Ain Shams University- Paving the way towards a paperless University

The conventional use of paper-based operations in daily working practices introduces numerous risks and financial burdens. Nowadays, Universities are aligning with the growing movement of "green" campuses. Going paperless is a green initiative contributing to sustainable development goals 11 and 12. Ain Shams University (ASU) attempted to establish a paperless campus through digital transformation as this movement promises high-quality academic and administrative services. This paper aims to highlight ASUs developed 3 R’s approach for paper waste reduction include switching to electronic exams, customizing paper amounts annually, implementing electronic payment and service options, and using barcodes for cafeterias by creating E-Systems to deliver services online. Starting with the ASU community’s cultural level, awareness campaigns are being conducted on proper waste management. Parallelly, segregation bins are placed throughout the campus to effectively separate waste streams for recycling options, either internally by the artistic activities or externally by our specialized partners. To ensure the efficiency of this digital transformation, this study investigates the different waste streams, generation rates and quantities. Statistical methods will be used to analyze relationships between variables and identify potential paper waste reduction and recycling plans. The outcome of this study is an evaluation of the current progress in implementing the strategy. Additionally, it could be used as a case study for developing strategies in moving toward establishing a successful paperless university mode

Addressing Climate Change Impacts on Health

Climate change is a global health emergency, with impacts felt most acutely by vulnerable populations and communities. This paper explores health risks from climate change in a global context, setting out key risks and actions towards addressing these. In the context of COP27, it draws in a focus on Egypt as a case study throughout to exemplify the risks faced by countries which are particularly vulnerable to the health impacts of climate change. This policy working paper has been produced by the Academy of Scientific Research and Technology in Egypt, with contributions from the UK Universities Climate Network, through an academic collaboration ahead of COP27 in Egypt in 2022

Impact of circ-0000221 in the pathogenesis of hepatocellular via modulation of miR-661–PTPN11 mRNA axis

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death in Egypt. A deep understanding of the molecular events occurring in HCC can facilitate the development of novel diagnostic and/or therapeutic approaches. In the present study, we describe a novel axis of hsa-circ-0000221–miR-661–PTPN11 mRNA proposed by in silico and in vitro analysis and its role in HCC pathogenesis. We observe a reduction in the expression levels of hsa-circ-0000221 and PTPN11 mRNA in HCC patients’ sera tested compared with control subjects. The reduction occurs with a concomitant increase in the expression of miR-661. Furthermore, the introduction of exogenous hsa-circ-0000221 into Hep-G2 or SNU449 cell lines results in detectable decrease in cellular viability and an increase in apoptotic manifestations that is associated with G1 accumulation and CCDN1 overexpression. Altogether, these findings indicate the tumor-suppressive role of hsa-circ-0000221 in HCC, which acts through miR-661 inhibition, along with a subsequent PTPN11 mRNA increase, where PTPN11 is known to inhibit cell proliferation in many forms of cancer. Our study encourages further investigation of the role of circRNAs in cancer and their potential use as molecular biomarkers

Efficacy of loco-regional treatment for hepatocellular carcinoma prior to living donor liver transplantation: a report from a single center in Egypt

Mohammad Kamal Shaker,1 Iman F Montasser,1 Mohamed Sakr,1 Mohamed Elgharib,2 Hany M Dabbous,1 Hend Ebada,1 Ahmed El Dorry,2 Mohamed Bahaa,3 Mahmoud El Meteini3 1Department of Tropical Medicine, 2Department of Radiodiagnosis and Interventional Radiology, 3Department of Hepatobiliary Surgery and Liver Transplantation, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt Background and aim: The number of loco-regional therapies (LRTs) for hepatocellular carcinoma (HCC) has increased dramatically during the past decade, bridging or downstaging patients on the waiting list for liver transplantation. This study aimed to analyze the outcomes of LRTs prior to living donor liver transplantation in patients with HCC. Methods: Sixty-two HCC patients received living donor liver transplantation at Ain Shams Center for Organ Transplantation over a 2-year period. Data from 29 HCC patients were analyzed. Twenty patients (68.97%) met the Milan Criteria and 4 patients (13.8%) exceeded the Milan Criteria, but met the University of California, San Francisco Criteria. Five patients (17.2%) exceeded the University of California, San Francisco Criteria. All patients underwent preoperative LRTs. The protocol of bridging/downstaging, methods, duration of follow-up, the number of patients who were successfully downstaged before liver transplantation (LT), and their outcomes after LT were recorded.Results: There was a decrease in the mean overall size of focal lesions (from mean 5.46 to 4.11 cm) in the last abdominal computed tomography (CT) scan after LRT (p=0.0018). Discrepancies between the radiological findings and histopathology were as follows: in 16 patients (55.17%) the CT findings were consistent with the histopathological examination of the explanted liver. Underestimated tumor stage was documented in 10 patients (34.48%), and was overestimated by CT scan findings in 3 patients (10.34%). The 1-year survival rate was 93%. No patient had HCC recurrence after median follow-up of 21 months (range 1–46 months).Conclusion: These results encouraged tumor bridging/downstaging as a potential treatment option among carefully selected patients with HCC beyond conventional criteria for LT. Further studies on a large number of patients are necessary. Keywords: hepatocellular carcinoma, loco-regional therapy, LRT , liver transplantation, Milan criteria, beyond Milan, HCC recurrence, bridge/down stagin

Neuropsychiatric complications after living donor liver transplantation: a prospective case series in an Egyptian center

Introduction and aim Neuropsychiatric complications that develop after living donor liver transplantation (LT) are frequently encountered, though not adequately estimated among Egyptian recipients. We aimed to estimate the frequency of neuropsychiatric manifestations and neurocognitive functional changes after living donor LT. Patients and methods A prospective observational cohort study was conducted to evaluate 30 adult patients with end-stage liver disease preoperatively in a single Egyptian Transplant Center from November 2012 till January 2014. Relevant preoperative, intraoperative, and postoperative data were recorded and recollected and at 3 and 6 months of follow-up. The assessment included neurologic evaluation, Child–Turcotte–Pugh score, model of end-stage liver disease score, clinical hepatic encephalopathy staging scale, West Haven criteria, and International Society for Hepatic Encephalopathy and Nitrogen Metabolism score for semiquantitative assessment of encephalopathy. Results Hepatitis C virus was the main etiology for liver disease in 27 (90%) patients. Overt hepatic encephalopathy was seen in 26.6%, whereas covert hepatic encephalopathy occurred in 43.3%. Postoperatively, 76.7% of the patients demonstrated neuropsychiatric manifestations, with 50% of them showing mainly early major events, namely, encephalopathy. Late minor manifestation rates were 50%. Early cyclosporine administration and cold ischemia time longer than 40 min were significant predictors of occurrence of early neurologic events postoperatively (P=0.031 and 0.025, respectively). Both risk factors were associated with earlier and higher rates of neurologic complications. Conclusion Patients of living donor LT are at increased risk of developing early postoperative major neurologic sequelae, which become of less clinical significance later on. The patients’ cognitive functions improve with time after transplant

Characterisation of dysplastic liver nodules using low-pass DNA sequencing and detection of chromosome arm-level abnormalities in blood-derived cell-free DNA

High grade dysplasia carries significant risk of transformation to hepatocellular carcinoma (HCC). Despite this, at the current standard of care, all non-malignant hepatic nodules including high grade dysplastic nodules are managed similarly. This is partly related to difficulties in distinguishing high-risk pathology in the liver. We aimed to identify chromosome arm-level somatic copy number alterations (SCNAs) that characterise the transition of liver nodules along the cirrhosis-dysplasia-carcinoma axis. We validated our findings on an independent cohort using blood-derived cell-free DNA. A repository of non-cancer DNA sequences obtained from patients with HCC (n=389) was analysed to generate cut-off thresholds aiming to minimize false positive SCNAs. Tissue samples representing stages from the multistep process of hepatocarcinogenesis (n=184) were subjected to low-pass whole genome sequencing. Chromosome arm-level SCNAs were identified in liver cirrhosis, dysplastic nodules, and HCC to assess their discriminative capacity. Samples positive for 1q+ or 8q+ arm-level duplications were likely to be either HCC or high-grade dysplastic nodules as opposed to low grade dysplastic nodules or cirrhotic tissue with an Odds Ratio (OR) of 35.5 (95% CI 11.5–110) and 16 (95% CI 6.4–40.2) respectively (p<0.0001). In an independent cohort of patients recruited from Nottingham, UK, at least 2 out of 4 alterations (1q+, 4q-, 8p- and 8q+) were detectable in blood-derived cell-free DNA of patients with HCC (n=22) but none of the control patients with liver cirrhosis (n=9). Arm-level SCNAs on 1q+ or 8q+ are associated with high-risk liver pathology. These can be detected using low-pass sequencing of cell-free DNA isolated from blood which may be a future early cancer screening tool for patients with liver cirrhosis

In Silico Identification and Clinical Validation of a Novel Long Non-Coding RNA/mRNA/miRNA Molecular Network for Potential Biomarkers for Discriminating SARS CoV-2 Infection Severity

(1) Background: The coronavirus (COVID-19) pandemic is still a major global health problem, despite the development of several vaccines and diagnostic assays. Moreover, the broad symptoms, from none to severe pneumonia, and the various responses to vaccines and the assays, make infection control challenging. Therefore, there is an urgent need to develop non-invasive biomarkers to quickly determine the infection severity. Circulating RNAs have been proven to be potential biomarkers for a variety of diseases, including infectious ones. This study aimed to develop a genetic network related to cytokines, with clinical validation for early infection severity prediction. (2) Methods: Extensive analyses of in silico data have established a novel IL11RA molecular network (IL11RNA mRNA, LncRNAs RP11-773H22.4 and hsa-miR-4257). We used different databases to confirm its validity. The differential expression within the retrieved network was clinically validated using quantitative RT-PCR, along with routine assessment diagnostic markers (CRP, LDH, D-dimmer, procalcitonin, Ferritin), in100 infected subjects (mild and severe cases) and 100 healthy volunteers. (3) Results: IL11RNA mRNA and LncRNA RP11-773H22.4, and the IL11RA protein, were significantly upregulated, and there was concomitant downregulation of hsa-miR-4257, in infected patients, compared to the healthy controls, in concordance with the infection severity. (4) Conclusion: The in-silico data and clinical validation led to the identification of a potential RNA/protein signature network for novel predictive biomarkers, which is in agreement with ferritin and procalcitonin for determination of COVID-19 severity

Egyptian Society of Liver Cancer Recommendation Guidelines for the Management of Hepatocellular Carcinoma [Corrigendum]

Omar A, Kaseb A, Elbaz T, et al. J Hepatocell Carcinoma. 2023;10:1547&#x2013;1571. The authors have advised affiliation 4 on page 1547 is incorrect. The correct affiliation should read &#x201C;4Tropical Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt&#x201D;. The authors apologize for this error