Honey bees face threats from a variety of pathogens and viruses, the most dangerous of which is the deformed wing virus [DWV]. Using natural materials as treatments or nutritional supplements for bees is the ideal solution, especially when transformed into nanoparticles. Propolis is a resinous product collected from honeybee colonies and is known for its wide-ranging therapeutic properties. The nanocomposite of the chitosan/ propolis alcoholic extracts were prepared and characterized for determining their chemical and physical properties. Cytotoxicity assay and antiviral activity of the prepared composites were also determined using cell culture from the head of adult honey bees in a dose-response assay. A quantitative real time-polymerase chain reaction [RT-qPCR] was done to measure their effects on the deformed wing virus load. The characterization results showed that the Caucasian propolis-chitosan nanocomposite have a higher phenols and flavonoid content and surface area compared to the Egyptian propolis. The Caucasian propolis showed higher toxicity to the cultured cells than the Egyptian propolis. The Chitosan-Caucasian propolis nanocomposites caused a more reduction in the deformed wing viral load of the honey bee cell line than the Egyptian one compared to the raw propolis. It is recommended to use the chitosan-Caucasian propolis nanocomposite as therapeutic and nutritional supplements for decreasing the deformed wing viral load in the honey bees a process that may help in increasing their performance and bee-product production.
Hepatocellular carcinoma (HCC) is a critical health problem that is classified as the fifth most prevalent malignancy in the world. Our study aimed to investigate the anti-tumor activity of the Egyptian cobra venom and honey bee venom in the treatment of DENA-induced HCC in rats compared to the chemotherapeutic drug cisplatin. 70 male adult albino rats were randomly placed into seven groups. Group 1 served as a negative control. Group 2 received 0.1 LD50 snake venom (SV). Group 3 received 0.1 LD50 bee venom (BV). While the other four groups received diethylnitrosamine (DENA) to induce HCC, they were subsequently divided as follows: Group 4 served as a positive control group (HCC), and the other three remaining groups represented the treated groups. Group 5: snake venom-treated group (HCC+SV). Group 6: bee venom-treated group (HCC+BV). Group 7: Cisplatin-treated group (HCC+CIS). DENA induced HCC, as proved by a significantly high increase in AST, ALT, GGT, and ALP activities and a decrease in total protein and albumin contents. Also, significantly elevated levels of urea, creatinine, proinflammatory cytokine (IL-1β), and tumor markers (NRP1, ANG2, TOPBP1) in comparison to the negative control group. Treatment of HCC rats using snake venom, bee venom, and cisplatin revealed a significant decrease in liver enzymes and tumor markers. The venoms showed a potent synergistic anti-tumor effect by significantly upregulating the expression of pro-apoptotic gene Caspase 3 and downregulating the expression of the anti-apoptotic gene (Bcl-2) in comparison to the positive control HCC group. Our findings were confirmed by histological analysis and immunohistochemical Caspase-3 expression. Both snake venom and bee venom have anti-inflammatory, apoptotic, and anticancer effects against induced HCC. However, the use of BV is more effective and safer than SV. Egyptian cobra venom and honey bee venom may serve as an apoptotic stimulator, and can be considered as novel potential therapeutic against HCC.
This study aimed to evaluate the role of two genetic polymorphisms (rs9399137 and rs4895441) in the HBS1L-MYB and rs766432 of BCL11A genes as determinant HbF level and disease severity in Egyptian β-thalassemia patients. Blood samples were obtained from 100 participants, comprising 50 individuals with β-thalassemia and 50 healthy controls. Hematological assessment was conducted through complete blood count (CBC), ferritin measurement, and hemoglobin electrophoresis. After genomic DNA extraction was done, HBS1L-MYB (rs9399137 and rs4895441) SNPs and rs766432 of BCL11A were all assessed by ARMS-PCR .The HBS1L-MYB rs4895441 assessed by RFLP-PCR with the restriction enzyme (RSA1). The genotypic frequencies of the rs766432 SNP of BCL11A and rs9399137 indicated that the genotype frequencies of these SNPs were significantly associated with severity of β thalassemia but there was no significant association between β-thalassemia severity and rs895441 SNP of HSB1L-MYB. In Egyptian β-thalassemia patients, rs766432 in BCL11A and rs9399137 in HBSIL-MYB were found to significantly increase HbF levels, but rs4895441 was not. New tailored management techniques to decrease transfusion needs can be developed based on these findings, which show how genetic and clinical factors affect the severity of β-thalassemia. Further research involving a larger sample size and additional modifier genes is needed.
The present study aimed to elucidate which pathways contribute to cardiometabolic adaptation in Egyptian fruit bats. Utilising cardiac tissues from Egyptian fruit bats (Rousettus aegyptiacus) and C57BL/6J mice, we combined liquid chromatography-mass spectrometry metabolic profiling, non-targeted ¹H NMR spectroscopy, and in silico computational modelling using the genome-scale mammalian network CardioNet. By integrating complementary untargeted and targeted metabolomics with genome-scale flux balance analysis, this approach enables systems-level inference of pathway activity beyond static metabolite abundance measurements. Our analyses revealed that bat hearts exhibit a distinct metabolic profile characterised by depleted glycogen reserves and increased reliance on lipid oxidation to meet energy demands. Notably, bat hearts displayed elevated fluxes in oxidative phosphorylation, β-oxidation of long-chain fatty acids, and the Krebs cycle, alongside reduced amino acid catabolism. These findings suggest that bats have evolved unique metabolic strategies to support the high-energy demands of flight, maintaining cardiac function without succumbing to pathological remodelling. This study provides the first comprehensive insight into the metabolic adaptations in the cardiac tissue of a bat species, contributing to our understanding of how these mammals endure extreme physiological stresses.
Hepatitis B virus (HBV) infection poses a significant public health challenge, leading to liver cirrhosis and hepatocellular carcinoma (HCC). The clinical course of HBV infection is influenced by viral, environmental, and host genetic variants. Recently, a Cirrhosis Risk Score (CRS) based on seven genetic variants has been developed to identify individuals at risk of developing cirrhosis. This study aimed to assess the predictive value of seven gene signatures in Egyptian patients with HBV infection as molecular biomarkers for cirrhosis. In this cross-sectional study, 170 HBV-infected patients exhibiting various degrees of liver fibrosis were recruited. Genotyping for the seven gene SNPs was performed using allelic discrimination assays. Subsequently, the non-invasive scores APRI and FIB-4 were computed and compared with CRS values. Furthermore, an in silico analysis was performed to examine the alterations in gene expression associated with the progression of fibrosis. The findings revealed a significantly higher prevalence of high CRS scores in late fibrosis (p = 0.006). The mean of CRS was higher in late than in early fibrosis (0.70 vs. 0.60; P = 0.003). However, APRI and FIB-4 scores did not differ significantly across the groups. The ROC analysis indicated that the CRS score can distinguish between patients with early and late fibrosis, with an AUC of 0.63 (p = 0.0034). The risk genotypes in DEGS1 (rs4290029), STXBP5L (rs17740066), and AQP2 (rs2878771) were associated with late fibrosis. According to the in silico analysis, there is a remarkable upregulation of DEGS1 and a downregulation of STXBP5L in late fibrosis as compared to early fibrosis. While the AQP2 showed no significant variation between early and late fibrosis. The CRS score showed a modest predictive ability in HBV-infected Egyptian patients; it can be used in conjunction with imaging and clinical tools to improve risk stratification. Moreover, DEGS1, STXBP5L, and AQP2 genetic variants demonstrated a significant association with cirrhosis risk. However, only the DEGS1 and STXBP5L genes showed dysregulated expression levels, suggesting their potential relevance as diagnostic biomarkers in liver fibrosis.
This study presents a mineralogical and geochemical investigation of Egyptian black sand deposits to constrain their provenance, depositional controls, and economic potential. Representative samples were collected from the Mediterranean North Coast (Dieba, Damietta, Rosetta, and Balteem) and from the Southern Sinai (Abu Zenima and Nebq). A multidisciplinary approach was applied, integrating mineral separation, grain counting, mineralogical examination using SEM-EDS, mineral chemistry, and bulk geochemistry, along with remote sensing data for Southern Sinai. The results indicate that North Coast black sands are multi-cycle sediments derived mainly from the Nile system and upgraded by coastal reworking. In contrast, Southern Sinai deposits represent first-cycle sediments controlled by local drainage and aeolian processes. Total heavy minerals (THMs) show variable contents averaging ~ 8% in Southern Sinai and ~ 15% along the North Coast, with economic heavy minerals (EHMs) forming ~ 60% and ~ 25% of THMs, respectively. EHMs are dominated by ilmenite (38-56%), magnetite (15-32%), zircon (5-19%), rutile (4-15%), and minor monazite (0‒6%). Mineral chemistry of EHMs, together with geochemical signatures of their host sands indicates polygenetic provenance, involving contributions from mafic-ultramafic, granitoid, metamorphic and sedimentary sources. EHM fractions contain significant contents of rare earth elements (∑REEs: 0.8-3.7 kg/ton), primarily hosted in monazite. Preliminary reserve estimates indicate higher economic potential along the North Coast (0.04‒0.1 million tons/km2 per 1 m depth), while Southern Sinai occurrences are smaller but locally enriched (0.03‒0.14 million tons/km2 per 1 m depth). These findings highlight the significance of Egyptian black sands as promising resources for Fe-Ti oxides, zircon, and REEs.
Bats are widely distributed mammals capable of harboring diverse pathogens, including antimicrobial-resistant bacteria. Staphylococcus aureus (S. aureus), particularly methicillin-resistant S. aureus (MRSA), poses a significant public health concern. This study aimed to investigate the occurrence, antimicrobial resistance profile, and presence of the Panton-Valentine leukocidin (pvl) virulence gene of S. aureus in Egyptian fruit bats. Fifty Egyptian fruit bats were captured using mist nets at both foraging and roosting sites and morphologically identified. A total of 150 samples (intestinal contents, oral swabs, and skin swabs) were collected for bacteriological examination. S. aureus isolates were confirmed by Gram staining, catalase test, and coagulase test. Genomic DNA was extracted for molecular identification using PCR targeting the 16S rRNA and nuc genes. Antimicrobial susceptibility testing was conducted using the disk diffusion method. PCR was additionally used to screen for methicillin resistance genes (mecA and mecC) and the pvl virulence gene. At the sample level, 67 of 150 samples (44.7%) were confirmed as S. aureus, while 42 of 50 bats (84.0%) tested positive at the bat level. The highest prevalence was observed in skin swabs (56.0%), followed by intestinal contents (40.0%) and oral swabs (38.0%). Eighteen isolates (26.9%) were classified as MRSA, and five isolates (7.5%) were multidrug-resistant (MDR), all of which were also MRSA. PCR analysis detected the mecA gene in 7 of the 18 (38.9%) MRSA isolates, while the mecC gene was not detected in any sample (0.0%). The pvl gene was identified in 6 of 67 isolates (9.0%). MRSA isolates exhibited diverse antimicrobial resistance patterns, with 61.1% demonstrating a multiple antimicrobial resistance index (MARI) value ≥ 0.2. This study provides evidence of S. aureus carriage in Egyptian fruit bats, including MRSA and PVL-positive isolates, some of which were multidrug-resistant. These findings suggest that bats may serve as ecological carriers of antimicrobial-resistant and virulent bacteria, highlighting the importance of wildlife surveillance within a One Health framework.
Dementia prevention targets modifiable factors from high-income cohorts, but most studies conflate dementia status and cognitive performance, distinct outcomes with potentially different outcomes. This distinction is critical to disentangle in resource-constrained low- and middle-income countries, where resource prioritization requires context-specific evidence. Cross-sectional analysis of 660 adults with dementia/mild cognitive impairment from the Egyptian Dementia Network registry (2022 to 2025). Parallel logistic/linear regression models identified factors associated with dementia status versus continuous Mini-Mental State Examination (MMSE) scores, comparing determinants across outcomes. The mean age of participants was 68 years, 51% were male, and 81% had a primary education. Multivariable models showed only college education (odds ratio [OR] 0.30, 95% confidence interval [CI]: 0.10 to 0.86) and social inactivity (OR 3.00, 95% CI: 1.27 to 7.08) associated with dementia status. Eight factors (age, diabetes, hypertension, cholesterol, family history, apolipoprotein ε4, body mass index, and sex; all p < 0.05) strongly predicted MMSE but not diagnosis. Dementia diagnosis and cognitive performance show mechanistically distinct cross-sectional associations. LMICs should prioritize education/social engagement for dementia prevention, framing vascular-metabolic management as cognitive maintenance.
The physicochemical properties of pesticides specifically solubility, volatility, and molecular structure are the primary factors determining their mobility. These factors govern their movement within the plant and their transport through the soil. The present work evaluated how variation in physicochemical properties influences the adsorption and leaching behavior of nine commonly used pesticides in tomato fields. The study includes a representative selection of major insecticides, fungicides, and herbicides to provide a comprehensive overview of their behavior in the soil. The adsorption capacity of the bulk soil was evaluated using the batch equilibration technique following two models. According to the Freundlich model, tebuconazole and difenoconazole were exhibited the highest adsorption affinity. On the contrary, the Langmuir model identified pendimethalin as having the strongest binding affinity to the soil followed by indoxacarb. Regarding the leaching experiments conducted in packed Egyptian soil columns, metalaxyl demonstrated the highest mobility, with 15% of the applied amount recovered in the leachate followed by acetamiprid. In contrast, the remaining pesticides exhibited low mobility, with the highest concentrations retained in the upper soil profile. These findings are step forward to develop management practices that mitigate the risks of pesticides, ensuring the protection of agricultural water quality and prevent groundwater contamination.
Duck hepatitis virus (DHV) continues to pose a substantial threat to duck production worldwide, causing acute hepatitis, neurological manifestations, and elevated mortality rates, even in vaccinated flocks. During 2022-2023, a significant outbreak involving DHV-1 and DHV-3 was reported in duck farms across five governorates in North Egypt. The outbreaks primarily affected Pekin ducklings aged 4-15 days, with mortality rates ranging from 50% to 70%. Affected ducklings exhibited characteristic pathological lesions, including hepatomegaly with haemorrhages, splenomegaly, and renal enlargement. A total of 30 liver and spleen samples collected from affected farms were analysed using reverse transcription PCR (RT-PCR) targeting the 3' untranslated region (3'UTR) and the VP1 gene. DHV was detected in 56.7% (17/30) of the samples. Among the positive cases (n = 17), DHV-1 was identified in 29.4% (5/17), whereas DHV-3 accounted for 70.6% (12/17). Phylogenetic analysis based on whole-genome sequencing revealed that DHV-1 strains clustered within sub-clade 1a, demonstrating high genetic similarity (99.2-99.8%) with previously reported Egyptian isolates and Chinese reference strains (e.g., DHAV-1-CH-2012). In contrast, DHV-3 strains grouped within sub-clade 3a and showed close genetic relatedness to Chinese strains (97.1-98.7%), while showing marked divergence (75.9-76.3% nucleotide identity) from currently used vaccine strains. Genetic analysis identified multiple mutations in both viral types. DHV-1 exhibited amino acid substitutions within VP0, VP3, and non-structural protein regions, alongside five mutations in hypervariable region 1 (HVR1) and one mutation in HVR2 of the VP1. DHV-3 demonstrated distinct mutations within the VP1, including a unique E681K substitution identified in the Egyptian strain ND3. The findings demonstrate ongoing genetic evolution of DHV circulating in Egyptian duck farms, characterized by the predominance of genetically distinct DHAV-3 strains, with significant divergence from currently used vaccine strains. This genetic divergence may contribute to altered vaccine performance and continued disease outbreaks; however, its impact on vaccine-induced protection requires further experimental validation. Continuous genomic surveillance and the development of updated, strain-matched or multivalent vaccines are therefore essential to control DHV infections and minimise economic losses in Egypt's duck industry.
One of serious side effects of liver cirrhosis is spontaneous bacterial peritonitis (SBP), which is defined by existence of infected ascites without a discernible secondary source of infection. One possible mechanism for development of SBP is microbial translocation. To ascertain prevalence, microbiological profile and outcomes of spontaneous bacterial and fungal peritonitis in Egyptian patients with liver cirrhosis. Three hundred cirrhotic patients with ascites who were hospitalized for spontaneous peritonitis (SP) participated in cross-sectional research. Laboratory investigations using bacterial and fungal cultures were carried out. All participants with diagnosis of SP were included. Their mean age was 59.50 years, and 68.7% of them were men. In addition, 13.7% of subjects had spontaneous fungal peritonitis, whereas 47.3% of participants had SBP. Of SBP cases, 50.7% (n = 72) had gram negative (-ve) bacteria isolated from them, whereas 49.3% (n = 70) had gram positive (+ ve) bacteria. Streptococcus 8.5% (n = 12) was the commenest gram-positive isolate, followed by Staphylococcus aureus 33.8%(n = 48). On the other hand, Klebsiella 29.6% (n = 42) was the commenest gram-negative isolate, followed by Escherichia coli 14.4%(n = 19). The outcome of SBP cases with and without multidrug resistance do not differ significantly. On multivariate analysis, femal (p = 0.013), low ascitic protein level and high ascitic lactate dehydrogenase (LDH) (p = 0.018, p = 0.014) were significant independent predictors for SFP. SBP and SFP frequently provide serious life-threatening dangers in cirrhotic patients with ascites. Alertness for SFP is increased with low ascitic protein level and high ascitic LDH.
This study compares power dynamics in two culturally and generically distinct medical television series: the Egyptian comedy Balto (2023) and the American drama The Resident (2018). Drawing on Halliday's Systemic Functional Linguistics (SFL), particularly the Mood system, six scenes (three from each series) are analysed to show how declarative, interrogative, and imperative clauses construct hierarchy, authority, and resistance. The analysis reveals that in Balto, power is framed through humour and exaggeration, with interns positioned by softened or ironic speech, while senior doctors assert dominance in playful yet critical ways. In The Resident, authority is enforced through direct commands and evaluative questions that blur mentorship with intimidation. These contrasts demonstrate how genre and cultural context shape linguistic realizations of institutional power, highlighting Mood as a key resource for negotiating authority across divergent settings.
This study investigates the impact of ecocentric leadership on environmental performance in the Egyptian hospitality and tourism sector. It explores the mediating roles of green organizational learning, as well as the sequential mediation of digital green culture and green work engagement, grounded in the Resource-Based View (RBV) and Social Exchange Theory (SET). Data were collected from 404 middle-level managers working in five-star hotels and category-A travel agencies in Greater Cairo using a structured questionnaire. A non-probability convenience sampling method was employed. Structural Equation Modeling (SEM) was used to test the hypothesized relationships. Findings confirm that ecocentric leadership significantly enhances environmental performance, both directly and indirectly through digital green culture and green work engagement, indicating a clear sequential mediation pathway. Moreover, green organizational learning partially mediates the relationship between ecocentric leadership and digital green culture, and digital green culture positively affects green work engagement, while green work engagement positively influences environmental performance. Hospitality and tourism organizations should invest in ecocentric leadership development and promote a culture of green learning and engagement to improve environmental outcomes. This study provides an integrated model linking leadership, learning, culture, and engagement to sustainability performance based on RBV and SET, offering practical and theoretical contributions within an emerging market context like Egypt.
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Carbapenem-resistant Enterobacterales (CRE) causing healthcare-associated infections (HAI) represent a growing public health threat. We conducted a large-scale multicenter study to characterize CRE isolates from ICU patients in Egypt. Non-repetitive CRE clinical isolates were collected from infected ICU patients in 10 tertiary hospitals across 7 governorates over one year. Identification and susceptibility testing were performed using VITEK-2. Carbapenemase genes were detected by multiplex PCR for blaNDM, blaOXA-48, blaVIM, blaSPM, blaGIM, blaIMP, blaKPC, blaDIM, blaSIM, and blaAIM, and whole genome sequencing (WGS) was conducted on 40 selected isolates. Of 646 CRE isolates, K. pneumoniae (86%) and E. coli (12%) predominated. High resistance rates were observed, with tigecycline showing the highest activity (78.7% susceptible). Ceftazidime-avibactam activity varied widely (2-74.2%) among hospitals. The most prevalent carbapenemase genes were blaNDM (77%) and blaOXA-48 (64%), while blaKPC was found in 4.6%. Fourteen isolates (2.2%) lacked the screened carbapenemase genes. WGS revealed four ST types among 14 E. coli isolates, mainly ST2 and ST650, while 26 K. pneumoniae isolates were dominated by ST147 (27%) and ST11 (23%). Genes linked to hypermucoviscosity (rmpA, rmpA2) were present in 31% of K. pneumoniae, alongside other carbapenem resistance mechanisms (absence of outer membrane porins, and efflux pump activation). Carbapenemase production is the main driver of CRE among ICU-HAIs in Egypt. WGS showed diverse sequence types suggesting limited local spread, frequent hypermucoviscosity, porin loss, and efflux-mediated resistance among CRE isolates.
Accurate age estimation significantly influences legal outcomes in several contexts. The sternum is one of the most important landmarks that identify age. This cross-sectional study aims to propose Sternum Maturation Models for age estimation, recruiting 247 Egyptian subjects who underwent chest Multidetector Computed Tomography (MDCT) imaging. The maturation of the manubriosternal joint (MSJ), the xiphisternal joint (XSJ), and the junctions between the four sternebrae (S1, S2, and S3) were investigated through a three-element fusion staging. MS-XS Score, an S1-S3 Score, an Overall Score, and an Overall Score excluding the MSJ were calculated. Despite the observed variability, 97% of females reached full sternal fusion by approximately 67 years, whereas males reached this stage a decade later. The ages of fusion initiation and termination were earlier in females, whereas males showed stronger correlations between age and all scores (rho values ranging from 0.552 to 0.750). For all individuals, including those aged ≤ 25 years, the Overall Score excluding the MSJ was the best age predictor, followed by the Overall Score. Above 25 years, the Overall Score excluding MSJ was the best age predictor, followed by the MS-XS Score. The Overall Scores, excluding and including the MSJ, ≥ 6, exhibited high accuracy in predicting ages ≥ 18 and 21 years in males (AUC ≥ 0.973) and substantial agreement with actual ages (kappa coefficients ≥ 0.840). Meanwhile, the performance of both models declined in older ages above 40 years, and in females. The MDCT-based Sternal Maturation Models are reliable, non-invasive approaches for forensic age estimation.
Despite the increasing integration of digital learning in postgraduate medical education, the utilization of Learning Management Systems (LMS) among Egyptian fellowship trainees remains suboptimal. Limited engagement and unclear perceived value highlight the need for structured training interventions. We aimed to assess the effectiveness of e-learning and the use of the LMS platform in enhancing hybrid training methods for Egyptian fellowship trainees at El-Behera governorate training centers. A quasi-experimental pre-post interventional study was conducted on 211 newly enrolled Egyptian fellowship trainees at El-Behera training centers between August and December 2024. Participants completed a validated self-administered questionnaire assessing perceptions of e-learning and LMS use. An orientation-based training intervention was delivered, including hands-on LMS navigation and resource utilization. Paired analysis was performed on 111 participants who completed both pre- and post-intervention assessments. Post-intervention, participants demonstrated significant improvements in perceived institutional support and overall perception of distance learning. Significant positive changes were observed across all LMS domains, including usability, accessibility of resources, perceived impact on clinical development, personalization of learning, and course scheduling (all p < .01). Additionally, the proportion of trainees who believed that LMS facilitates achievement of training requirements increased markedly (61.3% vs. 87.4%). However, no significant changes were observed in engagement levels or perceived effectiveness of distance learning. Structured LMS training significantly improves trainee perceptions and perceived utility of digital learning platforms but has limited impact on engagement and contextual barriers. Institutions should prioritize continuous training, infrastructure development, and interactive LMS design to maximize educational outcomes in hybrid postgraduate training models.
In Egypt, approximately 134,000 new cancer cases and over 30,000 deaths are recorded annually. Unfortunately, a considerable proportion of patients present with an advanced stage. This patient population often faces a misconception that if they understand their disease stage and treatment goals, it will increase their anxiety. This study assessed Egyptian patients' perceptions of their treatment objectives and the factors influencing their understanding. A survey-based study was conducted involving 487 Stage IV solid malignancy patients receiving palliative care at four Egyptian cancer centers. The survey assessed the patients' awareness of their cancer diagnosis, stage, and treatment goals. Demographic data were collected. Responses were compared with medical records, and a total knowledge score (TKS) was calculated. A cutoff of ≥ 75% was set for satisfactory knowledge. Of the 487 patients, 46 (9.4%) denied having cancer and were excluded. Among the remaining 441 patients, despite 85.5% accurately knowing their tumor site, only 20.4% defined their exact tumor stage, and only 12% understood that the treatment was palliative rather than curative, while 28.9% thought that their tumors were benign. Collectively, 12% demonstrated a satisfactory knowledge level. The most significant factor that correlated positively with TKS was the education level (rs = 0.311, P < 0.001). Illiterate/primary-level education patients were 2.28 times more likely to have misconceptions. A substantial percentage of cancer patients demonstrated insufficient knowledge about their disease nature and treatment goals, especially those with lower education levels. These findings highlight the importance of improving patient education and physician-patient communication to help improve the process of shared decision-making.
Antimicrobial resistance is one of the major public health threats facing humanity. Hence, the current investigation aimed to develop alternative therapeutic strategies by integrating apitherapy with biopolymer-based nanotechnology to combat multidrug-resistant (MDR) microbial pathogens. Out of 100 clinical microbial isolates, 29 highly MDR clinical pathogens from different infections, including Gram-negative and Gram-positive bacteria, as well as fluconazole-resistant Candida spp., were selected for the study. Three bee products (Turkish propolis extract (P), Egyptian honey (H), and Egyptian royal jelly (RJ)) were used, and their polyphenolic contents were determined via HPLC analysis. These bee products were encapsulated within carboxymethyl chitosan nanoparticles (CMC NPs). The resulting nano-formulations, namely Carboxymethyl chitosan-Propolis extract nanoparticles (CMC-P NPs), Carboxymethyl chitosan-Honey nanoparticles (CMC-H NPs), and Carboxymethyl chitosan-Royal Jelly nanoparticles (CMC-RJ NPs), were characterized in terms of particle size, surface charge, and chemical composition. Their antimicrobial activity and preliminary cytocompatibility were evaluated using standard microbiological assays and the MTT assay, respectively. HPLC analysis confirmed the presence of diverse polyphenolic compounds in the bee products. The highest concentrations were detected in the ethanolic extract of propolis (EEP) (51.0-40993 µg/g), followed by honey (1.06-1591.16 µg/g) and royal jelly (0.53-2796.37 µg/g). Among the nano-formulations, CMC-P NPs emerged as the most potent formulation (size: 100.7 nm, zeta potential: -70 mV), showing significant bactericidal activity (P < 0.05) against all MDR isolates. Notably, CMC-P NPs exhibited inhibition zones (17.67-31.33 mm) and MIC values (0.019-1.25 mg/mL) that were superior to standard antibiotic controls. CMC-H NPs and CMC-RJ NPs exhibited variable antimicrobial effects, depending on the pathogen and the encapsulated bee product. Indeed, all three nano-formulations demonstrated strong antimicrobial action against highly resistant Klebsiella pneumoniae and Klebsiella ozaenae. Further, MTT assay results confirmed the preliminary biocompatibility of the nanostructures, showing no significant toxicity toward RPE1 cells. Encapsulation of bee products within CMC NPs significantly enhances their antimicrobial performance against a wide range of MDR clinical pathogens. The developed nano-formulations exhibited suitable physicochemical properties, potent antimicrobial activity, and promising preliminary biocompatibility, supporting their potential as safe and effective antimicrobial candidates for further preclinical investigation.
AI integration into medical education and practice has its benefits and risks. This national web-based cross-sectional survey on Egyptian medical staff and students aimed to assess knowledge, attitudes, and concerns regarding the use of AI. This study comprised 2765 medical students and 500 medical staff, with a mean age of 20.8 and 29.9 years, respectively, and higher percentages of females among both groups. Medical students demonstrated satisfactory knowledge of AI compared to medical staff (p < 0.001). Unfortunately, the majority of both groups (80.4% of staff and 81.6% of students) expressed negative attitudes toward AI use. Male participants had significantly higher attitude scores than females in both groups. Knowledge score and gender were significant predictors of attitude towards AI among medical staff (p<0.005), while gender was a significant predictor of attitude scores among medical students (p < 0.001). The total AI usage score in this study was higher among students than staff, particularly for idea generation. Medical staff demonstrated a slightly higher total concern score regarding the use of AI in medical education and practice compared with students. The results emphasize the necessity of engagement, focused education and training, compatible solutions, uniform standards, guidelines, and the smooth incorporation of AI into medical education and clinical practice.