Ore Genesis of the Abu Ghalaga Ferro-Ilmenite Ore Associated with Neoproterozoic Massive-Type Gabbros, South-Eastern Desert of Egypt: Evidence from Texture and Mineral Chemistry

Massif-type mafic intrusions (gabbro and anorthosite) are known for their considerable resources of vanadium-bearing iron–titanium oxide ores. Massive-type gabbroic and anorthosite rocks are frequently associated with magmatic rocks that have significant quantities of iron, titanium, and vanadium. The most promising intrusions that host Fe-Ti oxide ores are the gabbroic rocks in the south-eastern desert. The ilmenite ore deposits are hosted in arc gabbroic and anorthosite rocks. They are classified into three types, namely black ore, red ore, and disseminated ore. The black ilmenite ore is located at the deeper level, while the oxidized red ore is mainly located at or near the surface. Petrographically, the gabbro and ilmenite ores indicate a crystallization sequence of plagioclase, titaniferous pyroxene, and ilmenite. This reveals that the ilmenite is a magmatic deposit formed by the liquid gravity concentration of ilmenite following the crystallization of feldspar and pyroxene. Meanwhile, quartz, tremolite, zoisite, and opaque minerals are accessory minerals. The Fe-Ti ores are composed of ilmenite hosting exsolved hematite lamellae of variable sizes and shapes, gangue silicate minerals, and some sulfides. The X-ray diffraction (XRD) data reveal the presence of two mineral phases: ilmenite and hematite formed by the unmixing of the ferroilmenite homogeneous phase upon cooling. As a result, the ore is mostly made up of hemo-ilmenite. Using an electron microscope (SEM), as well as by observing the textures seen by the ore microscope, ilmenite is the dominant Fe-Ti oxide and contains voluminous hematite exsolved crystals. Under the scanning electron microscope, ilmenite contained intergrowths of hematite as a thin sandwich and lens shape. The formation of hematite lamellae indicates an oxidation process. Mineral chemistry-based investigations reveal late/post-magmatic activity at high temperatures. The examined ilmenite plots on the ferro-ilmenite line were created by continuous solid solution over 800 °C, whereas the analyzed magnetite and Ti-magnetite plot near the magnetite line and were formed by continuous solid solution exceeding 600 °C

Prognostic impact of lipid profile in adult Egyptian acute leukemia patients

Introduction: Acute leukemia is a malignant disorder which results from clonal proliferation of lymphoid and myeloid blast cells. Several studies have reported changes in lipid metabolism at the time of diagnosis of leukemia. Although investigators have reported decreased total cholesterol, decreased high-density lipoprotein, and elevated triglyceride (TG) in leukemic patients, there is a lack of agreement about these changes among different types of leukemia and between children and adult patients, in addition to different data about their impacts on prognosis. In this study, lipid profile has been examined at the time of diagnosis of acute leukemia in order to correlate it with response to therapy. Material and methods: This is a prospective study carried out at the Oncology Center at Mansoura University, Egypt between 2018 and 2019. Fifty patients newly diagnosed with de novo acute leukemia were included. Thirty-four patients were diagnosed with acute myeloid leukemia (AML) (68%), while 16 patients were diagnosed with acute lymphoblastic leukemia (ALL) (32%). Lipid profile and body mass index (BMI) data was obtained. Results: Overweight/obese patients showed a more statistically significant association with female patients than with male patients (p = 0.009). By comparing the lipid profile between overweight/obese patients and other patients, there was no statistically significant association. 76.7% of AML patients were overweight or obese (p = 0.015), and 81.3% of ALL patients showed hypertriglyceridemia (p = 0.014). There was no statistically significant association between lipid profile and complete response (CR) rate; however, there was a marginally significant association between non-CR rate and overweight and obese patients (p = 0.051). In addition, there was no impact of BMI or lipid profile on overall survival among acute leukemia patients. Conclusions: Female, and acute myeloid leukemia, patients were more commonly associated with overweight and obesity, and high TG level was found to be associated with acute lymphoid leukemia. Changes in lipid profile showed no impact on complete response rate or on overall survival in acute leukemia patients

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Significance of OCT3/4 and SOX2 antigens expression by leukemic blast cells in adult acute leukemia

Abstract Objective This study aimed to address the prognostic impact of SOX2 and OCT3/4 expression on adult acute leukemia patients’ outcomes. Methods SOX2 and OCT3/4 expression by blast cells were evaluated by flow cytometry in 80 acute leukemia patients and 8 healthy controls. Results Baseline SOX2 and OCT3/4 expression were significantly higher in both ALL (P = < 0.001, P = 0.005 respectively) and AML patients (P < 0.001, P = 0.003 respectively) as compared to control, and decline at complete remission (CR) and elevated again at relapse. High SOX2 and OCT3/4 levels were significantly correlated with the presence of adverse risk stratification parameters. Conclusion Our findings indicated that both SOX2 and OCT3/4 could serve as biomarkers that could improve risk stratification of acute leukemia patients. Also, both SOX2 and OCT3/4 might be a therapeutic target, especially in resistant acute leukemia

Clinical Impact of CD25/CD123 Coexpression in Adult B-Cell Acute Lymphoblastic Leukemia Patients

This study aimed to determine the clinical impact of CD25+/CD123+ coexpression in adult B-cell acute lymphoblastic leukemia (B-ALL) cases. One hundred and twenty newly diagnosed B-ALL patients (≤60 years old) were included in this study. CD123 and CD25 expression on leukemic blast cells were assessed using flow cytometry. CD25+/CD123+ coexpression was detected in 40/120 B-ALL patients (33.3%). All B-ALL patients showed CD25+/CD123+ coexpression had lower induction of remission response and shorter overall survival as compared to B-ALL cases lacking coexpression. In conclusion, CD25+/CD123+ positive coexpression is a reliable flow cytometry marker for prediction of the outcome of adult B-ALL patients and could be used as a novel parameter for risk stratification of adult B-ALL cases

Wilms Tumor 1 Gene Mutations in Patients with Cytogenetically Normal Acute Myeloid Leukemia

OBJECTIVE: This study aimed to assess the prognostic impact of Wilms tumor 1 (WT1) mutations in cytogenetically normal acute myeloid leukemia (CN-AML) among Egyptian patients. METHODS: Exons 1, 2, 3, 7, 8, and 9 of WT1 were screened for mutations in samples from 82 CNAML patients out of 203 newly diagnosed AML patients, of age ranging from 21 to 74 years, using high-resolution capillary electrophoresis. RESULTS: Eleven patients out of 82 (13.41%) harbored WT1 mutations. Mutations were detected in exon 7 (n=7), exon 9 (n=2), exon 8 (n=1), and exon 3 (n=1), but not in exons 1 or 2. There was no statistically significant difference between the WT1 mutants and wild types as regards age, sex, French-American-British subtypes, and the prevalence of success of induction remission therapy (p=0.966; 28.6% vs. 29.3%). Patients with WT1 mutations had overall survival lower than patients with the wild type (HR=1.38; 95% CI 4.79-6.86; p=0.004). CONCLUSION: CN-AML patients with WT1 mutations have poor clinical outcome. We recommend molecular testing for WT1 mutations in patients with CN-AML at diagnosis in order to improve risk stratification of those patients

Eco-efficient reuse of alum-based water treatment sludge into structural sintering bricks

Water treatment sludge (WTS) disposal in landfills and estuaries has significant negative environmental effects. This study aims to produce a cleaner approach to recycling solid waste sludge from water treatment plants into eco-friendly construction materials. This approach involves the production of structural sintering clay bricks using WTS as a substitute for clay in the manufacturing process. Various mixtures of WTS content ranging from 10% to 50% and sand content of 10 and 20% were investigated. The Brick samples were shaped in the form of cubes and then fired in an oven at 700 °C for 3 h. Subsequently, several tests were conducted on the fired brick samples, including compressive strength, bulk density, water absorption, apparent porosity, efflorescence, freeze and thaw analysis, and microstructure investigation. The properties of WTS indicate a high concentration of silica, aluminum, and iron, which contribute to the improved properties of the fired bricks. It was observed that the bricks' compressive strength decreased from 29.8 to 8 MPa as the WTS content increased from 10% to 50%. In parallel, increasing the WTS content resulted in a decrease in bulk density from 1.005 to 0.75 g/cm3, an increase in apparent porosity values from 20% to 35%, and a higher water absorption from 12% to 37%. Furthermore, the addition of sand by 10 and 20% to the bricks leads to enhancements in both the mechanical and microstructure properties of the sintered bricks. Moreover, the efflorescence analysis of bricks is at a slight level. It can be concluded that WTS can be reused in the manufacturing of structural sintering clay bricks, providing a cleaner and more sustainable method of disposal for water treatment sludge

Neutrophil Apoptosis in Neutropenic Patients With Hepatitis C Infection: Role of Caspases 3, 10, and GM-CSF

Patients with chronic HCV infection are prone to increased susceptibility bacterial infection due to neutropenia complicating the course of this disease. Neutropenia in those patients may stem from enhanced neutrophil apoptosis. However, the molecular mechanism of neutrophil apoptosis has not been clearly defined. Neutrophils harvested from 26 neutropenic patients with hepatitis C infection and nine age and sex-matched healthy control subjects were examined for the degree of apoptosis. Neutrophil apoptosis was quantified by flow cytometry through determination of annexin-V expression at 0 time (fresh neutrophil), and 24 h culture. Neutrophils from healthy subjects were also incubated with either 10% heterologous normal or neutropenic sera, with and without 10 µg GM-CSF. Caspases 3, 10 were assessed colormetrically in neutrophils at 0 times and after 24 h culture. At 0 time culture the neutrophil apoptosis of the HCV patients was in significantly higher as compared to that of normal control (P = 0.059). At 24 h culture patients neutrophils cultured with neutropenic patients own sera showed neutrophil apoptosis significantly increased as compared to that at 0 time culture and this effect was significantly attenuated in similar culture with addition of GM-CSF (P < 0.001). On the other hand patient’s neutrophil cultured with normal sera showed insignificantly increased neutrophil apoptosis at 24 h culture as compared to that at 0 time culture. Caspases 3 and 10 activities were significantly higher in patients neutrophil after 24 h cultured with patients own sera as compared to 0 time culture (P < 0.001 for both). Addition of GM-CSF to the neutrophil culture down regulates the caspases 3 and 10 activities. The correlation study between annexin-V expression and caspases activities revealed a borderline positive correlation between annexin-V and caspase 3 (r = 0.376, P = 0.058), and significant positive correlation with caspase 10 activity (r = 0.494, P = 0.01). In conclusion, these findings suggest that enhanced neutrophil apoptosis demonstrated in neutropenic patients with HCV infection might be induced through activation of caspase 10 and is attenuated by GM-CSF