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Background: Airway allergies such as asthma and allergic rhinitis, as well as their comorbidities, are increasing worldwide, causing significant socioeconomic health burdens to societies. It is estimated that between 3% and 10% of the population is allergic to fungi. The type of fungal sensitization varies from one geographical region to another. The present study aimed to identify the common fungal aeroallergen sensitization patterns among airway-allergic patients residing in the Zagazig locality, Egypt, in order to obtain a better understanding of fungal allergy, in addition to improving the awareness and management strategies for those patients. Methods: The present cross-sectional study included 200 allergic rhinitis and asthma patients. Sensitization to fungal aeroallergens was evaluated by skin prick testing and in vitro measurement of total and specific immunoglobulin E. Results. As determined by a skin prick test, 58% of the patients studied were allergic to mixed molds. Alternaria alternata was the predominant fungal aeroallergen among the studied patients (72.2%), which was followed by Aspergillus fumigatus (53.45%), Penicillium notatum (52.6%), Candida albicans (34.5%), and Aspergillus niger (25%). Conclusion: Mixed mold sensitization ranked fourth among the most frequent aeroallergens in airway-allergic patients, and Alternaria alternata was the most frequently encountered fungal aeroallergen in the Zagazig locality.

Background: An increased risk of cardiovascular complications is reported in survivors of childhood acute lymphoblastic leukemia (ALL). Early identification of impaired vascular health may allow for early interventions to improve outcomes. Aim: The study was conducted to assess the endothelial dysfunction in ALL survivors using a new marker, serum endocan, and measurement of the mean common carotid arteries intima media thickness (cIMT). Methods: A case-control study was conducted on 100 childhood ALL survivors (aged 6–18 years), with 80 healthy age and sex-matched children as a control group. Lipid profile, hepatitis markers, and serum ferritin where measured, in addition to the measurement of serum endocan. and cIMT by B-mode high-resolution ultrasonography for all study participants. Results: Triglycerides, total cholesterol, post prandial glucose, and serum ferritin were significantly higher in ALL survivors than controls (p < 0.05). Dyslipidemia was detected in 6% of ALL survivors. ALL survivors showed statistically higher serum endocan levels (470.41 ± 556.1 ng/l, versus, 225.94 ± 185.2 ng/l, respectively) and increased cIMT levels compared with the control group (0.650 ± 0.129 mm versus 0.320 ± 0.095 mm, respectively) p < 0.05. Serum endocan was positively correlated with cIMT and blood cholesterol. Conclusions: The survivors of childhood ALL demonstrated an elevated level of serum endocan and increased cIMT. These can be used as predictors of endothelial dysfunction, and, as a consequence, the risk of developing premature atherosclerosis.

Background Osteonecrosis (ON) is one of the major therapy‐related complications in childhood acute lymphoblastic leukemia (ALL). The purpose of the current study is to assess the frequency of ON in children with ALL and to detect whether polymorphisms in vitamin D receptor gene (VDR) and plasminogen activator inhibitor‐1 (PAI‐1) gene can affect the risk of ON. Patients and Methods Nighty‐six ALL children were enrolled. Serum 25‐hydroxyvitamin D 25(OH)D levels were performed in addition to the detection of polymorphisms in PAI‐1and VDR genes by polymerase chain reaction. Results Ten out of 96 patients had ON (four males and six females aged above 10 years) and had an insufficient level of 25(OH)D. Fifty‐two percent of patients had PAI‐1 GG genotype while 48% had PAI‐1 GA genotype. PAI‐1 polymorphism was detected in 60% of all ON cases. The frequencies of VDR genotypes were CT (56.3%), CC (39.6%), and TT (4.2%). Osteonecrosis was found in eight patients with CC genotype and in two patients with CT genotype. Conclusion Osteonecrosis can develop early during the therapy of ALL. Older age and insufficient level of 25(OH)D were considered important risk factor for the development of osteonecrosis. PAT‐1 and VDR gene polymorphism may be a genetic risk factor in its pathogenesis. Osteonecrosis can develop early during the therapy of ALL. Older age and insufficient level of 25(OH)D were considered an important risk factor for the development of osteonecrosis. PAT‐1 and VDR gene polymorphism may be a genetic risk factor in its pathogenesis.

Collagen integrity should be considered on using a sterilizing agent for fish skin grafts. This study defined the optimal concentration of silver nanoparticles (Ag NPs) for sterilization of fish skin grafts without disrupting collagen content based on microbiological and histological evaluation. Strips of tilapia skin (n = 5) were randomly allocated to be immersed in Ag NPs solution at different concentrations of 25, 50, 100, and 250 µg/mL, respectively, for 5 min. The treated skin strips underwent bacteriological and histological evaluation. Yeast and fungi were more sensitive to Ag NPs than bacteria. On increasing the nanoparticles concentration, the total counts of aerobic bacteria decrease giving 933.3 ± 28.67, 601 ± 27.66, 288 ± 16.8, 15 ± 4.08 (CFU/cm 2  ± S.D) at 25, 50, 100, and 250 µg/mL, respectively, comparing with untreated sample (1453.3 ± 57.92). Yeasts and filamentous fungi also exhibited a similar response, achieving a complete inhibition at 100 and 250 µg/mL. Bacillus cereus and Escherichia coli were the dominant aerobic bacteria , Candida albicans and Rhodotorula glutinis were the dominant aerobic yeasts, whereas Aspergillus niger, Aspergillus fumigatus, and Rhizopus stolonifer were the dominant aerobic fungi. The collagen fibers were loose with a wavey pattern at 25 µg/mL, wavey and slightly disorganized at 50 µg/mL, highly disorganized at 100 µg/mL, and compactly arranged and slightly loose at 250 µg/mL. Ag NPs at a concentration of 250 µg/mL could be considered a reliable and feasible method for the sterilization of fish skin grafts before application on human skin with an effective antimicrobial effect and less disrupting impact on collagen content.

The aim of the present study was to investigate the effects of the biological properties of hDPSCs exposed to Bio MTA+ & ProRoot MTA pulp capping materials on the proliferation and odontogenic differentiation of hDPSCs. Human dental pulp stem cells (hDPSCs) were isolated from impacted third molars. Extracts of Bio MTA + and ProRoot MTA were prepared at a 1:1 ratio. The effects of the extracts on hDPSCs cytotoxicity and proliferation were assessed via a CCK-8 assay. Annexin V expression was investigated to assess the effects of both materials on the induction of apoptosis. The effects of ProRoot MTA and Bio MTA + extraction media on the stemness properties of hDPSCs were assessed via real-time quantitative PCR, and the expression of odontogenic markers (RUNX2, DMP1 & DSSP) was analyzed via RT‒PCR Alizarin Red staining. Cells exposed to Bio MTA + had the greatest degree of proliferation. The results of Annexin V staining indicated that Bio MTA + caused the least amount of apoptosis. RUNX2, DMP1 and DSSP were highly expressed by Bio MTA + and indicated successful odontogenic differentiation. Compared with ProRoot MTA, Bio MTA + exhibited an exceptional level of cytocompatibility, as well as advantageous bioactivities, including the preservation of stemness and an increase in the proliferation capacity of hDPSCs. In addition, it demonstrated favorable bioactive properties by stimulating odontogenic differentiation. Bio MTA + offers significant advantages in terms of biocompatibility, bioactivity, and regenerative potential, making it an excellent choice for procedures aimed at preserving or regenerating dental pulp tissue. However, additional research is required to address the lack of in vivo validation, as replicating physiological conditions is crucial for accurately assessing clinical outcomes and comparing them with results obtained from in vitro experiments.

Egypt’s thriving marble industry produces extensive waste marble powder (WMP) amounts. Recycling plentiful waste safely and effectively is a key national concern, as improper disposal poses a serious threat to the environment. This study addressed this challenge by exploring a new method to produce CaO from WMP by appropriate calcination (CWMP), which can be used as an effective additive for alkali-activated slag (AAS) cement. The CaO extracted from WMP (CWMP) was introduced into AAS cement at varying levels, ranging from 2.5 up to 15%, in 2.5% increments, by weight, as a partial slag replacement. Multiple assessments were conducted to evaluate the influence of CWMP (i.e., CaO derivative from WMP) on specific features of AAS cement. Superior analytical techniques were utilized to achieve a deeper comprehension of the results. The findings revealed a decrease in both flowability and setting time with including CWMP. As the CWMP amount increased, flowability decreased, and setting time became shorter. The introduction of CWMP up to 10% improved performance, with the optimal at 7.5%, improving compressive strength and the ability to withstand environmental conditions. Specifically, the optimal 7.5% CWMP addition increased the 28-day compressive strength by 22.96% and reduced the strength loss after durability cycling from 14.43 to 10.93%. Additionally, the persistent issue of drying shrinkage within this system could also be alleviated by including CWMP up to 10%, particularly at 7.5%. Amounts of CWMP over 10% showed detrimental effects. Repurposing WMP as a CaO source not only manages a problematic waste stream but also saves CaO produced from natural limestone.

One of the most applied procedures for the determination of trace analytes in complex matrices is QuEChERS (an acronym for Quick, Easy, Cheap, Effective, Rugged, and Safe). QuEChERS procedures include an extraction step followed by a dispersive solid-phase extraction (dSPE) for analytes cleaning-up from the matrix components. A challenging task in QuEChERS procedures is extracting and determining pesticides from samples of high fat such as milk samples. This challenge induced the innovation of new adsorbents for the clean-up step such as Z-Sep Plus® and EMR-Lipid® to enable removal of fatty matrix components without affecting the recovery of hydrophobic analytes. This work aims to apply experimental design to optimize the combined application of both QuEChERS clean-up adsorbents; Z-Sep Plus® and EMR-Lipid® in addition to other QuEChERS parameters in the determination of eight pesticides: hexachlorocyclohexane, dichlorodiphenyldichloroethane, dichlorodiphenyltrichloroethane, primiphos ethyl, diazinon, malathion, endrin, and dimethoate in milk matrix. This was augmented by optimization of GC–MS/MS and UPLC-MS/MS to detect and determine analytes in extracts. The experimental design of QuEChERS procedure enabled the optimization of Z-Sep Plus®- and EMR-Lipid®-added adsorbent amounts with other method parameters to enable the maximum recovery of analytes. Furthermore, the optimized methods enabled low detection limits of the studied pesticides within a short analysis time (28 min for GC and 12 min for LC methods, respectively). The procedure was validated according to European SANTE/11312/2021 Guideline. Quantitation limit ranged from 1.7 to 3.2 ng/mL for GC–MS/MS method and from 1.7 to 3 ng/mL for UPLC-MS/MS method. Greenness assessment of the methods followed four approaches indicating an excellent value of greenness for the proposed methods. Furthermore, 45 real milk samples collected from the Egyptian market were tested with the developed procedure for the presence of pesticides.

Image segmentation is considered one of the essential tasks for extracting useful information from an image. Given the brain tumor and its consumption of medical resources, the development of a deep learning method for MRI to segment the brain tumor of patients’ MRI is illustrated here. Brain tumor segmentation technique is crucial in detecting and treating MRI brain tumors. Furthermore, it assists physicians in locating and measuring tumors and developing treatment and rehabilitation programs. The residual U-Net++ encoder-decoder-based architecture is designed as the primary network, and it is an architecture that is hybridized between ResU-Net and U-Net++. The proposed Residual U-Net++ is applied to MRI brain images for the most recent and well-known global benchmark challenges: BraTS 2017, BraTS 2019, and BraTS 2021. The proposed approach is evaluated based on brain tumor MRI images. The results with the BraST 2021 dataset with a dice similarity coefficient (DSC) is 90.3%, sensitivity is 96%, specificity is 99%, and 95% Hausdorff distance (HD) is 9.9. With the BraST 2019 dataset, a DSC is 89.2%, sensitivity is 96%, specificity is 99%, and HD is 10.2. With the BraST 2017 dataset, a DSC is 87.6%, sensitivity is 94%, specificity is 99%, and HD is 11.2. Furthermore, Residual U-Net++ outperforms the standard brain tumor segmentation approaches. The experimental results indicated that the proposed method is promising and can provide better segmentation than the standard U-Net. The segmentation improvement could help radiologists increase their radiologist segmentation accuracy and save time by 3%.

Stereotactic guided biopsies have become the sampling method of choice in diagnosis of non-palpable breast microcalcifications which directly impact patients' management plans and consequently morbidity and mortality. The purpose is to compare the diagnostic accuracy of VAB and CNB in diagnosis of indeterminate breast microcalcifications and subsequent management of cases of indeterminate breast micro-calcifications. Retrospective review of stereotactic CNB and VAB was done, pathological data were classified as benign, high risk and malignant lesions and compared with gold standard surgical specimen. The influence on patients' surgical planning was depicted. A total of 268 lesions were included in our study divided as 136 lesions that underwent VAB and 132 lesions that underwent CNB, for the VAB group the overall PPV was 100% (96-100% CI) and NPV was 95.8% (90-98% CI) with overall diagnostic accuracy of 97% (92-99% CI), while for the CNB group the PPV was 100% (95-100% CI) and NPV was 80.2% (74.2-85% CI) with overall diagnostic accuracy of 84.8% (77-90% CI). 4/136 VAB lesions did not match the surgical specimen malignant diagnosis this could be explained by their mean diameter of 9.725 ± 1.8 cm and 3.172 ± 1.84 cm which was found statistically significant P value of less than 0.0001. The percentage of re-operation in VAB group was 2.9% while in CNB group was 7.5%. VAB is a superior diagnostic tool over CNB in diagnosis of indeterminate breast microcalcifications and reducing the percentage of re-operations which directly impacts the patient's morbidity. Moreover, it can replace surgery in cases of benign lesions and totally resected high risk lesions especially when operations are contraindicated or refused by the patient, yet with strict follow up.

Background: Caesarean section (CS) is a life-saving operation when vaginal delivery is risky to the mother or baby. However, if not medically indicated or performed under suboptimal conditions, it can be harmful and resource-intensive. Aims: To estimate the prevalence of CS in 6 Egyptian governorates and identify possible risk factors (including demographic, social and healthcare services factors) stratified according to geographical areas. Methods: We used secondary data collected from a large survey to investigate the sociodemographic and health indicators of 6 purposefully selected Egyptian governorates with suboptimal health indicators: 3 from Upper Egypt (Sohag, Assiut and Menia) and 3 from Lower Egypt (Sharkia, Beheira and Ismailia). The survey data were gathered using an interview questionnaire that targeted household members. Results: The CS rate was estimated at 55.1% for the 3 years preceding the study, and the highest rate was 67.8% in Behira and the lowest was 49.0% in Assiut. In most governorates, the CS rate was higher in rural than in urban areas, but the difference was not significant. High CS rates were significantly related to higher social class and lower number of children (≤ 3). Conclusion: In the governorates investigated, CS was performed more often, with higher rates than those reported in the 2015 Egypt Health Issue Survey. The adoption of protocols for elective CS should be enforced with a more multisectoral effort. Pregnant women should be well informed of the risks associated with CS and its medical indications.