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Reham Hammad,1 Mona A Eldosoky,1 Alshaimaa M Mosaad,2 Asmaa M El-Nasser,3 Fatma M Kotb,4 Salwa I Elshennawy,1 Noha Abdel-Rahman Eldesoky,5 Mohamed A Selim,6 Gina G Naguib,7 Ossama A Ahmed,7 Mohamed Alboraie,8 Reda Badr Aglan9 1Clinical Pathology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt; 2Hepatogastroenterology and Infectious Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 3Medical Microbiology and Immunology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt; 4Internal Medicine Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 5Biochemistry and Molecular Biology Department, Faculty of Pharmacy (for Girls), Al-Azhar University, Cairo, Egypt; 6Botany and Microbiology Department, Faculty of Science (for Boys), Al-Azhar University, Cairo, Egypt; 7Internal Medicine, Gastroenterology and Hepatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 8Department of internal medicine, Al-Azhar University, Cairo, Egypt; 9Hepatology and Gastroenterology Department, National Liver Institute Menoufia university, Menoufia, EgyptCorrespondence: Mohamed Alboraie, Department of internal medicine, Al-Azhar University, Cairo, Egypt, Tel +20222602687, Fax +20224020184, Email alboraie@azhar.edu.egBackground: Natural killer (NK) and B1a cells are implicated in innate immune surveillance against chronic hepatitis C virus (CHCV). NK group 2D (NKG2D) receptor is important for B cell differentiation. This study was designed to assess whether B1a cells and NK Cells expressing NKG2D are implicated in post-hepatitis C infection hepatocellular carcinoma (post-HCV HCC) and cirrhosis using flow cytometry and investigate the association between NK-expressing NKG2D and B1a in complications of CHCV infection.Methods: In this cross-sectional study, 111 participants were included and divided into the post-HCV HCC (n = 50), post-HCV liver cirrhosis (n = 31), and CHCV (n = 30) groups.Results: The percentage of B1a cells (B1a%) and the mean fluorescence intensity (MFI) of NKG2D (NKG2D MFI) showed a significant increase in the CHCV group compared with those in the post-HCV liver cirrhosis and post-HCV HCC groups (P < 0.05). A positive correlation was observed between NKG2D MFI and B1a% (r = 0.6, P < 0.001). The receiver operating characteristic (ROC) curve revealed that NKG2D MFI and B1a% differentiated between patients with CHCV infection and those with HCC with a sensitivity of 92% and 98%, respectively, and differentiated between patients with CHCV infection and those with liver cirrhosis with a sensitivity of 94% and 90%, respectively.Conclusion: Downregulation of B1a frequency and NKG2D intensity is implicated in the progression of CHCV infection to cirrhosis and HCC. NKG2D receptor is associated with the frequency of circulating B1a cells. NKG2D intensity and B1a% can be used as indicators of CHCV progression.Keywords: B1a cells, chronic hepatitis C, hepatocellular carcinoma, NKG2D

Mohamed M S Farag,1 Reda A Suef,1 Ghada M Al-Toukhy,2 Mohamed A Selim,1 Mostafa A Elbahnasawy,1 Nahla El Sharkawy,3 Sameera Ezzat,4 Nashwa Shebl,5 Mohamed T M Mansour6 1Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo 11884, Egypt; 2Virology & Immunology Department, Children’s Cancer Hospital, Cairo 57357, Egypt; 3Clinical Pathology Department, National Cancer Institute, Cairo University and Children Cancer Hospital, Cairo 57357, Egypt; 4Epidemiology & Preventive Medicine Department, National Liver Institute, Menoufia University, Al Minufya, Egypt; 5Hepatology Department, National Liver Institute, Menoufia University, Al Minufya, Egypt; 6Virology & Immunology Department, National Cancer Institute, Cairo University and Children Cancer Hospital, Cairo 57357, EgyptCorrespondence: Mohamed M S FaragBotany and Microbiology Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, EgyptTel +20 2 100 670 4553Fax + 20 2 22629358Email mohamed.farag@azhar.edu.egBackground: In chronic hepatitis B virus (CHB) patients, both dendritic cells (DCs) and T cells are functionally impaired and consequently the HBV-specific cellular immune responses are downregulated. The present study aims to investigate whether monocyte-derived DC (MoDCs)-pulsed-HBV subviral particles (HBVsvp) can polarize Th1 cells to induce HBV-specific cytotoxic T-lymphocytes (CTL) responses in CHB patients.Methods and Materials: To this end, the human hepatoma HepG2.2.15 cell line was used to produce HBVsvp as a culturing system, and HBVsvp were concentrated for highly virus titer using the polyethylene glycol protocol. Peripheral blood mononuclear cells (PBMCs), collected from CHB patients and healthy donors, were differentiated into MoDCs and T cells. PBMCs-derived MoDCs were first pulsed with HBVsvp and then cultured with PBMCs-derived T cells. MoDCs and/or T subsets cells were identified for phenotypic activation by FACS analysis. The cytokine secretion of IL-4, IL-12, and IFN-γ in the culture supernatants was detected.Results: The MoDCs were restored for their activation upon pulsing with HBVsvp in vitro, as identified by significantly overexpression of both CD86 and HLA-DR, and overproduction of IL-4 and IL-12. Furthermore, MoDCs-pulsed-HBVsvp induced Th1 frequencies and activated HBV-specific CTL to produce significantly highest amount of IFN-γ. Enhanced HBV-specific CTL led to strong cytolytic capacity against HepG2.2.15.Conclusion: Overall, our data suggest that in vitro activation of MoDCs with HBVsvp overcomes the functionally impaired DCs and T cells in CHB patients offering a promising tool for therapeutic or vaccine-based approaches against HBV.Keywords: CHB, MoDCs-pulsed-HBVsvp, HBV-specific CTL, immunotherapy

Introduction: Adnexal torsion is characterised by the rotation of the ovary and, occasionally, the fallopian tube around their supporting ligaments by more than 45 degrees. It predominantly occurs during the first and second trimesters of pregnancy, with an incidence of up to 0.1% in the third trimester. Dermoid and functional ovarian cysts, most commonly associated with benign serous cystadenomas, are frequently identified among the torted adnexal masses. Case Presentation: We report the case of a 32-year-old primigravida with a known ovarian cyst diagnosed in the first trimester, which was managed conservatively throughout the pregnancy. At 36 weeks of gestation, she presented with abdominal pain and was subsequently managed with an emergency caesarean section at 37 weeks due to the development of an acute surgical abdomen. During the procedure, a torted left tubo-ovarian complex was excised, with partial preservation of the healthy-appearing ovarian tissue. Histopathological examination identified the mass as a benign serous cystadenoma. Conclusions: Ovarian torsion during pregnancy poses a significant diagnostic challenge. The decision between conservative management and surgical intervention is primarily guided by a high index of suspicion for torsion.

The presence of heavy metals in wastewater has become a serious issue and a global concern for the environment and public health with rapid progress of modern textile industry. To minimize the health risks of heavy metals their complexation to a chelating agent constitute a promising process using membrane separation. We highlight for the first time the use of Keggin type-polyoxometalates (PW12) as complexing agent to eliminate heavy metals from synthetic textile wastewater. Indeed, filtration experiments were performed through the ultrafiltration organic regenerated cellulose membrane (3KDa). Effects of pressure (1–2.5 bar), PW12 concentration (10–50 mg·L−1), salt concentration (10−4–2 M) and pH value (2–12) on cadmium (Cd) and copper (Cu) removal were regularly explored. Experimental data showed that the addition of PW12 improves metal removal efficiency (up to 90%). The addition of NaCl salt significantly decreases the metals retention to 42%. The retention drop is probably due to the competition between Na+ and metals on complexation same negative sites of the PW12 and to the electric double-layer compressing. 24 full factorial design has been used to evaluate the most influencing parameters. The results obtained revealed that the maximum metal retention was 99% for both Cd and Cu. HIGHLIGHTS The PW12 is a new eco-friendly candidate used to improve membrane performance.; PW12-assisted ultrafiltration process can remove up to 99% of Cd and Cu metals.; Toxic metals were complexed with the anionic PW12 forming stable complex.; We attempt to study the effects of pressure, PW12 concentration, ionic strength, and pH value on heavy metals removal.; 24 full factorial design was used for optimization of removal parameters.;

The hydrodynamic flow of an incompressible and isotropic Casson fluid through a yawed cylinder is investigated by employing continuity, momentum, and energy equations satisfying suitable boundary conditions. The density variation is governed by Boussinesq approximation. The model equations consisting of coupled partial differential equations (PDEs) are transformed by applying non-similar transformation relations. The set of transformed PDEs is solved using the analytical technique of homotopy analysis method (HAM). The impacts of varying yaw angle, and mixed convection and Casson parameters over fluid velocity (chordwise and spanwise components), its temperature, Nusselt number, and skin friction coefficients are investigated and explained through various graphs. It is found that the enhancing yaw angle, Casson parameter, and convection parameter augment the fluid velocity, heat transfer rate, and skin friction and reduce the fluid temperature. The agreement of present and published results justifies the application of HAM in modeling the mixed convective Casson fluid flow past a yawed cylinder.

In this work, an attempt is done to apply the eigenvalue approach as well as Donnell thin-shell theory to find out the vibrational analyses of an irregular single-walled carbon (ISWCNT) incorporating initial stress effects. The effects of surface irregularity and initial stresses on natural frequency of vibration of nano materials, especially for single-walled carbon nanotubes (SWCNTs), have not been investigated before, and most of the previous research have been carried for a regular and initial stress-free CNTs. Therefore, it must be emphasized that the vibrations of prestressed irregular SWCNT are novel and applicable for the design of nano oscillators and nanodevices, in which SWCNTs act as the most prevalent nanocomposite structural element. The surface irregularity is assumed in the parabolic form at the surface of SWCNT. A novel equation of motion and frequency equation is derived. The obtained numerical results provide a better representation of the vibration behavior of prestressed ISWCNTs. It has been observed that the presence of either surface irregularity or initial stress has notable effects on the natural frequency of vibration, particularly in the short-length SWCNTs. Numerical results show that the natural frequency of SWCNT decreases with increase in surface irregularity and initial stress parameters. To the authors’ best knowledge, the effect of surface irregularity and initial stresses on the vibration behavior of SWCNTs has not yet been studied, and the present work is an attempt to find out this effectiveness. In addition, the results of the present analysis may serve as useful references for the application and the design of nano oscillators and nanodevices, in which SWCNTs act as the most prevalent nanocomposite structural element.

Fouling has been widely recognized as the Achilles’ heel of membrane processes and the growing perception about the relevance of this critical issue has driven the development of advanced antifouling strategies. Herein, novel fouling-resistant ultrafiltration (UF) membranes for Cadmium (Cd) remediation were developed via a blending method by combining the flexibility of cellulose acetate (CA) with the complex properties of poly(acrylic acid) (PAA). A systematic characterization, based on differential scanning calorimetry (DSC) and Fourier Transform Infrared Spectroscopy (FTIR), confirmed the homogeneity of the blend favored by hydrogen interconnections between CA and PAA polymeric chains. The concentration of PAA with respect to CA played a key role in tuning the morphology and the hydrophilic character of the novel UF membranes prepared via non-solvent-induced phase separation (NIPS). UF experiments revealed the tremendous advantages of the blend since CA/PAA membranes showed superior performance with respect to the neat CA membrane in terms of (i) water permeability; (ii) Cd rejection; and (iii) antifouling resistance to humic acid (HA). Concisely, the increasing of the concentration of PAA in the casting solution was found to be beneficial to improve the flux recovery ratio (FRR) coupled with the decline of the total fouling ratio (Rt). Overall, PAA is an effective additive to prepare CA membranes with enhanced antifouling properties exploitable for the remediation of water bodies contaminated by heavy metals via UF process.

Objective. To determine if whole body vibration therapy (WBV) effectively improves functional outcome in patients with poststroke hemiplegia. Materials and Methods. In this single-blind RCT, WBV group (n=10) had 40 hz frequency/4 mm amplitude vibration during 5 minutes/session, 3 days a week, for a duration of 4 weeks. The control group (n=11) had no vibration therapy for the same duration while standing on the same platform. Patients in both of the groups did 15 minutes of stretching and active range of motion exercises before the intervention. Outcome measures were Modified Ashworth Scale (MAS), Functional Independence Measurement (FIM), and Timed 10-Meter Walk Test (10 mWT). Results. Only 10 mWT improved at the 1st week (p=0.002), 1st month (p

Abstract Background Recent trials suggest that angiotensin-converting enzyme inhibitors (ACEI) are effective in prevention of ischemic stroke, as measured by reduced stroke incidence. We aimed to compare stroke severity between stroke patients who were taking ACEI before their stroke onset and those who were not, to examine the effects of pretreatment with ACEI on ischemic stroke severity. Methods We retrospectively studied 126 consecutive patients presenting within 24 hours of ischemic stroke onset, as confirmed by diffusion-weighted magnetic resonance imaging (DWI). We calculated the NIHSS score at presentation, as the primary measure of clinical stroke severity, and categorized stroke severity as mild (NIHSS [less than or equal to] 7), moderate (NIHSS 8–13) or severe (NIHSS [greater than or equal to] 14). We analyzed demographic data, risk-factor profile, blood pressure (BP) and medications on admissions, and determined stroke mechanism according to TOAST criteria. We also measured the volumes of admission diffusion- and perfusion-weighted (DWI /PWI) magnetic resonance imaging lesions, as a secondary measure of ischemic tissue volume. We compared these variables among patients on ACEI and those who were not. Results Thirty- three patients (26%) were on ACE-inhibitors. The overall median baseline NIHSS score was 5.5 (range 2–21) among ACEI-treated patients vs. 9 (range 1–36) in non-ACEI patients (p = 0.036). Patients on ACEI prior to their stroke had more mild and less severe strokes, and smaller DWI and PWI lesion volumes compared to non-ACEI treated patients. However, none of these differences were significant. Predictably, a higher percentage of patients on ACEI had a history of heart failure (p = 0.03). Age, time-to-imaging or neurological evaluation, risk-factor profile, concomitant therapy with lipid lowering, other antihypertensives or antithrombotic agents, or admission BP were comparable between the two groups. Conclusion Our results suggest that ACE-inhibitors may reduce the clinical severity of stroke, as measured by NIHSS score. Further, larger-scale, prospective studies areneeded to validate our findings, and to elucidate the mechanism(s) of ACEImediated benefits in patients with ischemic stroke.

Background: The relationship between chronic hepatitis B (CHB) infection and natural killer (NK) cell dysfunction is well-established, but the specific role of HBV viral antigens in driving NK cell impairment in patients with CHB remains unclear. This study investigates the modulatory effects of hepatitis B virus subviral particles (HBVsvp, a representative model for HBsAg) on the phenotypic regulation (activating and inhibitory receptors), cytokine production and cytotoxic potential of peripheral blood mononuclear cell-derived natural killer cells (PBMCs-derived NK cell), which contributes to NK cell dysfunction in CHB infection, potentially serving as an effective HBV immune evasion strategy by the virus., Methods: NK cells were isolated from peripheral blood of patients with CHB (n=5) and healthy individuals (n=5), stimulated with HBVsvp. Subsequent flow cytometric characterization involved assessing changes in activating (NKp46 and NKG2D) and inhibitory (CD94) receptors expression, quantifying TNF-α and IFN- γ cytokine secretion, and evaluating the cytotoxic response against HepG2.2.15 cells with subsequent HBVsvp quantification., Results: In CHB patients, in vitro exposure of PBMCs-derived NK cell with HBVsvp (represent HBsAg model) significantly reduced NK cell-activating receptors expression (P = 0.022), increased expression of CD94 + NK cells (p = 0.029), accompanied with a reduced TNF-α - IFN-γ cytokine levels, and impaired cytotoxic capacity (evidenced by increased cell proliferation and elevated HBVsvp levels in co-cultures with HepG2.2.15 cells in a time-dependent), relative to healthy donors., Conclusion: These findings suggest that HBVsvp may induce dysfunctional NK cell responses characterized by phenotypic imbalance with subsequent reduction in cytokine and cytotoxic levels, indicating HBVsvp immunosuppressive effect that compromises antiviral defense in CHB patients. These data enhance our understanding of NK cell interactions with HBsAg and highlight the potential for targeting CD94 inhibitory receptors to restore NK cell function as an immunotherapeutic approach. Further clinical research is needed to validate these observations and establish their utility as reliable biomarkers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Selim, Suef, Saied, Abdel-Maksoud, Almutairi, Aufy, Mousa, Mansour and Farag.)

Objective: The COVID-19 pandemic imposed unprecedented challenges to health systems globally. This study explored slum dwellers' experience of receiving essential health services during the pandemic and the challenges faced by healthcare providers in urban areas of Bangladesh., Design: The study followed a cross-sectional study design using qualitative methods., Setting: The study was conducted in Dhaka and Gazipur City Corporations during November 2020-February 2021., Participants: 17 key informant interviews were carried out with healthcare providers and policy-makers and 22 in-depth interviews were carried out with slum dwellers. Thematic analysis was performed., Results: The study identified challenges to the provision of essential healthcare in selected areas of Dhaka and Gazipur City Corporations during the COVID-19 pandemic. The lack of information on the availability of functional healthcare facilities, fear of contracting COVID-19 and restrictions on movement and transportation, resulted in delays in seeking essential healthcare during a pandemic. Access to healthcare facilities was further hindered by various hospitals' decision to refuse care to general patients without valid, negative COVID-19 test results. Healthcare providers identified patients' tendency to hide COVID-19 symptoms as a barrier to providing healthcare services to general patients. Conversely, patients concealed their symptoms to avoid COVID-19 tests and gain access to required treatment. In addition, the reallocation of human resources for COVID-19 treatment disrupted the delivery of essential health services., Conclusion: The pandemic affected the accessibility of the slum population to essential healthcare and disrupted health service delivery. The findings of the study have highlighted gaps in the health system during an emergency response period like COVID-19. The study will assist the government and other stakeholders in designing tailored interventions and allocating resources in a more efficient manner to ensure universal health coverage in the face of health emergencies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Worldwide, female breast cancer (BC) has surpassed lung cancer as the most commonly diagnosed cancer. Early diagnosis of cancer recurrence can provide substantial benefits for BC patients who are at high risk of relapse. We aimed to investigate the role of ALU 247, ALU 115, cfDNA integrity index, CA15-3 and CEA as potential diagnostic markers in BC patients and as markers for early prediction of recurrence. Fifty BC patients (10 patients showed recurrence), 26 BBD patients and 22 healthy controls were included. Real-time q-PCR was used to measure the concentration of ALU 247 and ALU 115 in plasma then cfDNA integrity index was calculated. "ECLIA" was used to measure the concentration of CA15-3 and CEA in serum. Our results showed significant higher levels of ALU 247, ALU 115, CA15-3 and CEA in BC patients in comparison to healthy controls (P=0.02, 0.008, <0.001 and < 0.001 respectively). Also, cfDNA integrity index was higher in BC patients in comparison to healthy controls but statistically insignificance (p = 0.46). In recurrent BC patients; ALU 247, ALU 115, cfDNA integrity index, CA15-3 and CEA levels were higher compared to non-recurrent BC patients but with no statistic significant (p = 0.46, 0.59, 0.09, 0.85 and 0.84 respectively). This may result from the short period of follow up (1-2 years) and the relatively small sample size due to exclusion of patients with chronic diseases or inflammation as well as those who received therapy or post-surgery. By using the ROC curve, the sensitivity of ALU 247, ALU 115, CA15-3 and CEA for discriminating BC patients from BBD patients and healthy controls was 79 %, 79.2 %, 76.0 % and 88.0 % respectively. This study suggested that ALU 247, ALU 115, CA15-3 and CEA could be promising non-invasive markers of BC for diagnosis and early prediction of recurrence after validation in large-scale future studies., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Abstract: Differentiated vulvar intraepithelial neoplasia (d-VIN) is an HPV-independent precursor to vulvar squamous cell carcinoma. The histology of d-VIN lesions is difficult to differentiate from that of non-neoplastic epithelial disorders, especially lichen sclerosus (LS). The authors present a case of LS, where relying on histopathology alone could have led to misdiagnosis. The patient was a 17-year-old female patient with clinical features of vulvar dermatitis and LS for 2 years. She was counseled to apply clobetasol 0.05% to the affected area daily but reported no improvement after 6 months. A biopsy of the right labia majora revealed histologic findings typical of d-VIN and near-contiguous p53 expression. These features are characteristic of d-VIN. However, d-VIN is exceedingly rare in young patients. The case was reviewed by 6 dermatopathologists and gynecologic pathologists, who observed that the degree of inflammation would be unusual postclobetasol therapy and could be due to noncompliance. A review of the patient's chart revealed that she "does not always remember to apply" clobetasol. The patient's clinician confirmed that there were compliance issues, and the follow-up biopsy was negative for d-VIN. The case was signed out as LS, with a note describing the above, and to rebiopsy if concern persisted. The authors conjecture that inflammatory infiltrates in the biopsied area caused reactive atypia due to lack of adherence to treatment. Although the patient's age helped rule out d-VIN, similar cases in elderly patients may be occurring. Pathologists must be aware that reactive forms of untreated LS can mimic d-VIN, to avoid misdiagnosis., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Inflammatory bowel disease is an autoimmune disease that affects the gut. T. spiralis larvae (E/S Ags) loaded on calcium-benzene-1,3,5-tricarboxylate metal-organic frameworks (Ca-BTC MOFs) were tested to determine whether they might prevent or cure acetic acid-induced murine colitis. Methods: T. spiralis larvae E/S Ags/Ca-BTC MOFs were used in prophylactic and therapeutic groups to either precede or follow the development of murine colitis. On the seventh day after colitis, mice were slaughtered. The effect of our target antigens on the progress of the colitis was evaluated using a variety of measures, including survival rate, disease activity index, colon weight/bodyweight, colon weight/length) ratios, and ratings for macroscopic and microscopic colon damage. The levels of inflammatory cytokines (interferon-γ and interleukin-4), oxidative stress marker malondialdehyde, and glutathione peroxidase in serum samples were evaluated. Foxp3 T-reg expression was carried out in colonic and splenic tissues. Results: T. spiralis larvae E/S Ags/Ca-BTC MOFs were the most effective in alleviating severe inflammation in murine colitis. The survival rate, disease activity index score, colon weight/length and colon weight/bodyweight ratios, and gross and microscopic colon damage scores have all considerably improved. A large decrease in proinflammatory cytokine (interferon-γ) and oxidative stress marker (malondialdehyde) expression and a significant increase in interleukin-4 and glutathione peroxidase expression were obtained. The expression of Foxp3+ Treg cells was elevated in colonic and splenic tissues. Conclusion: T. spiralis larvae E/S Ags/Ca-BTC MOFs had the highest anti-inflammatory, antioxidant, and cytoprotective capabilities against murine colitis and might be used to develop new preventative and treatment strategies.

As more data become available, the Banff 2007 working classification of skin-containing vascularized composite allograft (VCA) pathology is expected to evolve and develop. This report represents the Banff VCA Working Group's consensus on the first revision of the 2007 scoring system. Prior to the 2022 Banff-CanXadian Society of Transplantation Joint Meeting, 83 clinicians and/or researchers were invited to a virtual meeting to discuss whether the 2007 Banff VCA system called for a revision. Unanimously, it was determined that the vascular changes were to be included in the first revision. Subsequently, 2 international online surveys, each followed by virtual discussions, were launched. The goals were (1) to identify which changes define severe rejection, (2) to grade their importance in the evaluation of severe rejection, and (3) to identify emerging criteria to diagnose rejection. A final hybrid (in-person and virtual) discussion at the Banff/Canadian Society of Transplantation Joint Meeting finalized the terminology, the definition, a scoring system, and a reporting system of the vascular changes. This proposal represents an international consensus on this topic and establishes the first revision of the Banff 2007 working classification of skin-containing vascularized composite allograft pathology., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Objectives : Urinary tract infections [UTIs] are considered the third most known risk of infection in human health around the world. There is increasing appreciation for the pathogenicity of Gram-positive and Gram-negative strains in UTIs, aside from fungal infection, as they have numerous virulence factors. Materials and Methods : In this study, fifty urine samples were collected from patients suffering from UTI. Among the isolates of UTI microbes, six isolates were described as MDR isolates after an antibiotic susceptibility test carried out using ten different antibiotics. An alternative treatment for microbial elimination involved the use of biosynthesized silver nanoparticles (AgNPs) derived from Solanum lycopersicum [ S. cumin ]. Results : The sizes and shapes of AgNPs were characterized through TEM imaging, which showed spherical particles in a size range of 35-80 nm, of which the average size was 53 nm. Additionally, the silver nanoparticles (AgNPs) demonstrated inhibitory activity against Staphylococcus aureus (OR648079), exhibiting a 31 mm zone of inhibition at a minimum inhibitory concentration (MIC) of 4 mg/mL and a minimum bactericidal concentration (MBC) of 8 mg/mL. This was followed by Aspergillus niger (OR648075), which showed a 30 mm inhibition zone at an MIC of 16 mg/mL and a minimum fungicidal concentration (MFC) of 32 mg/mL. Then, Enterococcus faecalis (OR648078), Klebsiella pneumoniae (OR648081), and Acinetobacter baumannii (OR648080) each displayed a 29 mm zone of inhibition at an MIC of 8 mg/mL and an MBC of 16 mg/mL. The least inhibition was observed against Candida auris (OR648076), with a 25 mm inhibition zone at an MIC of 16 mg/mL and an MFC of 32 mg/mL. Furthermore, AgNPs at different concentrations removed DPPH and H 2 O 2 at an IC50 value of 13.54 μg/mL. Also, AgNPs at 3 mg/mL showed remarkable DNA fragmentation in all bacterial strains except Enterococcus faecalis . The phytochemical analysis showed the presence of different active organic components in the plant extract, which concluded that rutin was 88.3 mg/g, garlic acid was 70.4 mg/g, and tannic acid was 23.7 mg/g. Finally, AgNPs concentrations in the range of 3-6 mg/mL showed decreased expression of two of the fundamental genes necessary for biofilm formation within Staphylococcus aureus , fnbA (6 folds), and Cna (12.5 folds) when compared with the RecA gene, which decreased by one-fold when compared with the control sample. These two genes were submitted with NCBI accession numbers [OR682119] and [OR682118], respectively. Conclusions : The findings from this study indicate that biosynthesized AgNPs from Solanum lycopersicum exhibit promising antimicrobial and antioxidant properties against UTI pathogens, including strains resistant to multiple antibiotics. This suggests their potential as an effective alternative treatment for UTIs. Further research is warranted to fully understand the mechanisms of action and to explore the therapeutic applications of these nanoparticles in combating UTIs.

Coleus forskohlii (Willd.) Briq. is a medicinal herb of the Lamiaceae family. It is native to India and widely present in the tropical and sub-tropical regions of Egypt, China, Ethiopia, and Pakistan. The roots of C. forskohlii are edible, rich with pharmaceutically bioactive compounds, and traditionally reported to treat a variety of diseases, including inflammation, respiratory disorders, obesity, and viral ailments. Notably, the emergence of viral diseases is expected to quickly spread; consequently, these data impose a need for various approaches to develop broad active therapeutics for utilization in the management of future viral infectious outbreaks. In this study, the naturally occurring labdane diterpenoid derivative, Forskolin, was obtained from Coleus forskohlii . Additionally, we evaluated the antiviral potential of Forskolin towards three viruses, namely the herpes simplex viruses 1 and 2 (HSV-1 and HSV-2), hepatitis A virus (HAV), and coxsackievirus B4 (COX-B4). We observed that Forskolin displayed antiviral activity against HAV, COX-B4, HSV-1, and HSV-2 with IC 50 values of 62.9, 73.1, 99.0, and 106.0 μg/mL, respectively. Furthermore, we explored the Forskolin's potential antiviral target using PharmMapper, a pharmacophore-based virtual screening platform. Forskolin's modeled structure was analyzed to identify potential protein targets linked to its antiviral activity, with results ranked based on Fit scores. Cathepsin L (PDB ID: 3BC3) emerged as a top-scoring hit, prompting further exploration through molecular docking and MD simulations. Our analysis revealed that Forskolin's binding mode within Cathepsin L's active site, characterized by stable hydrogen bonding and hydrophobic interactions, mirrors that of a co-crystallized inhibitor. These findings, supported by consistent RMSD profiles and similar binding free energies, suggest Forskolin's potential in inhibiting Cathepsin L, highlighting its promise as an antiviral agent.

Atypical and malignant cutaneous tumors are understudied in the pediatric population, with limited data on long-term follow-up. This study examines pediatric (0-18 years) atypical melanocytic proliferations over a twenty-year period (January 2002-December2022) using the EPIC SlicerDicer at our institution. Over a twenty-year period, there were 55 cases of pediatric melanoma (53 patients). The median follow-up time was 8 years, 11 months. A proportion of 96% were treated with wide local excision (WLE), and 47% had a sentinel lymph node biopsy (SLNB) (35% positive rate). There were 101 atypical Spitz tumor cases (85% atypical Spitz tumors, 15% Spitz melanoma), with a median follow-up duration of 9 years. A proportion of 77% were treated with WLE (with one patient dying of metastatic disease). There were 10 cases of atypical melanocytic proliferations not otherwise specified, including 5 pigmented epithelioid melanocytomas (PEM), 4 deep-penetrating nevi, and 1 atypical cellular blue nevus. This study adds to the growing body of knowledge on pediatric atypical cutaneous melanocytic proliferations, aligning with many described characteristics such as disease location and overall survival rates, with distinct exceptions (higher melanoma positive SLNB rate, lower atypical Spitz tumor WLE rate, and a case of fatal metastatic atypical Spitz tumor).

Background and objective Characterizing the epidemiological features of coronavirus disease 2019 (COVID-19) is highly important for developing and implementing effective control measures against it. However, there is scarce data about the presenting features and outcomes in ICU patients with COVID-19 in the Kingdom of Saudi Arabia (KSA). In light of this, this study aimed to assess the characteristics of and outcomes in COVID-19 ICU patients in KSA in order to describe and identify the risks associated with morbidity and mortality among them. Methodology A retrospective, hospital-based study was conducted from March 2020 to October 2021, which involved the review of medical records of the patients admitted to the ICU at COVID-19 treatment centers. The demographic data, comorbidities, signs, and symptoms of the patients were collected, along with data on the need for ventilation, duration of ICU stay, and fatality rate. All data were analyzed and the associations between variables were evaluated. Results A total of 172 patients were included in the study, most of them males (n=97, 56.4%) and elderly (69.6 ±18.2 years). The majority were Saudi nationals (n=143, 83.1%). Regarding comorbidities accompanying COVID-19, about 95 (55.2%) patients had cardiac diseases while 85 (49.4%) had diabetes; 33.7% of the patients needed mechanical ventilation versus 40.7% who needed non-mechanical ventilation. Significant associations were found in terms of age, comorbidities, and mortality rate (90, 52.3%), especially with cardiac diseases (p=0.025), diabetes (p=0.009), and kidney diseases (p=0.003). Conclusion COVID-19 infection is associated with a wide range of characteristics and outcomes. Raising awareness about the risk factors associated with COVID-19 infection will improve clinical outcomes by ensuring correct resource allocations and implementation of appropriate preventive measures., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alharbi et al.)

Background: Public primary health facilities are an important source of nutrition services for the urban areas in Bangladesh. We aimed to understand the challenges and facilitators of delivering maternal and child nutrition services through public sector from the perspectives of the users and service providers., Method: The study was conducted in selected public primary health care facilities and their catchment area in Dhaka city from April-July 2019. We carried out 15 free listing exercises and 43 semi-structured interviews (SSI) with pregnant women and mothers of 0-24 months old children; 6 key informant interviews (KII) with facility managers and healthcare providers; and observed service delivery in 8 health facilities., Results: Findings reveal that public primary health facilities address some economic and cultural barriers to access such as cost and provision of female service providers for maternal and child health services but challenges such as distance, waiting time, and cleanliness remained. In terms of service provision, there were gaps in provision of anthropometric measurement and counseling, and healthcare providers had inadequate training and therefore, knowledge of nutrition. The low priority given to nutrition services during program design hampered the delivery of nutrition services provided through urban public sector health facilities., Conclusions: There were important gaps in terms of service provision and capacity of healthcare providers, and therefore, the quality of nutrition service provided through public primary health care facilities. To maximize the coverage of quality nutrition services in the urban areas, it is important to think through the design of nutrition service delivery and allocate adequate resources to fill the material and capacity gaps., (© 2023. The Author(s).)

Objective: Nonsclerotic lichen sclerosus (NSLS) refers to the clinicopathologic situation of examination findings consistent with lichen sclerosus (LS) but without dermal sclerosis on microscopy. This review aims to describe the features of NSLS and provide a classification framework., Methods: The International Society of the Study of Vulvovaginal Diseases tasked the Difficult Pathologic Diagnoses Committee with development of consensus documents for conditions with problematic histopathology. The Difficult Pathologic Diagnoses Committee reviewed the literature on NSLS and formulated descriptions and diagnostic criteria, then approved by the International Society of the Study of Vulvovaginal Diseases membership., Results: Nonsclerotic LS may be categorized into 4 histopathologic subtypes: lichenoid dermatitis, hypertrophic lichenoid dermatitis, dermal fibrosis without acanthosis, and dermal fibrosis with acanthosis. Each has a pathologic differential diagnosis of 1 or more entities, so clinical correlation is required for final diagnosis of LS. There is no evidence to support a reliable association between absent sclerosis and clinical appearance, duration, or oncogenic potential of LS., Conclusions: Pathologists and clinicians should be familiar with the concept of NSLS and its implications for patient management. Use of the term "early LS" to indicate a lack of sclerosis in presumed LS should be abandoned. Clinical correlation is required to confirm LS from among the differential diagnoses., Competing Interests: The authors have declared they have no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.)

Introduction: Onychocytic matricoma (OCM) is a benign acanthoma of the nail matrix that presents with longitudinal melanonychia and nail thickening. Only 18 previously reported cases of OCM are in the literature since it was first described in 2012., Case Presentation: The purpose of this case report was to report a unique presentation of OCM in the toenail of a Black patient as well as to review the clinical presentation, histologic features, and management of this rare entity. Previously described cases presented on the fingernails and were predominantly in white males., Conclusion: OCM is a benign entity that may mimic a nail unit melanoma or squamous cell carcinoma especially when pachyonychia is present. Despite some clinical clues to suggest a diagnosis of OCM, a nail matrix biopsy is often required to rule out malignancy., Competing Interests: The authors have no conflicts of interest to declare., (© 2023 S. Karger AG, Basel.)

Objective: Our study explored the impact of the COVID-19 pandemic on the food environment from the perspective of the urban poor and food vendors., Design: This was a qualitative study conducted during September 2020 and February 2021., Setting: The study was carried out in two purposively selected informal settlements of Dhaka City, Bangladesh., Participants: We conducted 21 in-depth interviews with residents of informal settlements and 10 key informant interviews with food vendors and food aid workers., Result: The availability of staple foods was not disrupted during the pandemic but some perishables foods became more expensive due to supply chain disruptions and increased transportation costs. Limited market hours affected market access and mobility restrictions adversely affected local vendors. Cart vendors selling perishables incurred business losses they could ill afford. Demand for food reduced as employment disruption lead to reduced purchasing power and, therefore, reduction of quantity, quality and desirability of foods purchased. Respondents reported skipping meals and going hungry. The aid received was considered inadequate to meet needs., Conclusion: The food environment of the urban poor was disrupted from both supply and demand sides and the organisational response (both government and non-government) was severely inadequate. The social safety net needs to be extended and redesigned to ensure food security and health for the urban working poor in the future., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Competing Interests: Conflicts of interest Dr Cardones was the recipient of the study grant from Pfizer, which was used to fund this study. Authors Petty, Emge, Blanchard, Selim, Scoggins, Liu, and Green have no conflicts of interest to declare.

Eccrine angiomatous hamartoma is an uncommon, benign clinical entity constituting a nodular proliferation of eccrine glands and vascular structures localized to the dermis that typically present as unilateral, flesh-colored, erythematous, or violaceous papules on the extremities. These hamartomas may be associated with pain, hyperhidrosis, joint deformity, or functional impairment depending on the severity of the disease process. We present a case of bilaterally symmetric, asymptomatic eccrine angiomatous hamartomas involving all proximal interphalangeal joints of both hands. To date, there are only four prior cases of bilaterally symmetric eccrine angiomatous hamartomas reported in the literature, suggesting that the distribution experienced by our patient may represent a previously undescribed syndrome.

We investigate the statistical mechanics of the photonic Ablowitz-Ladik lattice, the integrable version of the discrete nonlinear Schrödinger equation. In this regard, we demonstrate that in the presence of perturbations, the complex response of this system can be accurately captured within the framework of optical thermodynamics. Along these lines, we shed light on the true relevance of chaos in the thermalization of the Ablowitz-Ladik system. Our results indicate that when linear and nonlinear perturbations are incorporated, this weakly nonlinear lattice will thermalize into a proper Rayleigh-Jeans distribution with a well-defined temperature and chemical potential, in spite of the fact that the underlying nonlinearity is non-local and hence does not have a multi-wave mixing representation. This result illustrates that in the supermode basis, a non-local and non-Hermitian nonlinearity can in fact properly thermalize this periodic array in the presence of two quasi-conserved quantities.

We study the coherence characteristics of light propagating in nonlinear graded-index (GRIN) multimode fibers after attaining optical thermal equilibrium conditions. The role of optical temperature on the spatial mutual coherence function and the associated correlation area is systematically investigated. In this respect, we show that the coherence properties of the field at the output of a multimode nonlinear fiber can be controlled through its optical thermodynamic properties.

Rheumatoid arthritis (RA) is characterized by ongoing joint destruction. MicroRNAs (miRs) are blood-based biomarkers linked to RA pathogenesis. The musculoskeletal ultrasonography seven-joint score (US7) is an objective tool to assess RA activity. We aimed to evaluate miR-223 and miR-16 roles in monitoring RA activity and to investigate if there is a link between their plasma levels and US7 score. This study enrolled 76 RA patients classified according to Disease Activity Score 28-joint count with erythrocyte sediment rate (DAS28-ESR) to inactive cases (n = 38) and active cases (n = 38). Each patient's joint was scored for synovial proliferation (gray-scale ultrasound 'GSUS7') and vascularization (power Doppler ultrasound 'PDUS7'). Real-time quantitative PCR was used to measure the expression levels of miR-16 and miR-223 in plasma. When compared to inactive group, the active group revealed significant upregulation of miR-16 and miR-223, (P = 0.001 and P = 0.02, respectively). miR-16 and miR-223 levels were correlated with synovitis PDUS7 (r = 0.34, p < 0.01 and r= 0.25, P = 0.03, respectively). miR-16 was also positively correlated with synovitis GSUS7 (r= 0.42, p < 0.001). miR-223 upregulation discriminated active from inactive RA patients at AUC = 0.64, with 76% sensitivity and 50% specificity at cutoff > 2.8-fold change), whereas miR-16 distinguished the two groups at AUC = 0.78 with 87% sensitivity and 53% specificity at cutoff >38.27-fold change. In conclusion, upregulated miR-16 may have more potential to serve as activity biomarkers than miR-223 in RA. The miR-16 level was linked to synovitis GSUS7 and synovitis PDUS7 changes but miR-223 only linked to synovitis PDUS., (Copyright© by the Egyptian Association of Immunologists.)

Background: Liver transplantation (LT) for severe alcohol-associated hepatitis (AH) remains controversial due to perceived increased recidivism risk after LT because of a lack of protracted abstinence before LT. Data on risk stratification for alcohol relapse after LT are limited. We sought to evaluate the utility of having a mental health program embedded in a transplantation center in risk assessment for alcohol relapse-free patient survival after LT., Methods: We conducted a prospective analysis of all patients with a diagnosis of severe AH hospitalized at a single transplant center from April 2015 to April 2020. After a comprehensive mental health risk stratification, patients were either waitlisted for LT or declined for waitlisting. The primary endpoint was alcohol relapse-free patient survival rate for those who received LT. The secondary endpoint compared survival rates between patients who received LT and those who did not. The median follow-up was 10 months., Results: Among the 83 patients included in the study, 54 patients were waitlisted for LT (65%, group 1) and 29 were declined (35%, group 2). Patient characteristics and median Model for End-Stage Liver Disease score on presentation were comparable for both cohorts (36 in group 1, 38 in group 2; P = .8). Group 1 had significantly better Stanford Integrated Psychosocial Assessment for Transplantation total scores (median 40 vs 57; P < .01), presence of social support (100% of patients in group 1 vs 76% in group 2; P < .01), and less prevalence of active tobacco smokers (30% in group 1 vs 66% in group 2; P < .01). For those who were not waitlisted, 72.5% experienced rapid deterioration of hepatic function. Among the 54 patients waitlisted, 29 patients received LT (54%), whereas 19 died while on the waiting list (35%). One- and 3-year patient survival after LT were 92.5% and 92.5%, respectively. The overall and sustained alcohol relapse rates after LT were 10.3% and 3.5%, respectively., Conclusion: Severe AH is a complex medical and mental health disease and requires an intense risk assessment for recidivism after LT. Our study shows that an integrated transplantation mental health program provides an accurate risk stratification for alcohol relapse after LT, a successful intervention to mitigate recidivism risk, and optimal short-term alcohol relapse-free patient survival. Future studies should focus on enhancing the guidelines for broader application., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: The role of advanced practice providers (APPs) in an academic transplant surgical acute care setting remains to be defined. We sought to evaluate the impact of a transplant surgeon-APP (TSAPP) practice model on patient access and outcomes in the care of critically ill patients with end-stage liver disease (ESLD) in an academic transplant center., Methods: A retrospective analysis evaluated the effect of practice model evolution over an 11-year period on hospital access of patients with ESLD to an academic liver transplantation center and survival outcomes. We compared 3 practice models: era 1 (transplant surgeon-general surgery resident; January 2009 to Sept 2012): vs era 2 ( transition transplant surgeon-general surgery resident to TSAPP; October 2012 to December 2016): vs era 3 (TSAPP; January 2017 to December 2020)., Results: Patient access to hospitalization and inpatient service census increased significantly over time with TSAPP model (P < .01). At the time of liver transplant, the median Model for End-Stage Liver Disease scores for era 1 (25), era 2 (33), and era 3 (34), P < .01, and patient requirement for intensive care unit for era 1 (7.1%), era 2 (44.8%), and era 3 (56.4%), P < .01, have increased. The overall 1-year patient survival rates remained comparable across all eras: era 1 (93.88%), era 2 (93.11%), and era 3 (94.06%), P = .77 CONCLUSIONS: The APPs play an integral role in clinical transplantation practice. The integration of APPs into the transplant surgical workforce increased access of high-acuity patients with ESLD to the transplantation center. In addition, it provided excellent patient and graft survival outcomes after liver transplant., Competing Interests: Disclosures The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Advanced practice providers (APPs) are integral to the contemporary transplant surgeon-APP practice model. Patient understanding of APPs' role is vital for optimal patient care and experience. Data on patient knowledge of APPs' roles remain scarce. We sought to assess patient awareness of APPs in their transplantation surgical team., Methods: We conducted a prospective study on 100 consecutive transplant candidates and recipients ≥18 years, hospitalized in the transplant surgeon-APP Transplantation Intensive Care Unit (primary service) from September 16, 2019 through June 10, 2021. All patients received a 5-question survey (Table 1). Group 1 (first 50 patients) did not receive any printed introductory materials (Figs 1 and 2) before completing the questionnaire, whereas group 2 (last 50 patients) completed the survey after receiving the materials., Results: Although > 90% of patients were knowledgeable about physician assistants (PAs) and nurse practitioners (NPs), the term "advanced practice providers" was unfamiliar to patients in both groups (Table 1). The level of patient recognition and comfort with APPs in the transplant surgeon-APP care team were comparable for both groups., Conclusions: Our study showed that transplant candidates and recipients were knowledgeable and highly comfortable that PAs and NPs are members of their transplantation surgical team. However, the term advanced practice providers was unfamiliar to the patients. Our study suggested that patient education on provider terms used in current health care delivery is essential and may enhance the patient experience., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Hypereosinophilic syndrome is a rare disorder characterized by excessive peripheral eosinophilia and eosinophil associated end-organ damage. Clinical presentations are heterogenous and can involve skin, pulmonary, cardiac and neurologic dysfunction. Eosinophilic myocarditis is a life-threatening complication that increases the risk of cardiac microemboli, which can subsequently lead to embolic strokes. Secondary to changes in blood viscosity, impaired clearance of microemboli, impaired cerebral blood flow, and pro-thrombotic conditions in the setting of hypereosinophilia, infarcts often present in vascular border zone regions. Here we present two cases of cardioembolic strokes involving borderzone regions in the setting of hypereosinophilic syndrome., (Copyright © 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

Background and Aim: The submandibular salivary glands (SMG) represent a suitable model for studying epithelial cell growth and differentiation. Bisphenol A (BPA) is a xenoestrogen, synthesized to produce polymers such as polycarbonates and epoxy resins. There are concerns about the occurrence of BPA in food, water as well as its appearance in human tissues and body fluids. Lycopene (LYC) is a carotenoid compound that exerts antioxidant and anti-inflammatory properties. This work was performed to study possible protective effect of LYC against BPA toxicity in SMG., Material and Methods: 40 albino rats were divided into 4 groups; Group I: served as controls. Group II: rats received LYC (4 mg/kg, p.o), Group III: rats received BPA (10 mg/kg, p.o) and Group IV: rats received LYC (4 mg/kg, p.o) and BPA (10 mg/kg, p.o). All drugs were administered for 45 days then under anesthesia, rats were sacrificed. The SMG specimens were taken for histological and biochemical studies., Results: BPA resulted in a significant rise of malondialdehyde, tumor necrosis factor-α and interleukine-1β. In contrast, the tissue levels of glutathione and PPAR-γ were significantly decreased. BPA activated Wnt/β-catenin pathway evidenced by upregulating WNT3a, β-catenin and c-myc expression. Moreover, SMG of BPA showed degenerative changes that affected the parenchymal and stromal elements of the glands. The immunohistochemical localization of cytokeratin 5,6 and 18 of BPA rats revealed weak immunostaining of the serous secretory cells, myoepithelial cells and ductal cells. Upon treatment with LYC, glutathione and PPAR-γ were restored., Conclusion: LYC acted as a protective agent against BPA-induced pathological changes in SMG., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Virus-related hepatocellular carcinoma (HCC) pathogenesis involves liver inflammation, therefore, despite successful treatment, hepatitis C virus (HCV) may progress to HCC from initiated liver cirrhosis. Cytotoxic T cells (Tcs) are known to be involved in HCV-related cirrhotic complications and HCC pathogenesis. The inhibitory checkpoint leukocyte-associated immunoglobulin-like receptor-1 (LAIR-1) is expressed on Tcs. Therefore, we aimed to determine whether the Tc expression level of LAIR-1 is associated with HCC progression and to evaluate LAIR-1 expression as a noninvasive biomarker for HCC progression in the context of liver cirrhosis related to HCV genotype 4 (G4) in Egyptian patients' peripheral venous blood liquid biopsy. A total of 64 patients with HCC and 37 patients with liver cirrhosis were enrolled in this case-controlled study, and their LAIR-1 expression on Tc related to the progression of liver cirrhosis was examined and compared to that of the apparently healthy control group ( n = 20). LAIR-1 expression was analyzed using flow cytometry. Results: The HCC group had significantly higher LAIR-1 expression on Tc and percentage of Tc positive for LAIR-1 (LAIR-1+Tc%) than the HCV G4-related liver cirrhosis group. LAIR-1+Tc% was correlated with the HCC surrogate tumor marker AFP ( r = 0.367, p = 0.001) and insulin resistance and inflammation prognostic ratios/indices. A receiver operating characteristic (ROC) curve revealed that adding LAIR-1+Tc% to AFP can distinguish HCC transformation in the Egyptian patients' cohort. Upregulated LAIR-1 expression on Tc could be a potential screening noninvasive molecular marker for chronic inflammatory HCV G4 related liver cirrhosis. Moreover, LAIR-1 expression on Tc may be one of the players involved in the progression of liver cirrhosis to HCC.