Search results for: Nada Badaro Saliba
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 68

Search results for: Nada Badaro Saliba

38 Effect of Naameh Landfill (Lebanon) on Groundwater Quality of the Surrounding Area

Authors: Rana Sawaya, Jalal Halwani, Isam Bashour, Nada Nehme

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Mismanagement of municipal solid wastes in Lebanon might lead to serious environmental problems, especially that a big portion of mixed wastes including putrescible is transferred to Naameh landfill. One of the consequences of municipal solid waste deposition is the production of landfill leachate, which if unproperly treated will threaten the main crucial matrices such as soil, water, and air. The main aim of this one of a kind study is to assess the risk posed to groundwater as a result of leachate infiltration on off-site wells especially after stoppage of Naameh landfill's operation end of the year 2016 and initiation of the capping process which is still ongoing and will be finalized in December 2019. For this purpose, nine representative points around the landfill were selected to undergo physicochemical and microbial analysis on a seasonal basis (every three months). The study extended from the year 2014 until the end of the year 2016 (closure of Naameh landfill). The preliminary data obtained are statistically analyzed using the Statistical Package for Social Sciences (SPSS) and was found in conformity with international and Lebanese norms. Thus, the study will be extended an additional year, especially after the finalization of capping and the results obtained, will enable us to propose new techniques and tools (treatment systems) in water resources management depending on the direction of its usage (domestic, irrigation, drinking).

Keywords: contamination, groundwater, leachate, Lebanon, solid waste

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37 The Translation Of Original Metaphor In Literature

Authors: Esther Matthews

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This paper looks at ways of translating new metaphors: those conceived and created by authors, which are often called ‘original’ metaphors in the world of Translation Studies. An original metaphor is the most extreme form of figurative language, often dramatic and shocking in effect. It displays unexpected juxtapositions of language, suggesting there could be as many different translations as there are translators. However, some theorists say original metaphors should be translated ‘literally’ or ‘word for word’ as far as possible, suggesting a similarity between translators’ solutions. How do literary translators approach this challenge? This study focuses on Spanish-English translations of a novel full of original metaphors: Nada by Carmen Laforet (1921 – 2004). Original metaphors from the text were compared to the four published English translations by Inez Muñoz, Charles Franklin Payne, Glafyra Ennis, and Edith Grossman. These four translators employed a variety of translation methods, but they translated ‘literally’ in well over half of the original metaphors studied. In a two-part translation exercise and questionnaire, professional literary translators were asked to translate a number of these metaphors. Many different methods were employed, but again, over half of the original metaphors were translated literally. Although this investigation was limited to one author and language pair, it gives a clear indication that, although literary translators’ solutions vary, on the whole, they prefer to translate original metaphors as literally as possible within the confines of English grammar and syntax. It also reveals literary translators’ desire to reproduce the distinctive character of an author’s work as accurately as possible for the target reader.

Keywords: translation, original metaphor, literature, translator training

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36 Toward Green Islamic Finance: A Case Study from an Emirati Islamic Bank

Authors: Nada Hamed, Mariam Aldhaheri, Sonia Abdennadher

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Islamic Finance is not a new term that emerging in the global market, but it is still under scope by many countries. Its characteristics and regulation are not widely clear and implemented. In 2015, The United Nation announced a plan about potential benefits of using Islamic Finance as a sustainable development approach. Enhancing its application in financial markets could protect from unexpected crisis that might be created from the traditional tools of finance. This paper focuses on this area to test if Islamic finance could be used for maintaining sustainable development and if the term of 'Green Islamic Finance' could be implemented to minimize the deficiencies and 'pollution’ generated from traditional techniques and tools of finance. This paper intends to measure the impact on financial performance and sustainability when financial institutions use Islamic finance or better practice it. The objective of this explanatory research is to measure the performance of Islamic Finance with using a case study of an Islamic bank. The paper would analyze and compare the behavior of financial institutions that used traditional financing tools and converted to Islamic banking system. The methodology used is based on a case study of an Islamic bank in Dubai with comparing its performance before implementing Islamic Finance and after. The selected case study represents the first national bank in Emirates Arab Unis who adopt the Islamic finance approach. Based on a time series analysis, a quantitative analysis would be also used through looking at various set of ratios that are routinely used to measure bank performance.

Keywords: Islamic finance, financial stability, green finance, Islamic finance practices, financial ratios

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35 Effects of Punicalagin on Some Productive and Reproductive Traits in Virgin Rabbit Does

Authors: Nada A. El-Shahaw, Anas A.Salem, M. Kobeisy, Hoda M. Shabaan

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Reactive oxygen species (ROS) is collective term both oxygen radical, such superoxide (O₂•), hydroxyl(OH•), peroxyl (RO₂), and hydroperoxyl (HO₂•), and certain non-radical oxidizing agents, such as hydrogen peroxide (H₂O₂), hypochlorous acid (HOCL), and ozone (O₃), that can be convert easily to radical. The importance of antioxidants is shown here punicalagin. Punicalagin is preventing the harmful effect of (ROS) in all cells, specially gonadal cells. So, the aim of study was to investigate effects of punicalagin (PL) on maternal live body weight (MLBW), number of services/conception (NS), conception rate (CR), gestation length (GL), kindling rate (KR), total litter size (TLS), live litter size (LLS), kit weight (KW), progesterone (P4) and estradiol-17 (E2) concentrations at 1st and 2nd pregnancy of young does. A total of 28 healthy virgin does (6 months old) were divided into 2 equal groups. Group I, each doe, was injected IM with 100 ug PL twice/week pre-mating and one time 3 days post-mating. Group II, each doe was injected IM with sterilized water (control). Blood samples were taken at pre-mating, mating, post-mating, throughout pregnancy, and immediately post-kindling for assaying P4 and E2. All does were naturally mated with fertile bucks. Results revealed that PL displayed their significant impacts on MLBW, NS/conception, CR, GL, KR, TLS, LLS, KWs (birth and weaning), P4 and E2 concentrations either at 1ˢᵗ/2ⁿᵈ pregnancy or both of them. Conclusively, PL improved pregnancy outcomes of young do particularly at 2ⁿᵈ pregnancy and could be recommended in rabbit's farms.

Keywords: punicalagin, pregnancy, estradiol-17β, progesterone, does

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34 Prevention of COVID-19 Using Herbs and Natural Products

Authors: Nada Alqadri, Omaima Nasir

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Natural compounds are an important source of potential inhibitors; they have a lot of pharma potential with less adverse effects. The effective antiviral activities of natural products have been proved in different studies. The outbreak of COVID-19 in Wuhan, Hubei, in December 2019, coronavirus has had a significant impact on people's health and lives. Based on previous studies, natural products can be introduced as preventive and therapeutic agents in the fight against COVID-19; considering that no food or supplement has been authorized to prevent COVID-19, individuals continue to search for and consume specific herbs, foods, and commercial supplements for this purpose. This study will be aimed to estimate the uses of herbal and natural products during the COVID-19 infection to determine their usage reasons and evaluate their potential side effects. An online cross-sectional survey of different participants will be conducted and will be a focus on respondents’ chronic disease histories, socio-dmographic characteristics, and frequency and trends of using these products. Descriptive and univariate analyses will be performed to determine prevalence and associations between various products used and respondents’ socio-demographic data. Relationships will be tested using Pearson’s chi-square test or an exact probability test. Our main findings will give evidence of beneficial uses of natural products and herbal medicine as prophylactic and will be a vigorous approach to stop or at least slow down COVID-19 infection and transmission. This will be of great interest of public health, and the results of our study will lend health officials better control on the current pandemic.

Keywords: COVID-19, herbs, natural products, saudi arabia

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33 Development of an Ecological Binder by Geopolymerization of Untreated Dredged Sediments

Authors: Lisa Monteiro, Jacqueline Saliba, Nadia Saiyouri, Humberto Y. Godoy

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Theevolution of the global environmental context incites companies to reduce their impact by reusing local materials and promoting circular economy. Dredged sediments represent a potential source of materials due to their large volume. Indeed, the dredging operations carried out in Gironde alone generated an annual volume of sediment of approximately 9 million m³. Moreover, on the eve of the evolution of laws concerning dredging practices, the recovery of sediments is necessary to create a viable economy for their management. This thesis work is oriented towards the development of an ecological binder from the fine fraction of untreated dredged sediments. In fact, their physico-chemical properties make them favorable for the synthesis of geopolymer, current competitor of cement, thanks to its lower carbon footprint and environmental impact. However, several obstacles must be overcome before implementing this new family of materials: the use of sediments without thermal or chemical treatment, the absence of a formulation approach, ignorance of the reactions produced, etc. During the first year of the thesis, a physico-chemical characterization of the sediments made it possible to validate their use as precursors forgeopolymerization according to three criteria: their fineness, their mineralogical composition, and the percentage of amorphous phase. Following these results, several formulations have been defined, taking into account the environmental impact. The sediments were activated with an alkaline solution of sodium hydroxide and sodium silicate. Two other formulations with cement and blast furnace slag have been defined for comparison. The results highlighted the possibility of forming geopolymers from untreated and still wet dredged sediments. The development of structural bonds through the formation of hydrated sodium aluminosilicate thus leads to higher strengths at 90 days (4.78 MPa) than a mixture with cement (0.75 MPa). A 30% gain in CO₂ emissions has also been obtained compared to cement. In order to reduce the uncertainties linked to the absence of a formulation approach, to optimize the number of experiments to be carried out in the laboratory, and to obtain an optimal formulation, an analysis by mixing plan was conducted in order to frame the responses according to the proportions of the constituents. Following the obtaining of an optimal binder, the work will focus on the study of the durability and the interspecific variability of the sediments on the mechanical properties by testing the binder developed with different sediments dredged from the Bordeaux estuary. , the Grand Port Maritime of Bayonne, La Rochelle, and the Bassinsd'Arcachon.

Keywords: compressive strength, dredged sediments, ecological binder, geopolymers

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32 Analysis Influence Variation Frequency on Characterization of Nano-Particles in Preteatment Bioetanol Oil Palm Stem (Elaeis guineensis JACQ) Use Sonication Method with Alkaline Peroxide Activators on Improvement of Celullose

Authors: Luristya Nur Mahfut, Nada Mawarda Rilek, Ameiga Cautsarina Putri, Mujaroh Khotimah

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The use of bioetanol from lignocellulosic material has begone to be developed. In Indonesia the most abundant lignocellulosic material is stem of palm which contain 32.22% of cellulose. Indonesia produces approximatelly 300.375.000 tons of stem of palm each year. To produce bioetanol from lignocellulosic material, the first process is pretreatment. But, until now the method of lignocellulosic pretretament is uneffective. This is related to the particle size and the method of pretreatment of less than optimal so that led to an overhaul of the lignin insufficient, consequently increased levels of cellulose was not significant resulting in low yield of bioetanol. To solve the problem, this research was implemented by using the process of pretreatment method ultasonifikasi in order to produce higher pulp with nano-sized particles that will obtain higher of yield ethanol from stem of palm. Research methods used in this research is the RAK that is composed of one factor which is the frequency ultrasonic waves with three varians, they are 30 kHz, 40 kHz, 50 kHz, and use constant variable is concentration of NaOH. The analysis conducted in this research is the influence of the frequency of the wave to increase levels of cellulose and change size on the scale of nanometers on pretreatment process by using the PSA methods (Particle Size Analyzer), and a Cheason. For the analysis of the results, data, and best treatment using ANOVA and test BNT with confidence interval 5%. The best treatment was obtained by combination X3 (frequency of sonication 50 kHz) and lignin (19,6%) cellulose (59,49%) and hemicellulose (11,8%) with particle size 385,2nm (18,8%).

Keywords: bioethanol, pretreatment, stem of palm, cellulosa

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31 An Analysis of Legal and Ethical Implications of Sports Doping in India

Authors: Prathyusha Samvedam, Hiranmaya Nanda

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Doping refers to the practice of using drugs or practices that enhance an athlete's performance. This is a problem that occurs on a worldwide scale and compromises the fairness of athletic tournaments. There are rules that have been created on both the national and international levels in order to prevent doping. However, these rules sometimes contradict one another, and it is possible that they don't do a very good job of prohibiting people from using PEDs. This study will contend that India's inability to comply with specific Code criteria, as well as its failure to satisfy "best practice" standards established by other countries, demonstrates a lack of uniformity in the implementation of anti-doping regulations and processes among nations. Such challenges have the potential to undermine the validity of the anti-doping system, particularly in developing nations like India. This article on the legislative framework in India governing doping in sports is very important. To begin, doping in sports is a significant problem that affects the spirit of fair play and sportsmanship. Moreover, it has the potential to jeopardize the integrity of the sport itself. In addition, the research has the potential to educate policymakers, sports organizations, and other stakeholders about the current legal framework and how well it discourages doping in athletic competitions. This article is divided into four distinct sections. The first section offers an explanation of what doping is and provides some context about its development throughout time. Followed the role of anti-doping authorities and the responsibilities they perform are investigated. Case studies and the research technique that will be employed for the study are in the third section; finally, the results are presented in the last section. In conclusion, doping is a severe problem that endangers the honest competition that exists within sports.

Keywords: sports law, doping, NADA, WADA, performance enhancing drugs, anti-doping bill 2022

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30 Parental Engagement with Their Preschoolers’ Cognitive Development Prior to Their Kindergarten Admission: Sharjah-Based Case Study

Authors: Nada Mohammad Eljeshi

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In the United Arab Emirates (UAE), preschoolers can enroll in kindergarten after completing four years old by August 31 of their admission year. This study aims to better understand how Sharjah-based parents’ engagement with preschoolers contributes to their phonological awareness, literacy development, and print knowledge before their kindergarten admission considering cognitive development is addressed in the UAE national child care standards. More specifically, it will discuss the importance of cognitive development activities to preschoolers, the rationale behind defining the admission age to kindergarten and compare and benchmark the policy to other countries. To achieve this study's objectives, an online survey was conducted and distributed. Respondents were asked 13 dichotomous questions related to activities that promote the preschooler’s linguistics literacy and cognitive development. The results suggested parents’ emphasis on phonological awareness, followed by developing their print knowledge. However, the majority of the surveyed parents did not engage in literacy development with their preschoolers. On this basis, it is clear parents’ awareness should occur by introducing various activities such as book reading, that there is a need to introduce and encourage parents to various activities such as reading a printed book and drawings to keep up with their children's cognitive development. The survey results suggested an emphasis on phonological awareness, followed by developing their print knowledge. However, the majority of the surveyed parents did not engage in literacy development with their preschoolers. On this basis, parental awareness of the importance of preschoolers' cognitive development should be developed and engage the parents in understanding their preschooler’s cognitive development before entering kindergarten.

Keywords: preschoolers, cognitive development, parental engagement, Sharjah-based case study

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29 Entrepreneurship Training of Young People as a Pillar to Generate Income and Create Jobs: Progress Report of the Moroccan National Human Development Initiative in the Region of Meknes

Authors: Bennani Zoubir Nada, El Hiri Abderrazak, El Hajri Aimad

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In context of economic and health crisis, sustainable entrepreneurship has become one of the best solutions to economic recovery. This study is about the third program of the Moroccan national human development initiative in her third phase which began in 2019 and continuous until 2023, and which deals with income improvement and social inclusion of young people, under the high patronage of his majesty the king of Morocco. What is the approach of this program and how entrepreneurship training of young people can be a pillar to generate income and create jobs? Starting on the effectuation theory, we adopted an exploratory qualitative approach through semi-structured interviews with national human development initiative stakeholders in the area of Meknes-Morocco, which allowed us the state of progress of this program. We carried out a survey based on a grid of questions to collect information that we processed using NVIVO software. The most relevant results are that people eligible are jobless young people, who are between 18 and 35 years old, who reside in Meknes and surroundings and who have a project idea. They are trained by experts in entrepreneurship and management through targeted and diversified courses. To ensure the sustainability of projects, the project organisers have provided measures to ensure the sustainability of the companies through continuous monitoring and evaluation as well as support during all phases from the project idea to the realisation and progress.

Keywords: sustainable entrepreneurship, training, social inclusion, national human development initiative in Morocco (INDH), youth entrepreneurship, the effectuation theory

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28 The Development of Liquid Chromatography Tandem Mass Spectrometry Method for Citrinin Determination in Dry-Fermented Meat Products

Authors: Ana Vulic, Tina Lesic, Nina Kudumija, Maja Kis, Manuela Zadravec, Nada Vahcic, Tomaz Polak, Jelka Pleadin

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Mycotoxins are toxic secondary metabolites produced by numerous types of molds. They can contaminate both food and feed so that they represent a serious public health concern. Production of dry-fermented meat products involves ripening, during which molds can overgrow the product surface, produce mycotoxins, and consequently contaminate the final product. Citrinin is a mycotoxin produced mainly by the Penicillium citrinum. Data on citrinin occurrence in both food and feed are limited. Therefore, there is a need for research on citrinin occurrence in these types of meat products. The LC-MS/MS method for citrinin determination was developed and validated. Sample preparation was performed using immunoaffinity columns, which resulted in clean sample extracts. Method validation included the determination of the limit of detection (LOD), the limit of quantification (LOQ), recovery, linearity, and matrix effect in accordance to the latest validation guidance. The determined LOD and LOQ were 0.60 µg/kg and 1.98 µg/kg, respectively, showing a good method sensitivity. The method was tested for its linearity in the calibration range of 1 µg/L to 10 µg/L. The recovery was 100.9 %, while the matrix effect was 0.7 %. This method was employed in the analysis of 47 samples of dry-fermented sausages collected from local households. Citrinin wasn’t detected in any of these samples, probably because of the short ripening period of the tested sausages that takes three months tops. The developed method shall be used to test other types of traditional dry-cured products, such as prosciuttos, whose surface is usually more heavily overgrown by surface molds due to the longer ripening period.

Keywords: citrinin, dry-fermented meat products, LC-MS/MS, mycotoxins

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27 The Effect of Corporate Social Responsibility in the National Commercial Bank in Saudi Arabia

Authors: Nada Azhar

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The aim of the paper is to investigate the effect of corporate social responsibility (CSR) CSR on the National Commercial Bank (NCB) in Saudi Arabia. In order to achieve this, a case study was made of the CSR activities of this bank from the perspective of its branch managers. The NCB was chosen as it was one of the first Saudi banks to engage in CSR and currently has a wide range of CSR initiatives. A qualitative research method was used. Open-ended questionnaires were administered to eighty branch managers of the NCB, with fifty-five usable questionnaires returned and twenty managers were interviewed as part of the primary research. Data from both questionnaires and interviews were analysed using qualitative content analysis. Six themes emerged from the questionnaire findings were used to develop the interview questions. These themes are the following: Awareness of employees about CSR in the NCB; CSR activities as a type of investment; Government and media support; Increased employee loyalty in the NCB; Prestige and profit to the NCB; and View of CSR in Islam. This paper makes a theoretical contribution in that it investigates and increases understanding of the effect of CSR on the NCB in Saudi Arabia. In addition, it makes a practical contribution by making recommendations which can support the development of CSR in the NCB. A limitation of the paper is that it is a case study of only one bank. It is therefore recommended that future research could be conducted with other banks in Saudi Arabia, or indeed, with a range of other types of firm within the financial services area in Saudi Arabia. In this way, the same issues could be explored but with a greater potential generalisability of findings of CSR within the Saudi Arabian financial services industry. In addition, this paper takes a qualitative approach and it is suggested that future research be carried out using mixed methods, which could provide a greater depth of analysis.

Keywords: branch managers, corporate social responsibility, national commercial bank, Saudi Arabia

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26 Macrocephaly-Cutis Marmorata Telangiectatica Congenita Associated with Epilepsy: Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi Farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Cutis marmorata telangiectatica congenita (CMTC) is a rare cutaneous vascular malformation. It most often appears at birth or during the first days of life. Its origin is still unknown. It associates a livedo with telangiectasias of diffuse or segmental topography. In rare cases, it can be associated with neurological disorders such as macrocephaly and, less frequently, with epilepsy. Methodology: We report a case of an infant with Macrocephaly- Cutis marmorata telangiectatica congenita syndrome associated with epilepsy. Results: This is the case of a one month and 15 days old female infant from a non-consanguineous marriage, admitted for a status epilepticus in the context of apyrexia. Infectious and metabolic causes had been eliminated. Physical examination had shown non-infiltrated and reticular livedoid erythematous patches affecting the left upper limb and atrophic on the back of the left hand. Cerebral magnetic resonance imaging (MRI) showed thin layers of bifrontal, temporal, and left parietal hygromas associated with the widening of the bifrontal subarachnoid spaces. The electroencephalogram showed a well-organized sleep tracing with a single right occipital paroxysmal abnormality. Antiepileptic treatment has been administered with good clinical evolution and regression of the skin lesion and a control electroencephalogram without abnormality. Conclusion: This observation illustrates an association of CMTC with both macrocephaly and epilepsy. This pathology, which is relatively benign and has a good prognosis, generally does not require treatment. However, a detailed examination must be carried out, and a follow-up plan must be put in place for each patient presenting with CMTC, given the risk of association with other abnormalities, which can be potentially serious.

Keywords: cutis marmorata telangiectatica congenita, macrocephaly, epilepsy, children

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25 Enabling Translanguaging in the EFL Classroom, Affordances of Learning and Reflections

Authors: Nada Alghali

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Translanguaging pedagogy suggests a new perspective in language education relating to multilingualism; multilingual learners have one linguistic repertoire and not two or more separate language systems (García and Wei, 2014). When learners translanguage, they are able to draw on all their language features in a flexible and integrated way (Otheguy, García, & Reid, 2015). In the Foreign Language Classroom, however, the tendency to use the target language only is still advocated as a pedagogy. This study attempts to enable learners in the English as a foreign language classroom to draw on their full linguistic repertoire through collaborative reading lessons. In observations prior to this study, in a classroom where English only policy prevails, learners still used their first language in group discussions yet were constrained at times by the teacher’s language policies. Through strategically enabling translanguaging in reading lessons (Celic and Seltzer, 2011), this study has revealed that learners showed creative ways of language use for learning and reflected positively on thisexperience. This case study enabled two groups in two different proficiency level classrooms who are learning English as a foreign language in their first year at University in Saudi Arabia. Learners in the two groups wereobserved over six weeks and wereasked to reflect their learning every week. The same learners were also interviewed at the end of translanguaging weeks after completing a modified model of the learning reflection (Ash and Clayton, 2009). This study positions translanguaging as collaborative and agentive within a sociocultural framework of learning, positioning translanguaging as a resource for learning as well as a process of learning. Translanguaging learning episodes are elicited from classroom observations, artefacts, interviews, reflections, and focus groups, where they are analysed qualitatively following the sociocultural discourse analysis (Fairclough &Wodak, 1997; Mercer, 2004). Initial outcomes suggest functions of translanguaging in collaborative reading tasks and recommendations for a collaborative translanguaging pedagogy approach in the EFL classroom.

Keywords: translanguaging, EFL, sociocultural theory, discourse analysis

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24 Aire-Dependent Transcripts have Shortened 3’UTRs and Show Greater Stability by Evading Microrna-Mediated Repression

Authors: Clotilde Guyon, Nada Jmari, Yen-Chin Li, Jean Denoyel, Noriyuki Fujikado, Christophe Blanchet, David Root, Matthieu Giraud

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Aire induces ectopic expression of a large repertoire of tissue-specific antigen (TSA) genes in thymic medullary epithelial cells (MECs), driving immunological self-tolerance in maturing T cells. Although important mechanisms of Aire-induced transcription have recently been disclosed through the identification and the study of Aire’s partners, the fine transcriptional functions underlied by a number of them and conferred to Aire are still unknown. Alternative cleavage and polyadenylation (APA) is an essential mRNA processing step regulated by the termination complex consisting of 85 proteins, 10 of them have been related to Aire. We evaluated APA in MECs in vivo by microarray analysis with mRNA-spanning probes and RNA deep sequencing. We uncovered the preference of Aire-dependent transcripts for short-3’UTR isoforms and for proximal poly(A) site selection marked by the increased binding of the cleavage factor Cstf-64. RNA interference of the 10 Aire-related proteins revealed that Clp1, a member of the core termination complex, exerts a profound effect on short 3’UTR isoform preference. Clp1 is also significantly upregulated in the MECs compared to 25 mouse tissues in which we found that TSA expression is associated with longer 3’UTR isoforms. Aire-dependent transcripts escape a global 3’UTR lengthening associated with MEC differentiation, thereby potentiating the repressive effect of microRNAs that are globally upregulated in mature MECs. Consistent with these findings, RNA deep sequencing of actinomycinD-treated MECs revealed the increased stability of short 3’UTR Aire-induced transcripts, resulting in TSA transcripts accumulation and contributing for their enrichment in the MECs.

Keywords: Aire, central tolerance, miRNAs, transcription termination

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23 Pediatric Emergency Dental Visits at King Abdulaziz University Dental Hospital during the COVID-19 Lockdown: A Retrospective Study

Authors: Sara Alhabli, Eman Elashiry, Osama Felemban, Abdullah Almushayt, Faisal Dardeer, Ahmed Mohammad, Fajr Orri, Nada Bamashmous

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Background: In December of 2019, the coronavirus (SARS-CoV-2) first appeared and quickly spread to become a worldwide pandemic. This study aimed to evaluate the prevalence and types of pediatric dental emergencies during the COVID-19 lockdown in Jeddah, Saudi Arabia, at the University Dental Hospital (UDH) of King Abdulaziz University (KAU) and identified the management provided for these dental emergency visits. Materials and Methods: Data collection was done retrospectively from electronic dental records for children aged 0-18 that attended the UDH emergency clinic during the period from March 1st, 2020, to September 30th, 2020. An electronic form formulated specifically for this study was used to collect the required data from electronic patient records, including demographic data, emergency classification, management, and referrals. Results: A total of 3146 patients were seen at the emergency clinics during this period, of which 661 were children (21%). Types of emergency conditions included 0.8% emergency cases, 34% urgent, and 65.2% non-urgent conditions. Severe dental pain (73.1%) and abscesses (20%) were the most common urgent dental conditions. Most non-urgent conditions presented for initial or periodic visits, recalls, or routine radiographs (74%). Treatments rarely involved restorations, with 8% among urgent conditions and 5.4% among non-urgent conditions. Antibiotics were only prescribed to 6.9% of urgent conditions. Conclusions: The largest group of children presenting at the emergency dental clinics were found to be children with non-urgent conditions. Tele dentistry can be a solution to avoid large numbers of non-urgent patients presenting to emergency clinics. Additionally, dental care for non-urgent conditions during the pandemic should focus more on procedures with less aerosol generation.

Keywords: COVID-19 pandemic, dental emergencies, oral health, pediatric dentistry, children

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22 Entrepreneurial Leadership in a Startup Context: A Comparative Study on Two Egyptian Startup Businesses

Authors: Nada Basset

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Problem Statement: The study examines the important role of leading change inside start-ups and highlights the challenges faced by an entrepreneur during the startup phase of the business. Research Methods/Procedures/Approaches: A qualitative research approach is taken, using the case study analysis method. A comparative study was made between two day care nurseries in Greater Cairo. Non-probability purposive sampling was used and a triangulation of semi-structured interviews, document analysis and participant-observation were applied simultaneously. The in-depth case study analysis took place over a longitudinal study of four calendar months. Results/Findings: Findings demonstrated that leading change in an entrepreneurial setup must be initiated by the entrepreneur, who must also be the owner of the change process. Another important finding showed that the culture of change, although created by the entrepreneur, needs the support and engagement of followers, who should be sharing the same value system and vision of the entrepreneur. Conclusions and Implications: An important implication suggests that during the first year of a start-up lifecycle, special emphasis must be made to the recruitment and selection of personnel, who should play a role into setting the new start-up culture and help it grow or shrink. Another drawn conclusion is that the success of the change must be measured in both quantitative and qualitative terms. Increasing revenues and customer attrition rates -as quantitative KPIs- must be aligned with other qualitative KPIs like customer satisfaction, employee satisfaction, and organizational commitment and business reputation. Originality of Paper: The paper addresses change management in an entrepreneurial concept, with an empirical application on an Egyptian start-up model providing a service to both adults and children. This privileges the research as the constructs measured merged together the level of satisfaction of employees, decision-makers (parents of children), and the users (children).

Keywords: leadership, change management, entrepreneurship, startup business

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21 Pleomorphic Dermal Sarcoma: A Management Challenge

Authors: Mona Nada, Fahmy Fahmy

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Background: Pleomorphic dermal sarcoma is a rare form of skin cancer affecting cutaneous layer and, in some cases associated with recurrence and metastasis, very commonly to seen in elderly patient affecting the area of head and neck. Pleomorphic dermal sarcoma rises in ultraviolet light exposed areas. The symptoms and severity of this kind of skin cancer varies according to histological factors. The differentiation of Pleomorphic dermal sarcoma needs extensive immunohistochemistry, as the diagnosis depends mainly on exclusion to rule out other malignancy like poorly differentiated squamous cell carcinoma, melanoma, angiosarcoma and leiomyosarcoma. Objective: assessing the management of Pleomorphic dermal sarcoma in our unit and compared to the updated guidelines. Design: Retrospective study Collection of patient data from medical records at countess of Chester plastic surgery unit of the last 5 years, all histologically confirmed Pleomorphic dermal sarcoma (2017-2023). Data were collected confirmed to be Pleomorphic dermal sarcoma were included in the study. The data collected: clinical description of the lesions at first presentation, operation time, multidisciplinary team discussion, plan, referral as well as second operation and investigation done. With comparison of histological examination, immunohistochemistry staining, the excision and rate of recurrence. Results: data collected N19 from (2017-2023) showed the disease predominantly affecting males and the lesion mainly in head and neck, the diagnosis needed extensive immunohistochemistry to differentiate between other malignancy. recurrence present in numbers of the cases which managed after multidisciplinary team discussion either by excision or radiotherapy. Conclusion: Pleomorphic dermal sarcoma is a rare malignancy which needs more understanding and avoid missing as it is aggressive form of skin cancer, there is a chance of metastasis and recurrence which makes it very important to understand the process of development of the cancer and frequent review of the management guidelines.

Keywords: pleomorphic dermal sarcoma, recurrence, radiotherapy, surgical

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20 Epidemiology of Toxoplasma gondii Infection in Animals of the Arabian Peninsula: A Systematic Review and Meta-Analysis

Authors: Ebtisam A. Al-Mslemani, Khalid A. Enan, Asmaa Abdelgadier, Nada Assaad, Zaynab Elhussein, Khalid Eltom

Abstract:

Background: Toxoplasma gondii (T. gondii) is a zoonotic parasite that can be transmitted from animals to humans, with felids acting as its definitive host. Thus, understanding the epidemiology of this parasite in animal populations is vital to controlling its transmission to humans as well as to other animal groups. Objectives: This systematic review and meta-analysis aim to summarise and analyse reports of T. gondii infection in animal species residing in the Arabian Peninsula. Methods: It was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with relevant studies being retrieved from MEDLINE/PubMed, Scopus, Cochrane Library, Google Scholar and ScienceDirect. All articles published in Arabic or English languages between January 2000 and December 2020 were screened for eligibility. The random effects model was used to calculate the pooled prevalence of T. gondii infection in different animal populations which were found to harbour this infection. The critical appraisal tool for prevalence studies designed by the Joanna Briggs Institute (JBI) was used to assess the risk of bias in all included studies. Results: A total of 15 studies were retrieved, reporting prevalence estimates from 4 countries in this region and in 13 animal species. A quantitative meta-analysis estimated a pooled prevalence of 43% in felids [95% confidence interval (CI) = 23-64%, I2 index = 100%], 48% in sheep (95% CI = 27-70%, I2 = 99%) and 21% in camels (95% CI = 7-35%, I2 = 99%). Evidence of possible publication bias was found in both felids and sheep. Conclusions: This meta-analysis estimates a high prevalence of T. gondii infection in animal species that are of high economic and cultural importance to countries of this region. Hence, these findings provide valuable insight to public health authorities as well as economic and animal resources advisors in countries of the Arabian Peninsula.

Keywords: Arabian Peninsula, toxoplasma gondii, animals; meta-analysis, toxoplasmosis

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19 Neonatal Subcutaneous Fat Necrosis with Severe Hypercalcemia: Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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18 Metabolically Healthy Obesity and Protective Factors of Cardiovascular Diseases as a Result from a Longitudinal Study in Tebessa (East of Algeria)

Authors: Salima Taleb, Kafila Boulaba, Ahlem Yousfi, Nada Taleb, Difallah Basma

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Introduction: Obesity is recognized as a cardiovascular risk factor. It is associated with cardio-metabolic diseases. Its prevalence is increasing significantly in both rich and poor countries. However, there are obese people who have no metabolic disturbance. So we think obesity is not always a risk factor for an abnormal metabolic profile that increases the risk of cardiometabolic problems. However, there is no definition that allows us to identify the individual group Metabolically Healthy but Obese (MHO). Objective: The objective of this study is to evaluate the relationship between MHO and some factors associated with it. Methods: A longitudinal study is a prospective cohort study of 600 participants aged ≥18 years. Metabolic status was assessed by the following parameters: blood pressure, fasting glucose, total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. Body Mass Index (BMI) was calculated as weight (in kg) divided by height (m2), BMI = Weight/(Height)². According to the BMI value, our population was divided into four groups: underweight subjects with BMI <18.5 kg/m2, normal weight subjects with BMI = 18.5–24.9 kg/m², overweight subjects with BMI=25–29.9 kg/m², and obese subjects who have (BMI ≥ 30 kg/m²). A value of P < 0.05 was considered significant. Statistical processing was done using the SPSS 25 software. Results: During this study, 194 (32.33%) were identified as MHO among 416 (37%) obese individuals. The prevalence of the metabolically unhealthy phenotype among normal-weight individuals was (13.83%) vs. (37%) in obese individuals. Compared with metabolically healthy normal-weight individuals (10.93%), the prevalence of diabetes was (30.60%) in MHO, (20.59%) in metabolically unhealthy normal weight, and (52.29%) for metabolically unhealthy obese (p = 0.032). Blood pressure was significantly higher in MHO individuals than in metabolically healthy normal-weight individuals and in metabolically unhealthy obese than in metabolically unhealthy normal weight (P < 0.0001). Familial coronary artery disease does not appear to have an effect on the metabolic status of obese and normal-weight patients (P = 0.544). However, waist circumference appears to have an effect on the metabolic status of individuals (P < 0.0001). Conclusion: This study showed a high prevalence of metabolic profile disruption in normal-weight subjects and a high rate of overweight and/or obese people who are metabolically healthy. To understand the physiological mechanism related to these metabolic statuses, a thorough study is needed.

Keywords: metabolically health, obesity, factors associated, cardiovascular diseases

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17 Rare DCDC2 Mutation Causing Renal-Hepatic Ciliopathy

Authors: Atitallah Sofien, Bouyahia Olfa, Attar Souleima, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Ciliopathies are a spectrum of diseases that have in common a defect in the synthesis of ciliary proteins. It is a rare cause of neonatal cholestasis. Clinical presentation varies extremely, and the main affected organs are the kidneys, liver, and pancreas. Methodology: This is a descriptive case report of a newborn who was admitted for exploration of neonatal cholestasis in the Paediatric Department C at the Children’s Hospital of Tunis, where the investigations concluded with a rare genetic mutation. Results: This is the case of a newborn male with no family history of hepatic and renal diseases, born to consanguineous parents, and from a well-monitored uneventful pregnancy. He developed jaundice on the second day of life, for which he received conventional phototherapy in the neonatal intensive care unit. He was admitted at 15 days for mild bronchiolitis. On clinical examination, intense jaundice was noted with normal stool and urine colour. Initial blood work showed an elevation in conjugated bilirubin and a high gamma-glutamyl transferase level. Transaminases and prothrombin time were normal. Abdominal sonography revealed hepatomegaly, splenomegaly, and undifferentiated renal cortex with bilateral medullar micro-cysts. Kidney function tests were normal. The infant received ursodeoxycholic acid and vitamin therapy. Genetic testing showed a homozygous mutation in the DCDC2 gene that hadn’t been documented before confirming the diagnosis of renal-hepatic ciliopathy. The patient has regular follow-ups, and his conjugated bilirubin and gamma-glutamyl transferase levels have been decreasing. Conclusion: Genetic testing has revolutionized the approach to etiological diagnosis in pediatric cholestasis. It enables personalised treatment strategies to better enhance the quality of life of patients and prevent potential complications following adequate long-term monitoring.

Keywords: cholestasis, newborn, ciliopathy, DCDC2, genetic

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16 Adaptive Approach Towards Comprehensive Urban Development Simulation in Coastal Regions: Case Study of New Alamein City, Egypt

Authors: Nada Mohamed, Abdel Aziz Mohamed

Abstract:

Climate change in coastal areas is a global issue that can be felt on local scale and will be around for decades and centuries to come to an end; it also has critical risks on the city’s economy, communities, and the natural environment. One of these changes that cause a huge risk on coastal cities is the sea level rise (SLR). SLR is a result of scarcity and reduction in global environmental system. The main cause of climate change and global warming is the countries with high development index (HDI) as Japan and Germany while the medium and low HDI countries as Egypt does not have enough awareness and advanced tactics to adapt with this changes that destroy urban areas and cause loss in land and economy. This is why Climate Resilience is one of the UN sustainable development goals 2030, which is calling for actions to strengthen climate change resilience through mitigation and adaptation. For many reasons, adaptation has received less attention than mitigation and it is only recently that adaptation has become a focal global point of attention. This adaption can be achieved through some actions such as upgrading the use and the design of the land, adjusting business and activities of people, and increasing community understanding of climate risks. To reach the adaption goals, and we have to apply a strategic pathway to Climate Resilience, which is the Urban Bioregionalism Paradigm. Resiliency has been framed as persistence, adaptation, and transformation. Climate Resilience decision support system includes a visualization platform where ecological, social, and economic information can be viewed alongside with specific geographies that's why Urban Bioregionalism is a socio-ecological system which is defined as a paradigm that has potential to help move social attitudes toward environmental understanding and deepen human-environment connections within ecological development. The research aim is to achieve an adaptive integrated urban development model throughout the analyses of tactics and strategies that can be used to adapt urban areas and coastal communities to the challenges of climate changes especially SLR and also simulation model using advanced technological software for a coastal city corridor to elaborates the suitable strategy to apply.

Keywords: climate resilience, sea level rise, SLR, coastal resilience, adaptive development simulation

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15 The Effects of Self- and Partner Reported Attachment Orientations and Mate Retention Behaviors: Actor and Partner Effects in Romantic Couples

Authors: Jasna Hudek-Knezevic, Igor Kardum, Nada Krapic, Martina Jurcic

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The aim of this study was to examine the effects of self- and partner reported attachment orientations on self-reported mate retention behaviors in romantic couples using the actor-partner interdependence model. The study was carried out on 187 heterosexual couples aged from 18 to 35 years, with an average relationship length of 4.5 years. Participants were asked to complete the revised scale of adult attachment and short form of mate retention inventory. Actor and partner effects of self- and partner reported anxious and avoidant attachment orientations on mate retention categories (direct guarding, intersexual negative inducements, positive inducements, public signals of possession and intrasexual negative inducements) and domains (cost-inflicting and benefit-provisioning), as well on overall mate retention were examined. Actor effects for women estimate whether their attachment orientations predict their own mate retention behaviors, whereas men’s actor effects estimate whether their attachment orientations predict their own mate retention behaviors. Women’s partner effects estimate whether their attachment orientations predict their partner’s mate retention behaviors, whereas men’s partner effects estimate whether their attachment orientations predict their partner’s mate retention behaviors. The use of two data sources, self- and partner reports, allow the control of the effects of common method variance when exploring actor and partner effects. Positive actor and partner effects of anxious attachment, as well as negative actor and partner effects of avoidant attachment on mate retention, were expected. In other words, it was expected that more anxiously attached individuals themselves, as well as their partners, will use mate retention behaviors more frequently. On the other hand, more avoidantly attached individuals themselves, as well as their partners, will use mate retention behaviors less frequently. These hypotheses were partially confirmed. The results showed that the strongest and most consistent effects across both data sources were men’s actor effects on the cost-inflicting mate retention domain, and especially on two mate retention categories, direct guarding, and intersexual negative inducements. Additionally, a consistent positive partner effect of men’s anxious attachment orientations on direct guarding was also obtained. Avoidant attachment orientation exerted few and inconsistent actor and partner effects on mate retention domains and categories. The results are explained by theoretical propositions addressing the effects of attachment orientations on an interpersonal romantic relationship in early adulthood.

Keywords: actor and partner effects, attachment orientations, dyadic analysis, mate retention behavior

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14 Prevalence of ESBL E. coli Susceptibility to Oral Antibiotics in Outpatient Urine Culture: Multicentric, Analysis of Three Years Data (2019-2021)

Authors: Mazoun Nasser Rashid Al Kharusi, Nada Al Siyabi

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Objectives: The main aim of this study is to Find the rate of susceptibility of ESBL E. coli causing UTI to oral antibiotics. Secondary objectives: Prevalence of ESBL E. coli from community urine samples, identify the best empirical oral antibiotics with the least resistance rate for UTI and identify alternative oral antibiotics for testing and utilization. Methods: This study is a retrospective descriptive study of the last three years in five major hospitals in Oman (Khowla Hospital, AN’Nahdha Hospital, Rustaq Hospital, Nizwa Hospital, and Ibri Hospital) equipped with a microbiologist. Inclusion criteria include all eligible outpatient urine culture isolates, excluding isolates from admitted patients with hospital-acquired urinary tract infections. Data was collected through the MOH database. The MOH hospitals are using different types of testing, automated methods like Vitek2 and manual methods. Vitek2 machine uses the principle of the fluorogenic method for organism identification and a turbidimetric method for susceptibility testing. The manual method is done by double disc diffusion for identifying ESBL and the disc diffusion method is for antibiotic susceptibility. All laboratories follow the clinical laboratory science institute (CLSI) guidelines. Analysis was done by SPSS statistical package. Results: Total urine cultures were (23048). E. coli grew in (11637) 49.6% of the urine, whereas (2199) 18.8% of those were confirmed as ESBL. As expected, the resistance rate to amoxicillin and cefuroxime is 100%. Moreover, the susceptibility of those ESBL-producing E. coli to nitrofurantoin, trimethoprim+sulfamethoxazole, ciprofloxacin and amoxicillin-clavulanate is progressing over the years; however, still low. ESBL E. coli was predominating in the female gender and those aged 66-74 years old throughout all the years. Other oral antibiotic options need to be explored and tested so that we add to the pool of oral antibiotics for ESBL E. coli causing UTI in the community. Conclusion: High rate of ESBL E. coli in urine from the community. The high resistance rates to oral antibiotics highlight the need for alternative treatment options for UTIs caused by these bacteria. Further research is needed to identify new and effective treatments for UTIs caused by ESBL-E. Coli.

Keywords: UTI, ESBL, oral antibiotics, E. coli, susceptibility

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13 Formulation, Preparation, and Evaluation of Coated Desloratadine Oral Disintegrating Tablets

Authors: Mohamed A. Etman, Mona G. Abd-Elnasser, Mohamed A. Shams-Eldin, Aly H. Nada

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Orally disintegrating tablets (ODTs) are gaining importance as new drug delivery systems and emerged as one of the popular and widely accepted dosage forms, especially for the pediatric and geriatric patients. Their advantages such as administration without water, anywhere, anytime lead to their suitability to geriatric and pediatric patients. They are also suitable for the mentally ill, the bed-ridden and patients who do not have easy access to water. The benefits, in terms of patient compliance, rapid onset of action, increased bioavailability, and good stability make these tablets popular as a dosage form of choice in the current market. These dosage forms dissolve or disintegrate in the oral cavity within a matter of seconds without the need of water or chewing. Desloratadine is a tricyclic antihistaminic, which has a selective and peripheral H1-antagonist action. It is an antagonist at histamine H1 receptors, and an antagonist at all subtypes of the muscarinic acetylcholine receptor. Desloratadine is the major metabolite of loratadine. Twelve different placebos ODT were prepared (F1-F12) using different functional excipients. They were evaluated for their compressibility, hardness and disintegration time. All formulations were non sticky except four formulations; namely (F8, F9, F10, F11). All formulations were compressible with the exception of (F2). Variable disintegration times were found ranging between 20 and 120 seconds. It was found that (F12) showed the least disintegration time (20 secs) without showing any sticking which could be due to the use of high percentage of superdisintegrants. Desloratadine showed bitter taste when formulated as ODT without any treatment. Therefore, different techniques were tried in order to mask its bitter taste. Using Eudragit EPO resulted in complete masking of the bitter taste of the drug and increased the acceptability to volunteers. The compressible non sticky formulations (F1, F3, F4, F5, F6, F7 and F12) were subjected to further evaluation tests after addition of coated desloratadine, including weight uniformity, wetting time, and friability testing.. Fairly good weight uniformity values were observed in all the tested formulations. F12 exhibiting the shortest wetting time (14.7 seconds) and consequently the lowest (20 seconds) disintegration time. Dissolution profile showed that 100% desloratadine release was attained after only 2.5 minutes from the prepared ODT (F12) with dissolution efficiency of 95%.

Keywords: Desloratadine, orally disintegrating tablets (ODTs), formulations, taste masking

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12 Developing Commitment to Change in Egyptian Modern Bureaucracies

Authors: Nada Basset

Abstract:

Purpose: To examine the nature of the civil service sector as an employer through identifying the likely ways to develop employees’ commitment towards change in the civil service sector. Design/Methodology/Approach: a qualitative research approach was followed. Data was collected via a triangulation of interviews, non-participant observation and archival documents analysis. Non-probability sampling took place with a case-study method applied on a sample of 33 civil servants working in the Egyptian Ministry of State for Administrative Development (MSAD) which is the civil service entity acting as the change agent responsible for managing the government administrative reforms plan in the civil service sector. All study participants were actually working in one of the change projects/programmes and had a minimum of 12 months of service in the civil service. Interviews were digitally recorded and transcribed in the form of MS-Word documents, and data transcripts were analyzed manually using MS-Excel worksheets and main research themes were developed and statistics drawn using those Excel worksheets. Findings: The results demonstrate that developing the civil servant’s commitment towards change may require a number of suggested solutions like (1) employee involvement and participation in the planning and implementation processes, (2) linking the employee support to change to some tangible rewards and incentives, (3) appointing some inspirational change leaders that should act as role models, and (4) as a last resort, enforcing employee’s commitment towards change by coercion and authoritarianism. Practical Implications: it is clear that civil servants’ lack of organizational commitment is not directly related to their level of commitment towards change. The research findings showed that civil servants’ commitment towards change can be raised and promoted by getting them involved in the planning and implementation processes, as this develops some sense of belongingness and ownership, thus there is a fair chance that low organizationally committed civil servants can develop high commitment towards change; given they are provided a favorable environment where they are invited to participate and get involved into the move of change. Originality/Value: the research addresses a relatively new area of ‘developing organizational commitment in modern bureaucracies’ by virtue of investigating the levels of civil servants’ commitment towards their jobs and/or organizations -on one hand- and suggesting different ways of developing their commitment towards administrative reform and change initiatives in the Egyptian civil service sector.

Keywords: change, commitment, Egypt, bureaucracy

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11 Case Report of a Secretory Carcinoma of the Salivary Gland: Clinical Management Following High-Grade Transformation

Authors: Wissam Saliba, Mandy Nicholson

Abstract:

Secretory carcinoma (SC) is a rare type of salivary gland cancer. It was first realized as a distinct type of malignancy in 2010and wasinitially termed “mammary analogue secretory carcinoma” because of similarities with secretory breast cancer. The name was later changed to SC. Most SCs originate in parotid glands, and most harbour a rare gene mutation: ETV6-NTRK3. This mutation is rare in common cancers and common in rare cancers; it is present in most secretory carcinomas. Disease outcomes for SC are usually described as favourable as many cases of SC are lowgrade (LG), and cancer growth is slow. In early stages, localized therapy is usually indicated (surgery and/or radiation). Despitea favourable prognosis, a sub-set of casescan be much more aggressive.These cases tend to be of high-grade(HG).HG casesare associated with a poorer prognosis.Management of such cases can be challenging due to limited evidence for effective systemic therapy options. This case report describes the clinical management of a 46-year-oldmale patient with a unique case of SC. He was initially diagnosed with a low/intermediate grade carcinoma of the left parotid gland in 2009; he was treated with surgery and adjuvant radiation. Surgical pathology favoured primary salivary adenocarcinoma, and 2 lymph nodes were positive for malignancy. SC was not yet realized as a distinct type of cancerat the time of diagnosis, and the pathology reportvalidated this gap by stating that the specimen lacked features of the defined types of salivary carcinoma.Slow-growing pulmonary nodules were identified in 2017. In 2020, approximately 11 years after the initial diagnosis, the patient presented with malignant pleural effusion. Pathology from a pleural biopsy was consistent with metastatic poorly differentiated cancer of likely parotid origin, likely mammary analogue secretory carcinoma. The specimen was sent for Next Generation Sequencing (NGS); ETV6-NTRK3 gene fusion was confirmed, and systemic therapy was initiated.One cycle ofcarboplatin/paclitaxel was given in June 2020. He was switched to Larotrectinib (NTRK inhibitor (NTRKi)) later that month. Larotrectinib continued for approximately 9 months, with discontinuation in March 2021 due to disease progression. A second-generation NTRKi (Selitrectinib) was accessed and prescribedthrough a single patient study. Selitrectinib was well tolerated. The patient experienced a complete radiological response within~4 months. Disease progression occurred once again in October 2021. Progression was slow, and Selitrectinib continuedwhile the medical team performed a thorough search for additional treatment options. In January 2022, a liver lesion biopsy was performed, and NGS showed an NTRKG623R solvent-front resistance mutation. Various treatment pathways were considered. The patient pursuedanother investigational NTRKi through a clinical trial, and Selitrectinib was discontinued in July 2022. Excellent performance status was maintained throughout the entire course of treatment.It can be concluded that NTRK inhibitors provided satisfactory treatment efficacy and tolerance for this patient with high-grade transformation and NTRK gene fusion cancer. In the future, more clinical research is needed on systemic treatment options for high-grade transformations in NTRK gene fusion SCs.

Keywords: secretory carcinoma, high-grade transformations, NTRK gene fusion, NTRK inhibitor

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10 Ochratoxin-A in Traditional Meat Products from Croatian Households

Authors: Jelka Pleadin, Nina Kudumija, Ana Vulic, Manuela Zadravec, Tina Lesic, Mario Skrivanko, Irena Perkovic, Nada Vahcic

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Products of animal origin, such as meat and meat products, can contribute to human mycotoxins’ intake coming as a result of either indirect transfer from farm animals exposed to naturally contaminated grains and feed (carry-over effects) or direct contamination with moulds or naturally contaminated spice mixtures used in meat production. Ochratoxin A (OTA) is mycotoxin considered to be of the outermost importance from the public health standpoint in connection with meat products. The aim of this study was to investigate the occurrence of OTA in different traditional meat products circulating on Croatian markets during 2018, produced by a large number of households situated in eastern and north Croatian regions using a variety of technologies. Concentrations of OTA were determined in traditional meat products (n = 70), including dry fermented sausages (Slavonian kulen, Slavonian sausage, Istrian sausage and domestic sausage; n = 28), dry-cured meat products (pancetta, pork rack and ham; n = 22) and cooked sausages (liver sausages, black pudding sausages and pate; n = 20). OTA was analyzed by use of quantitative screening immunoassay method (ELISA) and confirmed for positive samples (higher than the limit of detection) by liquid chromatography tandem mass spectrometry (LC-MS/MS) method. Whereas the bacon samples contaminated with OTA were not found, its level in dry fermented sausages ranged from 0.22 to 2.17 µg/kg and in dry-cured meat products from 0.47 to 5.35 µg/kg, with in total 9% of positive samples. Besides possible primary contamination of these products arising due to improper manufacturing or/and storage conditions, observed OTA contamination could also be the consequence of secondary contamination that comes as a result of contaminated feed the animals were fed on. OTA levels obtained in cooked sausages ranged from 0.32 to 4.12 µg/kg (5% of positives) and could probably be linked to the contaminated raw materials (liver, kidney and spices) used in the sausages production. The results showed an occasional OTA contamination of traditional meat products, pointing that to avoid such contamination on households these products should be produced and processed under standardized and well-controlled conditions. Further investigations should be performed in order to identify mycotoxin-producing moulds on the surface of the products and to define preventative measures that can reduce the contamination of traditional meat products during their production on households and period of storage.

Keywords: Croatian households, ochratoxin-A, traditional cooked sausages, traditional dry-cured meat products

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9 Jarcho-Levin Syndrome: A Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

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