Significance of CEBPE Gene Promoter Polymorphism (Rs2239630 G > A ) Assessment in Childhood B-cell Acute Lymphoblastic Leukemia.

BACKGROUND: A significant association has been reported between CEBPE gene promoter polymorphisms (rs2239630 G > A ) and the incidence of B-cell acute lymphoblastic leukemia (B-ALL). However, no previous study on this issue has been included among the Egyptian cohort of pediatric patients with B-ALL. Therefore, this study was designed to address the associations between CEBPE polymorphisms and susceptibility to B-ALL, as well as its impact on the outcome of B-ALL Egyptian patients with B-ALL. PATIENTS AND METHODS: In the current study, we evaluated the rs2239630 polymorphism in 225 pediatric patients and 228 controls to assess the association of different rs2239630 genotypes with childhood susceptibility to B-ALL and the impact on the outcome of the patients. RESULTS: The frequency of the A allele was significantly higher in the cases of B-ALL compared with the control group ( P = 0.004). By analyzing different genotypes for the predictive value of disease development, the GA and AA genotypes have been identified to be the highest among multivariate factors with an odds ratio of 3.330 (95% CI: 1.105-10.035). Likewise, the A allele was significantly associated with the shortest overall survival. CONCLUSIONS: CEBPE gene promoter polymorphism (rs2239630 G > A ) AA is frequently associated with B-ALL; and has the worst overall survival among the 3 genotypes, followed by the GA and GG genotypes ( P < 0.001).

Biosorption of zinc (II) from synthetic wastewater by using Inula Viscosa leaves as a low-cost biosorbent: Experimental and molecular modeling studies.

The use of biosorption as a strategy for lowering the amount of pollution caused by heavy metals is particularly encouraging. In this investigation, a low-cost and efficient biosorbent, Inula Viscosa leaves were used to remove zinc ions (Zn2+) from synthetic wastewater. A Fourier transform infrared spectroscopy experiment, a scanning electron microscopy experiment, and an energy dispersive X-ray spectroscopy experiment were used to describe the support. Several different physicochemical factors, such as the beginning pH value, contact duration, initial zinc concentration, biosorbent dose, and temperature, were investigated in this study. When the Langmuir, Freundlich, Temkin, Toth, and Redlich-Peterson models were used to match the data from the Inula Viscosa leaves biosorption isotherms, it was found that the biosorption isotherms correspond most closely with the Langmuir isotherm. On the other hand, the kinetic biosorption process was investigated using pseudo-first-order, pseudo-second-order (PS2), and Elovich models. The PS2 model was the one that provided the most accurate description of the biosorption kinetics. The thermodynamics process shows the spontaneous and endothermic character of Zn2+ sorption on Inula Viscosa leaves, which also entails the participation of physical interactions. In addition, the atom-in-molecule analysis, density functional theory, and the conductor like screening model for real solvents, were used to investigate the relationship that exists between quantum calculations and experimental outcomes.

Predictive Value of B reg and Serum IL-10 Concentration Levels for Acute ITP Progression to Chronic Phase.

INTRODUCTION: Pediatric immune thrombocytopenia (ITP) is a potentially life threating autoimmune disorder with different responses to therapy and different bleeding phenotypes in critical organs. The molecular basis for the variable response has not yet been fully elucidated. This study was designed to address the predictive value of regulatory B-cell (B reg ) count and interleukin-10 (IL-10) serum levels for acute ITP patients who progress to chronic phase. The present study included 80 children with acute ITP )38 males and 42 females (with median age of 8 years and 40 matched healthy controls. Assessment of B reg (CD19 + CD24 hi CD38 hi ) was carried out by a multicolor flowcytometry, however, IL-10 serum levels were evaluated by enzyme-linked immunosorbent assay. A significant reduction of B reg percentage and a significant increase in serum IL-10 levels were identified in children with acute ITP as compared with controls ( P <0.001 for both). Fourteen ITP patients passed to chronic phase, while 66 patients achieved remission within 6 months. The absolute B reg was significantly lower, while IL-10 was significantly higher in patients with acute ITP who progressed to chronic phase in comparison with acute ITP patients who achieved complete remission. Cox proportional hazards for ITP chronicity revealed that IL-10 OR was 2.46 (confidence interval: 1.42-4.27; P =0.001) and absolute B reg OR was 0.147 (confidence interval: 0.128-0.624; P =0.005) in the peripheral blood. Therefore, they could predict chronicity in ITP cases. CONCLUSION: Reduced B reg count and elevated IL-10 levels in patients with acute ITP at diagnosis can predict chronicity.

Cortactin Expression is a Novel Biomarker for Risk Stratification of T-Cell Acute Lymphoblastic Leukemia.

The role of cortactin in T-cell acute lymphoblastic leukemia (T-ALL) tissue infiltration has been previously reported. However, its impact on patients' responsiveness to therapy and patient's outcome was not previously addressed. This study was conducted on 60 T-ALL pediatric patients at diagnosis and 10 nonleukemic controls. Cortactin and HS1 expressions were identified by real-time polymerase chain reaction. Cortactin and HS1 expression were significantly higher in T-All patients as compared with controls as well as postinduction levels (P≤0.001 for both). The high cortactin expression was significantly associated with high peripheral white cell counts (P≤0.001), blood blast cells (P≤0.001) and central nervous system (CNS) infiltration (P≤0.001), and early precursor T-ALL subtype (P≤0.001) as compared with the remaining groups. The induction of remission response was significantly higher in T-ALL patients with lower cortactin expression levels as compared with T-ALL patients with higher one (P≤0.001). The high cortactin and HS1 expressions were significantly predictors of CNS infiltrations (hazard ratios [HR]: 1.051, confidence interval [CI]: 1.02-1.13, P=0.04 and HR: 1.87, CI: 1.23-2.091, P=0.002, respectively) and bone marrow relapse (HR: 1.43, CI: 1.18-1.92, P=0.004 and HR: 1.07, CI: 1.01-1.24, P=0.002, respectively). Furthermore, high cortactin expression levels were associated with shorter B-ALL patients' overall survival as compared with those with lower cortactin levels (P=0.002). In conclusion, high expression of cortactin and/or HS1 at diagnosis is a bad prognostic marker of T-ALL patients' outcome. Moreover, cortactin and/or HS1 expression could be used as a biomarker for refining risk stratification of T-ALL.

Prevalence of iron deficiency anemia and beta thalassemia carriers among relatives of beta thalassemia patients in Nile Delta region, Egypt: a multicenter study.

BACKGROUND: Screening of ß thalassemia among close relatives is more feasible in highly prevalent countries with limited resources. The purpose of this study is to determine the prevalence of ß thalassemia carriers and iron deficiency anemia among relatives of ß thalassemia patients in Mid Delta, Egypt. METHODS: This is a cross-sectional multi-center study conducted on 2118 relatives of patients with ß thalassemia from different Egyptian governorates in the Mid Delta region. They were subjected to history taking with precise determination of geographic location, general examination, and the following investigations: complete blood counts, serum ferritin for those who showed microcytic hypochromic anemia, and high-performance liquid chromatography for those who were not diagnosed as iron deficiency anemia. RESULTS: The total prevalence of iron deficiency anemia among close relatives of confirmed ß thalassemia patients in the Nile Delta region was 17.19%. The highest prevalence of iron deficiency anemia (45.05%) was reported in Al-Gharbia Governorate, followed by Al-Menoufia Governorate (21.67%), and the lowest prevalence was that of Al-Sharkia Governorate (4.91%). The differences were highly statistically significant (p < 0.001). ß thalassemia carrier prevalence rate in the studied relatives was 35.84%, with the highest prevalence detected in Al-Sharkia Governorate (51.32%), followed by Kafr-Alsheikh and Al-Dakahilia Governorates (41.78%, 37.13%) respectively, while Al-Menoufia Governorate had the lowest prevalence rate (25.00%). These differences were also highly statistically significant (p < 0.001). CONCLUSION: More than one-third of relatives of patients with ß thalassemia are carriers of the disease, while 17.19% suffer from iron deficiency anemia. This study demonstrates the importance of tracing the high number of beta thalassemia carriers among relatives of patients with ß thalassemia in Egypt.

IKZF1 rs4132601 and rs11978267 Gene Polymorphisms and Acute Lymphoblastic Leukemia: Relation to Disease Susceptibility and Outcome.

(IKZF1) rs4132601 and rs11978267 are common gene polymorphisms and have been associated with the risk of acute lymphoblastic leukemia. However, these associations are less evident in races and/or ethnicities other than European and Hispanic. Therefore, we investigated the association between these single-nucleotide polymorphisms and acute lymphoblastic leukemia susceptibility and disease outcome. Real-time polymerase chain reaction typing was performed for IKZF1 rs4132601 and rs11978267 for 128 pediatric acute lymphoblastic leukemia (pALL), 45 adult acute lymphoblastic leukemia (aALL), and 436 healthy controls. The G allele-containing and G-containing genotypes (GG+GT) of rs4132601 were significantly higher in pALL (P=0.003, odds ratio [OR]=1.65, 0.009, OR=1.42, respectively) and aALL (P=0.016, OR=1.81 and 0.011, OR=1.61, respectively). However, the GG haplotype was associated with the risk of pALL (P=0.044), the GA haplotype was associated with the risk of aALL (P=0.007). In aALL, the GG genotype of rs4132601 was associated with absence of remission and poor overall survival (P=0.003 and 0.041, respectively). The IKZF1 rs4132601 single-nucleotide polymorphism can be considered a susceptibility risk factor for the development of pALL and aALL in the studied cohort of Egyptian patients. The GG genotype of IKZF1 rs4132601 may be a risk factor for poor outcome in aALL patients.

Serological and molecular screening of umbilical cord blood for Toxoplasma gondii infection.

BACKGROUND: Human umbilical cord blood has proven to be a successful alternate source of hematopoietic stem cells for pediatric patients with major hematologic disorders. Toxoplasma gondii is a global opportunistic protozoan which cause fatal complications in immunocompromised individuals. AIM: Our goal is to study the prevalence of toxoplasmosis in umbilical cord blood (UCB) and to assess the sensitivity of ELISA and PCR for Toxoplasma infection screening. MATERIAL AND METHODS: One hundred cord blood samples were collected immediately after delivery. Anti-Toxoplasma IgG and IgM antibodies were determined using ELISA method; Toxoplasma DNA was detected using nested PCR technique. Total nucleated cells (TNC) and HB were also determined. Demographic data and risk factors data related to the transmission of toxoplasmosis, were collected from mothers. RESULTS: Among 100 cord blood samples, 36 (36%) were positive for anti-Toxoplasma IgG antibodies and 6 (6%) were positive for anti-Toxoplasma IgM antibodies. The nested PCR showed 11 (11%) samples containing Toxoplasma DNA from which, 6 (55%) samples were IgM positive. There was no significant association between the risk of Toxoplasma transmission and cord blood positivity for toxoplasmosis. CONCLUSION: Owing to the prevalence of toxoplasmosis, its rapid progression and its fatal outcome in immunocompromised patients, cord blood screening for toxoplasmosis with nested PCR should be incorporated into cord blood bank screening protocols.

ARID5B rs10821936 and rs10994982 gene polymorphisms and acute lymphoblastic leukemia: relation to disease susceptibility and outcome.

ARID5B rs10821936 and rs10994982 single nucleotide polymorphism (SNP) have been associated with the risk of acute lymphoblastic leukemia (ALL) in different ethnic populations. We investigated the association between the ARID5B rs10821936 C > T, rs10994982 A > G, and susceptibility to ALL in a cohort of Egyptian individuals and investigated their role in relation to disease outcome. Real-time PCR typing was done for ARID5B rs10821936 and rs10994982 SNPs for 128 pediatric ALL (pALL), 45 adult ALL (aALL), and 436 healthy controls. Significant risk associations were found between the C allele (p < 0.001, OR = 2.02), CC genotype (p < 0.001, OR = 2.72), CT genotype (p = 0.011, OR = 1.45) of ARID5B rs10821936 and pediatric ALL especially T-ALL and adult ALL (p < 0.05). The CA haplotype (C allele of rs10821936 + A allele of rs10994982) was associated with the risk of ALL either pediatric ALL or adult ALL (p < 0.001). In the studied Egyptian population, it can be concluded that the C allele, CC, and CT genotypes of ARID5B rs10821936 and the CA haplotype may be a susceptibility risk factor for pediatric and adult ALL. However, the SNPs of ARID5B rs10821936 and rs10994982 were not found to be strongly associated with ALL outcomes.

Effect of different timings of umbilical cord clamping on the level of CD34+ cells in full-term neonates.

Despite the fact that delayed cord clamping (DCC) is recommended by many international organizations, early cord clamping is still widely practiced worldwide. The overarching goal of the DCC practice is to maximize neonatal benefits as achieving higher hemoglobin levels and decreasing the incidence of anemia as well as avoiding the adverse consequences. The current study was conducted to identify the effect of of DCC on the number of CD34+ stem cells in cord blood of full term neonates after two different timings (30 and 60 s after birth). One hundred and three full-term (FT) newborn babies (gestational age 37-40 weeks) delivered by elective cesarean section were randomly assigned into 2 groups: Group 1: babies were subjected to DCC 30 s after birth (50 newborns). Group 2: babies were subjected to DCC 60 s after birth (53 newborns). Neonates in group 2 had significantly higher levels of hemoglobin, hematocrit, total nucleated cells and CD34+ cells compared to those in group 1. The practice of DCC 60 s after birth achieved better CD34+ stem cells transfer in FT neonates than clamping the cord after 30 s.

Radio Frequency - Assisted Ultrasonic Spray Freeze Drying for Pharmaceutical Protein Solids.

This study examined physical stability of spray freeze dried (SFD) bovine serum albumin (BSA) solids produced using the radio frequency (RF)-assisted drying technique. BSA formulations were prepared with varying concentrations of trehalose and mannitol, using an excipient-free formulation as control. These formulations were produced using either traditional ultrasonic spray freeze drying (SFD) or RF-assisted ultrasonic spray freeze drying (RFSFD). The dried formulations were then characterized using Karl Fischer moisture content measurement, powder X-ray diffraction (PXRD), size exclusion chromatography (SEC), and solid-state hydrogen/deuterium exchange with mass spectrometry (ssHDX-MS). Moisture content did not have a good correlation with the physical stability of the formulations measured by SEC. ssHDX-MS metrics such as deconvoluted peak areas of the deuterated samples showed a satisfactory correlation (R2 = 0.914) with the SEC stability data. RFSFD improved the stability of formulations with 20 mg/ml of trehalose and no mannitol, and had similar stability with all other formulations as compared to SFD. This study demonstrated that RFSFD technique can significantly reduce the duration of primary drying cycle from 48.0 h to 27.5 h while maintaining or improving protein physical stability as compared to traditional lyophilization.

Critical Properties of Ternary Deep Eutectic Solvents Using Group Contribution with Extended Lee-Kesler Mixing Rules.

One of the most commonly used molecular inputs for ionic liquids and deep eutectic solvents (DESs) in the literature are the critical properties and acentric factors, which can be easily determined using the modified Lydersen-Joback-Reid (LJR) method with Lee-Kesler mixing rules. However, the method used in the literature is generally applicable only to binary mixtures of DESs. Nevertheless, ternary DESs are considered to be more interesting and may provide further tailorability for developing task-specific DESs for particular applications. Therefore, in this work, a new framework for estimating the critical properties and the acentric factor of ternary DESs based on their molecular structures is presented by adjusting the framework reported in the literature with an extended version of the Lee-Kesler mixing rules. The presented framework was applied to a data set consisting of 87 ternary DESs with 334 distinct compositions. For validation, the estimated critical properties and acentric factors were used to predict the densities of the ternary DESs. The results showed excellent agreement between the experimental and calculated data, with an average absolute relative deviation (AARD) of 5.203% for ternary DESs and 5.712% for 260 binary DESs (573 compositions). The developed methodology was incorporated into a user-friendly Excel worksheet for computing the critical properties and acentric factors of any ternary or binary DES, which is provided in the Supporting Information. This work promotes the creation of robust, accessible, and user-friendly models capable of predicting the properties of new ternary DESs based on critical properties, thus saving time and resources.

Molecular Guide for Selecting Green Deep Eutectic Solvents with High Monosaccharide Solubility for Food Applications.

Monosaccharides play a vital role in the human diet due to their interesting biological activity and functional properties. Conventionally, sugars are extracted using volatile organic solvents (VOCs). Deep eutectic solvents (DESs) have recently emerged as a new green alternative to VOCs. Nonetheless, the selection criterion of an appropriate DES for a specific application is a very difficult task due to the designer nature of these solvents and the theoretically infinite number of combinations of their constituents and compositions. This paper presents a framework for screening a large number of DES constituents for monosaccharide extraction application using COSMO-RS. The framework employs the activity coefficients at infinite dilution (γi∞) as a measure of glucose and fructose solubility. Moreover, the toxicity analysis of the constituents is considered to ensure that selected constituents are safe to work with. Finally, the obtained viscosity predictions were used to select DESs that are not transport-limited. To provide more insights into which functional groups are responsible for more effective monosaccharide extraction, a structure-solubility analysis was carried out. Based on an analysis of 212 DES constituents, the top-performing hydrogen bond acceptors were found to be carnitine, betaine, and choline chloride, while the top-performing hydrogen bond donors were oxalic acid, ethanolamine, and citric acid. A research initiative was presented in this paper to develop robust computational frameworks for selecting optimal DESs for a given application to develop an effective DES design strategy that can aid in the development of novel processes using DESs.

The curious case of polyphenols as green corrosion inhibitors: a review on their extraction, design, and applications.

Over the past century, a substantial amount of research focused on developing corrosion inhibitors, with a special focus on green "plant-based" corrosion inhibitors. Among the various types of inhibitors, polyphenols emerged as a promising candidate due to their advantageous characteristics, which include being inexpensive, biodegradable, renewable, and, most importantly, safe for both the environment and humans. Their performance as sustainable corrosion inhibitors have encouraged many electrochemical experiments as well as theoretical, mechanistic, and computational studies, with many papers reporting inhibition efficiencies of over 85%. In this review, the majority of literature contributions on the inhibition of various types of polyphenols, their natural extraction techniques, and their applications as "greener" corrosion inhibitors for metals are thoroughly described and discussed with a focus on their preparation, inhibition mechanism, and performance. Based on the reviewed literature, it can be concluded that polyphenols have a very promising potential to be used as both green and powerful corrosion inhibitors; therefore, further investigations, experimental or computational, are still required to realize higher inhibition efficiencies reaching up to ≈ 100%.

Natural deep eutectic solvents for Ultrasonic-Assisted extraction of nutritious date Sugar: Molecular Screening, Experimental, and prediction.

The aim of this study is to develop an environmentally friendly and effective method for the extraction of nutritious date sugar using natural deep eutectic solvents (NADES) and ultrasound-assisted extraction (USAE). The careful design of a suitable NADES-USAE system was systematically supported by COSMO-RS screening, response surface method (RSM) and artificial neural network (ANN). Initially, 26 natural hydrogen bond donors (HBDs) were carefully screened for sugar affinity using COSMO-RS. The best performing HBDs were then used for the synthesis of 5 NADES using choline chloride (ChCl) as HBA. Among the synthesized NADES, the mixture of ChCl, citric acid (CA) and water (1:1:1 with 20 wt% water) resulted in the highest sugar yield of 78.30 ± 3.91 g/100 g, which is superior to conventional solvents such as water (29.92 ± 1.50 g/100 g). Further enhancements using RSM and ANN led to an even higher sugar recovery of 87.81 ± 2.61 g/100 g, at conditions of 30 °C, 45 min, and a solvent to DFP ratio of 40 mL/g. The method NADES-USAE was then compared with conventional hot water extraction (CHWE) (61.36 ± 3.06) and showed 43.1% higher sugar yield. The developed process not only improves the recovery of the nutritious date sugar but also preserves the heat-sensitive bioactive compounds in dates, making it an attractive alternative to CHWE for industrial utilization. Overall, this study shows a promising approach for the extraction of nutritive sugars from dates using environmentally friendly solvents and advanced technology. It also highlights the potential of this approach for valorizing underutilized fruits and preserving their bioactive compounds.

Solvent Regeneration Methods for Combined Dearomatization, Desulfurization, and Denitrogenation of Fuels Using Deep Eutectic Solvents.

Deep eutectic solvents (DESs) can be used as potential solvents for various applications. However, their recovery depends on both economic and environmental considerations. In this study, the possibilities for the recovery of methyl triphenyl phosphonium bromide/triethylene glycol (MTPPB/TEG 1:4) after the application of combined dearomatization, desulfurization, and denitrogenation of fuels are investigated. The DES was first prepared and characterized for its density, viscosity, and water content. Then, the single-stage liquid-liquid extraction was conducted in addition to testing the repetitive use of the DES. After that, two regeneration methods were studied: the stripping method (with n-heptane) and the washing method (with distilled water or diethyl ether). In addition, a parametric study was conducted to optimize the regeneration methods. The results showed that washing the used DES with distilled water was significantly more effective than stripping the DES with n-heptane. In terms of quinoline reduction, distilled water reduced the quinoline content in the DES from 3.2 to 2.1 wt %, while n-heptane showed a minor reduction in the quinoline content (3.2 to 3 wt %). It was also found that a much more effective recovery could be achieved by (i) increasing the DES-to-regeneration solvent mass ratio and (ii) increasing the number of wash cycles. Furthermore, the regeneration temperature did not have a significant effect on the recyclability of the DES. The results demonstrated that the regenerated DES was as effective in extraction as a fresh batch of DES.

Searching for Sustainable Refrigerants by Bridging Molecular Modeling with Machine Learning.

We present here a novel integrated approach employing machine learning algorithms for predicting thermophysical properties of fluids. The approach allows obtaining molecular parameters to be used in the polar soft-statistical associating fluid theory (SAFT) equation of state using molecular descriptors obtained from the conductor-like screening model for real solvents (COSMO-RS). The procedure is used for modeling 18 refrigerants including hydrofluorocarbons, hydrofluoroolefins, and hydrochlorofluoroolefins. The training dataset included six inputs obtained from COSMO-RS and five outputs from polar soft-SAFT parameters, with the accurate algorithm training ensured by its high statistical accuracy. The predicted molecular parameters were used in polar soft-SAFT for evaluating the thermophysical properties of the refrigerants such as density, vapor pressure, heat capacity, enthalpy of vaporization, and speed of sound. Predictions provided a good level of accuracy (AADs = 1.3-10.5%) compared to experimental data, and within a similar level of accuracy using parameters obtained from standard fitting procedures. Moreover, the predicted parameters provided a comparable level of predictive accuracy to parameters obtained from standard procedure when extended to modeling selected binary mixtures. The proposed approach enables bridging the gap in the data of thermodynamic properties of low global warming potential refrigerants, which hinders their technical evaluation and hence their final application.

A non-invasive multipoint product temperature measurement for pharmaceutical lyophilization.

Monitoring product temperature during lyophilization is critical, especially during the process development stage, as the final product may be jeopardized if its process temperature exceeds a threshold value. Also, in-situ temperature monitoring of the product gives the capability of creating an optimized closed-loop lyophilization process. While conventional thermocouples can track product temperature, they are invasive, limited to a single-point measurement, and can significantly alter the freezing and drying behavior of the product in the monitored vial. This work has developed a new methodology that combines non-invasive temperature monitoring and comprehensive modeling. It allows the accurate reconstruction of the complete temperature profile of the product inside the vial during the lyophilization process. The proposed methodology is experimentally validated by combining the sensors' wirelessly collected data with the advanced multiphysics simulations. The flexible wireless multi-point temperature sensing probe is produced using micro-manufacturing techniques and attached outside the vial, allowing for accurate extraction of the product temperature.

Player Sex and Playing Surface Are Individual Predictors of Injuries in Professional Soccer Players.

Background: The factors contributing to soccer injuries and their influence on the occurrence of injury are controversial and inconclusive. This study aimed to determine the association between player characteristics and playing factors with injuries in professional soccer players. Methods: One hundred and fifty-two professional soccer players completed a self-administered questionnaire that asked about demographic information and injury profile, the type of playing surface on which they sustained their injury, medical treatment, and the time lost due to soccer injury at the end of the soccer season. Results: The injury rate was 44.74% (n = 68; males: 61.50% (n = 56), females: 19.70% (n = 12)). Players' age (OR: 1.15, 95%CI: 1.05−1.25, p < 0.002) and BMI (OR: 1.21, 95%CI: 1.06−1.38, p < 0.003) were significantly associated with soccer injuries. After adjusting for age and BMI, players' sex (OR: 5.39, 95%CI: 2.11−13.75, p < 0.001), previous soccer injury (OR: 3.308, 95%CI: 2.307−29.920, p < 0.001), and playing surfaces (OR: 11.07, 95%CI: 4.53−27.03, p < 0.001) were the significant predictors of soccer injuries. Conclusion: Players' age, BMI, sex, previous soccer injury, and playing surface were associated with injuries among professional soccer players. Old male athletes with high BMI, previous soccer injuries, and playing on natural grass were more likely to sustain soccer injuries than young female players with low BMI who had no previous injuries and played on synthetic surfaces.

Incidental diagnosis of pseudomyxoma peritonei by laparoscopy: a rare case from Syria.

Pseudomyxoma peritonei (PMP) is a rare malignancy of the abdomen, which is usually described as a gelatinous peritoneal fluid. A 33-year-old man came to the ER complaining of recurring abdominal pain with abdominal distention for the past 3 months. Abdominal ultrasound revealed moderate amount of turbulent ascitic fluid with septations, in addition to a mass with irregular margins consisting of liquid and cysts. Abdomen and pelvis computed tomography scan showed free abdominal fluid. A decision was made for abdominal diagnostic laparoscopy with biopsies from the peritoneum, mesenteries and the gelatinous fluid. We could not investigate all the abdominal cavities and appendix due to the presence of severe adhesions and tuberculosis suspension. The pathology report indicated PMP. The patient was referred to an oncologist for chemotherapy consultation. The diagnosis can be challenging, as the symptoms and signs vary from patient to another; most cases may be asymptomatic and discovered incidentally during laparoscopy.

The influence of sleep quality and quantity on soccer injuries in professional teams.

BACKGROUND: There is inconsistency in the relationship between sleeping measures and the occurrence of soccer injuries. Further, most studies investigated sleeping quantity and quality during soccer season but not during off-season. The purpose of this study was to determine the influence of sleeping off-season and during soccer season on the occurrence of injuries in professional soccer players. It was hypothesized that lower sleeping hours and players' thought of inadequate sleeping quantity and quality during off-season and soccer season would associate with the occurrence of soccer injuries. METHODS: One-hundred and fifty-two professional soccer players (premier league and division I teams, age: 21.82±4.44, BMI: 22.21±2.74, sex: men [N.=91], women [N.=61]) answered questions related to their sleeping duration and whether that amount of sleep was enough prior to (off-season) and during soccer season. The sleep questions related to sleep quantity were derived from the Arabic Pittsburgh Sleep Quality Index. Players indicated also. Players indicated their injury profile, medical treatment, and time loss due to soccer injury. Sleeping measures were evaluated using univariate and multivariate logistic regression models to determine predictors of soccer injuries. RESULTS: Sixty-eight players (44.73%) were injured. Lower total sleeping time during off-season (OR:0.66, 95% CI:0.51-0.85, P=0.002), answering no on "did you regularly get enough sleep during off-season" (OR: 5.64, 95% CI: 2.58-12.27, P<0.001), and answering no on "do you think that your sleeping hours during off-season were enough" (OR:4.76, 95% CI: 1.98-11.46, P=0.001) associated significantly with soccer injuries (R2:38). CONCLUSIONS: Lower total sleeping time and not getting regularly enough sleeping time during off-season associated with more soccer injuries. This highlights the influence of sleeping quantity and quality off-season on the occurrence of soccer injuries among professional players.