Neutrophil CD64 as a diagnostic marker of sepsis in children

Background: Sepsis is one of the leading causes of mortality among children worldwide. Reliable evidence was insufficient in pediatric sepsis and many aspects in clinical practice actually depend on expert consensus with some evidence in adult sepsis.Objective: This study aimed to investigate neutrophil expression of CD64 in septic children and in healthy controls. We hypothesized that these receptors are elevated during sepsis and can be used as a diagnostic marker.Methods: This study was carried out on 50children with pediatric sepsis and 40 apparently healthy children as controls. Cases were recruited from the PICU of Al Zahraa University Hospital, Al-Azhar University for Girls in the period from May 2014 to March 2015. All the cases were assessed clinically and by routine laboratory investigations. Expression of neutrophil CD64 was measured by flow cytometry.Results: The mean CD64 expression in children with sepsis (66.49 ± 23.45) was significantly higher than in the control group (9.39 ± 6.17) p<0.001 .CD64 expression had a significant positive correlation with CRP level (r=0.416, p<0.003). ROC curve for CD64 expression showed100% sensitivity and specificity. The most common isolated organisms were gram negative organisms mainly E. coli. A highly significant increase was demonstrated in CRP and TLC values in the culture proven sepsis group compared to clinical sepsis group, while there was nostatistical significant difference in CD64 values between the two groups.Conclusion: change in cell surface expression of CD64 on peripheral blood neutrophils can be considered a sensitive marker for the detection of pediatric sepsis.Keywords: Neutrophil, CD64, sepsis, childre

Role of Proangiogenic Tyrosine Kinase with Immunoglobulin and Endothelial Growth Factor Homology Domains 2 Expressing Monocytes in Chronic Lymphocytic Leukemia

Background: Globally, highest hematologic malignancy in prevalence is considered chronic lymphocytic leukemia (CLL). The expression of angiopoietin-2 (Ang2) and tyrosine kinase with immunoglobulin and endothelial growth factor homology domains (Tie1), two critical components of the Ang-Tie2 pro-angiogenic pathway, in CLL cells has been demonstrated. Objective: Clarification of Tie2-expressing monocytes’ (TEMs) involvement in the pathophysiology of CLL is the goal of this study. Patients and Methods: The study was case control, which was performed on 21 CLL patients; their age ranged from 46 to 71 with a mean of 58.2 ± 6.9, in addition to 21 age and sex matched healthy control subjects. Full medical histories, clinical examinations, and laboratory tests were conducted on all individuals. The percentage of TEMs in peripheral blood was determined by flow cytometry and their phenotypic characteristics defined as CD14+/CD16+/Tie-2+ cells. Results: Compared to the control group, there was a statistically significant increase in TEMs in the cases group. Among the cases group there was a statistical significant increase in LDH, uric acid, WBCs, reticulocyte, CD 38 β2 microglobulin and TEMS and statistical significant decrease in Hb with increase Binet stage. There was a statistical significant +ve correlation between TEMs and LDH, WBCs, reticulocytes, CD38 and β2 microglobulin. Also, there was a statistical significant negative correlation between TEMs and Hb and platelets count among the cases group. TEMs percentage had sensitivity, specificity and accuracy (100%) in diagnosis of leukemia at cut off > 20.95%. Conclusion: TEMs could be a part of CLL pathogenesis which can be a predictor of disease progression alongside with other prognostic indicators

Generalised and Versatile Connected Health Solution on the Zynq SoC

This chapter presents a generalized and versatile connected health solution for patient monitoring. It consists of a mobile system that can be used at home, an ambulance and a hospital. The system uses the Shimmer sensor device to collect three axes (x, y and z) accelerometer data as well as electrocardiogram signals. The accelerometer data is used to implement a fall detection system using the k-Nearest Neighbors classifier. The classification algorithm is implemented on various platform including a PC and the Zynq system on chip platform where both programmable logic and processing system of the Zynq are explored. In addition, the electrocardiogram signals are used to extract vital information, the signals are also encrypted using the Advanced Encryption Standard and sent wirelessly using Wi-Fi for further processing. Implementation results have shown that the best overall accuracy reaches 90% for the fall detection while meeting real-time performances when implemented on the Zynq and while using only 48% of Look-up Tables and 22% of Flip-Flops available on chip

Mothers’ Attitudes towards Children’s Use of Electronic Games and their Impact on Them: A ‏Survey

هدفت الدراسة إلى التعرف على تأثير معدل متابعة الألعاب الإلكترونية واستخدامها في الأطفال الذين تتراوح أعمارهم ما بين (6-15) سنة من وجهة نظر الأمهات للوقوف على بعض الجوانب السلبية والإيجابية وتنتمي هذه الدراسة إلى الدراسات الوصفية مستخدمة المنهج المسحي عبر عينة من الأمهات بالإجابة على استبانة تضم 17 سؤالا مستهدفة  وصف أثر استخدام الألعاب الإلكترونية على الأطفال في مدينة الدمام بالمملكة العربية السعودية، واعتمدت منهج المسح الإعلامي عبر عينة لجمهور الأمهات، للتعرف على كيفية استخدام أبنائهن للألعاب الإلكترونية، والنتائج المتحققة لديهن من متابعة تلك الألعاب وتأثيرها على تحصيلهم الدراسي، ومن أهم نتائج الدراسة: اتفاق نتائج الدراسة مع ما توصلت إليه الدراسات السابقة من حيث وجود أضرار نفسية ودراسية واضحة على الأطفال، وجاء الذكور أكثر استخداما للجوال والبلايستيشن بنسب متقاربة، بينما تميل الإناث لاستخدام الجوال أكثر من الذكور ولا تميل إلى استخدام البلاي ستيشن، بينما لا يميل أيا من الجنسين لاستخدام الإكس بوكس، وكذلك الذكور هم الأكثر مداومة في الجلوس على أجهزة إلكترونية مختلفة، ويفضلون استخدام ألعاب المغامرات والأكشن ثم الألعاب التعليمية، ومن ثم فالتأثير السلبي نحو التعامل بعنف وتأخر تحصيهم الدراسي كان أعلى من الإناث، ويُفضل الإناث ألعاب المغامرات والألعاب التعليمية ثم الألغاز، ولا يداومن على الجلوس على الأجهزة المختلفة بكثرة كما الذكور، ومن ثم تبدو نسبة التعامل مع الآخرين أقل عنفًا وتأخر التحصيل الدراسي أقل، ويُفضل الذكور استخدام ألعاب الرعب مقارنة بالإناث، وتُشير النتائج إلى أن ممارسة الألعاب يؤثر سالبا على الأطفال في التعامل مع الآخرين بعنف وتأخر الطفل في التحصيل الدراسي، وكان الذكور أعلى في التأثر من الإناث، وهناك تقارب في نسب التأثيرات الإيجابية بين الذكور والإناث إثر التعلق بالألعاب الإلكترونية على حياتهم اليومية، وجاءت التأثيرات السلبية أعلى تأثيرا من التأثيرات الإيجابية.The study aimed to identify the impact of the rate of follow-up and use of electronic games on children between the ages of (6-15) years from the mothers’ point of view to find out some of its negative and positive aspects. This study is a descriptive study which used the survey method through a sample of mothers by answering a questionnaire containing 17 questions that aims to describe the impact of the use of electronic games on children in Dammam, Saudi Arabia. It relied on the media survey method through a sample of the mothers' audience, to know how their children use electronic games, and the effects achieved by them from following these games and their impact on their academic achievement, and among the most important results of the study: The results of the study are consistent with the findings of previous studies in terms of clear psychological and academic change for children. The males showed frequent usage for mobile devices and PlayStation in close proportions while females tend to use mobile phones more than males and do not tend to use PlayStation. However, neither gender tends to use Xbox. The males are the most persistent in sitting on different electronic games. They prefer to use adventure and action games and then educational games, so the negative impact towards dealing violently and delaying their academic achievement was higher than that of females. Females preferred adventure games, educational games, then puzzles. They do not persist in sitting on different devices as much as males do, so the percentage of dealing with others more violent and the delay in academic achievement is   less. Males prefer to use horror games compared to females. The results generally indicate that playing games negatively affects children in dealing with others violently and a steep decrease in their school achievement, and males were more affected than females. There is a convergence in the proportions of positive effects between males and females towards attaching electronic games to their daily lives, and the negative effects were higher than the positive ones

Allelic Discrimination of Vitamin D Receptor Polymorphisms and Risk of Type 2 Diabetes Mellitus: A Case-Controlled Study

(1) Background: Type 2 diabetes mellitus (T2DM) is one of the rapidly growing healthcare problems, and several vitamin D receptor (VDR) polymorphisms seem to modulate the risk of T2DM. Our research was designed to investigate the allelic discrimination of VDR polymorphisms and T2DM occurrence risk. (2) Methods: This case-control research included 156 patients with T2DM and 145 healthy control subjects. Most of the study population were males 56.6% vs. 62.8% in the case and control groups, respectively. Genotyping for VDR single nucleotide polymorphisms (SNPs), rs228570 (Fok1), rs7975232 (Apa1), and rs1544410 (Bsm1) was compared between both groups. (3) Results: There was a negative link between vitamin D levels and insulin sensitivity. A significant difference was noted in the allelic discrimination of VDR polymorphism rs228570 and rs1544410 between the study groups (p \u3c 0.001). No difference was observed in the allelic discrimination of VDR polymorphism rs7975232 between the groups (p = 0.063). Moreover, T2DM patients had significantly higher levels of fasting blood sugar (FBS), glycated hemoglobin HbA1c, 2-h post-prandial blood sugar (PP), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), total cholesterol, and triglycerides (p \u3c 0.001), while High-Density Lipoprotein (HDL) Cholesterol (HDL-C) was significantly decreased (p = 0.006). (4) Conclusions: VDR polymorphisms had a positive association with T2DM risk among the Egyptian population. Further large-scale research using deep sequencing of samples is strongly urged to investigate different vitamin D gene variants and interactions, as well as the influence of vitamin D on T2DM

Clinical significance of altered nm23-H1, EGFR, RB and p53 expression in bilharzial bladder cancer

<p>Abstract</p> <p>Background</p> <p>Clinical characterization of bladder carcinomas is still inadequate using the standard clinico-pathological prognostic markers. We assessed the correlation between <it>nm23-H1</it>, <it>Rb, EGFR </it>and <it>p53 </it>in relation to the clinical outcome of patients with muscle invasive bilharzial bladder cancer (MI-BBC).</p> <p>Methods</p> <p><it>nm23-H1</it>, <it>Rb, EGFR and p53 </it>expression was assessed in 59 MI-BBC patients using immunohistochemistry and reverse transcription (RT-PCR) and was correlated to the standard clinico-pathological prognostic factors, patient's outcome and the overall survival (OS) rate.</p> <p>Results</p> <p>Overexpression of <it>EGFR </it>and <it>p53 </it>proteins was detected in 66.1% and 35.6%; respectively. Loss of <it>nm23-H1</it>and <it>Rb </it>proteins was detected in 42.4% and 57.6%; respectively. Increased <it>EGFR and </it>loss of <it>nm23-H1 </it>RNA were detected in 61.5% and 36.5%; respectively. There was a statistically significant correlation between <it>p53 </it>and <it>EGFR </it>overexpression (<it>p </it>< 0.0001), <it>nm23 </it>loss (protein and RNA), lymph node status (<it>p </it>< 0.0001); between the incidence of local recurrence and <it>EGFR </it>RNA overexpression (p= 0.003) as well as between the incidence of metastasis and altered <it>Rb </it>expression (<it>p </it>= 0.026), <it>p53 </it>overexpression (<it>p </it>< 0.0001) and mutation (<it>p </it>= 0.04). Advanced disease stage correlated significantly with increased <it>EGFR </it>(protein and RNA) (<it>p </it>= 0.003 & 0.01), reduced <it>nm23-H1 </it>RNA (<it>p </it>= 0.02), altered <it>Rb </it>(<it>p </it>= 0.023), and <it>p53 </it>overexpression (<it>p </it>= 0.004). OS rates correlated significantly, in univariate analysis, with <it>p53 </it>overexpression (<it>p </it>= 0.011), increased <it>EGFR </it>(protein and RNA, <it>p </it>= 0.034&0.031), <it>nm23-H1 RNA </it>loss (<it>p </it>= 0.021) and aberrations of ≥ 2 genes. However, multivariate analysis showed that only high <it>EGFR </it>overexpression, metastatic recurrence, high tumor grade and the combination of ≥ 2 affected markers were independent prognostic factors.</p> <p>Conclusion</p> <p><it>nm23-H1, EGFR </it>and <it>p53 </it>could be used as prognostic biomarkers in MI-BBC patients. In addition to the standard pathological prognostic factors, a combination of these markers (≥ 2) has synergistic effects in stratifying patients into variable risk groups. The higher is the number of altered biomarkers, the higher will be the risk of disease progression and death.</p

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Sulphated tubers extract from the giant taro Alocasia macrorrhiza inhibits the carcinogenesis initiation and modulates macrophage functions

Alocasia macrorrhizos (L.) G. Don, Araceae, is a traditionally edible plant known as giant taro. This work aimed to prepare sulphatedpolysaccharide extract of A. macrorrhizos tubers (SAM) and to investigate its tumor anti-initiation and anti-promotion activities. Methods:Enzymatic, colorimetric, fluorometric, and cell-based assays were used throughout the study. Tumor anti-initiation activity was investigatedby estimation of SAM effect on cytochrome P450 1A1 (Cyp1A1) glutathione-S-transferases (GST), glutathione (GSH), epoxide hydrolase(mEH), and quinone reductase (QR), while Tumor anti-promotion activity was investigated by macrophage proliferation, nitric oxide (NO),and LPS binding to macrophages. SAM inhibited the carcinogen metabolizing enzyme Cyp1A1 and it induced, to variable extent, thedetoxification enzymes (GST, mEH and QR), especially mEH. Additionally, SAM showed anti-inflammatory property by inhibiting NO andit induced the affinity of macrophage to bind pathogens and neoplastic cells. Additionally, SAM was cytotoxic to colon HCT-116 cells.The findings suggested SAM as a promising inhibitor of the carcinogenesis initiation phase.Keywords: Alocasia macrorrhiza; sulphated; Tumor anti-initiation; Cyp1A1; Epoxide hydrolase; glutathione-S-transferases; quinonereductase; FITC-LPS; macrophag

Sulphated tubers extract from the giant taro Alocasia macrorrhiza inhibits the carcinogenesis initiation and modulates macrophage functions

Alocasia macrorrhizos (L.) G. Don, Araceae, is a traditionally edible plant known as giant taro. This work aimed to prepare sulphatedpolysaccharide extract of A. macrorrhizos tubers (SAM) and to investigate its tumor anti-initiation and anti-promotion activities. Methods:Enzymatic, colorimetric, fluorometric, and cell-based assays were used throughout the study. Tumor anti-initiation activity was investigatedby estimation of SAM effect on cytochrome P450 1A1 (Cyp1A1) glutathione-S-transferases (GST), glutathione (GSH), epoxide hydrolase(mEH), and quinone reductase (QR), while Tumor anti-promotion activity was investigated by macrophage proliferation, nitric oxide (NO),and LPS binding to macrophages. SAM inhibited the carcinogen metabolizing enzyme Cyp1A1 and it induced, to variable extent, thedetoxification enzymes (GST, mEH and QR), especially mEH. Additionally, SAM showed anti-inflammatory property by inhibiting NO andit induced the affinity of macrophage to bind pathogens and neoplastic cells. Additionally, SAM was cytotoxic to colon HCT-116 cells.The findings suggested SAM as a promising inhibitor of the carcinogenesis initiation phase.Keywords: Alocasia macrorrhiza; sulphated; Tumor anti-initiation; Cyp1A1; Epoxide hydrolase; glutathione-S-transferases; quinonereductase; FITC-LPS; macrophag