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Almost one-third of colorectal cancer (CRC) patients experience recurrence after resection; nevertheless, follow-up strategies remain controversial. We sought to systematically assess and compare the accuracy of carcinoembryonic antigen (CEA), imaging [positron emission tomography (PET) and computed tomography (CT) scans], and circulating tumor DNA (CtDNA) as surveillance strategies.PubMed, Medline, Embase, Scopus, Cochrane, Web of Science, and CINAHL were systematically searched. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to assess methodological quality. We performed a bivariate random-effects meta-analysis and reported pooled sensitivity, specificity, and diagnostic odds ratio (DOR) values for each surveillance strategy.Thirty studies were included in the analysis. PET scans had the highest sensitivity to detect recurrence (0.95; 95%CI 0.91-0.97), followed by CT scans (0.77; 95%CI 0.67-0.85). CtDNA positivity had the highest specificity to detect recurrence (0.95; 95%CI 0.91-0.97), followed by increased CEA levels (0.88; 95%CI 0.82-0.92). Furthermore, PET scans had the highest DOR to detect recurrence (DOR 120.7; 95%CI 48.9-297.9) followed by CtDNA (DOR 37.6; 95%CI 20.8-68.0).PET scans had the highest sensitivity and DOR to detect recurrence, while CtDNA had the highest specificity and second highest DOR. Combinations of traditional cross-sectional/functional imaging and newer platforms such as CtDNA may result in optimized surveillance of patients following resection of CRC.

Water is one of the important requirements for human health and life. However, it is also the most effective carrier of pathogens causing a number of infectious diseases. Water borne diseases are the most common prevalent infectious diseases in developing countries especially in rural areas, and is still a major public health and environmental concern. The living conditions in rural areas are poor, which makes rural populations more vulnerable to inaccessibility to safe drinking water and high risk of water borne diseases .Water safety in a community depends on a range of factors, from the quality of source water to storage and handling in the domestic setting. This is a descriptive cross sectional community based study conducted in East Nile locality in the capital state of Khartoum in Sudan among 384 households from April to June 2019, to assess water handling practices on a household level and the factors associated with the prevalence of water borne diseases. A questionnaire was used to collect data and the data was analysed by using Statistical Packages for Social Sciences (SPSS). The result revealed that artesian wells were the commonest source of drinking water used by 81% of participants. The majority of the respondents (80.2%) didn’t treat their water at household level and only 3% used boiling. 2.9% of the respondents washed their hands before collecting water, 3.4% of the respondents cleaned their water container regularly and 91.7% covered their water collection container. The prevalence of water borne diseases was 79% and diarrhoeal disease were the most prevalent water borne diseases among households in all the selected villages accounting for 52.1% of the total followed by typhoid fever at 38%. The study concluded that the practice of hygienic water handling practices among participants was poor. Source of drinking water, socioeconomic status as well as the adoption of measures to treat water were the major factors responsible for the occurrence ....

Reports of thrombotic response after receiving COVID-19 Adenoviral-Vector Based Vaccines raise concerns about vaccine-induced thrombotic thrombocytopenia (VITT); therefore, we conduct this systematic review to report susceptible demographics outcomes, commonalities, and prognosis of reporting cases. We identified published articles by searching PubMed, SCOPUS, and Web of Science from December 2020 till May 2021, with an updated search in September 2021. All case reports and case series reporting thrombotic response after receiving COVID-19 Adenoviral-Vector Based Vaccines were eligible for including. In addition, two authors independently extracted data and assessed the quality of the included studies. A total of 157 patients with thrombotic events after the ChAdOx1 nCoV-19 vaccine and 16 patients with thrombotic events after Ad26.COV2. S vaccine was included in our study. 72% of the ChAdOx1 nCoV-19 cases were females, while in Ad26.COV2.S subgroup, all reported patients were females. The commonest presentations were deep vein thrombosis 20 (12.7%) and cerebral venous sinus thrombosis 18 (11.5%) in the ChAdOx1 nCoV-19 subgroup while cerebral venous sinus thrombosis 14 (87.5%) and pulmonary embolism 2 (12.5%) in the Ad26.COV2. S subgroup. In this study, we described the certain demographics associated with VITT and the clinical presentations of those cases in the ChAdOx1 nCoV-19 and Ad26.COV2. S vaccines. Young individuals, particularly females, may be more susceptible to VITT, and future studies should seek to confirm this association. In addition, the clinical presentation of VITT commonly includes cerebral thrombi, pulmonary embolism, and deep venous thrombosis, but other presentations are also possible, highlighting the importance of clinical vigilance in recent vaccine recipients.

Water is one of the important requirements for human health and life. Safe and adequate water supply is a vital element to preserve human health, however access to clean water is limited in many developing countries. Household water treatment and safe storage (HWTS) provides a solution, when employed correctly and consistently, for managing water safety at home, have been shown to be effective in improving the microbiological quality of drinking water. This is a pre- post quasi experimental community based study conducted in East Nile locality in the capital state of Khartoum in Sudan among 384 households from May 2018 to June 2020, to evaluate the effects of a health education program on water treatment and safe storage. A questionnaire was used to collect data pre and post health education, the data was analysed by using Statistical Packages for Social Sciences (SPSS). The result revealed that artesian well was the commonest source of drinking water used by 81% of participants. Nearly all of households 99.5% transported the water from points of sources to their houses using barrels carried by donkeys while only small portion 0.5% used buckets. The proportion of households who stored drinking water containers close to potential source of contamination was significant decrease from (96.9 %) before health education to (1.8%) after health education, and cleaned the water containers with water and soap before storing water, was improved from (4.3%) before health education to (98.4%) after health education. Households who stored drinking water in a covered containers were high before health education (91.7%) and remained high after health education (99.0%). Before health education, 19.8% of households practiced home-based water treatment. Conversely 99.7% of the households practiced home-based water treatment at the end line of the programme which showed significant change compared with the baseline (P

The aim of this study was to study the importance Osteochondral lesion (OCL) depth as a singular factor for treatment outcomes using marrow stimulation. We hypothesized that the clinical outcomes of marrow stimulation would be inferior for lesions with depths of more than 5 mm compared to those less than 5 mm.An interventional prospective cohort study was conducted on 55 ankles in 55 patients who had been diagnosed with full-thickness osteochondral lesions of the talus; stage II, III, IV according to Anderson staging system based on magnetic resonance imaging; depth of 10 mm or less; and area of 150 mmFor groups A and B the average preoperative Foot and Ankle Outcome Scores (FAOS) were 43.1 ± 8.8 (range, 25-52) and 46 ± 8.5 (range, 32-60), respectively, and improved to 90 ± 4.3 (range, 80-96) (P = 0.001) and 75 ± 6.4 (range, 65-88) (P = 0.001) at the final follow-up. The average time to full weight bearing was 12 weeks (range, 10-16) in group A and 16 weeks (range, 12-20) in group B.Although treatment of OCLs is still undergoing changes and there are many prognostic factors that affect outcomes during marrow stimulation treatment, depth of OCL was shown to be an independent factor affecting outcomes. OCLs of less than 5 mm in depth were more likely to have superior clinical outcomes compared to OCLs of more than 5 mm.The depth of OCL talus is an important factor as it affects the outcome of arthroscopic marrow stimulation inversely.I.

The resource description framework (RDF) was adopted by the World Wide Web (W3C) as an essential semantic web standard and the RDF scheme. It accords the hard semantics in the description and wields the crisp metadata. However, it usually produces vague or ambiguous information. Consequently, fuzzy RDF helps deal with such special data by transforming the crisp values into a fuzzy set. A method for analyzing fuzzy RDF data is proposed in this paper. To this end, first, we decompose the RDF into fuzzy RDF variables. Second, we are designing a model for global sensitivity analysis based on the decomposition of fuzzy RDF. It figures out the ambiguities of fuzzy RDF data. The proposed global sensitivity analysis model provides the importance of fuzzy RDF data by considering the response function’s structure and reselects it to a certain degree. A practical tool for sensitivity analysis of fuzzy RDF data has also been implemented based on the proposed model.

Muhammad O Awiwi,1 Khaled M Elsayes,1 Yehia I Mohamed,2 Lina Altameemi,2 Migena Gjoni,3 Omayr Muhammad Irshad,4 Ahmed Sayed Ahmed,5 Ahmad O Kaseb,2 Usama Salem1 1Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 2Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 3Department of Internal Medicine, The of Istanbul-Cerrahpasa Hospital, Istanbul, Turkey; 4John Sealy School of Medicine, Galveston, TX, USA; 5Department of Gastroenterology, The University of Texas MD Anderson Cancer Center, Houston, TX, USACorrespondence: Khaled M Elsayes, 1515 Holcombe Blvd, Houston, TX, 77030, USA, Tel +1 877 632-6789, Fax +1 713 794-4535, Email KMElsayes@mdanderson.orgPurpose: To identify prognostic clinical and radiologic features in patients with unresectable hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab.Patients and Methods: Clinical and imaging records of patients with unresectable HCC were retrospectively reviewed, and baseline features were recorded. Patients’ records and imaging studies were used to determine the patients’ overall survival (OS) and progression-free survival (PFS). Univariate and multivariate analyses were performed to determine prognostic features. Subanalyses of treatment-naïve patients (who never received local or systemic therapy) and previously treated patients were also performed.Results: Fifty-five patients were included in the final analysis, 23 (41.8%) of whom were treatment naïve. The median PFS and OS for the entire cohort were 3.0 months and 7.9 months. The 3-, 6- and 12-month OS rates were 85.5%, 79.8% and 45.7%, respectively. The 3-, 6- and 12-month PFS rates were 50.1%, 41.2% and 20.1%, respectively. On multivariate analysis, independent prognostic features for poor PFS of the entire cohort were pleural effusions (p = 0.047, HR: 6.3; CI: 1.03– 38.90) and hepatic vein tumor thrombus (p = 0.005; HR: 23.37; CI: 2.63– 207.67); independent prognostic features for poor OS were ascites (p = 0.008; HR: 37.37; CI: 2.53– 467.64), pleural effusion (p = 0.003; HR: 110.17; CI: 5.00– 2426.54), and low (< 40HU) pre-contrast attenuation on CT images (p = 0.007; HR: 0.09; CI: 0.02– 0.53). On subanalysis of treatment-naïve patients, the median OS and PFS were 7.4 months and 2.8 months, respectively. The 3-, 6- and 12-month PFS rates were 43.5%, 38.6% and 24.8%, respectively. Pleural effusion was the only independent poor prognostic feature (p = 0.036; HR: 206.34; CI: 1.41– 30,167.58).Conclusion: Independent prognostic features for survival outcomes include the presence of ascites, pleural effusions, hepatic vein tumor thrombus, and HCC with low attenuation (< 40 HU) on unenhanced CT images. Although several biochemical variables were significant on univariate analysis, none were independent predictors of OS or PFS.Keywords: radiographic, radiology, RECIST, survival, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio

Handling laundry is a major task that must be managed safely by health care workers (HCW) for maintaining a green hospital environment. Laundry processing, especially in hemodialysis units is a source of many hazards, especially bacteriological ones. This study aimed to assess safe laundry handling and disposing of in hemodialysis units. A descriptive research design was utilized. Subject A convenience sample of 46 nurses (nursing and auxiliary members) was enrolled in this study. Materials and method: The current study was conducted in dialysis units at the following Hospitals; Students’ University and Health Insurance (Gamal Abd-El-Naser); Alexandria. Tool: One tool was utilized "Safety practices of laundry handling and disposing of in hemodialysis units: Observational Checklist”; it was developed by the researchers after a thorough review of related literature. It comprised two parts, Part I: Personal data as age, gender, years of experience, employment position, educational level, and previous attendance in-service training regarding safe laundry management. Part II: Safety Laundry Handling and Disposing Observational Checklist. Result: This study reflected satisfactory safe practices level of laundry handling scores in both settings. While, no significant correlation was detected between both settings regarding safe practices of laundry handling and disposal, while a significant relationship between overall practice levels and staff socio-demographic characteristics except gender was noticed. Conclusion: A significant correlation between the availability of all-time PPE and laundry processing; with satisfactory scores for applying safety laundry practices was noticed. Recommendations: Periodic monitoring for staff as well as continuous training programs regarding safe laundry processing must take place. All linen must be handled, stored, and transported in a manner that maintains a green environment for all patients, health care workers, as well as visitors for the sustainability of health and safety in hemodialysis units.

Background: Differentiation of benign from malignant follicular thyroid lesions remains difficult and the ability of molecular markers to differentiate between them still unclear. The aim of this study was to evaluate the usefulness of IMP3 expression to distinguish benign from malignant thyroid lesions. Methods: This is a retrospective study upon selected 57 thyroid lesions designated as; 7 cases of Hashimoto thyroiditis (HT), 10 cases of hyperplastic nodules (HN), 15 cases of follicular thyroid adenoma (FTA), 13 cases of conventional papillary thyroid carcinoma (PTC), 6 cases of follicular variant of papillary thyroid carcinoma (FV-PTC), and 6 cases of follicular thyroid carcinoma (FTC). Immunohistochemistry was applied on formalin-fixed, paraffin-embeded tissue blocks using IMP3. clinicopathological data were reviewed from patients' pathological reports and correlated with IMP3 expression. Results: IMP3 positivity was seen in1/7 cases (14.3%) of HT, 2/10 cases (20%) of HN, 4/15 cases (26.7%) of FTA, 12/13 cases of PTC, and in all (100%) FV-PTC & FTC cases. IMP3 staining was significantly increased from normal thyroid tissue up to malignant tumors (P