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Abstract Hydroxyapatite (HAp) and hydroxyapatite-based materials show promising potential in the healthcare sector due to their distinctive properties such as biocompatibility, antimicrobial efficacy, non-toxicity, and robust mechanical characteristics. This makes HAp materials play an important role in hindering infection spreading in healthcare provider institutions. This study assesses the antimicrobial efficacy of the developed hydroxyapatite-based composites incorporating copper, zinc, and silver nanoparticles. The synthesized HAp and its modified composite variants (Cu/HAp, Zn/HAp, and Ag/HAp) with varying ratios ranging from 0 to 15% (wt) were characterized using XRD, XPS, SEM, and TEM analyses. Furthermore, the antibacterial and antifungal properties of the synthesized HAp and HAp-based composites were evaluated. The antibacterial effectiveness of the HAp and its composites was evaluated using a modified disc diffusion test, where the resulting inhibition zones on the agar surface were observed. All the HAp and HAp-based composites (HAp, Cu/HAp, Zn/HAp, and Ag/HAp materials) elicited in the formation of inhibitory zones. The most substantial inhibition values were observed for the 5% Ag/HAp formulation, with values of 19.7 and 13.8, against E. coli and S. aureus, respectively. The 5% Ag/HAp concentration may strike an ideal balance, providing high antimicrobial activity without adverse effects on biocompatibility or material stability. These findings underscore the recommendation of the proposed HAp-based composites for infection control measures through their application on medical instruments, textiles, healthcare personnel attire, and patient garments.

Abstract Background The staging and management of patients with breast cancer are significantly influenced by the pathological state of the axillary lymph nodes (ALN). Thus, it is very desirable to have a differential diagnosis of metastatic ALN. Purpose The aim of this research is to assess the effectiveness of non-invasive ALN staging using PEM versus traditional breast mammography and ultrasound in patients presenting with early-stage breast cancer. This study focuses on determining if PEM can reliably stage ALNs and potentially eliminate the need for more invasive methods. Methods In a study involving 94 breast cancer patients, PEM was used to assess ALNs. The nodes were visually evaluated for positive or negative uptake, and further categorized as non-specific, indeterminate, or malignant based on their maximum uptake values. This classification was then compared with histopathological results. Results There were a total of 94 breast cancer patients; the results from PEM demonstrated an ALN detection sensitivity of 83.3%. The specificity of PEM in this context was found to be 98.08%, and the overall accuracy rate was 91.49%. Additionally, the Positive Predictive Value (PPV) was calculated to be 97.2%, and the Negative Predictive Value (NPV) was 87.9%. Conclusions The initial study has shown encouraging outcomes in terms of accurate lymph node assessment.

Abstract Clinical research relies on high-quality patient data, however, obtaining big data sets is costly and access to existing data is often hindered by privacy and regulatory concerns. Synthetic data generation holds the promise of effectively bypassing these boundaries allowing for simplified data accessibility and the prospect of synthetic control cohorts. We employed two different methodologies of generative artificial intelligence – CTAB-GAN+ and normalizing flows (NFlow) – to synthesize patient data derived from 1606 patients with acute myeloid leukemia, a heterogeneous hematological malignancy, that were treated within four multicenter clinical trials. Both generative models accurately captured distributions of demographic, laboratory, molecular and cytogenetic variables, as well as patient outcomes yielding high performance scores regarding fidelity and usability of both synthetic cohorts (n = 1606 each). Survival analysis demonstrated close resemblance of survival curves between original and synthetic cohorts. Inter-variable relationships were preserved in univariable outcome analysis enabling explorative analysis in our synthetic data. Additionally, training sample privacy is safeguarded mitigating possible patient re-identification, which we quantified using Hamming distances. We provide not only a proof-of-concept for synthetic data generation in multimodal clinical data for rare diseases, but also full public access to synthetic data sets to foster further research.

Abstract Background Stereotactic guided biopsies have become the sampling method of choice in diagnosis of non-palpable breast microcalcifications which directly impact patients’ management plans and consequently morbidity and mortality. Purpose The purpose is to compare the diagnostic accuracy of VAB and CNB in diagnosis of indeterminate breast microcalcifications and subsequent management of cases of indeterminate breast micro-calcifications. Methods Retrospective review of stereotactic CNB and VAB was done, pathological data were classified as benign, high risk and malignant lesions and compared with gold standard surgical specimen. The influence on patients’ surgical planning was depicted. Results A total of 268 lesions were included in our study divided as 136 lesions that underwent VAB and 132 lesions that underwent CNB, for the VAB group the overall PPV was 100% (96–100% CI) and NPV was 95.8% (90–98% CI) with overall diagnostic accuracy of 97% (92–99% CI), while for the CNB group the PPV was 100% (95–100% CI) and NPV was 80.2% (74.2–85% CI) with overall diagnostic accuracy of 84.8% (77–90% CI). 4/136 VAB lesions did not match the surgical specimen malignant diagnosis this could be explained by their mean diameter of 9.725 ± 1.8 cm and 3.172 ± 1.84 cm which was found statistically significant P value of less than 0.0001. The percentage of re-operation in VAB group was 2.9% while in CNB group was 7.5%. Conclusions VAB is a superior diagnostic tool over CNB in diagnosis of indeterminate breast microcalcifications and reducing the percentage of re-operations which directly impacts the patient’s morbidity. Moreover, it can replace surgery in cases of benign lesions and totally resected high risk lesions especially when operations are contraindicated or refused by the patient, yet with strict follow up.

Abstract Inorganic nanoparticles have been widely incorporated in conventional dental materials to help in improving their properties. The literature has shown that incorporating nanoparticles in dental materials in different specialties could have a positive effect on reinforcing the mechanical properties of those materials; however, there was no consensus on the effectiveness of using nanoparticles in enhancing the mechanical properties of dental materials, due to the variety of the properties of nanoparticles itself and their effect on the mechanical properties. This article attempted to analytically review all the studies that assessed the effect of different types of inorganic nanoparticles on the most commonly used dental materials in dental specialties such as polymethyl methacrylate, glass ionomer cement, resin composite, resin adhesive, orthodontic adhesive, and endodontic sealer. The results had shown that those inorganic nanoparticles demonstrated positive potential in improving those mechanical properties in most of the dental materials studied. That potential was attributed to the ultra-small sizes and unique physical and chemical qualities that those inorganic nanoparticles possess, together with the significant surface area to volume ratio. It was concluded from this comprehensive analysis that while a definitive recommendation cannot be provided due to the variety of nanoparticle types, shapes, and incorporated dental material, the consensus suggests using nanoparticles in low concentrations less than 1% by weight along with a silane coupling agent to minimize agglomeration issues and benefit from their properties.

Abstract Background Zein-coated magnesium oxide nanoparticles (zMgO NPs) demonstrate a potent antimicrobial effect, endorsing it as a compelling additive to dental materials formulations for oral health care advances. However, currently there is no data on the imprint of zMgO NPs on the color permanence of dental composites. The objective of this study is to evaluate the color stability of different types of composite enhanced with antimicrobial zein-coated magnesium oxide nanoparticles (zMgO NPs) of different shapes before and after thermocycling. Methods Two hundred composite samples were divided into four groups: Gp1: Tetric N-Flow with zMgO nanowires, Gp2: Tetric N-Flow with zMgO nanospheres, Gp3: Tetric N-Ceram with zMgO nanowires; Gp4: Tetric N-Ceram with zMgO nanospheres. Each group was subdivided into 5 subgroups (n = 10) with concentrations of zMgO NPs 0%, 0.3%, 0.5%, 1% and 2%. The characterization of the modified composite containing the zMgO was done via X-ray Diffraction, Field Emission Scanning Electron Microscopy (FESEM), and Fourier Transform Infrared Spectroscopy (FTIR). Colorimetric evaluation was performed through spectrophotometry with a white background. Samples underwent color assessment using a spectrophotometer, followed by thermocycling, and then another color assessment. Results FESEM analysis showed a uniform distribution of the zMgO nanoparticles in the composite and FTIR illustrated no change in the spectra. However, the XRD spectra exhibited an amorphous pattern in the composite enhanced with zMgO NPs. There was no compelling discrepancy in color variation ΔE among the different groups before and after thermocycling (p > 0.05). A statistically notable variation in ΔL was found amid the control and N-Flow and N-Ceram with 2% zMgO nanospheres before and after thermocycling respectively (p 0.05). Conclusion Enhancing N-Flow and N-Ceram composite with antimicrobial zMgO nanowires and nanospheres did not alter the total color stability of the materials before and after thermocycling.

In newly diagnosed acute myeloid leukemia, immediate initiation of treatment is standard of care. However, deferral of antileukemic therapy may be indicated to assess comorbidities or pre-therapeutic risk factors. We explored the impact of time from diagnosis to treatment on outcomes in newly diagnosed acute myeloid leukemia undergoing venetoclax-based therapy in two distinct cohorts. By querying the Study Alliance Leukemia database and the global health network TriNetX, we identified 138 and 717 patients respectively with an average age of 76 and 72 years who received venetoclax-based firstline therapy. When comparing patients who started treatment earlier or later than 10 days after initial diagnosis, no significant difference in median overall survival was observed - neither in the SAL cohort (7.7 vs. 9.6 months, p=.42) nor in the TriNetX cohort (7.5 vs. 7.2 months, p=.41). Similarly, severe infections, bleeding, and thromboembolic events were equally observed between early and later treatments, both in the overall patient groups and specific subgroups (age ≥75 years or leukocytes ≥20x109/L). This retrospective analysis indicates that delaying the start of venetoclax-based therapy in newly diagnosed acute myeloid leukemia might be a safe option for selected patients, provided that close clinical monitoring is performed.

Electrospun nanofibers based on polyvinyl alcohol (PVA), polyacrylamide (PAAm), and a PVA-PAAm blend (50/50 wt.%) were effectively made a room temperature(RT) and a voltage of (12kV). The products were studied using Field Emission Scanning Electron Microscope (FESEM), X-ray diffraction (XRD), Fourier-transform infrared spectroscopy(FT-IR) and Ultraviolet-visible (UV–Vis) spectroscopy. The result of FESEM analysis showed that the polymer PVA, PAAm, and blend samples produced a random distribution of fine fibres at an average diameter of (214.12, 317.1, 157.65) nm with a smooth surface. In addition, the FESEM images demonstrate the fibres' suitability for use in gas sensing applications due to their branching fibres and porosity surface. XRD showed that the film polymeric of PVA, PAAm polymeric blend PVA-PAAm was seen to have a semicrystalline nature. According to the FTIR analysis, the PVA and PAAm networks in the PVA-PAAm polymer nanofibers were entangled due to the powerful hydrogen bond contact between the PAAm and PVA chains. Observed around (3473.79 and 3414) cm-1 were attributed to the N–H vibration and overlapped to O–H stretching. The spectra of the prepared films exhibit prominent absorption peaks, which are at the wavelength range (200-320) nm. PVA-PAAm polymer nanofibers decrease the energy gap from 3.70eV to 3.40eV. The Wemple-DiDomenico model was used to derive dispersion parameters such as dispersion energy, single oscillator energy, Urbach energy, the static refractive index and the moments of optical spectra the result of calculating by this model was compatible with that value calculated by the Tauc relation. While increased which qualifies them to be used in the electronic devices.

Abstract Background Increasingly large and complex biomedical data sets challenge conventional hypothesis-driven analytical approaches, however, data-driven unsupervised learning can detect inherent patterns in such data sets. Methods While unsupervised analysis in the medical literature commonly only utilizes a single clustering algorithm for a given data set, we developed a large-scale model with 605 different combinations of target dimensionalities as well as transformation and clustering algorithms and subsequent meta-clustering of individual results. With this model, we investigated a large cohort of 1383 patients from 59 centers in Germany with newly diagnosed acute myeloid leukemia for whom 212 clinical, laboratory, cytogenetic and molecular genetic parameters were available. Results Unsupervised learning identifies four distinct patient clusters, and statistical analysis shows significant differences in rate of complete remissions, event-free, relapse-free and overall survival between the four clusters. In comparison to the standard-of-care hypothesis-driven European Leukemia Net (ELN2017) risk stratification model, we find all three ELN2017 risk categories being represented in all four clusters in varying proportions indicating unappreciated complexity of AML biology in current established risk stratification models. Further, by using assigned clusters as labels we subsequently train a supervised model to validate cluster assignments on a large external multicenter cohort of 664 intensively treated AML patients. Conclusions Dynamic data-driven models are likely more suitable for risk stratification in the context of increasingly complex medical data than rigid hypothesis-driven models to allow for a more personalized treatment allocation and gain novel insights into disease biology.

Abstract Functional perturbations of the cohesin complex with subsequent changes in chromatin structure and replication are reported in a multitude of cancers including acute myeloid leukemia (AML). Mutations of its STAG2 subunit may predict unfavorable risk as recognized by the 2022 European Leukemia Net recommendations, but the underlying evidence is limited by small sample sizes and conflicting observations regarding clinical outcomes, as well as scarce information on other cohesion complex subunits. We retrospectively analyzed data from a multi-center cohort of 1615 intensively treated AML patients and identified distinct co-mutational patters for mutations of STAG2, which were associated with normal karyotypes (NK) and concomitant mutations in IDH2, RUNX1, BCOR, ASXL1, and SRSF2. Mutated RAD21 was associated with NK, mutated EZH2, KRAS, CBL, and NPM1. Patients harboring mutated STAG2 were older and presented with decreased white blood cell, bone marrow and peripheral blood blast counts. Overall, neither mutated STAG2, RAD21, SMC1A nor SMC3 displayed any significant, independent effect on clinical outcomes defined as complete remission, event-free, relapse-free or overall survival. However, we found almost complete mutual exclusivity of genetic alterations of individual cohesin subunits. This mutual exclusivity may be the basis for therapeutic strategies via synthetic lethality in cohesin mutated AML.

Abstract Background The role of allogeneic hematopoietic cell transplantation (alloHCT) in acute myeloid leukemia (AML) with mutated IDH1/2 has not been defined. Therefore, we analyzed a large cohort of 3234 AML patients in first complete remission (CR1) undergoing alloHCT or conventional chemo-consolidation and investigated outcome in respect to IDH1/2 mutational subgroups (IDH1 R132C, R132H and IDH2 R140Q, R172K). Methods Genomic DNA was extracted from bone marrow or peripheral blood samples at diagnosis and analyzed for IDH mutations with denaturing high-performance liquid chromatography, Sanger sequencing and targeted myeloid panel next-generation sequencing, respectively. Statistical as-treated analyses were performed using R and standard statistical methods (Kruskal–Wallis test for continuous variables, Chi-square test for categorical variables, Cox regression for univariate and multivariable models), incorporating alloHCT as a time-dependent covariate. Results Among 3234 patients achieving CR1, 7.8% harbored IDH1 mutations (36% R132C and 47% R132H) and 10.9% carried IDH2 mutations (77% R140Q and 19% R172K). 852 patients underwent alloHCT in CR1. Within the alloHCT group, 6.2% had an IDH1 mutation (43.4% R132C and 41.4% R132H) and 10% were characterized by an IDH2 mutation (71.8% R140Q and 24.7% R172K). Variants IDH1 R132C and IDH2 R172K showed a significant benefit from alloHCT for OS (p = .017 and p = .049) and RFS (HR = 0.42, p = .048 and p = .009) compared with chemotherapy only. AlloHCT in IDH2 R140Q mutated AML resulted in longer RFS (HR = 0.4, p = .002). Conclusion In this large as-treated analysis, we showed that alloHCT is able to overcome the negative prognostic impact of certain IDH mutational subclasses in first-line consolidation treatment and could pending prognostic validation, provide prognostic value for AML risk stratification and therapeutic decision making.

Introduction: Early identification and management of physical and mental illness is vital to maintain quality of life as we age. Markers of peripheral inflammation and liver function show elevations with aging, and are also associated with depression symptoms, suggesting a similar pattern in both aging and clinical groups. Methods: The current study examined the relationship between such markers and measures of depression/negative mood in 284 healthy older adults using data from the Australian Research Council Longevity Intervention (ARCLI). Baseline data in adults aged 60–75 included mood symptoms via Profile of Mood States and Beck Depression Inventory II, and peripheral inflammatory (TNF-α, IL-6, hs-CRP) and liver markers (GGT, ALT, AST, AST:ALT ratio) derived from blood samples. Results: The inflammation and liver enzyme relationship significantly predicted mood symptoms scores. Results showed that a significant relationship between C-reactive protein (CRP) and negative mood scores on Total Mood Disturbance and four of the six subscales (all p

Purpose The term “intentional injuries” refers to a spectrum of injuries resulting from self-inflicted injuries, interpersonal violence, and group acts of violence. Intentional injuries are underreported in Saudi Arabia. This study aimed to analyze and evaluate the characteristics of intentional injuries in patients who presented to the emergency department of a primary trauma center in Medina, Saudi Arabia in 2013. Methods A prospective cohort database analysis of the clinical patterns and treatment outcomes of 252 patients who had intentional injuries between January and December 2013 was done. Results The proportion of trauma patients with intentional injuries was 1.3%. The mean age was 34.2±9.4 years, 141 patients (56.0%) were male, and 111 (44.1%) were female (male to female ratio, 1.27:1). The majority (n=159, 63.1%) of injuries occurred at night. Most occurred outside the home (n=180, 71.0%). Financial problems (n=62, 24.6%) and social disputes (n=61, 24.2%) were the most common reasons. Sharp objects (n=93, 36.9%) were the most common weapons used. The head and neck were the most commonly injured areas (n=63, 54.4%). Superficial cuts (n=87, 34.5%), were the most common type of injury. Suturing of wounds (n=54, 21.4%) and surgical debridement (n=47, 18.7%) were the most commonly performed modalities of management. Conclusions We conclude that intentional injuries in Saudi Arabia are a health care hazard that is, unfortunately, underreported. The clinical pattern is similar in most aspects to international reports but differs in certain features due to the specific religious and conservative characteristics of the community. Nationwide clinical studies are strongly recommended.

Abstract Background Extramedullary manifestations (EM) are rare in acute myeloid leukemia (AML) and their impact on clinical outcomes is controversially discussed. Methods We retrospectively analyzed a large multi-center cohort of 1583 newly diagnosed AML patients, of whom 225 (14.21%) had EM. Results AML patients with EM presented with significantly higher counts of white blood cells (p

Abstract Background Nipple discharge is one of the commonest encountered complaints in the field of breast imaging. Excluding malignancy as a cause of pathological nipple discharge is of utmost importance. Our aim in this study was to assess the role of contrast-enhanced spectral mammography (CESM) in the diagnostic workup of patients with pathological nipple discharge (PND). Results In the current prospective study, 59/140 lesions were benign and 81/140 lesions were malignant. Analysis of CESM had achieved a higher sensitivity of 97.5% and a similar specificity of 54.2% as compared to sono-mammography, which achieved a sensitivity of 92.6% and specificity of 54.2%. The diagnostic accuracy of CESM was higher (79.3%) than sono-mammography (76.3%). CESM performed better than sono-mammography in the assessment of disease extent, as it was able to detect multifocality, multicentricity, and diffuse abnormalities, which were found in 24.1%, 43.0% and 8.9% of cases, respectively, as compared to 20.5%, 37.2%, and 3.8% of cases by sono-mammography. Conclusion CESM can be a valuable diagnostic imaging tool in the detection of malignancy associated with PND if sono-mammographic findings are equivocal. Its greater impact is on the delineation of disease extent, which will alter the treatment strategy.

Cure rates in adult acute lymphoblastic leukemia (ALL) improved using pediatric-based chemotherapy and stem cell transplantation (SCT). However, limited data on the health condition of cured adults are available whereas pediatric data cannot be transferred. The GMALL analyzed the health status in survivors of adult ALL retrospectively. Physicians answered a questionnaire on general condition (Eastern Cooperative Oncology Group [ECOG] status) and comorbidity or syndrome occurrence observed after treatment. Five hundred and thirty-eight patients with a median age of 29 (range, 15-64) years at diagnosis were analyzed, median follow-up was 7 (range, 3-24) years. Thirty-one percent had received SCT. ECOG status was 0-1 in 94%, 34% had not developed significant comorbidities. Most frequent comorbidities involved the neurologic system (27%), endocrine system (20%), skin (18%), graft-versus-host-disease (15%), cardiac system (13%), fatigue (13%). SCT impacted ECOG status and comorbidity occurrence significantly. ECOG 0-1 was observed in 86% of SCT and 98% of non-SCT patients (P

تبحث هذه الدراسة موضوع ( التطورات السياسية في المالديف والموقف البريطاني منها 1954 – 1965 )، إذ شهدت تلك المرحلة تحولات سياسية مؤثرة في البلاد، ففي عام 1954 عاد الحكم الملكي للبلاد بعد تجربة النظام الجمهوري لمدة سنتين تقريباً، وأصبح محمد فريد ديدي سلطاناً للبلاد، الذي سَنَّ دستور جديد للبلاد، ووضع خطة لتحديث البلاد، ووقع في عام 1956 مع البريطانيين اتفاقية أولية حول تأجير قاعدة جان العسكرية، والتي تسببت بأزمة داخلية في البلاد، انفصلت على أثرها ثلاث جزر جنوبية ( فوام الله وثينادو وأدو أتول ) عن الحكومة المركزية، وشكلت جمهورية خاصة بها باسم (جمهورية سوفاديف المتحدة )، وبعد ذلك، عُدلت اتفاقية جان في شباط 1960 في عهد رئيس الوزراء المالديفي إبراهيم ناصر، الذي قاد دبلوماسية البلاد، واستطاع حسم اغلب الأمور المعقدة في البلاد بعد التفاوض مع البريطانيين بشأن مسألتين مهمتين وقتذاك، أولهما، إعادة الجزر الانفصالية إلى سلطة الحكومة المركزية، وثانيها، التفاوض من أجل الاستقلال التام للبلاد، ونجح بعد مفاوضات مع البريطانيين في إرجاع الجزر الثلاث إلى سلطة الحكومة المركزية في عام 1963، واستطاع إن يحقق استقلال البلاد في تموز 1965، وان يعتق المالديف من الهيمنة البريطانية التي دامت أكثر من قرن ونصف .

تناول البحث دور النماذج المناخية وتأثيرها على المخاطر المورفومناخية وانعكاسها على البيئة التي تم دراستها وفق الأساليب الإحصائية لبناء نماذج مناخية حرارية ومطرية (متطرفة) التي بلغت بواقع (12) تكراراً في محطات الدراسة. فضلاً عن الخصائص الطبيعية المتمثلة بـ (جيولوجيا، الارتفاعات والانحدارات، التربة، النبات الطبيعي)، بينما قد سجلت اعلى كمية مياه للشدة المطرية في محطتي (الكفل، القاسم) التي لها دور فعال في تباين شدة المخاطر المورفومناخية في المنطقة، تم تقدير حجم التعرية المائية وفق نموذج (فورنية، جافريلوفيك) وكانت المنطقة ضمن صنف (معتدلة - عالية) وعلاقتها الارتباطية مع النماذج المناخية اذ بلغت اشدها مع نموذج البارد الرطب بمقدار(0.72), اما التعرية الريحية وفق (chepil) التي تعد عالية جداً وعلاقتها بلغت اقوى مع النموذج الحار الجاف بمقدار (0.80), وبناء نموذج لمخاطر المورفومناخية (مخاطر التعرية المائية , مخاطر زحف الكثبان الرملية) لتحديد درجات الخطورة لمخاطر التعرية المائية اذ شغلت الأراضي عالية الخطورة نسبة (42%) , متوسطة الخطورة (39.7%) وقليلة الخطورة (18.3%)، بينما درجة خطورة مخاطر زحف الكثبان الرملية عالية الخطورة (29%) ومتوسطة الخطورة (53.6%) وقليلة الخطورة (17.4%)، ثم تقييمها ومطابقتها مع خريطة الاستعمالات البشرية اذ تبين ان الأنشطة البشرية المتمثلة (الأراضي الزراعية، طرق النقل، المواقع الدينية والاثرية، السياحية) اكثر تأثيراً في مخاطر التعرية المائية وزحف الكثبان الرملية التي تقع ضمن الأراضي عالية الخطورة، وعلاقة الارتباط بينهما (قوية جداً).

Abstract Targeting the interaction between leukemic cells and the microenvironment is an appealing approach to enhance the therapeutic efficacy in acute myeloid leukemia (AML). AML infiltration induces a significant release of inflammatory cytokines in the human bone marrow niche which accelerates leukemogenesis. As the transmembrane glycoprotein CD38 has been shown to regulate cytokine release, we assessed the anti-leukemic potential of CD38 inhibition in AML. CD38 expression in AML cells proved to depend on microenvironmental cues and could be significantly enforced through addition of tretinoin. In fact, the anti-CD38 antibody daratumumab showed significant cytostatic efficacy in a 3D in vitro triple-culture model of AML, but with modest cell-autonomous cytotoxic activity and independent of CD38 expression level. In line with a predominantly microenvironment-mediated activity of daratumumab in AML, CD38 inhibition significantly induced antibody-dependent phagocytosis and showed interference with AML cell trafficking in vivo in a xenograft transplantation model, but overall lacked robust anti-leukemic effects.

Abstract Background Overall survival remains poor in older patients with acute myeloid leukemia (AML) with less than 10% being alive after 5 years. In recent studies, a significant improvement in event-free, relapse-free and overall survival was shown by adding gemtuzumab ozogamicin (GO), a humanized antibody-drug conjugate directed against CD33, to intensive induction therapy once or in a sequential dosing schedule. Glasdegib, the small-molecule inhibitor of smoothened (SMO), also showed improved overall survival in patients not eligible for intensive chemotherapy when combined with low-dose cytarabine compared to low-dose cytarabine alone. These findings warrant further investigations in the phase III GnG trial. Methods/Design This is a randomized phase III trial with measurable residual disease (MRD) after induction therapy and event-free survival (EFS) as primary endpoints. The two research questions are addressed in a 2 by 2 factorial design. Patients age 60 years and older are upfront randomized 1:1 in one of the two induction arms: GO administered to intensive induction therapy on days 1,4, and 7 versus GO administered once on day 1 (GO-147 versus GO-1), and double-blinded 1:1 in one of the subsequent treatment arms glasdegib vs. placebo as adjunct to consolidation therapy and as single-agent maintenance therapy for six months. Chemotherapy backbone for induction therapy consists of standard 7 + 3 schedule with cytarabine 200 mg/m2 continuously days 1 to 7, daunorubicin 60 mg/m2 days 1, 2, and 3 and high-dose cytarabine (1 g/m2, bi-daily, days 1, 2, and 3) for consolidation therapy. Addressing two primary endpoints, MRD-negativity after induction therapy and event-free survival (EFS), 252 evaluable patients are needed to reject each of the two null hypotheses at a two-sided significance level of 2.5% with a power of at least 85%. Ethics and dissemination Ethical approval and approvals from the local and federal competent authorities were granted. Trial results will be reported via peer-reviewed journals and presented at conferences and scientific meetings. Trial status Protocol version: 1st version 20.10.2020, no amendments yet. Study initiation on February 16, 2021. First patient was recruited on April 1st. Trial registration ClinicalTrials.gov NCT04093505 ; EudraCT 2019-003913-32. Registered on October 30, 2018.

Abstract To investigate the efficacy and toxicities of CPX-351 outside a clinical trial, we analyzed 188 patients (median age 65 years, range 26–80) treated for therapy-related acute myeloid leukemia (t-AML, 29%) or AML with myelodysplasia-related changes (AML-MRC, 70%). Eighty-six percent received one, 14% two induction cycles, and 10% received consolidation (representing 22% of patients with CR/CRi) with CPX-351. Following induction, CR/CRi rate was 47% including 64% of patients with available information achieving measurable residual disease (MRD) negativity (

In this bioassay, we assessed the comparative effect of antibiotic growth promoter(AGP) and of essential oil (EO) addition on the growth performance, carcass traits, and some physiological indicators in the male Ross 308 broilers. A total of 90 healthy chicks (1 day of age) were randomly allocated to three groups, each comprising 6 replicates of 5 chicks. The first group was a control without any additive in water or feed, the second one was offered a drinking water with 0.5 g/l/day of antibiotic, and the third one was supplied a drinking water with 0.5 ml/liter of EO. In this study, neither AGP nor EO supplementation affected BW, BWG, FI, and FCR (p < /em> < 0.05) compared with those fed the control diet group. AGP and EO supplemented diets had no significant effect on the carcass, breast and thigh muscles, liver, gizzard, heart spleen, and abdominal fat weight (p < /em> < 0.05). All the blood plasma concentrations under this study were not affected (p < /em> < 0.05) by AGP and EO supplementations compared to the untreated control group. In conclusion, it seems that there were no significant differences between the use of AGP or EO supplementation compared with the control group. Therefore, finding from this study demonstrated that essential oil (EO) could be used as a substitute for colistin antibiotic growth promoters (AGP) for broilers, and it’s the best strategic way to achieve healthy hygiene meat production free of antibiotic residues.

Although growth hormone (GH) gene mutations are described in several species, the studies concerning their variabilities and associations with economic traits in rabbits are scarce, particularly associations with semen traits. A total of 149 rabbit bucks from five populations (V-line=36, Moshtohor line=28, APRI line=42, cross ½A½M=23, and Gabali=20) were used in the present study to identify polymorphism of c.-78 C>T single nucleotide polymorphism (SNP) of GH gene among these populations and to investigate the association of GH gene polymorphism with body weight (BW), daily weight gain (DG) and semen traits. DNA was extracted from blood samples for genotyping of c.-78 C>T SNP of GH gene based on polymerase chain reaction with the restriction fragment length polymorphism (PCR-RFLP) technique. The genetic diversity of SNP C>T of GH gene was assessed in terms of genotypic and allelic frequencies, effective number of alleles (Ne), observed (Ho) and expected (He) heterozygosity, Hardy-Weinberg equilibrium (HWE), reduction in heterozygosity due to inbreeding (FIS) and polymorphism information content (PIC). Three genotypes of TT, CC and TC of PCR product of 231 bp of GH gene were detected and all the populations were in HWE in terms of GH gene. The highest Ne was obtained for the Moshtohor line (1.978), while the lowest allelic numbers were obtained for V-line (1.715) and Gabali breed (1.800). The highest genotype frequency of GH gene was 0.48 in TT genotype of V-line, 0.21 in CC genotype of Moshtohor line, 0.67 and 0.56 in TC genotype of ½A½M and Gabali rabbits (P

Achievement of complete remission signifies a crucial milestone in the therapy of acute myeloid leukemia (AML) while refractory disease is associated with dismal outcomes. Hence, accurately identifying patients at risk is essential to tailor treatment concepts individually to disease biology. We used nine machine learning (ML) models to predict complete remission and 2-year overall survival in a large multicenter cohort of 1,383 AML patients who received intensive induction therapy. Clinical, laboratory, cytogenetic and molecular genetic data were incorporated and our results were validated on an external multicenter cohort. Our ML models autonomously selected predictive features including established markers of favorable or adverse risk as well as identifying markers of so-far controversial relevance. De novo AML, extramedullary AML, double-mutated CEBPA, mutations of CEBPA-bZIP, NPM1, FLT3-ITD, ASXL1, RUNX1, SF3B1, IKZF1, TP53, and U2AF1, t(8;21), inv(16)/t(16;16), del(5)/del(5q), del(17)/del(17p), normal or complex karyotypes, age and hemoglobin concentration at initial diagnosis were statistically significant markers predictive of complete remission, while t(8;21), del(5)/del(5q), inv(16)/t(16;16), del(17)/del(17p), double-mutated CEBPA, CEBPA-bZIP, NPM1, FLT3-ITD, DNMT3A, SF3B1, U2AF1, and TP53 mutations, age, white blood cell count, peripheral blast count, serum lactate dehydrogenase level and hemoglobin concentration at initial diagnosis as well as extramedullary manifestations were predictive for 2-year overall survival. For prediction of complete remission and 2-year overall survival areas under the receiver operating characteristic curves ranged between 0.77–0.86 and between 0.63–0.74, respectively in our test set, and between 0.71–0.80 and 0.65–0.75 in the external validation cohort. We demonstrated the feasibility of ML for risk stratification in AML as a model disease for hematologic neoplasms, using a scalable and reusable ML framework. Our study illustrates the clinical applicability of ML as a decision support system in hematology.

We retrospectively studied 125 patients with acute myeloid leukemia and trisomy 4 (median age at diagnosis, 58 years; range, 16-77 years) treated between 2000 and 2019 within a multicenter study. Trisomy 4 was the sole abnormality in 28 (22%) patients and additional abnormalities were present in 97 (78%) patients. Twenty-two (22%) and 15 (15%) of 101 tested patients harbored NPM1 and FLT3-ITD mutations. Two (3%) of 72 tested patients had double CEBPA mutations. Data on response to intensive anthracycline-based induction therapy were available for 119 patients. Complete remission was achieved in 67% (n=80) and the early death rate was 5% (n=6). Notably, patients with trisomy 4 as sole abnormality had a complete remission rate of 89%. Allogeneic hematopoietic cell transplantation was performed in 40 (34%) patients, of whom 19 were transplanted in first complete remission. The median follow-up of the intensively treated cohort was 5.76 years (95% confidence interval [95% CI]: 2.99-7.61 years). The 5-year overall survival and relapse-free survival rates were 30% (95% CI: 22-41%) and 27% (95% CI: 18-41%), respectively. An Andersen-Gill regression model on overall survival revealed that favorable-risk according to the European LeukemiaNet classification (hazard ratio [HR]=0.34; P=0.006) and trisomy 4 as sole abnormality (HR=0.41; P=0.01) were favorable factors, whereas age with a difference of 10 years (HR=1.15; P=0.11), female gender (HR=0.74; P=0.20) and allogeneic hematopoietic cell transplantation (HR=0.64; P=0.14) did not have an significant impact. In our cohort, patients with trisomy 4 as their sole abnormality had a high complete remission rate and favorable clinical outcome. Allogeneic hematopoietic cell transplantation did not seem to improve overall survival.

In this work, an HPLC-DAD method was developed for the residual analysis of some estrogens such as estrone (E1), 17-β estradiol (E2), estriol (E3), natural estrogens, and 17-α ethinylestradiol (E4), an exoestrogen, in meat samples of different categories (chicken, n = 155, beef, n = 124, sheep, n = 122, and camels, n = 40), collected from the Saudi Market. Although banned, the use of E4 as a growth promoter in the black market is still encountered. Symmetry C18 column (3.5 µm, 4.6 mm × 150 mm) was used with a mobile phase consisting of 50% aqueous acetonitrile. Protein precipitation with acetonitrile was used for the sample preparation. The method was fully validated, as per the ICH guidelines, in the concentration ranges of 0.35–125 µg/g (E1, E2), 0.188–125 µg/g (E3), and 0.188–450 µg/g (E4). The method allowed the trace analysis of estrogens with LOD values of 0.094 (E3, E4) and 0.126 µg/g (E1, E2), and LOQ values of 0.188 (E3, E4) and 0.350 µg/g (E1, E2). The analyzed samples contained different levels of estrogens. Within the same category, processed products contained the highest levels of E4, while the internal organs contained the least estrogen content. Finally, the estimated daily intake, µg/kg bw/day, of estrogens through the consumption of meat-based food products was calculated.

Context: Limited evidence has been found on the effectiveness of Stimulan® antibiotic beads for the treatment of diabetic foot ulcer. Aims: The aim of the study was to evaluate the safety and efficacy of Stimulan® antibiotic beads in treating diabetic foot infection and review the healing rate, infection recurrence rate, and the length of postoperative hospital stay. Settings and Design: It was a retrospective review of patients implanted with Stimulan® antibiotic beads at a district general hospital in England from 2017 to 2019. Subjects and Methods: Nineteen patients with Wagner Grade 3 and 4 ulcers were included, with a mean age of 62.3 years. Stimulan®, an antibiotic loaded absorbable calcium sulfate biocomposite, was used to treat persistent diabetic foot infection with chronic osteomyelitis. Staphylococcus aureus was the most common bacteria isolated. Exclusion criteria consisted of those with Wagner Grade 1 or 2 ulcers and infections that had clinically responded to long courses of systemic antibiotics treatment. Results: All patients underwent local wound debridement with the application of Stimulan® beads and received intravenous antibiotics for 48 h postoperatively. The average postoperative hospital stay was 2 days. After 1 month of follow-up, 16 wounds (84%) fully healed, two wounds (11%) had partially healed, and one wound (5%) showed no sign of healing. Two patients (11%) had shown recurrence of diabetic foot infection in a different foot after 24 months. Amputation rate was 0% over 24 months. Conclusions: This study recorded the clinical efficacy of Stimulan® antibiotic beads by demonstrating 0% amputation rate after two years and shortened hospital stay. With a low recurrence rate (16%), Stimulan® beads could be considered as one of the alternative treatments in managing diabetic foot infection.

Abstract Background Dynamic contrast-enhanced MRI of the breast has been used for several years in the assessment of indeterminate mammographic findings. Contrast-enhanced mammography is a relatively novel imaging technique that has shown comparable sensitivity and specificity to MRI. Contrast-enhanced mammography is a relatively easy feasible study with high sensitivity and low cost. Our aim was to assess the feasibility of replacing dynamic contrast-enhanced (DCE)-MRI by contrast-enhanced mammography in the assessment of sonomammographic indeterminate lesions (BIRADS 3 and 4). Results The study included 82 patients with 171 breast lesions. They all performed contrast-enhanced mammography and dynamic contrast-enhanced MRI. DCE-MRI sensitivity and NPV were significantly higher than those of contrast-enhanced mammogram (CEM). The overall accuracy of MRI was better than that of CEM; however, no statistically significant difference could be detected. Conclusion Contrast-enhanced mammography and dynamic contrast-enhanced MRI improved the characterization of breast lesions. CEM showed slightly lower sensitivity and accuracy compared to MRI; however, because of being relatively easy, available, cheap, and acceptable by women, CEM can replace DC-MRI as a problem-solving tool in the characterization of indeterminate breast lesions.

Abstract Background Bleeding is the most common complication of oral anticoagulants, due to inadequate dosing. Case presentation This report describes the clinical course of a patient who developed severe bleeding under therapy with phenprocoumon, despite an INR in the lower therapeutic range. Strikingly, aPTT was prolonged, while factor IX activity was significantly reduced. Acquired hemophilia was excluded, due to missing detection of inhibitors. Finally, sequencing part of the factor IX gene including nucleotide position c.110 revealed a hemizygous factor IX mutation c.110C > T p (Ala37Val). Conclusions In rare cases, missense mutations in factor IX propeptide are associated with severe bleeding complications. The substitution of alanin at position 37 to either valin or threonin (Ala37Val or Ala37Thr) leads to hypersensitivity to vitamin k antagonists.

Abstract Primary mucinous adenocarcinoma is an exceptionally rare neoplasm with a propensity for local recurrence and metastasis. We report the second case in the world literature of a primary mucinous adenocarcinoma of the orbit in a 66‐year‐old man suffering from pain, progressive protrusion of left eye, and a deep drop in vision on the left for several weeks. His first external examination revealed significant proptosis with downward displacement of the left globe with no signs of lagophthalmos. A limitation of abduction was also noted. A CT of the orbit with and without contrast showed intra‐ and extra‐conical solid expansive process. MRI of the orbit with contrast and without contrast has shown a process of the supero‐internal angle of the left orbit. The patient was operated via a combined approach, and complete enucleation was done. The final pathologic diagnosis was mucinous adenocarcinoma of the orbit. The postoperative neuroimaging showed a complete resection of the tumor. The patient is referred for adjuvant radiotherapy. A CT of the orbit was made 3 months postoperatively and did not show any local recurrence.

IntroductionImmune checkpoint inhibitors (ICI) are increasingly being used to treat numerous cancer types. Together with improved recognition of toxicities, this has led to more frequent identification of rare immune-related adverse events (irAE), for which specific treatment strategies are needed. Neutropenia is a rare hematological irAE that has a potential for a high mortality rate because of its associated risk of sepsis. Prompt recognition and timely treatment of this life-threatening irAE are therefore critical to the outcome of patients with immune-related neutropenia.MethodsThis multicenter international retrospective study was conducted at 17 melanoma centers to evaluate the clinical characteristics, diagnostics, treatment, and outcomes of melanoma patients with grade 4 neutropenia (

Abstract Background Breast symmetry is one of the major things that radiologists assess when looking at mammograms and is one of the most challenging mammographic findings to evaluate. Contrast-enhanced spectral mammography (CESM) is an emerging mammography technique that has shown comparable sensitivity and specificity to MRI. The purpose of this study is to assess the value of CESM in characterization of breast asymmetries (BAs) and if it should be incorporated in its diagnostic work-up. Results Three hundred sixty-five patients with mean age of 47 years were included in the study. CESM was performed aiming for characterization of 380 suspicious or indeterminate breast asymmetries. Assessment of subtracted high-energy images (HEI) markedly improves the overall accuracy reaching 88.4%. Further improvement of the overall accuracy was achieved on combined assessment of the low-energy images (LEI), subtracted high-energy images (HEI), and ultrasound reaching 91.3%. Conclusion CESM is considered as a valuable complementary imaging tool considering the evaluation of breast asymmetries and should be incorporated in its diagnostic work-up in cases not resolved on an initial combined mammography and targeted ultrasound study especially in the presence of a heterogeneous dense breast parenchyma. Yet, this may be hindered in the presence of inflammatory signs because of the overlapping imaging criteria.

Abstract: The present study was carried out from November (2015) - October (2017) to determine the toxicological effects of pesticides exposure on agricultural application workers. Blood samples of the investigated workers were collected from Giza, Qalyubiyah and El-Buhayrah Governorates, Egypt. Thirty male individuals represented pesticide application workers were involved from the three governorates. Also, 25 male individuals (aged 18-55 years) were selected randomly from Cairo Governorate to represent the unexposed (control) group. Ten ml of blood sample per individual was collected and serological analysis for hematological (RBCs, TLC, Hb, PCV, MCV, MCH, MCHC), biochemical (ALT, AST, total protein, urea, creatinine and uric acid) and oxidative stress (GSH.R, MDA and AChE) parameters were carried out. Results: About 53% of workers involved was with an average level of education, between 18 and 35 years of age (57%), working in their field for 6 to 10 years (40%), about eight hours a day for six days a week on average (67%). Hb, MCH, MCHC, ALT, AST, AlP, TP, urea, creatinine and MDA were increased significantly by 5.58, 9.23, 3.75, 55.49, 42.44, 30.07, 6.83, 49.33, 25.48, and 133.02% respectively. While the levels of Alb, GSH.R and AChE activity were significantly decreased by 14.51, 8.33 and 21.04% respectively. a significant positive correlation between exposure duration and ALT, AST, creatinine, urea and MDA. While, there were significant negative correlations between exposure duration and total protein, alkaline phosphatase, AChE Activity, GSH.R, RBCs, Hb, PCV, MCV and MCH. Conclusions: Increasing of pesticide application workers vital parameters gives an indication of the occurrence of various health consequences due to chronic exposure to pesticides. These results can be explained by the fact that the negligence of workers in following occupational safety and health measures from wearing protective tasks, not smoking, drinking and eating during the application of pesticides, resulting from the low awareness of workers about the risks of the materials dealt with and the decrease in their educational and cultural level increases the chances of exposure to the pesticide. On the health of the worker.

Summary: In the prostate, stem and progenitor cell regenerative capacities have been ascribed to both basal and luminal epithelial cells. Here, we show that a rare subset of mesenchymal cells in the prostate are epithelial-primed Nestin-expressing cells (EPNECs) that can generate self-renewing prostate organoids with bipotential capacity. Upon transplantation, these EPNECs can form prostate gland tissue grafts at the clonal level. Lineage-tracing analyses show that cells marked by Nestin or NG2 transgenic mice contribute to prostate epithelium during organogenesis. In the adult, modest contributions in repeated rounds of regression and regeneration are observed, whereas prostate epithelial cells derived from Nestin/NG2-marked cells are dramatically increased after severe irradiation-induced organ damage. These results indicate that Nestin/NG2 expression marks a novel radioresistant prostate stem cell that is active during development and displays reserve stem cell activity for tissue maintenance. : In this article, Frenette and colleagues show that Nestin/NG2-expressing cells contribute to prostate epithelium during organogenesis and retain reserve stem cell activity during severe irradiation-induced tissue damage while epithelial-primed Nestin-expressing cells maintain bilineage epithelial differentiation potential in the unperturbed adult prostate. Keywords: prostate stem cell, Nestin, mesenchymal-to-epithelial transition

Administrative decentralization experiment in Iraq is considered is a necessity whose importance increases a long with its ability to fulfill the requirements of citizens on the local level. The adoption of the concept of Administrative decentralization by the state doesn't mean to exclude the technique of Administrative decentralization as there are public interests that can't be Administrative by decentralization authorities. However; the actual reality following 2003 in particular, has proven many failures in implementation and mal- Administration, which might be attributed to the obstacles that hinder the implementation of Administrative decentralization in Iraq. A wide range of solutions have been developed that can achieve the desired objectives if an appropriate ground is available. In this research, a number of conclusions and recommendations have been attained the most important of which is that administrative decentralization is among the most important experiments at all states levels, but there has been no evident vision of it besides no ground is ready for optimal application. E-administration represents one of the modern administrative solutions that should Iraq appeal to in order to enhance its governmental solutions in all aspects to eliminate bureaucracy and administrative routine.

Cancer-related pain constitutes a dominant reason for admission to emergency services, and a significant patient and healthcare challenge. Evidence points to the rising prevalence of opioid misuse in this patient group. We sought to compare drug delivery in an oncology-dedicated emergency department (OED) and a general emergency department (GED) within the same hospital. As such, we obtained patient and drug-related data for OED and GED during a designated three-month period, and compared them using Fisher’s exact test, chi-square tests and the Mann-Whitney test. In total, 584 patients had 922 visits to emergency services (OED n = 479; GED n = 443), and were given 1478 drugs (OED n = 557; GED n = 921). Pain was a prominent chief complaint among visitors to the OED (17%) and GED (21%). Approximately a fifth of all drugs used were analgesics (OED—18.5%; GED—20.4%), however, in the GED, 51.6% (n = 97) were used for non-pain-related admissions, compared with 33.0% (n = 34) in OED. Opioid usage significantly differed between emergency settings. The GED administered three times as many intravenous opioids (p p = 0.003) and no rapid-acting opioids, significantly fewer pain adjuvants (10.9% versus 18.7%, p < 0.001), and, finally, non-guideline-recommended drugs for pain, such as meperidine and benzodiazepines. Taken together, compared with the GED, the management of cancer-related pain in the OED was more personalized, and characterized by fewer intravenous opioids, enhanced diversity in drug type, route and method of delivery. Efforts should be directed toward reduction of disparities in the treatment of cancer pain in emergency settings.

Abstract Background Rheumatic fever (RF) is the result of an autoimmune response to pharyngitis caused by infection with Streptococcus pyogenes. RF is most prevalent in Africa and the Middle East. Rheumatic heart disease (RHD) is the most serious complication of RF. Mannose-binding lectin 2 gene (MBL2) has been reported to be correlated with different cardiac conditions. In Egyptian patients as a new studied ethnic population, it is the first time to evaluate the association between MBL2 gene polymorphism rs1800450 and RF with and without RHD. Methods One hundred and sixty RF patients (80 with RHD and 80 without RHD) and eighty healthy ethnically matched controls were studied. MBL2 (rs1800450) was genotyped by real-time PCR using TaqMan® allele discrimination assay. The MBL level was measured by ELISA. Westergren erythrocytes sedimentation rate (ESR), anti-streptolysin O titer (ASOT), C-reactive protein (CRP) and complements (C3 and C4) were determined. Results The AA genotype with high production of MBL was associated with increased risk of RHD more than the B allele carrying subjects. However, MBL2 genotype related to the low production of MBL was more frequently observed in those patients without RHD. Conclusions Our results suggested the involvement of MBL2 (rs1800450) polymorphism and its protein in RHD pathogenesis. Also, it might be a promising future strategy to utilize this polymorphism to help differentiate patients with RHD from those without RHD.

Solute Carrier (SLC) is a cluster of families of membrane bound transporters, of which many members lack defined substrate profile, and many more are poorly characterized. Many play a vital role in regulating metabolic systems, protein synthesis, and post translational modifications. SLC38 is one of the families of SLCs, which are also known as sodium-coupled neutral amino acid transporters (SNATs). In mice, it has 11 members (SNAT1-11) but in Drosophila there are two homologs for the SLC38 family; CG13743 and CG30394. Here, we show characteristics of Drosophila CG13743 which closely resembles SLC38A11 in humans. SLC38A11 still remains an orphan member of the SLC38 family which has not been functionally well studied. We used the UAS-GAL4 system to investigate and control gene expression using RNAi lines for ubiquitous knockdown of the CG13743 gene. It was found to be expressed mainly in salivary gland and brain. Knockdown flies had reduced body weight and consumed less sugar compared with controls. The gene knockdown also affected stored energy pools (lipids and glycogen) and influenced feeding pattern and total activity. In all, this shows novel findings for the characterization of CG13743 in Drosophila and a possible role in maintaining general metabolic pathways and behavior of the fly.

Para este trabalho, especificamente apresentamos uma proposta de intervenção grupal psicodramática intitulada de “Ressonância Corporal”, fundamentada no estudo e na prática de ações que utilizam a linguagem não verbal – comunicação corporal –, objetivando desvelar aquilo que é falado e sentido, bem como potencializar a capacidade expressiva do corpo inerente às pessoas. A vivência apresentada promove o resgate e a consciência da linguagem corporal, a partir da prática e da reflexão da relação comunicação-corpo. A ressonância corporal pode ser classificada como uma intervenção psicodramática que implica duas ou mais pessoas “ressoarem” a mensagem emitida por um indivíduo ou um grupo por meio de uma ação corporal executada.

In Morocco, agriculture is an important sector of the economy, accounting for 15 to 20% of Gross Domestic Product. However, it has faced several challenges: intensive tillage of land that has accelerated water erosion, seriously threatening water and soil potential, low plant cover density and misuse of traditional agricultural practices, causing a decrease in organic matter levels and destroying aggregate stability. Climate change is making water and soil management in agriculture more and more complicated. The major challenge for Moroccan agriculture is to increase agricultural production while preserving natural resources. The objective of our study is to evaluate the effect of no tillage (NT) on the physico- chemical properties of soil in the El Koudia experimental station, Rabat, Morocco. The crop is durum wheat, Arrehane variety. Soil samples are pre-dried, ground and screened to 0.2mm for organic matter (OM) analysis and 2mm for the remainder of the analyses. Plugs, canned, are then sintered, screened and dried for structural stability tests. The results show that no tillage (NT) favours the accumulation of surface OM, particularly at the 0-5cm horizon unlike conventional tillage (CT). The NT promotes structural stability, with a mean weight diameter (MWD) = 0.94mm for the NT compared to 0.83mm for the CT. These results show that soils ploughed in CT are more exposed to erosion degradation than soils not ploughed (NT). In addition, NT preserves soil moisture and promotes additional water retention of 5 to 10%.

No matter how mature it gets it has to affect and get affected by other languages. leadey to vocabulary exchange from one languages to other The research highlights the new words Arabic and Exotic in Mohet Al Mohet glossary by Al Bostani . The study presents the most important Arabized and Exotic added to Arabic over a period of political instability ,and cultural decline which could be considered the main reason for many new words entry. The study will present the most important words added to Arabic .It will examine those words source and language of origin , and the most important changes that have occurred to those words on the phoneme , morphological , or semantics . the results will demonstrate the most influential languages for Arabic and the reasons behind that The study also will enable identifying the most semantic fields in demand for new vocabulary and highlighting the changes that have occurred to those words .

BACKGROUND AND OBJECTIVES: Intracranial germ cell tumors (GCTs) are not a common disease. We reviewed the experience of a single institution to determine the variables that affect treatment outcome. DESIGN AND SETTING: A retrospective review of patients with the diagnosis of intracranial germ cell tumors treated in a single institution (KFSHRC) during the period from March 1985 to December 2007. PATIENTS AND METHODS: Fifty-seven patients with the diagnosis of intracranial GCT were recorded in the KFSHRC Tumor Registry during the period from 1985 to 2007. Seven patients with a pineal region tumor treated as germinomas in the earlier years without a tissue diagnosis were excluded. This retrospective study was restricted to the remaining 50 patients with a tissue or marker diagnosis: 31 germinomas and 19 non-germinomatous germ cell tumors (NGGCTs). RESULTS: The 10-year overall survival (OS), event-free survival (EFS) and relapse-free survival (RFS) were 87%, 88% and 96% for patients with germinoma, with a median follow-up of 4.5 (range 2–17) years, compared with 26%, 29% and 46% for patients with NGGCT with a median follow-up of 3 (range 1.5–13) years. For NGGCT, variables favorably influencing OS were younger age (< 16 y vs ≥ 16 y, P=.01), higher radiation dose (>50 Gy vs ≤ 50 Gy; P=.03) and later year of diagnosis (>1990 vs 50 Gy are important factors that influence the outcome. Second-look surgery and resection of residual/refractory tumors is always recommended.

This study investigates the use of dress words in the 4th Century (AH), particulary in two books by Ghazi Tanoukhi. The article attempts to reveal the phonological and lexical changes and developments related to clothing. It also examines the manner of articulation such sounds and compare them with the manner of articulation of Arabic sounds, so that the differences and commonalities are shown. The article also discusses changes which occurred to Arabized words. In relation to the meanings of such words, this study examines them according to their etimology in Arabic dictionaries and dictionaries of Arabized words, so that it is revealed whether the meanings of these words match with their meanings as used by the people of that period. The article then describes the semantic changes which occurred in the language of people in the 4th century. Ø´

Disruption of circadian rhythm is believed to play a critical role in cancer development. Cryptochrome 1 (CRY1) is a core component of the mammalian circadian clock and we have previously shown its deregulated expression in a subgroup of patients with chronic lymphocytic leukemia (CLL). Using real-time RT-PCR in a cohort of 76 CLL patients and 35 normal blood donors we now demonstrate that differential CRY1 mRNA expression in high-risk (HR) CD38+/immunoglobulin variable heavy chain gene (IgVH) unmutated patients as compared to low-risk (LR) CD38-/IgVH mutated patients can be attributed to down-modulation of CRY1 in LR CLL cases. Analysis of the DNA methylation profile of the CRY1 promoter in a subgroup of 57 patients revealed that CRY1 expression in LR CLL cells is silenced by aberrant promoter CpG island hypermethylation. The methylation pattern of the CRY1 promoter proved to have high prognostic impact in CLL where aberrant promoter methylation predicted a favourable outcome. CRY1 mRNA transcript levels did not change over time in the majority of patients where sequential samples were available for analysis. We also compared the CRY1 expression in CLL with other lymphoid malignancies and observed epigenetic silencing of CRY1 in a patient with B cell acute lymphoblastic leukemia (B-ALL).

To determine the accuracy of prospective ECG-gated computed tomography coronary angiography (CTCA) using 256-slice scanner for detecting significant coronary artery disease (CAD) and to quantitatively estimate lumen narrowing with CTCA in comparison to invasive coronary angiography (ICA). Methods: This study included 109 consecutive patients who had ICA on the basis of a previous CTCA (within 60 days) for clinical suspicious of CAD. All CTCA scans were performed with a 256-slice scanner using prospective ECG-gated image acquisition. The presence of stenosis ⩾50%, measured by QCA for ICA and Visual assessment for CTCA, was considered significant stenosis. Results: Obstructive CAD was present in 73.4% of patients. On patient-based analysis, the sensitivity of CTCA was 98%, specificity 83%, PPV 94% and NPV 92%. For segment-based analysis, a total of 1584 segments were analyzed with a sensitivity of 89%, specificity 98%, PPV 85% and NPV 99%. High correlation was observed between degrees of luminal stenosis assessed by CTCA in comparison to QCA in all segments (r2 = 0.961). There was high agreement between observers regarding the presence of significant luminal stenosis (k = 0.78) and good correlation for percentage of luminal stenosis (r = 0.68, p

Abstract A simple reversed phase high performance liquid chromatographic method with diode array detector (HPLC-DAD) has been developed and subsequently validated for the determination of fexofenadine hydrochloride (FEX) and its related compounds; keto fexofenadine (Impurity A), meta isomer of fexofenadine (Impurity B), methyl ester of fexofenadine (Impurity C) in addition to the methyl ester of ketofexofenadine (Impurity D). The separation was based on the use of a Hypersil BDS C-18 analytical column (250 × 4.6 mm, i.d., 5 μm). The mobile phase consisted of a mixture of phosphate buffer containing 0.1 gm% of 1-octane sulphonic acid sodium salt monohydrate and 1% (v/v) of triethylamine, pH 2.7 and methanol (60:40, v/v). The separation was carried out at ambient temperature with a flow rate of 1.5 ml/min. Quantitation was achieved with UV detection at 215 nm using lisinopril as internal standard, with linear calibration curves at concentration ranges 0.1-50 μg/ml for FEX and its related compounds. The optimized conditions were used to develop a stability-indicating HPLC-DAD method for the quantitative determination of FEX and its related compounds in tablet dosage forms. The drugs were subjected to oxidation, hydrolysis, photolysis and heat to apply stress conditions. Complete separation was achieved for the parent compounds and all degradation products. The method was validated according to ICH guidelines in terms of accuracy, precision, robustness, limits of detection and quantitation and other aspects of analytical validation.

Children who undergo liver transplantation and subsequently develop BSI are at risk for adverse outcomes. Research from high-income settings contrasts the dearth of information from transplant centers in low- and middle-income countries, such as South Africa. Therefore, this study from Johannesburg aimed to describe the clinical and demographic profile of children undergoing liver transplantation, and determine the incidence and pattern of BSI and associated risk factors for BSI during the first year after liver transplant. Pediatric liver transplants performed from 2005 to 2014 were reviewed. Descriptive analyses summarized donor, recipient, and post-transplant infection characteristics. Association between BSI and sex, cause of liver failure, age, nutritional status, PELD/MELD score, graft type, biliary complications, and acute rejection was determined by Fisher's exact test; and association with length of stay by Cox proportional hazards regression analysis. Survival estimates were determined by the Kaplan-Meier method. Sixty-five children received one transplant and four had repeat transplants, totaling 69 procedures. Twenty-nine BSI occurred in 19/69 (28%) procedures, mostly due to gram-negative organisms, namely Klebsiella species. Risk for BSI was independently associated with biliary atresia (44% BSI in BA compared to 17% in non-BA transplants; P = .014) and post-operative biliary complications (55% BSI in transplants with biliary complications compared to 15% in those without; P = .0013). One-year recipient and graft survival was 78% (CI 67%-86%) and 77% (CI 65%-85%), respectively. In Johannesburg, incident BSI, mostly from gram-negative bacteria, were associated with biliary atresia and post-operative biliary complications in children undergoing liver transplantation., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Mortality in the first year of maintenance dialysis is higher than in subsequent years and, within this first year, the risk of death is highest in the first 90 days. Some studies have shown that pre-dialysis education reduces early mortality. Limited data have been published from South Africa regarding early mortality after commencement of maintenance dialysis treatment and the effect of pre-dialysis intervention programmes on these outcomes. The aim of this study was to assess the impact of a pre-dialysis intervention programme on 90- and 365-day outcomes and to determine incident mortality in a population of chronic haemo- and peritoneal dialysis patients in South Africa., Methods: This study used a retrospective cohort of 269 patients who received a pre-dialysis intervention [Healthy Start (HS)] and a matched group of 269 patients who did not receive the intervention. Both groups subsequently commenced maintenance haemo-/peritoneal dialysis with National Renal Care (NRC). A between-group comparative analysis was conducted to determine whether there were any differences in morbidity and mortality at 90 and 365 days of chronic dialysis treatment. Survival curves for the first 365 days of treatment were calculated using the Kaplan-Meier estimation for the entire population and by age group, gender, race, diabetes, dialysis modality and presence of a central venous catheter (CVC) at start of dialysis treatment., Results: There were no significant differences between the HS and non-HS groups at 90 and 365 days when comparing mortality, cause of death, hospital admission rates and length of stay. Data were then pooled and a Kaplan-Meier analysis showed 90- and 365-day survival of 96.7 and 85.6%, respectively. The peak mortality occurred at 150 days of dialysis treatment, but this was not significant. Older age and the presence of a CVC were associated with an increased risk of death in the first year of treatment., Conclusion: The HS Programme made no difference to mortality in the first year of chronic dialysis. Early survival for both HS and non-HS groups was excellent when compared to international data. Increasing age and the presence of a CVC at the start of chronic dialysis were the two factors that impacted significantly on 1-year survival.