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Background and aimsChanges in the phenotype and genotype in Hypertrophic Obstructive Cardiomyopathy (HOCM) are thought to involve the myocardium as well as extracardiac tissues. The extent and significance of extra-myocardial changes has not been adequately studied. We here describe the structural and functional changes in the ascending aorta of HOCM patients.MethodsChanges in the aortic wall were studied in a cohort of 102 consecutive HOCM patients undergoing myectomy, and 10 normal controls. Biopsies were examined histologically, immunohistochemically and by electron microscopy. Changes in protein expression were quantified using morphometry and western blotting. Pulse wave velocity (PWV) was measured using Cardiac Magnetic Resonance (CMR), in 86 HCM patients compared to 166 age-matched normal controls.ResultsIn HCM, the number of medial lamellar units (MLU) was significantly decreased, associated with an increase in the interlamellar distance and a preserved thickness of the aortic wall, as compared to controls. Electron microscopy showed an altered lamellar structure with disorientation of elastin fibers from the circumferential direction. There was an altered composition and orientation of smooth muscle cells. In addition, there was a significant decrease in alpha-smooth muscle actin, smooth muscle myosin, smooth muscle 22 and integrin beta1, and a significant increase in calponin and caspase3. Fibulins 1, 2 and 5, had a reduced expression in HOCM aortic biopsies. Functionally, PWV was significantly higher in HOCM patients compared to healthy controls.ConclusionIn HOCM patients, specific molecular and structural changes in the composition and organisation of the arterial wall have been identified. This was associated with increased stiffness of the arterial wall.Translational PerspectiveThis study sheds light for the first time on the altered lamellar organization in the aorta of Hypertrophic Obstructive Cardiomyopathy (HOCM), in addition to the Smooth muscle cells and Extracellular Matrix abnormalities, to explain the increased wall stiffness associated with patients clinical phenotype. The data provide insights on extra-myocardial targets that can have potential value for risk stratification and personalized therapeutics for HOCM patients.

Background Consanguinity is prevalent in Egypt (35%) resulting in a high incidence of homozygosity. The influence of homozygosity on the genetics of Hypertrophic Cardiomyopathy (HCM) has not been adequately studied. Purpose The purpose of this study is to define the genetic architecture of HCM in Egypt using ethnically-matched case and control cohorts. Methods Prospective Egyptian patients (n=514) and controls (n=400) were recruited to Aswan Heart Centre for clinical phenotyping and genetic testing for 174 genes implicated in inherited cardiac conditions (Illumina). Rare variation (gnomAD filtering allele frequency ≤4x10–5) in 13 validated HCM genes were classified according to the American College of Medical Genetics (ACMG) guidelines and compared with a prospective HCM cohort of predominantly European ancestry (n=684). Results Significantly fewer rare variants detected in Egyptian patients could be classified as (likely) pathogenic compared to Europeans (40.8% vs. 61.6%, p-value=1.6x10–5). Incorporating analysis from these Egyptian case-control cohorts into the ACMG guidelines increased this yield to 53.8%. Homozygous variants were more frequently observed in Egyptian patients (4.1% vs 0.1%, p-value=2x10–7), with variants in the minor HCM genes MYL2, MYL3 and CSRP3 more likely to present in homozygosity than the major genes (MYH7, MYBPC3 and troponins), suggesting such variants are less penetrant in the heterozygous state. Conclusions The integration of Egyptian-specific genetic and phenotypic data significantly improves variant interpretation in HCM and consequently the precision of genetic testing. The observed prevalence of homozygosity and rare variation in minor HCM genes in Egyptian patients provides important insights into its disease-mechanisms and genetics. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Science and Technology Development FundAl Alfi Foundation

Introduction Changes in the Extracellular Matrix (ECM) in Hypertrophic Cardiomyopathy (HCM) is thought to involve the myocardium as well as extracardiac tissues. The extent and significance of extra-myocardial changes has not been adequately studied. Purpose To describe the structural, molecular, and functional changes in the aorta of HOCM patients. Methods The structural and molecular changes in the aortic wall were studied in a cohort of 102 consecutive patients with hypertrophic obstructive cardiomyopathy undergoing myectomy. The biopsies were examined histologically, immunohistochemically and by Electron microscopy. The findings were compared to 10 normal controls obtained from the homograft bank of the Harefield hospital, following IRB guidelines. Changes in expression were quantified using morphometry and western blotting. For aortic stiffness, pulse wave velocity [PWV] was measured using Cardiac Magnetic Resonance (CMR), in the 102 HCM patients as well as age-matched 166 normal controls. Results Specimens from HCM aortas showed a misalignment in collagen and elastin fibres. There was a significant reduction in smooth muscle cells [SMCs] markers; integrin beta1 and smooth muscle actin, and an increase in an apoptosis marker, Caspase3. In addition, there was a significant decrease in the number of lamellae and an increase in the interlamellar distance in HCM aortas. FBLNs 1, 2 and 5 showed a reduction in expression in tunica intima and tunica media of HCM biopsies. PWV was significantly higher in HCM patients compared to healthy controls with the highest levels in patients with LV fibrosis. Conclusion This study illustrates the link between functional abnormalities in the aorta of HCM patients with structural and molecular changes. These findings can have a potential value in risk stratification and identify new therapeutic targets in HCM. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): STDF-EgyptMagdi Yacoub Foundation

In this paper, a new robust computational method that applies the geometrical theory of diffraction (GTD) in conjunction with the ray tracing (RT) technique is developed to evaluate the electromagnetic scattering pattern due to a plane wave represented as beam of parallel rays incident on a rough surface of quite arbitrary statistical parameters. The development of the proposed technique is explained in detail taking into consideration the generation of the geometrical model of the rough surface. The Fresnel reflection model is applied under the assumption of arbitrary electrical and optical properties of the rough surface material. Also the polarization of the plane wave primarily incident on the rough surface is taken into consideration. The algorithm developed in the present work accounts for multiple bounces of an incident ray and, hence, it can be considered arbitrary higher-order GTD-RT technique. The accuracy of the obtained results is verified through the comparison with the experimental measurements of the scattering pattern of a light beam incident on rough sheets with specific statistical properties. The numerical results of the present work are concerned with investigating the dependence of the scattering pattern on the surface roughness, refractive index, angle of incidence, and the resolution of the geometric model of the rough surface. Also, it is shown that, for limited resolution of the rough surface model, the accuracy of the calculated scattered field depends on the angle of incidence of the primary beam and the surface roughness.

In this work, a cavity-backed slot antenna has been designed to cover vehicle-to-everything (V2X) frequencies (5.85−5.9255.85-5.925 GHz). The antenna is made to be easily integrated in a vehicle windshield or rear mirror. The cavity-backed slot antenna does not require a ground plane to sit on which makes it an ideal model for below horizon performance. Antenna simulation has been done using high-frequency structure simulator (HFSS) and then on-foam and on vehicle’s windshield measurements have been carried out inside an anechoic chamber. The proposed antenna achieved a linear average gain (LAG) above 2.5 dBi in the targeted V2X elevation and azimuth angles with better than 15 dB return loss. The antenna performance has been reported in terms of reflection coefficient, surface current density, radiation pattern, LAG, and efficiency.

The aims of this research are to 1) assess farmers' behavior (knowledge, attitudes, and practices) concerning the sustainable agriculture (crop, land and water management) in Kharga Oasis, 2) explore farmers' behavioral gaps concerning the sustainable agriculture practices, and 3) determine variables related to farmers' behavior (knowledge, attitudes, and practices) concerning the sustainable agriculture in Kharga Oasis. In order to achieve the study’s objectives, El Mounira village had been randomly selected to be the place of this study. Data were collected from a sample of 120 respondents during February to March 2021 through personal interviews using a pre-tested questionnaire form. A list of thirty-three sustainable crop, soils and water management practices was developed based on reviewing the literature, Findings revealed that the overall mean value of respondents’ knowledge on sustainable agriculture practices is 22.74 score which represents 68.91% of the total score, 84.1% for attitudes, and 55.3% for implementation of the studied practices. Considering the overall behavioral gaps, findings revealed that K-R gap -knowledge-recommended gap- is 16%, which mean that farmers did not knew about 16% of the recommended knowledge, and the implementation-knowledge gap, I-K gap, is 5.3% this mean that farmers did not implement about 5.3% of practices they knew, and the I-R gap reached 21.39%, this imply that farmers did not implement more the one fifth of the recommended sustainable agriculture practices. The gap of attitude-full positive attitude, A-F gap reached about 15.9%, this mean that farmers need change 16% of their attitudes to reach the full positive attitudes towards the sustainable agriculture practices. Findings also showed that six variables are affects farmers' knowledge, attitudes towards and implementation of sustainable agriculture practices. These variables are age, farm size, farming experience, availability of agricultural drainage, adequacy of irrigation water in the summer season, and attitudes towards environment. Based on the obtained findings, some recommendations were formulated.

Accumulation of metals (Fe, Zn, Cu, Mn, Pb, Cd and Ni) in the muscles and gills of Oreochromis niloticus, Oreochromis aureus and Tilapia zillii was assessed based on seven locations in the Qahr El-Bahr area in Lake Al-Manzalah. The average accumulation of metals was in the following order: Tilapia zillii > Oreochromis aureus > Oreochromis niloticus. To determine the risk of fish consumption, the estimated daily intake, carcinogenic, non-carcinogenic and relative risk indices were calculated. The results indicate that the intake of individual metals through the consumption of fish is almost safe for human health, whereas the intake of combined metals poses a high potential health risk to consumers. Assessment of carcinogenic risk of Cd and Ni from the consumption of tilapia species indicates that consumers are at risk of cancer. The contribution of Pb and Cd to the overall relative risk index ranged from 34% to 41%. Of the three species studied, Oreochromis niloticus is relatively safe for consumption as it poses the least health hazard, while Tilapia zillii is more predisposed to accumulate metals in its tissues. Histopathological changes were observed in the muscles, gills and liver of Oreochromis niloticus as a result of heavy metal accumulation in these organs.

يهدف البحث بصفة أساسية إلى دراسة أثر جائحة کوفيد-19 على قطاع الزراعة من وجهة نظر المزارعين وذلک من خلال الأهداف التالية: 1) التعرف على مصادر معلومات المزارعين حول فيروس کورونا المستجد (کوفيد-19)، 2) التعرف على أثر کوفيد-19 على القطاع الزراعي من وجهة نظر المبحوثين، 3) قياس سلوک التعايش المزارعين مع کوفيد-19، 4) تحديد العوامل المؤثرة في سلوک تعايش المزارعين مع کوفيد-19، 5) التعرف على دور الإرشاد الزراعي خلال الجائحة من وجهة نظر المبحوثين. وقد تم جمع بيانات الدراسة من خلال إستمارة الإستبيان الإلکترونية من 120 مبحوث بمحافظة الوادي الجديد، خلال الفترة من 25 يونيو إلى 5 يوليو 2020. وقد تم إستخدام التکرارات والنسب المئوية ومقاييس التوسط وإختبار مربع کاي لعرض النتائج. وتشير النتائج إلى تصدر البرامج التليفزيونية وصفحة وزارة الصحة والسکان على موقع facebook لقائمة مصادر معلومات المبحوثين حول کوفيد-19 بنسبة مئوية قدرها 54.17% و51.67% لکل منها، کما تشير النتائج إلى تغير التفاعلات الإجتماعية للمبحوثين بالزيادة في التفاعلات الرقمية على حساب النقص في التفاعلات المباشرة. کما أشارت النتائج إلى تأثير کوفيد-19 زيادة الطلب وأسعار المنتجات الزراعية (50% من المبحوثين)، إضافة إلى الزيادة في إستهلاک الخضروات والفواکه (75% و66.7%). وفيما يخص تدابير التعايش، تشير النتائج إلى تنفيذ 54.17% من المبحوثين لهذه التدابير بدرجة متوسطة. کما بينت النتائج عدم قيام الإرشاد الزراعي بأنشطة متعلقة بکوفيد-19 (83.33%)، على الرغم من رغبة المزارعين في ذلک (67.5%)، کما أفاد المبحوثين برغبتهم في تلقي الرسائل الإرشادية عبر الوسائل الإلکترونية مثل الواتس آب (39.17%) أو الفيس بوک (32.5%)، کما خلصت الدراسة إلى بعض التوصيات وإقتراح آلية للتحول الرقمي لتقديم الخدمات الإرشادية الزراعية الرقمية في أوقات الأزمات.

Background Wilms’ tumor (WT) affects one in 10,000 children and accounts for 5% of all childhood cancers. Although the overall relapse rate for children with WT has decreased to less than 15 %, the overall survival for patients with recurrent disease remains poor at approximately 50 %. The aim of the study to evaluate the outcome of relapsed Wilms’ tumor pediatric patients treated at the National Cancer Institute (NCI), Egypt, between January 2008 and December 2015. Results One hundred thirty (130) patients diagnosed with WT during the study period, thirty (23%) patients had relapsed. The median follow up period was 22.3 months (range 3.6–140 months). The Overall Survival (OS) was 30.9% while the event-free survival (EFS) was 29.8% at a 5-year follow up period. Median time from diagnosis to relapse was 14.4 months. A second complete remission was attained in 18/30 patients (60%). The outcome of the 30 patients; 11 are alive and 19 had died. Three factors in our univariate analysis were prognostically significant for survival after relapse. The first was radiotherapy given after relapse (p = 0.012). The 5-year EFS and OS for the group that received radiotherapy were 41.9% versus 16.7% and 11.1% respectively for those that did not. The second was the state of lymph nodes among patients with local stage III (p = 0.004). Lastly, when risk stratification has been applied retrospectively on our study group, it proved to be statistically significant (p = 0.029). Conclusion Among relapsed pediatric WT, radiotherapy improved survival at the time of relapse and local stage III with positive lymph nodes had the worst survival among other stage III patients.

The present study aims to evaluate the water quality of two locations in Rosetta Branch of River Nile and its histopathological and genetic adverse effects on Nile tilapia (Oreochromis niloticus). Water and fish samples were collected from up and downstream of El-Rahawy Drain discharge point (location I and II, respectively) during the summer and winter seasons. The water quality, liver histopathology and DNA alteration of fish was examined. ISSR-PCR technique was used to assess the genetic variation of fish samples from these locations. The water quality parameters ( BOD, COD,……)were increased at location II compared with location I in addition to depletion in dissolved oxygen. Moreover, the fish samples collected from location II showed severe histological and molecular alterations than those collected from location I. It is recommended that the government must increase the awareness of people around the River Nile, and improve the environmental management to reduce the risks of polluted water and consuming the fish exposed to this water on human health.

The fish is a good source of proteins for human. Fish of Oreochromis niloticus [1] were treated with different concentrations of Enterotoxigenic Escherichia coli (ETEC) as 103-105, 106 -107 and 109-1010 CFU/ml water. The investigation had conducted to detect experimentally the impact of E. coli toxins on Oreochromis niloticus fish throughout cells blood counts (WBCs, RBCs and Platelets), hemoglobin concentration and histopathological changes of muscles. The values of WBCs, RBCs, Platelets and hemoglobin ranged between (90.70 K/ml -7.10 K/ml), (2.00 m/ml - 0.53 m/ml), (21 K/ml - 3 K/ml) and (8.2 G/dl to 2.50 G/dl) for the hematological indices respectively. The concentration of WBCs, RBCs, Platelets and hemoglobin were lower than control in all the experiment phases. Histopathological changes of O. niloticus treated with E. coli included degeneration, necrosis, atrophy and inflammatory infiltration of WBCs. The results revealed mortality of fish in the highest concentration and high incidence of E. coli toxins in the muscles of O. niloticus induced damage in the muscle tissues and may transfer to the human consumer and cause serious illness. It is recommended to prevent fishing in seas or rivers polluted with sewage or usage of sanitation on farms.

Objectives The prognostic value of quantitative diffusion-weighted magnetic resonance imaging (DWI MRI) in predicting neurologic outcomes after pediatric cardiopulmonary arrest (CPA) has not been determined. The aim of this study was to identify a DWI MRI threshold for brain volume percent that correlates with neurologic outcome in children who remain comatose or display significant neurologic deficits immediately after resuscitation from CPA. Methods This single-center retrospective study analyzed DWI MRIs of pediatric patients who remained neurologically impaired after CPA. Any MRI obtained within 2 weeks after CPA was analyzed. The apparent diffusion coefficient (ADC) value of each voxel within the brain was determined. Percentage brain volume with voxels below each ADC threshold between 300 and 1200 × 10−6 mm2/s with a step of 50 were calculated. Area under the receiver operating characteristics curve (AUC) was used to identify optimal DWI MRI thresholds for brain volume percent most predictive of poor neurologic outcome. The primary outcome measure was neurologic outcome 6-months after CPA based on Pediatric Cerebral Performance Category (PCPC) score. Poor neurologic outcome was defined as PCPC score of 3–6, or a worsening from baseline score ≥1 if baseline PCPC score was ≥3. Results Twenty-six patients were included in this study. The median age was 8.5 years (2.2–14) and median time from CPA to MRI was 4 days (2–7). Two ADC thresholds for brain volume percent had the largest AUC for predicting poor neurologic outcome. An ADC threshold of Conclusions In pediatric patients who remain comatose or have significant neurologic deficits after CPA, quantitative DWI MRI correlates with neurologic outcome. Both an ADC threshold of