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Nahla M Elsherbiny,1 Mohammed Ramadan,2 Nagla H Abu Faddan,3 Elham Ahmed Hassan,4 Mohamed E Ali,2 Abeer Sharaf El-Din Abd El-Rehim,4 Wael A Abbas,5 Mohamed AA Abozaid,5 Ebtisam Hassanin,6 Ghada A Mohamed,7 Helal F Hetta,1 Mohammed Salah8 1Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt; 2Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut, Egypt; 3Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt; 4Department of Gastroenterology and Tropical Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt; 5Department of Internal Medicine, Gastroenterology and Hepatology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt; 6Clinical Pathology, Ministry of Health, Assiut, Egypt; 7Department of Internal Medicine, Endocrine Unit, Faculty of Medicine, Assiut University, Assiut, Egypt; 8Department of Microbiology and Immunology, Faculty of pharmacy, Port Said University, Port Said, EgyptCorrespondence: Elham Ahmed Hassan, Department of Gastroenterology and Tropical Medicine, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt, Tel +20 882410285, Fax +20 882333327, Email mam_elham75@yahoo.com; elham.abdelhalem@med.aun.edu.egPurpose: To investigate the compositional and functional characteristics of T1DM-associated gut microbiota in two Egyptian cities and to study the geographical locality effects.Patients and Methods: This case-control study included 32 children with controlled T1DM and 16 controls, selected from two different regions of Egypt. The gut microbiota of both diabetic and control children was analyzed through 16S rRNA gene sequencing; this was done using the Illumina MiSeq platform.Results: Consistent findings among the diabetic children included significantly lower alpha diversity than the control children, as well as a lower mean Firmicutes/Bacteroidetes (F/B) ratio, and reduced proportions of Firmicutes and the genera Prevotella and Ruminococcus. In the diabetic children, there were also significantly enriched representations of Actinobacteria, Bacteroidetes, and Proteobacteria and the genera Lactobacilli, Bacteroides, and Faecalibacterium. When comparing the two diabetic groups, the Ismailia group (IsDM) was found to have a significantly higher F/B ratio and diversity indices, with resultant differences at the functional level.Conclusion: There are a number of consistent changes in the microbiota profile characterizing the diabetic groups irrespective of the geographical location including significantly lower alpha diversity, mean Firmicutes/ Bacteroidetes (F/B) ratio, and reduced proportions of Firmicutes and genera Prevotella and Ruminococcus. There are also significantly enriched representations of Actinobacteria, Bacteroidetes, and Proteobacteria and genera Lactobacilli, Bacteroides, and Faecalibacterium pointing to the greater driving power of the disease.Keywords: gut microbiota, dysbiosis, type 1 diabetes mellitus, children

Wael Abd Elgwad Elsewify,1 Elham Ahmed Hassan,2 Mohamed A Mekky,2 Abeer Sharaf El-Din Abd El-Rehim,2 Zain El-Abdeen Ahmed Sayed,3 Mohamed Omar Abdel Malek,2 Tarek TH ElMelegy,4 Abeer Sabry5 1Department of Internal Medicine, Faculty of Medicine, Aswan University, Aswan, Egypt; 2Department of Gastroenterology and Tropical Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt; 3Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt; 4Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt; 5Department of Internal Medicine, Faculty of Medicine, Helwan University, Cairo, EgyptCorrespondence: Wael Abd Elgwad ElsewifyDepartment of Internal Medicine, Faculty of Medicine, Aswan University, Aswan 81528, EgyptTel +20 1001657295Fax +20 973480449Email waelelsewify@yahoo.comBackground: Screening of hepatocellular carcinoma (HCC) is challenged especially in patients with normal alpha-fetoprotein (AFP) levels. Aberrant p16 methylation has been implicated in HCC.Objectives and Aims: This study aimed to assess serum methylated p16 (MP16) expression levels and to evaluate MP16 diagnostic performance in HCC detection among HCV-infected Egyptian patients with normal AFP levels.Methods: MP16 levels were quantified using real-time PCR in 230 serum samples (30 healthy controls, 95 with HCV-HCC, 40 with chronic hepatitis C “CHC” and 65 with HCV cirrhosis). Diagnostic performance of MP16 for diagnosis of HCC was done using receiver operator characteristic curve analysis.Results: Serum MP16 levels were significantly higher in HCC than CHC, cirrhosis, and healthy subjects and significantly higher in HCC with normal AFP levels than those with higher AFP. ROC curves revealed promising diagnostic performance for MP16 in discriminating HCC with normal AFP levels from non-HCC cases. This predictive ability improved by combining MP16 and AFP (AUC of 0.872 with 100% sensitivity, 76.5% specificity, 79.1% positive predictive value, 100% negative predictive value, and 87.5% accuracy).Conclusion: MP16 can be a potential noninvasive molecular biomarker for HCC detection in patients with hepatic mass(es) and normal AFP levels especially in those where liver biopsy and radiological imaging cannot be done.Keywords: methylated p16, hepatitis C virus, hepatocellular carcinoma, alpha-fetoprotein, quantitative real-time PCR

Ahmed Mohamed Saleh,1 Essam Ali Hassan,1 Ahmed Ali Gomaa,1 Tamer Mahmoud El Baz,2 Mohamed El-Abgeegy,3 Mohamed Ismail Seleem,3 Yousry Esam-Eldin Abo-amer,4 Heba Fadl Elsergany,3 Eman Ibrahim El-Desoki Mahmoud,3 Sherief Abd-Elsalam51Tropical Medicine Department, Fayoum University, Al Fayyum, Egypt; 2Endemic Medicine Department, Cairo University, Giza, Egypt; 3Liver Transplantation Team, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt; 4Hepatology, Gastroenterology, and Infectious Diseases Department, Mahala Hepatology Teaching Hospital, Gharbia, Egypt; 5Tropical Medicine Department, Tanta University, Tanta, EgyptBackground and aim: Liver transplantation (LT) has emerged as an established therapeutic option for patients with chronic liver disease. Patients with end-stage liver disease are at high risk of infection with multidrug-resistant organisms, which may affect the outcome of LT. The aim of this study was to evaluate the impact of pre-transplant infection on the outcome of living-donor LT.Methods: Prospective follow-up was done for 50 patients with chronic liver disease who had had LT performed from September 2013 to December 2017. We divided patients into group 1 (patients who had had infection within 3 months before transplantation with adequate treatment [n=20]), and group 2 (patients without infection [n=30]). Both groups were followed for 4 months post-operatively.Results: Patients with high Modelfor End-Stage Liver Disease scores were more susceptible to infection pre- and post-operatively, and chest infection was the most common infection pre-transplant. There were no significant statistical differences regarding hospital and ICU stay and post-operative course between the groups, but the mortality rate was higher in group 1 (40%) than in group 2 (23.3%), and the causes of mortality in the group 1 were mainly due to medical causes (infections and sepsis, 75%) versus 28.6% in group 2.Conclusion: Liver-cell failure and concomitant infection 3 months before LT with adequate treatment had no significant statistical differences regarding hospital, ICU stay, or medical complications, but post-operative infection and mortality rate were more frequent in group 1 and the causes of mortality were mainly medical.Keywords: hepatitis C virus, cirrhosis, steatosis, chronic liver disease, liver transplantation, outcome

Shereen A Sayed,1 Ehsan AB Hassan,2 Muhamad R Abdel Hameed,3 Michael N Agban,2 Mostafa F Mohammed Saleh,3 Hayam H Mohammed,4 Abu-Baker M Abdel-Aal,5 Sherein G Elgendy2 1Department of Microbiology and Immunology, Faculty of Veterinary Medicine, Assiut University, Assiut, Egypt; 2Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt; 3Department of Internal Medicine & Hematology Unit, Assiut University Hospitals and Bone Marrow Transplantation Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; 4Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; 5Department of Organic Chemistry, Faculty of Pharmacy, Assiut University, Assiut, EgyptCorrespondence: Muhamad R Abdel HameedDepartment of Internal Medicine & Hematology Unit, Assiut University Hospitals and Bone Marrow Transplantation Unit, South Egypt Cancer Institute, Assiut University, Assiut, 71515, EgyptTel +20 1097510010Fax +20 88-2080278Email dr.muhamadramadan@yahoo.comSherein G ElgendyDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, 71515, EgyptTel +20 1021887728Fax +20 88-2080278Email Shereinelgendy@yahoo.comBackground and Objectives: Candida albicans is a significant source of morbidity and mortality for patients with acute myeloid leukemia (AML). Prolonged use of fluconazole as empirical antifungal prophylaxis in AML patients leads to overexpression of efflux pump genes that resulted in the emergence of azole-resistant species. Consequently, the introduction of a new strategy to improve the management of C. albicans infections is an urgent need. Nonsteroidal anti-inflammatory drug (NSAID) ketorolac is associated with a reduction in cancer relapses. The present study was performed to investigate the use of ketorolac-fluconazole combination to reverse fluconazole resistance in C. albicans isolated from AML patients on induction chemotherapy.Patients and Methods: One hundred and seventy AML patients were evaluated. Fifty C. albicans were isolated and subjected to disc diffusion assay and broth microdilution for fluconazole alone and combined with different concentrations of ketorolac. Efflux pump gene (CDR1, CDR2, and MDR1) expressions were quantified by real-time PCR.Results: The tested ketorolac acted synergistically with fluconazole against resistant C. albicans with the minimum inhibitory concentration (MIC) of fluconazole decreased from > 160 μg/mL to 0.3– 1.25 μg/mL in (93.8%) of resistant isolates with fractional inhibitory concentration index (FICI) value of 0.25. The majority of the resistant isolates overexpressed CDR1 (71.1%) and MDR1 (60%).Conclusion: Ketorolac-fluconazole in vitro combination would be a promising strategy for further clinical in vivo trials to overcome fluconazole resistance in AML patients on induction chemotherapy.Keywords: ketorolac, fluconazole resistance, acute myeloid leukemia, CDR1, MDR1

Abstract We consider experimental limits on colour triplet fermions that decay dominantly to three jets via a scalar mediator that can be on- or off-shell. These fermions arise in top-partner models that can solve the hierarchy problem, and limits on this scenario are weaker than those on traditional top-partner models because of the messy all-hadronic final state with significant backgrounds. We do find, however, that while there are no dedicated searches for this scenario, especially in case of an on-shell mediator, the suite of LHC all- hadronic searches still constrains a significant portion of the parameter space. In particular, we find that searches for pair production of di-jet and tri-jet resonances are complementary, covering different regions of parameter space. We also find that if the final state is rich in b- jets, current limits do not change significantly relative to the scenario with all light jets, and we describe how modifications of current search strategies can improve limits in that case.

A set of techniques for efficient implementation of Hodgkin-Huxley-based (H-H) model of a neural network on FPGA (Field Programmable Gate Array) is presented. The central implementation challenge is H-H model complexity that puts limits on the network size and on the execution speed. However, basics of the original model cannot be compromised when effect of synaptic specifications on the network behavior is the subject of study. To solve the problem, we used computational techniques such as CORDIC (Coordinate Rotation Digital Computer) algorithm and step-by-step integration in the implementation of arithmetic circuits. In addition, we employed different techniques such as sharing resources to preserve the details of model as well as increasing the network size in addition to keeping the network execution speed close to real time while having high precision. Implementation of a two mini-columns network with 120/30 excitatory/inhibitory neurons is provided to investigate the characteristic of our method in practice. The implementation techniques provide an opportunity to construct large FPGA-based network models to investigate the effect of different neurophysiological mechanisms, like voltage-gated channels and synaptic activities, on the behavior of a neural network in an appropriate execution time. Additional to inherent properties of FPGA, like parallelism and re-configurability, our approach makes the FPGA-based system a proper candidate for study on neural control of cognitive robots and systems as well.

This study aimed to screen the bioactive components in Streptococcus equinus WC 1 (SE-WC 1 ) and Limosilactobacillus reuteri GM 4 (LR-GM 4 ) and estimate the therapeutic role in Ehrlich solid tumors (EST) mice model. Forty-four male albino EST mice were assigned into 7 groups and treated daily for 2 weeks, including the EST group, the EST mice that received SE-WC 1 at a low or a high dose (0.5 ml *10 6 or 0.5 ml *10 8  cfu), the EST mice that received LR-GM 4 at the low or the high dose (0.5 ml *10 6 or 0.5 ml *10 8  cfu), and the EST mice that received SE-WC 1 plus LR-GM 4 at the low or the high dose. Tumors were harvested, weighed, examined, and used for the determination of apoptosis-related gene expression. Samples of the intestine, liver, and kidney were gathered for histological examination. The GC-MS identified 24 and 36 bioactive compounds in SE-WC 1 and LR-GM 4 , respectively. The main compound in SE-WC 1 was lupeol; however, the main compound in LR-GM 4 was retinaldehyde. EST mice showed disturbances in Bcl-2, Bax, and p53 mRNA expression along with histological changes in the intestine, liver, and kidney. Administration of both bacterial strains reduced the tumor weight, alleviated the disturbances in the gene expression, and improved the histological structure of the intestine, liver, and kidney in a dose-dependent. Moreover, LR-GM 4 was more effective than SE-WC 1 due to its higher content of bioactive compounds. It could be concluded that these strains of probiotics are promising for the treatment of solid tumors., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Multiple myeloma (MM) is defined by the excessive growth of cancerous plasma cells in the bone marrow, resulting in the production of an abnormal monoclonal paraprotein and signs of damage to vital organs. The diagnosis of multiple myeloma can be complex. This paper centers on the diagnosis of MM and examines the role of the gamma gap (GG) in prompting tests to assess treatment effectiveness., Methods: Sixty individuals newly diagnosed with MM were selected from medical facilities in Iraq, specifically Baghdad Hospital/Medical City and Hematological Center, between November 2022 and March 2023. Additionally, 30 healthy participants were included as a comparison group. The assessment of suspected MM patients involves confirming the presence of a monoclonal paraprotein using serum electrophoresis (SEPG) and immunofixation (SIF), as well as analyzing free light chains (FLC). Spectrophotometric methods were used to measure total serum protein and albumin levels and calculate the globulin-to-albumin ratio by subtracting serum albumin from total serum protein., Results: In most MM cases the monoclonal immunoglobulin (as M-spike) was identified and quantified by SPEP. Based on the findings from IFE detection, the prevalence of M-spike, particularly type IgG, was observed in 45 cases (83.3%), of which 40% were type κ, 24.6% were type λ, and 19.3% were of an unknown type. Additionally, type IgA was the second most prevalent (10 cases, 16.7%), with 14.3% being type κ and 1.7% being type λ. Moreover, the results indicated a significant association between GG and M-spike, as well as a strong correlation between GG and pre- and post-treatment M-spike levels. The area under the curve was deemed acceptable (AUC = 0.735, p = 0.0001), demonstrating high diagnostic accuracy (86.2) in distinguishing MM patients before and after treatment., Conclusion: The evaluation of GG in the serum of MM patients demonstrated elevated levels, which were significantly associated with patients post-treatment. Therefore, our findings have significant implications for the use of GG as a prognostic indicator for monitoring treatment response in MM patients., (© 2024. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Background: Irisin is a precious hormone-like myokine that plays a key role in glucose/energy expenditure and metabolic regulation This paper aimed to determine the irisin levels in patients with type 1 diabetes mellitus and their correlation with insulin therapy and glycaemic control., Methods: Ninety type 1 diabetes mellitus patients were collected. The patients were subdivided into two groups: group I (37) newly diagnosed type 1 diabetes mellitus and group II (53) T1DM (on insulin injection); for comparison, 30 healthy individuals were included as control. The serum levels of irisin were estimated using ELISA. FSG and lipid profile were measured through spectrophotometrically. Glycated hemoglobin was determined using High-performance liquid chromatography., Result: Serum levels of irisin were significantly lower (P = 0.01), as compared to the control group. Also irisin level was significantly lower in group I compared to group II. Fasting serum glucose, glycated hemoglobin, and lipid profile were significantly elevated in patient groups compared to the control group. Serum irisin was negatively correlated to fasting serum glucose, and glycated hemoglobin, whereas it positively correlated to serum lipid profile. In multiple stepwise regression, only glycated hemoglobin (β =  - 0.600, P = 0.040) was determined as an independent predictor for predicting the irisin levels. The AUC was excellent (AUC = 0.996, P = 0.0001), with high diagnostic accuracy (88.2) in differentiating newly diagnosed type 1 diabetes mellitus from the healthy subject group., Conclusion: We demonstrated low irisin levels in type 1 diabetes mellitus and the association of the highest irisin amounts to an insulin therapy and a better glycaemic control. Furthermore, the measurement of irisin levels could be useful as laboratory markers to monitor type 1 diabetes mellitus severity and therapy response., (© 2024. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Background: Critical care nurses should help in reducing noise to improve the well-being of patients and health care providers., Aim/s: To measure actual noise levels in intensive care units, identify nurses' perceived irritation levels of noise sources and examine the impact of noise on nurses' work performance and well-being., Study Design: This cross-sectional study was conducted from January to April 2023 at a teaching hospital's six intensive care units. It involved three phases: mapping locations for noise measurement, actual noise measurements in decibels and a cross-sectional survey to identify nurses' perceptions and the adverse effects of noise. Actual noise was measured between patients' beds, nursing stations and beside 16 noise sources for 7 days 24 h a day. For nurse perceptions, the mean of perceived irritation levels by a Likert scale for each noise source was calculated to present perceived noise levels. Ranking of noise sources according to the actual measured and perceived irritation by nurses was done based on mean values. Curve estimation regression test was used to predict the relationship between actual and perceived noise and stepwise multiple linear regression identified factors associated with noise adverse effects., Results: The mean noise level in the intensive care units was 65.55 dB. Nurses perceived mechanical ventilator alarms as the most irritating noise. However, the mean noise measurements showed that conversations among colleagues were the primary source of noise. There was no significant predictive relationship between the actual and perceived noise. Nurses reported feeling distressed, irritable, fatigued and less productive due to noise., Conclusions: There was a discrepancy between actual and perceived noise levels by nurses. Perceived noise levels had more impact on nurses than actual noise., Relevance to Clinical Practice: By incorporating both objective measurements and subjective perceptions into efforts aimed at reducing noise, health care providers can create quieter intensive care units., (© 2024 British Association of Critical Care Nurses.)

Introduction: Blood parasites pose a significant threat to livestock production in southern Egypt, yet there is a scarcity of information regarding their circulation and epidemiology in sheep in this region. This study aimed to investigate the seroprevalence of blood parasite infections in sheep in Assiut governorate, Upper Egypt., Methods: A total of 400 blood samples were collected from sheep of varying ages and genders. The preliminary screening for the presence of piroplasms, mainly Babesia and Theileria spp., via microscopic examination, followed by investigation of the potential risk factors linked with the exposure to infection. Moreover, molecular identification of both parasites on some of positive samples was performed using PCR targeting Babesia 18S rRNA and Theileria annulata Tams1 gene., Results: The microscopic examination revealed that among the examined sheep, there was an overall prevalence of blood parasites at 44% (176 out of 400), with Babesia spp. observed in 14% (56 out of 400) and Theileria spp. in 30% (120 out of 400). Furthermore, the infection rate was non-significantly higher in young animals (50%) compared to adults (38.5%) ( P = 0.246). Male sheep exhibited a significantly higher vulnerability to both parasites' infection (63.3%) compared to females (35.7%) ( P = 0.011). Interestingly, the prevalence of both blood parasites was significantly higher during the cold season (66.1%) compared to the hot season (15.9%) ( P = < 0.001). The molecular analysis identified the presence of Babesia ovis and Theileria annulata among a subsample of the positive sheep's bloods films. The identified species were recorded in the GenBank™ databases and assigned specific accession numbers (OQ360720 and OQ360719 for B. ovis ), and (OP991838 for T. annulata )., Conclusions: Taken together, this study confirms a high prevalence of piroplasmosis and offers epidemiological and molecular insights into blood parasites in sheep from Upper Egypt, highlighting the importance of detecting these parasites in various hosts and their competent vectors (ticks)., Competing Interests: The 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. The reviewer MR declared a shared affiliation with the author FE to the handling editor at the time of review., (Copyright © 2024 Dyab, Mohamed, Abdel-Aziz, Gareh, Osman, Elgohary, Hassan, Alsowayeh, Alzaylaee, Ahmed, Bravo-Barriga and Elmahallawy.)

The growth of material science and technology places a high importance on the creation of better processes for the synthesis of copper nanoparticles. So that, an easy, ecological, and benign process for producing copper nanoparticles (CuNPs) has been developed using candy leaf (Stevia rebaudiana) leaves aqueous extract for the first time. UV-visible spectroscopy, dynamic light scattering (DLS), X-ray diffraction (XRD), high-resolution transmission electron microscope (HR-TEM), Fourier transmission infrared (FTIR), and zeta potential were applied to demonstrate strong characterization for the biosynthesized stevia-CuNPs. The UV-visible absorbance at 575 nm of surface plasmon resonance (SPR) was 1.2. The particle size mean diameter was recorded as 362.3 nm with - 10.8 mV zeta potential. The HR-TEM scanning revealed 51.46-53.17 nm and spherical-shaped stevia-CuNPs surrounded by coat-shell proteins. The cytotoxicity and cytocompatibility activity assay revealed that stevia-CuNPs was safe in lower concentrations and had a significant cell viability reduction in higher concentrations. The produced stevia-CuNPs were applied as antimicrobial agents against eight pathogenic bacteria and five fungi strains. The inhibitory action of the stevia-CuNPs was more pronounced in bacteria than in fungi, and they likewise demonstrated further inhibition zones in Staphylococcus aureus (50.0 mm) than in Aspergillus flavus (55.0 mm). With inhibition zone sizes of 50.0 mm and 47.0 mm and 50 µg/ml minimum inhibitory concentration, S. aureus and A. flavus were the most inhibited pathogens. The minimum lethal effect (MLC) estimate for S. aureus was 50 µg/ml, whereas 75 µg/ml for A. flavus. The stevia-CuNPs mode of action was characterized as bactericidal/fungicidal as the ratio of MIC to MLC was estimated to be equal to or less than 2. After all, stevia-CuNPs could be used as an alternative to commercial antibiotics to solve the problem of multidrug-resistant (MDR) microorganisms., (© 2024. The Author(s).)

Monitoring of ingestive activities is critically important for managing the health and wellness of individuals with various health conditions, including the elderly, diabetics, and individuals seeking better weight control. Monitoring swallowing events can be an ideal surrogate for developing streamlined methods for effective monitoring and quantification of eating or drinking events. Swallowing is an essential process for maintaining life. This seemingly simple process is the result of coordinated actions of several muscles and nerves in a complex fashion. In this study, we introduce automated methods for the detection and quantification of various eating and drinking activities. Wireless surface electromyography (sEMG) was used to detect chewing and swallowing from sEMG signals obtained from the sternocleidomastoid muscle, in addition to signals obtained from a wrist-mounted IMU sensor. A total of 4675 swallows were collected from 55 participants in the study. Multiple methods were employed to estimate bolus volumes in the case of fluid intake, including regression and classification models. Among the tested models, neural networks-based regression achieved an R 2 of 0.88 and a root mean squared error of 0.2 (minimum bolus volume was 10 ml). Convolutional neural networks-based classification (when considering each bolus volume as a separate class) achieved an accuracy of over 99% using random cross-validation and around 66% using cross-subject validation. Multiple classification methods were also used for solid bolus type detection, including SVM and decision trees (DT), which achieved an accuracy above 99% with random validation and above 94% in cross-subject validation. Finally, regression models with both random and cross-subject validation were used for estimating the solid bolus volume with an R 2 value that approached 1 and root mean squared error values as low as 0.00037 (minimum solid bolus weight was 3 gm). These reported results lay the foundation for a cost-effective and non-invasive method for monitoring swallowing activities which can be extremely beneficial in managing various chronic health conditions, such as diabetes and obesity., (© 2024. The Author(s).)

Background: Neuregulin-1(NRG-1) is a protein that belongs to the group of epidermal growth factors. It plays vital roles in anti-fibrotic effects on the myocardium. The current paper explores the role of NRG-1 in type 2 diabetes mellitus (T2DM) and its relation to atherogenic index as a factor for increasing cardiovascular disease(CVD) risk., Material and Methods: In this study, 79 diabetes mellitus patients are independent insulin. These patients consisted of 53 females and 26 males their age were ranged 40-67 years. They were divided into two groups depending on the atherogenic index of plasma (AIP). Group I including48 diabetic patient with high risk of CVD and group II including 31 diabetic patients without risk CVD. Forty healthy individuals were included as control., Result: When compared to the control group, the serum levels of NRG-1 were significantly lower (p = 0.01). Additionally, group I had a much lower NRG-1level than group II. The results of multiple stepwise regression showed that the only independent predictor for NRG-1 level prediction was AIP (β =  - 0.600, P = 0.040). When comparing the diabetic patients with high risk factors for CVD to the healthy subject group, the AUC was outstanding (AUC = 0.889, P = 0.001) and had a high diagnosis., Conclusions: We proved low NRG-1 levels in diabetic patients and the association of highest NRG-1 amounts to a better AIP. Moreover, the measurement of NRG-1 levels could be beneficial as laboratory markers to monitor for increasing CVD risk in type 2 diabetes mellitus., (© 2024. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Background: Globally, hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death due to a lack of early predictive and/or diagnostic tools. Thus, research for a new biomarker is important. LncRNAs play a functional role in target gene regulation and their deregulation is associated with several pathological conditions including HCC., Objective: This study aimed to explore the diagnostic potential of two LncRNAs MALAT1 and CASC2 in HCC compared to the routinely used diagnostic biomarker., Materials and Methods: The current study is a case-control study carried out at Fayoum University Hospital and conducted on 89 individuals. The study included three groups of 36 HCC patients on top of HCV(HCC/HCV), 33 HCV patients, and 20 healthy volunteers as a control group. All study subjects were subjected to radiological examinations. The determination of CBC was performed by the automated counter and liver function tests by the enzymatic method were performed. In addition, HCV RNA quantification and the expression level of two LncRNAs (MALAT1 and CASC2) were performed by qRT-PCR., Results: The results revealed a statistically significant difference between study groups regarding liver function tests with a higher mean in HCC/HCV group. Also, serum MALAT1 significantly up-regulated in HCV (11.2±2.8) and HCC/HCV (4.56±1.4) compared to the control group. Besides, serum CASC2 levels in the HCV group were significantly upregulated (14.9±3.6), while, downregulated in the HCC group (0.16± 0.03). Furthermore, The ROC analysis for diagnostic efficacy parameters indicated that CASC2 has higher accuracy (94.6%) and sensitivity (97.2%) for HCC diagnosis than AFP with an accuracy of (90.9%), sensitivity (69.4%), and MALAT1 showed an accuracy of (56.9%), sensitivity (72.2%)., Conclusion: Our study results indicated that CASC2 is a promising biomarker and is considered better and could help in HCC diagnosis on top of HCV than MALAT1 and the routine biomarker AFP., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Golam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The study aimed to determine the variability in the stages of diabetic nephropathy by examining specific biochemical functions associated with the target organ. As a result, various biochemical parameters were assessed in all of the groups under investigation., Material and Methods: These parameters encompassed soluble α-Klotho and serum insulin, which were determined through ELISA. Additionally, spectrophotometric methods were employed to assess other parameters such as blood levels of urea in all groups. Instead of using HPLC method, HbA1c levels were determined. Blood and urine samples were obtained from a total of 90 participants, who were aged between 37 and 70 years. A total of 70 patients were categorized into three groups according to their ACR. The first group consisted of patients with an ACR value of less than 30 mg/g. The second group included patients with an ACR value ranging from 30 to 300 mg/g. The third group comprised patients with an ACR value greater than 300 mg. Additionally, the study also involved 20 healthy individuals., Result: The serum soluble α-Klotho in the patient group was significantly lower than that of the healthy subjects. There were strong negative correlations between serum soluble α-Klotho and both ACR and HOMA-IR. The AUC value was excellent, measuring at 0.93 with a p < 0.0001., Conclusions: Soluble α-Klotho levels in the sera of diabetic patients were shown to be lower and significantly linked to patients with diabetic nephropathy. This implies that klotho levels may be influenced by ACR in addition to playing a significant role in insulin resistance., (© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. Currently, several biomarkers are being used as CLL prognosticators, including elevated protein levels, elevated RNA levels, gene mutations, and epigenetic changes. Materials and Methods: This study is a prospective study conducted on 55 patients newly diagnosed with CLL, serum IL-6 level was measured initially and after a 6-month treatment course. Correlation with the course of the disease and the known CLL prognostic parameters was done initially and after 6 months. Results: The initial serum IL-6 level in the patient group (pre-treatment) ranges from 36-91 pg/mL (median 57), and in the patient group (post-treatment) ranges from 1-32 pg/mL (median 2). Serum IL-6 level was positively correlated with WBC count, β2 microglobulin, LDH, ESR, B symptoms, Uric Acid, BM Aspirate (% of lymphocytes), and Binet and Rai staging systems. Conclusion: Serum IL-6 is a useful poor prognostic marker in newly diagnosed CLL patients; its prognostic value goes with the other known prognostic markers such as the BM lymphocyte count, ESR, and LDH., (Copyright © 2024 Tehran University of Medical Sciences.)

The kidney lost a lot of protein in the urine when you have nephrotic syndrome (NS). Clinical manifestations mostly common in NS include massive proteinuria, hypoalbuminemia, hyperlipidemia, and edema. Idiopathic nephrotic syndrome is currently classified into steroid-dependent (SDNS) and steroid-resistant (SRNS) based on the initial response to corticosteroid therapy at presentation. Several reports examined the association of the MYH9 gene (rs3752462, C > T) variant and ELMO1 gene (rs741301 G > A) variant as risk factors for Nephrotic Syndrome. This study aimed to determine the potential effect of the MYH9 gene (rs3752462, C > T) and ELMO1 gene (rs741301) variant on the risk of (NS) among Egyptian Children. This study included two hundred participants involving 100 nephrotic syndrome (NS) cases and 100 healthy controls free from nephrotic syndrome (NS). The MYH9 gene (rs3752462, C > T) variant and ELMO1 gene (rs G > A741301) variant were analyzed by ARMS-PCR technique. Nephrotic syndrome cases include 74% SRNS and 26% SDNS. Higher frequencies of the heterozygous carrier (CT) and homozygous variant (TT) genotypes of the MYH9 (rs3752462, C > T) variant were observed in NS patients compared to the controls with p-value < 0.001. The frequencies of the MYH9 (rs3752462, C > T variant indicated a statistically significant elevated risk of NS under various genetic models, including allelic model (OR 2.85, p < 0.001), dominant (OR 3.97, p < 0.001) models, and the recessive model OR 5.94, p < 0.001). Higher frequencies of the heterozygous carrier (GA) and homozygous variant (AA) genotypes of ELMO1gene (rs G > A741301) variant were observed in NS patients compared to the controls with p-value < 0.001. The frequencies of the ELMO1 (rs G > A741301) variant indicated a statistically significant elevated risk of NS under various genetic models, including allelic model (OR 2.15, p < 0.001), dominant models (OR 2.8, p < 0.001), and the recessive model (OR 4.17, p = 0.001). Both MYH9 and ELMO1 gene variants are significantly different in NS in comparison with the control group (p < 0.001). The MYH9 gene (rs3752462, C > T) and ELMO1gene (rs G > A741301) variants were considered independent risk factors for NS among Egyptian Children., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Renewable solar energy storage facilities are attracting scientists' attention since they can overcome the key issues affecting the shortage of energy. A nanofluid phase change material (PCM) is introduced as a new sort of PCM is settled by suspending small proportions of nanoparticles in melting paraffin. ZnO/α-Fe 2 O 3 nanocrystals were prepared by a simple co-precipitation route and ultrasonically dispersed in the paraffin to be a nanofluid-PCM. The behaviors of the ZnO/α-Fe 2 O 3 nanocrystals were verified by X-ray diffraction (XRD) analysis, and the average particle size and the morphology of the nanoparticles were explored by transmission electron microscopy (TEM). For the object of industrial ecology concept, aluminum-based waste derived from water-works plants alum sludge (AS) is dried and augmented with the ZnO/α-Fe 2 O 3 nanocrystals as a source of multimetals such as aluminum to the composite, and it is named AS-ZnO/α-Fe 2 O 3 . The melting and freezing cycles were checked to evaluate the PCM at different weight proportions of AS-ZnO/α-Fe 2 O 3 nanocrystals, which confirmed that their presence enhanced the heat transfer rate of paraffin. The nanofluids with AS-ZnO/α-Fe 2 O 3 nanoparticles revealed good stability in melting paraffin. Additionally, the melting and freezing cycles of nanofluid-PCM (PCM- ZnO/α-Fe 2 O 3 nanoparticles) were significantly superior upon supplementing ZnO/α-Fe 2 O 3 nanoparticles. Nanofluid-PCM contained the AS-ZnO/α-Fe 2 O 3 nanocrystals in the range of 0.25, 0.5, 1.0, and 1.5 wt%. The results showed that 1.0 wt% AS-ZnO/α-Fe 2 O 3 nanocrystals contained in the nanofluid-PCM could enhance the performance with 93% with a heat gained reached 47 kJ., Competing Interests: The authors declare no conflicts of interest.

Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has a high incidence of spread. On January 30, 2020, the World Health Organization proclaimed a public health emergency of worldwide concern. More than 6.9 million deaths and more than 768 million confirmed cases had been reported worldwide as of June 18, 2023. This study included 51 patients and 50 age- and sex-matched healthy subjects. The present study aimed to identify the expression levels of lncRNA CASC2 and miRNA-21-5p (also known as miRNA-21) in COVID-19 patients and their relation to the clinicopathological characteristics of the disease. The expression levels of noncoding RNAs were measured by RT-PCR technique. Results detected that CASC2 was significantly downregulated while miRNA-21-5p was significantly upregulated in COVID-19 patients compared to healthy subjects. A significant negative correlation was found between CASC2 and miRNA-21-5p. ROC curve analysis used to distinguish COVID-19 patients from controls. MiRNA-21-p serum expression level had a significant positive association with temperature and PO2 (p = 0.04 for each). These findings indicate that CASC2 and miRNA-21-p might be used as potential diagnostic and therapeutic biomarkers in COVID-19., (© 2024. The Author(s).)

The NAPinICU questionnaire, specifically designed to assess the needs of older adult patients in intensive care units, serves as a valuable tool for understanding and addressing their unique requirements. This study applied a cross-cultural translation process, followed by a cross-sectional survey to measure patients' needs and evaluate the psychometric properties of the Arabic-translated version of the NAPinICU questionnaire. The older adults' translated questionnaire demonstrated high content validity, good test-retest reliability and acceptable internal consistency. Discriminative validity confirmed significant differences in needs ratings between university and private hospital patients. This translated and validated tool can help in assessing the needs of older adults in intensive care units. Assessment of these patients' needs assists in enhancing the quality of care delivered to them by nurses and other healthcare providers., (© 2024 British Association of Critical Care Nurses.)

Background: Ulcerative colitis (UC) has emerged as an accelerated-incidence chronic condition. UC has been identified as a precancerous lesion for colorectal cancer. Up-to-date genomic research revealed the value of many noncoding RNAs (ncRNAs) in UC pathogenesis, diagnosis, and prognosis., Aim: The present study was aimed at measuring both MALAT-1 and CCAT-1 in the sera of UC patients as diagnostic and prognostic biomarkers and correlating them with the Mayo score which is a novel predictive indicator of malignant transformation as well as with clinicopathological characteristics of the disease., Patients and Methods: Sixty-six UC patients and 80 healthy individuals participated in this study, the serum fold changes of MALAT-1 and CCAT-1 were measured by using quantitative real-time PCR (qRT-PCR)., Results: The current study findings include overexpressed lncRNAs MALAT-1 and CCAT-1 in the sera of ulcerative colitis patients [(median (IQR) = 2.290 (0.16-9.36), mean ± SD = 3.37 ± 3.904 for MALAT-1, and median (IQR) = 7.305 (0.57-16.96), mean ± SD = 6.81 ± 4.002 for CCAT-1 than controls, ROC curve analysis reported that these genes could predict UC. Both genes were positively correlated with each other which enforces their synergistic effects. Both genes are diagnostic for UC patients.We related studied genes to the severity of the disease. In addition to a significant positive correlation between each gene with ESR and Mayo score, we further classified the patients according to severity (according to Mayo score to remission, mild, moderate, and severe groups) with the following results; lower levels of MALAT-1 and CCAT-1 were significantly associated with mild disease and increased gradually with more severe forms of the disease (p < 0.05). Linear regression analysis with Mayo Score as a dependent variable revealed that only the predictive power of CCAT-1 and ESR are significant. Moreover, ROC curve analysis when compared to that of the Mayo score revealed that CCAT-1 reached 99 % accuracy. In summary, both genes are prognostic factors for UC patients., Conclusion: MALAT-1 and CCAT-1 are diagnostic and prognostic serum biomarkers of ulcerative colitis., Competing Interests: No conflict of interest related to this study., (© 2024 The Authors.)

Bovine cysticercosis is categorized as a serious parasitic zoonotic infestation. The infection is mainly caused by the tapeworm Taenia saginata , which infects cattle and humans. The larval stage, Cysticercus bovis (C. bovis) , is found in the skeletal and cardiac muscles of infected cattle. Despite its potential public health concern, few studies have been conducted on cardiac cysticercosis in Upper Egypt. This study investigates the prevalence, epidemiology, and impact of cardiac cysticercosis in Upper Egypt, emphasizing how histopathological changes in cardiac muscle and physiological parameters might be associated with the infection. From December 2022 to October 2023, a total of 941 animals from Assiut province, Upper Egypt, were slaughtered and their cardiac muscles were examined for the presence of C. bovis . Cysts were classified as viable or degenerated through macroscopic inspection. The overall prevalence of C. bovis infected hearts made up 10.8% of the total examined. The highest prevalence rate was in the summer season followed by spring; winter had the lowest infections. The histopathological examination of infected tissues revealed immune cell infiltration around Cysticercus-infected areas. Additionally, Bax immunostaining demonstrated the apoptotic effect of cysticercosis. Regarding the measured physiological parameters, there were non-significant changes in plasma levels of total protein and albumin in cattle infected with cysticercosis compared with control animals. Moreover, there was a significant decrease in total antioxidant capacity (TAC) combined with a significant increase in lipid peroxide (Malondialdehyde) (MDA), troponin T, and lactate dehydrogenase (LDH) activity in infected animals. The present work documented a set of epidemiological and pathological findings, revealing that C. bovis is a potentially harmful parasite and can cause significant health problems in both cattle and humans.

Highlighting waste as a wealth is the future sustainability of the world. Also, using solar energy stored during off-sun periods will overcome the energy crisis. The introduction of wood chip waste for thermal energy storage systems is a sustainable opportunity. Cellulose derived from wood chips was mixed with the environmentally benign magnetite to form a composite (WCM) and mixed with paraffin-based PCM. The composite was characterized through transmission electron microscopy, TEM analysis, scanning electron microscopy, SEM (augmented with dispersive X-ray analysis, EDX). Micrographs, Fourier transform infrared (FTIR), and X-ray diffraction (XRD), which confirmed that the composite material was prepared. Various system proportions of the composite (0.5, 1.0, 2.0, and 4.0%) are embedded in paraffin, and then the thermal system performance is compared. The experimental data revealed that the addition of 2.0 weight percent of composite material showed superior system performance. Also, differential scanning calorimeter (DSC) and TEM analyses of the paraffin-based WCM-composite materials are conducted. The system achieved a heat gain of 87 kJ/min in comparison to 7 kJ/min for 2.0% WCM-PCM and pristine PCM, respectively. Hence, WCM-PCM embedded with waste stream nanoparticles could be suggested as a potential candidate for heating applications.

The attention of the research community is focused not only on waste elimination, but also on waste valorization. The natural marine biopolymer gel substance chitosan, which can be derived from the waste substances of marine life, is a polymer-matrix-based nanocomposite. Chitosan attracts special attention due to its potential applications, especially in wastewater treatment. In this regard, magnetite-incorporated chitosan powders of nanometer scale were synthesized by a simple co-precipitation method to attain the dual functions of chitosan gel and magnetite. The synthesized magnetite-incorporated chitosan nanopowders were verified using X-ray diffraction (XRD), Fourier-transform infrared (FTIR) spectroscopy, a vibrating-sample magnetometer (VSM), a scanning electron microscope (SEM), and transmission electron microscopy (TEM) images, which showed that the synthesized magnetite-incorporated chitosan was nanosized. The superior application of such a material to offset the deterioration of the environment caused by insecticides is attained through a photocatalytic reaction. The experimental results verified the function of magnetite-incorporated chitosan, since it increased the composite-specific surface area, resulting in high methomyl molecule oxidation. Methomyl oxidation reached almost complete insecticide removal (99%) within only one hour of irradiance time. The optimal operational conditions were investigated, and the maximal removal rate occurred when the aqueous solution was at an acidic pH of 3.0. The reaction was affected by differing hydrogen peroxide and catalyst doses, and the optimized reagent was recorded at the levels of 40 and 400 mg/L of catalyst and hydrogen peroxide, respectively. Also, catalyst reusability was attained, confirming its sustainability, since it could be used for successive cycles. From the current investigation, it is proposed that magnetite-chitosan nanoparticles could serve as a promising photocatalyst for the elimination of insecticides from wastewater in a green manner.

Background: Toxigenic fungi (Aspergillus and Fusarium) and their metabolites represent the major cause of corn and corn-based products contamination and consequently lead to severe economic and health issues., Aim: Our current study aimed to investigate the efficacy of using L. macroides Bac6 as a biological control agent against the toxigenic fungi; A. flavus f10 and F. proliferatum f30 and their mycotoxins., Results: The results illustrated that A. flavus f10 produced the aflatoxins AFB 1 and AFG 2 with concentrations of 21.239 and 13.593 ppb, respectively. While F. proliferatum f30 produced fumonisin B 1 (9600 ppb). Furthermore, L. macroides showed a high potential for inhibition of toxigenic fungal growth using a dual culture method. F. proliferatum f30 and A. flavus f10 were found to be inhibited by a percentage of 80 and 62.5%, respectively. The results were confirmed using the scanning electron microscope. The antagonistic bacteria, L. macroides, showed chitinase productivity and activity of 26.45 U/L and 0.12 U/mL/min, respectively, which illustrates its potential application as a biocontrol agent. The GC-MS analysis revealed an abundance of Pyrrolo[1,2-a] pyrazine-1,4-dione, Hexahydro in the bacterial supernatant that exhibited antifungal characteristics. L. macroides had a significant reduction of AFB 1 and AFG 2 produced by A. flavus f10, recording 99.25% and 99% inhibition, respectively. It also showed strong inhibition of fumonisin B 1 (90% inhibition) produced by F. proliferatum f30., Conclusion: Thus, the current study is a prospective study evaluating for the first time the potential impact of L. macroides Bac6 against the toxigenic fungi and their toxins., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Pyrogallol is widely used in several industrial applications and can subsequently contaminate aquatic ecosystems. Here, we report for the first time the presence of pyrogallol in wastewater in Egypt. Currently, there is a complete lack of toxicity and carcinogenicity data for pyrogallol exposure in fish. To address this gap, both acute and sub-acute toxicity experiments were conducted to determine the toxicity of pyrogallol in catfish (Clarias gariepinus). Behavioral and morphological endpoints were evaluated, in addition to blood hematological endpoints, biochemical indices, electrolyte balance, and the erythron profile (poikilocytosis and nuclear abnormalities). In the acute toxicity assay, it was determined that the 96 h median-lethal concentration (96 h-LC 50 ) of pyrogallol for catfish was 40 mg/L. In sub-acute toxicity experiment, fish divided into four groups; Group 1 was the control group. Group 2 was exposed to 1 mg/L of pyrogallol, Group 3 was exposed to 5 mg/L of pyrogallol, and Group 4 was exposed to 10 mg/L of pyrogallol. Fish showed morphological changes such as erosion of the dorsal and caudal fins, skin ulcers, and discoloration following exposure to pyrogallol for 96 h. Exposure to 1, 5, or 10 mg/L pyrogallol caused a significant decrease in hematological indices, including red blood cells (RBCs), hemoglobin, hematocrit, white blood cells (WBC), thrombocytes, and large and small lymphocytes in a dose-dependent manner. Several biochemical parameters (creatinine, uric acid, liver enzymes, lactate dehydrogenase, and glucose) were altered in a concentration dependent manner with short term exposures to pyrogallol. Pyrogallol exposure also caused a significant concentration-dependent rise in the percentage of poikilocytosis and nuclear abnormalities of RBCs in catfish. In conclusion, our data suggest that pyrogallol should be considered further in environmental risk assessments of aquatic species., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

There is a lack of reports describing ultrasonographic and histopathologic features of ocular diseases in donkeys. The present study aimed to document ultrasonographic and histopathologic changes associated with common ocular diseases in donkeys. The study included 45 donkeys (64 eyes) with ocular diseases that had reached the end of their working lives and requested to be used for educational and research purposes. Complete clinical, ophthalmic, ultrasonographic, gross pathologic and histopathologic examinations were included. Ocular abnormalities were documented, tabulated, and analyzed. Seventy-five ocular abnormalities were diagnosed with multiple involvements within the same eye including anterior uveitis (n = 13; 22.8%), cataract (n = 57; 76%), retinal detachment (n = 3; 4%), lens and phthisis bulbi (n = 2; 2.6%). Descriptive ultrasonographic findings of ocular abnormalities were included. Gross pathologic and histopathology findings confirmed the ultrasonography findings. Ultrasonography provided a clinically useful tool offering insight into detailed intraocular structures especially with opacification of the dioptric structures of the eye., (© 2023. The Author(s).)

Introduction: Domestic dogs and cats can be a source of human infection by a wide diversity of zoonotic pathogens including parasites. Genotyping and subtyping tools are useful in assessing the true public health relevance of canine and feline infections by these pathogens. This study investigated the occurrence, genetic diversity, and zoonotic potential of common diarrhea-causing enteric protist parasites in household dogs and cats in Egypt, a country where this information is particularly scarce., Methods: In this prospective, cross-sectional study a total of 352 individual fecal samples were collected from dogs ( n  = 218) and cats ( n  = 134) in three Egyptian governorates (Dakahlia, Gharbeya, and Giza) during July-December 2021. Detection and identification of Cryptosporidium spp., Giardia duodenalis , Enterocytozoon bieneusi , and Blastocystis sp. were carried out by PCR and Sanger sequencing. Basic epidemiological variables (geographical origin, sex, age, and breed) were examined for association with occurrence of infection by enteric protists., Results and Discussion: The overall prevalence rates of Cryptosporidium spp. and G. duodenalis were 1.8% (95% CI: 0.5-4.6) and 38.5% (95% CI: 32.0-45.3), respectively, in dogs, and 6.0% (95% CI: 2.6-11.4) and 32.1% (95% CI: 24.3-40.7), respectively, in cats. All canine and feline fecal samples analyzed tested negative for E. bieneusi and Blastocystis sp. Dogs from Giza governorate and cats from Dakahlia governorate were at higher risk of infection by Cryptosporidium spp. ( p  = 0.0006) and G. duodenalis ( p  = 0.00001), respectively. Sequence analyses identified host-adapted Cryptosporidium canis ( n  = 4, one of them belonging to novel subtype XXe2) and G. duodenalis assemblages C ( n  = 1) and D ( n  = 3) in dogs. In cats the zoonotic C. parvum ( n  = 5) was more prevalent than host-adapted C. felis ( n  = 1). Household dogs had a limited (but not negligible) role as source of human giardiasis and cryptosporidiosis, but the unexpected high frequency of zoonotic C. parvum in domestic cats might be a public health concern. This is the first molecular-based description of Cryptosporidium spp. infections in cats in the African continent to date. Molecular epidemiological data provided here can assist health authorities and policy makers in designing and implementing effective campaigns to minimize the transmission of enteric protists in Egypt., Competing Interests: The 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 © 2023 Elmahallawy, Gareh, Abu-Okail, Köster, Dashti, Asseri, Gouda, Mubaraki, Mohamed, Mohamed, Hassan, Elgendy, Hernández-Castro, Bailo, González-Barrio, Xiao and Carmena.)

Objective: Incidence of ulcerative colitis is globally increased. Enteric infections and their role in ulcerative colitis flares present a common health problem and a unique clinical challenge. We aimed to identify enteropathogens in flared ulcerative colitis patients and their antimicrobial susceptibilities and relation with the disease activity., Methods: Stool samples were collected from 95 patients with ulcerative colitis (17 inactive cases and 78 active cases) according to the Mayo score assessment of ulcerative colitis severity. Enteropathogens were examined using an automated VITEK2 system and FilmArray gastrointestinal pathogen panel., Results: Enteric infections were found in 81 patients (85.3%) with a significantly higher percentage in active ulcerative colitis (96.2% vs. 35.3%, P  < 0.001). In 78 symptomatic patients, (78.7%) of bacteria as enteroaggregative and enteropathogenic E. coli , (11.5%) parasitic as Cryptosporidium and (7.7%) viral as Norovirus were the most detected microbial pathogens. Mixed, multidrug-resistant organisms (MDROs) and opportunistic infections were reported in 70.7%, 52.9% and 46.7% respectively. Raoultella ornithinolytica was reported for the first time as an enteropathogen in ulcerative colitis flare. Multiple organisms, MDROs, extended-spectrum beta-lactamases-producing and AmpC-resistant bacteria were significantly associated with disease severity., Conclusion: Identifying enteropathogens especially opportunistic and MDR organisms as a cause of ulcerative colitis flare-ups is a matter of worry increasing their diagnostic and therapeutic burden. Periodic studies evaluating changes in microbial profiles and their antimicrobial susceptibilities are needed to achieve antibiotic stewardship and improve management., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

In the current study, fifty-eight Ingoldain fungal species assignable to forty-one genera were recovered from two water bodies receiving the treated sewage and the effluents of oils and soaps factory at Assiut Governorate (Upper Egypt), of which Anguillospora, Amniculicola, Flagellospora, and Mycocentrospora were the most prevalent genera. The most widespread identified species were Anguillospora furtive, Amniculicola longissima and Flagellospora fusarioides. Forty-three species were identified for the first time in Egypt. The most Ingoldain taxa were estimated for El-Zinnar canal, with the highest recorded taxa in winter. Whereas, the highest dominance of Ingoldian fungi was estimated for the El-Ibrahimia canal. The highest Simpson and Shannon diversity indexes were estimated for El-Zinnar canal samples recording 0.9683 and 3.741, respectively. The poorest water sites with Ingoldian fungi were those exposed directly to either treated sewage or industrial effluents, with which relatively higher values of water conductivity, cations and anions. Water temperature was the main abiotic factor driving the seasonal occurrence of Ingoldian fungi. It is interesting to isolate some Ingoldian fungal species from the stressful water sites receiving the effluents which provide valuable insights regarding their adaptation, predictive and putative role as bioindicators and their potentiality in pollutants degradation, organic decomposition, and transformation of xenobiotic compounds., (© 2023. The Author(s).)

The present study aimed to evaluate osteogenic potential and biocompatibility of combining biphasic calcium phosphate with zirconia nanoparticles (4Zr TCP/HA) compared to biphasic calcium phosphate (TCP/HA) for reconstruction of induced mandibular defects in dog model. TCP/HA and 4Zr TCP/HA scaffolds were prepared. Morphological, physicochemical, antibacterial, cytocompatibility characterization were tested. In vivo application was performed in 12 dogs where three critical-sized mandibular defects were created in each dog. Bone defects were randomly allocated into: control, TCP/HA, and 4Zr TCP/HA groups. Bone density and bone area percentage were evaluated at 12 weeks using cone-beam computed tomographic, histopathologic, histomorphometric examination. Bone area density was statistically increased (p < 0.001) in TCP/HA and 4Zr TCP/HA groups compared to control group both in sagittal and coronal views. Comparing TCP/HA and 4Zr TCP/HA groups, the increase in bone area density was statistically significant in coronal view (p = 0.002) and sagittal view (p = 0.05). Histopathologic sections of TCP/HA group demonstrated incomplete filling of the defect with osteoid tissue. Doping with zirconia (4Zr TCP/HA group), resulted in statistically significant increase (p < 0.001) in bone formation (as indicated by bone area percentage) and maturation (as confirmed by Masson trichrome staining) compared to TCP/HA group. The newly formed bone was mature and organized with more trabecular thickness and less trabecular space in between. Physicochemical, morphological and bactericidal properties of combining zirconia and TCP/HA were improved. Combining zirconia and TCP/HA resulted in synergistic action with effective osteoinduction, osteoconduction and osteointegration suggesting its suitability to restore damaged bone in clinical practice., (© 2023. The Author(s).)

Background: Cardiopulmonary resuscitation (CPR) is an essential skill required by critical care nurses. Evidence has shown that the use of a novel method called simulation-based flipped classroom (SBFC) can save training time in nursing laboratories and, to some extent, enhance social distancing during the current COVID-19 pandemic., Aim: To evaluate the effects of SBFC on nursing students' acquisition of CPR skills., Study Design: A two-parallel prospective, single-centre, simulation-based, randomized, controlled trial., Methods: The total sample size was 326 students. A CPR video was recorded and uploaded on Microsoft Teams channel for the SBFC group only. Thereafter, both groups demonstrated and redemonstrated the CPR procedure. Both groups were then compared according to the simulation experience satisfaction scale and CPR skills acquisition checklist., Results: Two equally randomly selected groups of 163 undergraduate nursing students completed the study. The SBFC group had a significantly better satisfaction with the simulation experience than the traditional simulation (TS) group (p = 0.03). As regards the mean score of the CPR checklist after simulation, the SBFC group had a significantly higher score than TS group (p = 0.01)., Conclusions: SBFC using a pre-recorded video can be an effective method that can reduce the time needed for CPR clinical simulation and can be used for the CPR simulation among critical care nurses., Relevance to Clinical Practice: This study provides critical care nursing educators with a deep understanding regarding the benefits and value of utilizing the SBFC method in the clinical training of CPR skills. SBFC can be used to increase critical care nurses' satisfaction and skill acquisition during CPR training., (© 2022 British Association of Critical Care Nurses.)

Background: The production of biopolymers from waste resources is a growing trend, especially in high-population countries like Egypt. Beta-glucan (β-glucan) belongs to natural polysaccharides that are derived from plant and microbial origins. In this study, following increasing demands for β-glucan owing to its bioactive properties, a statistical model to enhance microbial β-glucan production was evaluated for its usefulness to the food and pharmaceutical industries. In addition, a trial to convert β-glucan polymer to nanostructure form was done to increase its bioactivity., Results: Ingredients of low-cost media based on agro-industrial wastes were described using Plackett-Burman and central composite design of response surface methodology for optimizing yeast β-glucan. Minerals and vitamin concentrations significantly influenced β-glucan yield for Kluyveromyces lactis and nitrogen and phosphate sources for Meyerozyma guilliermondii. The maximum predicted yields of β-glucan recovered from K. lactis and M. guilliermondii after optimizing the medium ingredients were 407 and 1188 mg/100 ml; respectively. For the first time, yeast β-glucan nanoparticles (βGN) were synthesized from the β-glucan polymer using N-dimethylformamide as a stabilizer and characterized using UV-vis spectroscopy, transmission electron microscope (TEM), dynamic light scattering (DLS) and Fourier transform infrared spectroscopy (FT-IR). The average size of βGN was about 300 nm as determined by DLS. The quantitative variation of functional groups between β-glucan polymer and βGN was evaluated by FT-IR for explaining the difference in their biological activity against Normal Homo sapiens-Hela contaminant and Hepatic cancer cell lines., Conclusions: Enriching the low-cost media based on agro-industrial wastes with nutritional ingredients improves the yield of yeast β-glucan. The present study succeeds to form β-glucan nanoparticles by a simple method., (© 2023. The Author(s).)

Doxorubicin (DOX) is a potent anticancer drug with adverse cardiotoxic effects. Alginates are multifunctional biopolymers and polyelectrolytes derived from the cell walls of brown seaweeds. They are nontoxic, biocompatible, and biodegradable, and hence, utilized in several biomedical and pharmaceutical applications. Here, we investigated the potential cardioprotective effect of thermally treated sodium alginate (TTSA), which was extracted and purified from the seaweed Sargassum aquifolium, in treating acute DOX cardiotoxicity and apoptotic pathways in rats. UV-visible spectroscopy, Fourier-transform infrared, and nuclear magnetic resonance ( 1 H-NMR) spectroscopy techniques were used to characterize TTSA. CK-MB and AST levels in sera samples were determined. The expression levels of Erk-2 (MAPK-1) and iNOS genes were investigated by quantitative real-time polymerase chain reaction (qRT-PCR). The protein expression levels of Erk-2, anti-apoptotic p53, and caspase-3 were analyzed using western blotting and ELISA. For the in vivo studies, sixty rats were randomly divided equally into six groups and treated with DOX, followed by TTSA. We revealed that treatment with TTSA, which has low molecular weight and enhanced antioxidant properties, improved DOX-mediated cardiac dysfunction and alleviated DOX-induced myocardial apoptosis. Furthermore, TTSA exhibited a cardioprotective effect against DOX-induced cardiac toxicity, indicated by the increased expression of MAPK-1 (Erk2) and iNOS genes, which are implicated in the adaptive responses regulating DOX-induced myocardial damage. Moreover, TTSA significantly (p < 0.05) suppressed caspase-3 and upregulated anti-apoptotic protein p53 expression. TTSA also rebalanced the cardiomyocyte redox potential by significantly (p < 0.05) increasing the levels of endogenous antioxidant enzymes, including catalase and superoxide dismutase. Our findings suggest that TTSA, particularly at a dose of 400 mg/kg b.w., is a potential prophylactic supplement for treating acute DOX-linked cardiotoxicity., (© 2023. The Author(s).)

The study evaluated the antitumor efficacy of APAN, "synthesized indoloquinoline analog derived from the parent neocryptolepine isolated from the roots of Cryptolepis sanguinolenta ", versus the chemotherapeutic drug etoposide (ETO) in Ehrlich solid tumor (EST)-bearing female mice as well as its protective effect against etoposide-triggered hepatic disorders. APAN showed an ameliorative activity against Ehrlich solid tumor and hepatic toxicity, and the greatest improvement was found in the combined treatment of APAN with ETO. The results indicated that EST altered the levels of tumor markers (AFP, CEA, and anti-dsDNA) and liver biomarker function (ALT, AST, ALP, ALB, and T. protein). Furthermore, EST elevated CD68 and anti-survivin proteins immuno-expressions in the solid tumor and liver tissue. Molecular docking studies were demonstrated to investigate their affinity for both TNF-α and topoisomerase II as target proteins, as etoposide is based on the inhibition of topoisomerase II, and TNF-α is quite highly expressed in the solid tumor and liver tissues of EST-bearing animals, which prompted the authors' interest to explore APAN affinity to its binding site. Treatment of mice bearing EST with APAN and ETO nearly regularized serum levels of the altered parameters and ameliorated the impact of EST on the tissue structure of the liver better than that by treatment with each of them separately.

Background: The coronavirus disease 2019 (COVID-19) pandemic directly affects the psychological well-being of critical care nurses. Several studies had investigated the psychological impact of the pandemic on nurses caring for patients with COVID-19, but few were conducted to identify the predictors of this impact., Aims: The objective of this study is to identify the predictors of critical care nurses' stress, anxiety, and depression in response to the COVID-19 pandemic., Design: A cross-sectional survey was conducted in five intensive care units in five hospitals in Alexandria, Egypt., Methods: An online questionnaire was distributed. It included socio-demographic and work-related data and the depression, anxiety, and stress scale scores of the nurses under study. A multiple linear regression model was developed to identify the predictors of critical care nurses' stress, anxiety, and depression in response to the COVID-19 pandemic., Results: Two hundred (64%) of 308 nurses completed the electronic questionnaire. Significant predictors of stress included the number of infected colleagues (P < .001) and availability of hospital resources (P = .01). Significant predictors of anxiety were age, gender, satisfactory income (P < .001), years of experience, time spent caring for patients with COVID-19 (P = .04), continuous training, number of infected colleagues (P = .01), and availability of hospital resources (P = .02). Finally, significant predictors of depression included gender, history of physical problems (P = .04), educational attainment, availability of hospital resources, history of psychological problems (P < .001), and number of infected colleagues (P = .001)., Conclusion: The hospital's lack of human and physical resources and the number of colleagues infected with COVID-19 were the strongest predictors of stress, anxiety, and depression among nurses., Relevance to Clinical Practice: Identifying the predictors of stress, anxiety, and depression among nurses who care for patients with COVID-19 is a vital step in developing mental health promotion strategies to support nurses during this pandemic., (© 2021 British Association of Critical Care Nurses.)

Background: Hepatocellular Carcinoma (HCC) is a universal health problem responsible for 8.2% of all cancer deaths. Numerous risk factors were documented to be contributed to HCC development with viral hepatitis C ranking as the major predisposing factor in Egypt. The presence of a detectable amount of long noncoding RNAs (lncRNAs) in the circulation is linked to the development and spread of tumors. LncRNAs NBAT-1 and FOXCUT expression levels were used as genetic markers for the detection of gastrointestinal tract cancers. We hypothesized that serum expression levels of NBAT-1 and FOXCUT are new biomarkers for HCC that are related to laboratory and pathological markers., Patients and Methods: This study included 165 hepatitis C virus (HCV)-related HCC Egyptian patients, 180 HCV-infected noncancer patients, and 180 healthy controls, the serum expression levels of NBAT-1 and FOXCUT were measured by using quantitative real-time polymerase chain reaction., Results: This study's results include that medians (inter-quartile range [IQRs]) of NBAT-1 in HCC and HCV patients were (1.9 [0.87-4.94], 10.01 [7.34-13.29] respectively) which exhibited significantly higher expression than controls, while the medians (IQRs) of FOXCUT in HCC and HCV patients were (0.15 [0.04-0.52], 6.42 [2.49-10.10], respectively) that exhibited significantly lower expression than controls regarding HCC patients but significantly higher expression than controls regarding HCV patients. In comparing serum fold changes of NBAT-1 and FOXCUT between HCC patients and HCV patients; we obtained significantly higher levels of target genes in HCV patients (p < 0.001) than in HCC patients. Also, a positive correlation was detected between NBAT-1 and FOXCUT in HCC group (r = 0.262, p = 0.001) and in HCV group (r = 0.937, p < 0.001). Higher serum NBAT-1 and FOXCUT were significantly associated with better clinical and laboratory data of the disease. Multivariate regression analysis showed that FOXCUT was an independent predictor for HCC among HCV patients (p < 0.001)., Conclusion: Our study cited that NBAT-1 and FOXCUT could be considered new diagnostic serum biomarkers for HCC on top of HCV., (© 2022 Wiley Periodicals LLC.)

Background: Alopecia areata is an autoimmune condition that causes non-scarring hair loss. To date, there is no single cure and treatment remains challenging., Objectives: To evaluate the efficacy of Jessener solution versus intralesional steroid in treatment of Alopecia Areata., Methods: This study included 40 patients who presented with multifocal patchy alopecia areata (AA). For each patient, three patches were randomly selected to be treated one with intralesional steroid, another with topical Jessner solution and the third with normal saline. Three sessions were done 3 weeks apart and were followed up for 3 months. Response was assessed clinically and by trichoscope., Results: Fifteen percent of patches coated with Jessner or injected with steroids showed an excellent response while 20% of patches coated with Jessner and 32.5% patches injected with steroids showed a good response. A significant difference was observed between the three modalities of treatment regarding the prognostic score for response (p < 0.001) as patches coated with Jessner and those steroid injected showed a significant higher response rate than patches injected with saline (p < 0.001) while no significant difference was reported between patches either treated with Jessner or steroids (p > 0.05)., Conclusion: Jessners solution can be a novel and feasible and well tolerated modality of treatment for patients suffering from alopecia areata., (© 2022 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

In this study, we utilized pomegranate peel and marine algae Ulva lactuca (U. lactuca) as rich and sustained sources of bioactive compounds to combat tomato-black spot disease. n-Hexane extracts from the peel of pomegranate (Punica granatum) (PPE) and the marine algal biomass U. lactuca (ULE) were used alone and in combinations to verify their impact against Alternaria alternata (A. alternata). The applied extracts exhibited severe destructive effects on both fungal growth and structure such as mycelia malformation, underdeveloped conidia, cell wall deformation, and shrinkage. Moreover, increased deformations and protrusions, and notch-like structures, were noticed in A. alternata mycelia treated with mixed extracts (PPE and ULE) compared to all other treatments. The protein and reduced sugar contents in tomato fruits were significantly increased in the infected fruits with A. alternata. The highest enzyme activities of pectinase, cellulase, catalase (CAT), and ascorbate peroxidase (APX) were recorded in infected tomatoes in comparison with the healthy ones. Molecular docking studies showed that each extract is rich with bioactive compounds that have a promising inhibition effect on A. alternata cellulases. Pomegranate and Ulva extract showed promising antifungal activity against A. alternata which revealed their feasibility and applicability as biocontrol agents in postharvest disease management and food preservation against fungal pathogens., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: COVID- 19 vaccines have been released, giving a major hope of getting rid of the dark pandemic crisis. The availability of vaccines does not necessarily mean that the mass vaccination program is a success. We aimed to investigate COVID-19 vaccination knowledge level, acceptance rate, and perception state among Egyptians., Methods: An analytical cross-sectional online survey was carried out utilizing a selfadministered adult questionnaire that assesses vaccination acceptance with related sociodemographic factors and perceptions based on health belief model perspectives. Predictors of vaccination acceptance were based on logistic regression analysis., Results: We analyzed data for 957 participants, aged 18-78 years, 55.7% were females, and 66.9% were healthcare workers (HCWs). About one-fourth had a history of confirmed COVID-19 infection and 56.5% would accept to have one of the COVID-19 vaccines, where "Pfizer" was the preferable one (37.8%), while "AstraZeneca" was the most rejected vaccine (26.8%). The 1st vaccine dose was received by 273 (28.5%) of which 260 were intended to receive the 2nd dose. Vaccine efficacy, side effects, protection time, and administration route were essentially among the factors that may influence their decision to accept COVID-19 vaccines. About 83.1% had good knowledge about vaccination which was significantly higher with increased age, among graduates/professionals, governmental workers, HCWs in addition to those able to save/invest money, had a history of confirmed COVID-19 infection and intending to have COVID-19 vaccine. Perceptions that vaccination decreases the chance of getting COVID-19 or its complications (OR = 9.28; CI: 5.03-17.12), vaccination makes less worry about catching COVID-19 (OR = 6.76; CI: 3.88-11.76), and being afraid of getting COVID-19 (OR = 2.04; CI: 1.26-3.31) were strong significant predictors for vaccine acceptance., Conclusion: Vaccine campaigns should emphasize vaccine benefits and highlight the severity of infection while addressing barriers to vaccination in order to improve vaccine coverage among populations., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Monitoring oxygen saturation in shocked patients is a challenging nursing procedure. Shock syndrome alters peripheral tissue perfusion and hinders peripheral capillary oxygen saturation (SpO2) measurements. Our study aimed to find a solution to this problem. The pharynx is expected to be an accurate SpO2 measurement site in shocked patients. We clinically evaluated the pharyngeal SpO2 measurements against the arterial oxygen saturation (SaO2) measurements., Methods: A prospective cohort research design was used. This study included 168 adult shocked patients. They were admitted to five intensive care units from March to December 2020 in an Egyptian hospital. A wrap oximeter sensor was attached to the posterior surface of an oropharyngeal airway (OPA) by adhesive tape. The optical component of the sensor adhered to the pharyngeal surface after the OPA insertion. Simultaneous pharyngeal peripheral capillary oxygen saturation (SpO2) and arterial oxygen saturation (SaO2) measurements were recorded. The pharyngeal SpO2 was clinically evaluated. Also, variables associated with the SpO2 bias were evaluated for their association with the pharyngeal SpO2 bias., Results: The pharyngeal SpO2 bias was - 0.44% with - 1.65 to 0.78% limits of agreement. The precision was 0.62, and the accuracy was 0.05. The sensitivity to detect mild and severe hypoxemia was 100%, while specificity to minimize false alarm of hypoxemia was 100% for mild hypoxemia and 99.4% for severe hypoxemia. None of the studied variables were significantly associated with the pharyngeal SpO2 bias., Conclusion: The pharyngeal SpO2 has a clinically acceptable bias, which is less than 0.5% with high precision, which is less than 2%., (© 2022. The Author(s).)

Objectives: Sarcopenia is a common entity in cirrhosis with significant morbidity and mortality. However,the effects of sarcopenia on the risk of complications and survival after liver transplant remain controversial.We aimed to evaluate the effect of sarcopenia on survival and complications after liver transplant., Materials and Methods: Our study cohort included 61 adult patients with hepatitis C-related cirrhosis who underwent living donor liver transplant. Pretransplant clinical and anthropometric assessments included body mass index, hand grip, mid-arm circumference, triceps skin fold thickness, and gait speed. Sarcopenia was determined by computed tomography using the skeletal muscle index at the third lumbar vertebra cut-off value of <38.5 cm2/m2 for women and <52.4 cm2/m2 for men; these patients were then followed up for 6 months after transplant to determine survival and complications., Results: At time of liver transplant, sarcopenia was present in 27/61 patients (44.3%). At follow-up after transplant, sarcopenia was found in 14 patients (30.4%) among 46 survivors; all patients who survived were male patients. Among patients with sarcopenia posttransplant, 12 had sarcopenia before transplant and 2 developed sarcopenia after transplant. Liver dysfunction, lower triceps skin fold thickness, recent infections, and sarcopenia pretransplant were associatedwithposttransplant complications, especially infection(42.8%) and prolonged intensive careunit stay. Age and pretransplant sarcopenia were found to be independent predictors of posttransplant mortality., Conclusions: Sarcopenia is a common entity in patients with cirrhosis who are on liver transplant wait lists and may continue after liver transplant. De novo sarcopenia after liver transplant is also a common finding. Sarcopenia can affect patient outcomes, including prolonged intensive care unit stay and poor short-term survival.

Objective: To evaluate bioactivity and osteogenic potential of calcium silicate (CS)-doped iron oxide (Fe 2 O 3 ) nanoparticles versus pure CS in the reconstruction of induced critical-sized mandibular defects., Design: CS-doped Fe 2 O 3 was prepared; morphological and microstructure identification of nanoparticles were made. An in vivo randomised design was developed on 24 adult male dogs where four critical-sized mandibular defects were created in each dog. Bone defects were allocated into control, CS, CS-3% Fe 2 O 3 and CS-10% Fe 2 O 3 group. Dogs were euthanized at 1 and 3 months (12 dog/time) for histopathologic and histomorphometric evaluation., Results: At three months, bone formation and maturation were evident where mean ± SD percent of mature bone was 2.66 ± 1.8, 9.9 ± 2.5, 22.9 ± 4.9, and 38.6 ± 8.1 in control, CS, CS-3% Fe 2 O 3 , and CS-10% Fe 2 O 3 groups respectively. A high significant ( P  < 0.001) increase in area percent of mature bone was recorded in CS, CS-3% Fe 2 O 3 , and CS- 10% Fe 2 O 3 groups compared to control group (73%, 88% and 93.3% respectively). Significant increase ( P  < 0.001) in area of mature bone was recorded in CS-3% Fe 2 O 3 and CS-10% Fe 2 O 3 groups compared to CS group. A significant increase ( P  < 0.001) in area of mature bone formation was detected in CS-10% Fe 2 O 3 group compared to other groups., Conclusion: CS-doped Fe 2 O 3 has good osteoconductive, biocompatible properties with promoted bone regeneration. Fe 2 O 3 has synergistic effect in combination with CS to promote bone formation. Increasing concentration of Fe 2 O 3 nanoparticles resulted in improved osteogenesis and maturation. Results suggests that the novel CS-Fe 2 O 3 alloplasts could be used for reconstruction of critical-sized bone defects., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Background: Insulin-like growth factor-1 (IGF-1) is structurally similar to insulin and acts as an endocrine hormone secreted by the liver., Objective: Production of recombinant human IGF-1 (rhIGF-1) in Escherichia coli (E.coli) and evaluation of its proliferation stimulatory activity., Methods: hIGF-1 gene cloned into pBSK (+) simple vector was transformed into TOP 10 chemically competent cells of E. coli . Polymerase chain reaction (PCR) was achieved using specific hIGF-1 gene primers to confirm the successful transformation. To express the rhIGF-1 in E. coli (Rosetta (DE3) pLysS); the hIGF-1 gene was cloned into the pET-15b expression vector and then the recombinant pET-15b/IGF-1 vector was transformed into a chemically prepared competent expression bacterial cells; Rosetta (DE3) pLysS. The rhIGF-1 was expressed as insoluble aggregates called inclusion bodies (IBs) using a 2 mM Isopropyl β-D-1-thiogalactopyranoside (IPTG) inducer. IBs were solubilized in a denatured form using 6 M guanidinium hydrochloride (GdmCl), followed by in vitro protein refolding using the rapid dilution method. The refolded hIGF-1 was purified using the HiTrap- ANX anion exchange column. Western blot and ELISA using rabbit polyvalent anti-hIGF- 1 were performed to confirm the protein antigenic identity. Cell proliferation activity of rhIGF-1 was testified on normal human lung cell line (WI-38)., Results: rhIGF-1 was purified from the HiTrap-ANX column at a concentration of 300 μg/ml. Western blot showed a single 7.6 kDa band obtained in the induced Rosetta (DE3) pLYsS. ELISA confirmed the molecular identity of the rhIGF-1 epitope, the concentration of purified rhIGF-1 obtained from the ELISA standard curve using rhIGF-1 reference protein as a standard was 300 μg/ml, and activity on WI-38 cells was 2604.17I U/mg., Conclusion: Biologically active native rhIGF-1 protein was successfully expressed. Patents related to the preparation of IGF-1 were mentioned along the text., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Instead of ventilator-associated pneumonia (VAP), the modern definition of ventilator-associated events (VAEs) has been introduced to identify infectious and noninfectious respiratory complications. Some studies revealed that compliance to the ventilator bundle is associated with decreased occurrence of VAP, but little is known about its association with the decrease of VAEs occurrence., Methods: A prospective cohort research design was used. Data were collected over eight months from May 2019 to February 2020 in five general intensive care units. The researchers assessed the compliance to ventilator care bundle using the Institute for Healthcare Improvement ventilation bundle checklist. Mechanically ventilated patients were prospectively assessed for the occurrence of VAEs using a pre-validated calculator from the Centers for Disease Control and Prevention. All are non-invasive tools and no intervention was done by the authors., Results: A total of 141 mechanically ventilated patients completed the study. The odds ratio of having VAEs in patients who received ventilator bundle was -1.19 (95% CI, -2.01 to -0.38), a statistically significant effect, Wald χ2(1) = 8.18, p = 0.004., Conclusion/ Implications for Practice: Ventilator bundle compliance was associated with a reduced risk for VAEs occurrence. Nurses should comply with the ventilator bundle because it is associated with decreased VAEs occurrence., (© 2022. The Author(s).)

Introduction: COVID-19 severity and mortality predictors could determine admission criteria and reduce mortality. We aimed to evaluate the clinical-laboratory features of hospitalized patients with COVID-19 to develop a novel score of severity and mortality., Methodology: This retrospective cohort study was conducted using data from patients with COVID-19 who were admitted to five Egyptian university hospitals. Demographics, comorbidities, clinical manifestations, laboratory parameters, the duration of hospitalization, and disease outcome were analyzed, and a score to predict severity and mortality was developed., Results: A total of 1308 patients with COVID-19, with 996 (76.1%) being moderate and 312 (23.9%) being severe cases, were included. The mean age was 46.5 ± 17.1 years, and 61.6% were males. The overall mortality was 12.6%. Regression analysis determined significant predictors, and a ROC curve defined cut-off values. The COVEG severity score was defined by age ≥ 54, D-dimer ≥ 0.795, serum ferritin ≥ 406, C-reactive protein ≥ 30.1, and neutrophil: lymphocyte ratio ≥ 2.88. The COVEG mortality score was based on COVEG severity and the presence of cardiac diseases. Both COVEG scores had high predictive values (area under the curve 0.882 and 0.883, respectively)., Conclusions: COVEG score predicts the severity and mortality of patients with COVID-19 accurately., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2022 Mohamed El-Kassas, Maha El Gaafary, Mohamed Elbadry, Mohamed Ahmed Medhat, Hany Dabbous, Essam Ali Hassan, Ahmed Abdelmoaty, Haidi Karam-Allah, Hamdy Sayed, Amr Abdalazeem, Ahmed Fouad Sherief, Eman Fares, Maha Alsadik, Ehab Moustafa, Wagida Anwar, Hossam Abdelghaffar, Khaled Abdelghaffar.)