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Ahmed Yamany, Mervat E Behiry, Sahar A Ahmed Faculty of Medicine, Cairo University, Cairo, EgyptCorrespondence: Mervat E Behiry Tel +20 1124205071Fax +20 26 28 884Email lambaa2020@yahoo.comPurpose: Systemic lupus erythematosus (SLE) is an autoimmune disease with multi-organ involvement. Hyponatremia is common in inflammatory diseases such as meningitis. Also, it has been found to be strongly associated with the degree of inflammation. However, it has not been fully evaluated in lupus. This study aimed to assess the inflammatory impact of hyponatremia in SLE patients and investigate its relationship with SLE disease activity.Patients and Methods: A total of 101 patients with SLE were enrolled in this study and divided into two groups according to Na level; a normo-natremic group and a hyponatremic group. Demographic and clinical data were collected. SLE activity was assessed by the systemic lupus erythematosus disease activity index (SLEDAI). The estimated sedimentation rate (ESR) as well as levels of C-reactive protein (CRP) and complements (C3 and C4) were measured.Results: The majority of patients were females (98 subjects) (97%) with a mean age of 33± 8 years. Out of 101 participants, 40 patients (39.6%) were hyponatremic with a mean Na level of 131.58± 3.11 mmol/L. There was a statistically negative correlation between both ESR and SLEADI score and Na level (r=− 0.436 and − 0.436, respectively) with p=0.002, whereas Na level was positively correlated with complements, Cl, and albumin levels (r=0.653, 0.314, and 0.460, respectively) (p=0.000, 0.027, and > 0.001, respectively). CRP was not correlated with Na level. ESR was independently correlated with hyponatremia at the 95% CI for Exp B (0.997– 0.058) with a p-value of 0.048.Conclusion: Hyponatremia could be used as an indicator of SLE activity. Also, it might be an easily and rapidly detected as well as a prognostically useful marker of inflammation.Keywords: lupus erythematosus, activity, hyponatremia, complement, inflammation

Effective project management is crucial for the successful delivery of construction projects, ensuring they are completed on time, within budget, and to the desired quality standards. Project scope definition is at the heart of project management, which forms the basis for project planning, execution, and control. However, despite its importance, there is a lack of comprehensive investigation into project scope definition compared to other areas of management knowledge. This research paper identifies the key enablers and elements of project scope definition, as well as their relative importance. Moreover, this study develops an assessment model using the Analytic Hierarchy Process (AHP) to evaluate the completeness of the project scope definition. Data was gathered through a questionnaire survey deployed to subject matter experts specialized in building projects in Saudi Arabia. The results highlight the significance of understanding the direct impact of scope definition on project success, which emerged as the most influential enabler in facilitating scope definition. Among the top ten elements of scope definition are project financial requirements, regulatory requirements, and building site location and geotechnical data. The findings and AHP assessment model can assist project stakeholders and managers in effectively defining project scope, potentially leading to efficient management of building projects.

BACKGROUND: Multiple myeloma (MM) represents the second most common hematologic malignancy (15%). Induction with bortezomib, cyclophosphamide, and dexamthasone VCd (d: low dose dexamthasone) regimen is widely used due to its high effectiveness, low toxicity and good tolerability, particularly with renal impairment. Real-world data on the use of VCD in clinical practice is lacking. OBJECTIVES: Evaluate the real-world experience of the VCD regimen DESIGN: Retrospective SETTING: Tumor registry database of tertiary cancer care center PATIENTS AND METHODS: Newly diagnosed MM patients who received VCD induction and underwent autologous stem cell transplant (ASCT) from July 2007 to July 2020 MAIN OUTCOME MEASURES: Response evaluation, progression-free survival (PFS) and overall survival (OS). SAMPLE SIZE: 87 patients RESULTS: Of 102 patients who started induction with VCd, 87 patients experienced a partial response or more overall response rate of 85%). The median age of these 87 patients at diagnosis was 52 years, of which 29.9% presented with renal impairment and 60.3% of patients had stage 2 by the Revised International Staging System (R-ISS). Patients with a standard cytogenetic risk achieved a better response compared to those with a poor cytogenetic risk (P=.044). The post-induction response rates were 6.9% stringent complete remission (sCR), 35% complete remission (CR); 41.4% very good partial response (VGPR), and 16.1% partial response (PR), respectively; the response rates became greater for sCR and CR post-transplantation at day 100 with 16.1% sCR, 35.6% CR, 32.2% VGPR and 16.1% PR, respectively. The median PFS was 49 months and 5 years OS was 84%. PFS was better in patients who achieved sCR vs PR (83 vs 35 months, P=.037). High LDH, high-risk cytogenetic and stage 3 R-ISS showed a worse median PFS and OS. CONCLUSIONS: VCD induction in newly diagnosed MM is highly effective, convenient, tolerable and affordable regimen, especially in low and middle-income countries with limited resources, also with favorable outcomes and survival. while those who did not respond successfully shifted to VRD or VTD. LIMITATIONS: The usual limitations of a retrospective analysis using registry-level data, no data on quality of life.

Abstract Background An inflammatory disorder known as trigger finger (TF) results in pain in the proximal and distal palm and digit, as well as restricted movement and diminished function. Physiotherapists use a specific treatment called dry needling (DN) to reduce musculoskeletal pain and assist patients with mobility restriction. Objectives This study aimed to examine the effectiveness of DN on quality of life in patients suffering from trigger finger. Methods Forty patients, ranging in age from 45 to 75, were randomized into one of two groups in this Prospective pre and post-test, single-blind parallel group randomized controlled trial. Twenty patients were assigned to the intervention group, which included traditional physiotherapy splinting and ultrasound (ultrasonic dosage was 3MHz, the intensity of 0.5 W/cm2, and the duty cycle 50%. Duration: 5 minutes) as well as to DN upon a nodule at the proximal end of the 1st annular (A1) pulley as well as the discrepancy that existed between the flexor tendon's diameter along with its sheath at the metacarpal head. Twenty patients were assigned to the control group, which consisted of traditional treatment alone, twice weekly, for a total of ten sessions over five weeks. The trial evaluated the quality of life, severity of pain, and hand grip strength using the World Health Organization Quality-of-Life Scale (WHOQOL-BREF), visual analogue scale, and Camry dynamometer respectively two times, beforetreatment and after 10 treatment sessions. Results Within-group analysis using MANOVA demonstrated a significant decline in VAS (p = 0.001) and a significant improvement in quality of life (p = 0.001) and hand grip strength (p = 0.001). Regarding between group comparison using MANOVA there was significant improvement in favor of the DN intervention (p = 0.001) for all measured variables. Conclusions A 5-week dry needling approach with a traditional physiotherapy program was effective in improving in quality of life, pain intensity, and hand grip strength in patients with trigger finger, emphasizing it as the better option. Trial registration: Clinical Trial. Gov, NCT05671523 . Registered 14 December 2022.

Abstract The present study was conducted in the Laboratory of Tissue Culture, Horticulture Department, Faculty of Agriculture, Damietta University, Egypt. The objective of this study was to establish a micropropagation protocol suitable for three imported peach rootstocks: Okinawa (P. persica), Nemared (P. persica × P. davidiana) × P. persica), and Garnem (P. dulcis × P. persica) in vitro. The results showed that soaking the explants in sodium hypochlorite (NaOCl) at 20% for 15 min produced the highest responsiveness (82.81%), survival (96.61%), with the lowest mortality (3.14%) and contamination (0.24%). Explants of the Garnem genotype had the best response (89.12%), survival (90.62%), lowest mortality (0.00%), and highest contamination (9.37%) when compared to the other genotypes. In comparison with axillary buds, the shoot tip displayed the highest responsiveness, survival, and death (100, 87.40, and 12.59%, respectively), as well as the least significant contamination (0.00%). Additionally, the percentages of responsive, survived, dead, and contaminated explants at the various collection dates varied significantly. The 6-benzylaminopurine (BAP) concentrations used (3 to 5.0 mg/L) demonstrated similar behavior in terms of in vitro proliferation, with rates of 3.77 to 6.11, 4.33 to 8.88, and 3.33 to 7.44 shoot numbers per explant for the Okinawa, Nemared, and Garnem peach rootstocks, respectively, indicating that the number of shoot proliferations is genotype-dependent. Additionally, using 5.0 mg/L BAP in combination with 0.2 mg/L IBA significantly increased average shoot proliferation (96.29%), number of shoots per explant (7.48), and average leaf number/explant (16.33) compared to the other treatments. Based on these results, adventitious bud development was enhanced during in vitro multiplication of the Okinawa, Nemared, and Garnem peach rootstocks by the synergistic interaction of indole-butyric acid (IBA) and 6-benzylaminopurine (BAP).

Abstract Background Today, low back pain is a serious global health issue. Currently, 85% of low back pain is caused by muscular imbalance and is a result of Lower cross syndrome (LCS), which are chronic postural defects. The physical therapy technique known as Global Postural Re-education (GPR) was created in France and is based on the concept that muscle chains make up the entire muscular system. Aim The purpose of this study was to investigate the effect of global postural re-education on low back pain patients with lower cross syndrome. Design Prospective pre and post-test, single-blind randomized controlled trial. Setting Outpatient physio therapy clinic at Damanhur teaching hospital. Population Fifty participants (25 to 40 years old) suffer from low back pain with lower cross syndrome. Methods Participants were randomly assigned to two equal groups: global posture re-education approach and conventional physiotherapy was given to study group "A" and conventional physiotherapy was given to control group "B" throughout the course of 15 treatment sessions, twice sessions weekly. The patients' pre- and post-treatment progress was assessed using the clinometer digital smartphone application to measure anterior pelvic tilting, flexible ruler to measure lumbar lordosis, Modified Thomas test to measure hip flexor flexibility, Visual analogue scale (VAS) to measure pain and Oswestry Low Back Pain Disability Questionnaire Arabic version to measure function disability. Results Comparing the study group and the control group after treatment showed that the study group had a significantly lower anterior pelvic tilting (P = 0.001), lower lumbar lordosis (p = 0,024), higher flexibility of hip flexor muscle (p = 0,001), lower VAS (p = 0,001) and improving in function disability (p = 0,001) compared to the control group. Conclusion Adding a Global postural re-education approach is thought to be effective in treating low back pain patients with lower cross syndrome. Clinical Rehabilitation Impact Global postural re-education approach decreases anterior pelvic tilting angle, lumbar lordotic angle, pain, and disability caused by low back pain and increase hip flexor flexibility.

ABSTRACT Yellow fever mosquito, Aedes aegypti, has been associated with several severe human diseases. Larvae and adults of Ae. aegypti has been widely studied, but pupae have not received much attention. In this study, external morphology and chaetotaxy of Ae. aegypti pupae were investigated using scanning electron microscopy (SEM) to determine additional morphological characteristics for proper species identification. Ae. aegypti pupae exhibit high mobility with rapid submergence in response to external disturbances. Pupae contact air through paired respiratory horns. A pupal body is covered with a translucent cuticle composed of a cephalothorax and a narrow, articulated abdomen. Anterior region of cephalothorax is occupied by mouthparts and a flattened head. Adult's compound eyes are visible on both sides of their head. Before compound eyes, antennae emerge in upper part and are bent in reverse along sides of thorax. First abdominal segment has two straightforward palmate bundles, essential for maintaining pupal body above water's surface. Compared to other eight abdominal segments, ninth is relatively tiny; it holds a couple of movable appendages called paddles which are fundamental organs in pupal movement, and a midrib supports them. This morphological analysis of pupae attributes of Ae. aegypti is critical for controlling mosquito-borne diseases and taxonomy.

Radio Occultation (RO) is pivotal for profiling the neutral and ionized atmosphere, with the PlanetiQ mission, via its GNOMES satellites, striving to establish an advanced atmospheric observing system. However, an assessment of the spatiotemporal distributions of PlanetiQ observations and comparisons with reliable datasets are lacking. This study addresses this gap by examining the temporal and spatial distribution of RO observations from PlanetiQ during its initial 198 operational days in 2023, alongside comparisons with COSMIC and Numerical Weather Prediction (NWP) models. Data from GN02, GN03, and GN04 satellites, yielding 1099, 1313, and 1843 RO events per day, respectively, were analyzed. The satellite constellation’s observations demonstrate a generally well-distributed pattern, albeit minor deficiencies in equatorial and polar regions. Single-profile comparisons with COSMIC data reveal strong correlations for pressure, temperature, Water Vapor Pressure (WVP), and refractivity profiles, with temperature exhibiting larger variations (RMSE = 1.24 °C). Statistical analyses confirm statistically insignificant differences between the PlanetiQ and COSMIC profiles at the same spatio-temporal coordinates. Comparisons with NWP models show slight differences with GFS, with overall RMSE values of 0.23 mb (WVP), 0.6 mb (pressure), 1.3 (refractivity), and 1.5 °C (temperature). However, assessments against GFS/ECMWF models indicate overall compatibility, with insignificant differences between PlanetiQ profiles and model observations.

Abstract Background Despite the increased interest in publishing data on central neurocytoma, its management remains controversial. The overall incidence is approximately 0.5% of brain tumors. The reporting of institutional experience is of major need for such category of tumors to increase our knowledge and experience. In this study, we describe the clinical presentation, pathological data, and treatment outcomes of central neurocytoma. Results Medical records of patients with neurocytoma treated in our center from July 2008 to December 2018 were retrospectively reviewed. Extra ventricular neurocytomas were excluded from analysis due to the known aggressive behavior compared to central neurocytoma. Seventeen patients treated at our center as central neurocytoma were included in the study. The frequent clinical presentation was headaches (58.8%) and paresis (35.3%). Ten patients (58.8%) developed symptoms before the age of 30 years. All patients were treated with surgical resection. Gross total resection was performed in 11 cases (64.7%) and subtotal resection was performed in 3 cases (17.7%). Four patients developed disease progression following the first excision (23.5%), for which additional resection was performed. Two patients received fractionated radiotherapy; one after the first resection due to residual disease postoperatively and the other patient following the third excision due to multiple recurrences with radiotherapy doses of 50.4 Gy and 54 Gy, respectively. The median follow-up time was 51 months (range of 14–106). The 5-year progression-free survival was 70 ± 13%. The overall survival for our cohort of patients was 100%. Conclusions Central neurocytoma is a rare tumor of neuronal origin and surgery is the mainstay of treatment with a favorable prognosis. Adjuvant radiotherapy can be offered in patients with residual disease or multiple recurrences, especially in patients with tumors of high MIC-1 LI.

Tumors at the craniocervical junction represent a formidable challenge due to its intimate association with the medulla and cervical spinal cord, lower cranial nerves, and vertebral artery (VA). Foramen magnum meningioma (FMM) reparents 2% of all intracranial meningiomas and 4% of posterior fossa meningiomas. The far lateral approach is preferred for FMM with VA involvement. Here, we describe a case of a 58-year-old woman who presented with headache, nausea and vomiting and gait disturbance and was found to have large FMM encasing the dominant VA. The patient was treated with a left far lateral approach with limited condylectomy resulting in gross total resection and preservation of lower cranial nerves function.

The prevalence of metabolic syndrome (MetS) has been rising alarmingly and it has now become a global concern causing an enormous economic burden on the health care system. MetS is generally linked to complications in lipid metabolism, oxidative stress and low grade inflammation. The aim of the current study was to evaluate the effect of rosuvastatin, co-enzyme Q10 (CoQ10), and their combination on blood pressure, blood sugar, dyslipidemia, and liver function in rats with MetS induced by high fructose and high fat diet (HF-HFD) and the possible underlying mechanism. Oral administration of rosuvastatin (10 mg/kg/day), CoQ10 (10 mg/kg/day) and their combination for 4 weeks in HF-HFD-fed rats elevated serum high density lipoprotein and reduced glutathione. On the other hand, treatment with rosuvastatin, CoQ10 or their combination decreased the serum levels of malondialdehyde, triglycerides, total cholesterol, and low density lipoprotein-cholesterol as well as systolic blood pressure, body weight and fasting blood glucose level. In addition, the drugs or their combination declined serum pro-inflammatory cytokines, namely tumor necrosis factor-α and interleukin-1β. In conclusion, our results showed that rosuvastatin or CoQ10 protected against HF-HFD-induced MetS through the regulation of dyslipidemia, elevated blood glucose, elevated blood pressure, antioxidant defenses and inflammatory response. Rosuvastatin or CoQ10 also alleviated the impairment of liver function that was induced by HF-HFD. Interestingly, CoQ10 augmented rosuvastatin's effect in ameliorating MetS, via exerting synergistic modulatory effects on oxidative stress and inflammation. Thus, rosuvastatin and CoQ10 combination therapy may have possible applications in ameliorating metabolic disorders.