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Abstract Background The final decision to fast or not fast for routine lipid profile examination in a standard, healthy population is unclear. Whereas the United States and European protocols state that fasting for regular lipid analysis is unnecessary, the North American and Chinese guidelines still recommend fasting before routine lipid testing. Aim This study aimed to unravel the contradiction between the different protocols of lipid profile testing worldwide and clarify the effect of diet on lipid profile testing only in a regular, healthy population. Methods A literature search was conducted through May 2024. The analyses included studies performed from the date 2000 until now because the contradiction of guidelines for lipid profile testing appeared for the first time in this period. A planned internal validity evaluation was performed using the National Institute of Health (NIH) quality measurement tools for observational cohort, case‒control, controlled interventional, and cross-sectional studies. The data were synthesized according to RevMan 5.3. Results Eight studies with a total of 244,665 participants were included. The standardized mean difference in cholesterol in six studies showed significant differences in overall effect among fasting and nonfasting states (P

Primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is a very rare presentation of MALT lymphoma. The presence of a completely negative autoimmune and inflammatory background makes it a real challenge and very rare presentation (probably the second reported case in the literature). We report a case of primary pulmonary MALT lymphoma with negative autoimmune background, demonstrating as multifocal bulky variceal masses causing significant clinical symptoms.

An ultra-wideband patch antenna (UWB) that makes use of tapered slot technology is designed and analyzed in this article. Coplanar waveguide feeds the projected antenna. The presented antenna displayed superior UWB performances with -10 dB return-loss bandwidth, ranging from 1.9 to 12 GHz. The projected slot antenna has another benefit of minimizing the interference effect of the narrow band communications conducted by two notch bands operating at 3.3–3.8 GHz (WiMAX) and 5.1-6 GHz (WLAN and HIPERLAN/2), respectively. The Dual-Bands rejection is generated by etching out a complementary split ring resonator (CSRR) from the patch and placing a trapezoidal split ring resonator (TSRR). Adaptable single or dual-band rejection characteristics have been added to the behavior of the UWB antenna, by mounting electronic switching across SRR and CSRR. Furthermore, the presented UWB slot antenna is printed on an FR4-epoxy substrate (εr = 4.4) and it has an overall size of . 55x48x1.5 mm3

Abstract Background and Objective Genetic and epigenetic changes characterize the multi-step process of breast carcinogenesis. It is believed that abnormal microRNA (miRNA) expression has a role in the onset and progression of breast cancer. This study aimed to examine the link between miRNA-127 and miRNA-138 and metastasis, tumor invasion, and apoptosis in Egyptian women with breast cancer, as well as their correlation with its molecular types. Methodology A total of 150 participants were included in this study, including 75 women with breast cancer and 75 supposedly healthy women who were age and gender-matched. Every patient underwent a thorough physical examination, a general clinical examination, a mammogram, and lab tests, such as the determination of the levels of miRNA-127 and miRNA-138 expression by real-time PCR and the measurement of blood carcinoembryonic antigen (CEA) and carcinoma antigen 15–3 (CA15-3) and CA15-3 and CEA levels. Results There was a significant low expression of miRNA-127 in favor of high TNM stage (Classification of Malignant Tumors), left-sided tumor, metastasis, high-grade disease, increased axillary nodal involvement, absence of estrogen and progesterone receptors, and low antigen Kiel 67 (Ki67) expression. Also, a significant expression of miRNA 127 in triple-negative breast cancer was found, followed by human epidermal growth factor receptor 2 (HER2/neu) overexpression, then luminal B, and the highest expression was with the Luminal A molecular subtype. A significant negative correlation existed between miRNA 127 and miRNA 138 with CEA and CA15.3 levels. Conclusion The miRNA-127 and miRNA-138 suppression may promote metastasis. Consequently, the restoration of miRNA-127 and miRNA-138 in breast cancer may have therapeutic potential; so, the miRNA-127 and miRNA-138 may play a role in breast cancer development.

The thrombopoietin receptor (MPL) gene is a critical regulator of hematopoiesis, and any alterations in its structure or function can result in a range of hematological disorders. Non-synonymous single nucleotide polymorphisms (nsSNPs) in MPL have the potential to disrupt normal protein function, prompting our investigation into the most deleterious MPL SNPs and the associated structural changes affecting protein–protein interactions. We employed a comprehensive suite of bioinformatics tools, including PredictSNP, InterPro, ConSurf, I-Mutant2.0, MUpro, Musitedeep, Project HOPE, STRING, RegulomeDB, Mutpred2, CScape, and CScape Somatic, to analyze 635 nsSNPs within the MPL gene. Among the analyzed nsSNPs, PredictSNP identified 28 as significantly pathogenic, revealing three critical functional domains within MPL. Ten of these nsSNPs exhibited high conservation scores, indicating potential effects on protein structure and function, while 14 were found to compromise MPL protein stability. Although the most harmful nsSNPs did not directly impact post-translational modification sites, 13 had the capacity to substantially alter the protein’s physicochemical properties. Some mutations posed a risk to vital protein–protein interactions crucial for hematological functions, and three non-coding region nsSNPs displayed significant regulatory potential with potential implications for hematopoiesis. Furthermore, 13 out of 21 nsSNPs evaluated were classified as high-risk pathogenic variants by Mutpred2. Notably, amino acid alterations such as C291S, T293N, D295G, and W435C, while impactful on protein stability and function, were deemed non-oncogenic “passenger” mutations. Our study underscores the substantial impact of missense nsSNPs on MPL protein structure and function. Given MPL’s central role in hematopoiesis, these mutations can significantly disrupt hematological processes, potentially leading to a variety of disorders. The identified high-risk pathogenic nsSNPs may hold promise as potential biomarkers or therapeutic targets for hematological diseases. This research lays the foundation for future investigations into the MPL gene’s role in the realm of hematological health and diseases.

Abstract The breakthrough infection following COVID-19 vaccination has been a subject of concern recently. Evidence suggests that COVID-19 vaccine efficacy diminishes over time due to multiple factors related to the host, and vaccine. Coinfection with other pathogens was claimed earlier as a contributing cause for this phenomenon. Hence, we aimed to stratify the association of post-COVID-19 vaccination breakthrough coinfection with Toxoplasma gondii (T. gondii) and its impact on disease severity. This cross-sectional study included 330 COVID-19-vaccinated patients confirmed by RT-PCR. They were also screened for anti- T. gondii antibodies using ELISA. Toxoplasma seropositive cases’ whole blood was screened for DNA using PCR to correlate results with COVID-19 severity. Out of 330 COVID-19 vaccinated patients with breakthrough infection, 34.5% (114 patients) showed positivity for Toxoplasma IgG by ELISA, and none of the cases was IgM positive. Eleven patients (9.6%) of the IgG-positive cases were positive by PCR. Positive PCR cases correlated positively with the Toxoplasma IgG titer (P

Background and Aim. Hepatitis B virus (HBV) infection causes a variety of clinical manifestations, including liver cirrhosis and hepatocellular carcinoma (HCC). Toll-like receptors (TLRs) have crucial functions in immune and inflammatory control. Therefore, this study highlights the impact of TLR2 gene polymorphism on the progression of HBV-linked liver diseases (liver cirrhosis and HCC). Methods. In total, 170 chronic HBV patients and 50 healthy controls of comparable age and gender were included in this case-control study. Clinical, laboratory, and imaging evaluations were conducted. ELISA was used to determine serum IL-6 levels, and TLR2 (rs3804099) genotyping allelic discrimination assay was performed using real-time PCR. Results. IL-6 values were significantly higher in the HCC group, followed by the cirrhotic group, than those in chronic hepatitis and control groups (p

BackgroundAfter its emergence in China, the coronavirus SARS-CoV-2 has swept the world, leading to global health crises with millions of deaths. COVID-19 clinical manifestations differ in severity, ranging from mild symptoms to severe disease. Although perturbation of metabolism has been reported as a part of the host response to COVID-19 infection, scarce data exist that describe stage-specific changes in host metabolites during the infection and how this could stratify patients based on severity.MethodsGiven this knowledge gap, we performed targeted metabolomics profiling and then used machine learning models and biostatistics to characterize the alteration patterns of 50 metabolites and 17 blood parameters measured in a cohort of 295 human subjects. They were categorized into healthy controls, non-severe, severe and critical groups with their outcomes. Subject's demographic and clinical data were also used in the analyses to provide more robust predictive models.ResultsThe non-severe and severe COVID-19 patients experienced the strongest changes in metabolite repertoire, whereas less intense changes occur during the critical phase. Panels of 15, 14, 2 and 2 key metabolites were identified as predictors for non-severe, severe, critical and dead patients, respectively. Specifically, arginine and malonyl methylmalonyl succinylcarnitine were significant biomarkers for the onset of COVID-19 infection and tauroursodeoxycholic acid were potential biomarkers for disease progression. Measuring blood parameters enhanced the predictive power of metabolic signatures during critical illness.ConclusionsMetabolomic signatures are distinctive for each stage of COVID-19 infection. This has great translation potential as it opens new therapeutic and diagnostic prospective based on key metabolites.

Cadmium is an extremely dangerous heavy metal that can lead to disastrous consequences in all organisms. Several natural remedies reduce the toxicities of experimentally generated metals in animals. Strawberry Fragaria ananassa contains several bioactive compounds that may mitigate heavy-metal toxicity. The study aim was to evaluate the ability of a strawberry fruit methanol extract (SE) to reduce Cd toxicity and to identify and quantify the active constituents of SE. Forty Wistar rats were classified into four groups: the control group– 1 ml saline IP; SE group– 100 mg of SE/kg rats orally; cadmium (Cd) group–2 mg CdCl2/kg body weight/IP daily; and treated group– SE given 1 hour before Cd administration. Administration of Cd induced several histopathological and immunohistochemical alterations in lung sections. Biochemical analysis of lung homogenates and mRNA levels of antioxidants and inflammatory cytokines indicated significant changes to the risk profile. SE administration significantly decreased the oxidative stress, inflammation, tissue damage, the mean area percentage of collagen fibers, and positive immuno-expressions of TNF-α and NF-κB induced by CdCl2. Moreover, the MDA, TNF-α, GM-CSF, and IL-1β levels in Cd-exposed rat lung tissue were significantly lower in the SE-treated group than in the Cd-group. SE significantly augmented lung GSH, SOD, HO‐1, GPx-2, and Nrf2 levels in Cd-exposed rats. SE mitigated Cd-caused oxidative stress and lung inflammation. Therefore, regularly consuming a strawberry-rich diet could benefit general health and help prevent and treat diseases.

Treatment strategies for steatohepatitis are of special interest given the high prevalence of obesity and fatty liver disease worldwide. This study aimed to investigate the potential therapeutic mechanism of L-carnitine (LC) and Ginkgo biloba leaf extract (GB) supplementation in ameliorating the adverse effects of hyperlipidemia and hepatosteatosis induced by a high-cholesterol diet (HCD) in an animal model. The study involved 50 rats divided into five groups, including a control group, a group receiving only an HCD, and three groups receiving an HCD along with either LC (300 mg LC/kg bw), GB (100 mg GB/kg bw), or both. After eight weeks, various parameters related to lipid and glucose metabolism, antioxidant capacity, histopathology, immune reactivity, and liver ultrastructure were measured. LC + GB supplementation reduced serum total cholesterol, triglyceride, low-density lipoprotein cholesterol, glucose, insulin, HOMA-IR, alanine transaminase, and aspartate transaminase levels and increased high-density lipoprotein cholesterol levels compared with those in the HCD group. Additionally, treatment with both supplements improved antioxidant ability and reduced lipid peroxidation. The histological examination confirmed that the combination therapy reduced liver steatosis and fibrosis while also improving the appearance of cell organelles in the ultrastructural hepatocytes. Finally, the immunohistochemical analysis indicated that cotreatment with LC + GB upregulated the immune expression of GLP-1 and β-Cat in liver sections that were similar to those of the control animals. Mono-treatment with LC or GB alone substantially but not completely protected the liver tissue, while the combined use of LC and GB may be more effective in treating liver damage caused by high cholesterol than either supplement alone by regulating hepatic oxidative stress and the protein expression of GLP-1 and β-Cat.

Background: Thalassemias are a group of genetically transmitted blood diseases characterized by defects in the production of α- or β-chains of hemoglobin called α-thalassemia and β-thalassemia, respectively. One of the common features of β-thalassemia is ineffective erythropoiesis because of the imbalance of globin chain production, which result in increased apoptosis during erythroblast maturation. Objective: To evaluate the ß/α globin mRNA ratio in patients with ß-thalassemia syndrome and to correlate the ß/α ratio with hematological and clinical condition of the patients. Methods: Thirty-five patient samples were collected from Thalassemia Centre of Ibn Al-Balady Hospital; 18 patients with β-thalassemia major and 17 patients with β-thalassemia intermedia. The patients were randomly selected regarding sex, whereas their age ranged from 3 to 17 years. Along with those samples, twenty control leftover samples that were the remaining of samples collected for laboratory investigation, were taken from Al-Kadhimiya Pediatric Hospital, and were age and sex matched with the patients group. The α and β globin chain ration were calculated by the real-time reverse transcription-polymerase chain reaction (qRT-PCR). The β/α -globin mRNA ratio of the samples was measured by the 2−ΔΔCT method. Results: Analysis of the β-globin/α-globin mRNA ratio showed that disease severity increased with a reduction of the ratio. There was a highly significant difference in α level, ß level and ß/α ratio among studied groups with a p value of (p < 0.001). The highest level was in control group, followed by that in β-thalassemia intermedia and the lowest was in β-thalassemia major. Conclusion: The severity of ß/α globin chain imbalance showed a significant and negative correlation with the mean corpuscular volume and there was no significant correlation between the ß/α ratio and markers of erythropoiesis in ß-thalassemia major and ß-thalassemia intermedia patients. The ß/α ratio was a good tool for diagnosis in ß-thalassemia major and ß-thalassemia intermedia as compared to control group with high sensitivity and specificity. A ß-chain gene expression was the lowest in ß-thalassemia major followed by ß-thalassemia intermedia as compared to control group. Keywords: Thalassemia, ß/α -globin mRNA ratio Citation: Yousif MH, Al-Mamoori HS. The Correlation of β/α mRNA Ratio with Clinical and Hematological Parameters in Patients with β-thalassemia Syndrome. Iraqi JMS. 2022; 20(1): 139-145. doi: 10.22578/IJMS.20.1.18

Development of a precise and delicate reaction has been acquired for the determination of vancomycin hydrochloride using batch and cloud point extraction (CPE) methods. The first method is based on the formation of azo dye as a result of diazotized dapsone coupled with vancomycin HCl (VAN) in a basic medium. The sensitivity of this reaction was enhanced by utilizing a nonionic surfactant (Triton X-114) and the cloud point extraction technique (second method). The azo dye formed was extracted into the surfactant-rich phase, dissolved in ethanol and detected at λmax 440 nm spectrophotometrically. The reaction was investigated using both batch and CPE methods (with and without extraction), and a simple comparison between the two developed methods was made. The conditions that affect the extraction process and the sensitivity of the methods have been carefully examined. The linearity of the calibration curves was in the range of 3-50 and 0.5- 25 µg.mL-1 with limits of detection of 0.806 and 0.462 µg.mL-1 for VAN in both batch and CPE procedures, respectively. The percentage of relative standard deviation (R.S.D.%) for the two methods was better than 2.54% and 2.83%, respectively. The recommended procedures have been effectively used to assay VAN in commercial injections.

Introduction: Preeclampsia can lead to a number of adverse maternal and perinatal effects. The association between iron status [serum iron, ferritin and total iron-binding capacity (TIBC)], unsaturated iron-binding capacity, hepcidin, interleukin-6 (IL-6) levels and preeclampsia is not fully understood.Objective: To assess the levels of iron status, hepcidin and interleukin-6 in women with preeclampsia compared with healthy pregnant women.Method: A case-control study (60 women were recruited in each group) was conducted at Saad Abuelela Maternity Hospital in Khartoum, Sudan. Sociodemographic and clinical data were gathered through a questionnaire. The levels of iron status, hepcidin and IL-6 were measured using applicable methods.Results: There was no significant difference in the median [interquartile range (IQR)] of age, parity or body mass index between the two groups. Moreover, the median (IQR) of the iron status, hepcidin and interleukin-6 did not differ between women with preeclampsia and healthy controls. There were no significant correlations between haemoglobin, hepcidin and IL-6. There were also no significant correlations between serum iron, serum ferritin, hepcidin and IL-6. However, there was a significant positive correlation between hepcidin and IL-6 (r = 0.393, p = 0.002).Conclusion: In this study, women with preeclampsia had levels of iron status, hepcidin and IL-6 similar to those observed in healthy pregnant women. There was no significant correlation between iron status, hepcidin and IL-6.

Abstract Background Obesity and diabetes are two chronic metabolic diseases whose prevalence is increasing at an alarming rate globally. A close association between obesity, diabetes, and insulin resistance has been identified, and many studies have pinpointed obesity as a causal risk factor for insulin resistance. However, the mechanism underlying this association is not entirely understood. In the past decade, ceramides have gained attention due to their accumulation in certain tissues and their suggested role in initiating insulin resistance. This study aims to determine the association of specific ceramides and their major metabolizing enzymes with obesity-associated insulin resistance. Methods The samples comprised subcutaneous adipose tissues collected from three cohorts: lean non-diabetic (controls; n = 20), obese-non-diabetic (n = 66), and obese-diabetic (n = 32). Ceramide levels were quantified using LC-MS/MS and mRNA expression level for different enzymes were estimated using real-time PCR-based RNA expression analysis. Results C16-ceramide (P = 0.023), C16-dihydro-ceramide (P

One of the leading causes of female infertility is PCOS, which is a hormonal disorder affecting women of childbearing age. The common symptoms of PCOS include increased acne, irregular period, increase in body hair, and overweight. Early diagnosis of PCOS is essential to manage the symptoms and reduce the associated health risks. Nonetheless, the diagnosis is based on Rotterdam criteria, including a high level of androgen hormones, ovulation failure, and polycystic ovaries on the ultrasound image (PCOM). At present, doctors and radiologists manually perform PCOM detection using ovary ultrasound by counting the number of follicles and determining their volume in the ovaries, which is one of the challenging PCOS diagnostic criteria. Moreover, such physicians require more tests and checks for biochemical/clinical signs in addition to the patient’s symptoms in order to decide the PCOS diagnosis. Furthermore, clinicians do not utilize a single diagnostic test or specific method to examine patients. This paper introduces the data set that includes the ultrasound image of the ovary with clinical data related to the patient that has been classified as PCOS and non-PCOS. Next, we proposed a deep learning model that can diagnose the PCOM based on the ultrasound image, which achieved 84.81% accuracy using the Inception model. Then, we proposed a fusion model that includes the ultrasound image with clinical data to diagnose the patient if they have PCOS or not. The best model that has been developed achieved 82.46% accuracy by extracting the image features using MobileNet architecture and combine with clinical features.

Abstract Background Pulmonary embolism (PE) is a common life-threatening medical emergency that needs prompt diagnosis and management. Providing urgent care is a key determinant of quality in the emergency department (ED) and time-based targets have been implemented to reduce length of stay and overcrowding. The study aimed to determine factors that are associated with having a time-to-disposition of less than 4 h in patients with suspected PE who underwent computed tomography pulmonary angiography (CT-PA) to confirm the diagnosis. Methods After obtaining approval from the ethics committee, we conducted a retrospective observational study by examining CT-PA scans that was performed to rule out PE in all adult patients presenting at the ED between January 2018 and December 2019. Demographic information and clinical information, as well as arrival and disposition times were collected from electronic health records. Multivariable regression analysis was used to identify the independent factors associated with meeting the 4-h target in the ED. Results In total, the study involved 232 patients (76 men and 156 women). The median length of stay in the ED was 5.2 h and the 4-h target was achieved in 37% of patients. Multivariable logistic regression analysis revealed that a positive CT-PA scan for PE was independently associated with meeting the four-hour target in the ED (odds ratio [OR]: 2.2; 95% CI: 1.1–4.8). Furthermore, Hemoptysis was the only clinical symptom that served as an independent factor associated with meeting the 4-h target in the ED (OR: 10.4; 95% CI: 1.2–90.8). Conclusion Despite the lower number of staff and higher volume of patients on weekends, patients who presented on weekends had shorter stays and were more likely to meet the 4-h target. Careful clinical assessment, prior to requesting a CT-PA scan, is crucial, since negative CT-PA scans may be associated with failure to meet the 4-h target.

Abstract Background Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may not elicit lifelong protective immunity and reinfection could occur. Liver function impairment is a common manifestation of coronavirus disease 2019 (COVID-19). However, acute hepatic failure in the setting of COVID-19 is very rare. Case presentation We report the case of a 47-year-old woman who presented with acute abdominal pain and vomiting. Abdominal examination revealed a soft and lax abdomen with mild tenderness in the right upper quadrant. The patient recovered from COVID-19 2 months previously with negative results on reverse transcription-polymerase chain reaction (RT-PCR). Laboratory investigations revealed markedly elevated transaminases with normal results on viral hepatitis serology panel and undetectable blood paracetamol level. Prior to admission, the patient underwent RT-PCR for SARS-CoV-2, which revealed a positive result. The patient experienced rapid deterioration in the neurological status with a remarkable increase in the liver enzyme levels. Despite aggressive resuscitation, the patient suffered irreversible cardiac arrest and died. Conclusion Fulminant hepatic failure is a rare manifestation in patients with re-positive RT-PCR tests for SARS-CoV-2. Clinicians should maintain a high index of suspicion for hepatic injury with active monitoring of liver enzymes.

Abstract Background Family medicine physicians may encounter a wide variety of conditions, including acute and urgent cases. Considering the limited access to diagnostic investigations in primary care practice, chest X-ray remains the imaging modality of choice. The current study assessed the competency of family medicine residents in the interpretation of chest X-rays for emergency conditions and to compare it with that of diagnostic radiology residents, general practitioners, and medical interns. Methods An online survey was distributed to 600 physicians, including family medicine residents, medical interns, general practitioners, and diagnostic radiology residents. The study included some background information such as gender, years in practice, training type, interest in pulmonary medicine and diagnostic radiology, and having adequate training on the interpretation of chest X-rays. The survey had 10 chest X-ray cases with brief clinical information. Participants were asked to choose the most likely diagnosis and to rate their degree of confidence in the interpretation of the chest X-ray for each case. Results The survey was completed by 205 physicians (response rate = 34.2%). The overall diagnostic accuracy was 63.1% with a significant difference between family medicine and radiology residents (58.0% vs. 90.5%; P

Abstract Background Hepatocellular carcinoma (HCC) is the most common primary liver malignancy that is strongly associated with chronic liver disease. Isolated hepatic tuberculosis is an uncommon type of tuberculosis. Concomitant occurrence of both conditions is extremely rare. Case presentation We report the case of a 47-year-old man who presented with fever and abdominal pain for 3 months prior to presentation. He reported a history of anorexia and significant weight loss. Abdominal examination revealed a tender, enlarged liver. Abdominal computed tomography (CT) demonstrated a solid heterogeneous hepatic mass with peripheral arterial enhancement, but no venous washout, conferring a radiological impression of suspected cholangiocarcinoma. However, a CT-guided biopsy of the lesion resulted in the diagnosis of concomitant HCC and isolated hepatic tuberculosis. Conclusion A rapid increase in tumor size should draw attention to the possibility of a concomitant infectious process. Clinicians must have a high index of suspicion for tuberculosis, especially in patients from endemic areas, in order to initiate early and proper treatment.

Sclerosing encapsulating peritonitis (SEP) is a rare clinical condition characterized by the formation of a thick, fibrous membrane encasing the intestines, which may lead to intestinal obstruction. The pathogenesis is not completely understood, but various risk factors are well established. However, there are only few reported cases of SEP associated with peritoneal carcinomatosis. Herein, we report a case of a 69-year-old male patient who presented clinically with acute intestinal obstruction 2 years after undergoing a resection procedure for gastric cancer. An abdominal computed tomography revealed findings typical of SEP. Consequently, the patient underwent exploratory laparoscopy, which confirmed the diagnosis of SEP and established the etiology as peritoneal metastases. The patient was managed conservatively, and his symptoms showed some improvement. The patient was at an advanced stage of the disease, and thus remained on palliative care and passed away 1 month later. Although very rare, physicians should consider SEP in their differential diagnoses of intestinal obstruction in patients, particularly in those with a history of intra-abdominal malignancies.

White supremacist hate speech is one of the most recently observed harmful content on social media. The critical influence of these radical groups is no longer limited to social media and can negatively affect society by promoting racial hatred and violence. Traditional channels of reporting hate speech have proved inadequate due to the tremendous explosion of information and the implicit nature of hate speech. Therefore, it is necessary to detect such speech automatically and in a timely manner. This research investigates the feasibility of automatically detecting white supremacist hate speech on Twitter using deep learning and natural language processing techniques. Two deep learning models are investigated in this research. The first approach utilizes a bidirectional Long Short-Term Memory (BiLSTM) model along with domain-specific word embeddings extracted from white supremacist corpus to capture the semantic of white supremacist slangs and coded words. The second approach utilizes one of the most recent language models, which is Bidirectional Encoder Representations from Transformers (BERT). The BiLSTM model achieved 0.75 F1-score and BERT reached a 0.80 F1-score. Both models are tested on a balanced dataset combined from Twitter and a Stormfront dataset compiled from white supremacist forum.

Context: Identification of modifiable risk factors of neurocognitive dysfunction (NCDs) that would help in preventing neurocognitive dysfunction by means of appropriate measures. Objectives: The study aims to provide an insight into the extent and cofactors ofNCDs among Saudi type II diabetes (T2DM) patients at the primary care level. Settings and Design: A cross-sectional study was conducted at five randomly selected primary health care centers (PHCCs) of Jeddah, Saudi Arabia. Subject and Methods: T2DM patients above 40 years, who were followed for T2DM diagnosed ≥ 1 year ago were recruited. The Arabic version of the Mini-Mental State Evaluation (MMSE) was used for screening NCDs, using education-adjusted cut-offs. Statistical Analysis Used: Sociodemographic, diabetes-related, and other clinical and lifestyle factors were analyzed as cofactors of NCDs. Results: The study included 236 T2DM patients, who had mean ± SD age of 60.29 ± 9.45 years. The majority (61.0%) were female, and mean ± SD duration of T2DM was 14.1 ± 8.4 years (range = 1–45 years). The prevalence of NCDs was 35.2% (95% CI = 29.1%, 41.6%), and 5.1% of the participants had MMSE scores ≤ 10 indicating severe neurocognitive impairment. The congruence of significant sociodemographic factors delineated a high-risk profile, and multivariate regression analysis showed female gender, low educational level, longer duration of diabetes, geriatric age at T2DM diagnosis, inadequate glycemic control, and sedentary lifestyle as the independent risk factors for NCDs. Conclusions: The population of middle-aged and older T2DM patients is highly exposed to NCDs, with the great contribution of other comorbidities and higher risk incurred by older, lowly educated females with long diabetes duration. Further improvements should be achieved to enhance the care offered to diabetic patients by improving glycemic control, screening for comorbidities, and early detection of neurocognitive decline.

Abstract Background Pulmonary embolism (PE) is a common life-threatening condition with non-specific clinical presentations. The diagnosis of PE depends highly on imaging studies, which may also provide prognostic information. This study aimed to describe the clinical and imaging profiles of patients with PE, emphasizing the differences between central and peripheral PE. Methods After ethics review board approval, this retrospective observational study examined the non-negative results in adult patients who underwent computed tomography pulmonary angiography (CT-PA) at our hospital between May 2016 and December 2019. Demographic and clinical information and imaging findings were collected from the electronic medical records. Results The study included 85 cases that were identified after re-interpreting the 103 non-negative CT-PA scans. Six cases were excluded for incomplete data and 12 cases were false-positive. Central PE was found in 63.5% of the cases. Obesity was the most common risk factor seen in 37.6% of the cases. Furthermore, 9.4% of the patients had sickle cell disease, which tended to be associated with peripheral PE. There was no difference between the peripheral and central PE in most clinical and imaging parameters evaluated (P > 0.05). However, patients with isolated subsegmental PE were more likely to develop hemoptysis (P = 0.04). Conclusion This study suggests that patients with obesity and sickle cell disease constitute an important proportion of all PE cases. Furthermore, the clinical and imaging profiles in patients with peripheral PE are similar to those in patients with central PE. Future research should focus on the clinical value of peripheral PE in patients with sickle cell disease.

Abstract Background The practice of clinical radiology has become more sedentary in the era of the Picture Archiving and Communication System. Physical inactivity is a well-known risk factor for various chronic diseases. This study aimed to determine the frequency and pattern of physical exercises among radiologists in the Eastern Province of Saudi Arabia and the association between physical exercises and the prevalence of work-related musculoskeletal symptoms. Methods An online survey was sent to radiologists in all hospitals (academic, public, and private) in the major cities of the Eastern Province of Saudi Arabia. It covered information about demographic characteristics and the frequency and pattern of physical exercises. It also included an evaluation of work-related musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire. This survey of 263 radiologists was conducted in April 2019. The study outcome was the presence of disabling musculoskeletal symptoms in any body region which restricted the performance of normal activities within the last 12 months. The study results were analyzed descriptively using the Chi-square test. Results The survey was completed by 198 participants (111 men and 87 women) with a response rate of 75.3%. Most participants (71.2%) were less than 40 years. Eighty-three men (74.8%) did a physical exercise at least weekly, compared to 45 (51.7%) women. Men were more likely to engage in various physical exercises than women. Overall, 60.9% of participants who did not do any physical exercise regularly (less than monthly) reported having disabling neck pain. This figure was found lower among participants who did physical exercises monthly (45.8%) or at least weekly (32.8%). A similar pattern was observed with shoulder pain, with 45.7% found in participants who did not exercise and only 25.8% in those engaging in physical activities at least weekly. Conclusions Physical inactivity is common among radiologists, especially female ones, in the Eastern Province of Saudi Arabia. The physical inactivity was significantly associated with work-related musculoskeletal symptoms. Gender-specific health promotion programs are needed to mitigate the negative health outcomes due to the sedentary nature of the radiology current practice.

Steganography is a technique of concealing secret data within other quotidian files of the same or different types. Hiding data has been essential to digital information security. This work aims to design a stego method that can effectively hide a message inside the images of the video file. In this work, a video steganography model has been proposed through training a model to hiding video (or images) within another video using convolutional neural networks (CNN). By using a CNN in this approach, two main goals can be achieved for any steganographic methods which are, increasing security (hardness to observed and broken by used steganalysis program), this was achieved in this work as the weights and architecture are randomized. Thus, the exact way by which the network will hide the information is unable to be known to anyone who does not have the weights. The second goal is to increase hiding capacity, which has been achieved by using CNN as a strategy to make decisions to determine the best areas that are redundant and, as a result, gain more size to be hidden. Furthermore, In the proposed model, CNN is concurrently trained to generate the revealing and hiding processes, and it is designed to work as a pair mainly. This model has a good strategy for the patterns of images, which assists to make decisions to determine which is the parts of the cover image should be redundant, as well as more pixels are hidden there. The CNN implementation can be done by using Keras, along with tensor flow backend. In addition, random RGB images from the "ImageNet dataset" have been used for training the proposed model (About 45000 images of size (256x256)). The proposed model has been trained by CNN using random images taken from the database of ImageNet and can work on images taken from a wide range of sources. By saving space on an image by removing redundant areas, the quantity of hidden data can be raised (improve capacity). Since the weights and model architecture are randomized, the actual method in which the network will hide the data can't be known to anyone who does not have the weights. Furthermore, additional block-shuffling is incorporated as an encryption method to improved security; also, the image enhancement methods are used to improving the output quality. From results, the proposed method has achieved high-security level, high embedding capacity. In addition, the result approves that the system achieves good results in visibility and attacks, in which the proposed method successfully tricks observer and the steganalysis program.

A successive interference cancellation receiver is one of the important blocks in non-orthogonal multiple access (NOMA) transmission. The quality of detection of the strongest user signals often decides about the quality of the whole system and minimizes the error propagation effect. In this paper, we propose an improved detection algorithm, which allows for using the NOMA transmission in a much smaller range of power differences between the terminals sharing common radio resources in the uplink, as compared with standard successive cancellation. The idea lies in the application of tentative decisions about weaker signals in the detection of stronger ones and then, after improved detection of stronger user signals, achieving more reliable decisions about the weaker ones. The simulation results reported in the paper confirm our idea, showing a much higher detection quality of the proposed receiver when compared with the standard solution.

Background. Adrenal cavernous hemangiomas (AH) are benign nonfunctional vascular tumors rarely discovered as incidental findings on imaging studies or autopsies. This study presents a single case report of AH with another rare finding of the Liesegang ring. Also, we reviewed 73 case reports of cavernous adrenal hemangioma to provide an overview of AH’s clinical characteristics. Case Report. A nonfunctional AH was incidentally discovered in a 59-year-old morbidly obese female patient with a 10-year history of hypertension and thyroidectomy. An abdominal computed tomography (CT) scan showed a left suprarenal mass of ∼16 cm in diameter. While the patient had no clinical manifestations from the hemangioma, all laboratory tests were within the normal values with no indication of a functional adrenal tumor. The mass was removed by open left adrenalectomy. The microscopic histological examination revealed a laminated structure with wide blood-filled spaces with a central core of necrotic and hemorrhagic changes, characteristic of a cavernous AH with the presence of a rare Liesegang ring. Conclusion. Although rare, AH should be considered as a differential diagnosis for adrenal masses. This is the first reported case of a cavernous AH with rare microscopic findings of the Liesegang ring.

No abstract available.

The coronavirus pandemic (COVID-19) is disrupting the entire world; its rapid global spread threatens to affect millions of people. Accurate and timely diagnosis of COVID-19 is essential to control the spread and alleviate risk. Due to the promising results achieved by integrating machine learning (ML), particularly deep learning (DL), in automating the multiple disease diagnosis process. In the current study, a model based on deep learning was proposed for the automated diagnosis of COVID-19 using chest X-ray images (CXR) and clinical data of the patient. The aim of this study is to investigate the effects of integrating clinical patient data with the CXR for automated COVID-19 diagnosis. The proposed model used data collected from King Fahad University Hospital, Dammam, KSA, which consists of 270 patient records. The experiments were carried out first with clinical data, second with the CXR, and finally with clinical data and CXR. The fusion technique was used to combine the clinical features and features extracted from images. The study found that integrating clinical data with the CXR improves diagnostic accuracy. Using the clinical data and the CXR, the model achieved an accuracy of 0.970, a recall of 0.986, a precision of 0.978, and an F-score of 0.982. Further validation was performed by comparing the performance of the proposed system with the diagnosis of an expert. Additionally, the results have shown that the proposed system can be used as a tool that can help the doctors in COVID-19 diagnosis.

Purpose: The life of students is full of stressors that might have an impact on their mood and academic performance. These stressors are exaggerated among medical and dental students, as they have to worry more about financial, social, and academic issues. The study aimed to estimate the prevalence and predictors of inappropriate self-prescribing of propranolol (Inderal®) among medical and dental students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) Riyadh, Saudi Arabia. Methods: A cross-sectional study using consecutive sampling was carried out among Saudi medical and dental students, who were enrolled in KSAU-HS during the study period. A validated newly developed English questionnaire was sent via E-mail to all eligible participants with response rate of 86.9%. Chi-square test was used to compare between groups, whereas multivariate logistic regression analysis was carried out, where the variables that were included in the model were the ones that showed statistical significance at the bivariate level. Results: Around 30% of the sample used propranolol (Inderal®) during their college years. Propranolol use predictors showed that females from both specialties were less likely to use propranolol (OR=0.11, 95% CI=0.06–0.24, P-value

Background/Aims Comparison of the accuracy of magnetic resonance elastography (MRE) and diffusion weighted imaging (DWI) for the diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB). Methods : In this retrospective analysis, we investigated 63 patients with CHB and liver fibrosis. DWI was performed with both breath-hold (DWI-BH) and free-breathing (DWI-FB) sequences (b=0, 500). The mean liver stiffness and apparent diffusion coefficient (ADC) were calculated by drawing regions of interest maps. Fibrosis staging according to the METAVIR system was independently performed by an experienced pathologist. A receiver operating curve (ROC) analysis was conducted to determine the accuracy of MRE, DWI-BH and DWI-FB in the detection and stratification of liver fibrosis. The performance of the detection of significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4) was also evaluated by comparing areas under the ROC. Results : There was a moderate and significantly negative correlation between the ADC values and liver stiffness. The accuracies for the detection of ≥F2/≥F3/F4 stage fibrosis with DWI-FB, DWI-BH and MRE were 0.84/0.76/0.72, 0.72/0.83/0.79 and 0.99/0.99/0.98, respectively. The performance of MRE was significantly better than DWI-FB and DWI-BH. There were no significant differences between the performance of DWI-FB and DWI-BH. Conclusion : s MRE is more accurate than DWI for the detection and stratification of liver fibrosis in CHB.

Lead pollution is an important environmental problem, despite consciousness of its harmful health effects in the world. This study was an attempt to find the effects on some possible biochemical parameters. The study has been conducted in Baghdad City from March 2017 to April 2018 divided in to two groups exposure 75 workers and non- exposure 10 control. Biochemical tests of liver and kidney Functions, showed clear lead effect on them. The average [ALK, GPT, and GOT] in battery factories workers were 75.52 ± 5.47, IU/L 33.54 ± 4.58, 42.64 ± 6.59 IU/L and fuel station workers 62.41 ± 3.70,27.15 ± 2.16,29.42 ± 1.48 IU/L compared with the control group respectively 45,10 ± 6,39, 17,95 ± 2,11 and 28,71 ± 2.65 IU /L the study showed significant increase in the mean liver enzyme of exposed workers, compare with control. The mean of serum urea and creatine level in battery factory workers, fuel station and control. Were 41.16 ± 2.21 mg/dl, 38.04 ± 1, 69 mg/dl and 20, 40 ± 0.54 mg/dl and 0.986 ± 0.06 mg/d, 0.941 ± 0.05 mg/dl , and 0.710 ± 0.06 mg/dl respectively there was significant increase in serum urea and creatinin of the workers compared with control.

Background and Objective: Hysterosalpingography (HSG) is commonly used in the evaluation of the subfertile and infertile women. This study was undertaken to assimilate the findings observed during HSG in Saudi Arabian infertile patients and to find the most common pathology identified by the HSG. Patients and Methods: A retrospective analysis was conducted of subfertile and infertile patients who had undergone HSG between June 2007 and May 2012. Patients′ demographic data were collected from the medical records of the King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The data included age, years of marriage, menstrual history either regular or irregular, primary/secondary infertility, hormonal profile, previous infection or pelvic surgery, and diagnostic laparoscopy. Radiographic reports of HSG were collected from the IPAC system and analyzed for fimbrial findings, tubal patency, and cervical and uterine cavitary pathology. The data were entered in the database and analyzed using a t-test to compare means between the age, type of infertility, different pathologies and for all the parameters assessed. All tests were performed using Statistical Package for the Social Sciences, version 14.0, Chicago, Illinois, USA. A P < 0.05 was considered statistically significant with a confidence interval of 95%. Results: Data from the medical records of 117 patients with an average age of 32.59 ± 5.48 years were analyzed. Of this total, 48 (41%) had been diagnosed as having primary infertility. In 95 (81.2%) patients, there was an abnormality in the fallopian tubes and in 27 (23%) patients, there was an abnormality in the uterus. Patients with primary infertility were significantly younger (29.7 ± 5.6 vs. 34.58 ± 4.75; P < 0.001), and tubal and uterine pathology was more common (P < 0.08 and 0.01). Conclusions: Our review indicates that the most common pathology found through HSG in women presenting with infertility is tubal blockage.

Melioidosis, a bacterial infection caused by Burkholderia pseudomallei is expanding in its endemicity around the world. Melioidosis most commonly infects adults with an underlying predisposing condition, mainly diabetes mellitus. Primary skin and soft tissue involvement is more common in younger patients. Almost every organ can be affected, but the most commonly affected organ is the lung followed by the spleen. Melioidosis has a wide range of radiological manifestations making it a mimicker. Diagnosis requires a high index of clinical suspicion in patients with septicemia or a fever of unknown origin living in or with a travel history to endemic areas. We present a pictorial review of the radiological manifestations of melioidosis, which is a useful knowledge for radiologists to help arrive at an early diagnosis. In this pictorial review, we present the radiological manifestations chosen from 139 patients with culture proven melioidosis. Illustrated examples are chosen from our clinical experience of the past 15 years at the National University Hospital in Singapore.

Background/Aims: Desmoplasia is a prominent feature of pancreatic ductal adenocarcinoma (PDA). Stromal desmoplasia reflects the low cellularity that is characteristic of PDA, and it may play a role in PDA chemoresistance. In this retrospective study, we evaluated the relationship between tumor cellularity in resected PDA specimens and long-term patient outcomes. Methods: We retrospectively reviewed the data from 175 patients who underwent PDA resection between January 2010 and December 2015 at Seoul National University Bundang Hospital, and analyzed their clinicopathological features and the relationship between tumor cellularity (high vs low based on a cutoff of 30% cellularity) and patient outcomes. Results: The high-cellularity group had significantly shorter overall survival (OS) (18.7 months vs 26.6 months, p=0.006) and disease-free survival (11.0 months vs 16.9 months, p=0.031) than the low-cellularity group. Multivariate analysis revealed that high tumor cellularity was an independent risk factor for poor OS (hazard ratio, 2.008; 95% confidence interval, 1.361 to 2.962; p

Background: Renal involvement is immensely include in antineutrophil cytoplasmic autoantibody (ANCA)-associated systemic vasculitis .It is a significant cause of end-stage renal failure. Objective: To comparison between cytoplasmic autoantibodies a cytoplasmic pattern and antineutrophil cytoplasmic autoantibodies a perinuclear pattern in patients with renal disease . Patients and Methods: Prospective study reports presenting serological , hematological and biochemical investigations of 44 new patients diagnosed in teaching laboratories of Baghdad hospital from March 2015 to June 2016. All studied groups tested for hemaglobin (Hb), White blood cells (WBC), serum blood urea, Serum blood creatinine, c-reactive protein in addition to antineutrophil cytoplasmic autoantibodies a perinuclear pattern (p-ANCA) and antineutrophil cytoplasmic autoantibodies a cytoplasmic pattern (c-ANCA) detected by enzyme linked immunosorbent assay technique . Results: All patients with renal disease had antineutrophil cytoplasmic autoantibody a cytoplasmic pattern negative whereas (27.3%) of those patients had positive antineutrophil cytoplasmic autoantibody a perinuclear pattern. Patients with age group range between (20-29) years showed (18.2%) pANCA positive results which mainly involved in female. Clinically evident systemic lupus erythematosus was present in 6 of the 12 patients with positive pANCA . Conclusion: Serum anti-neutrophil cytoplasmic antibody measurement should not be used alone in the diagnosis of ANCA-associated disease, whereas pANCA is more convincing in the diagnosis than cANCA.

The goal of this paper is to enhance the bandwidth of a Rectangular Patch Microstrip Antenna, RPMA, operating at higher order mode, TM03 mode, using three techniques: thick substrate, capacitive-feeding and stacked patches techniques. The constant of substrate, for all designs, is 9.8 with loss tangent 0.001, Alumina substrate. Four RPMA’s operating at TM03 mode are designed: a conventional RPMA with two thicknesses, thin and thick substrate thickness, a capacitively-fed RPMA, and stacked capacitively-fed RPMA. The composite effect of integrating the three techniques is appeared in stacked capacitively-fed RPMA design. This design offer a wide bandwidth reach 65% with maximum gain 8.78dB. The performance of these designs(VSWR, the far field radiation pattern, and the current distribution) has been analyzed with the aid of Microwave Office software (MW-Office 2006,Version 7).

Background: Insulin resistance (IR) is the primary metabolic disorder associated with obesity. Obesity is a growing worldwide health problem affecting both adults and children. Objectives: To determine the association between leptin and IR, and to identify the ratio of fasting glucose/leptin (G/L) and insulin/leptin (I/L) as a new simple method for the detection of IR in obese children.Methods: This study was done in the National DiabeticCenter/ AL-Mustansiriya University during the period fromMay 2013 until the end of October 2013. Fasting bloodglucose (FBG), serum insulin, leptin, and lipid profile weremeasured in 52 obese children (24 children with IR and 28without IR); their age range was (5-15) years, they werecompared with 38 healthy children as a control group.Results: Means of FBG, insulin, leptin, total cholesterol(TC), triacylglycerol (TAG), low density lipoproteincholesterol (LDL-C), and non high density lipoproteincholesterol (non HDL-C) were significantly increased inobese children with IR as compared in children without IR,(P

Background:- Endometriosis is a common chronic gynecological disorder characterized by the presence and proliferation of functional endometrial gland and stroma outside the uterine cavity, affecting approximately 10% of reproductive age women. Il-6 level increased in the patient with endometriosis. Objective:- Evaluate the correlation of IL-6 levels with the degree of severity of endometriosis Patients and methods:- In this study, 84 samples 51women with endometriosis (20 newly diagnosed and 31 treated cases) and 33 of healthy control group, were collected starting from November 2011 to end of January 2012, to investigate the IL-6 serum level by using ELISA kit. Results :- Endometriosis patients mainly presented at the age between (28-37). IL-6 serum levels were significantly decrease in those with stage IV endometriosis. Also appear to be significantly affected by the use of danazol or zoladex treatment of endometriosis and remain low even in treated patients. Serum IL-6 test was highly specific but with low sensitivity. Conclusion:-Serum IL-6 concentration seem to be the highly specific test that can be used as an early detection marker for endometriosis.

The correlation between dyslipidemia and the severity of coronavirus disease 2019 has been widely categorized. Dyslipidemia is one of the most dominant disorders among these patients. Systemic inflammation accompanied by cytokine storm hemostasis modifications and severe vasculitis have all been reported to occur among COVID-19 patients, and these may contribute to some severe complications. The aim of this study is to assess the possible relationship between dyslipidemia and the severity of coronavirus disease 2019. This work encompassed 200 patients with coronavirus disease 2019 (100 dyslipidemic and 100 normolipidemic) who were hospitalized at Baghdad Teaching Hospital/ Medical City-Baghdad, Iraq, from October 2021 to October 2022; their ages ranged between 40 and 55. Eligible individuals had a positive nasal swab polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 infection. Every participant’s anthropometric and clinical features were measured. The study includes the measurements of glycemic, lipid profile, renal function test, D-dimer, C-reactive protein, serum ferritin, and interleukin-6 in dyslipidemic and normolipidemic groups.Considerable increase (p= 0.001) in glycemic and lipid levels in the dyslipidemic group compared to normolipidemic. Moreover, dyslipidemic patients have higher lipid indices (ratios) than the normolipidemic group. Significant increases (p= 0.001) in serum urea and creatinine levels were found among the dyslipidemic group compared to normolipidemic. There was a non-considerable decrease (p= 0.062) in serum total protein in the dyslipidemic group concerning the normolipidemic. In contrast, a considerable decrease (p= 0.045) in serum albumin was detected in the dyslipidemic group compared to normolipidemic. D-dimer, serum C-reactive protein, ferritin, and interleukin-6 were significantly increased (p= 0.001) in the dyslipidemic group compared to normolipidemic. Dyslipidemia potentially raises the severity of coronavirus disease 2019. There was a significant disturbance in renal function tests among coronavirus disease 2019 patients. The study found a significant and statistical difference in kidney functions between dyslipidemic and normolipidemic groups. The patients, especially the dyslipidemic ones, have experienced protein abnormalities and a significant inflammation rate reflected by higher C-reactive protein and interleukin-6, which is due to the severity of coronavirus disease 2019. It is possible to conduct more research with a larger sample size. The majority of people who have dyslipidemia need to be enlightened. [ABSTRACT FROM AUTHOR]