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We have recently identified a protected topological semimetal in graphene which presents a zero-energy edge mode robust to disorder and interactions. Here, we address the characteristics of this semimetal and show that the $\mathbb{Z}$ topological invariant of the Hall conductivity associated to the lowest energy band can be equivalently measured from the resonant response to circularly polarized light resolved at the Dirac points. The (non-quantized) conductivity responses of the intermediate energy bands, including the Fermi surface, also give rise to a $\mathbb{Z}$2 invariant. We emphasize on the bulk-edge correspondence as a protected topological half metal, i.e. one spin-population polarized in the plane is in the insulating phase related to the robust edge mode while the other is in the metallic regime. The quantized transport at the edges is equivalent to a $\frac{1}{2}-\frac{1}{2}$ conductance for spin polarizations along z direction. We also build a parallel between the topological Hall response and a pair of half numbers (half Skyrmions) through the light response locally resolved in momentum space and on the sphere.

The tuberculosis (TB) bacillus, Mycobacterium tuberculosis (Mtb), and HIV-1 act synergistically; however, the mechanisms by which Mtb exacerbates HIV-1 pathogenesis are not well known. Using in vitro and ex vivo cell culture systems, we show that human M(IL-10) anti-inflammatory macrophages, present in TB-associated microenvironment, produce high levels of HIV-1. In vivo, M(IL-10) macrophages are expanded in lungs of co-infected non-human primates, which correlates with disease severity. Furthermore, HIV-1/Mtb co-infected patients display an accumulation of M(IL-10) macrophage markers (soluble CD163 and MerTK). These M(IL-10) macrophages form direct cell-to-cell bridges, which we identified as tunneling nanotubes (TNTs) involved in viral transfer. TNT formation requires the IL-10/STAT3 signaling pathway, and targeted inhibition of TNTs substantially reduces the enhancement of HIV-1 cell-to-cell transfer and overproduction in M(IL-10) macrophages. Our study reveals that TNTs facilitate viral transfer and amplification, thereby promoting TNT formation as a mechanism to be explored in TB/AIDS potential therapeutics.

Autoregressive Integrated Moving Average (ARIMA) Box-Jenkins models combine the autoregressive and moving average models to a stationary time series after the appropriate transformation, while the nonlinear autoregressive (N.A.R.) or the autoregressive neural network (ARNN) models are of the kind of multi-layer perceptron (M.L.P.), which compose an input layer, hidden layer and an output layer. Monthly streamflow at the downstream of the Euphrates River (Hindiya Barrage) /Iraq for the period January 2000 to December 2019 was modeled utilizing ARIMA and N.A.R. time series models. The predicted Box-Jenkins model was ARIMA (1,1,0) (0,1,1), while the predicted artificial neural network (N.A.R.) model was (M.L.P. 1-3-1). The results of the study indicate that the traditional Box-Jenkins model was more accurate than the N.A.R. model in modeling the monthly streamflow of the studied case. Performing a one-step-ahead forecast during the year 2019, the forecast accuracy between the forecasted and recorded monthly streamflow for both models was as follows: the Box-Jenkins model gave root mean squared error (RMSE = 48.7) and the coefficient of determination = 0.801), while the (NAR) model gave (RMSE = 93.4) and = 0.269). Future projection of the monthly stream flow through the year 2025, utilizing the Box-Jenkins model, indicated the existence of long-term periodicity. Highlights Box-Jenkins models and artificial neural network (ANN) were used to model the flow of Hindiya Barrage.; The collected data covered the period of January 2000 to December 2019.; Box-Jenkins model was more accurate than ANN in modeling the monthly flow of the studied river.; The outcomes indicated long-term periodicity (until 2025).;

Sustainable development is based on environmental, social, economic, and technical dimensions. In this study, the sustainability of wastewater treatment techniques in urban areas of Iraq was assessed using a multi-criteria decision analysis (MCDA)/the weighted sum model (WSM). The analysis was performed on 13 operating wastewater treatment plants in 10 provinces, Iraq, using a questionnaire sheet with the assistance of 52 specialists in the Ministry of Municipalities and Public Works, Iraq. Four types of wastewater treatment techniques (Conventional Treatment, Oxidation Ditches, Aeration Lagoons, and membrane bio-reactor (MBR)) were assessed. The environmental, social, economic, and technical dimensions were represented by 11, 5, 7, and 4 indicators, respectively. The main results of this study indicate that the sustainability of MBR recorded the highest total importance; the order of the total importance from the highest to the lowest was: MBR > Oxidation Ditches > Aeration Lagoons > Conventional Treatment. The environmental dimension proved its dominance in the four studied treatment techniques' sustainability as it recorded the maximum contribution to sustainability. While the technical dimension recorded the least contribution to sustainability, the order from the highest to the lowest was: Environmental Dimension > Economic Dimension > Social Dimension > Technical Dimension. Highlights A multi-criteria decision analysis (MCDA) was used to assess the sustainability of 13 WWTP.; The weighted sum model (WSM) was to validate the analysis.; Chemical Treatment, Oxidation Ditch, Aeration Lagoon, and membrane bio-reactor (MBR) were studied.; 31 environmental (En), social (S), economical (E), and technical (T) indicators were analysed.; The effects of these indicators on sustainability of the WWTP was: En > E > S > T;

Abstract Background Acute pain in post joint replacement surgeries is common, which makes the management of acute pain following joint replacement surgeries to be very important. Thus, this study was conducted to evaluate acute pain management of post TKR surgeries. Results Patients with negative pain management index (PMI) scores were classified as receiving inadequate analgesic treatment for their pain. Zero PMI was the most frequent score among the others with 195 (80.6%). The rest were − 1 (11 (4.5%)), 1 (27 (11.2%)), and 2 (9 (3.7%)), respectively. Only 4.5% (11/242) patients have negative PMI score, which could be considered as inadequate pain management in which these patients received inadequate analgesic treatment. Conclusion Acute pain management in post-TKR surgeries in both medical centers achieved an acceptable level, and majority of patients received an adequate analgesia in post-TKR surgeries.

Dendrogenin A, cholesterol metabolite, has tumor suppressive properties but the mechanisms are unknown. Here the authors show that Dendrogenin A can induce autophagy-mediated cell death in both melanoma and acute myeloid leukaemia.

Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphomas are tumors that carry translocations involving the ALK gene at the 2p23 locus, leading to the expression of ALK tyrosine kinase fusion oncoproteins. Amongst hematologic malignancies, these lymphomas are particular in that they express very low levels of B-cell lymphoma 2 (BCL2), a recognized inhibitor of apoptosis and autophagy, two processes that share complex interconnections. We have previously shown that treatment of ALK-positive anaplastic large cell lymphoma cells with the ALK tyrosine kinase inhibitor crizotinib induces autophagy as a pro-survival response. Here, we observed that crizotinib-mediated inactivation of ALK caused an increase in BCL2 levels that restrained the cytotoxic effects of the drug. BCL2 downregulation in combination with crizotinib treatment potentiated loss of cell viability through both an increase in autophagic flux and cell death, including apoptosis. More importantly, our data revealed that the blockade of autophagic flux completely reversed impaired cell viability, which demonstrates that excessive autophagy is associated with cell death. We propose that the downregulation of BCL2 protein, which plays a central role in the autophagic and apoptotic machinery, combined with crizotinib treatment may represent a promising therapeutic alternative to current ALK-positive anaplastic large cell lymphoma treatments.

Glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1), and matrix metalloproteinase 9 (MMP-9) are potential biomarkers of traumatic brain injury (TBI) but also of secondary insults to the brain. The aim of this study was to describe the cerebral distribution of GFAP, UCH-L1, and MMP-9 in a rat model of diffuse TBI associated with standardized hypoxia-hypotension (HH). Adult male Sprague-Dawley rats were allocated to Sham (n = 10), TBI (n = 10), HH (n = 10), and TBI+HH (n = 10) groups. After 4 hours, brains were rapidly removed and immunostaining of GFAP, UCH-L1, and MMP-9 was performed. Areas of interest that have been described as particularly sensitive to hypoxic insults were analyzed. For GFAP, in the neocortex, immunostaining revealed a significant decrease in strong staining for HH and TBI+HH groups compared with TBI group ( P

Objective: To develop and update evidence-based and consensus-based guidelines on laparoscopic and robotic pancreatic surgery. Summary Background Data: Minimally invasive pancreatic surgery (MIPS), including laparoscopic and robotic surgery, is complex and technically demanding. Minimizing the risk for patients requires stringent, evidence-based guidelines. Since the International Miami Guidelines on MIPS in 2019, new developments and key publications have been reported, necessitating an update. Methods: Evidence-based guidelines on 22 topics in 8 domains were proposed: terminology, indications, patients, procedures, surgical techniques and instrumentation, assessment tools, implementation and training, and artificial intelligence. The Brescia Internationally Validated European Guidelines on Minimally Invasive Pancreatic Surgery (EGUMIPS, September 2022) used the Scottish Intercollegiate Guidelines Network (SIGN) methodology to assess the evidence and develop guideline recommendations, the Delphi method to establish consensus on the recommendations among the Expert Committee, and the AGREE IIGRS tool for guideline quality assessment and external validation by a Validation Committee. Results: Overall, 27 European experts, 6 international experts, 22 international Validation Committee members, 11 Jury Committee members, 18 Research Committee members, and 121 registered attendees of the 2-day meeting were involved in the development and validation of the guidelines. In total, 98 recommendations were developed, including 33 on laparoscopic, 34 on robotic, and 31 on general MIPS, covering 22 topics in 8 domains. Out of 98 recommendations, 97 reached at least 80% consensus among the experts and congress attendees, and all recommendations were externally validated by the Validation Committee. [ABSTRACT FROM AUTHOR]

Background: Total knee replacement (TKR) is a major orthopedic surgery that is considered high risk for the development of venous thromboembolism (VTE). Objective: The aim of this study is to evaluate the clinical outcomes that resulted from the use of a new proposed VTE risk stratification protocol for selecting a suitable extended VTE prophylaxis for post TKR surgery patients administered in conjunction with patient education programs. Method: A randomized controlled trial was conducted in two medical centers in Saudi Arabia. A total of 242 patients were enrolled in the study, 121 patients in each group. The experimental group (A) was assessed by using the proposed VTE risk stratification protocol and also took part in patient education programs about TKR and its complications. The control group (B) was assessed by using the 2005 Caprini risk assessment tool and no education programs were given to this group. Both groups were followed for 35 days post operation. Results: The mean age of the participants was 65.86 (SD 8.67) and the majority of them were female 137 (56.6%). The mean body mass index of the study sample was 32.46 (SD 5.51). There were no significant differences between the two groups except for surgery type; the proportion of bilateral TKR in group A was higher than in group B (69/121 (28.5%) vs. 40/121(16.5%), p˂0.05). There were no confirmed pulmonary embolism cases in the study sample and diagnosis of deep-vein thrombosis was confirmed in 12/242 (5.0%) of patients: 1/121 (0.8%) in group A and 11/121 (9.1%) in group B (p˂0.05). The readmission rate for all patients was 2.5% (6/242), all of whom were in group B (p˂0.05). Conclusion: The proposed VTE risk stratification protocol that was applied in conjunction with patient education programs reduced VTE complications and readmission events, post TKR surgery. Trial Registration: ClinicalTrials.gov Identifier: NCT04031859.

This cross-sectional study is aimed at assessing the quality of life in a cohort of breast cancer patients at the Oncology Department, King Abdulaziz University Hospital (KAUH), King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA), and to differentiate QoL among different groups. Mean time since diagnosis was 3.97±1.90 years. European Organization for Research and Treatment of Cancer Quality of Life Questionnaires-Core30 and BR23 (EORTC QLQ-C30 & BR23) were used to assess QoL in breast cancer survivors. ANOVA and independent t-test (parametric tests) were used for the categorical variables and Kruskal-Wallis and Mann-Whitney tests used for non-parametric tests. Linear regression analysis was done to measure predictors' significance and to calculate the coefficient of determination. Two hundred and eighty-four patients completed the survey. Global health status and functional scales, in most of the domains, were high, while symptom scales were moderate-to-low for most items, showing better QoL. Insomnia and fatigue were the most disturbing symptoms. Patients exhibited higher scores for body image and future perspective, while the least score is for sexual functioning. Global health, physical functioning, and role functioning were better in the age group ≤50 years (p

DC-SIGN (CD209/CLEC4L) is a C-type lectin receptor (CLR) that serves as a reliable cell-surface marker of interleukin 4 (IL-4)-activated human macrophages [M(IL-4)], which historically represent the most studied subset within the M2 spectrum of macrophage activation. Although DC-SIGN plays important roles in Mycobacterium tuberculosis (Mtb) interactions with dendritic cells, its contribution to the Mtb–macrophage interaction remains poorly understood. Since high levels of IL-4 are correlated with tuberculosis (TB) susceptibility and progression, we investigated the role of DC-SIGN in M(IL-4) macrophages in the TB context. First, we demonstrate that DC-SIGN expression is present both in CD68+ macrophages found in tuberculous pulmonary lesions of non-human primates, and in the CD14+ cell population isolated from pleural effusions obtained from TB patients (TB-PE). Likewise, we show that DC-SIGN expression is accentuated in M(IL-4) macrophages derived from peripheral blood CD14+ monocytes isolated from TB patients, or in macrophages stimulated with acellular TB-PE, arguing for the pertinence of DC-SIGN-expressing macrophages in TB. Second, using a siRNA-mediated gene silencing approach, we performed a transcriptomic analysis of DC-SIGN-depleted M(IL-4) macrophages and revealed the upregulation of pro-inflammatory signals in response to challenge with Mtb, as compared to control cells. This pro-inflammatory gene signature was confirmed by RT-qPCR, cytokine/chemokine-based protein array, and ELISA analyses. We also found that inactivation of DC-SIGN renders M(IL-4) macrophages less permissive to Mtb intracellular growth compared to control cells, despite the equal level of bacteria uptake. Last, at the molecular level, we show that DC-SIGN interferes negatively with the pro-inflammatory response and control of Mtb intracellular growth mediated by another CLR, Dectin-1 (CLEC7A). Collectively, this study highlights a dual role for DC-SIGN as, on the one hand, being a host factor granting advantage for Mtb to parasitize macrophages and, on the other hand, representing a molecular switch to turn off the pro-inflammatory response in these cells to prevent potential immunopathology associated to TB.