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Lymphomas are a diverse group of malignant proliferations that arise as discrete tissue masses. The most widely accepted taxonomy for lymphoma is the World Health Organization classification of tumours of haematopoietic and lymphoid tissues, the 5th edition of which was released in June 2022. Most (85% to 90%) lymphoid neoplasms are of B cell origin. Mature B-cell neoplasms are a heterogeneous group of malignancies with similar disease courses and treatment paradigms. This review focuses on the various mature B-cell lymphomas in Malaysia, including Hodgkin lymphoma. A literature search was performed in various bibliographic databases. A total of 64 papers were included in this review. We found 15 papers on Hodgkin lymphoma, 14 on follicular lymphoma, 12 on Burkitt lymphoma, 5 on mucosa-associated lymphoid tissue (MALT) lymphoma, 4 on plasmablastic lymphoma, 3 on mantle cell lymphoma, 1 each on primary mediastinal large B-cell lymphoma, B-lymphoblastic lymphoma, and 3 on other unspecified B-cell lymphomas. The site, age, distribution, prognostic markers, and the various subclassification of B cell lymphomas were studied from these papers. Prognostic genetic markers in B-cell lymphomas include C-MYC, BCL2 and BCL6 as they are the most prevalent mutations in this condition. Anecdotal outcomes range from rapid fatality to unexplained spontaneous remission. This review adds to the existing literature on lymphoma in Malaysia by compiling the evidence that may lead to further research on the diagnosis and treatment of lymphoma in Malaysia and worldwide.

In IoT environment applications generate continuous non-stationary data streams with in-built problems of concept drift and class imbalance which cause classifier performance degradation. The imbalanced data affects the classifier during concept detection and concept adaptation. In general, for concept detection, a separate mechanism is added in parallel with the classifier to detect the concept drift called a drift detector. For concept adaptation, the classifier updates itself or trains a new classifier to replace the older one. In case, the data stream faces a class imbalance issue, the classifier may not properly adapt to the latest concept. In this survey, we study how the existing work addresses the issues of class imbalance and concept drift while learning from nonstationary data streams. We further highlight the limitation of existing work and challenges caused by other factors of class imbalance along with concept drift in data stream classification. Results of our survey found that, out of 1110 studies, by using our inclusion and exclusion criteria, we were able to narrow the pool of articles down to 35 that directly addressed our study objectives. The study found that issues such as multiple concept drift types, dynamic class imbalance ratio, and multi-class imbalance in presence of concept drift are still open for further research. We also observed that, while major research efforts have been dedicated to resolving concept drift and class imbalance, not much attention has been given to with-in-class imbalance, rear examples, and borderline instances when they exist with concept drift in multi-class data. This paper concludes with some suggested future directions.

The electrochemical performance of NiCo2O4 with urea precursors was evaluated in order to develop a non-enzymatic urea sensor. In this study, NiCo2O4 nanostructures were synthesized hydrothermally at different concentrations of urea and characterized using scanning electron microscopy and X-ray diffraction. Nanostructures of NiCo2O4 exhibit a nanorod-like morphology and a cubic phase crystal structure. Urea can be detected with high sensitivity through NiCo2O4 nanostructures driven by urea precursors under alkaline conditions. A low limit of detection of 0.05 and an analytical range of 0.1 mM to 10 mM urea are provided. The concentration of 006 mM was determined by cyclic voltammetry. Chronoamperometry was used to determine the linear range in the range of 0.1 mM to 8 mM. Several analytical parameters were assessed, including selectivity, stability, and repeatability. NiCo2O4 nanostructures can also be used to detect urea in various biological samples in a practical manner., Funding Agencies|Higher Education Commission Pakistan [NRPU/8350]; King Saud University, Riyadh, Saudi Arabia; Ajman University; [RSP2023R79]; [2022-IRG-HBS-5]

Cement has shaped the modern built environment, but its production generates substantial carbon dioxide emissions. Consequently, there is an urgent need to identify alternative cementitious building materials for sustainable construction. In this study, cement mortars (CMs) were produced by partially replacing cement with nanoclay (NC) and granite dust (GD). The replacement proportions (% by weight of cement) of these materials were 1.5, 3, and 4.5% for NC and 10, 20, and 30% for GD. For mortars containing NC but not GD, the strength was maximized when the NC replacement proportion was 3%. To evaluate the combined effect of partially replacing cement with both NC and GD on the fresh and hardening properties of cement-blended mortars, ternary binder mixtures containing 3% NC together with 10, 20, or 30% GD were prepared, and their workability, bulk density, compressive strength (at 7, 28, and 90 days), and flexural strength were measured. Increasing the content of NC and/or GD reduced the flowability of these mortars relative to that of the reference mortar mix because it increased the content of fine materials. CM containing 3% NC and 10% GD had the highest compressive strength at 7, 28, and 90 days while also having the greatest flexural strength when compared to the control mix. This is most likely due to the high silica and alumina content of NC and GD, as well as their high specific surface area, which would improve the maturity and density of the matrix when compared to cement alone., Validerad;2023;Nivå 2;2023-10-11 (joosat);CC BY 4.0 License

BackgroundIntravesical recurrence (IVR) after surgery for upper tract urothelial carcinoma (UTUC) is a clinical problem. We investigated if preoperative invasive diagnostic modalities (IDM) such as antegrade/retrograde uretero-pyelography and/or selective urine cytology/barbotage, and URS with or without concomitant biopsy are associated with IVR after radical surgery for UTUC. Risk of death from urothelial cancer and all causes was investigated as secondary outcomes. MethodsWe investigated a population-based cohort of 1038 consecutive patients subjected to radical surgery for UTUC 2015-2019 in Sweden, using the Bladder Cancer Data Base Sweden (BladderBaSe 2.0), comprising all patients in the Swedish National Registry of Urinary Bladder Cancer. Risk estimates of IVR, death from urothelial cancer, and all causes was assessed using multivariable Cox regression models. ResultsThe study included 536 cases with and 502 without preoperative IDM. IDM was associated with increased risk of IVR (HR 1.24, 95% CI 1.03-1.52) and risk of urothelial cancer death (HR 1.56, CI 1.12-2.18), compared to no IDM after a median follow-up of 1.3 yrs. Stratified analysis for tumor location showed that IDM was associated with risk of IVR in ureteric cancer (HR 1.66, 95% CI 1.21-2.28) but not in renal pelvic cancer (HR 1.07, 95% CI 0.81-1.41). Limitations included the observational setting and the lack of variables such as tumour grade, multifocality and preoperative hydronephrosis. ConclusionsWorse outcomes for patients subjected to preoperative IDM highlight the need for carefully considering diagnostic decisions for UTUC patients, specifically in tumours located in the ureter., Funding Agencies|Swedish Cancer Society [CAN 2019/62, CAN 2020/0709]; Swedish Research Council [2021-00859]; Lund Medical Faculty (ALF); Skane University Hospital Research Funds; Gyllenstierna Krapperups Foundation; Stiftelsen Sigurd och Elsa Goljes Minne; Bergqvist Foundation; Skane County Councils Research and Development Foundation [REGSKANE-622351]; Foundation of Urological Research; Hillevi Fries Research Foundation

Commercial documents are an essential trading tool that businesspeople or commercial companies use. In various business affairs and issues, it creates rights and obligations for the surrounding parties or interested parties. Guarantee is one of the important and common principles in commercial documents and will increase its credibility and security. The purpose of this research is to examine and explain the guarantee of commercial documents in Afghan law so that with an overview of the type of responsibility, the conditions of the guarantee and the effects of the guarantee according to its status in commercial documents, it will be known. This descriptive research is an analysis that is guided by a research question. Library resources form the statistical society of the research. According to the research findings, it was determined that the guarantor of a commercial document is considered a party to the transaction of the document; Afghanistan followed the obligatory by obligation theory. Commercial documents can be guaranteed by the guarantor in general or in part. Although the guarantor's obligation is a joint liability, since he has a responsibility as a guarantor and not the main responsibility, his obligation is equal to the extent of the surety's obligation.

Abdul Sattar Raslan,1 Jennifer K Quint,1,2 Sarah Cook1 1Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK; 2National Heart and Lung Institute, Imperial College London, London, UKCorrespondence: Sarah Cook, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Floor 9, Michael Uren Building, 86 Wood Lane, White City, London, W12 0BZ, UK, Email sarah.cook@imperial.ac.ukBackground: Type 2 diabetes (T2D) and chronic obstructive pulmonary disease (COPD) are common non-communicable diseases. Both have an inflammatory nature and similar risk factors, and there is overlap and interaction between them. To date, there is a lack of research on outcomes in people that have both conditions. The aim of this study was to investigate whether the presence of COPD in people with T2D was associated with an increased risk of all-cause, respiratory-cause and cardiovascular-cause mortality.Methods: A three-year cohort study (2017– 19) was done using the Clinical Practice Research Datalink Aurum database. The study population was 121,563 people with T2D aged ≥ 40. The exposure was COPD status at baseline. Incident rates for all-cause, respiratory-cause and cardiovascular-cause mortality were calculated. Poisson models for each outcome were fitted to estimate rate ratios for COPD status adjusted for age, sex, Index of Multiple Deprivation, smoking status, body mass index, prior asthma and cardiovascular disease.Results: COPD was present in 12.1% people with T2D. People with COPD had a higher all-cause mortality rate (448.7 persons per 1000 person years) compared with people without COPD (296.6 persons per 1000 person years). People with COPD also had substantially higher respiratory mortality incidence rates and moderately raised cardiovascular mortality rates. Fully adjusted Poisson models showed that people with COPD had a 1.23 (95% CI 1.21, 1.24) times higher rate of all-cause mortalit

Municipal solid waste (MSW) management is a global concern, especially in low–middle-income countries such as Pakistan, which require the redressal of MSW treatment issues to attain sustainability in the waste sector. The prosperity of municipal solid waste (MSW) collectors, i.e., the sanitary workers, is critical in the waste management hierarchy. Hence, the health, safety, social welfare, economic conditions and overall wellbeing of this tier need to be focused on more. Safeguarding the interests of the sanitary workers will support the MSW management sector in sustainability, which will help to generate revenue and minimize climatic impacts. An innovative MSW business model with waste ownership and technological intervention has excellent potential to support the sector towards a circular economy in Pakistan, the fifth most populous country in the world, generating about 100,000 metric tons of MSW per day. The proposed recycling business model will ensure a daily material recovery of 26,070 tons with 4721 tons of compost manufacturing in the country, which ultimately helps towards achieving the sustainable development goals (SDGs) and meeting the targets of nationally determined contributors (NDCs) by 2030. In addition, the sector’s economic potential can contribute 5.5% to the total annual budget and possibly pay 1.4% of the gross domestic product (GDP) per annum to service national foreign debt, thus helping maintain the debt threshold value with an opportunity to accelerate the economic growth of Pakistan.

Solid Waste Management (SWM) is a technical subject which requires comprehensive planning, execution, and effective operational monitoring under cost-effective modes compatible with environmentally sound technologies. The policymakers made some enormous efforts for the sustainability of this sector as well as setting a benchmark for other municipalities and Waste Management Companies (WMCs) in the country. Provincial Government prioritizes its focus on SWM, i.e., waste collection, transportation, treatment, and final disposal. The waste management sector in Lahore has achieved sustainability in waste collection and haulage components by gaining experience from international outsourcing and, now, sharing its knowledge with other municipalities to strengthen the sector in the country. Lahore has emerged with the highest collection efficiency (84%) in SAARC countries and placed fifth in rank in comparison to 54 low–middle-income countries/cities worldwide. The sectorial interventions in Lahore reveal an aspiration for the sustainability of the SWM sector in Pakistan. However, there is an urgent need to focus and invest in waste-related infrastructure development, i.e., permanent/mobile transfer stations, semi-underground containers for commercial and planned areas, material recovery facilities (MRF), and landfill. Environmental and economic sustainability in this sector can be achieved through public–private partnership (PPP) modality in compost, anaerobic digestion, recycling, and refuse-derived fuel (RDF) as it is a more feasible option to strengthen the industry in the country.

Chemical and biomass processing systems release volatile matter compounds into the environment daily. Catalytic reforming can convert these compounds into valuable fuels, but developing stable and efficient catalysts is challenging. Machine learning can handle complex relationships in big data and optimize reaction conditions, making it an effective solution for addressing the mentioned issues. This study is the first to develop a machine-learning-based research framework for modeling, understanding, and optimizing the catalytic steam reforming of volatile matter compounds. Toluene catalytic steam reforming is used as a case study to show how chemical/textural analyses (e.g., X-ray diffraction analysis) can be used to obtain input features for machine learning models. Literature is used to compile a database covering a variety of catalyst characteristics and reaction conditions. The process is thoroughly analyzed, mechanistically discussed, modeled by six machine learning models, and optimized using the particle swarm optimization algorithm. Ensemble machine learning provides the best prediction performance (R2 > 0.976) for toluene conversion and product distribution. The optimal tar conversion (higher than 77.2%) is obtained at temperatures between 637.44 and 725.62 {\deg}C, with a steam-to-carbon molar ratio of 5.81-7.15 and a catalyst BET surface area 476.03-638.55 m2/g. The feature importance analysis satisfactorily reveals the effects of input descriptors on model prediction. Operating conditions (50.9%) and catalyst properties (49.1%) are equally important in modeling. The developed framework can expedite the search for optimal catalyst characteristics and reaction conditions, not only for catalytic chemical processing but also for related research areas.

Introduction: Plantar fasciitis (PFS) is described by an intense pain over medial tubercle of calcaneus, increased with the first step after waking up, after rest and during weightbearing activity. It is the most common cause of plantar heel pain in adults with the prevalence estimated 10% of the general population. Ultrasound imaging is commonly being used to measure the PF thickness, evaluate the efficacy of different treatments and a guide therapeutic technique in patients with PFS. The objective of this study was to systematically review the studies that were previously published to evaluate the role of ultrasound in the assessment of PF in patients with PFS. Methods: A systematic search was carried out over the last 5 years from 2017 to 2022 on basis the following electronic databases: Science Direct, Scopus, Web of Science, Springer and PubMed. The keywords that used in the searching were: ultrasound, sonography, ultrasonography, plantar fasciitis, imaging of plantar fascia, physiotherapy of plantar fasciitis, interventional treatment of plantar fasciitis, randomized controlled trial of plantar fasciitis and interventional ultrasound. The review focused on the assessment of PF in patients with PFS underwent different interventions using B-mode, shear wave elastography (SWE) and color Doppler ultrasound. Results: During the search process, 1661 were recorded using the proper keywords from 2017 to 2022 in which 666 original articles were found after removing the review and duplicated articles. Of these, thirty articles met the inclusion criteria and included in this review. The articles have assessed the PF in patients with PFS under different conditions using different ultrasound modes. Twenty-six articles evaluated the effectiveness of different treatment on PF in patients with PFS using different ultrasound modes. In 8 of 26 articles, the ultrasound was used as both an assessment tool of PF and guide therapeutic technique in patients with PFS. In 18 articles

Purpose To evaluate a method of transurethral visual response-staging in patients with urothelial muscle-invasive urinary bladder cancer (MIBC), undergoing neoadjuvant chemotherapy (NAC) and radical cystectomy (RC). Methods A prospective study at four Swedish cystectomy centers, cystoscopy was performed after final NAC-cycle for MIBC. Fifty-six participants underwent cystoscopy for visual staging of the tumor immediately pre-RC. Visual assessments were correlated to pathoanatomical outcomes post-RC. Results Seventeen tumors were classified as complete response (CR), i.e. pT0. Twenty-five patients had residual MIBC and 14 had non-muscle invasive residual tumors (NMIBC). Of the 39 patients with residual tumor, 25 were correctly identified visually (64%). Eleven patients were pN+. The diagnostic accuracy of cystoscopy to correctly identify complete response or remaining tumor was 70% (CI = 56-81%) with a sensitivity of 64% (CI = 47-79%), specificity 82% (CI = 57-96%), PPV 89% (CI = 74-96%) and NPV 50% (CI =38-61%). Twenty-eight cystoscopy evaluations showed signs of residual tumors and 3/28 (11%) were false positive. In 4/14 patients assessed having residual NMIBC the estimates were correct, 8/14 had histopathological MIBC and 2/14 had CR. In 11/14 patients (79%), the suggested visual assessment of MIBC was correct, 2/14 had NMIBC and 1/14 had CR. Twenty-eight cystoscopies had negative findings, 14 were false negatives (50%), when cystoscopy falsely predicted pT0. Among them there were eight patients with pTa, pT1 or pTis and six MIBC-tumors. In 17 patients with histopathological pT0, 14 were correctly identified with cystoscopy (82%). Conclusion Cystoscopy after the final NAC-cycle cannot robustly differentiate between NAC-responders and non-responders. Visually, negative MIBC-status cannot be determined safely., Funding Agencies|Swedish Research Council funding for clinical research in medicine (ALF) in Vasterbotten, VLL, Sweden [BasALF/VLL RV-848051]; Cancer Research Foundation in Norrland, Umea, Sweden [CFF LP 13-2000]

This study seeks to determine the impact of corporate governance dimensions (compliance with the corporate governance code, top management, control environment, transparency and disclosure, rights of shareholders and stakeholders) on the three main types of organizational commitment, (affective, continuance and normative). It also aims at examining the impact of organizational culture, as an intermediate variable, on the relationship between the two above mentioned variables. The sample of this study comprised 152 respondents working at five types of Jordanian companies. The results of the study have confirmed the positive effect of the three corporate governance dimensions (compliance with the corporate governance code, top management, and control environment) on three types of organizational commitment (affective, continuance, and normative). The results also confirmed that there is no significant effect of t transparency and disclosure and the rights of shareholders and stakeholders on affective and normative commitment.

Municipal solid waste management (MSWM) is a critical administrative, environmental and financial issue in low-income countries, such as Pakistan, where waste collection efficiency is less than 75% in all urban areas, except Lahore. Therefore, it is pertinent to develop practical decision-making tools to enhance waste collection efficiency by local municipalities and waste management companies (WMCs). A tool/calculator, holistically measure analyze forecast honestly (HMAFH), is proposed for waste collection in urban areas based on the lessons learned. The tool was developed considering local conditions, i.e., business environment, socio-economic and cultural dynamics, city infrastructure and stakeholders’ desires. It is flexible to various proposed waste collection modes, with heterogeneous fleet choices, and it presents an opportunity to integrate collection with a material recovery facility (MRF) or direct haulage to the disposal site. The HMAFH was tested successfully in the Lahore district. Based on the proposed scenarios, the result shows a material recovery of up to 33% by defining dedicated waste collection streams with a 26% saving on fuel. The proposed interventions can prove to be a defining step toward building a circular economy (CE) that allows the integration of treatment options with economic potential to account for 35% of the current operating expenditures and a reduction in greenhouse gases (GHGs) emission, i.e., 1,604,019 tons of CO2-eq./annum.

Objective To study the telomerase reverse transcriptase (TERT) mutation and the p53 pathway in T1 urinary bladder cancer (UBC). Materials and Methods This prospectively performed population-based study included all patients in the Southeast Healthcare Region in Sweden with T1 UBC registered in the period 1992-2001, inclusive. Given that p53 and TERT are important factors for tumour proliferation, although their interrelationships are unknown, we assessed both the TERT and the p53 mutations. Furthermore, we conducted a p53 immunohistochemistry (IHC) analysis using two thresholds for p53 positivity: 10% of tumour cells and 50% of tumour cells (p53 IHC50%). Cox proportional hazards analysis and Kaplan-Meier curves were used to study time to tumour progression. Results Out of 158 patients, we observed the TERT mutation in 74 (47%), the p53 mutation in 48 (30%), and p53 IHC50% positivity in 72 patients (46%). The TERT mutation was more common in p53 mutation-positive patients (P = 0.009), and the latter group also had more patients with p53 IHC50%-positive tumour cells (P = 0.02). In the TERT mutation-negative tumours a p53-positive mutation was associated with a shorter time to progression (P = 0.03) compared to patients with p53-negative mutation. In contrast, in tumours with both TERT mutation positivity and p53 mutation positivity, a longer time to progression was observed in the group with p53 IHC50% positivity compared to the group with p53 IHC50%-negative tumours. Conclusions In stage T1 UBC, the combination of the TERT mutation and the p53 mutation was associated with tumour progression. A protective effect of the TERT promotor mutation against tumour progression induced by the p53 mutation and subsequent p53 accumulation in tumour cells might be possible, but further investigations are necessary.

In this study, we report enzyme-free glucose sensors based on palladium (Pd) nanoparticles deposited onto Co3O4 nanostructures. A simple, low-temperature aqueous method was used for the fabrication of Co3O4 nanostructures. Then, Pd nanoparticles were decorated onto Co3O4 nanostructures using the ultraviolet reduction method. Morphology, elemental composition and crystalline features of the proposed composite nanostructures were investigated by powder X-ray diffraction, scanning electron microscopy and energy dispersive spectroscopy techniques. Cyclic voltammetry and linear sweep voltammetry were used to investigate the electrochemical behaviour of Pd-Co3O4 nanostructures during glucose sensing. The proposed nanostructures showed excellent electrochemical activity for the quantitative detection of glucose at a potential of 0.6 V vs. Ag/AgCl. Importantly, the fabricated enzyme-free glucose sensor shows a linear response over the range of 1-6.0 mM glucose, with a limit of detection of 0.01 mM. The interference study was also carried out to probe the selectivity of Pd-Co3O4 nanostructures towards glucose detection in the presence of different interfering substances. The combined results attest that the as-synthesized Pd-Co3O4 nanostructures are highly stable and selective for the detection of glucose, suggesting their great potential for the quantitative determination of glucose in different biological fluids., Funding Agencies|King Saud University, Riyadh, Saudi ArabiaKing Saud University [RSP-2022/79]

Objective Papillary urothelial neoplasm of low malignant potential (PUNLMP) and stage TaG1 non-muscle invasive bladder cancer (NMIBC) represent separate categories in current WHO 1999 grade definitions. Similarly, PUNLMP and Ta low-grade are separate entities in the WHO 2004/2016 grading system. However, this classification is currently questioned by reports showing a similar risk of recurrence and progression for both categories. Patients and methods In this population-based study, risk estimates were evaluated in patients diagnosed with PUNLMP (n = 135) or stage TaG1 (n = 2176) NMIBC 2004-2008 with 5-year follow-up registration in the nation-wide Bladder Cancer Data Base Sweden (BladderBaSe). The risk of recurrence was assessed using multivariable Cox regression with adjustment for multiple confounders (age, gender, marital status, comorbidity, educational level, and health care region). Results At five years, 28/135 (21%) patients with PUNLMP and 922/2176 (42%) with TaG1 had local recurrence. The corresponding progression rates were 0.7% (1/135) and 4.0% (86/2176), respectively. A higher relative risk of recurrence was detected in patients with TaG1 tumours compared to PUNLMP (Hazard Ratio 1.6, 95% CI 1.2-2.0) at 5-year follow-up, while progression events were too few to compare. Conclusions The difference in risk of recurrence between primary stage TaG1 and PUNLMP stands in contrast to the recently adapted notion that treatment and follow-up strategies can be merged into one low-risk group of NMIBC., Funding Agencies|Swedish Cancer SocietySwedish Cancer Society [CAN 2019/62, CAN 2017/278]; Lund Medical Faculty (ALF); Skane University Hospital Research Funds; Gyllenstierna Krapperups Foundation; Cancer Research Fund at Malmo General Hospital; Stiftelsen Sigurd och Elsa Goljes Minne; Bergqvist Foundation; Skane County Councils Research and Development Foundation [REGSKANE-622351]; Gosta Jonsson Research Foundation; Foundation of Urological Research; Hillevi Fries Research Foundation

Introduction and objectives Bladder cancer is primarily a disease of older age and little is known about the differences between patients diagnosed with bladder cancer at a younger versus older age. Our objectives were to compare bladder cancer specific survival in patients aged Materials and methods The Swedish bladder cancer database provided data on patient demographics, clinical characteristics and treatments for this observational study. Cox proportional hazard regression models were adjusted for appropriate variables. All analyses were stratified by disease stage (non-muscle-invasive bladder cancer and muscle-invasive bladder cancer. Furthermore, we compared the frequency of lower urinary tract infections within 24 months prior to bladder cancer diagnosis by sex and age groups. Results The study included 15,452 newly-diagnosed BC patients (1997-2014); 1,207 (8%) patients were <50 whilst 14,245 (92%) were aged 50-70. Patients aged <50 at diagnosis were at a decreased risk of bladder cancer death (HR = 0.82, 95%CI: 0.68-0.99) compared to those aged 50-70. When stratified by non-muscle-invasive and muscle-invasive bladder cancer, this association remained in non-muscle-invasive patients only (<50, HR = 0.43, 95% CI: 0.28-0.64). The frequency of lower urinary tract infection diagnoses did not differ between younger and older patients in either men or women. Conclusions Patients diagnosed with non-muscle-invasive bladder cancer when aged <50 are at decreased risk of bladder cancer-specific death when compared to their older (50-70) counterparts. These observations raise relevant research questions about age-related differences in diagnostic procedures, clinical decision-making and, not least, potential differences in tumour biology.

COVID-19, a highly contagious and rapidly spreading viral infection caused by the new corona virus SARS-COV-2, was first identified in China. On March11th, 2020 World Health Organization announced it a pandemic. The novel infection which is still being studied has a wide range of severity, ranging from no symptoms to severe pneumonia that can lead to death Objective: To find correlation between D-Dimer and platelets count with the severity of the disease Methods: It was a cross sectional study. The duration of the study was 6 months from November, 2020 to May 2021. The study was conducted in University Institute of Medical Laboratory Technology (UIMLT), University of Lahore. Data of 101 COVID-19 positive patients was taken from Shaukat Khanum Hospital, Farooq Hospital & University of Lahore Teaching Hospital (UOL), Lahore. Hematological and biochemical parameters such as Complete blood count (CBC), D-Dimer, Lactate Dehydrogenase (LDH), Platelet count (PLT) and Ferritin levels were observed. The data was analyzed using Statistical Package for Social Sciences (SPSS) Version 21.0. P-value less than and equal to 0.05 was taken as significant Results: Platelet count was decreased in severe patients of COVID-19 and was statisticallysignificant (P-value = 0.004) LDH, D-dimer, and Ferritin were increased with severity of disease and they were also statistically significant (P-value 0.005, 0.000. 0.027) respectively Conclusions:The platelet count, D-Dimer, LDH and Ferritin levels could act as the biomarker to determine the severity in COVID-19 infection

The main purpose of this article is to bring up the challenges faced by the teacher educators during the implementation of B.Ed (Hons.) elementary program initiated by the provincial governments and HEC in collaboration with United State Agency for International development (USAID) in Pakistan. In this study two general universities i.e., University of Sindh and Karachi University were included which received the funding from USAID for upliftment of Elementary Education in the Sindh province, where this teacher educators’ program was piloted and later on fully implemented. In-depth semi-structured face to face interview schedule was developed to conduct the survey type qualitative research design. Five teacher educators from each university (N=10) through purposive sampling were selected and interviewed to collect the data. The gathered data were thematically analyzed on the pattern of Braun & Clarke (2006) approach. On the bases of the analyses, it was inferred that the program despite of its successful completion of first round faced many intrinsic problems such as the lack of trained human resources, lack of involvement of the concerned faculty in curriculum decisions, lack of implementation of the modern pedagogies for bringing quality into the program. Moreover, the external factors such as physical resources and the quality of the intake were also slanting the performance of the program to some extent. These finding are in alignment with the previous studies conducted in the similar context to assess the implementation of teacher education programs. However, the administration of the institutes of so far found playing active role in carrying on the program smoothly despite of the challenges. In the light of the findings of the study, it is recommended that the intervention to provide the funds as well as physical facilities at this stage is inevitable. Keywords: B.Ed elementary teacher educator program, implementing program, challenges

Background Control computerized tomography (cCT) is routinely used in many cystectomy centres before the final treatment cycle in patients with muscle-invasive urinary bladder cancer (MIBC) undergoing neoadjuvant chemotherapy (NAC). This is for evaluating response or nonresponse to NAC treatment. In a real-world retrospective cohort, we intended to evaluate the frequency of changed individual treatment strategies following cCT and to investigate any discrepancies between cCT-results on nodal staging and final pN-stages. Methods We performed a retrospective data-based, multicenter study of 242 MIBC-patients, staged cT2N0M0-cT4aN0M0, having undergone NAC and radical cystectomy (RC) between 2008 and 2019 at four Swedish cystectomy centres. Statistical analysis was performed using IBM SPSS statistics 26. Results Overall, 139/242 patients were examined with cCT. Six patients were staged as progressive at cCT and 5/139 (3.6%) underwent a change of previously planned treatment strategy. 2/6 patients with suspected progression (33%) did not change strategy and underwent all preplanned NAC-cycles plus RC. Only 1/6 patients assigned as progressive at the cCT, showed progression in the postoperative pathology specimen. In total 133/139 patients were considered being without progress on cCT, yet 28/133 (21%) presented with nodal progression at postoperative pathology examinations. Only 1/29 patients with histopathologically verified nodal dissemination were detected with cCT, thus 28/29 (96.6%) with pN + were undetected. The sensitivity for cCT to predict pTNM was 17% CI [0%-64%] and the specificity was 78% CI [71%-86%]. Conclusions CCT prior to the final treatment cycle of NAC in MIBC, leads to a low percentage of treatment strategy changes and cCT cannot accurately predict pN-status., Funding Agencies|Swedish Research Council, SwedenSwedish Research Council [Bas-ALF/VLL RV-848051]; Cancer Research Foundation in Norrland, Umea, Sweden [CFF LP 13-2000]

Objective For patients undergoing radical cystectomy for bladder cancer, a procedure requiring complex urinary tract reconstruction prone to major postoperative complications, the timing and quality of the surgery have been associated with outcomes. Patients and methods This study investigated if radical cystectomy for bladder cancer performed during holiday periods had worse disease-specific (DSS) and overall survival (OS), higher 90-day mortality and risk of readmissions. All patients operated on with radical cystectomy for primary bladder cancer during 1997-2014 with holiday periods as exposure (with one narrow (7 weeks) and one wider (14 weeks) definition) in the Swedish population-based bladder cancer research-database (BladderBaSe) were studied. DSS and OS after radical cystectomy during holiday periods were analysed with Cox regression models adjusted for sex, age, comorbidity, marital status, T-stage and nodal metastases, neoadjuvant chemotherapy, hospital volume and year of cystectomy. Results Surgery during the holiday periods (narrow and wide definitions) were not associated with DSS (Hazard ratio [HR] = 1.05, 95% confidence interval [95% CI] = 0.90-1.21 and HR = 1.04, 95% CI = 0.91-1.17), respectively. HRs for OS were similar, and no associations between radical cystectomy during any of the holiday period definitions and 90-day mortality and readmission were found. Conclusion Survival after radical cystectomy in Sweden is similar during holiday and non-holiday periods., Funding Agencies|Swedish Cancer SocietySwedish Cancer Society [CAN 2019/62, CAN 2017/278]; Lund Medical Faculty (ALF); Skane University Hospital Research Funds; Gyllenstierna Krapperup s Foundation; Skane County Councils Research and Development Foundation [REGSKANE-622351]; Gosta Jonsson Research Foundation; Foundation of Urological Research; Hillevi Fries Research Foundation

BACKGROUND: Routine VTE prophylaxis within 30 days of radical cystectomy (RC) for urinary bladder cancer (UBC) is used to protect from venous thromboembolism (VTE). However, randomized studies and nationwide population-based studies are lacking. OBJECTIVE: To study VTE and risk factors for VTE in muscle-invasive UBC in a nationwide population-based series, with a focus on the association with RC with and without chemotherapy. MATERIALS AND METHODS: We studied all patients with clinical stage T2-T4 UBC diagnosed 1997 to 2014 in the Bladder Cancer Data Base Sweden (BladderBaSe). Previous VTE events and risk factors for VTE were registered from 1987. Cox regression analyses and Kaplan-Meier curves were performed to study risk factors for VTE and cumulative incidence of VTE. RESULTS: In 9720 patients (71% males) with a median age of 74 years 546 (5.6%) had VTE after diagnosis. In Cox analyses controlling for patients and tumour characteristics, and risk factors for VTE, VTE after diagnosis and first treatment date were associated with chemotherapy with or without RC. Cumulative incidence of VTE increased during 24 months after diagnosis and first treatment date. VTE were less common in patients with previous cardiovascular disease. CONCLUSION: VTE was commonly observed after 30 days from diagnosis and from first treatment date in patients with T2-T4 UBC, particularly after chemotherapy. The findings suggest that long-term intervention studies of benefit and possible harms of VTE prophylaxis after UBC should be undertaken., Funding Agencies|Swedish Cancer SocietySwedish Cancer Society [CAN 2016/470, CAN 2017/278]

Objective To assess the value of second-look resection (SLR) in stage T1 bladder cancer (BCa) with respect to progression-free survival (PFS), and also the secondary outcomes recurrence-free survival (RFS), bladder-cancer-specific survival (CSS), and cystectomy-free survival (CFS). Patients and methods The study included 2456 patients diagnosed with stage T1 BCa 2004-2009 with 5-yr follow-up registration in the nationwide Bladder Cancer Data Base Sweden (BladderBaSe). PFS, RFS, CSS, and CFS were evaluated in stage T1 BCa patients with or without routine SLR, using univariate and multivariable Cox regression with adjustment for multiple confounders (age, gender, tumour grade, intravesical treatment, hospital volume, comorbidity, and educational level). Results SLR was performed in 642 (26%) individuals, and more frequently on patients who were aged < 75 yr, had grade 3 tumours, and had less comorbidity. There was no association between SLR and PFS (hazard ratio [HR] 1.1, confidence interval [CI] 0.85-1.3), RFS (HR 1.0, CI 0.90-1.2), CFS (HR 1.2, CI 0.95-1.5) or CSS (HR 1.1, CI 0.89-1.4). Conclusions We found similar survival outcomes in patients with and patients without SLR, but our study is likely affected by selection mechanisms. A randomised study defining the role of SLR in stage T1 BCa would be highly relevant to guide current praxis., Funding Agencies|Swedish Cancer SocietySwedish Cancer Society [CAN 2019/62, CAN 2017/278]; Lund Medical Faculty (ALF); Skane University Hospital Research Funds; Gyllenstierna Krapperups Foundation; Cancer Research Fund at Malmo General Hospital; Stiftelsen Sigurd och Elsa Goljes Minne; Bergqvist Foundation; Skane County Councils Research and Development Foundation [REGSKANE622351]; Gosta Jonsson Research Foundation; Foundation of Urological Research; Hillevi Fries Research Foundation

Background and objective To study the cumulative incidence and surgical treatment of midline incisional hernia (MIH) after cystectomy for bladder cancer. Methods In the nationwide Bladder Cancer Data Base Sweden (BladderBaSe), cystectomy was performed in 5646 individuals. Cumulative incidence MIH and surgery for MIH were investigated in relation to age, gender, comorbidity, previous laparotomy and/or inguinal hernia repair, operative technique, primary/secondary cystectomy, postoperative wound dehiscence, year of surgery, and period-specific mean annual hospital cystectomy volume (PSMAV). Results Three years after cystectomy the cumulative incidence of MIH and surgery for MIH was 8% and 4%, respectively. The cumulative incidence MIH was 12%, 9% and 7% in patients having urinary diversion with continent cutaneous pouch, orthotopic neobladder and ileal conduit. Patients with postoperative wound dehiscence had a higher three-year cumulative incidence MIH (20%) compared to 8% without. The corresponding cumulative incidence surgery for MIH three years after cystectomy was 9%, 6%, and 4% for continent cutaneous, neobladder, and conduit diversion, respectively, and 11% for individuals with postoperative wound dehiscence (vs 4% without). Using multivariable Cox regression, secondary cystectomy (HR 1.3 (1.0-1.7)), continent cutaneous diversion (HR 1.9 (1.1-2.4)), robot-assisted cystectomy (HR 1.8 (1-3.2)), wound dehiscence (HR 3.0 (2.0-4.7)), cystectomy in hospitals with PSMAV 10-25 (HR 1.4 (1.0-1.9)), as well as cystectomy during later years (HRs 2.5-3.1) were all independently associated with increased risk of MIH. Conclusions The cumulative incidence of MIH was 8% three years postoperatively, and increase over time. Avoiding postoperative wound dehiscence after midline closure is important to decrease the risk of MIH., Funding Agencies|Swedish Cancer SocietySwedish Cancer Society [CAN 2019/62, CAN 2017/278]; Lund Medical Faculty (ALF); Skane University Hospital Research Funds; Gyllenstierna Krapperups Foundation; Skane County Councils Research and Development Foundation [REGSKANE-622351]; Gosta Jonsson Research Foundation; Foundation of Urological Research; Hillevi Fries Research Foundation

Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide, especially in the Western world and Asia-Pacific regions. This study was designed to determine the prevalence of NAFLD detected by sonographic assessment among the rural indigenous population in Peninsula Malaysia and its association with anthropometric and biochemical factors. Methods: A cross-sectional survey was carried out from January 2014-February 2016. Subjects were recruited among indigenous peninsula Malaysia population in rural villages, aged ≥18 years old. The survey was questionnaire-based followed by anthropometric and blood parameters measurements. All subjects underwent abdominal ultrasound assessment to screen for the presence of NAFLD. Semi-quantitative visual grading was performed to assess for mild, moderate or severe NAFLD. Results: A total of 270 subjects underwent the screening program (mean age 43.3 ±14.0 years). Approximately 53 subjects (19.6 %) were identified with NAFLD. Of those with NAFLD, approximately 83% had moderate grade of fatty liver and the remainder were diagnosed with mild grade. NAFLD was closely associated with age, body mass index (BMI), central obesity, hypertension, total cholesterol (TC), triglyceride/high density lipoprotein-cholesterol (TG/HDL-C) ratio. On multivariate logistic regression, a high BMI (≥23.0 kg/m2), central obesity, and raised TG/HDL-C ratio were independent risk factors for developing NAFLD. Conclusion: This pioneer study defines the prevalence of NAFLD among rural indigenous population in Peninsula Malaysia. Lifestyle-related diseases, such as NAFLD can affect both rural and urban communities with equal severity. High BMI, central obesity, and elevated TG/HDL-C ratio were independent risk factors for developing NAFLD.

Yamuna Sucedaram,1 Edward James Johns,2 Ruby Husain,3 Munavvar Abdul Sattar4 ,† Mohammed H Abdulla,2 Giribabu Nelli,3 Nur Syahrina Rahim,5 Manizheh Khalilpourfarshbafi,1 Nor Azizan Abdullah1 1Department of Pharmacology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia; 2Department of Physiology, University College Cork, Cork, T12 K8AF, Ireland; 3Department of Physiology, Universiti Malaya, Kuala Lumpur, 50603, Malaysia; 4School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, 11800, Pulau Pinang, Malaysia; 5Faculty of Medicine & Health Science, Universiti Sains Islam Malaysia, Nilai, 71800, Malaysia†Prof. Dr. Munavvar Abdul Sattar passed away on January 6, 2021Correspondence: Nor Azizan AbdullahDepartment of Pharmacology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, MalaysiaTel +60122386655Fax +60379674791Email azizan@ummc.edu.myPurpose: We hypothesized that low estrogen levels aggravate obesity-related complications. Diet-induced obesity can cause distinct pathologies, including impaired glucose tolerance, inflammation, and organ injury that leads to fatty liver and chronic kidney diseases. To test this hypothesis, ovariectomized (OVX) rats were fed a high-fat style diet (HFSD), and we examined structural changes and inflammatory response in the kidney and liver.Methods: Sprague-Dawley female rats were ovariectomized or sham-operated and divided into four groups: sham-operated rats fed a normal diet (ND); ovariectomized rats fed a normal diet (OVX-ND); sham-operated rats fed a HFSD; ovariectomized rats fed a high-fat style diet (OVX-HFSD). Mean blood pressure and fasting blood glucose were measured on weeks 0 and 10. The rats were sacrificed 10 weeks after initiation of ND or HFSD, the kidney and liver were harvested for histological, immunohistochemical and immunofluorescence studies.Results: HFSD-fed rats presented a significantly greater adiposity index compared to their ND counter

As one of the most efficient methods for waste management and sustainable energy production, anaerobic digestion (AD) countenances difficulties in the hydrolysis of lignocelluloses biomass. Different pretreatment methods have been applied to make lignocelluloses readily biodegradable by microorganisms. These pretreatments can affect biogas yield by different mechanisms at molecular scale, including changes in chemical composition, cellulose crystallinity, degree of polymerization, enzyme adsorption/desorption, nutrient accessibility, deacetylation, and through the formation of inhibitors. The present article aims at critically reviewing the reported molecular mechanisms affecting biogas yield from lignocelluloses via different types of pretreatments. Then, a new hypothesis concerning the impact of pretreatment on the microbial community developed (throughout the AD process from an identical inoculum) was also put forth and was experimentally examined through a case study. Four different leading pretreatments, including sulfuric acid, sodium hydroxide, aqueous ammonia, and sodium carbonate, were performed on rice straw as model lignocellulosic feedstock. The results obtained revealed that the choice of pretreatment method also plays a pivotally positive or negative role on biogas yield obtained from lignocelluloses through alteration of the microbial community involved in the AD. Considerable changes were observed in the archaeal and bacterial communities developed in response to the pretreatment used. Sodium hydroxide, with the highest methane yield (338 mL/g volatile solid), led to a partial switch from acetoclastic to the hydrogenotrophic methane production pathway. The findings reported herein undermine the default hypothesis accepted by thousands of previously published papers, which is changes in substrate characteristics by pretreatments are the only mechanisms affecting biogas yield. Moreover, the results obtained could assist with the development of more

Objective The incidence of benign ureteroenteric strictures following radical cystectomy (RC) for urinary bladder cancer (UBC) is investigated mainly in single-centre studies from high-volume centres. The aim of this study was to evaluate the cumulative incidence of strictures and risk factors in a population-based cohort. Patients and methods Data was collected from Bladder Cancer Data Base Sweden (BladderBaSe). The primary endpoint was stricture with intervention. Secondary endpoint included hydronephrosis both with/without intervention. Results In total, 5,816 patients were registered as having had RC due to UBC between 1997 and 2014. After a median follow-up of 23.5 months (IQR = 9.0-63.1 months; range = 0.0-214.0 months), we found that 515 (8.9%) patients underwent intervention for stricture. Seven hundred and sixty-one (13.1%) patients were diagnosed with hydronephrosis without intervention. The cumulative incidence of strictures with intervention was 19.7% (95% CI = 16.7-23.1%) during the 17 years of follow-up. In the first year, the cumulative incidence of strictures was 5.6% (95% CI = 5.0-6.2%), and in the first 2 years 8.4% (95% CI = 7.6-9.3%). For the secondary endpoint, the cumulative incidence was 30.4% (95% CI = 26.7-33.1%) after 17 years. Only the year of RC was associated with stricture incidence in Cox regression analysis, whereas hospital cystectomy volume, patient age and patient sex were not. Conclusion Ureteroenteric strictures requiring intervention may be more common than previously reported, affecting nearly one fifth of patients who have undergone RC for UBC. The annual incidence was highest in the first 2 years after surgery but the cumulative incidence increased continuously during 17 years of follow-up., Funding Agencies|Swedish Government; county councils; ALF-agreement [ALFGBG-873181]

BackgroundWhereas the literature has demonstrated an acceptable safety profile of stapled anastomoses when compared to the hand-sewn alternative in open surgery, the choice of intestinal anastomosis using sutures or staples remains inadequately investigated in robotic surgery. The purpose of this study was to compare the surgical outcomes of both anastomotic techniques in robotic-assisted radical cystectomy.MethodsA retrospective analysis of patients with urinary bladder cancer undergoing cystectomy with urinary diversion and with ileo-ileal intestinal anastomosis at a single tertiary centre (2012–2018) was undertaken. The robotic operating time, hospital stay and GI complications were compared between the robotic-sewn (RS) and stapled anastomosis (SA) groups. The only difference between the groups was the anastomosis technique; the other technical steps during the operation were the same. Primary outcomes were GI complications; the secondary outcome was robotic operation time.ResultsThere were 155 patients, of which 112 (73%) were male. The median age was 71 years old. A surgical stapling device was used to create 66 (43%) separate anastomoses, while a robot-sewn method was employed in 89 (57%) anastomoses. There were no statistically significant differences in primary and secondary outcomes between RS and SA.ConclusionsCompared to stapled anastomosis, a robot-sewn ileo-ileal anastomosis may serve as an alternative and cost-saving approach., Funding Agencies|FoU grant from the County Council of Ostergotland, Linkoping, Sweden; ALF research grant from the County Council of Ostergotland, Linkoping, Sweden

The current research is concerned with knowing the extent of the impact of change management on organizational excellence and reviewing the literature that searches for the relationship between the two variables and which emphasized the importance and role of change management in defining and mapping features of organizational excellence in organizations. To achieve the goal of the current research, a model was built and selected that explains and explains the relationship and impact of the two variables (change management and organizational excellence).         In order to test the research hypotheses, a sample of the heads of people was chosen in a number of government banks in Thi -Qar Governorate (Al-Rashid Bank - Al-Rafidain Bank - the Iraqi Commercial Bank) where a questionnaire was prepared for this purpose, as the researcher distributed (50) a questionnaire that was retrieved from it ( 40) A questionnaire, which was approved for statistical analysis , The data were analyzed using a number of statistical methods through the use of a program (SPSS) to reach the required results, which came to confirm the research hypotheses, which is the existence of a correlation between change management and organizational excellence, as well as the effect of change management on organizational excellence in the performance of the work of the organizations under research.

Cache memory plays a central role in improving the performance of web servers, especially for big data transmission, which response time is constrained. It is necessary to use an effective method, such as web cache. Browsers' cache has a significant role according to less bandwidth use, response time and traffic load as well as beneficial if the internet connection is slow. Due to the space limitations, modern browsers companies attempt to use a method to store a great number of web objects and to advance the effectiveness of web browsers. Many scientists have been working to discover and recommend various techniques for this purpose. This study consequently reviews the recent likelihood probabilistic methods, to figure out how browsers store web objects in their caches, and which methods are used to load more speedily and to store a great number of web objects. The comparison between numerous browsers performed to pick and recommend the utmost one for usage. The result has shown that each browser using RI (Ratio Improvement) has powerful performance; to be discussed later. It has proposed using Google Chrome browser because web objects are placed in its cache through the RI technique that correlated with browsers' effectiveness.

Purpose To investigate if patients receiving neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) had an increased risk of thromboembolic events (TEE) and to evaluate when these events occur on a timeline starting from 6 months pre-cystectomy, during NAC-administration and 60 months post-cystectomy. Methods Two hundred and fifty five patients undergoing radical cystectomy during 2009-2014 at three Swedish cystectomy centers (Umea, Linkoping and Sundsvall) were in-detail reviewed retrospectively, using individual medical records. One hundred and twenty nine patients were ineligible for analysis. NAC patients (n = 67) were compared to NAC-naive NAC-eligible patients (n = 59). The occurrence of TEE was divided into different periods pre-cystectomy and post-cystectomy. Statistical analyses included Chi-squared and logistical regression tests. Results Significant associations were found between receiving NAC and acquiring a TEE during NAC therapy pre-cystectomy. All but one pre-cystectomy event was venous and all but one of the patients received NAC. 31% (14/45) of TEEs occurred pre-cystectomy. The incidence of TEEs pre-cystectomy in NAC-naive NAC-eligible patients was only 10% (2/20), whereas the incidence of TEEs in NAC patients occurred pre-cystectomy in 48% (12/25) and 11/12 incidents were detected during NAC therapy-this including 7/11 (64%) incidents affecting veins in anatomical conjunction with the placement of central venous access for chemotherapy administration. Conclusions There is a significantly increased risk for TEE pre-cystectomy during chemotherapy administration in MIBC patients receiving NAC, compared to the risk in NAC-naive NAC-eligible MIBC patients. In 64% of the pre-RC TEEs in NAC patients, there was a clinical connection to placement of central venous access., Funding Agencies|Umea University; Swedish Research Council funding for clinical research in medicine (ALF) in Vasterbotten, VLL, Sweden [Bas-ALF/VLL RV-848051]; Cancer Research Foundation in Norrland, Umea, Sweden [CFF LP 13-2000]

Purpose To examine the relationship between the number of tumour draining sentinel nodes (SNs) and pathoanatomical outcomes, in muscle-invasive bladder cancer (MIBC), in patients undergoing neoadjuvant chemotherapy (NAC) and radical cystectomy (RC). Materials and Methods In an ongoing prospective multicenter study, we included 230 patients with suspected urothelial MIBC from ten Swedish urological centers. All underwent TURb and clinical staging. From the cohort, 116 patients with urothelial MIBC; cT2-cT4aN0M0, underwent radical cystectomy (RC) and lymphadenectomy with SN-detection (SNd). 83 patients received cisplatin-based NAC and 33 were NAC-naive. The number and locations of detected SNs and non-SNs were recorded for each patient. The NAC treated patients were categorized by pathoanatomical outcomes post-RC into three groups: complete responders (CR), stable disease (SD) and progressive disease (PD). Selected covariates with possible impact on SN-yield were tested in uni -and multivariate analyses for NAC-treated patients only. Results In NAC treated patients, the mean number of SNs was significantly higher in CR patients (3.3) and SD patients (3.6) compared with PD patients (1.4) (p = 0.034). In a linear multivariate regression model, the number of harvested nodes was the only independent variable that affected the number of SNs (p = 0.0004). Conclusions The number of tumor-draining SNs in NAC-treated patients was significantly lower in patients with progressive disease., Funding Agencies|Umea University; Swedish Cancer SocietySwedish Cancer Society; Wallenberg Foundation; Swedish Medical Research CouncilSwedish Medical Research Council (SMRC); Regionala forskningsradet i Uppsala-Orebroregionen (RFR in Uppsala-Orebro); Swedish Research Council funding for clinical research in medicine (ALF) in Vasterbotten, VLL, Sweden; Cancer Research Foundations of Radiumhemmet; Cancer Research Foundation in Norrland, Umea, Sweden

The Leggett inequality is a constraint on the bipartite correlation that admits certain types of non-localities. Existing tests mainly focused on the electromagnetic systems where measurement apparatus are assumed to be projective and sharp. However, in nature there are interactions that do not obey the same conservation laws for photon, and the actual measurements may subject to unavoidable uncertainties due to the fundamental physical principles. In this work, we generalize the Leggett inequality to incorporate the measurements that are unsharp and/or biased. It is found that the parity violation in nature provides a spontaneous implementation of an unsharp measurement for the spin of hyperon. A fine structured Leggett inequality for hyperon decays characterized by the asymmetry parameters is obtained and its violation is found which could be observed with the yet obtained data in experiment, like BESIII and Belle., Comment: 22 pages, 7 figures; published in Phys. Rev. D

Nonlocality is a key feature of quantum theory and is reflected in the violation of Bell inequalities for entangled systems. The experimental tests beyond the electromagnetism and massless quanta are of great importance for understanding the nonlocality in different quantum interactions. In this work, we develop a generalized Clauser-Horne inequality pertaining especially to the high energy physics processes, which is quantum mechanical intervene free. We find, in the process of pseudoscalar quarkonium exclusive decay to entangled $\Lambda\bar{\Lambda}$ pairs, the inequality could be violated and is verifiable in high energy experiments, like BES III or BELLE II., Comment: 13 pages, 1 figure

Objective To study how patients with urinary bladder cancer (UBC) with previous or concomitant other primary cancers (OPCs) were treated, and to investigate their prognosis. Patients And Methods Using nationwide population-based data in the Bladder Cancer Data Base Sweden (BladderBaSe), we analysed the probability of treatment with curative intent, and UBC-specific and overall survival (OS) in patients with UBC diagnosed in the period 1997-2014 with or without OPC. The analyses considered the patients characteristics, UBC tumour stage at diagnosis, and site of OPC. Results There were 38 689 patients, of which 9804 (25%) had OPCs. Those with synchronous OPCs more often had T2 and T3 tumours and clinically distant disease at diagnosis than those with UBC only. Patients with synchronous prostate cancer, female genital cancer and lower gastro-intestinal cancer were more often treated with curative intent than patients with UBC only. When models of survival were adjusted for age at diagnosis, marital status, education, year of diagnosis, Charlson Comorbidity Index and T-stage, UBC-specific survival was similar to patients with UBC only, but OS was lower for patients with synchronous OPC, explained mainly by deaths in OPC primaries with a bad prognosis. Conclusions OPC is common in patients with UBC. Treatment for UBC, after or in conjunction with an OPC, should not be neglected and carries just as high a probability of success as treatment in patients with UBC only. The needs of patients with UBC and OPC, and optimisation of their treatment considering their complicated disease trajectory are important areas of research., Funding Agencies|Swedish Cancer SocietySwedish Cancer Society [CAN 2019/62, CAN 2017/278]

We study the scattering of J/$\Psi$-J/$\Psi$ mesons using Quadratic and Cornell potentials in our tetraquark ($c$$\bar{c}$$c$$\bar{c}$) system. The system's wavefunction in the restricted gluonic basis is written by utilizing adiabatic approximation and Hamiltonian is used via quark potential model. Resonating group technique is used to get the integral equations which are solved to get the unknown inter-cluster dependence of the total wavefunction of our tetraquark system. T-Matrix elements are calculated from the solutions and eventually the scattering cross sections are obtained using the two potentials respectively. We compare these cross sections and find that the magnitude of scattering cross sections of Quadratic potential are higher than Cornell potential., Comment: 13 pages, 5 figures. Note: This manuscript will be published in Chinese Physics C

Background: Colorectal cancer is the second most common cancer in Malaysia. Its disease burden is likely to increase over time owing to its current trends in this region. This study was undertaken to determine the 5-year survival rate and prognostic factors for survival in colorectal cancer patients treated in a tertiary hospital, in Malaysia. Methods: We reviewed the records of colorectal cancer patients treated in Hospital Tuanku Ja’afar Seremban, Malaysia from 2008 to 2012. Survival analysis at five years was performed using the Kaplan-Meier method. Cox proportional hazard regression analysis was carried out to determine the predictors of 5-year colorectal cancer survival. Results: Of the 275 patients, 43.3% were colon cancers, 51.8% were rectal cancers. Only 2.2% were diagnosed in Stage I. 28.7%, 33.1%, and 16.7% were in Stage II, III and IV respectively; 62/79 (78%) of Stage II patients were in Stage IIb; 15.7% of patients were below the age of 50 and fewer of them presented early (P=0.002). The overall 5-year survival was 46.5%. It was 67.9%, 50.5% and 12.8% for Stage I&II, III and IV patients respectively. Early stage of cancer (P<0.001) and age below the mean (P=0.01) were the most significant factor in predicting better survival. Gender and ethnic group were not associated with late presentation nor survival. Neither was there a difference between colon and rectum cancers nor patients who received elective surgical treatment compared to patients receiving other treatment first (P=0.085). Conclusions: Late presentation is the most important predictor for poor outcome for colorectal cancer in Seremban. Patients under the age of 50 years present late more often, but do not have poorer survival.

Introduction: Renal size measurement using ultrasound is a valuable parameter in the diagnosis of renal function and its diseases. This study is aimed to determine the differences of mean and correlation between the renal length (RL), renal width (RW) and renal parenchymal thickness (RPT) with age, gender and anthropometric measurements among indigenous population in Malaysia. Methods: A prospective cross-sectional study was carried out in this survey. Abdominal sonography was performed on 240 subjects. Sonography of the renal size included measurements of RL, RW and RPT. A portable ultrasound machine (Mindray DP-50, Shenzen, China) with a 3.5 MHz convex probe was used in this study. An independent-samples t-test, one-way ANOVA and Pearson's correlation coefficient test were performed in statistical analysis. Data were analyzed using SPSS program version 22.0. A P-value of <0.05 was considered significant. Results: The mean left RL was significantly decreased after the age of 54 years. RL of both kidneys was positively significant correlated with height (P<0.001), weight (P<0.001), waist circumference (WC) (P<0.001) and hip circumference (HC)(P<0.001). Similarly, a significant positive correlation was found between right RW and right RPT with weight (P=0.007 and P=0.003, respectively). Left RPT was significant correlated with height (P=0.006), weight (P<0.001) and HC (P=0.035). There was a significant positive correlation between left RW and height (P=0.048). A significant difference was also reported between right RL (P<0.001), left RL (P<0.001) and left RPT (P=0.040) with BMI. Conclusion: The normal values of renal size measurements are related to age, gender, height, weight, BMI, WC, and HC.

Efficient computation of quality of service (QoS) during medical data processing through intelligent measurement methods is one of the mandatory requirements of the medial healthcare world. However, emergency medical services often involve transmission of critical data, thus having stringent requirements for network quality of service (QoS). This paper contributes in three distinct ways. First, it proposes the novel adaptive QoS computation algorithm (AQCA) for fair and efficient monitoring of the performance indicators, i.e., transmission power, duty cycle and route selection during medical data processing in healthcare applications. Second, framework of QoS computation in medical applications is proposed at physical, medium access control (MAC) and network layers. Third, QoS computation mechanism with proposed AQCA and quality of experience (QoE) is developed. Besides, proper examination of QoS computation for medical healthcare application is evaluated with 4-10 inches large-screen user terminal (UT) devices (for example, LCD panel size, resolution, etc.). These devices are based on high visualization, battery lifetime and power optimization for ECG service in emergency condition. These UT devices are used to achieve highest level of satisfaction in terms, i.e., less power drain, extended battery lifetime and optimal route selection. QoS parameters with estimation of QoE perception identify the degree of influence of each QoS parameters on the medical data processing is analyzed. The experimental results indicate that QoS is computed at physical, MAC and network layers with transmission power (- 15 dBm), delay (100 ms), jitter (40 ms), throughput (200 Bytes), duty cycle (10%) and route selection (optimal). Thus it can be said that proposed AQCA is the potential candidate for QoS computation than Baseline for medical healthcare applications.

Purpose Preoperative chemotherapy is underused in conjunction with radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) due to concerns for complications and delay of surgery. Prospective data on short-term complications from population-based settings with frequent use of preoperative chemotherapy and standardised reporting of complications is lacking. Methods We identified 1,340 patients who underwent RC between 2011 and 2015 in Sweden due to MIBC according to the Swedish Cystectomy Register. These individuals were followed through linkages to several national registers. Propensity score adjusted logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for complications and death within 90 days of surgery, comparing patients receiving preoperative chemotherapy or not. Results Minimum two cycles of preoperative chemotherapy were given to 519 (39%) of the patients, who on average tended to be younger, have higher education, better physical status, and more advanced bladder cancer than patients not receiving chemotherapy. After adjusting for these and other parameters, there was no association between treatment with preoperative chemotherapy and short-term complications (OR 1.06 95% CI 0.82-1.39) or mortality (OR 0.75 95% CI 0.36-1.55). We observed a risk reduction for gastrointestinal complications among patients who received preoperative chemotherapy compared with those who did not (OR 0.49 95% CI 0.30-0.81). Conclusion This nation-wide population-based observational study does not suggest that preoperative chemotherapy, in a setting with high utilisation of such treatment, is associated with an increased risk of short-term complications in MIBC patients treated with radical cystectomy., Funding Agencies|Lions Cancer Research Foundation; Foundation for Medical Research at Orebro University Hospital, Sweden

This editorial is prepared for the Applied Energy Journal as a Virtual Special Issue (VSI) and it overviews the research work presented at the NAXOS 2018 6th International Conference on Sustainable Solid Waste Management, held from 13th to 16th June 2018 in Naxos Island, Greece. The research articles presented in VSI highlight the recent developments in waste valorisation for the recovery of energy, fuels and value-added products. They also cover the primary hurdles and potential solutions moving towards more sustainable society. This editorial not only presents the overall summary of the extended research papers from NAXOS 2018, but also provides an overview of the current trends and developments in the fields of waste management, waste valorization, and energy production systems. The articles published in this VSI cover a wide range of topics, including energy recovery from waste, waste to energy technologies, sustainable energy systems, anaerobic digestion, thermal arc plasma gasification, microalgal-based biorefinery, waste management, modelling of advanced gasification systems, waste valorization, and microbial fuel cell technology. 10 manuscripts, out of total 21 extended mansucripts invited, were accepted for publication in the Applied Energy Journal through peer review process conducted by the expert reviewers in the relevant fields with the aid of the guest editors.