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Lymphoblastic lymphoma (LBL) with an early T-cell precursor phenotype has only been rarely reported. Nijmegen breakage syndrome (NBS) is an inherited chromosomal instability disorder with known predisposition to malignancies that is very rare as well. We report a case of early T-precursor LBL (ETP-LBL) in a patient with NBS, a rare combination that has not been reported. We raise the question of whether a chromosomal instability disorder such as NBS increases the propensity for early T-precursor acute lymphoblastic leukemia/lymphoma (ETP-ALL/LBL), given that ETP-ALL has been shown to have increased genomic instability compared to T-ALL., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Using spectroscopy, two quick and sensitive analytical methods based on eosin Y ion pairing were developed and assessed in order to determine capivasertib and futibatinib with high selectivity and sensitivity. The quenching impact of futibatinib or capivasertib on the eosin Y's fluorescence at a pH 3.8 and 3.3 for futibatinib and capivasertib, respectively, in 0.1-M acetate buffer solution was observed using two spectrofluorometric techniques. These techniques are regarded as the original spectrofluorometric techniques for the assay of futibatinib and capivasertib. For futibatinib and capivasertib, the quenching effect on fluorescence was ranged from 100 to 1000 and 150 to 1500 ng mL -1 , respectively. The absorbance of the generated ion-pair was measured using two different spectrophotometric methods at 550 nm in aqueous buffered solutions with pH values of 3.8 and 3.3 for futibatinib and capivasertib, respectively. In the concentration range of 1.0-10.0 and 2.0-10.0 μg mL -1 , Beer's law was followed. The four approaches were applied to the analysis of dosage forms with a high percent recovery successfully, and they were assessed in compliance with ICH guidelines., (© 2024 John Wiley & Sons Ltd.)

This work developed a novel sustainable adsorbent (PF-Aq) prepared by the amino-functionalization of palm oil fibers (PF). XPS, SEM/EDS, TGA/DSC, and FT-IR techniques proved the successful functionalization of the PF with the amino group. The PF-Aq adsorbent presents a high adsorption capacity for phosphate and Cr(VI) ions. Adsorption kinetics of the ions onto the PF-Aq followed the general-order models, with 240- and 300-min equilibrium times for phosphate and Cr(VI), respectively. The Freundlich equilibrium model can explain the adsorption of phosphate and Cr(VI) on the PF-Aq. Besides, the maximum adsorption capacities were 151.07 mg g -1 for phosphate and 206.08 mg g -1 for Cr(VI). The best pH for the adsorption of both ions on PF-Aq was 4.0. Interestingly, adsorption was exothermic for phosphate and endothermic for Cr(VI). The adsorption capacities were reduced by 16% for phosphate and 10% for Cr(VI) after 5 adsorption-desorption cycles, demonstrating the good recyclability of the PF-Aq. It can be concluded that PF-Aq is a relevant adsorbent to uptake phosphate and Cr(VI) from water due to its high adsorption capacity, low cost, recyclability, availability, and fast kinetics. Finally, the excellent adsorption potential results from inserting amino groups in the PF, allowing electrostatic interactions between adsorbent and adsorbate., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Inositol 1,4,5-trisphosphate (IP3) receptor type 1 ( ITPR1 ), 2 ( ITPR2 ), and 3 ( ITPR3 ) encode the IP3 receptor (IP3R), a key player in intracellular calcium release. In four unrelated patients, we report that an identical ITPR3 de novo variant-NM_002224.3:c.7570C>T, p.Arg2524Cys-causes, through a dominant-negative effect, a complex multisystemic disorder with immunodeficiency. This leads to defective calcium homeostasis, mitochondrial malfunction, CD4 + lymphopenia, a quasi-absence of naïve CD4 + and CD8 + cells, an increase in memory cells, and a distinct TCR repertoire. The calcium defect was recapitulated in Jurkat knock-in. Site-directed mutagenesis displayed the exquisite sensitivity of Arg 2524 to any amino acid change. Despite the fact that all patients had severe immunodeficiency, they also displayed variable multisystemic involvements, including ectodermal dysplasia, Charcot-Marie-Tooth disease, short stature, and bone marrow failure. In conclusion, unlike previously reported ITPR1-3 deficiencies leading to narrow, mainly neurological phenotypes, a recurrent dominant ITPR3 variant leads to a multisystemic disease, defining a unique role for IP3R3 in the tetrameric IP3R complex.

Here, we present the case of an otherwise healthy patient, without risk factors, who developed a refractory case of onychomycosis caused by Kloeckera apiculata , an uncommon human pathogen. The diagnosis was ultimately confirmed by fungal nail plate culture, histopathology, and PCR. Whereas prior treatments with topical 5 % tavaborole solution, oral terbinafine, and oral fluconazole were ineffective, complete clinical and mycological cure was achieved with a 3-month course of oral itraconazole., Competing Interests: There are none., (© 2024 The Authors.)

Skin cancer is a widespread type of cancer representing 30% of all cancer types worldwide. Resveratrol (RSV) is an anticancer drug used for skin cancer treatment. Several limitations of RSV such as poor aqueous solubility, first-pass metabolism, and instability limit their topical use. The study aimed to develop and optimize RSV-loaded invasomes for topical administration as well as assess their efficacy in vivo. The optimized RSV-loaded invasomes showed small particle size (208.7 ± 74 nm), PDI (0.3 ± 0.03), high % entrapment efficiency (77.7 ± 6%), and negative zeta potential (-70.4 ± 10.9 mV). They showed an initial burst effect followed by controlled drug release for 24 h. RSV-loaded invasomal gel revealed the highest skin deposition percentage (65%) in ex vivo rat skin, the highest potency (low IC 50 of 6.34 μg/mL), and the highest cellular uptake when tested on squamous cancerous cells (SCCs) when compared to other formulations. The antitumor effect of topical RSV-loaded invasomes was also evaluated in vivo in Ehrlich-induced mice models. The results revealed that RSV-loaded invasomal gel exhibited the smallest tumor volume with no signs of organ toxicity indicating its safety in skin cancer treatment. Upregulation of BAX and Caspase-3 gene levels and downregulation of NF-kB and BCL2 protein levels were demonstrated using RT-PCR and ELISA tests, respectively. Interestingly, the present study is the first to develop RSV-loaded invasomal gel for topical skin cancer treatment. According to our results, invasomes are considered promising lipid-based nanosystems for topical RSV delivery having high skin penetration ability and anticancer effect in the treatment of skin carcinoma., (© 2024. The Author(s).)

Solidification/Stabilization (S/S) of spent radioactive ion exchange resins (IER) is one of many critical problems facing developing nuclear industries all over the world. Immobilization technology using Ordinary Portland Cement (OPC) as an inert matrix, has been widely applied for the solidification/stabilization of spent ion exchange resin. In this study incorporation of simulated IER into cement matrix and characterization of the final solid waste form (FWF) had been searched practically in laboratory scale experiments. Factors that can affect the properties of the FWF including the water/cement (w/c) ratios and the resin concentration were studied systematically. Mechanical integrities, thermal analysis, and mass loss during hardening and curing for 28 days were evaluated for FWF hard blocks. Scanning Electron Microscope (SEM) and X-Ray Diffraction (X-RD) examinations were performed to investigate the internal architecture of the FWF. Moreover, the heat of cement hydration reactions was recorded during the IER solidification process. Based on the experimental results obtained, it is worth to state that according to its acceptable characteristics and advantages of cement as an inert matrix, it can be suggested safely for the immobilization of untreated spent radioactive ion exchange resins., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Isolated optic nerve (ON) relapse is a rare occurrence in lymphoblastic leukemia (LBL). A 10-year-old boy with T-LBL presented 8 months after diagnosis with blurred vision and thickening of right ON on magnetic resonance imaging consistent with relapse. Cerebrospinal fluid and bone marrow were negative for leukemia. He received reinduction chemotherapy (including nelarabine and craniospinal radiation) followed by a myeloablative matched sibling donor bone marrow transplant. He remains in remission 2 years post-transplant with normal vision. We also review the literature for reports of isolated ON relapse in patients with LBL. Our patient's clinical course demonstrates that disease control can be achieved with early detection of ON relapse before disease progression., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Interfollicular Hodgkin lymphoma (IHL) has been rarely reported in the literature and is recognized by the WHO Classification as a morphologic pattern sometimes seen in mixed cellularity classic Hodgkin lymphoma (CHL). The changes may be subtle due to preservation of architecture. We report a case of a 9-year-old male with IHL showing preserved follicular architecture but with the presence of interfollicular infiltrates consisting of eosinophils, plasma cells, and Hodgkin-Reed-Sternberg (HRS) cells. Immunophenotyping confirmed the morphologic suspicion for IHL. A discussion and review of the literature are offered. We conclude that IHL is a variant that requires a high index of suspicion, as it may be easily missed due to the subtle morphologic features and preserved architecture seen in most cases. We further emphasize that unexplained interfollicular infiltrates of eosinophils may be clues that should prompt a search of HRS cells and consideration of immunohistochemical staining if needed., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In this study, we discuss the removal of fluoride from water through column adsorption methods using Al(OH) 3 @AC as a functional granular activated carbon. The height of the bed, fluoride concentration, and flow rate are the experimental factors used to obtain the breakthrough curves. As the flow rate increased, the breakthrough and saturation times decreased. The analysis of simplified column models, such as the Adams-Bohart, Thomas, and Yoon-Nelson models, revealed that the Clark model best described the adsorption process when fitting the experimental data. The obtained breakthrough curves agreed with the corresponding experimental data. The highest capacity for adsorption obtained during the column procedure was found to be 41.84 mg g -1 with a bed height of 3 cm, an initial fluoride concentration of 10 mg L -1 and a flow rate of 7.5 mL min -1 ., Competing Interests: There are no relevant financial or non-financial interests to declare for the authors., (This journal is © The Royal Society of Chemistry.)

Objectives: The current study was conducted to assess the protective mechanisms of n- BuOH fraction from the aerial part of Genista cephontala (BEGC) on APAP-induced liver injury compared to necrostatine-1 (Nec-1)., Materials and Methods: A model of APAP-induced hepatotoxicity was created in male rats by injecting a single dose; 1000 mg/kg APAP, the protective effect was performed with (200 mg/kg; 10 days) BEGC compared to Nec-1, (1.8 mg/kg)., Results: BEGC or NeC-1 pretreatment significantly abolished impaired effects in APAP-rats, by decreasing the generation of TBARS and ROS in mitochondrial and cytosolic fractions and maintaining liver function activities. A marked response was observed in the levels of both GSH and GSH-system enzymes in liver homogenates and mitochondrial fractions to BEGC. BEGC/ Nec-1 successfully regulated the inflammatory mediators (IL-β, TNF-α, HMGB1, and acHMGB1) and MPO levels. During APAP treatment, no caspase-3 or -8 activity was detected, and the level of fk18; M30 was higher than the levels of cck18; M65. Moreover, RIPK3 and MLKL levels were increased in the APAP group. These results suggested that necroptosis predominates during the APAP liver injury model. Interestingly, these necroptotic factors were significantly down-regulated by BEGC treatment. Both biochemical and histopathological findings were consistent with each other., Conclusion: From all these findings, the hepatoprotective effect of BEGC could be due to the abundance of polyphenols identified by LC-MS/MS analysis, as well as the synergistic interactions of all contents., Competing Interests: The authors declare that they have no conflicts of interest.

Despite substantially decreasing the risk of hospitalization and death from COVID-19, COVID-19 booster vaccination rates remain low around the world. A key question for public health agencies is how to increase booster vaccination rates, particularly among high-risk groups. We conducted a large preregistered randomized controlled trial (with 57,893 study subjects) in a county health system in northern California to test the impact of personal reminder messages and small financial incentives of $25 on booster vaccination rates. We found that reminders increased booster vaccination rates within 2 wk by 0.86 percentage points ( P = 0.000) or nearly 33% off the control mean of 2.65%. Monetary incentives had no additional impact on vaccination rates. The results highlight the potential of low-cost targeted messages, but not small financial incentives, to increase booster vaccination rates.

The evolution of low-cost ecotechnologies in water treatment and purification is highly increased. Face to the growing global demand for eco-friendly water treatment materials, the non-valorized herb-based biomass covering a large area could be a promising alternative. Herbs (HB) are currently one of the cheapest biomasses. Therefore, the utilization of HB for environmental applications is relevant. HB was treated and activated in this work to produce an eco-friendly adsorbent for nitrate removal from groundwater. HB was treated with modified carbonization at 220 °C to produce highly reactive biochar (BCH). Ammonium groups (AM) are immobilized covalently over the BCH surface, and then, the resulting materials BCH-AM are fully characterized. Results showed that ammonium is successfully grafted at the BCH surface, producing a highly stable material. Measurements on nitrate ion adsorption revealed that BCH-AM are of great interest as 80% of nitrate ions (NO 3 - ) were removed. Importantly, the eco-friendly BCH-AM demonstrated the ability to easily desorb the nitrate ions using Na 2 CO 3 as a green eluent. Parametric studies confirmed the effectiveness of the prepared adsorbent and approved that the adsorption occurred by electrostatic interactions. To demonstrate the performance of the adsorbent, BCH-AM was evaluated to remove NO 3 - from groundwater upstream in a water treatment plant. This work opens an immense perspective for herb biomass to be the actual challenge to resolve environmental problems., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Acute myeloid leukemia (AML) with megakaryocytic differentiation (AMkL) is a rare subtype of AML more common in children. Recent literature has identified multiple fusions associated with this type of leukemia., Methods: Morphology, cytogenetics, and genomic sequencing were assessed in patients from Children's Oncology Group trials AAML0531 and AAML1031 with central-pathology review confirmed non-Down syndrome AMkL. The 5-year event-free survival (EFS), overall survival (OS), and RR were evaluated in these AMkL subcategories., Results: A total of 107 cases of AMkL (5.5%) were included. Distinct fusions were identified in the majority: RBM15::MRTFA (20%), CBFA2T3::GLIS2 (16%), NUP98 (10%), KMT2A (7%), TEC::MLLT10 (2%), MECOM (1%), and FUS::ERG (1%); many of the remaining cases were classified as AMkL with (other) myelodysplasia-related changes (MRC). Very few cases had AML-associated somatic mutations. Cases with CBFA2T3::GLIS2 were enriched in trisomy 3 (p = .015) and the RAM phenotype, with associated high CD56 expression (p < .001). Cases with NUP98 fusions were enriched in trisomy 6 (p < .001), monosomy 13/del(13q) (p < .001), trisomy 21 (p = .026), and/or complex karyotypes (p = .026). While different 5-year EFS and OS were observed in AMkL in each trial, in general, those with CBFA2T3::GLIS2 or KMT2A rearrangements had worse outcomes compared to other AMkL, while those with RBM15::MRTFA or classified as AMkl-MRC fared better. AMkL with NUP98 fusions also had poor outcomes in the AAML1031 trial., Conclusion: Given the differences in outcomes, AMkL classification by fusions, cytogenetics, and morphology may be warranted to help in risk stratification and therapeutic options., (© 2023 Wiley Periodicals LLC.)

Phenolic compounds are frequently occurring in wastewaters from various industrial processes at high concentrations, imposing prominent risk to aquatic biosphere and human health. Bioremediation has been proven to be an effective approach to remove these compounds, and hunting for functional organisms is still of primary importance to develop efficient processes. In this study, we report several newly isolated bacillus strains with superior performances in metabolizing phenols, one of which showed paramount efficiencies to metabolize phenol at concentrations up to 1200 mg L -1 and could simultaneously degrade a wide range of other phenolic compounds. The genes encoding for phenol hydroxylase (PH) and catechol-2,3-dioxygenase (C23O) have been detected and characterized, evidencing that phenol degradation occurs via the meta pathway. The GC level of the PH gene was found to be much higher than that of genes from other Bacilli but was quite close to that of the genes from Rhodococcus, and the induction of both enzymes by phenols was confirmed by RT-PCR experiments. We intend to believe this novel strain might be promising to serve as preferred organisms for developing more robust and efficient bioremediation processes of degrading phenolic compounds due to its validated performance., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Epstein-Barr virus (EBV) infection may present with fulminant constitutional symptoms, cytopenia(s), and systemic lymphadenopathy, raising clinical suspicion for lymphoma and prompting lymph node and bone marrow biopsies. At the microscopic level, the histopathologic findings in cases of acute EBV lymphadenitis may mimic certain lymphoid neoplasms, creating a range of differential diagnoses and diagnostic pitfalls.We present a case of fulminant EBV infection in an adolescent whose clinical and radiographic findings led to lymph node and bone marrow biopsies to rule out lymphoma. One week after being diagnosed with acute EBV infection (infectious mononucleosis), a 17-year-old Caucasian male presented with worsening symptoms including persistent fever, progressive, painful lymphadenopathy, and splenomegaly. A peripheral blood smear showed lymphocytosis with many reactive lymphocytes, anemia, and thrombocytopenia. Laboratory studies showed elevated ferritin, triglycerides, and soluble IL-2/CD25. A cervical lymph node biopsy demonstrated an EBV-positive, reactive B-immunoblast proliferation with large atypical lymphoid cells mimicking Reed-Sternberg cells of Hodgkin lymphoma, in addition to patchy vasculitis, coagulative necrosis, and prominent hemophagocytic activity. Bilateral bone marrow biopsies showed a hypercellular marrow with patchy infiltrates of similar EBV-positive, large atypical lymphoid cells, as well as prominent hemophagocytic activity. The diagnosis of acute EBV associated lymphoproliferation with concurrent hemophagocytic lymphohistiocytosis (HLH) was rendered.Recognition of common and uncommon clinical presentations of acute EBV infection is essential, particularly when histopathologic findings raise suspicion for a possible hematolymphoid neoplasm. Both the lymph node architectural and viral cytopathic changes observed in EBV lymphadenitis exhibit significant morphologic overlap with classic Hodgkin lymphoma (cHL) and several other lymphomas, including anaplastic large cell lymphoma, diffuse large B cell lymphoma, and angioimmunoblastic T cell lymphoma. Recognition of immunohistochemical staining patterns in EBV lymphadenitis is critical to avoid misdiagnosis. Conversely, bona fide lymphoma, particularly cHL, can masquerade as EBV infection. We provide a concise discussion and tables of the histopathologic differential diagnosis of EBV lymphadenitis, including cHL and other lymphomas. Pathologists should include acute EBV infection within the differential diagnosis when confronted with clinical and pathologic findings concerning for lymphoma, particularly in adolescents and young adults., (© 2023. The Author(s).)

Objective: This study aims to explore the user archetypes of health apps based on average usage and psychometrics., Methods: The study utilized a dataset collected through a dedicated smartphone application and contained usage data, i.e. the timestamps of each app session from October 2020 to April 2021. The dataset had 129 participants for mental health apps usage and 224 participants for physical health apps usage. Average daily launches, extraversion, neuroticism, and satisfaction with life were the determinants of the mental health apps clusters, whereas average daily launches, conscientiousness, neuroticism, and satisfaction with life were for physical health apps., Results: Two clusters of mental health apps users were identified using k-prototypes clustering: help-seeking and maintenance users and three clusters of physical health apps users were identified: happy conscious occasional , happy neurotic occasional , and unhappy neurotic frequent users., Conclusion: The findings from this study helped to understand the users of health apps based on the frequency of usage, personality, and satisfaction with life. Further, with these findings, apps can be tailored to optimize user experience and satisfaction which may help to increase user retention. Policymakers may also benefit from these findings since understanding the populations' needs may help to better invest in effective health technology., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Qatar is a peninsular country with predominantly hot and humid weather, with 88% of the total population being immigrants. As such, it leaves the country liable to the introduction and dissemination of vector-borne diseases, in part due to the presence of native arthropod vectors. Qatar's weather is expected to become warmer with the changing climatic conditions across the globe. Environmental factors such as humidity and temperature contribute to the breeding and distribution of different types of mosquito species in a given region. If proper and timely precautions are not taken, a high rate of particular mosquito species can result in the transmission of various vector-borne diseases. In this study, we analyzed the environmental impact on the probability of occurrence of different mosquito species collected from several different sites in Qatar. The Naive Bayes model was used to calculate the posterior probability for various mosquito species. Further, the resulting Naive Bayes predictions were used to define the favorable environmental circumstances for identified mosquito species. The findings of this study will help in the planning and implementation of an active surveillance system and preventive measures to curb the spread of mosquitoes in Qatar., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Tahir, Bansal, Rehman, Ajjur, Skariah, Belhaouari, Al-Romaihi, Al-Thani, Farag, Sultan and Al-Ghamdi.)

Objectives: To assess differences in radiation exposure between transradial access (TRA) and transfemoral access (TFA) for coronary procedures., Background: TRA is associated with increased radiation exposure as compared to TFA. We compared radiation exposure between the two access sites., Methods: Databases were searched from June 2014 to August 2021 for randomized controlled trials (RCTs) reporting coprimary outcomes of fluoroscopy time (FT) and/or dose area product (DAP) comparing TRA with TFA. Meta-regression was performed to assess the behavior of weighted mean difference (WMD) in FT from 1995 to 2021. Observational study data was used for corroborative evidence., Results: Data from 8 RCTs (11,611 patients) showed the WMD of FT was 0.62 min (37 s) (95% confidence interval [CI]: [0.08-1.17], p = 0.023) in favor of TFA, WMD in DAP (9169 patients) was 1.94 Gy.cm 2 (95% CI: [-2.1 to 5.9], p = 0.35) showing no significant difference. Pooled data from OBS and RCTs (83,990 patients) showed a similar trend. Studies from outside US between 1995 and 2021 showed WMD of FT between TRA and TFA of 0.88 min (52 s) (95% CI: [0.67-1.09], p = 0.005) versus 2.1 min (126 s) (95% CI: [1.38-2.8], p = 0.005) for US in favor of TFA. Meta-regression showed a declining WMD of FT between TRA and TFA from 1.6 min (96 s) in 1996 to 0.5 min (30 s) in 2020 with the lower limit of CI crossing the zero line in 2019., Conclusion: Radiation exposure between TRA and TFA continues to decrease overtime and is becoming clinically nonsignificant., (© 2022 Wiley Periodicals LLC.)

Vitamin D is a pleiotropic hormone, widely controversial for its role in the development of chronic diseases and cancers, including haematological malignancies, and also for its impact on overall survival. Observational and interventional studies are being conducted on hypovitaminosis D and haematological malignancies and their subtypes in order to improve the therapeutic management of patients. We carried out a prospective observational study over three years on a population of 251 patients followed up for newly diagnosed haematological malignancies to investigate the impact of vitamin D deficiency on this category of patients. Our population was dominated by the lymphoproliferative syndrome and included 125 patients (49.8%). Anthropometric data showed a significant difference in body mass index between the sexes with a p value of 0.001. Vitamin D levels at diagnosis were inadequate in more than half the patients (56%). This hypovitaminosis was linked to the female sex ( p  = 0.006), obesity ( p  = 0.031) and the digestive involvement of the lymphoma ( p  = 0.03). There was also a relationship between vitamin D deficiency and hypoalbuminemia ( p  = 0.02). This relationship was confirmed in multivariate analysis, with hypoalbuminemia being a factor associated with the deficiency ( p  = 0.022, OR = 0.95, IC95% 0.91-0.93). However, we did not find any impact on overall survival.

Background: Emerging evidence from randomized clinical trials (RCTs) comparing distal radial access (DRA) with conventional radial access (RA) is available., Objectives: The aim of this study was to provide a quantitative appraisal of the effects of DRA) vs conventional RA for coronary angiography with or without intervention., Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for RCT comparing DRA vs conventional RA for coronary angiography and/or intervention. Data were pooled by meta-analysis using a random-effects model. The primary endpoint was radial artery occlusion (RAO) at the longest available follow-up., Results: Fourteen studies enrolling 6,208 participants were included. Compared with conventional RA, DRA was associated with a significant lower risk of RAO, either detected at latest follow-up (risk ratio [RR]: 0.36; 95% CI: 0.23-0.56; P < 0.001; number needed to treat [NNT] = 30) or in-hospital (RR: 0.32; 95% CI: 0.19-0.53; P < 0.001; NNT = 28), as well as EASY (Early Discharge After Transradial Stenting of Coronary Arteries) ≥II hematoma (RR: 0.51; 95% CI: 0.27-0.96; P = 0.04; NNT = 107). By contrast, DRA was associated with a higher risk of access site crossover (RR: 3.08; 95% CI: 1.88-5.06; P < 0.001; NNT = 12), a longer time for radial puncture (standardized mean difference [SMD]: 3.56; 95% CI: 0.96-6.16; P < 0.001), a longer time for sheath insertion (SMD: 0.37; 95% CI: 0.16-0.58; P < 0.001), and a higher number of puncture attempts (SMD: 0.59, 95% CI: 0.48-0.69; P < 0.001)., Conclusions: Compared with conventional RA, DRA is associated with lower risks of RAO and EASY ≥II hematoma but requires longer time for radial artery cannulation and sheath insertion, more puncture attempts, and a higher access site crossover., Competing Interests: Funding Support and Author Disclosures Dr Lefèvre has received honoraria from Abbott, Boston, and Terumo. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2022 American College of Cardiology Foundation. All rights reserved.)

Background: Robotic percutaneous coronary intervention (R-PCI) has been shown to provide benefits to operators and patients when compared with traditional percutaneous coronary intervention. Despite being available for 16 years in the United States, utilization of R-PCI remains low. This may be because of an expected learning curve with this technology. We sought to describe the characteristics and magnitude of the learning curve with R-PCI., Methods: Consecutive patients undergoing R-PCI (Corpath GRX-2) at a tertiary care center by a single operator were studied prospectively. Demographic, angiographic, and procedural variables were collected. The primary study endpoints included fluoroscopy time, procedure time, and contrast volume. The distributions of each of these variables were plotted against the case numbers in chronological sequence, and the best curve fits were identified. Using the best model, the slope of the relationships was analyzed. Flattening of the slope of these plots were considered suggestive of a learning effect., Results: A total of 546 R-PCI and 1654 traditional percutaneous coronary intervention procedures were studied; 22 crossovers to traditional percutaneous coronary intervention occurred. Most of the crossovers occurred in the first quartile of procedures; no crossovers occurred in the latter half of the cohort. Procedure time decreased as the procedure number increased, with the slope flattening at procedure number 50. Contrast volume decreased as experience increased, with a slope flattening at procedure number 30. Both parameters continued to decrease as experience increased. Fluoroscopy time demonstrated a flattening slope after procedure number 15. This likely is driven by the lower complexity by Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score remained stable over the procedure sequence, with no significant complexity change over the study period., Conclusion: The "learning effect" of R-PCI is observed with steep improvement in study metrics up to 50 procedures and a continuing improvement of lesser magnitude afterward.

Despite rapid initial uptake, COVID-19 vaccinations in the United States stalled within a few months of widespread rollout in 2021. In response, many state and local governments, employers and health systems used public health messaging, financial incentives and creative scheduling tools to increase vaccine uptake. Although these approaches drew on evidence from influenza and other vaccination efforts, they were largely untested in the context of SARS-CoV-2. In mid-2021, months after vaccines were widely available, we evaluated vaccination intentions and vaccine uptake using a randomized control trial. To do this, we recruited unvaccinated members of a Medicaid managed care plan in California (n = 2,701) and randomly assigned them to different public health messages, $10 or $50 financial incentives for vaccination, a simple vaccination appointment scheduler, or control. While messages increased vaccination intentions, none of the interventions increased vaccination rates. Estimates for financial incentives rule out even relatively small increases in vaccination rates. Small financial incentives and other behavioral nudges do not meaningfully increase COVID-19 vaccination rates amongst the vaccine hesitant., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Desmoplastic small round cell tumor (DSRCT) is an aggressive pediatric round cell sarcoma containing a characteristic EWSR1-WT1 gene fusion. In the absence of genetic data, distinguishing DSRCT from other small round cell tumors of childhood can be problematic due to overlapping histologic and immunohistochemical features. We studied the utility of immunohistochemistry with antibodies targeting both the amino-terminal and carboxy-terminal regions of the Wilms tumor-1 (WT1) protein in differentiating these groups of tumors. The study cohort included 33 cases of genetically confirmed pediatric round cell tumors (10 DSRCTs, 12 Wilms tumors, 10 Ewing sarcomas, and 1 CIC -rearranged sarcoma). Immunoreactivities and immunolocalization of both the WT1 amino-terminus and carboxy-terminus were scored and documented. All DSRCTs displayed selective reactivity for only the WT1 carboxy-terminus (10/10), while dual immunoreactivity for both the WT1 carboxy-terminus (12/12) and amino-terminus antibodies (12/12) were characteristic of Wilms tumors. CIC -rearranged sarcoma showed variable WT1 nuclear immunopositivity (1/1, 1/1) and Ewing sarcomas were consistently WT1-negative for both the WT1 amino-terminus (0/10) and carboxy-terminus (0/10). Dual WT1 amino-terminus and carboxy-terminus immunohistochemistry remains a helpful diagnostic tool in discriminating intraabdominal small round cell tumors, which serves as an adjunct to the genetic information in preventing misdiagnosis.

Purpose of Review: Robotics has been used in multiple areas of procedural medical intervention. Robotic percutaneous coronary intervention (PCI) has been available since 2004. Its adoption has been slow with initial application in simple cases., Recent Findings: With increasing adoption, robotic PCI has been applied to a broader variety of coronary substrates with demonstration of safety and efficacy. Improvements in the robotic console with future generation devices should add to the utility of this platform. Robotic PCI advances the innovations in endovascular space into a different dimension, removing the dependence of the procedure on patient-operator ergonomics and likely operator skill., (© 2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

The triggering effect of herpes simplex virus infection on the development of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is now well established. However, there are very few reports that has linked a varicella zoster virus (VZV) reactivation with anti-NMDAR encephalitis. In this report, we describe a case of a 57-year-old man presented with atypical clinical presentation of anti-NMDAR encephalitis with gait ataxia, complete ophtalmoplegia, and abolished reflexes followed by drowsiness and confusion. Initial diagnosis of Bickerstaff's brainstem encephalitis was suspected. Few days later, the patient developed herpes zoster in a localized right T1-T2 dermatome. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) for VZV was negative. CSF anti-NMDA antibodies were proved positive. A diagnosis of anti-NMDAR encephalitis with concomitant VZV skin reactivation was retained. Favorable outcome with combined antiviral treatment and immunomodulatory therapy was observed. Concomitant VZV reactivation with autoimmune encephalitis is possible. Prognosis and therapeutic options in this rare condition remain to be clarified., (© 2022. Journal of NeuroVirology, Inc.)

Introduction: Kidney transplantation (KT) has been established as an efficient treatment of end stage renal disease (ESRD) with the advantage of allowing the patient to live a nearly healthy life. We aimed to determine whether pre-transplant body mass index (BMI) affects renal allograft function and survival in pediatric KT recipients., Methods: cross sectional cohort study included 50 post KT recipients (more than 3 years) with an age range of 10 to 15 years, regularly following at the Kidney Transplantation Outpatient Clinic, Cairo University Children's Hospital, were subjected to a detailed history and physical examination, laboratory investigation in the form of fasting blood glucose (FBG),oral glucose tolerance test (OGTT), lipid profile, hemoglobin A1c (HbA1c) and microalbuminuria., Results: Pre- post- kidney transplant BMI has significant positive correlation with graft rejection episodes, HbA1c, FBG, BMI post-KT, total cholesterol, triglycerides, and low-density lipoprotein (p < 0.01). There was a statistically significant negative correlation between the mean difference of BMI (post - pre) and graft survival in years (p = 0.036). Obese patients displayed lower survival compared with non-obese subjects at 5 years, but this was statistically not significant (p-value = 0.165)., Conclusion: obesity is an independent risk factor for graft loss and patient death in kidney transplantation. Careful patient selection with pre-transplantation weight reduction is mandatory to reduce the rate of early post-transplantation complications and to improve long-term outcomes., (© 2022. The Author(s).)

Recently, microalgal biotechnology has received increasing interests in producing valuable, sustainable and environmentally friendly bioproducts. The development of economically viable production processes entails resolving certain limitations of microalgal biotechnology, and fast evolving genetic engineering technologies have emerged as new tools to overcome these limitations. This review provides a synopsis of recent progress, current trends and emerging approaches of genetic engineering of microalgae for commercial applications, including production of pharmaceutical protein, lipid, carotenoids and biohydrogen, etc. Photochemistry improvement in microalgae and CO 2 sequestration by microalgae via genetic engineering were also discussed since these subjects are closely entangled with commercial production of the above mentioned products. Although genetic engineering of microalgae is proved to be very effective in boosting performance of production in laboratory conditions, only limited success was achieved to be applicable to industry so far. With genetic engineering technologies advancing rapidly and intensive investigations going on, more bioproducts are expected to be produced by genetically modified microalgae and even much more to be prospected.

In the context of an evolving understanding of early T-cell precursor (ETP) lymphoma and leukemia, we present a case of concurrent T-cell lymphoblastic lymphoma and ETP lymphoma in an adolescent female. To our knowledge, this represents the first reported case of both lymphoblastic lymphoma and ETP lymphoma as distinct and conjoined components of the same neoplasm. As an exception to current literature, our patient had a strictly lymphomatous ETP component with no leukemic manifestation. Her ETP component remained viable following induction, supporting ETP resistance to chemotherapy. The patient remains in remission 4 years postallogeneic matched sibling donor bone marrow transplant., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

In the last decade, adsorption has exhibited promising and effective outcomes as a treatment technique for wastewater contaminated with many types of pollutants such as heavy metals, dyes, pharmaceuticals, and bacteria. To achieve such effectiveness, a number of potential adsorbents have been synthesized and applied for water remediation and antimicrobial activities. Among these inorganic adsorbents (INAD), activated carbon, silica, metal oxide, metal nanoparticles, metal-organic fibers, and graphene oxide have been evaluated. In recent years, significant efforts have been made in the development of highly efficient adsorbent materials for gas and liquid phases. For gas capture and water decontamination, the most popular and known functionalization strategy is the chemical grafting of amine, due to its low cost, ecofriendliness, and effectiveness. In this context, various amines such as 3-aminopropyltriethoxysilane (APTES), diethanolamine (DEA), dendrimer-based polyamidoamine (PAMAM), branched polyethyleneimine (PEI), and others are employed for the surface modification of INADs to constitute a large panel of resource and low-cost materials usable as an alternative to conventional treatments aimed at removing organic and inorganic pollutants and pathogenic bacteria. Amine-grafted INAD has long been considered as a promising approach for the adsorption of both inorganic and organic pollutants. The goal of this review is to provide an overview of surface modifications through amine grafting and their adsorption behavior under diverse conditions. Amine grafting strategies are investigated in terms of the effects of the solvent, temperature, and the concentration precursor. The literature survey presented in this work provides evidence of the significant potential of amine-grafted INAD to remove not only various contaminants separately from polluted water, but also to remove pollutant mixtures and bacteria.

Developing green and functional adsorbents for the removal of inorganic pollutants from industrial wastewater is still a great challenge. Activated carbons (ACs) are promising eco-friendly materials for adsorption applications. This study reports on the preparation and functionalization of AC and its application for fluoride removal from water. Activated carbon was prepared from date stems, and the material was employed as a support for different modifications such as incorporation of Al(OH) 3 , in situ dispersion of aluminum particles (Al 0 ) and grafting of 3-(aminopropyl)triethoxysilane (APTES). The resulting functional adsorbents were fully characterized by Fourier transform infrared spectroscopy, scanning electronic microscopy, energy dispersive X-ray fluorescence, X-ray diffraction, differential scanning calorimetry and zeta potential analysis. The results evidenced successful surface modifications. All adsorbents had affinity for the removal of fluoride ions (F - ). The highest F - removal rate was up to 20 mg g -1 for AC-Al(OH) 3 . Removal of fluoride ions obeyed Langmuir isotherms and a second-order kinetic model, and reached 99% uptake. The AC-Al(OH) 3 adsorbent was successfully used to treat a groundwater solution contaminated by fluoride ions. These results open an interesting avenue for developing eco-friendly functionalized AC for adsorption applications., Competing Interests: The authors declare no conflict of interest., (This journal is © The Royal Society of Chemistry.)

Introduction: Many trusted organizations recommend a particular set of gear for hikers. Termed the "10 essentials," the importance of these items to wilderness preparedness has not been critically evaluated. We sought to better understand the value of these items in day hiker preparedness by assessing the association between carried items, the occurrence of adverse events, and satisfaction., Methods: A cross-sectional survey study was conducted at Mount Monadnock (NH) over 4 non-consecutive days. Adults finishing a day hike were invited to participate. The survey assessed items carried, adverse events, satisfaction, and whether hikers felt prepared for the adverse events that occurred. The primary outcome was the occurrence of an adverse event., Results: A total sample of 961 hikers reported 1686 adverse events. Hikers felt prepared for 89% of the events experienced. The most common adverse events reported were thirst (62%), hunger (50%), feeling cold (18%), and needing rain gear (11%). Medical events such as sprains and lacerations made up 18% of all adverse events. Carrying more items was associated with an increased likelihood of reporting an adverse event and a decreased likelihood of adverse events that the hiker was not prepared for, without a change in satisfaction rates., Conclusions: Carrying more items did not translate into improved satisfaction for day hikers, but was associated with fewer events for which the hiker was unprepared. Other than adverse events related to hunger, thirst, weather, and minor medical events, adverse events were unlikely during this day hike. Nutrition, hydration, and insulation were the items reported as most often needed, followed by a kit to treat minor medical events, while the remaining 6 items were infrequently used., Competing Interests: Declaration of Competing Interest None., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Introduction: Socioeconomic differences may confound racial and ethnic differences in SARS-CoV-2 testing and COVID-19 outcomes., Methods: A retrospective cohort study was conducted of racial/ethnic differences in SARS-CoV-2 testing and positive tests and COVID-19 hospitalizations and deaths among adults impaneled at a Northern California regional medical center and enrolled in the county Medicaid managed care plan (N=84,346) as of March 1, 2020. Logistic regressions adjusted for demographics, comorbidities, and neighborhood characteristics., Results: Nearly 30% of enrollees were ever tested for SARS-CoV-2, and 4% tested positive. A total of 19.7 per 10,000 were hospitalized for and 9.4 per 10,000 died of COVID-19. Those identified as Asian, Black, or of other/unknown race had lower testing rates, whereas those identified as Latino had higher testing rates than Whites. Enrollees of Asian or other/unknown race had slightly higher odds of a positive test, and Latinos had much higher odds of a positive test (OR=3.77, 95% CI=3.41, 4.17) than Whites. The odds of hospitalization (OR=2.85, 95% CI=1.85, 4.40) and death (OR=4.75, 95% CI=2.23, 10.12) were higher for Latino than for White patients, even after adjusting for demographics, comorbidities, and neighborhood characteristics., Conclusions: In a Medicaid managed care population, where socioeconomic differences may be reduced, the odds of a positive SARS-CoV-2 test, COVID-19 hospitalization, and COVID-19 death were higher for Latino but not Black patients than for White patients. Racial/ethnic disparities depend on local context. The substantially higher risk facing Latinos should be a key consideration in California's strategies to mitigate disease transmission and harm., (Copyright © 2021 American Journal of Preventive Medicine. All rights reserved.)

Background: Association of history of coronary artery bypass graft surgery (CABG) with clinical outcomes in patients presenting with ST-segment elevation myocardial infarction (STEMI) is unclear from current data., Methods: Using Nationwide Inpatient Sample (NIS) data from 2003 to 2014, adult patients hospitalized with principal diagnosis of STEMI were extracted. The cohort was divided into patients with a history of CABG and those without a history of CABG. The primary outcome measure was in-hospital mortality (IHM)., Results: 2,710,375 STEMI patients were included in final analysis of which 110,066 had history of CABG. Patients with history of CABG had higher unadjusted (12.2% vs. 8.8%, P  < 0.001) and adjusted (odds ratio [OR]1.16; 95% confidence interval [CI] 1.14 to1.19, P  < 0.001) IHM compared to those without previous CABG. Compared to a trend of decreasing IHM in STEMI patients without previous CABG, a trend of increasing IHM was observed over the study period in those with a history of previous CABG. Although patients with previous CABG when treated with primary PCI (PPCI) had a higher unadjusted IHM compared to those without previous CABG, (4.8% vs 4.3%, P  < 0.001), after adjusting for comorbidities and in-hospital complications no significant increase in IHM was observed in patients with previous CABG treated with PPCI., Conclusion: STEMI patients with previous CABG have a significantly higher IHM compared to those without previous CABG. PPCI improves IHM with no independent mortality disadvantage attributable to previous CABG., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Published by Elsevier B.V.)

The dynamic evolution of chromatin state patterns during metastasis, their relationship with bona fide genetic drivers, and their therapeutic vulnerabilities are not completely understood. Combinatorial chromatin state profiling of 46 melanoma samples reveals an association of NRAS mutants with bivalent histone H3 lysine 27 trimethylation (H3K27me3) and Polycomb repressive complex 2. Reprogramming of bivalent domains during metastasis occurs on master transcription factors of a mesenchymal phenotype, including ZEB1, TWIST1, and CDH1. Resolution of bivalency using pharmacological inhibition of EZH2 decreases invasive capacity of melanoma cells and markedly reduces tumor burden in vivo, specifically in NRAS mutants. Coincident with bivalent reprogramming, the increased expression of pro-metastatic and melanocyte-specific cell-identity genes is associated with exceptionally wide H3K4me3 domains, suggesting a role for this epigenetic element. Overall, we demonstrate that reprogramming of bivalent and broad domains represents key epigenetic alterations in metastatic melanoma and that EZH2 plus MEK inhibition may provide a promising therapeutic strategy for NRAS mutant melanoma patients., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Duplex Doppler ultrasonography (USG) remains the gold standard for evaluation of radial artery occlusion (RAO) after transradial access (TRA). The diagnostic accuracy of digital plethysmography, which is cheaper and widely available, for evaluation of RAO after TRA is not known., Methods: Patients undergoing TRA were prospectively studied. After undergoing TRA for diagnostic or interventional coronary procedure and obtaining radial artery hemostasis, the radial artery was evaluated for presence or absence of RAO using digital plethysmography of the ipsilateral index finger and the thumb using modified reverse Barbeau's test (MRBT) and USG. Sensitivity, specificity, predictive values, likelihood ratios and other metrics of evaluation of diagnostic performance of MRBT in reference to USG, the current gold standard, were evaluated., Results: 503 patients who underwent TRA for coronary procedures were studied. MRBT demonstrated a sensitivity = 96.2%, specificity = 99.8%, positive predictive value = 96.1, negative predictive value = 99.8, likelihood ratio (+) = 481, likelihood ratio (-) = 0.38, diagnostic accuracy = 99.6, diagnostic odds ratio = 11,904, Youden's index = 0.96, receiver operator characteristic derived c-statistic = 0.98 and Cohen's k = 0.98 when compared to USG. MRBT performed using the ipsilateral index finger and the thumb was no different. Agreement between absence of ipsilateral radial artery pulsation and RAO was weak (Cohen's k = 0.69)., Conclusions: MRBT using ipsilateral digital plethysmography performs comparably to USG for assessment of presence of RAO after TRA. There is no significant difference between MRBT performed using the ipsilateral thumb or the index finger., (Published by Elsevier Inc.)

Objectives: The study evaluated the association between distance from radiation source and radiation exposure., Background: Radiation exposure during medical procedures is associated with increased risk of cancer and other adverse effects., Methods: An American National Standards Institute phantom was used to study the relationship between measured entrance surface exposure (MESE) and distance from the X-ray source in postero-anterior, left anterior oblique, and right anterior oblique projections. Three distance settings for table height were evaluated with "low" defined as 52 cm, "mid" 66 cm, and "high" 80 cm from the focal point of the X-ray source. Air-kerma and dose-area product measurements were recorded. Operator exposure with each of these conditions was measured, in a short operator (150 cm) as well as in a tall operator (190 cm)., Results: Aggregate results for the three projections were as follows. MESE (μGy/frame) significantly decreased as table-height increases (median, interquartile range, p-value) (low table-height 192.5 [122.4-201.2], mid table-height 105.8 [82.7-115.8], and high table-height 71.7 [58.4-75], p < .0005). The operator exposure (μGy/frame), significantly increased as the table-height increased (low table-height 0.0943 [0.0598-0.1157], medium table-height 0.1128 [0.0919-0.1397], and high table-height 0.158 [0.1339-0.2165], p < .0005). A shorter operator received higher radiation exposure compared to a taller operator (short operator 0.1405 [0.1155-0.1758] and tall operator 0.0995 [0.0798-0.1212], p < .0005)., Conclusions: Increasing table-height is associated with a significant decrease in MESE. Operator radiation exposure increases with increasing table-height and shorter operators receive greater radiation exposure compared to taller operators., (© 2020 Wiley Periodicals LLC.)

Background: Lack of health insurance is associated with adverse clinical outcomes; however, the association between health insurance status and in-hospital outcomes after out-of-hospital ventricular fibrillation (OHVFA) arrest is unclear., Hypothesis: Lack of health insurance is associated with worse in-hospital outcomes after out-of-hospital ventricular fibrillation arrest., Methods: From January 2003 to December 2014, hospitalizations with a primary diagnosis of OHVFA in patients ≥18 years of age were extracted from the Nationwide Inpatient Sample. Patients were categorized into insured and uninsured groups based on their documented health insurance status. Study outcome measures were in-hospital mortality, utilization of implantable cardioverter defibrillator (ICD), and cost of hospitalization. Inverse probability weighting adjusted binary logistic regression was performed to identify independent predictors of in-hospital mortality and ICD utilization and linear regression was performed to identify independent predictors of cost of hospitalization., Results: Of 188 946 patients included in the final analyses, 178 005 (94.2%) patients were insured and 10 941 (5.8%) patients were uninsured. Unadjusted in-hospital mortality was higher (61.7% vs. 54.7%, p < .001) and ICD utilization was lower (15.3% vs. 18.3%, p < .001) in the uninsured patients. Lack of health insurance was independently associated with higher in-hospital mortality (O.R = 1.53, 95% C.I. [1.46-1.61]; p < .001) and lower utilization of ICD (O.R = 0.84, 95% C.I [0.79-0.90], p < .001). Cost of hospitalization was significantly higher in uninsured patients (median [interquartile range], p-value) ($) (39 650 [18 034-93 399] vs. 35 965 [14 568.50-96 163], p < .001)., Conclusion: Lack of health insurance is associated with higher in-hospital mortality, lower utilization of ICD and higher cost of hospitalization after OHVFA., (© 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.)

Background and Aims: Malnutrition is highly prevalent in the hemodialysis population. Nutritional screening is important to identify patients at risk of malnutrition. This study aimed to investigate the concurrent validity of BMI cut-offs (BMI < 23 kg/m 2 and BMI < 18.5 kg/m 2 ) and DMS, as simple nutritional screening tools, compared to PG-SGA, as the reference standard, in detecting the risk of malnutrition in hemodialysis patients., Design: A Single-centered cross-sectional study design., Methods: A total of 98 patients on maintenance hemodialysis, who were at least 18 years old (mean age: 51.33 ± 14.12) and subjected to hemodialysis for at least 3 months, were screened. Concurrent validity was assessed using receiver operating characteristic (ROC) curve analysis as well as sensitivity, specificity, accuracy, PPV, NPV, LR + and LR - , against diagnosed malnutrition., Results: The patients considered malnourished were 71.4% (n = 70), with the majority being females (60%), and possessed a BMI distribution of 28.2 ± 6.3 kg/m 2 . DMS (score ≥ 14) agreed with diagnosed malnutrition (κ = 0.450 (95% CI 0.26-0.64) <0.0005). Furthermore, DMS (score ≥ 14) showed a sensitivity and a specificity of 84.3% and 60.7%, respectively. However, BMI cut-offs (<23 kg/m 2 or < 18.5 kg/m 2 ) did not show any agreement with diagnosed malnutrition., Conclusion: DMS is a useful screening tool for detecting the risk of malnutrition in hemodialysis patients. On the contrary, BMI <23 kg/m 2 and BMI <18.5 kg/m 2 were not valid tools for identifying the risk of malnutrition in hemodialysis patients., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)