephalomyelitis and humans with multiple sclerosis, we identified a new role for the nuclear receptor NR3C2 and its corepressor NCOR2 in limiting XBP1-driven pathogenic astrocyte responses. In summary, we used FIND-seq to identify a therapeutically targetable mechanism that limits XBP1-driven pathogenic astrocyte responses. FIND-seq enables the investigation of previously inaccessible cells, including rare cell subsets defined by unique gene expression signatures or other nucleic acid markers.

Abstract Background Cancer patients are often treated with radiation, therefore increasing their exposure to high energy emissions. In such cases, medical errors may be threatening or fatal, inducing the need to innovate new methods for maximum reduction of irreversible events. Training is an efficient and methodical tool to subject professionals to the real world and heavily educate them on how to perform with minimal errors. An evolving technique for this is Serious Gaming that can fulfill this purpose, especially with the rise of COVID-19 and the shift to the online world, by realistic and visual simulations built to present engaging scenarios. This paper presents the first Serious Game for Lung Cancer Radiotherapy training that embodies Biomedical Engineering principles and clinical experience to create a realistic and precise platform for coherent training. Methods To develop the game, thorough 3D modeling, animation, and gaming fundamentals were utilized to represent the whole clinical process of treatment, along with the scores and progress of every player. The model’s goal is to output coherency and organization for students’ ease of use and progress tracking, and to provide a beneficial educational experience supplementary to the users’ training. It aims to also expand their knowledge and use of skills in critical cases where they must perform crucial decision-making and procedures on patients of different cases. Results At the end of this research, one of the accomplished goals consists of building a realistic model of the different equipment and tools accompanied with the radiotherapy process received by the patient on Maya 2018, including the true beam table, gantry, X-ray tube, CT Scanner, and so on. The serious game itself was then implemented on Unity Scenes with the built models to create a gamified authentic environment that incorporates the 5 main series of steps; Screening, Contouring, External Beam Planning, Plan Evaluation, Treatment, to simulate the practical workflow of an actual Oncology treatment delivery for lung cancer patients. Conclusion This serious game provides an educational and empirical space for training and practice that can be used by students, trainees, and professionals to expand their knowledge and skills in the aim of reducing potential errors.