Evaluation of Some Prognostic Biomarkers in Human Papillomavirus-Related Multiphenotypic Sinonasal Carcinoma.

Background: Human papillomavirus (HPV)-related multi phenotypic sinonasal carcinoma (HMSC) is a recently described tumor subtype with an unknown prognosis, often misdiagnosed with other sinonasal carcinomas, and associated with high-risk HPV (HR-HPV). The present study aimed to evaluate the expression of vascular endothelial growth factor (VEGF), Bcl-2-associated X protein (BAX), epidermal growth factor receptors (EGFR), ProExTMC, and human telomerase reverse transcriptase (hTERT) and assess their association with survival and clinicopathological characteristics. Methods: Between 2017 and 2022, 40 HMSC patients underwent surgical resection at the School of Medicine, Zagazig University Hospitals (Zagazig, Egypt). Tissue samples were examined for the presence of HR-HPV; absence of myeloblastosis (MYB), MYB proto-oncogene like 1 (MYBL1), and nuclear factor I/B (NFIB) fusions and the presence of myoepithelial proteins (calponin, S100, SMA), squamous differentiation markers (p63, p40, calponin), VEGF, BAX, ProExTMC, and hTERT by immunohistochemistry. All patients were followed up for about 54 months until death or the last known survival data. Data were analyzed using the Chi square test and Kaplan-Meier method. Results: The expression of VEGF, hTERT, and ProExTMC was significantly associated with age, advanced tumor stages, lymph node metastasis, tumor size, mortality, relapse, poor disease-free survival (DFS), and overall survival (OS) (P<0.001). BAX expression was significantly associated with tumor size, age, poor DFS, and relapse (P=0.01, P<0.001, P=0.035, and P=0.002, respectively). Conclusion: HMSC is strongly associated with HR-HPV. The expression of VEGF, EGFR, BAX, hTERT, and ProExTMC is associated with aggressive malignant behavior, poor survival, and poor prognosis, making them novel prognostic biomarkers for targeted therapeutics in HMSC.

Epstein-Barr Virus Promotes Tumorigenicity and Worsens Hodgkin Lymphoma Prognosis by Activating JAK/STAT and NF-κB Signaling Pathways.

Background: Epstein-Barr virus (EBV) is detected in 40% of patients with Hodgkin lymphoma (HL). During latency, EBV induces epigenetic alterations to the host genome and decreases the expression of pro-apoptotic proteins. The present study aimed to evaluate the expression levels of mRNA molecules and the end product of proteins for the JAK/STAT and NF-κB pathways, and their association with clinicopathological and prognostic parameters in patients with EBV-positive and -negative classical Hodgkin lymphoma (CHL). Methods: A prospective cohort study was conducted from 2017 to 2022 at the Faculty of Medicine, Zagazig University Hospital (Zagazig, Egypt). Biopsy samples of 64 patients with CHL were divided into EBV-positive and EBV-negative groups. The expression levels of mRNA molecules (JAK2, STAT1, IRF-1, PD-L1, IFN-γ, NF-κB, Bcl-xL, COX-2) and the end product of proteins (PD-L1, Bcl-xL, COX-2) were determined and compared with clinicopathological and prognostic parameters. Data were analyzed using the Chi square test and Kaplan-Meier estimate. Results: EBV-positive CHL patients were significantly associated with positive expression of mRNAs molecules (P<0.001) and the end product of proteins (P<0.001) for the JAK/STAT and NF-κB pathways, B-symptoms (P=0.022), extra-nodal involvement (P=0.017), and advanced stage of CHL (P=0.018). These patients were more susceptible to cancer progression, higher incidence of relapse (P=0.008), poor disease-free survival rate (P=0.013), poor overall survival rate (P=0.028), and higher mortality rate (P=0.015). Conclusion: Through the activation of JAK/STAT and NF-κB signaling pathways, EBV-positive CHL is associated with poor clinicopathological parameters, higher incidence of disease progression, relapse, and poor overall survival. A preprint of this manuscript is available on research square (doi: 10.21203/rs.3.rs-1857436/v1).

Evaluation of Different Doses of the Aromatase Inhibitor Letrozole for the Treatment of Ectopic Pregnancy and Its Effect on Villous Trophoblastic Tissue.

Letrozole, an aromatase inhibitor, has recently been introduced as a favorable medical treatment for ectopic pregnancy. We aimed at evaluating the effects of different doses of letrozole for termination of ectopic pregnancy and study their effects on villous trophoblastic tissue. Sixty patients with undisturbed ectopic pregnancy were classified into three equal groups. Group I: the control group that contained women who underwent laparoscopic salpingectomy, Group II: patients who received letrozole (5 mg day-1) for 10 days, and Group III: patients who received letrozole (10 mg day-1) for 10 days. Subsequently, the ß-hCG levels were determined on the first day and after 11 days of treatment. Group IV consisted of patients of GII and GIII; their ß-hCG did not drop below 100 mIU/ml within 11 days, and underwent salpingectomy. Placental tissues from patients undergoing salpingectomy either from the control group or GIV were processed for the evaluation of estrogen (ER) and progesterone (PR) receptors, vascular endothelial growth factor (VEGF), and cleaved caspase 3 (CC-3) expression. Cases exposed to high dose letrozole 10 mg day-1 resulted in a higher ectopic pregnancy resolution rate of 85% (17/20), while the resolution rate of the low dose letrozole-treated group (5 mg day-1) was 65% (13/20), and also showed a significant reduction in ß-hCG levels on the 11th day, 25.63 ± 4.29 compared to the low dose letrozole group 37.91 ± 7.18 (P < 0.001), Meanwhile, the letrozole-treated group GIV showed markedly reduced expression of ER, PR, and VEGF and a significant increase in the apoptotic index cleaved caspase-3 compared to the control group (P < 0.001). The utilization of letrozole at a dose of 10 mg day-1 for medical treatment of ectopic pregnancy results in a high-successful rate without any severe side effects. Letrozole depriving the placenta of estrogen that had vascular supporting signals resulted in destroying the vascular network with marked apoptosis.

Public knowledge, beliefs, psychological responses, and behavioural changes during the outbreak of COVID-19 in the Middle East.

OBJECTIVE: To evaluate the knowledge, believes, psychological and behavioural impact of COVID-19 on the general population in the Middle East, exploring how it impacted public lives. METHODS: A descriptive cross-sectional online survey was sent to a convenience sample in the Middle East through social media (Facebook and WhatsApp) between 16th of June and 30th of June 2020. The questionnaire was designed to collect the demographic, participant's source of information regarding COVID-19, knowledge and believes about COVID-19, the psychological consequences of COVID-19, impact of COVID-19 on participant's behaviour. The final version of the questionnaire was further tested for content validity by experts in the field. RESULTS: A total of 2,061 participants completed the survey, with the majority being females (n=1394, 67.6%), from urban areas (n=1896, 92%) and the majority were from countries of The Levant (n=1199, 58.1%), followed by the Arabian Peninsula (n=392, 19.1%), Iraq (n=300, 14.6%) and Egypt (n=138, 6.7%). Few participants (3.0%) reported to have been infected and many (n=1847, 89.6%) were committed to quarantine at home. Social media platforms were the most common sources of information (41.2%). Many (63%) believed that COVID-19 is a biological weapon and were afraid of visiting crowded places (85%). The majority avoided public facilities (86.9%) such as prayer places and believed that the news about COVID-19 made them anxious (49.5%).

Accurate detection of COVID-19 patients based on distance biased Naïve Bayes (DBNB) classification strategy.

COVID-19, as an infectious disease, has shocked the world and still threatens the lives of billions of people. Early detection of COVID-19 patients is an important issue for treating and controlling the disease from spreading. In this paper, a new strategy for detecting COVID-19 infected patients will be introduced, which is called Distance Biased Naïve Bayes (DBNB). The novelty of DBNB as a proposed classification strategy is concentrated in two contributions. The first is a new feature selection technique called Advanced Particle Swarm Optimization (APSO) which elects the most informative and significant features for diagnosing COVID-19 patients. APSO is a hybrid method based on both filter and wrapper methods to provide accurate and significant features for the next classification phase. The considered features are extracted from Laboratory findings for different cases of people, some of whom are COVID-19 infected while some are not. APSO consists of two sequential feature selection stages, namely; Initial Selection Stage (IS2) and Final Selection Stage (FS2). IS2 uses filter technique to quickly select the most important features for diagnosing COVID-19 patients while removing the redundant and ineffective ones. This behavior minimizes the computational cost in FS2, which is the next stage of APSO. FS2 uses Binary Particle Swarm Optimization (BPSO) as a wrapper method for accurate feature selection. The second contribution of this paper is a new classification model, which combines evidence from statistical and distance based classification models. The proposed classification technique avoids the problems of the traditional NB and consists of two modules; Weighted Naïve Bayes Module (WNBM) and Distance Reinforcement Module (DRM). The proposed DBNB tries to accurately detect infected patients with the minimum time penalty based on the most effective features selected by APSO. DBNB has been compared with recent COVID-19 diagnose strategies. Experimental results have shown that DBNB outperforms recent COVID-19 diagnose strategies as it introduce the maximum accuracy with the minimum time penalty.

Public knowledge, beliefs, psychological responses, and behavioural changes during the outbreak of COVID-19 in the Middle East

Objective: To evaluate the knowledge, believes, psychological and behavioural impact of COVID-19 on the general population in the Middle East, exploring how it impacted public lives. Methods: A descriptive cross-sectional online survey was sent to a convenience sample in the Middle East through social media (Facebook and WhatsApp) between 16th of June and 30th of June 2020. The questionnaire was designed to collect the demographic, participant’s source of information regarding COVID-19, knowledge and believes about COVID-19, the psychological consequences of COVID-19, impact of COVID-19 on participant’s behaviour. The final version of the questionnaire was further tested for content validity by experts in the field. Results: A total of 2,061 participants completed the survey, with the majority being females (n=1394, 67.6%), from urban areas (n=1896, 92%) and the majority were from countries of The Levant (n=1199, 58.1%), followed by the Arabian Peninsula (n=392, 19.1%), Iraq (n=300, 14.6%) and Egypt (n=138, 6.7%). Few participants (3.0%) reported to have been infected and many (n=1847, 89.6%) were committed to quarantine at home. Social media platforms were the most common sources of information (41.2%). Many (63%) believed that COVID-19 is a biological weapon and were afraid of visiting crowded places (85%). The majority avoided public facilities (86.9%) such as prayer places and believed that the news about COVID-19 made them anxious (49.5%) (AU)

Detecting COVID-19 patients based on fuzzy inference engine and Deep Neural Network.

COVID-19, as an infectious disease, has shocked the world and still threatens the lives of billions of people. Recently, the detection of coronavirus (COVID-19) is a critical task for the medical practitioner. Unfortunately, COVID-19 spreads so quickly between people and approaches millions of people worldwide in few months. It is very much essential to quickly and accurately identify the infected people so that prevention of spread can be taken. Although several medical tests have been used to detect certain injuries, the hopefully detection efficiency has not been accomplished yet. In this paper, a new Hybrid Diagnose Strategy (HDS) has been introduced. HDS relies on a novel technique for ranking selected features by projecting them into a proposed Patient Space (PS). A Feature Connectivity Graph (FCG) is constructed which indicates both the weight of each feature as well as the binding degree to other features. The rank of a feature is determined based on two factors; the first is the feature weight, while the second is its binding degree to its neighbors in PS. Then, the ranked features are used to derive the classification model that can classify new persons to decide whether they are infected or not. The classification model is a hybrid model that consists of two classifiers; fuzzy inference engine and Deep Neural Network (DNN). The proposed HDS has been compared against recent techniques. Experimental results have shown that the proposed HDS outperforms the other competitors in terms of the average value of accuracy, precision, recall, and F-measure in which it provides about of 97.658%, 96.756%, 96.55%, and 96.615% respectively. Additionally, HDS provides the lowest error value of 2.342%. Further, the results were validated statistically using Wilcoxon Signed Rank Test and Friedman Test.

A new COVID-19 Patients Detection Strategy (CPDS) based on hybrid feature selection and enhanced KNN classifier.

COVID-19 infection is growing in a rapid rate. Due to unavailability of specific drugs, early detection of (COVID-19) patients is essential for disease cure and control. There is a vital need to detect the disease at early stage and instantly quarantine the infected people. Many research have been going on, however, none of them introduces satisfactory results yet. In spite of its simplicity, K-Nearest Neighbor (KNN) classifier has proven high flexibility in complex classification problems. However, it can be easily trapped. In this paper, a new COVID-19 diagnose strategy is introduced, which is called COVID-19 Patients Detection Strategy (CPDS). The novelty of CPDS is concentrated in two contributions. The first is a new hybrid feature selection Methodology (HFSM), which elects the most informative features from those extracted from chest Computed Tomography (CT) images for COVID-19 patients and non COVID-19 peoples. HFSM is a hybrid methodology as it combines evidence from both wrapper and filter feature selection methods. It consists of two stages, namely; Fast Selection Stage (FS2) and Accurate Selection Stage (AS2). FS2relies on filter, while AS2 uses Genetic Algorithm (GA) as a wrapper method. As a hybrid methodology, HFSM elects the significant features for the next detection phase. The second contribution is an enhanced K-Nearest Neighbor (EKNN) classifier, which avoids the trapping problem of the traditional KNN by adding solid heuristics in choosing the neighbors of the tested item. EKNN depends on measuring the degree of both closeness and strength of each neighbor of the tested item, then elects only the qualified neighbors for classification. Accordingly, EKNN can accurately detect infected patients with the minimum time penalty based on those significant features selected by HFSM technique. Extensive experiments have been done considering the proposed detection strategy as well as recent competitive techniques on the chest CT images. Experimental results have shown that the proposed detection strategy outperforms recent techniques as it introduces the maximum accuracy rate.

Expression, genetic localization and phylogenic analysis of NAPlr in piscine Streptococcus dysgalactiae subspecies dysgalactiae isolates and their patterns of adherence.

Streptococcus dysgalactiae, the long recognized mammalian pathogen, has currently received a major concern regarding fish bacterial infection. Adhesion to host epithelial cells and the presence of wall-associated plasminogen binding proteins are prerequisites to Streptococcus infection. This is the first study of the occurrence of nephritis-associated plasminogen-binding receptor (NAPlr) and α-enolase genes in piscine S. dysgalactiae subspecies dysgalactiae (SDSD) isolates. Further characterization of surface localized NAPlr of fish SDSD revealed a similar immune-reactive band of 43 KDa as that from porcine S. dysgalactiae subsp. equisimilis (SDSE). The phylogenetic analysis revealed that NAPlr of fish SDSD is more associated with those of mammalian SDSE and Streptococcus pyogenes rather than of other streptococci. Our findings warrant public attention to the possible implication of these virulence genes in dissemination of SDSD to different tissues of infected hosts and to get advantage to new niches. The SDSD adherence patterns were also studied to better understand their pathogenicity. The patterns of adherence of SDSD on two different cell lines showed a different pattern of adherence. Such difference gives an insight about the variance in host susceptibility to infection.

Neutron skin of (208)Pb, nuclear symmetry energy, and the parity radius experiment.

A precise determination of the neutron skin Δr(np) of a heavy nucleus sets a basic constraint on the nuclear symmetry energy (Δr(np) is the difference of the neutron and proton rms radii of the nucleus). The parity radius experiment (PREX) may achieve it by electroweak parity-violating electron scattering (PVES) on (208)Pb. We investigate PVES in nuclear mean field approach to allow the accurate extraction of Δr(np) of (208)Pb from the parity-violating asymmetry A(PV) probed in the experiment. We demonstrate a high linear correlation between A(PV) and Δr(np) in successful mean field forces as the best means to constrain the neutron skin of (208)Pb from PREX, without assumptions on the neutron density shape. Continuation of the experiment with higher precision in A(PV) is motivated since the present method can support it to constrain the density slope of the nuclear symmetry energy to new accuracy.

An epidemiological study on survival of oropharyngeal cancer cases in Alexandria, Egypt.

A retrospective cohort study was conducted to determine the 5-year survival and prognostic factors for survival for 407 oropharyngeal cancer cases registered in the 3 main hospitals in Alexandria, Egypt, from 1996-2000. Survival analysis was conducted using Kaplan-Meier curves, and multivariate Cox regression analysis. The overall 5-year survival rate was 30.8%. Multivariate analysis showed that significant prognostic factors for survival were tumour stage (hazard ratio = 2.39; 95% CI: 1.41-11.72), tumour site and patient's age. Secondary prevention of oral cancers can be conducted through examination of the oral cavity to find precancerous and early cancerous lesions and hence improve survival.

Nuclear symmetry energy probed by neutron skin thickness of nuclei.

We describe a relation between the symmetry energy coefficients c(sym)(rho) of nuclear matter and a(sym)(A) of finite nuclei that accommodates other correlations of nuclear properties with the low-density behavior of c(sym)(rho). Here, we take advantage of this relation to explore the prospects for constraining c(sym)(rho) of systematic measurements of neutron skin sizes across the mass table, using as example present data from antiprotonic atoms. The found constraints from neutron skins are in harmony with the recent determinations from reactions and giant resonances.

An epidemiological study on survival of oropharyngeal cancer cases in Alexandria, Egypt

A retrospective cohort study was conducted to determine the 5-year survival and prognostic factors for survival for 407 oropharyngeal cancer cases registered in the 3 main hospitals in Alexandria, Egypt, from 1996-2000. Survival analysis was conducted using Kaplan-Meier curves, and multivariate Cox regression analysis. The overall 5-year survival rate was 30.8%. Multivariate analysis showed that significant prognostic factors for survival were tumour stage [hazard ratio = 2.39; 95% CI: 1.41-11.72], tumour site and patient's age. Secondary prevention of oral cancers can be conducted through examination of the oral cavity to find precancerous and early cancerous lesions and hence improve survival

Mexican Americans' perceptions of culturally competent care.

Although the literature abounds with authors' discussions of the need for nurses and other health care providers to deliver safe and optimal care to patients of diverse ethnic groups, little work has focused on defining and measuring the dimensions of culturally competent care. The purpose of this research was to identify culturally competent concepts from the perspective of Mexican Americans. Focus group interviews with Mexican American registered nurses and Mexican American lay recipients of health care were used to explore the participants' subjective perceptions regarding the indicators of culturally competent care. For this group of Mexican American registered nurses, the influence of culture remained strong despite nursing professional experience and knowledge of Western biomedical system. The predominance of themes emphasizing respect, caring, understanding, and patience in health care encounters support the critical importance of personal processes of health care with Hispanics.

Phospholipid- and fatty acid-composition in the erythrocyte membrane of the one-humped camel [Camelus dromedarius] and its influence on vesicle properties prepared from these lipids.

The lipid composition of the membrane of erythrocytes from the one-humped camel (Camelus dromedarius) concerning the different lipid classes and the fatty acids was investigated for the first time. The most frequently occurring lipids are sphingomyelin (28.8% of total lipids), phosphatidylcholine and phosphatidylserine (each about 12%). The cholesterol/lipid ratio was calculated to be 0.30 (w/w). The fatty acids consist of shorter and/or more unsaturated chains, which resulted in a more fluid membrane compared to human RBC membranes. Liposomes prepared from erythrocyte lipid extracts were used to investigate the membrane properties resulting from this special lipid mixture. These vesicles were sufficient stable in buffer and significantly more stable than vesicles prepared from human erythrocyte lipid extracts in serum at 37 degrees C. Lipoplexes prepared from cationic erythrocyte lipid liposomes and a reporter gene showed in vitro an improved transfection on two colon carcinoma cells with an enhancement of up to 400% in beta-galactosidase activity in comparison to Lipofectin.

Response of one-humped camel (Camelus dromedarius) to intravenous glucagon injection and to infusion of glucose and volatile fatty acids, and the kinetics of glucagon disappearance from the blood.

The effects of glucagon injection and infusion of glucose and volatile fatty acids were studied in one-humped camels. Twenty adult male camels were divided into four equal groups. The first group was infused with physiological saline and served as a control. The second group was injected with a single dose of glucagon, the third group was infused with glucose (50%) in sterile saline, and the fourth group was infused with a volatile fatty acid (VFA) mixture. In the first, third and fourth groups, sampling was performed before the beginning of infusions (control time), and at 15, 30, 60 and 120 min post-infusion. Plasma glucagon concentrations were monitored in the second group at 5, 10, 15, 20, 30, 45, 90, 105 and 120 min after injection. For glucagon injection, glucose concentration peaked at 15 min post-injection, and tended to decrease thereafter. Plasma glucose concentrations showed significant rises above the basal value at all times after glucose infusion. VFA infusion had no apparent effect on plasma glucose concentration. After injection of glucagon, the plasma lactate concentration dropped significantly at 15 and 30 min, then increased gradually until it reached the original concentration of lactate at 120 min. However, glucose infusion elevated the plasma lactate concentration only at the end of the infusion period. A decrease in plasma lactate was observed at 60 min after VFA infusion. The present investigation provides evidence that the glucagon level in camels is higher than that in other ruminants and in man, and suggests that this is a probable species specificity, which would explain the higher level of glucose in the blood of camels than in that of other ruminants. The disappearance curve of injected glucagon had, as in other ruminants, an exponential two-compartment function. The hormone was rapidly distributed and was eliminated with a high rate of clearance.

The impact of cultural and familial context on behavioral and emotional problems of preschool Latino children.

This study examined the impact of financial, cultural, and family variables on the incidence of behavioral and emotional problems in a group of two- and three-year-old Latino children. The vulnerability of these children to mental health problems stems from the many challenges faced by their families, especially those associated with acculturation and poverty. Results indicate that most problems experienced by the children were related to depression and social withdrawal. Children were at greatest risk whose parents had immigrated from Central America, whose families relied more extensively on internal coping strategies such as passive resignation, and whose parents were dissatisfied with their family's interactions.

Bird face deformity secondary to bilateral temporomandibular joint ankylosis.

This paper describes our experience in the treatment of 10 patients with bilateral longstanding temporomandibular joint ankylosis occurring during the active growth period and causing severe bird face deformity. The clinical manifestations were: (1) upper airway obstruction in the form of either severe night snoring or obstructive sleep apnoea; (2) inability to open the mouth and (3) severely convex facial profile. Surgery consists of simultaneous release of the ankylosed joints, advancement of the mandible and insertion of posterior mandibular costochondral graft struts. A Le Fort I osteotomy was performed concomitantly in marked deformities to help in the restoration of the posterior facial height. Dramatic improvement in the airway, facial profile and jaw function were obtained by this programme.

Collaboration between families and university faculty: a partnership in education.

1. Collaboration between nursing faculty and family members of persons with mental illness can help nursing students form a positive view of the family as a resource to treatment and as a source of support for the client. 2. Faculty and family collaboration may result in a program of home visiting, which can augment the psychiatric nursing practicum and increase nursing student empathy and sensitivity to the family burden of mental illness. 3. Nursing students use of CAMI instructional resources has accelerated the incorporation of biological perspectives of mental illness into the nursing curriculum.

The family and chronic sorrow: role theory approach.

This article explores the presence of chronic sorrow in families of chronically ill children and applies role theory concepts in the understanding of this phenomenon. Research findings in the area of chronic sorrow, family adaptation, and role theory are used to formulate propositions specific to the application of role theory in the study of chronic sorrow. The clinical and research applicability for nurses working with families of chronically disabled children are discussed to assist in providing quality family-nursing care.