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Omaima Mohamed Ali,1 Aml Ahmed Sayed,1 Wafaa Salah Mohammed,2 Ragaa Ramadan Mohammed3 1Internal Medicine Department, Faculty of Medicine, Aswan University, Aswan, Egypt; 2Clinical Pathology Department, Faculty of Medicine, Aswan University, Aswan, Egypt; 3Internal Medicine Department, Faculty of Medicine, Al-Azhar University for Girls, Cairo, EgyptCorrespondence: Omaima Mohamed AliDepartment of Internal Medicine, Faculty of Medicine, Aswan University, Aswan 81528, EgyptTel +201005373193Fax +20973480449Email Omaimaaly3@gamil.comBackground: The incidence of end-stage renal disease (ESRD) has increased by 30– 40% in the last decade. These patients have a higher mortality rate of 3– 8 times compared to the general population. In the present study, we aimed to detect cardiovascular complications and their relation to the first-year mortality rate in patients on hemodialysis in Aswan University Hospital, upper Egypt.Patients and Methods: Our study was a cross-sectional study which was done at the hemodialysis unit in Aswan University Hospital from May 2016 to May 2018. The study included 100 patients with ESRD on regular hemodialysis (first year on programmed hemodialysis). All patients were subjected to full clinical examination and laboratory studies includngd complete blood count (CBC), kidney function tests, serum calcium and phosphorus level, parathormone (PTH) hormone, serum albumin level, C-reactive protein (CRP), echocardiography and electrocardiogram (ECG), and lateral abdominal x-ray for detection of aortic calcification. Results: The present study included 47 males and 53 females, with a mean age of 50.6 ± 13.89 years. The main risk factors for patients with ESRD were hypertension (48%) followed by diabetic nephropathy (36%), glomerulonephritis (15%), idiopathic etiology (11%), obstructive uropathy (8%), lupus nephritis (6%), polycystic kidney disease (4%) and cardio renal syndrome (1%). Twenty-seven deaths have been noted during the first year of dialysis treatment. The leading causes of death were cardio-vascular events (66, 67%), infection (22, 22%) and malignancy (11, 11%), The most common cardiovascular events were myocardial infarction (27.8%), sudden cardiac death (SCD) (27.8%) and heart failure (22.2%).Conclusion: In conclusion, our study showed that the main risk factors for ESRD patients in Aswan University Hospital are hypertensive nephrosclerosis, diabetic nephropathy, glomerulonephritis and idiopathic etiology, and the main causes of first-year mortality were cardiovascular events followed by infection and malignancy.Keywords: end-stage renal disease, cardiovascular complication, mortality rate

This study tried to assess the possibility of using the estimated levels of plasma expression of microRNAs (miR-) for distinguishing healthy subjects with latent pulmonary tuberculosis (LTB) from healthy controls (HC) and patients with active tuberculosis (ATB). Study participants included 30 newly diagnosed ATB patients, 30 of the households of ATB patients who were free of clinical manifestations, had normal chest radiography but had positive results on the whole-blood QuantiFERON tuberculosis (TB) Gold In-Tube (QFT-GIT) test (LTB patients), and 30 HC who were free of clinical symptoms and showed normal chest X-rays and negative QFT-GIT tests. All participants gave blood samples for quantitation of the plasma expression levels of miR- using the reverse transcription-quantitative polymerase chain reaction. Plasma levels of miR-150-5p were significantly downregulated in ATB samples than in other samples. However, miR-155-5p and miR-378-5p were significantly overexpressed in patients' samples compared to HC's samples and in ATB samples compared to LTB samples. On the contrary, plasma miR-4523-5p showed significant upregulation in LTB samples compared to ATB and HC samples, indicating insignificant in-between differences. The receiver operating characteristic curve analysis showed the ability of the estimated levels of the four miR- to differentiate TB patients from HC. Multivariate regression analysis defined expression levels of miR-155-5p and miR-378-5p as the significant biomarkers for distinguishing TB patients and levels of miR-378-5p and miR-4523-5p for identification of LTB patients. Pulmonary TB induces deregulated expression of miR-, according to the infection severity. An estimation of the expression levels of miR-378-5p and miR-4523-5p might be a reliable combination for identifying LTB patients.

Background: Francisella tularensis is a Gram-negative bacterium that causes tularemia in both human and animals. Tularemia is a potential serious zoonotic disease that is transmitted by different routes, including tick bites. Materials and Methods: This study deals with investigating the prevalence of F. tularensis in the ticks of local animal farms in Kurdistan region since the farmers are normally in close contact with livestock. We used molecular methods for this purpose. A total of 412 tick and 126 blood samples were gathered from goat, sheep, and cow flocks. The existence of F. tularensis 16Sr RNA gene was examined in the samples using nested-PCR technique. Results: In the animal blood specimens, no F. tularensis was found. The incidence of F. tularensis was 1.7% (7 out of 412) in the tick samples, representing a very lower possibility of tuleremia infection. Moreover, the two subspecies of F. tularensis novicida and holarctica were identified based on the sequencing of pdpD and RD genes, respectively. The F. tularensis subsp. novicida was isolated from four species of ticks, Hyalomma anatolicum, Rhipicephalus annulatus, Rhipicephalus sanguineus , and Ornithodoros spp., whereas the F. tularensis subsp. holarctica was isolated from Haemaphysalis parva and Hyalomma dromedarii species of ticks. Conclusion: Although its prevalence is very low, the isolation of F. tularensis subsp. holarctica from the ticks of farm animals suggests possible transmission of Tularemia through tick bite in Kurdistan region of Iraq. Ref: IR-UU-AEC-3/22.

Neospora caninum ( N. caninum) is the etiologic agent of neosporosis, a potential cause of severe reproductive disorders in cattle, small ruminants, equines, wild animals and canids across the world. The current study is performed to estimate molecular prevalence of N. caninum in small ruminants and equines that had abortion in Kurdistan region of Iraq. A total of 64 tissue samples (brain, placenta, heart, lung and liver) were taken from aborted foetuses, with a total of 122 dam blood samples taken from 63 sheep, 39 goats, 12 mares and 8 jennies in local breed fields. Besides, a risk factor analysis for N. caninum positive animals was performed. The observed prevalence of N. caninum DNA in the blood of sheep, goats, horses and donkeys were 20.6%, 17.9%, 21.4% and 25.0%, respectively, and 19.3%, 17.6%, 18.1 and 20.0% in the aborted foetuses of the animals, respectively. Moreover, occurrence of N. caninum was 20.3% in the blood of aborted dams, while it was 18.7% in their aborted foetuses. Confirmatory analysis was also done through constructing a phylogenetic tree to compare the partial sequences of the Nc-5 gene in our isolates (OP771519, OP771520, OP771521 and OP771522) with the GenBank sequences. This showed 98-100% sequence identity with other N. caninum strains in the GenBank database. Older small ruminants and equines had a higher risk of being positive for N. caninum and exposure to dogs were considered as significant risk factors for N. caninum infection in the studied animals (p<0.05). Thus, the results of this study suggest that N. caninum is one of the microbial abortive agents in small ruminants and equines in Kurdistan region of Iraq. It is hoped that the results of this study will help to control animal abortion in livestock and reduce the economic losses., (Copyright© by the Polish Academy of Sciences.)

Objectives: The present study was intended to investigate the effect of different concentrations of chitosan nanoparticles mixed with an orthodontic primer on the shear bond strength and bond failure of stainless steel brackets bonded to dental enamel., Methods: Four concentrations of chitosan nanoparticles (0%, 1%, 5%, and 10%) were prepared and mixed with Transbond™ XT primer. Forty-eight extracted maxillary first premolars were bonded under a standardized procedure with stainless steel orthodontic brackets utilizing those different concentrations (12 teeth per each group). After the bonding procedure, the specimens were stored in deionized water (37°C for 24 hr) and then thermocycling 5,000 times before shear bond testing, which was performed using a universal testing device. Bond failure sites were examined under a stereomicroscope. Scanning electron microscopy and X-ray diffraction were also performed to verify and evaluate the phase of the nanopowder., Results: The data were statistically analyzed using one-way analysis of variance) and Kruskal-Wallis H tests, and the findings revealed statistically nonsignificant group differences regarding the shear bond strength and adhesive remnant index ( p > 0.05)., Conclusions: Primers containing varying concentrations of chitosan nanoparticles demonstrated acceptable shear bonding strength and adhesive remnant index., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Rawnaq R. Mohammed and Reem A. Rafeeq.)

Abstract: Essential foods as part of a daily meal may include numerous kinds of biogenic amines (BAs) at various concentrations. BAs have a variety of toxicological effects on human health and have been linked to multiple outbreaks of foodborne disease. BAs also are known to cause cancer based on their ability to react with nitrite salts, resulting in the production of carcinogenic organic compounds (nitrosamines). Ingestion of large quantities of BAs in food causes toxicological effects and health disorders, including psychoactive, vasoactive, and hypertensive effects and respiratory, gastrointestinal, cardiovascular, and neurological disorders. The toxicity of BAs is linked closely to the BAs histamine and tyramine. Other amines, such as phenylethylamine, putrescine, and cadaverine, are important because they can increase the negative effects of histamine. The key method for reducing BA concentrations and thus foodborne illness is management of the bacterial load in foods. Basic good handling and hygiene practices should be used to control the formation of histamine and other BAs and reduce the toxicity histamine and tyramine. A better understanding of BAs is essential to enhance food safety and quality. This review also includes a discussion of the public health implications of BAs in foods., (Copyright ©, International Association for Food Protection.)

Background: Patient-reported outcomes (PROs) allow for the direct measurement of functional and psychosocial effects related to treatment. However, technological barriers, survey fatigue, and clinician adoption have hindered the meaningful integration of PROs into clinical care. The objective of the authors was to develop an electronic PROs (ePROs) program that meets a range of clinical needs across a head and neck multidisciplinary disease management team., Methods: The authors developed the ePROs module using literature review and stakeholder input in collaboration with health informatics. They designed an ePROs platform that was integrated as the standard of care for personalized survey delivery by diagnosis across the disease management team. Tableau software was used to create dashboards for data visualization and monitoring at the clinical enterprise, disease subsite, and patient levels. All patients who were treated for head and neck cancer were eligible for ePROs assessment as part of the standard of care. A descriptive analysis of ePROs program implementation is presented herein., Results: The Head and Neck Service at Memorial Sloan Kettering Cancer Center has integrated ePROs into clinical care. Surveys are delivered via the patient portal at the time of diagnosis and longitudinally through care. From August 1, 2018, to February 1, 2020, a total of 4154 patients completed ePROs surveys. The average patient participation rate was 69%, with a median time for completion of 5 minutes., Conclusions: Integration of the head and neck ePROs program as part of clinical care is feasible and could be used to assess value and counsel patients in the future. Continued qualitative assessments of stakeholders and workflow will refine content and enhance the health informatics platform., Lay Summary: Patients with head and neck cancer experience significant changes in their quality of life after treatment. Measuring and integrating patient-reported outcomes as a part of clinical care have been challenging given the multimodal treatment options, vast subsites, and unique domains affected. The authors present a case study of the successful integration of electronic patient-reported outcomes into a high-volume head and neck cancer practice., (© 2020 American Cancer Society.)

Diabetes mellitus (DM) has been treated with herbs for centuries and many herbs reported to exert antidiabetic activity. Laurus nobilis is an aromatic herb belonging to the Lauraceae family, commonly known as bay. This study aimed to investigate the activity of Laurus nobilis leave extracts on histopathological and biochemical changes in β-cells of streptozotocin (STZ)-induced diabetic rats. Thirty healthy adult male albino rats were included in the study and divided equally into 5 groups for 4 weeks as follow; control group (C), diabetic group (D), diabetic Laurus nobilis extract group (DLN), Laurus nobilis extract group (LN) and diabetic acarbose (DA) group. Histopathologically, D group rats exhibited various degenerative and necrotic changes in their liver, pancreas and kidney, whereas the DLN rats had nearly normal histology. Insulin immunostaining in the pancreatic beta cells was decreased in the D group compared to the C group, whereas the DLN group was similar to the C group. The glucose concentration decreased significantly in both diabetic rats treated with L. nobilis and acarbose ( p  < 0.05). Additionally, the levels of aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT) and alanine aminotransferase (ALT) enzyme were significantly decreased in both diabetic rats treated with L. nobilis and acarbose, compared to the D group ( p ˃ 0.05). Outcomes of this study said that leave extracts of L. nobilis has valuable effect on blood glucose level and ameliorative effect on regeneration of pancreatic islets, it also restored the altered liver enzymes, urea, creatine kinase, total protein levels, calcium and ferritin to near normal., Competing Interests: There is no conflict of interest., (© 2020 The Authors.)

This paper proposes a novel approach for gait analysis from wearable sensing, based on an adaptive periodic model of any gait signal. The proposed method learns a model of the gait cycle during online measurement, using a continuous representation that can adapt to inter and intra-personal variability by creating an individualized model. Once the algorithm has converged to the input signal, key gait events can be identified relative to the estimated gait phase; these events can then be used to calculate gait parameters. The approach is implemented and tested on a human motion dataset where heel impact and toe takeoff events are extracted with an average error of 0.04 cycles.

Palm Oil Mill Effluent (POME) treatment has always been a topic of research in Malaysia. This effluent that is extremely rich in organic content needs to be properly treated to minimize environmental hazards before it is released into watercourses. The main aim of this work is to evaluate the potential of applying natural, chemically and thermally modified banana peel as sorbent for the treatment of biologically treated POME. Characteristics of these sorbents were analyzed with BET surface area and SEM. Batch adsorption studies were carried out to remove color, total suspended solids (TSS), chemical oxygen demand (COD), tannin and lignin, and biological oxygen demand (BOD) onto natural banana peel (NBP), methylated banana peel (MBP), and banana peel activated carbon (BPAC) respectively. The variables of pH, adsorbent dosage, and contact time were investigated in this study. Maximum percentage removal of color, TSS, COD, BOD, and tannin and lignin (95.96%, 100%, 100%, 97.41%, and 76.74% respectively) on BPAC were obtained at optimized pH of 2, contact time of 30 h and adsorbent dosage of 30 g/100 ml. The isotherm data were well described by the Redlich-Peterson isotherm model with correlation coefficient of more than 0.99. Kinetic of adsorption was examined by Langergren pseudo first order, pseudo second order, and second order. The pseudo second order was identified to be the governing mechanism with high correlation coefficient of more than 0.99., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Guillain-Barré syndrome (GBS) and acute disseminated encephalomyelitis (ADEM) are clinically distinct demyelinating disorders that share an autoimmune pathogenesis and prior history of viral infection or vaccination. Concurrent GBS and ADEM are uncommon with few reported cases. Our patient is a 10-year-old girl who presented with acute quadriparesis, areflexia, and urinary retention. Lumber puncture revealed mild pleocytosis and elevated protein. She required mechanical ventilation and failed to improve after intravenous immunoglobulins. She subsequently developed double vision and disturbed level of consciousness. Brain MRI revealed multiple white matter lesions suggestive of ADEM. Based on the temporal association and exclusion of alternative etiologies, we made a diagnosis of GBS and ADEM. She improved remarkably after intravenous methylprednisolone. We conclude that co-morbid GBS and ADEM is an uncommon entity presenting with severe neurological morbidity. Prompt recognition and treatment can hasten the recovery and therefore improve the neurological outcome.