Hepatocellular carcinoma surveillance in patients with non-alcoholic fatty liver disease

Karim Seif El Dahan,Darine Daher,Amit G. Singal 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.-

Non-alcoholic fatty liver disease (NAFLD) may progress to cirrhotic or non-cirrhotic hepatocellular carcinoma (HCC), and is currently recognized as the fastest growing cause of HCC worldwide. Accordingly, professional society guidelines recommend HCC surveillance in patients with cirrhosis from any etiology, and some may consider it beneficial in subgroups with non-cirrhotic NAFLD at higher risk for HCC. Notably, patients with NAFLD-related HCC are more likely to have HCC diagnosed at more advanced stages and have poorer outcomes when compared to other etiologies, and suboptimal effectiveness of HCC surveillance programs is a major culprit. In this review, we summarize the current guidelines for HCC surveillance and discuss its benefits versus potential harms for NAFLD patients. We also address the unique challenges of HCC surveillance in NAFLD, including higher proportion of NAFLD-related HCC without cirrhosis, poor recognition of at-risk patients, lack of consensus regarding the value of surveillance in non-cirrhotic NAFLD, subpar effectiveness of surveillance tools related to NAFLD phenotype, and preponderant surveillance underuse among NAFLD patients. Finally, we examine the effectiveness of currently used surveillance tools (i.e., ultrasound and alpha fetoprotein) and outline future perspectives including emerging risk stratification tools, imaging surveillance strategies (e.g., abbreviated magnetic resonance imaging protocols), blood-based biomarkers (e.g., GALAD and circulating tumor DNA panels), and interventions to improve surveillance adherence.

Hydrochemical equilibrium and statistical approaches as effective tools for identifying groundwater evolution and pollution sources in arid areas

Mohamed El Alfy,Fathy Abdalla,Karim Moubark,Talal Alharbi 한국지질과학협의회 2019 Geosciences Journal Vol.23 No.2

Hydrochemical investigations, including geochemical analyses, multivariate statistics and geostatistics, were conducted to assess the factors that influence groundwater geochemistry and pollution potentiality in Luxor area, Upper Egypt. A total of thirty-one groundwater and surface water samples from the Quaternary aquifer and the River Nile were analyzed for fourteen physical and chemical variables for each sample. Spatial variations in total dissolved solids and nitrate concentration were mapped. Piper and Durov diagrams indicate that the hydrochemistry of groundwater is influenced by the secondary processes; mixing with fresh water from the River Nile and El Kalabia Canal, irrigation return flow, and sewage leakage, and reverse ion-exchange process. The hydrochemical modeling of mineral phase saturation indices shows that nearly all of the groundwater points are undersaturated with reference to calcite, aragonite, dolomite, anhydrite, gypsum, and halite. Correlation coefficients of the different variables are consistent with the saturation indices. Cluster analysis was used to identify four significant, distinct groundwater zones where the original groundwater was influenced differently by mixing processes. Factor analysis showed four mutually interfering factors reveal the chemical characteristics of the groundwater; these factors are caused by rock-water interactions, mixing of waters of different origins, and anthropogenic effects. Integration of hydrochemical and statistical analyses approach can be applied for the better management of water resources at a regional scale and in areas with comparable conditions.

Immunohistochemical expression of programmed death-ligand 1 and CD8 in glioblastomas

Dina Mohamed El Samman,Manal Mohamed El Mahdy,Hala Sobhy Cousha,Zeinab Abd El Rahman Kamar,Khaled Abdel Karim Mohamed,Hoda Hassan Abou Gabal 대한병리학회 2021 Journal of Pathology and Translational Medicine Vol.55 No.6

Background: Glioblastoma is the most aggressive primary malignant brain tumor in adults and is characterized by poor prognosis. Immune evasion occurs via programmed death-ligand 1 (PD-L1)/programmed death receptor 1 (PD-1) interaction. Some malignant tumors have responded to PD-L1/PD-1 blockade treatment strategies, and PD-L1 has been described as a potential predictive biomarker. This study discussed the expression of PD-L1 and CD8 in glioblastomas.Methods: Thirty cases of glioblastoma were stained immunohistochemically for PD-L1 and CD8, where PD-L1 expression in glioblastoma tumor tissue above 1% is considered positive and CD-8 is expressed in tumor infiltrating lymphocytes. The expression of each marker was correlated with clinicopathologic parameters. Survival analysis was conducted to correlate progression-free survival (PFS) and overall survival (OS) with PD-L1 and CD8 expression.Results: Diffuse/fibrillary PD-L1 was expressed in all cases (mean expression, 57.6%), whereas membranous PD-L1 was expressed in six of 30 cases. CD8-positive tumor-infiltrating lymphocytes (CD8+ TILs) had a median expression of 10%. PD-L1 and CD8 were positively correlated (p = .001). High PD-L1 expression was associated with worse PFS and OS (p = .026 and p = .001, respectively). Correlation of CD8+ TILs percentage with age, sex, tumor site, laterality, and outcomes were statistically insignificant. Multivariate analysis revealed that PD-L1 was the only independent factor that affected prognosis.Conclusions: PD-L1 expression in patients with glioblastoma is robust; higher PD-L1 expression is associated with lower CD8+ TIL expression and worse prognosis.

Robotic versus laparoscopic revisional bariatric surgeries: a systematic review and metanalysis

Karim Ataya,Hussein El Bourji,Ayman Bsat,Amir Al Ayoubi,Al Moutuz Al Jaafreh,George Abi Saad 대한내시경로봇외과학회 2023 Journal of Minimally Invasive Surgery Vol.26 No.4

Purpose: In recent years, the need for revisional bariatric surgery (RBS) procedures has experienced a noteworthy surge to confront complexities and weight recidivism. Despite being a subject of controversy for many, the utilization of the Da Vinci robotic platform (Intuitive Surgical, Inc.) may present benefits in RBS. This study aimed to evaluate the outcomes of robotic RBS in comparison to Laparoscopic RBS. Methods: A meticulous and thorough analysis was ensured through a comprehensive exploration of the literature, which included PubMed, Medline, Scopus, and Cochrane. This exploration was conducted in adherence to the directives outlined in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Newcastle- Ottawa scale was used for quality assessment. Results: A total of 11 studies were included in this meta-analysis, comprising 55,889 in the laparoscopic group and 5,809 in the robotic group. No significant differences were observed in the leak, bleeding, operative time, or length of stay across both groups. However, the robotic group showed higher rates of conversion to open surgery (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.53–0.79; p < 0.0001; I2 = 0%), reoperation (OR, 0.70; 95% CI, 0.57– 0.87; p = 0.0009; I2 = 6%), and readmission (higher rate of readmission in the robotic group; OR, 0.76; 95% CI, 0.62–0.92; p = 0.005; I2 = 30%) Conclusion: Robotic-assisted bariatric surgery has no significant advantage over conventional laparoscopic surgery. Further research is warranted to explore and evaluate surgeons’ methodology and proficiency differences.

Alloxan-induced diabetic thermal hyperalgesia, prophylaxis and phytotherapeutic effects of Rheum ribes L. in mouse model

Karim Raafat,Maha Aboul-Ela,Abdalla El-Lakany 대한약학회 2021 Archives of Pharmacal Research Vol.44 No.8

Rheum ribes L., known as Syrian rhubarb, isused in traditional Lebanese folk medicine for the treatmentof diabetes. The present study aims to investigate theactivities of R. ribes aqueous extract for glucose homeostasis,in vivo antioxidant and diabetic neuropathy protectionin mice. The acute and the subacute effects of variousdoses of R. ribes on blood glucose and in vivo antioxidantactivity utilizing serum catalase level (CAT) were studiedin alloxan-diabetic mice. The high doses significantlylowered glucose level and increased serum CAT inalloxan-diabetic mice. Pretreatment with the extract priorto alloxination, protected the mice from acquiring diabetesand diabetic neuropathy. Treatment with the extract for8 weeks alleviated hyperalgesia in diabetic mice. Ourfindings provide clinicians with promising drugs intendedfor the management of the symptoms of diabetic complications. The protective activity of R. ribes against acquiringdiabetes and diabetic neuropathy might pave the wayfor preparing a prophylactic treatment for diabetes riskgroups.

Non-alcoholic fatty liver disease-related hepatocellular carcinoma

Darine Daher,Karim Seif El Dahan,Amit G. Singal 대한간암학회 2023 대한간암학회지 Vol.23 No.1

Non-alcoholic fatty liver disease (NAFLD), one of the most common causes of liver disease, is an increasingly common cause of hepatocellular carcinoma (HCC). Several demographic, clinical, and genetic factors contribute to HCC risk in NAFLD patients, which may inform risk stratification scores. Proven efficacious approaches to primary prevention approach in patients with non-viral liver disease remain an area of need. Semi-annual surveillance is associated with improved early tumor detection and reduced HCC-related mortality; however, patients with NAFLD have several challenges to effective surveillance, including under-recognition of at-risk patients, low surveillance utilization in clinical practice, and lower sensitivity of current tools for early-stage HCC detection. Treatment decisions are best made in a multidisciplinary fashion and are informed by several factors including tumor burden, liver dysfunction, performance status, and patient preferences. Although patients with NAFLD often have larger tumor burden and increased comorbidities compared to counterparts, they can achieve similar post-treatment survival with careful patient selection. Therefore, surgical therapies continue to provide a curative treatment option for patients diagnosed at an early stage. Although there has been debate about the efficacy of immune checkpoint inhibitors in patients with NAFLD, current data are insufficient to change treatment selection based on liver disease etiology.

Hybrid Homomorphic Encryption Method for Protecting the Privacy of Banking Data in the Cloud

Maha Tebaa,Karim Zkik,Said El Hajji 보안공학연구지원센터 2015 International Journal of Security and Its Applicat Vol.9 No.6

The time and cost saving for banks when implementing cloud computing strategies are staggering. However, it is important to consider the security and protection of data when it comes to the widespread adoption of cloud. Fully homomorphic encryption is currently still undergoing experimentations. One of its limitation is the time required to encrypt and decrypt the sensitive data, as the traditional encryption systems showed a level of resistance and considerable maturity that can be rehabilitated or hybridized for application in the field of sensitive data protection hosted in the Cloud. In this paper we will propose hybrid homomorphic system that will be applied to the banking data to perform operations on encrypted data without decrypting, based on the encrypting, the decryption and the operation treatment time on the ciphertext which were obtained by simulating an addition and multiplication homomorphic cryptosystem and comparing it with DGHV that is somewhat homomorphic; then we will choose our model which is most suitable for banking application.

Prediction of ultimate shear strength and failure modes of R/C ledge beams using machine learning framework

Ahmed M. Yousef,Karim Abd El-Hady,Mohamed E. El-Madawy Techno-Press 2022 Structural monitoring and maintenance Vol.9 No.4

The objective of this study is to present a data-driven machine learning (ML) framework for predicting ultimate shear strength and failure modes of reinforced concrete ledge beams. Experimental tests were collected on these beams with different loading, geometric and material properties. The database was analyzed using different ML algorithms including decision trees, discriminant analysis, support vector machine, logistic regression, nearest neighbors, naïve bayes, ensemble and artificial neural networks to identify the governing and critical parameters of reinforced concrete ledge beams. The results showed that ML framework can effectively identify the failure mode of these beams either web shear failure, flexural failure or ledge failure. ML framework can also derive equations for predicting the ultimate shear strength for each failure mode. A comparison of the ultimate shear strength of ledge failure was conducted between the experimental results and the results from the proposed equations and the design equations used by international codes. These comparisons indicated that the proposed ML equations predict the ultimate shear strength of reinforced concrete ledge beams better than the design equations of AASHTO LRFD-2020 or PCI-2020.

Modeling of ultimate value and kinetic of compressive strength and hydration heat of concrete made with different replacement rates of silica fume and w/b ratios

Djezzar, Mahdjoub,Ezziane, Karim,Kadri, Abdelkader,Kadri, El-Hadj Techno-Press 2018 Advances in concrete construction Vol.6 No.3

The objective of this study was to evaluate the influence of silica fume (SF) on the hydration heat and compressive strength of concrete. Portland cement with w/(c+sf) ratios varying between 0.25 to 0.45 was substituted by 10%, 20% and 30% of SF by mass. A superplasticizer was used to maintain a fluid consistency of the concrete. The heat of hydration was monitored continuously by a semi-adiabatic calorimetric method for 10 days at $20^{\circ}C$. Compressive strengths are tested for each mixture until age of 180 days. The results show that silica fume considerably influences the evolution and the ultimate values of the compressive strengths as well as the hydration heat especially for 10% rate. The w/b ratio has a considerable effect where its decrease modifies compressive strength and hydration heat more than silica fume. The correlation of the obtained results allows deducing of ultimate properties as well as the ages to reach half of their values. The correlation coefficients are close to unity and reflect the judicious choice of these relationships to be used to predict compressive strength and hydration heat.

Predicted of hydration heat and compressive strength of limestone cement mortar with different type of superplasticizer

Didouche, Zahia,Ezziane, Karim,Kadri, El-Hadj Techno-Press 2018 Advances in concrete construction Vol.6 No.6

The use of some superplasticizers in the production of mortar or concrete influences the hydration kinetic and the amount of total heat. This results in a modification of some properties, namely mortar workability, mechanical strength and durability. Three superplasticizers were used; a polynaphthalenesulfonate (PNS), a melamine resin (PMS) and a polycarboxylate (PC). They have been incorporated into various amount in a standardized mortar based on limestone cement. The aim of this study was to evaluate the rheological, mechanical and Calorimeters properties of this mortar. This will select the most compatible product and more able to be used depending on the climate of the country and the cement used. The PNS is incompatible with this type of cement registering a decrease of strength but the PMS and the PC modify the kinetics of hydration with significant heat generation and improved mechanical strength. The measured heat flow is significantly influenced by the type and dosage of superplasticizer especially for low dosage. Hydration heat and compressive strength of the different mixtures can be evaluated by determining their ultimate values and ages to reach these values where the correlation coefficients are very satisfactory.