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Abstract Inborn errors of immunity (IEIs) are a group of conditions whereby parts of the immune system are missing or dysfunctional. Once thought to primarily be a pediatric disorder, it is now estimated that more than 50% of worldwide incident IEI cases are accounted for by adults. Delayed diagnosis, late symptom onset, and IEI phenocopies can all lead to adult-onset recognition of IEIs. Lack of awareness regarding the diversity of IEI manifestations in adults contributes to diagnostic and treatment delays. Prompt referral to immunology is critical so that patients can receive a precise molecular diagnosis and targeted therapy when available. This article serves as a primer on IEIs in adulthood, highlighting the pathophysiology, epidemiology and clinical features. We present clinical vignettes of three key IEIs to assist clinicians in building illness scripts on their presentations. We provide a framework for the laboratory evaluation of IEIs and their initial treatment, with the aim of improving recognition and management of these conditions.

This study investigated the impact of commonly used treatment chemicals on the morphology and molecular structure of microfibers (MFs) and microplastic films (MPFs) to determine whether significant changes could occur during wastewater treatment. MFs and MPFs were exposed to sodium hypochlorite (NaOCl), hydrogen peroxide (H2O2), calcium hydroxide (Ca(OH)2, pH 11), sodium hydroxide (NaOH, pH11), and hydrochloric acid (HCl, pH 3) at typical doses and exposure times used at wastewater treatment plants. Scanning electron microscopy (SEM) analysis and attenuated total reflectance-Fourier-transform infrared (ATR-FTIR) were used to examine any morphological or chemical changes after the treatment. Morphological changes were observed in the form of cracks, and increased roughness was revealed in the SEM and 3-D surface images. The results showed that MFs were more resistant to surface degradation than MPFs. Moreover, intensity peaks of ATR-FTIR revealed some partial dislodgement of the bonds in both MFs and MPFs after chemical treatment, but the overall polymer structure remained intact. The changes that occur on the surface of MFs and MPFs during chemical treatment can impact their fate, removal, and transportation behavior both at the treatment plant and after discharge to the environment. HIGHLIGHTS We investigated the impact of treatment chemicals on the morphology and molecular structure of microfibers (MFs) and microplastic films (MPFs).; MFs and MPFs were exposed to NaOCl, H2O2, Ca(OH)2, NaOH and HCl.; SEM and ATR-FTIR were used to examine the changes.; Results showed some degradation of MFs and MPFs at low concentrations and exposure times, which may impact their fate, removal, and transport.;

Abstract Background Ewing sarcoma (ES) is a malignant bone tumor most commonly affecting non‐Hispanic White (NHW) adolescent males, though recognition among Hispanic individuals is rising. Prior population‐based studies in the United States (US), utilizing Surveillance, Epidemiology, and End Results (SEER) have shown higher all‐cause mortality among White Hispanics, Blacks, and those of low socioeconomic status (SES). Florida is not part of SEER but is home to unique Hispanic populations including Cubans, Puerto Ricans, South Americans that contrasts with the Mexican Hispanic majority in other US states. This study aimed to assess racial/ethnic disparities on incidence and survival outcomes among this diverse Florida patient population. Methodology Our study examined all patients diagnosed with osseous ES (2005–2018) in Florida (n = 411) based on the state's population‐based cancer registry dataset. Florida Age‐adjusted Incidence Rates (AAIRs) were computed by sex and race‐ethnicity and compared to the equivalent populations in SEER. Cause‐specific survival disparities among Florida patients were examined using Kaplan–Meier analysis. Univariable and multivariable analyses using Cox regression were performed for race/ethnicity, with adjustment for age, sex, year of diagnosis, site of disease, staging, SES, and insurance type. Results There was a significantly higher incidence of osseous ES in Florida Hispanic males (AAIR 2.6/1,000,000); (95% CI: 2.0–3.2 per 1,000,000; n = 84) compared to the SEER Hispanic males (AAIR 1.2/1,000,000;1.1–1.4 per 1,000,000; n = 382). Older age, distant metastasis, lack of chemotherapy or surgical resection were statistically significant determinants of poor survival while SES, insurance status and race‐ethnicity were not. However, among nonmetastatic ES, Florida Hispanics had an increased risk of death compared to Florida NHW (adjusted Hazard Ratio 2.32; 95%CI: 1.20–4.46; p = 0.012). Conclusions Florida Hispanic males have a higher‐than‐expected incidence of osseous ES compared to the US. Hispanics of both sexes show remarkably worse survival for nonmetastatic disease compared to NHW. This disparity is likely multifactorial and requires further in‐depth studies.

DICER1 syndrome is a rare genetic disorder predisposing young patients to multiple types of cancer. A 17-year-old woman with a history of mixed Sertoli-Leydig cell tumor and juvenile granulosa cell tumor of the left ovary at age 14 presented with a pelvic mass. She underwent fertility preservation cytoreductive surgery and the pathology showed high-grade sarcoma with rhabdomyosarcomatous differentiation. After the surgery, patient received one cycle of chemotherapy but her disease continued to progress. She therefore underwent total hysterectomy, right salpingo-oophorectomy and hyperthermic intraperitoneal chemotherapy followed by consolidation chemotherapy. Magnetic resonance imaging revealed no evidence of the disease before and after the completion of her chemotherapy. Genetic testing confirmed the DICER1 pathogenic variant. However, she presented again with a recurrence of the disease 6 months later and ultimately died of the disease 11 months after the surgery. Our case demonstrates the challenging management of this rare disease in a young patient and the need for new and effective treatments.

In order to assess the potential of the medium-range weather forecast in predicting the cotton productivity using crop simulation model, the CROPGRO-cotton model was calibrated and validated with the experimental data which was collected during kharif 2021 in an experiment that was carried out with two Bt cotton hybrid (RCH 776 and RCH 773) and one non-Bt (F2228), and sown at five dates i.e., April 25th, May 05th, May 15th, May 25th and June 04th in split-plot design with three replications at Punjab Agricultural University (PAU) Regional Research Station, Bathinda. The validated model was further used to assess the cotton productivity under different sowing dates using medium range weather forecast data on rainfall, maximum temperature and minimum temperature obtained for the period 2013-2021. The results showed that simulated values with medium range weather forecast were in close agreement with the simulated values for phenology and yield of cotton. The simulated cotton yield using daily medium range weather forecast data showed more or less significant efficiency to capture year-to-year as well as datewise variability in simulated cotton yield.

Background: Improving equitable access to healthcare requires innovative interventions and strengthening a service innovation operational model to achieve transformative change and bring sustainability to public health interventions. The current study aims to identify the components of the Mobile Medical Units (MMUs) operational model as an innovative intervention to provide equitable and inclusive access to healthcare. Methods: The study used qualitative research to identify the components of the operational model of MMUs for primary healthcare in future. Data has been collected via semi-structured in-depth interviews with 103 healthcare professionals from six states representing India's Tier I, Tier II, and Tier III regions. A thematic analysis was performed to examine emergent salient themes. Results: The study identified and examined scalability, affordability, replicability, and sustainability as the four critical components of the operational model of MMUs. The findings of the study indicated that MMUs with these four components played a vital role in COVID-19 immunization, especially in resource-limited settings. The study found that MMUs are a cost-effective and scalable healthcare delivery model that can be easily replicated in primary healthcare service delivery. Conclusion: The findings underscore the significant role of MMUs in addressing healthcare disparities, particularly in resource-limited settings. The adaptability and cost-effectiveness of MMUs make them an ideal solution for primary healthcare delivery, especially in Tier I, II, and III regions of India. It lays a foundation for future research and policy-making, emphasizing the need for innovative, equitable, and sustainable healthcare delivery models like MMUs to transform and strengthen healthcare systems globally.

The growth and productivity of cotton (Gossypium herbaceum L.) crop are greatly influenced by major fluctuations in the local weather. The output of cotton is negatively impacted by extended periods of unfavourable weather, despite the crop's apparent relative resistance to heat and drought. Among various cotton growing states in India, Gujarat often leads as the highest cotton-producing state in the country followed by Maharashtra, Telangana, Rajasthan, Karnataka and Andhra Pradesh. These states collectively contribute more than 65% to India's cotton production. In Punjab, the optimal sowing window for cotton spans from the 1stApril to 15th May. Deviating from this recommended time frame, be it through excessively early or late sowing, correlates with compromised crop establishment and reduced productivity. Temperature thresholds dictate progression of the cotton crop's key stages. For germination, a threshold temperature of 16°C is required, while the range of 21 to 27°C is conducive to vegetative growth, and 27 to 32°C supports reproductive development. The diurnal/night time temperature for fostering cotton root growth resides within 30°C/22°C to 35°C/27°C. Elevated temperatures (40°C/32°C), even under adequate water and nutrient conditions, results in the emergence of shallow root systems. Strategic measures encompassing suitable sowing dates, precise plant spacing, favourable row orientations, judicious irrigation techniques and mulching can effectively temper the influence of climate change on cotton output. Furthermore, the application of crop simulation models and access to timely, accurate weather forecasts and agro-advisories equips decision-makers with invaluable insights for short-term operational planning.