Helwan University

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder marked by immune system dysfunction, resulting in systemic inflammation and organ damage. To measure and evaluate the association between long non-coding RNA (lncRNA)-NEAT1 and circular RNA (circRNA)-UHRF1 expression levels in the serum of SLE patients and to compare the results with healthy controls to evaluate their potential as diagnostic biomarkers regarding the disease severity. One hundred subjects subdivided equally into SLE patients and healthy-matched individuals were enrolled. Real-time PCR (RT-qPCR) for quantitative expression levels of NEAT-1 and circRNA-UHRF1 was used. The expression levels of both NEAT-1 and circRNA-UHRF1 in the serum of SLE patients were significantly upregulated in comparison with healthy controls. Results also revealed that the expression level of both NEAT-1 and circRNA-UHRF1 tended to increase with the severity of the disease. It was detected as well that there were negative correlations between circRNA-UHRF1 and TLC (r=-0.284, p = 0.046), circRNA-UHRF1 and serum albumin (r=-0.297, p = 0.036). There were positive correlations between ESR and CRP (r = 0.668, p < 0.0001), ESR and neutrophils percentage (r = 0.364, p = 0.009), ESR and urinary albumin (r = 0.285, p = 0.045), ESR and interstitial inflammation (r = 0.309, p = 0.029) and negative correlations between ESR and lymphocytes percentage (r=-0.315, p = 0.026), ESR and ALT (r=-0.364, p = 0.009). Though renal biopsy as well as laboratory tests are generally used to diagnose SLE considering symptoms, it is an invasive cost-effective procedure. The combination of evaluating NEAT-1 with circRNA-UHRF1 could be a promising non-invasive early diagnostic indicator and therapeutic target for SLE.

Background/Objectives: Diabetic peripheral neuropathy (DPN) and Charcot foot (CF) represent progressive and disabling neuropathic complications of type 2 diabetes mellitus (T2DM). Circulating microRNAs and inflammatory cytokines may reflect underlying molecular alterations associated with disease progression and offer potential value for discriminating between stages of diabetic neuropathic complications. This study aimed to evaluate circulating miRNA expression profiles and inflammatory cytokine biomarkers in T2DM patients with and without neuropathic complications and to assess their potential non-invasive utility as combined biomarkers for differentiating disease stages and identifying molecular patterns associated with progression from T2DM to DPN and CF. Methods: The study included the following four groups: healthy controls, T2DM patients without complications, T2DM patients with DPN, and T2DM patients with CF. Expression profiles of five miRNAs (miR-19b-3p, miR-451a, miR-199a-3p, miR-146a-5p, and miR-93-5p) were quantified using qPCR. Inflammatory cytokine biomarkers including NLRP3, TNF-α, NF-κB, IL-1β, caspase-3, and Serpin E2 were measured using ELISA assays. Results: Distinct expression patterns of both miRNAs and inflammatory cytokine biomarkers were observed across diabetic neuropathy stages. Several miRNAs demonstrated significant dysregulation in DPN and CF compared with T2DM patients without complications. Correlation analyses revealed stage-specific patterns of interaction between inflammatory cytokines and miRNAs, indicating coordinated molecular alterations across different stages of diabetic neuropathic complications. Conclusions: These findings suggest that combining circulating miRNA and inflammatory marker profiles may improve the discrimination of CF from other diabetic neuropathic stages and may support clinical assessment when conventional diagnostic methods remain unclear. However, prospective longitudinal studies are required to determine their value for risk prediction and disease progression.

Fiber metal laminates (FMLs) sandwich panels are typically installed using mechanical joints. This investigation aims to enhance the bearing behavior of pin joints made of aluminum 1050–E glass FMLs. A novel core modification was achieved using a functionally graded material (FGM) technique. The impact of inserting aluminum layers at the mid-thickness of the specimens and stacking sequences of the composite core ([Al/(0o/90o/0o)s/Al] and [Al/(90o/0o/90o)s/Al]) on joint performance was also examined across different ratios of joint geometries. Furthermore, composite-like and sandwich-like layups were also compared. All tests were conducted in accordance with ASTM D5931/5961 M-17. The results indicated that the sandwich-like layup slightly enhanced the bearing strength of these joints, ranging from 1.37% to 6.16% depending on the joint geometry. Notably, inserting the mid-aluminum layer increased joint bearing strength by 11.18% by constraining delamination within the composite core. Using an FGM technique can increase the bearing strength of pin joints in FMLs by up to 27%. Furthermore, visual examination indicated that the [0°] layers exhibited shear-out, while the [90°] layers failed in net tension. The SEM images show fiber breakage, fiber-matrix debonding, matrix crack, delamination between the [0°] and [90°] composite layers, and delamination between the composite and metal layers.

Breast cancer related lymphedema (BCRL) is a frequent postoperative complication that can substantially impair physical function and quality of life. While objective detection tools such as bioimpedance spectroscopy and imaging are accurate, they are resource intensive and difficult to deploy at scale in routine clinical workflows. Early identification of patients at elevated risk using routinely available clinical data may enable timely surveillance and intervention. We developed a comparative machine learning framework for postoperative BCRL risk prediction using routinely collected clinical data from 1,328 breast cancer patients treated at a single tertiary care center. Twenty four demographic, clinical, pathological, and treatment related variables were analyzed in tabular form. Nine classifiers spanning linear, ensemble, boosting, and transformer based models were systematically evaluated across seven preprocessing pipelines addressing missing data, feature scaling, class imbalance, and decision threshold optimization. Model performance was assessed using minority class F1 (F1_m), accuracy, and the Brier score to jointly evaluate discrimination and probabilistic calibration. Predictive performance varied substantially across preprocessing strategies. When emphasis was placed on minority-class discrimination and probabilistic calibration, ensemble-based models including Random Forest, CatBoost, and LightGBM, as well as the transformer-based TabPFN, achieved the strongest results under the task-specific Custom preprocessing pipeline. Among these, TabPFN attained the highest overall performance, reaching F1_m values of approximately 0.86 and accuracy around 0.89 on the held-out test set. Random Forest, CatBoost, and LightGBM demonstrated robust and competitive performance, with F1_m values in the range of approximately 0.78 to 0.80 and accuracies around 0.83 to 0.86, together with stable Brier scores. In contrast, preprocessing pipelines that avoided targeted data exclusion yielded more conservative but consistent performance, highlighting trade-offs between discrimination, calibration, and data retention in real-world clinical settings. This study demonstrates that preprocessing choices play a critical role in BCRL risk modeling using real world clinical data. While task specific preprocessing can substantially improve minority class performance, such gains should be interpreted cautiously in light of data exclusion and potential selection bias. The proposed framework provides a transparent and reproducible foundation for retrospective BCRL risk stratification and offers a methodological template for future multi center validation studies in postoperative breast cancer care.

New pyrazole/pyrimidine derivatives endowed with azobenzenes were synthesized using microwave and traditional methods. Our compounds were assessed for cytotoxicity against HepG2, MCF-7, HCT-116 and A549 cell lines as dual inhibitors of EGFRT790M and VEGFR-2. A docking study was carried out to show the binding affinities and orientations of our derivatives in the active sites of VEGFR-2 and EGFRT790M. The data of the docking study were highly correlated with the biological data. The HCT116 and A549 cell lines were extremely affected by our derivatives. Derivative 12 showed the greatest activity against A549, HepG2, MCF-7 and HCT116 cells, with IC50 = 5.12, 6.77, 5.85 and 5.25 µM, respectively. It showed higher cytotoxicity than erlotinib (IC50 = 5.49, 7.73, 8.20 and 13.91 µM, respectively) and lower cytotoxicity than sorafenib (IC50 = 4.04, 4.00, 5.58 and 5.05 µM, respectively) against the tested cell lines. The cytotoxicity of the highly active derivatives 5, 6, 8, 9, 10 and 12 against the MCF-10 healthy cell lines was evaluated. The assessed derivatives showed low cytotoxicity against MCF-10 cells, with IC50 = 50.90–55.50 µM. Additionally, all derivatives were assessed as dual VEGFR-2 and EGFRT790M inhibitors. Compounds 12, 8 and 10 displayed very good inhibitions toward VEGFR-2, with IC50 = 0.90, 0.95 and 1.00 µM, respectively. Similarly, structures 12, 8, 10, 5 and 9 showed strong EGFRT790M inhibitions, with IC50 = 0.25, 0.30, 0.33, 0.35 and 0.40 µM, respectively. In addition, in silico ADMET predictions were calculated for the highly active derivatives 8, 10 and 12 and correlated to Lipinski's rule of five using erlotinib and sorafenib as standard ligands. The results presented our derivatives as promising candidates for advanced manipulations to get more potent anticancer agents with advanced VEGFR-2 and EGFRT790M inhibitions.

Impostor phenomenon (IP) is widely cited as a significant challenge in medical education, yet its conceptual and methodological foundations are unstable, hindering a clear understanding of its true scope and impact. Thus, this systematic review and meta-analysis aimed to first establish a pooled prevalence of IP among medical students, and second, to critically appraise the measurement tools and definitions used in the literature. We systematically searched PubMed, Scopus, Web of Science, and CINAHL through July 2025 for all studies quantitatively assessing IP prevalence in medical students. Using a random-effects model, we analyzed data from 34 studies, including 9,550 participants. The overall pooled prevalence of IP was 49% (95% CI [0.43–0.54]), but this figure is complicated by extreme heterogeneity across studies (I2 =95.6%, P < 0.001) despite multiple sensitivity analyses. Subgroup analyses revealed significant prevalence differences by gender (females 51% vs. males 40%; P = 0.021), geographic region (P < 0.001), and the measurement tool used (P < 0.001). The qualitative synthesis suggested associations between IP and negative mental health outcomes, including anxiety, depression, and burnout. Nevertheless, the variance driven by different measurement tools suggests that researchers may not be consistently measuring the same construct. The reliance on unvalidated cutoffs further weakens the validity of prevalence estimates. We conclude that while IP is clearly a prevalent concern, the construct’s weak theoretical grounding and inconsistent measurement impede meaningful progress. Advancing this area of medical education research requires a foundational shift toward conceptual clarity and methodological rigor.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a complex and heterogeneous neurodevelopmental disorder, characterized by symptoms of inattention and/or hyperactivity/impulsivity that present across multiple contexts. Although brain-derived neurotrophic factor (BDNF) and its precursor proBDNF are associated with the etiology of ADHD, little is known about their relation to EEG alterations, especially as they manifest differently in males and females. To investigate sex-related differences in serum levels of BDNF, proBDNF, and the proBDNF/BDNF ratio among children with ADHD, and to examine how these biomarkers relate to EEG findings, cognitive performance, and behavioral symptoms. Ninety children aged 4–12 years were included (60 children with ADHD and 30 healthy controls). All participants underwent IQ assessment using the Stanford–Binet Intelligence Scales, and measurement of serum BDNF, proBDNF, and the proBDNF/BDNF ratio. Participants with ADHD were further assessed using sleep EEG recording, and the Conners’ Parent Rating Scale to evaluate severity of ADHD symptoms. ADHD boys with abnormal EEG had significantly lower IQ compared to those with normal EEG and controls, whereas ADHD boys with normal EEG exhibited more severe behavioral symptoms. There were significantly reduced levels of BDNF overall in boys with ADHD compared to controls, and there was also a significant increase in the ratio between proBDNF/BDNF. Female reductions were also showed in BDNF levels, while none of the proBDNF levels, proBDNF/BDNF ratio, IQ scores, or behavioral symptoms differed significantly across EEG groups. Sex differences are associated with variations in neurotrophic biomarkers and clinical presentation in ADHD. A high proBDNF/BDNF ratio in boys with ADHD may indicate that their neuroplasticity is impaired. These results underscore the value of performing sex-specific analyses in ADHD research and may inform the development of new, more individualized approaches for the diagnosis and treatment of ADHD.

Fibre-reinforced polymers (FRPs) have been thoroughly researched for their effectiveness in repairing and enhancing the flexural capacity of reinforced concrete (RC) beams. This paper seeks to introduce an optimised reliability-based design of a strengthened RC beam with spiral FRP. The critical cross-section of the beam is analysed in accordance with British Standard 8110 to satisfy the strain compatibility conditions. Based on this analysis, the relationship between the moment capacity and beam curvature is established. Furthermore, the influence of the FRP wrapping angle on the beam curvature is determined for both the horizontal and vertical faces. A parametric study is executed, considering different design parameters for the strengthened RC beam. It is concluded that the best achievable wrapping angles on the vertical and horizontal faces of the beam within the feasible design domain are 50°, 48° and 12° and the best achievable thickness–width ratios within the feasible design domain for the FRP strip are 0.0042, 0.0022 and 0.0012 when the moduli of elasticity are 75 GPa, 138 GPa and 200 GPa, respectively.