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Hematopoietic cell transplantation (HCT) uses cytotoxic chemotherapy and/or radiation followed by intravenous infusion of stem cells to cure malignancies, bone marrow failure and inborn errors of immunity, hemoglobin and metabolism. Lung injury is a known complication of the process, due in part to disruption in the pulmonary microenvironment by insults such as infection, alloreactive inflammation and cellular toxicity. How microorganisms, immunity and the respiratory epithelium interact to contribute to lung injury is uncertain, limiting the development of prevention and treatment strategies. Here we used 278 bronchoalveolar lavage (BAL) fluid samples to study the lung microenvironment in 229 pediatric patients who have undergone HCT treated at 32 childrens hospitals between 2014 and 2022. By leveraging paired microbiome and human gene expression data, we identified high-risk BAL compositions associated with in-hospital mortality (P = 0.007). Disadvantageous profiles included bacterial overgrowth with neutrophilic inflammation, microbiome contraction with epithelial fibroproliferation and profound commensal depletion with viral and staphylococcal enrichment, lymphocytic activation and cellular injury, and were replicated in an independent cohort from the Netherlands (P = 0.022). In addition, a broad array of previously occult pathogens was identified, as well as a strong link between antibiotic exposure, commensal bacterial depletion and enrichment of viruses and fungi. Together these lung-immune system-microorganism interactions clarify the important drivers of fatal lung injury in pediatric patients who have undergone HCT. Further investigation is needed to determine how personalized interpretation of heterogeneous pulmonary microenvironments may be used to improve pediatric HCT outcomes.

ABSTRACTThis study investigates the impact of different fertilizers under varying irrigation systems and crop water requirements in water-scarce Sinai, Egypt. Field experiments were conducted during the agricultural winter seasons of 2021 and 2022 to study the response of wheat growth, yield, and water productivity under drip and furrow irrigation. The results showed that under drip irrigation system, pH showed no clear trend, while total dissolved solids (TDS) decreased with depth and were reduced by bio-fertilizer and the combination treatment. On the other hand, under furrow irrigation system, maintained a slightly alkaline pH with minimal fertilizer influence. TDS levels significantly varied, and the effects of fertilizers differed. Calcium carbonate content and organic matter varied with fertilizer types and depths. Increasing the crop water requirement from 80% to 100% improved plant growth and yield, with the 80% treatment demonstrating higher water productivity. Furrow irrigation resulted in higher growth and yields, while drip irrigation exhibited greater water productivity. Nano-fertilizer treatments consistently outperformed bio-fertilizer in growth, yields, and water productivity. Specific combinations showed superior performance due to interactions between factors. Suitable irrigation methods and regimes enhance water use efficiency. Higher irrigation levels enhance wheat growth and yield, requiring careful water management to avoid stress. Drip irrigation demonstrates superior water productivity. Reducing the water input to 80% of crop water requirements improves efficiency without compromising yield. Nano-fertilizers promote growth and grain retention as an alternative to soluble fertilizers. Combining nano with bio-fertilizers further enhances wheat growth, yield, and water productivity. These findings provide valuable insights for optimizing wheat production in water-scarce regions, considering irrigation methods, crop water requirements, and nitrogen fertilization sources.

Abstract Background COVID-19, caused by the SARS-CoV-2 virus, is one of the most known pandemics ever affecting human life and global economics. Recently, it has shown several symptoms related to different organ systems, including the nervous system, represented in some reported neurological manifestations. Therefore, a smart prediction system that can determine the likelihood and certainty of having COVID-19 based on those neurological manifestations can help in early detection of the disease, which helps in diagnosis and limiting the prevalence of COVID-19. Patients and methods This study involved a comprehensive data collection process. We gathered information from thousands of patients, encompassing both neurological and non-neurological manifestations of COVID-19. This data, derived from various research works, including mild and moderate cases, was then subjected to rigorous statistical analysis. The results of this analysis formed the basis for the design of a fuzzy interference system (FIS), which utilizes a fuzzy logic approach to determine the certainty of COVID-19 based on neurological symptoms. Results Statistical analysis of the collected data showed neurological symptoms in all surveyed cases in the first week of the COVID-19 presentation. Headache has been reported in 70–80% of all cases; anosmia–dysgeusia showed up in 50–60% of total cases; Myalgia presented in 40–45% of all cases; Fatigue was there in 30–35% of the surveyed cases; dizziness was recorded in 30–35% of patients; 0–10% of subjects showed noncommon symptoms like numbness, migraine, loss of concentration, and seizures. By applying these statistical results to the fuzzification process and developing the rulesets, the fuzzy logic-based forecasting system could determine the certainty of COVID-19 with high accuracy, reaching 95% by comparing it with the clinical data. Conclusions Surveying neurological and non-neurological symptoms of thousands of COVID-19 patients in many related literature showed neurological manifestations in all patients with different ratios and weights, including mild and moderate cases, by statistically analyzing these data to form the rulesets of a predesigned fuzzy logic-based forecasting system. The fuzzy logic system was able to yield a successful prediction of the likelihood of having COVID-19 in a group of patients based on their neurological symptoms with an accuracy of 95% by comparing the predicted data with the clinical data.

Abstract Background Every branch of surgery relies in some way on histology to obtain a conclusive diagnosis. Since precise and comprehensive information on the request form is crucial to the correct analysis and interpretation of test results, it is anticipated that all patient data and information for any requested test be provided. One of the most significant duties of the peri-operative team is the care and handling of intraoperative surgical specimens. Poor labeling and handling of surgical specimens can lead to unfavorable consequences such as misdiagnosis, incorrect or delayed therapy, and even the need for repeat surgery. The study’s. objective is to highlight the primary mistakes that occur in the pre analytical stage of histopathology request forms and specimens at two Khartoum-based histopathological institutions. Methods A prospective descriptive laboratory based cross-sectional study was carried out on 528 request forms and specimens sent to two histopathology centers between the period of May to August 2019 having gotten Ethical clearance from SMSB. Results A total of 528 laboratory request forms and specimens, Age was written in 75.6% (n 399), while the gender only was written only in 46.2% (n 244). No clinical history in 48.3% (n 255). The differential diagnosis found only in 29.5% (n156) of request forms. Regarding specimen 15.7% (83) were inadequate relative to the size of the container and only 5.3% (28) were not labeled with any information. 17.4% (92) were not sent in formalin but in normal saline. Marking of the specimen was not needed in 60% (317) and among the rest cases; 34.2% was not marked. Conclusion The study shows that laboratory request forms were not properly and thoroughly completed. Most of the specimens sent for histology had inadequate fixative and unsuitable containers, or they were mislabeled and not properly tagged. This for sure will have a detrimental effect on the quality of care.

Abstract Background The relationship between the microbiome and oral health is intricate, yet there is a lack of comprehensive knowledge regarding the microbiome’s impact on oral health. Integrating knowledge regarding the oral microbiome and its significance in oral and systemic diseases holds profound implications for dental professionals in patient care and professional development. This study assessed dental professionals’ oral microbiome comprehension and knowledge levels in Saudi Arabia and its implications for oral healthcare. Methods Data were gathered using a cross-sectional design by administering a comprehensive online questionnaire to 253 dental professionals from diverse demographic backgrounds. The questionnaire, administered in English, was divided into four sections: (1) Microbiome awareness and understanding, (2) Diet, nutrition, and microbiome relationship, (3) Microbiome and oral and systemic diseases, and (4) Counselling, education, and implications. Statistical analyses were used to identify and understand underlying patterns, including descriptive statistics, chi-squared tests, ANOVA, and post hoc tests. The Spearman rank correlation coefficient was applied to assess self-rated knowledge. Results Of the 253 participants, 94.6% were familiar with the term “microbiome.” Merely 13% of participants considered the oral microbiome to be the second most diverse, following the gut microbiome. About 39.9% of participants knew the connection between oral mucosal diseases and the oral microbiome. Furthermore, only 6.7% thought there was a connection between systemic diseases and the oral microbiome. Participant comprehension of oral microbiome questions averaged 9.19 out of 13, with 83.7% scoring “good”. There were significant differences in knowledge scores among dental specializations (F = 7.082, P

Abstract Background Spondylodiscitis is an infection of the vertebral body extending to the intervertebral disc, and possibly the surrounding paraspinal structures. Objectives To evaluate the clinical results of posterior long segment transpedicular screws fixation and decompression of the infected area for management of idiopathic pyogenic spondylodiscitis of the thoracic and lumbar spine. Methods This retrospective study included 14 patients with idiopathic active pyogenic spondylodiscitis of the lumber and thoracic spine between January 2017 and December 2021, with follow-up continuing until December 2022. All patients had posterior long-segment rigid fixation with infection decompression. Results All patients after 6-month follow-up had achieved complete fusion. There was no evidence of postoperative wound infection, and no patient had a recurrence of infection at the lesion site during follow-up. Prior to surgery, the mean VAS score for back pain was 7.6 (range 6–9), however, after surgery, it fell to 1.3 (0–3), a statistically significant improvement (P

Abstract The development of a novel method for modelling fluid flow and heat transfer in naturally fractured geothermal reservoirs represents a significant advancement in geothermal energy research. This Study presents a hybrid approach, which combines discrete fracture and single continuum techniques, to effectively capture the complex interactions between fluid flow and heat transfer in geothermal fractured reservoirs. In addition, the incorporation of the local thermal nonequilibrium method for simulating heat transmission accounts for the disparities in temperature between the rock matrix and the fluid, providing a more realistic representation of heat transfer processes. The study also presents a fully coupled thermo-poro-elastic framework that integrates fluid flow and heat transfer to comprehensively evaluate reservoir responses to injection/production scenarios. This coupled approach allows for the prediction of changes in reservoir properties, such as permeability and porosity, under varying fluid pressure and temperature conditions. The application of the proposed model to evaluate a geothermal reservoir’s long-term response to injection/production scenarios provides valuable insights into the reservoir’s behaviour and potential energy production capacity. The sensitivity analysis further enhances the model’s utility by identifying the key reservoir parameters that significantly influence the thermal depletion of the reservoir. Overall, this novel modelling approach holds promise for improving the understanding and management of naturally fractured geothermal reservoirs, contributing to the optimization of geothermal energy extraction strategies.

We investigated the impact of the number of induction/consolidation cycles on outcomes of 3113 adult AML patients who received allogeneic hematopoietic cell transplantation (allo-HCT) between 2008 and 2019. Patients received allo-HCT using myeloablative (MAC) or reduced-intensity (RIC) conditioning in first complete remission (CR) or with primary induction failure (PIF). Patients who received MAC allo-HCT in CR after 1 induction cycle had 1.3-fold better overall survival (OS) than 2 cycles to CR and 1.47-fold better than ≥3 cycles. OS after CR in 2 or ≥3 cycles was similar. Relapse risk was 1.65-fold greater in patients receiving ≥3 cycles to achieve CR. After RIC allo-HCT, the number of induction cycles to CR did not affect OS. Compared to CR in 1 cycle, relapse risk was 1.24-1.41-fold greater in patients receiving 2 or ≥3 cycles. For patients receiving only 1 cycle to CR, consolidation therapy prior to MAC allo-HCT was associated with improved OS vs. no consolidation therapy. Detectable MRD at the time of MAC allo-HCT did not impact outcomes while detectable MRD preceding RIC allo-HCT was associated with an increased risk of relapse. For allo-HCT in PIF, OS was significantly worse than allo-HCT in CR after 1-3 cycles.

With the advent of new technologies that are developing unusually, it has greatly affected the design of outdoor furniture, as it makes it different from what is known in its traditional form, and in light of the urgent need to preserve the environment when planning new cities and the impact of the abnormal development of technology in the few years The past on the production of outdoor furniture, and what about its service to users of central public areas. Hence the problem of the research, which is the lack of outdoor furniture design for public areas, the use of new technology, the Internet of Things (IOT) to achieve the principles of sustainability and taking into account the environmental aspects. The research assumes that new technology and the manufacture of sustainable outdoor furniture affect the spaces of central public areas and lead to the emergence of modern vocabulary when planning new cities, such as the Internet of Things (IOT) technology to produce environmentally friendly outdoor furniture and provide many services to users of central public areas, and also serve decision makers by monitoring many Information and self-analysis for a better quality of life. The research found that the use of the surrounding environment as information to provide functions and comfort to its users, this is done by designing sustainable outdoor furniture based on new technology techniques, the Internet of Things (IOT), which controls many applications aimed at taking into account the environmental aspect, and maximizing the role of cities Smart in a concept that aims to improve the quality of life through applications that allow users to smart services to raise the efficiency of operations and services, as well as discover the vocabulary of the elements of the outdoor space and the use of smart outdoor furniture in adding more valuable information about the different places and locations of the users, functions and comfort as well for them, through Intelligent applications serve both users and decision-makers.

Objective: This study aimed to demonstrate the superiority of cryocompression over cryotherapy alone in the prevention of chemotherapy-induced peripheral neuropathy (CIPN) grade 2 or above. Methods: This prospective randomized study was conducted between May 2020 and January 2023 in Innsbruck. Eligible patients had a diagnosis of gynecological cancer and received a minimum of 3 cycles of taxane-based CT (neoadjuvant, adjuvant or palliative therapy). Patients were randomized 1:1 to receive either cryotherapy or cryocompression on their upper extremities during chemotherapy (CT). We performed temperature measurements, two QoL questionnaires and neurological tests during CT and at follow-up 3 and 6–9 months after the completion of CT. CIPN was assessed using the CTCAE score. Results: Of 200 patients recruited, both groups showed a lower prevalence of CIPN in this study compared to recent literature. In the group receiving cryotherapy, the prevalence of grade 1 CIPN was 30.1 %, and that of grade 2 CIPN or above was 13.7 %; in the group treated with cryocompression, the prevalence of grade 1 CIPN was 32.8 %, and that of grade 2 or above CIPN was 17.2 %. We found a significant reduction in temperature in the cryotherapy and cryocompression groups. Regarding the two QOL questionnaires as well as the neurological tests no significant differences were found between the two groups. Conclusion: Our study suggests that cryotherapy as well as cryocompression is a safe and effective way to cool patients’ extremities to lower the prevalence of CIPN. Cryocompression was not more effective than cryotherapy alone in the prevention of CIPN.

Abstract In this study, a neural network model is developed for the prediction of oil flow rates in wells lifted by electrical submersible pumps (ESPs). Three attributes of the model in this work make this study unique. First, the knowledge on the computational cost of models has been presented, a rarity in most neural network models on this subject; second, the models have been explicitly presented, a feature uncommon in published ANN predictive modelling studies; and third, it includes a sensitivity analysis of input variables. The dataset utilized for the model development comprises 275 data points collected from ESP-lifted wells in the Middle East. Statistical evaluation of the model’s performance using the metrics such as mean square error, root mean square error and coefficient of determination demonstrates high predictive accuracy with respective values of 0.0000201861, 0.00449 and 0.999. In order to ascertain the parametric importance of the inputs, Garson’s algorithm was utilized. In this regard, choke size and upstream pressure had the highest influence (19% and 16%, respectively), while casing head pressure had the least effect (4.8%) on oil flow rate. In terms of memory requirements and processing speed for software applications, the model had a memory footprint of 888 bytes and required 191 multiply and accumulate operations to give an output. By utilizing the proposed models, the time-consuming separator tests measurements of flow rate would no longer be necessary and real-time results could be provided in the field. This work would be useful to production engineers who seek a quick and accurate means of estimating oil flow rate from ESP wells in real time.

Abstract Background This work aims to develop clinical practice recommendations for the management of systemic sclerosis (SSc). Results Fourteen expert panels had completed the two rounds of surveys. After the end of round 2, recommendations were released and distributed on 11 domains. The percentage of the agreement on the recommendations was 92.3% to 100%. All 11 key questions were answered at the end of the second round with agreement. Conclusion This guideline tried to tackle the gaps in research that limit treatment options. Stratifying the patients according to their disease domains has helped to set up sequential management pathways for each domain.

Abstract Purpose To assess the relationship between the triad of obesity, fracture risk factors, and osteoporosis and its impact on fragility fractures. Results Osteoporosis was least prevalent (p

Abstract Background Inflammation is a cardinal mechanism of diabetic kidney disease (DKD). Interleukin-6 (IL6) is a reliable indicator that plays a role in the progression of DKD. Monocyte-to-lymphocyte ratio (MLR) is also implicated in this inflammatory process. The progression of DKD is associated with increased carotid intima-media thickness (CIMT), which is an independent predictor of atherosclerosis. Aim The role of IL6 and MLR ratio influencing the progression of DKD was assessed using the urinary albumin creatinine ratio (UACR) and glomerular filtration rate (GFR). Moreover, their contribution to increasing CIMT in DKD was assessed. Methods An observational prospective study was conducted on ninety diabetic patients presented to the Internal Medicine Clinic at Kasr AlAiny. The subjects were classified into three groups, thirty patients for each, according to UACR: with normoalbuminuria, microalbuminuria, and macroalbuminuria. A history and clinical assessment, CBC, MLR, HbA1c, lipid profile, IL6, creatinine, and eGFR were carried out. Furthermore, CIMT was measured using Doppler ultrasound. Results The results showed that IL6 and MLR were significantly higher in the macroalbuminuria group compared to the other two groups with p 0.001. IL6 and MLR were positively correlated with CIMT in micro and macroalbuminuric patients. Conclusion Both MLR and IL-6, as simple biomarkers associated with increased CIMT, play an important role in predicting the nephropathy of DKD patients.

Abstract Background Far lateral lumbar disc herniation is a clinical condition characterized by nerve root compression out of the spinal canal, in its extraforaminal/extracanalicular course at the inferior or lateral aspect of the facet joint. Objective To analyze the effect of unilateral full facetectomy with instrumented fusion in management of foraminal and far lateral lumbar disc herniation. Methods This retrospective trial carried out on 34 cases (24 males, 10 females) aged from 27 to 68, with mean value of 49 years who were entered to the Neurosurgery Department, Menoufia University Hospital from January 2018 and January 2022. All patients suffered from foraminal and/or far lateral lumbar disc herniation and were treated with unilateral full facetectomy with instrumented fusion. Results The herniation level was at L2-3, L3-4, L4-5, and L5-S1 in 2, 10, 18, and 4 patients, respectively. Overall, the mean preoperative VAS score decreased from 8.6 to 2.3 in the short-term. When the long-term functional outcome following surgery was analyzed according to the MacNab Criteria, the recovery was excellent, good, fair, and poor in 26, 8, 0, and 0, respectively. Conclusions Full facetectomy ± laminectomy technique provides direct visualization of the complete course of the nerve root extending far laterally to avoid missed disc fragments and protect the nerve root from inadvertent trauma. Pedicle fixation for stabilization following full facetectomy has been indicated to avoid postoperative pain syndromes due to `micro-instability'.

Abstract Background The aim of this work is to develop guidelines for health care professionals in the giant cell arteritis diagnosis and management, based on patients’ stratification and targeted outcome measures. Results Fourteen expert panel had completed the two rounds surveys. After the end of round two, twenty three recommendations were released distributed on 8 domains. The percentage of the agreement on the recommendations was 76.9% to 100%. All 23 key questions were answered at the end of the second round with agreement upon. Conclusion Patient stratification facilitate the initiation of an appropriate management approach for patients with giant cell arteritis aiming at achieving targeted disease remission state and prevention of visual loss and/or development of ischaemic events. Treat to Target approach is a new concept in giant cell arteritis management which aims to provide tight control to achieve and maintain disease remission. This work defined the treatment targets in relation to the disease stage.

Background: T-cell-based adoptive cell therapies have emerged at the forefront of cancer immunotherapies; however, failed long-term survival and inevitable exhaustion of transplanted T lymphocytes in vivo limits clinical efficacy. Leukemia blasts possess enhanced glycolysis (Warburg effect), exploiting their microenvironment to deprive nutrients (e.g., glucose) from T cells, leading to T-cell dysfunction and leukemia progression. Methods: Thus, we explored whether genetic reprogramming of T-cell metabolism could improve their survival and empower T cells with a competitive glucose-uptake advantage against blasts and inhibit their uncontrolled proliferation. Results: Here, we discovered that high-glucose concentration reduced the T-cell expression of glucose transporter GLUT1 (SLC2A1) and TFAM (mitochondrion transcription factor A), an essential transcriptional regulator of mitochondrial biogenesis, leading to their impaired expansion ex vivo. To overcome the glucose-induced genetic deficiency in metabolism, we engineered T cells with lentiviral overexpression of SLC2A1 and/or TFAM transgene. Multi-omics analyses revealed that metabolic reprogramming promoted T-cell proliferation by increasing IL-2 release and reducing exhaustion. Moreover, the engineered T cells competitively deprived glucose from allogenic blasts and lessened leukemia burden in vitro. Conclusions: Our findings propose a novel T-cell immunotherapy that utilizes a dual strategy of starving blasts and cytotoxicity for preventing uncontrolled leukemia proliferation.

Student Evaluations of Teaching (SETs) gather crucial feedback on student experiences of teaching and learning and have been used for decades to evaluate the quality of teaching and student experience of instruction. In this paper, we make the case for an important improvement to the analysis of SET data that can further refine its interpretation. An extensive literature explores the reliability and consistency of SETs, and factors hypothesized to affect student evaluation of instructors. Much less attention has been given to the statistics used by institutions of higher education to summarize and report SET data--historically, arithmetic means and standard deviations computed from Likert scale scores. Here, we argue that a combination of two different statistics--interpolated median (IM) and percent favourable (PF) rating--together with a measure of dispersion suitable for ordinal data offer a fairer and more meaningful set of metrics for summarizing and interrogating SET data collected using balanced Likert scale surveys. To illustrate the power of these proposed metrics, we present an analysis of SET data from two academic years at a major Canadian university, and we also highlight an interesting and previously unreported relationship that we identified between the interpolated median and percent favourable rating.

Summary: Background: Sinusoidal obstruction syndrome is a potentially fatal complication following hematopoietic cell transplantation, high-intensity chemotherapies and increasingly seen with calicheamicin based leukemia therapies. Paediatric specific European Society for Blood and Marrow Transplantation (pEBMT) diagnostic criteria have demonstrated benefit in single center studies compared to historic criteria. Yet, the extent to which they have been universally implemented remains unclear. Methods: We conducted a retrospective multi-centre study to examine the potential impact of the Baltimore, modified Seattle and pEBMT criteria on the incidence, severity, and outcomes of sinusoidal obstruction syndrome among paediatric hematopoietic cell transplantation patients. Findings: The incidence of sinusoidal obstruction syndrome in this cohort (n = 488) was higher by pEBMT (21.5%) vs historic modified Seattle (15.6%) and Baltimore (7.0%) criteria (p

Abstract Large-scale longitudinal biobank data can be leveraged to identify genetic variation contributing to human diseases progression and traits trajectories. While methods for genome-wide association studies (GWAS) of multiple correlated traits have been proposed, an efficient multiple-trait approach to model longitudinal phenotypes is not currently available. We developed GAMUT, a genome-wide association approach for multiple longitudinal traits. GAMUT employs a mixed-effects model to fit longitudinal outcomes where a fast algorithm for inversion by recursive partitioning of the random effects submatrix is introduced. To evaluate performance of the algorithms introduced and assess their statistical power and type I error, stochastic simulation was conducted. Consistent with our expectation, power was greater for cross-sectional (CS) than longitudinal (LT) effects, particularly with a diminishing LT/CS ratio. With a minimum minor allele count of 3 within genotype by time categories, observed type I error was roughly equal to theoretical genome-wide significance. Additionally, 28 blood-based biomarkers measured at 2 time points on participants of the UK Biobank were used to compare GAMUT against single-trait standard and longitudinal GWAS (including rate of change). Across all biomarkers, we observed 539 (CS) and 248 (LT) significant independent variants for the GAMUT method, and 513 (CS) and 30 (LT) for single-trait longitudinal GWAS, respectively. Only 37 variants were identified by modeling rates of change using standard GWAS.

Abstract Background Lumbar radicular pain (LRP) is one of the most encountered complaints in neurosurgical practice that pose a challenge in its management as adequate pain control, which is not always achieved. Objective The aim of this study was to evaluate the role of pulsed radiofrequency as a minimally invasive tool in the management of lumbar radicular pain of lumbar discogenic origin. Methods This is a prospective study that included 20 patients with lumbar radicular pain with radiological evidence of lumbar disc prolapse, who have been subjected to pulsed radiofrequency. Results The mean preoperative visual analogue score was 71 ± 14.38 dropped to a mean of 43.5 ± 21.47 at six-month follow-up. Seventy percentage of the study population had a satisfactory outcome, which did not correlate with the age, sex, or body mass index of the patients. Conclusions Pulsed radiofrequency is a safe and useful tool that may be used in the management of lumbar radicular pain.

Abstract Background Radiological diagnosis of cervical spondylotic myelopathy should be made as early as possible to obtain favourable clinical outcomes when compared with later stages. Diffusion tensor imaging can reveal early structural changes of the cord in patients with cervical compressive myelopathy. Aim This study aimed to assess the role of magnetic resonance diffusion tensor imaging in the accurate evaluation of cervical spondylotic myelopathy. Patients and methods This prospective study included a group of 60 patients with neurological symptoms suggestive for cervical spondylotic myelopathy and a control group of 30 healthy subjects. The clinical severity of compressive myelopathy was assessed based on the European myelopathy score. Magnetic resonance diffusion tensor imaging and tractography were done for all patients and controls. Results Fractional anisotropy values at the most compressed segments of spinal cord are lower while apparent diffusion coefficient values of the same segments are higher than healthy segments in controls. Fractional anisotropy and apparent diffusion coefficient parameters had higher sensitivity (97.0% and 88.1%, respectively) than conventional T2 WIs (13.4%) and fibre tractography (10%) for the detection of early compressive myelopathy with cutoff values ≤ 0.56 and > 1.23, respectively, in differentiating between patients and control groups. Conclusion Diffusion tensor imaging indices are valuable tools for quantitative assessment of degenerative cervical spondylotic myelopathy in addition to routine cervical spine magnetic resonance.

Abstract Background Dual-energy X-ray absorptiometry (DXA) is an important diagnostic test for bone mass status. The aim of this work was to set the standards for structured reporting of DXA measurements in adults within the context of fracture and fall risk assessment. Results Two rounds of Delphi were completed. The first Delphi round had a 68% response rate, while round two had a 100% response rate. After round 2, a total of 28 items were obtained, which were classified into three domains. The percentage of people who agreed with the recommendations (ranks 9–7) ranged from 76.5 to 100%. The wording of all 19 clinical standards determined by the scientific committee was agreed upon (i.e., 75% of respondents strongly agreed or agreed). Conclusion The DXA scan report is an independent document that contains sufficient information to enable optimal osteoporosis management advised by an experienced healthcare professional. Setting up quality standards for DXA scans not only supports healthcare professionals reporting/interpreting bone densitometry but also meets the parameters outlined in national as well as international guidelines or recommendations for the optimal management of osteoporosis and subsequent prevention of low trauma fractures.

The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLA-matched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P ≤ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P ≤ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (≤18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.

Cytogenetic and molecular abnormalities are known to influence post-transplant outcomes in acute myeloid leukemia (AML) but data assessing the prognostic value of combined genetic models in the HCT setting are limited. We developed an adapted European LeukemiaNet (aELN) risk classification based on available genetic data reported to the Center for International Blood and Marrow Transplant Research, to predict post-transplant outcomes in 2289 adult AML patients transplanted in first remission, between 2013 and 2017. Patients were stratified according to aELN into three groups: favorable (Fav, N = 181), intermediate (IM, N = 1185), and adverse (Adv, N = 923). Univariate analysis demonstrated significant differences in 2-year overall survival (OS) (Fav: 67.7%, IM: 64.9% and Adv: 53.9%; p