Title: An unusual adverse effect during crusted scabies treatment

IntroductionAdams-Oliver syndrome (AOS) is a rare congenital disorder characterized by congenital cutaneous aplasia of the scalp and terminal transverse limb anomalies (1). The lesions of congenital cutaneous aplasia are generally located on the midline of the parietal or occipital regions, where they may be associated with a parietal bone defect, but may also appear on the abdomen or limbs(1–3). First described by Adams and Oliver in 1945, this syndrome also presents severe forms of expression, including central nervous system anomalies, cardiovascular disease, and gastrointestinal malformations (1,4–6). Several modes of transmission have been described: autosomal dominant, autosomal recessive, and sporadic mutations (7–9). Six genes responsible for Adams-Oliver syndrome have been identified, including ARHGAP31, RBPJ, NOTCH1, DLL4, DOCK6, and EOGT (5,10,11). We report the case of a term newborn with severe intrauterine growth retardation (IUGR) presenting with typical signs of Adams-Oliver syndrome without associated visceral complications. This syndrome remains rare and poorly described in the scientific literature in Burundi.

INTRODUCTIONTakotsubo syndrome is an acute heart disease that mimics the typical features of acute coronary syndrome (ACS) [1]. Although takotsubo syndrome has an uncertain prevalence in the general population, in women with suspected ACS, the prevalence is estimated to be around 5-6% [2]. The annual incidence is very low and is approximately 0.02% [3][4].Unlike ACS, TS is reversible and the heart often heals within four to eight changes weeks. The syndrome is characterised by transient systolic and diastolic left ventricular dysfunction with wall motion abnormalities [5][6]. This condition, which was first described by Dote et al. in Japan in 1990 [3][4], usually affects postmenopausal women who have experienced some physical or psychological stress. However, it can also occur in the absence of these triggers [1][7].The prevalence of saccular aneurysms in the general population is estimated at 3.2%. Approximately 20 to 30% of cases present in the form of multiple aneurysms [8]. Intracranial aneurysms are generally diagnosed after episodes of subarachnoid haemorrhage (SAH), which causes a high rate of morbidity and mortality [9]. Rupture of an aneurysm is believed to be responsible for 0.4 to 0.6% of all aneurysm deaths, and approximately 10% of patients die before arriving at the hospital. [10]Takotsubo syndrome is generally reported to have an incidence of 0.8-17% in patients with SAH caused by ruptured aneurysm [11]. However, this case report is relevant for the clinical and pathophysiological observation of the possible association between aneurysms of the internal carotid arteries (ICA) and TS, with the latter being able to serve as an alert for possible aneurysms and thus allow for intervention prior to disruption.

Deadly Aspiration Pneumonia Secondary to Superior Mesenteric Artery Syndrome

This article demonstrates how scientists and engineers can use modern AI (artificial intelligence) tools such as ChatGPT and GitHub Copilot to learn computer programming skills that are relevant for their jobs. It begins by summarizing common ways that AI tools can already help people learn programming in general. Then it presents six learning opportunities that are catered to the needs of scientists and engineers, including using AI tools to 1) create customized programming tutorials for one’s own domain of work, 2) learn complex data visualization libraries, 3) learn to refactor exploratory code into more maintainable software, 4) learn about inherited legacy code, 5) learn new programming languages on-demand within the context of one’s workflow, and 6) question the assumptions that one’s scientific code is making. Taken together, these opportunities point toward a future where AI can help scientists and engineers learn programming on-demand within the context of their existing real-world workflows.

The Western Ghats (WG) tropical forests in peninsular India are recognized for their capacity to sequester carbon, owing to their diverse geology, topography, and ecology. To ensure sustainable forest management and ecosystem services (ESs), it is crucial to evaluate the Soil Quality Index (SQI) across various forest types and vegetation. However, comprehensive profile data on soil quality in relation to total soil organic carbon (SOC) stock and biomass stand particularly under different forest types, and its drivers is limited. In this study, we evaluated SQI and SOC stock of three forest types, i.e., tropical wet evergreen (TWE), tropical semi evergreen (TSE) and tropical moist deciduous (TMD) from nine forest stands under WS range of Karnataka. SQI was estimated through selection of minimum data set (MDS) using principal component analysis (PCA) and two indexing approaches (i.e., additive index and weightage index) and scoring methodologies, i.e., linear scoring function (LSF) and non-linear scoring function (NLSF) were involved in calculating SQI. Study resulted significant correlation (p<0.05) and superiority of weightage indexing through NLSF over other methodologies for detection of forest above ground bio mass (AGB). Within the forest types, mean SQI-NLSF resulted as TMD>TWE>TSE, ranging from 0.28 (Rippon pet RF) in control section (0-100cm) to 0.68 (Mookambika RF) in surface (0-30cm) soils. Total SOC stock follows the similar trend as SQI over forest types, whereas highest found under Kollegal RF (339.3 MG ha -1) and lowest in Rippon pet RF (102.5 MG ha -1) under TMD and TSE forest type respectively. Higher rhizodeposition and soluble acid formation may induce aluminium toxicity in Poomale RF, indicative of potential forest soil degradation. Our results demonstrate that the SQI along with SOC estimation could be a useful tool to indicate the soil ESs in forest systems and can be can be used as a key indication of sustainable forestry practises.

BACKGROUND: In biostatistics, evaluating fragility is crucial for understanding their vulnerability to miscategorization. One proposed measure of statistical fragility is the unit fragility index (UFI), which measures the susceptibility of the p-value to flip significance with minor changes in outcomes. Although the UFI provides valuable information, it relies on p-values, which are arbitrary measures of statistical significance. Alternative measures, such as the fragility quotient (FQ) and the percent fragility index, have been proposed to decrease the UFI's reliance on sample size. However, these approaches still rely on p-values and thus depend on an arbitrary cutoff of p < 0.05. Instead of quantifying fragility by relying on p-values, this study evaluated the effect of small changes on relative risk. METHODS: Random 2x2 contingency tables associated with an initial p-value of 0.001 to 0.05 were evaluated. Each table's UFI and relative risk index (RRI) were calculated. A derivative of the RRI, the percent RRI, was also calculated along with the FQ. The UFI, FQ, RRI, pRRI, initial p-value, and sample size were compared. RESULTS: A total of 15000 cases were tested. The correlation between the UFI and the p-value was the strongest (r = -0.807), and the correlation between the pRRI was the weakest (r = -0.395). The RRI had the strongest correlation with the sample size (r = 0.826), and the UFI had the weakest correlation (r = 0.3904). The coefficient of variation for the average RRI was the smallest at 28.3%, and for the FQ, it was the greatest at 57.0%. The correlation between the UFI, FQ, and p-value is significantly greater than the correlation between the RRI, pRRI, and p-value (for all comparisons, p < 0.001). CONCLUSION: The RRI and pRRI are significantly less correlated with the p-value than the UFI and FQ, indicating relative independence of the RRI and pRRI from p-values.

Objective: to test the hypothesis that PROMPT reduces permanent brachial plexus palsy and perinatal tears. Design: prospective / retrospective cohort study. Setting: Hanover Medical School, Germany. Population / Sample: a self-selected population. Methods: training period November 9 th 2017 until 31 st December 2019, control January 1 st 2004 until November 8 th 2017. Main outcome measures: shoulder dystocia, non-permanent and permanent brachial plexus injuries (BPI), perineal tears III°/ IV°, manual manoeuvres, and asphyxia. Results: there was a total of 22,640 births, shoulder dystocia increased from 48/18.031 (0.27%) to 23/4.609 (0.50%) (p=0.017), OR 1.88, 95%-CI [1.14; 3.09] whereas BPIs decreased from 7/48 (14.6%) to 1/23 (4.3%) (p=0.261). There was 1/7 (14.2%) of permanent BPI before and 0/1 (0%) case after. Perinatal asphyxia increased from 3/48 (6.3%) to 4/23 (17.4%) (p=0.23). However, adverse outcomes after one year were zero. McRoberts’ increased from 37/48 (77.1%) to 23/23 (100%) (p=0.013), OR 1.62, 95%-CI [1,33; 1,98] and internal rotation manoeuvres and manual extraction of the posterior arm from 6/48 (12.5%) to 5/23 (21.7%) (p=0.319). Episiotomies decreased from 5.267/18.031 (29.2%) to 836/4.609 (18.1%) (p<0.001) OR 0.54, 95 %-CI [0.49, 0.58], whereas perineal tears III°/IV° associated with shoulder dystocia increased from 1/48 (2.1%) to 1/23 (4.8%), (p=0.546). Vaginal operative deliveries remained constant (6.5% vs 7%). Conclusions: PROMPT significantly improves the management of shoulder dystocia and decreases permanent brachial plexus injuries, but not perinatal tears III°/IV°.

The availability of electron acceptors (EAs) in peatlands determines the potential of methene (CH 4) formation under anaerobic conditions. Previous studies suggested that EAs can suppress CH 4 production based on Gibbs free energy under the Redox Ladder Theory. However, there is a growing body of evidence that challenges this theory, raising the question of how the coupling of soil substrates with EAs influences CH 4 emissions. To answer this key question, peat soils were collected across different climatic zones with different degrees of soil degradation. Anoxic incubation experiments were set up, and continuous addition of SO 4 2-, Fe 3+ and humic acid (HA) at different levels of concentrations followed by characterization of dissolved organic matter (DOM) using fluorescence spectroscopy. Results suggest that low concentrations of SO 4 2- (1000 μmol L -1), Fe 3+ (100 μmol L -1), and HA (30 mgC L -1) promoted CH 4 production in most of the peat soils. With the addition of SO 4 2- and HA, increased CH 4 emissions were contributed to the facilitation of dissolved organic carbon and reduced quinone-like component C1, which increased the substrate availability for methanogenesis. Furthermore, strengthened microbial activity as indicated by fluorescence component C2 led to higher CH 4 production under Fe 3+ treatments. On the other hand, at high concentrations of SO 4 2- (5000 μmol L -1), Fe 3+ (500 μmol L -1) and HA (50 mgC L -1), CH 4 emissions rapidly decreased by 70.65 ± 1.57% to 96.25 ± 0.45% compared to control group without EAs addition, accompanied by increased δ 13C-CH 4 signatures indicating the outweighed CH 4 production under anaerobic oxidation of methane (AOM) when coupling with reduced EAs. The effect of EAs on CH 4 emissions in peat soils could also be related to natural organic substrates. Our results suggest that the CH 4 production in peatlands could be facilitated by regulating organic substrates at low EAs concentrations, but excessive EAs will reduce net CH 4 emissions through AOM.

Infected charcot spineHiromu Yoshizato (MD)Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan5-1-1 Nabeshima, Saga, 849-8501, Japan22624011@edu.cc.saga-u.ac.jpTadatsugu Morimoto (MD, PHD)Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan5-1-1 Nabeshima, Saga, 849-8501, Japanmorimot3@cc.saga-u.ac.jpToshihiro Nonaka (MD)Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan5-1-1 Nabeshima, Saga, 849-8501, Japannohcanon.2@gmail.comHirohito Hirata (MD, PHD)Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan5-1-1 Nabeshima, Saga, 849-8501, Japanh.hirata.saga@gmail.comCorresponding Author’s InformationTadatsugu Morimotomorimot3@cc.saga-u.ac.jpStatements relating to ethics and integrity policiesWe declare that we follow the ethical policies of the journal, including patient consent, disclosure of funding information, and data availability.Manuscript Type: Case ImagesKey words: Pain-Free, Low Back Pain, Spondylitis, Diagnosis, Differential, StphilisIntroduction.Low back pain is an often encountered complaint among clinical physicians. Although it can be caused by various conditions, there may be diseases that, if overlooked, could lead to serious consequences. Examples include aortic aneurysm, pyogenic spondylitis, metastatic spinal tumors, etc. Charcot spine, which occurs as a result of syphilis or spinal cord injury, exhibits severe deformity despite mild lower back pain. Infected Charcot spine (ICS), even if accompanied by fever, may not present lower back pain or only exhibit mild symptoms. As a result, the diagnosis may not be accurately made until the vertebral destruction progress severely and neurological paralysis emerges.CaseA 44-year-old man was admitted with complaints of weakness in the lower extremities. He had no low back pain and walked unaided. Although he had no history of diabetes or spinal trauma, he had positive syphilis was serology. A physical examination revealed right tibialis anterior muscle weakness, decreased pain sensation in the lateral thigh, decreased vibration sensation in both medial calves, and bladder dysfunction. There was no heat or redness in the lumbar region. Blood tests showed C-reactive protein (CRP) 30 mg/µL. X-rays showed severe destruction of the L4 vertebra (figure1, arrow) and angulated kyphosis, and magnetic resonance imaging revealed fluid retention in the destroyed L4 vertebra (figure2, arrow). The severe spinal destruction without back pain was diagnosed as an infected Charcot spine (ICS) , and an anterior-posterior lumbar fusion was performed.DiscussionTabes dorsalis occurs 20 to 30 years after the initial infection of syphilis, causing progressive degeneration of the posterior columns and posterior nerve roots. As a result, proprioception and vibratory sensation are lost, contributing to the development of Charcot spine and Charcot joints. In this case, the patient had no low back pain, despite a paralyzing severe spinal deformity. The reason for facing difficulty in diagnosing such a condition lies in the pathophysiology of ICS, which results in few complaints of back pain due to diminished sensation, and the rapid progression of vertebral destruction due to concurrent infection. Due to the paucity of symptoms, comprehensive examination by a physician may not be performed, resulting in a delayed diagnosis until there is evidence of progressive vertebral destruction or the onset of nerve palsy. What points should be noted when diagnosing ICS? First, it is crucial to understand the symptoms of Charcot spine. Churruca et al. reported that 92% of Charcot spine cases exhibit any symptoms. Specifically, these include increased spasticity, reflex disorders, autonomic nervous system symptoms, and pain (2). Second, having knowledge of differential diagnosis is essential. Differential diagnoses should include pyogenic vertebrates, osteomyelitis, Paget’s disease of bone, and destructive tumors. While ICS is rare, it should be included in the differential diagnoses for febrile patients with a history of syphilis or spinal cord injury. Early diagnosis allows prompt initiation of suitable treatments, preventing severe spinal damage and nerve paralysis.Author ContributionHiromu Yoshizato : Writing-original draft. Tadatsugu Morimoto : Writing- review and editing.Toshihiro Nonaka : Writing-original draft. Hirohito Hirata : Writing – review and editing.Funding InformationThe authors have no current financial arrangement or affiliation with any organization that could directly influence their work.Conflict of Interest StatementWe do not have any conflict of interest.Data Availability statementAdditional data related to this patient case, beyond what is presented in this publication, isnot publicly available to maintain patient consent, confidentiality, and anonymity.ConsentThe patient provided written informed consent to publish this report in compliance with thejournal’s patient consent policy.ORCIDHiromu Yoshizatohttps://orcid.org/0009-0004-7933-3744Refferenceskarthik Yelamarthy P krishna, Rustagi T, Mahajan R, Singh V, Das K, Bansal ML, et al. Infected charcot spine arthropathy. Spinal Cord Ser Cases. 2018;4:73.Arco Churruca AD, Vázquez Bravo JC, Álvarez SG, Donat SM, Llona MJ. Charcot arthropathy in the spine. Experience in our centre. About 13 cases. Review of the literature. Rev Esp Cir Ortop Traumatol. 2021 S1888-4415(21)00014-X.Suda Y, Saito M, Shioda M, Kato H, Shibasaki K. Infected Charcot spine. Spinal Cord. 2005;43:256–259.

IntroductionTinea capitis is a common infection of the scalp and hair caused by dermatophyte fungi that principally affects children1. It is an uncommon infection in adults and generally occurs in postmenopausal women and immunocompromised patients. Adult tinea capitis may have atypical clinical presentations2 34. The causative pathogens in children and adults belong to two genera: Trichophyton andMicrosporum 5. The clinical manifestations characterized by an erythematous and scaly plaques, itching, suppurative swelling with purulent discharge, areas of alopecia and regional lymphadenopathy. It is often misdiagnosed as a bacterial infection, leading to unnecessary antibiotic prescription or surgical intervention. Treatment delay may result in permanent hair loss6 7. The diagnosis of tinea capitis is made by fungal culture (gold standard), microscopy, wood’s lamp and trichoscopy5 8.

In this paper, a new skew geometric mean constant is introduced first, and then another new constant is introduced after restricting the isosceles orthogonal condition. These constants are used to characterize Hilbert spaces. Some basic properties of these constants in Banach spaces are derived, and the values of constants in specific spaces are calculated. On this basis, the relationship between the new geometric constants and other famous constants is studied. Finally, based on these identities, the relationship between the new geometric constants and the geometrical properties in Banach spaces is discussed, such as uniform non-square and normal structure.

In this paper, we are concerned with the energy decay rates for the viscoelastic wave equation with nonlinear damping and nonlinear time-varying delay in the boundary and acoustic boundary conditions. Here we consider with minimal condition on the relaxation function g, namely g ′ ( t ) ≤ − µ ( t ) G ( g ( t ) ) , where G is an increasing and convex function near the origin and µ is a positive nonincreasing function. The decay rates of the energy depend on the functions µ,G and on the function F defined by f 0 which represents the growth at the origin of

Background: Pediatric acute lymphoblastic leukemia (ALL) is the most common childhood cancer worldwide. Developed countries have a 90% 5-year overall survival rate with proper treatment, while LMICs have a poor rate of around 30-50%. The research aims to identify mutations in frequently mutated genes’ hotspot regions to design appropriate treatment plans based on patients’ somatic makeup. Methods: Sanger sequencing was conducted on TP53, PAX5, and JAK2 gene hotspot regions in 60 Patients with ALL diagnosed with acute lymphoblastic leukemia, categorized into B-ALL and T-ALL subtypes. Results: The exon mutation rate was 8.33%. The mutation frequency for PAX5 was 5%, while for TP53, it was 3.33%. New mutations found in TP53 and PAX5 genes intron region. None of these mutations was found significant to have a poor prognosis either on the whole cohort or chemotherapy recipient patients. Among the mutated samples, Chr17:7674089 (A→C) and Chr17:7674109 (G→A) were found to have a worse prognosis in patients diagnosed with T-ALL. Chemotherapy treatment response is significant with p = 0.011, and there was a linkage between chemotherapy response and the overall mutation in chemotherapy patients (p=0.0013). The TP53 mutation in chemotherapy patients is related to poor survival (p=0.001) rather than the PAX5 mutation (p=0.087). Conclusion: TP53 gene mutation is associated with poor chemotherapy response, and subtypes specific study is required for the precise treatment plan for Bangladeshi pediatric patients with ALL.

A rediscovery of Chevalier Jackson: Earlier historical descriptions of Barrett’s Oesophagus, its premalignant potential, and oesophageal adenocarcinomaA rediscovery of Chevalier Jackson: Earlier historical descriptions of Barrett’s Oesophagus, its premalignant potential, and of oesophageal adenocarcinomaSir,Foregut functions like breathing and swallowing are integrated across several anatomical regions. These regions have different types of sensorimotor supply. Controlling these functions depends on receiving and integrating information from the full path over which they are executed. Clinically however, converging sensory signals like between glossopharyngeal and vagus nerves in the pharynx, between the visceral and somatic vagal pathways at the pharyngo-oesophageal junction, and between multiple cranial nerves at the sensory trigeminal nucleus, degrades symptom localisation.A giant of Laryngology, Chevalier Jackson (1865-1958) intuitively understood the significance of poor symptom localisation in oesophageal cancer (Figure 1A). He also appreciated the vagueness with which early symptoms were described (Figure 1B) and studied the language patients with oesophageal cancer used to describe their earliest symptoms (Figure 1C-E). He argued against making ‘inferential diagnoses’ (Figure 1F). He created instruments and standardised surgical and anaesthetic techniques for examining the foregut and performed over 4,000 pharyngolaryngeal, oesophageal, and upper gastric examinations in awake patients (Figure 1G-H). 1From this clinical experience, Jackson made and published key observations. This included a series of 671 patients whose pathology included 337 and 316 cases of oesophageal squamous cell carcinoma and adenocarcinoma, respectively (Figure 1K).2 This predated Morson and Belcher’s case report description of oesophageal adenocarcinoma by almost 3 decades.3 It raises profound questions about current and prevailing views on the epidemiology of oesophageal cancer.Jackson also described a series of 88 patients with peptic ulcer4 and identified gastric mucosa within the oesophagus in a proportion of them (Figure 1J). Two decades later, this would be described again and would come to be known as Barrett’s oesophagus. 5 Jackson, for good measure, also identified the association between gastric-lined oesophagus and oesophageal cancer (Figure 1L).It is not difficult to imagine the impact Jackson’s work could have had on early diagnosis if it had continued, and on treatment if it had intersected with Sir Harold Hopkins’ work. He provides clues about why this did not happen (Figure 1M) and felt responsible for not insisting on competency standards for clinicians who took up his techniques. Today, with advanced diagnostic methods like Transnasal Panendoscopy and with treatments like Endoscopic Submucosal Dissection, opportunities have again arisen to make a difference to patient survival. It is an opportunity we can seize by working together (Figure 1N), by recognising early cancer symptoms, and by expeditiously diagnosing and treating early foregut cancers.

A physically informed neural network（PINN）for predicting material fatigue life is proposed. The Basquin formula and the Walker equivalent driving force model combined with the neural network custom blocks form physical information neurons to output preliminary lifetime results consistent with the S-N curve. The fully connected neural network evaluates the influence of temperature, notch stress coefficient and other factors that are not easy to directly participate in the calculation on fatigue life. The output of the physics module and the fully connected neural network is integrated by a single-layer fully connected neural network to generate the final life prediction result. The learning process of the obtained neural network embedded in the physical model is relatively stable, and the influence of outlier samples can be properly handled. The proposed method was validated using published experimental data. The prediction results are basically within 2 times the error bar, which meets the expectations of physical constraints and has certain extrapolation capabilities

This article investigates the problem of output feedback control for fractional-order (0 1) uncertain systems subject to deception attacks based on observer-based event-triggered scheme. Compared to the existing deception attacks, the proposed model consists of two random deception attacks on the fractional-order system. To decrease communication resource usage while maintaining desired system performance, an observer-based event-triggered scheme has been proposed. But it also has no Zeno behavior. The Lyapunov functional theory is used to establish sufficient conditions for ensuring the global asymptotic stability of an uncertain fractional-order system. By generalized applying singular value decomposition matrix, linear matrix inequalities (LMIs), we obtained the observer, and controller gain matrices. Finally, DC-DC power converter model is used to demonstrate the efficiency of the proposed methodology.

Nanoscale memristors open up new opportunities for the development of brain neural networks. Simple and precise memristors enhance the performance of various neural networks and operational circuits. In this letter, a three-terminal memristor is proposed, which makes the memristor more flexible and practical in circuit design and application through the introduction of a control port. Consid-ering that the resistance of a three-terminal memristor consists of three parts, i.e., metal region, low-resistance region, and high-resistance region, a three-segment piecewiselinear method is applied to fit these three regions. The model of this memristor is constructed through the derivation of the memristor formula and working principle. Candence simulations are conducted on the resultant circuit to verify its correctness.

A novel stripline diplexer design using frequency dependent couplings to achieve multiple transmission zeros is developed in this paper. The transmission zeros generated by the frequency dependent couplings are flexible and controllable, on the basis of the existing cross-coupled, more transmission zeros are introduced to improve the frequency selection characteristics. Based on this characteristic, we designed a 2.6G Hz diplexer, its transmitting channel filter is 5 order with 4 transmission zeros, and the receiving channel filter is 4 order with 5 transmission zeros. We fabricated and measured it, the synthesis results, simulation results, and the tested results are well matched with each other, which will provide more flexibility in the design of diplexers for wireless communication system.

Objective: To integrate the qualitative research on self-management experience of breast cancer patients, and conduct a systematic review on their self-management experience. Methods: Using a computer to search a series of databases such as CNKI, Wanfang, VIP, and China Biomedical Database, systematically collect and integrate qualitative research on the self-management experience of breast cancer patients, and the search time is limited to 2010 January to December 2022. The qualitative research quality evaluation standard of the Joanna Briggs Institute (JBI) Center for Evidence-Based Health Care in Australia was used as the evaluation standard of this project to complete the accurate evaluation of the literature; Meta-analysis was used to complete the effective integration of the results. Results: A total of 17 literatures were included in this project, and 37 research results with strong integrity were extracted accordingly. On this basis, 7 different categories were summarized, and 3 integrated results were obtained, which were experience of maintaining self-management, symptom recognition, and self-management. Conclusion: In the different stages of self-management of breast cancer patients, medical staff should give targeted guidance to help patients obtain good prognosis. Patient or Public Contribution： Patients, service users, care-givers, people with lived experience or members of the public were involved at several stages of the trial, including the design, management and conduct of the trial, but all the information was collected from public database. The statement is not applicable.

Cyclophosphamide (Cy) is a prodrug that is mainly bioactivated by the cytochrome enzyme CYP2B6. Several other enzymes are also involved in its bioactivation and affect its kinetics. Previous studies have shown the effect of the enzymes’ genetic polymorphisms on Cy kinetics and its clinical outcome. These results were controversial primarily because of the involvement of several interacting enzymes in the Cy metabolic pathway, which can be also affected by several clinical factors as well as other drugs interactions. In this article, we present the effect of CYP2B6 polymorphisms on Cy kinetics since it is the main bioactivating enzyme, as well as discussing all previously reported enzymes and clinical factors that can alter Cy efficacy. Additionally, we present explanations for key Cy side effects due to its extrahepatic bioactivation. Finally, we discuss the role of busulphan in conditioning regimens in the Cy metabolic pathway as a clinical example of drug-drug interactions involving several enzymes. By the end of this article, our aim is to have provided a conclusive summary of Cy pharmacogenomics and the effect of its kinetics. The use of these findings in new strategies for Cy personalized patient dose adjustment will certainly help in optimizing the Cy dose and in improving the clinical outcome.

Background: Dupilumab, a monoclonal antibody that blocks IL-4 receptor alpha, is effective and safe for the treatment of severe atopic dermatitis (AD). Conjunctivitis is one of the most frequently reported adverse events associated with the use of dupilumab. Although the mechanism of conjunctivitis remains unclear, a recent study has suggested that dupilumab may decrease goblet cell (GC) density and mucin production, leading to conjunctivitis. Methods: To investigate the effect of diquafosol, a topical mucin secretagogue, in the prevention of dupilumab-associated conjunctivitis in patients with severe AD. Patients with AD who were treated with dupilumab were randomly assigned to either the control or diquafosol groups. For patients in the diquafosol group, one drop of diquafosol was administered to both eyes 2–6 times per day during the first 3 months after the initiation of dupilumab. The incidence of conjunctivitis was investigated in both groups after 6 months of dupilumab treatment. Results: The incidence of conjunctivitis was significantly lower in the diquafosol group than in the control group (6.6% versus 23.8%, respectively; P=0.005). The severity of conjunctivitis was mostly mild to moderate in both groups. Only one patient in the control group developed severe conjunctivitis and had to discontinue dupilumab treatment. Conclusion: Prophylactic use of diquafosol eye drops can reduce the incidence of dupilumab-associated conjunctivitis in patients with severe AD, suggesting that the use of diquafosol eye drops may be a useful preventive strategy for managing this adverse event.

This study focuses on the communication effect of policy on social media. We identify the underlying communication process and construct a communication effect evaluation framework, incorporating the following dimensions: interaction, emotion and attitude, theme, and innovation values. We conduct a case study of ‘Mass Entrepreneurship and Innovation policy’ in China via Sina Weibo. It was found that government units are the most important nodes in the communication and interaction network, although ordinary users are more active. While audiences’ themes of interest are included in the policy content, they are more concerned with policy practice rather than policy content. Audiences’ innovation and entrepreneurship value systems are in the initial stage of establishment. Additionally, college students from Fuzhou University are very active in the interaction on policy topics.

This study aims to green synthesize and full characterize CdO nanoparticles by means of an environmentally friendly synthesis using Crocus sativus in its reaction with cadmium ions. The CdO nanoparticles were characterized and their purity was confirmed by XRD and UV.-Vis. spectroscopy. Moreover, scanning electron microscopy (SEM) showed that the prepared cadmium oxide nanoparticles were polymorphic. Furthermore, cadmium oxide nanoparticles were cast in the gas storage (H 2) study. The hydrogen storage results prove that the maximum H 2 uptake was equal to 2.85 Wt.%H 2 at a pressure of 69 bar at 77 K with ∆H=0.62607 KJ/mol H 2 and ∆S=3.35697 J/mol H 2. K. Moreover, the thermodynamic studies under four different temperatures proves that the maximum H 2 uptake could be recorded at a pressure limit of 69-86.2 bar.