Detection And Removal Of Sub-Centimetre Polyps

Introduction Colonoscopic polypectomy has been shown to reduce the incidence and mortality of colorectal cancer. Most polyps encountered during colonoscopy are small and approximately 10% will have advanced pathology. Therefore,it is important that colonoscopy and polypectomy is performed to a high standard. Aim To determine if simple interventions can be used to improve the detection and removal of sub-centimetre polyps. Methods 1. A systematic review of 7 randomised controlled trials was performed to determine if chromoendoscopy increased the polyp detection rate compared with conventional white light endoscopy. 2. Data from the English BCSP was analysed to describe the variation in polypectomy techniques employed for the removal of sub-centimetre polyps in relation to polyp characteristics, completeness of histological excision and safety. 3. An observational prospective study was undertaken to determine the efficacy of cold snare polypectomy with a thin wire mini-snare (0.30mm) versus a thick wire mini snare (0.47mm). 4. A single centre, randomised controlled trial was performed to compare the efficacy of standard cold snare polypectomy versus a novel suction pseudopolyp technique. Results In the systematic review, chromoendoscopy showed a significant increase in the detection of neoplastic and non-neoplastic polyps, but there was no increase in the detection of larger or advanced polyps compared with conventional white light endoscopy. Analysis of the BCSP database showed that removal of sub-centimetre polyps is safe despite wide variations in practice. The use of cold resection techniques and EMR has increased over time (p<0.001). However, assessment for the completeness of histological resection is limited with almost two thirds of cases reported as not assessable. In the observational prospective study, completeness of endoscopic excision was significantly better with the thin wire snare compared with the thick wire snare (90.2% vs. 73.3%, p<0.05). In the RCT comparing standard cold snare polypectomy with the suction pseudopolyp technique, no clinically significant difference was observed between the two techniques (92.6% vs 98.6%, p=0.08). No perforation or bleeding requiring hemostasis occurred in either of these two studies. Discussion From this body of work it is apparent that chromoendoscopy, cold snare polypectomy with a thin wire snare and the suction pseudopolyp technique are safe, quick and effective. These simple interventions are easy to learn and can be performed by all colonoscopists to improve the detection and removal of polyps

State budget formulation process and good governance framework in the context of Egypt

Budget formulation process is the phase where the decisions are made regarding the allocation of resources. This process should reflect the objectives of the government, which consequently should mirror the priorities of citizens. Post January 2011 Revolution, Egypt witnessed economic, social and political challenges that affected the overall government performance. Due to the intrinsic role of the State budget at political, social and economic levels, specific attention was directed to its efficiency and effectiveness. Consequently, it is normal to question its ability to achieve the stated objectives, especially with the increasing demands of transparency, accountability and social justice. This attention paves the way for introducing reform initiatives for public financial management system in Egypt. Therefore, as a step to understand the foundation of the State budget process in Egypt, this research assesses the budget formulation process in Egypt within the framework of good governance in both the executive and legislative authorities against international standards. Also this research examines the significant factors affecting the process and the extent to which the legal and political contexts in Egypt help improve budget formulation process. Hence, this study provides a roadmap for the government, containing the prerequisites for enhancing budget formulation process in Egypt. In light of these prerequisites, the government should focus on the institutional aspects that include; moving to program-based budget, adopting fiscal decentralization, merging preparation of the recurrent and investment budget under one authority and applying monitoring and evaluation system. Nevertheless, concentrating on the institutional aspects should be inline with other legal and political ones

Morphological Changes of Reach Two of the Nile River

Sediment Transport and Morphodynamic

Prevalence of Sexual Long COVID (SLC) in Egypt: A Single Institute Study

Objectives: we conducted a cross section study to assess the prevalence and severity of ED among COVID-19 survivors presenting to andrology outpatients’ clinics, Kasr AlAiny hospital, faculty of medicine, Cairo university. Materials and Methods: a total of 1000 COVID-19 survivors were screened for ED using validated Arabic version of the international index of erectile function (ArIIEF-5) during the period between Jan 2022 till Jan 2023. All patients were previously diagnosed with positive PCR for COVID-19 infection at least 3 months before the time of data collection.&nbsp;&nbsp; Result: we found that the prevalence of ED among COVID-19 survivors were 11.4%, mild ED in 7%, moderate in 3.2% and severe ED in 1.2%, severity of ED was not associated with demographic, clinical, laboratory and penile duplex characteristics. Conclusion: severity of ED among COVID-19 survivors showed no statistically significant association with demographics, depression, anxiety, penile duplex findings and hormonal disturbances

Enhancing ESL rural students’ speaking skills through multimedia technology-assisted project-based learning: Conceptual paper

The recent Covid-19 pandemic has changed and impacted the country's education landscape, a paradigm shift from face-to-face teaching and learning style into home-based learning and teaching (PdPR). During the period, teachers had come out with various teaching strategies to assess pupils’ and some of these strategies are still relevant in this current post pandemic education. Speaking skills in the Malaysian Primary ESL classroom are five elements assessed in the Classroom-Based Assessment (CBA). The CBA achievement of a class in a rural school in Kudat, Sabah, showed that most students performed poorly in speaking skills. Based on the teacher's perspective as a researcher, the problem occurred due to the English Language's lack of exposure and usage. It is only spoken during an English class and not practised outside schooling hours. In this paper, the researcher aims to provide a literature review and past studies on enhancing primary ESL students' speaking skills through multimedia technology-assisted project-based learning. After investigating how multimedia technology-assisted project-based learning could improve the students' speaking skills from the literature review, the researcher proposes this study be carried out at a rural government school in Kudat, Sabah. This research aims to investigate students' speaking performance after the implementation of multimedia technology-assisted project-based learning

Virtual reality in Malaysian English as a second language learning: A systematic review and implications for practice and research

Virtual Reality (VR) technology was crucial in aiding remote teaching and learning session during the Covid-19 pandemic. Transitioning to the post pandemic era, VR technologies are deemed as a useful tool to facilitate learning. Several literature reviews have analysed and synthesized the use of VR in education; however, academic activity lacks a recent systematic literature review (SLR) on VR in the field of English as a Second Language Learning (ESL) in the context of Malaysian ESL learning. 13 scholarly manuscripts from 12 journals were retrieved from the year 2011 to 2021, analysed, and synthesized under the following focus: (a) VR technology utilized, the duration of educational activities, and the language learning settings in the Malaysian ESL context; (b) the possible benefits and drawbacks of adopting VR as a teaching tool in the Malaysian ESL classroom; (c) future directions regarding the educational use of VR. The study concluded that VR technologies encourage English language learning; intrinsically motivate pupils to learn; provide convenience for feedback and communication; practicality; and creates an enjoyable authentic classroom environment. However, challenges like lacks of technical support for practitioners; limited internet access; limited application designated for language learning; participants’ unfamiliarity with VR; outdated software and/or hardware; and dearth number of research papers were also identified in this study. It is suggested that in the future, bigger-scale research on main language skills should be done; further research on VR technologies available; increase duration of study; research in other areas and levels of schools, and initiate more experimental studies

Vocabulary learning strategies preferences among the post-UPSR learners in Kota Kinabalu, Sabah

This study aimed to identify the extent to which vocabulary learning strategies influence the results of English writing in UPSR of the post-UPSR learners. The subjects were 267 high-achievers Form 1 learners from four secondary schools who had completed the UPSR in Kota Kinabalu, Sabah. The purpose of this study was to determine which VLSs was used the most frequently by the post-UPSR learners. Participants completed a VLS questionnaire and the findings revealed the strategies of vocabulary learning the post-UPSR inclined to employ from each category of determination, social, memory, cognitive, and metacognitive. We conclude that while VLSs use should be encouraged in general, instructors may not need to cater to individual vocabulary learning styles

The importance and factors of enjoyment In Malaysian ESL classroom: A multisite case study

Affective factors such as emotion and attitudes have long been identified as contributing factors to success and enjoyment in language learning. With the new movement of education in the new norm, a weightage needs to be focused on the affective dimensions among learners. This study aimed to discover the importance and factors of enjoyment in learning English as a Second Language (ESL) among Malaysian secondary school students. This multisite case study took place in five secondary schools in Malaysia. Focus Group Discussion (FGD) was held among five ESL teachers and an open-ended questionnaire was distributed to 65 students in the respective schools. The findings reveal both teachers and students think enjoyment is important in learning ESL as it bridges up engagement in learning, enhances motivation and for the usefulness of learning the language. Furthermore, the study also discovers the factors of enjoyment in learning ESL namely teacher-factor, sense of achievement and relationship with peers. This study provides valuable information on the of the understudy topic of enjoyment in Malaysian ESL classroom

Antisense oligonucleotide inhibition of hepatitis C virus genotype 4 replication in HepG2 cells

BACKGROUND: Hepatitis C (HCV) viral infection is a serious medical problem in Egypt and it has a devastating impact on the Egyptian economy. It is estimated that over 15% of Egyptians are infected by the virus and thus finding a cure for this disease is of utmost importance. Current therapies for hepatitis C virus (HCV) genotype 4 with interferon/ribavirin have not been successful and thus the development of alternative therapy for this genotype is disparately needed. RESULTS: Although previous studies utilizing viral subgenomic or full cDNA fragments linked to reporter genes transfected into adhered cells or in a cell free system showed promise, demonstration of efficient viral replication was lacking. Thus, we utilized HepG2 cells infected with native HCV RNA genomes in a replication competent system and used antisense phosphorothioate Oligonucleotides (S-ODN) against stem loop IIId and the AUG translation start site of the viral polyprotein precursor to monitor viral replication. We were able to show complete arrest of intracellular replication of HCV-4 at 1 uM S-ODN, thus providing a proof of concept for the potential antiviral activity of S-ODN on native genomic replication of HCV genotype 4. CONCLUSION: We have successfully demonstrated that by using two S-ODNs [(S-ODN1 (nt 326–348) and S-ODN-2 (nt 264–282)], we were able to completely inhibit viral replication in culture, thus confirming earlier reports on subgenomic constructs and suggesting a potential therapeutic value in HCV type 4

A survey on refinement in formal methods and software engineering

In software engineering, formal methods allow the design, modelling and verification of hardware and software systems. Formal methods introduce preciseness, remove ambiguity in specifications, and support the verification of requirements and design properties. Methods and approaches are needed to manage the formal models and handle their complexity. Refinement has been carried out for system artefacts ranging from modelling and design levels like architectures, and state machines to implementation and programming levels like source code. Refinement is a significant way for building complicated systems starting from simple ones by adding features gradually. Refinement has to be understood carefully in the context of formal specification and verification. This article provides a survey on some refinement techniques and methods and in the context of formal methods and software engineering. We believe that this survey sheds a light on the research direction in regards to the refinement of formal methods. This survey also helps formal methods practitioners and users in observing and understanding the advantages and limitations of refinements methods and techniques of various studied formal methods. Accordingly, they can decide which formal method is to be used in modelling systems via refinement or which formal method is to be extended with new concepts and notions to support refinement