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The objective of this study is to explore the possibility of treating APL patients fully as outpatients. A total of 21 consecutive APL patients were identified over 30 years in the Centro de Hematología y Medicina Interna de Puebla, at Clínica Ruiz, but only 17 were studied, treated as outpatients, and followed for at least 1 month; they were observed for median of 95 months, their median age was 27 years and all were treated with ATRA, prednisone, and adriamycin as outpatients. Treatment was completed on an outpatient basis in 15/17 cases. Molecular remission was achieved in 16/17 patients. The median follow-up was 95 months (IQR 19 - 360). The median OS and LFS were not reached, and the 12-month LFS was 94%. We have confirmed that APL can be treated entirely on an outpatient basis: this observation is of utmost relevance in a resource-limited setting, such as those prevailing in low- and middle-income countries.

Abstract Background Attractive targeted sugar bait (ATSB) stations are a novel tool with potential to complement current approaches to malaria vector control. To assess the public health value of ATSB station deployment in areas of high coverage with standard vector control, a two-arm cluster-randomized controlled trial (cRCT) of Sarabi ATSB® stations (Westham Ltd., Hod-Hasharon, Israel) was conducted in Western Province, Zambia, a high-burden location were Anopheles funestus is the dominant vector. The trial included 70 clusters and was designed to measure the effect of ATSBs on case incidence and infection prevalence over two 7-month deployments. Reported here are results of the vector surveillance component of the study, conducted in a subset of 20 clusters and designed to provide entomological context to guide overall interpretation of trial findings. Methods Each month, 200 paired indoor-outdoor human landing catch (HLC) and 200 paired light trap (LT) collections were conducted to monitor An. funestus parity, abundance, biting rates, sporozoite prevalence, and entomological inoculation rates (EIR). Results During the study 20,337 female An. funestus were collected, 11,229 from control and 9,108 from intervention clusters. A subset of 3,131 HLC specimens were assessed for parity: The mean non-parous proportion was 23.0% (95% CI 18.2–28.7%, total n = 1477) in the control and 21.2% (95% CI 18.8–23.9%, total n = 1654) in the intervention arm, an OR = 1.05 (95% CI 0.82–1.34; p = 0.688). A non-significant reduction in LT abundance (RR = 0.65 [95% CI 0.30–1.40, p = 0.267]) was associated with ATSB deployment. HLC rates were highly variable, but model results indicate a similar non-significant trend with a RR = 0.68 (95%CI 0.22–2.00; p = 0.479). There were no effects on sporozoite prevalence or EIR. Conclusions Anopheles funestus parity did not differ across study arms, but ATSB deployment was associated with a non-significant 35% reduction in vector LT density, results that are consistent with the epidemiological impact reported elsewhere. Additional research is needed to better understand how to maximize the potential impact of ATSB approaches in Zambia and other contexts. Trial registration number: This trial was registered with Clinicaltrials.gov (NCT04800055, 16 March 2021).

Invasive lobular breast cancer (ILC) is characterized by a relatively high risk for late recurrence and a unique metastatic pattern with an increased risk for metastasis to gynecologic organs and peritoneum. We present a unique case of recurrent ILC with metastasis to the abdominal peritoneum as well as the uterine myometrium and cervix. Treatment was complicated by the discovery of concomitant uterine carcinosarcoma. This patient was effectively treated with a combination of hormonal therapy for her metastatic ILC and a combination of chemotherapy and immunotherapy for uterine carcinosarcoma. Molecular evaluation revealed a characteristic CDH1 mutation within the ILC and a PI3KCA mutation within the uterine carcinosarcoma, both of which have been linked to epithelial-to-mesenchymal transitions. Examination of the tumor immune microenvironment revealed proportionally more cytotoxic NK cells. This robust immune infiltration may be an indicator of the response to immunotherapy observed in this tumor or a result of the metastatic breast cancer within the uterus. This report provides a characterization of the molecular and immunologic landscape in this case with metastatic ILC and uterine carcinosarcoma.

Demand response (DR) and Energy Communities are highlighted as two key means to facilitate the energy transition in Europe by providing flexibility to the grid in a decentralized way. This paper uses a theoretical framework, the balanced readiness level assessment, to review five social and techno-economic dimensions regarding the status of demand response technology, emphasizing key challenges and opportunities. Focusing specifically on Energy Communities in Spain, issues such as the split-incentive problem in technology investments, market rules favouring large generators, and the imperative for improved coordination in the electricity market and network operations are identified as significant hurdles to further DR development. A balanced readiness level score of 7.25 is assessed for Spanish energy communities, composed of a 9 for the technological, a 7 for the regulatory and the acceptance, and a 5 for explicit and 7 for implicit market readiness level.The application of the balanced readiness level assessment methodology is novel to the energy industry and does not only prove the value it can create in this sector, but also provides insights for policymakers and stakeholders navigating the dynamic landscape of Demand Response for Spanish Energy Communities.

Given the preponderance of teams in business schools, and their effect on student learning and experience, it is important to carefully consider team formation. While random assignment, student choice and various professor chosen methods have been considered, they have drawbacks. Therefore, this paper explores two methods using similar student motivation--either for the course or a topic--as the mechanism for team assignment. Three classes were surveyed about their experiences. Aspects examined included individual contribution, and team satisfaction and environment, as well as qualitative experience. The results suggest that these methods can be effective, assuming they align with course goals and context, and students strongly recommend using them.

BACKGROUND: Multiple myeloma (MM) is a hematologic malignancy resulting from clonal proliferation of plasma cells in which significant heterogeneity has been demonstrated, both cytogenetically and molecularly. Translocation (11;14)(q13;q32), involving the CCND1 gene, has been described as the most common one, its estimated prevalence being around 15%–24%. OBJECTIVE: The objective of the study was to report the prevalence of t(11;14) in Mexican individuals with MM in a single institution. MATERIALS AND METHODS: A descriptive cross-sectional study in 26 patients with MM undergoing a fluorescence in situ hybridization study with fluorescent probes for the detection of t(11;14) employing a fluorescence microscope and studying 200 interphase nuclei, referred to Laboratorios Ruiz and Synlab, Puebla, México from 2017 to 2021. RESULTS: The t(11;14) was found in 5 (19%) of the cases. Data on the clinical evolution of the patients was not available. In the 26 subjects, serum immunofixation was performed to identify the type of monoclonal gammopathy (MG), 13 (50%) were compatible with MG immunoglobulin (Ig) G-Lambda, 8 (30.7%) with IgG-Kappa, 4 (15.3%) with IgA-Lambda, and 1 (4%) with IgA-Kappa. Of the five individuals positive for t(11;14), four were IgG Lambda and one IgG Kappa. CONCLUSION: The presence of t(11;14) in our cohort is similar to that reported in other populations. The clinical implications of the t(11;14) translocation in MM have been observed in various populations, but further studies are needed to comprehensively assess its relationship to the clinical course of the disease.

Abstract Background Concurrent malignant brain tumors in patients with multiple sclerosis (MS) constitute a rare but paradigmatic phenomenon for studying neuroimmunological mechanisms from both molecular and clinical perspectives. Methods A multicenter cohort of 26 patients diagnosed with both primary brain tumors and multiple sclerosis was studied for disease localization, tumor treatment-related MS activity, and molecular characteristics specific for diffuse glioma in MS patients. Results MS neither predisposes nor protects from the development of gliomas. Patients with glioblastoma WHO grade 4 without isocitratdehydrogenase (IDH) mutations have a longstanding history of MS, whereas patients diagnosed with IDH-mutant astrocytoma WHO grade 2 receive multiple sclerosis diagnosis mostly at the same time or later. Concurrent MS is associated with a lesser extent of tumor resection and a worse prognosis in IDH-mutant glioma patients (PFS 32 vs. 64 months, p = 0.0206). When assessing tumor-intrinsic differences no distinct subgroup-defining methylation pattern is identified in gliomas of MS patients compared to other glioma samples. However, differential methylation of immune-related genetic loci including human leukocyte antigen locus on 6p21 and interleukin locus on 5q31 is found in MS patients vs. matched non-MS patients. In line, inflammatory disease activity increases in 42% of multiple sclerosis patients after brain tumor radiotherapy suggesting a susceptibility of multiple sclerosis brain tissue to pro-inflammatory stimuli such as ionizing radiation. Conclusions Concurrent low-grade gliomas should be considered in multiple sclerosis patients with slowly progressive, expansive T2/FLAIR lesions. Our findings of typically reduced extent of resection in MS patients and increased MS activity after radiation may inform future treatment decisions.

Background and Objectives: The disruption of the intestinal epithelial barrier leads to increased intestinal permeability (IP), allowing endotoxins and pathogens to enter the bloodstream contributing to chronic inflammation. Western diets are associated with increased IP, while diets rich in polyphenols, fiber, and omega-3 fats are linked to decreased IP. The relationship between diet, disease activity, and IP in ulcerative colitis (UC) is poorly understood. We evaluated the effects of serum zonulin and lipopolysaccharide-binding protein (LBP) and their relationship to dietary factors in UC. Methods: A cross-sectional analysis was conducted on 37 UC participants who had baseline measures of dietary intake, disease activity and serum. Serum LBP and zonulin levels were measured by ELISA. Spearman’s rank correlations explored relationships between baseline IP, diet, and disease activity. Results: The median age was 35 years (29–47 years), 54% were male, and 76% were in clinical remission or had mild disease activity (partial Mayo score ≤ 4). LBP was significantly correlated (p < 0.05) with disease activity (partial Mayo score (r = 0.31), and positively correlated with total fat (r = 0.42) and refined grains (r = 0.35), but negatively correlated with fruit consumption (r = −0.50) and diet quality (r = −0.33). Zonulin was negatively correlated with protein (r = −0.39), niacin (r = −0.52) and vitamin B12 (r = −0.45) with a trend for significance (p = 0.06) with body mass index (r = 0.32). Conclusions: Baseline LBP levels were correlated with disease activity markers and dietary factors, suggesting that it could be a useful biomarker for assessing disease activity and diet quality in UC. Further trials are needed to confirm these findings.