Association between pretreatment haemoglobin levels and morphometric characteristics of the tumour, response to neoadjuvant treatment and long-term outcomes in patients with locally advanced rectal cancers

Aim The study was carried out to investigate whether pretreatment haemoglobin (Hb) levels act as a biomar- ker in the management of patients with locally advanced rectal cancer. Method\ud We prospectively collected data on all patients within our cancer network with localized low rectal cancer treated with preoperative radiotherapy/chemora- diotherapy at Mount Vernon Centre for Cancer Treat- ment between March 1994 and July 2008. Pretreatment Hb level was assessed as an independent variable for the whole study sample and dichotomised at a value of 12 g/dl. A multivariate analysis of covariance (MANCOVA) was conducted on parameters that had significant association on univariate analysis of covariance (ANCOVA) and cor- relational (Kendall tau/Pearson) analyses. Kaplan – Meier survival analysis and Cox proportional hazard models were used to determine significant prognostic markers. Statistical significance was set at 0.05. Results 463 patients (male/female 2:1; median age = 66 years, interquartile range = 56.5 – 73.0) were included in the analysis. There was significant tumour response of T stage ( P < 0.001) and N stage ( P < 0.001), with 17.6% of patients achieving a pathological complete response. Pretreatment Hb value was inversely related to the craniocaudal vertical tumour length ( P = 0.02) and pretreatment T stage of the tumour ( P = 0.01). Patients with Hb levels of < 12 g/dl and moderately differenti- ated adenocarcinoma were less responsive. Local recur- rence was more common in patients with a pretreatment Hb of < 12 g/dl (hazard ratio = 1.78) over a median follow up of 24 months, but this was not statistically significant ( P = 0.08). Conclusion The pretreatment Hb level might be used as a biomarker of rectal tumour morphology, response to neoadjuvant chemoradiation and risk of local recur- renc

Language-in-education policy and planning : the case of Lebanon

Recent changes in Lebanon's educational legislation indicate a shift away from using the national language, Arabic, as a medium of instruction in favour of other foreign languages, namely English, French, and German. The latest decree that was passed in 1994 stipulated that these foreign languages can be used as instructional languages in all cycles, including the pre-school and elementary levels. The issue of language-in-education in Lebanon is an old one, dating back to the arrival of foreign missionaries during the second half of the 17th century. Since then several policies and decisions have been made by the colonial powers and the successive Lebanese governments. This paper reviews these policies and decisions in the light of the country's political history with special emphasis on their impact on students and communities at the socioeconomic, educational and political levels. The paper maintains that the policies made by the French during their mandate over Lebanon (1920-1943) favoured the Christian Catholic and Maronite communities. Meanwhile, the policies adopted by the successive Lebanese governments in the era of independence (1943-1975) were largely improvised and more of responses to emotions triggered by independence. Consequently, several socio-economic and educational incentives determined the spread of foreign languages, especially English, in contemporary Lebanon. This widened the gaps among the classes that make up Lebanese society and contributed to the distribution of quality education along sectarian and socioeconomic lines.peer-reviewe

SELF-ASSEMBLING HYDROGELS BASED ON Î’-CYCLODEXTRIN POLYMER AND POLY (ETHYLENE GLYCOL) BEARING HYDROPHOBIC MOIETIES FOR PROTEIN DELIVERY

Objective: The development of injectable and stable hydrogels for protein delivery is a major challenge. Therefore, the objective of this study was to evaluate the potential of polymerized β-CD for the formulation of stable hydrogels suitable for loading and release of bioactive agents and to investigate the mechanism of hydrogel formation. Methods: Hydrogels based on the inclusion complexation of polymerized β-cyclodextrin and cholesterol terminated poly(ethylene glycol) polymers were formed by rehydration of a lyophilized mixture of both polymers. The mechanism of hydrogel formation was investigated via isothermal titration calorimetry, fluorescence spectroscopy and dynamic light scattering measurements. The release behavior of bovine serum albumin (BSA) as a model protein from the modified gels was explored. Results: Rheological analysis demonstrated that the prepared hydrogels had a viscoelastic behavior even at elevated temperature (&gt; 37 ˚C). There are two competing mechanisms for hydrogel formation. The first mechanism is the inclusion complexation between cholesterol moieties and β-CD cavities. The second one is the self association of cholesterol modified PEGs. β-CD had the ability to dissociate the PEG-cholesterol associations. The quantitative and complete release of BSA was observed within 4 weeks. Conclusion: The polymerized form of β-CD, rather than native β-CD is essential for the formation of stable hydrogels. These results were supported by the ability of the modified hydrogel system for loading and release of BSA, making such hydrogel systems promising devices in drug delivery applications

A New Aprroach for the Assesment of Coronary Artery Disease Risk

Abstract: Coronary artery diseas

EFFECT OF IRRIGATION SYSTEMS IMPROVEMENT ON WATER UNIT PRODUCTIVITY UNDER NORTH DELTA REGION CONDITIONS OF EGYPT

Several field trials and laboratory studies were conducted to evaluate the impact of the implementation of the activities and processes of the development of the field irrigation systems at ElMahmoudia area, El-Beheira Governorate, Egypt, during the successful growing seasons winter 2016/17 and summer 2017 to investigate the effect of irrigation systems improvement projects on water productivity. The measurements were conducted in a tertiary canal (Mesqa) at the head of Nekla canal (Arafa Mousa Mesqa). Water consumption values for different crops were calcaulated, and water application was calculated through calibrating the capacities of the pumps and recording the operation hours. The most important results were as follows: Applied irrigation water decreased after irrigation improvement. Applied irrigation water for wheat, rice, maize, sweet potatoes and watermelon before irrigation improvement were higher than the corresponding values after irrigation improvement by 9.0%, 15%, 11%, 15% and 10% respectively. The productivity of wheat, rice, maize, sweet potatoes and watermelon increased after irrigation improvement by 7.0%, 4.0%, 3.0%, 8.0% and 9.0% respectively. Water productivity increased after irrigation improvement, and the increase ratios for wheat, rice, maize, sweet potatoes were 14.0%, 16.0%, 13.0%, 20.0%, and 18.0% respectively

Contribution of the highly conserved EaeH surface protein to enterotoxigenic Escherichia coli pathogenesis

Enterotoxigenic Escherichia coli (ETEC) strains are among the most common causes of diarrheal illness worldwide. These pathogens disproportionately afflict children in developing countries, where they cause substantial morbidity and are responsible for hundreds of thousands of deaths each year. Although these organisms are important targets for enteric vaccines, most development efforts to date have centered on a subset of plasmid-encoded fimbrial adhesins known as colonization factors and heat-labile toxin (LT). Emerging data suggest that ETEC undergoes considerable changes in its surface architecture, sequentially deploying a number of putative adhesins during its interactions with the host. We demonstrate here that one putative highly conserved, chromosomally encoded adhesin, EaeH, engages the surfaces of intestinal epithelial cells and contributes to bacterial adhesion, LT delivery, and colonization of the small intestine

Accelerated versus Standard Corneal Cross-linking for Progressive Keratoconus in Syria

Purpose: To compare the outcomes of accelerated versus standard corneal cross-linking for the treatment of progressive keratoconus. Methods: In this retrospective comparative study, 63 eyes of 40 patients with progressive keratoconus were divided into two groups; 27 eyes in group one were treated with an accelerated protocol (10 mW/cm2, 9 min) and 36 eyes in group two were treated with the standard method (3 mW/cm2, 30 min). Visual acuity, refraction, corneal topography, corneal tomography, and anterior and posterior corneal higher-order aberrations (HOAs) were assessed preoperatively and 18–30 months postoperatively. Results: The LogMAR uncorrected and corrected distance visual acuity values were improved in both groups postoperatively. However, the improvement was significantly higher in group one (P &lt; 0.05, all). The flattening in the anterior keratometry readings, flat K, steep K, and average K were significantly higher in group two (P &lt; 0.001, all). The maximum anterior keratometry (AKf) values significantly decreased in both groups, whereas the maximum posterior keratometry (AKb) values increased. The reduction in the minimum corneal thickness (ThKmin) was significantly greater (36.49um) in group two, compared to 10.85um in group one. There was a significant increase in the posterior average keratometry, and a significant decrease in the posterior astigmatism, along 3 mm meridian in S-CXL (P = 0.03, P = 0.008, respectively), while the corresponding values showed no statistical significance in group one (P &gt; 0.05). The anterior corneal trefoil was significantly reduced in group one (P = 0.002), whereas anterior total HOAs and coma were significantly improved in group two (P &lt; 0.0014, all). The posterior corneal spherical aberration decreased significantly in group one (P = 0.02), while group two revealed significant reduction in the posterior trefoil values (P = 0.011). The change in the anterior maximum keratometry was significantly and positively correlated to the preoperative maximum keratometry in group two (P = 0.53, P = 0.003). Conclusion: An accelerated cross-linking protocol using 10 mW/cm2 for 9 min showed more visual improvement and less pachymetric reduction when compared to the standard protocol, however, anterior corneal flattening, posterior corneal steepening, and the change in the posterior astigmatism were significantly higher in the standard protocol; while corneal HOAs were improved in both protocols

The critical level of vitamin D in childhood asthma

Objectives: Studies have suggested a significant link between vitamin D status and asthma. We sought to determine the cutoff level of25 hydroxy (25-OH) vitamin D that is significantly linked to asthma status in children.Methods: Our cross-sectional study comprised 90 asthmatic children, aged 2-18 years. They were evaluated clinically and classified according to asthma severity and control. Asthma control test (ACT) was performed in those aged above 4 years.Pulmonary functions were performed in cooperative children (n=59). Serum 25-OH vitamin D levels were measured by ELISA in all patients.Results: The study comprised 52 boys (57.7%) and 38 girls (42.3%) with mean age 7.03±4.36 years. Thirty-six patients (40%) had mild asthma, 37 (41%) moderate asthma and 17 (19%) had severe asthma. Forty-two patients (46.6%) had controlled asthma; 14 (15.6%) partially controlled and 34 (37.8%) had uncontrolled asthma. ACT score ranged: 11-26, with mean score: 18.9 ± 4.3 SD. Serum 25-OHvitamin D levels ranged between 2-48 ng/ml (mean± SD: 12.2 ± 9 ng/ml); levels were comparable among different grades of asthma severity (f= 1.975, p=0.145), while the uncontrolled asthma group showed the lowest levels (f=8.511, p &lt;0.001). 25-OH vitamin D levels correlated positively with ACT score (r= 0.369, p= &lt;0.001) but not with inhaled steroids doses or any of the pulmonary function parameters. A level of 7.5 ng/ml was associated with partial/completeuncontrol of asthma with 81 % sensitivity and 53 % specificity.Conclusion: 25-OH vitamin D levels below 7.5 ng/ml are associated with poor asthma status in children.Keywords: Asthma, allergy, children, severity, inhaled steroids, 25 hydroxy vitamin D

Effect of Periodontal Surgery on Tissue Plasminogen Activator and Plasminogen Activator Inhibitor Type-1 Gene Expression in Gingival Tissues of Periodontitis Patients: A Controlled Before-And-After Study

Background: Regulation of the plasminogen activation system (PAS) is a vital component in governing proteolytic events within the extracellular matrix (ECM). PAS is believed to play a substantial role in the destruction and healing of periodontal tissues. Thus, the current work aimed to study the histopathological effect of open flap debridement (OFD) on periodontitis, as well as its effect on tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type-1 (PAI-1) gene levels in gingival tissues. Methods: A total of 30 subjects were enrolled in the present study. They were divided into two groups: Group I (control group) included 10 periodontally healthy volunteers and group II (periodontitis group) comprised 20 patients suffering from stage III grade B periodontitis. Gingival tissue samples were collected from all periodontitis patients, before and after OFD, and from healthy controls. Hematoxylin and eosin (H&amp;E) stained slides were subsequently examined and gene expression levels of t-PA and PAI-1 were assessed in the gingiva through quantitative reverse transcription polymerase chain reaction (RT-PCR). Results: Gingival tissue samples from periodontitis patients showed dilated blood vessels, diffuse hemorrhage, areas of edema, and disorganized collagen fibers together with large amounts of inflammatory cells in between. &nbsp;Following OFD, smaller sized blood vessels, a restored collagen fiber distribution, and an obvious decrease in the inflammatory infiltrate were noted. Gene expression levels of t-PA and PAI-1 were significantly higher in the periodontitis patients compared to the healthy controls. Although their levels showed a significant decrease following OFD in the periodontitis group, they were still significantly higher than the control group. Conclusion: OFD procedures resulted in down regulation of t-PA and PAI-1 expression levels in the gingiva of periodontitis patients, which could signify an important role of these proteins on periodontal disease progression