Background: Mesenchymal stromal cells (MSCs) are widely used for osteoarthritis (OA) treatment. Optimizing dose, timing, and safety while comparing efficacy with standard therapies like hyaluronic acid (HA) is essential for their standardization. Objectives: To assess the safety and efficacy of eCB-MSCs in client-owned horses with fetlock or carpus OA. Study design: Prospective blinded randomized clinical study. Methods: Horses of any breed, age, sex, or sport horse discipline diagnosed by blocking with fetlock or carpus OA were randomly assigned to receive either 10 or 20 million eCB-MSCs in hyaluronic acid (HA), while the control group received 3 ml of HA alone. Subjective lameness examinations were performed at baseline, 3- and 6- weeks post-treatment; additionally, 24-72 hours post-injection, horses were evaluated for adverse reactions. Follow-up surveys were sent to owners 18-weeks after treatment. Results: A total of 27 client-owned horses were enrolled. No significant adverse reactions occurred. There were no significant differences in lameness outcomes between treatment groups (HA: 1.7 ± 1.24 [1.22-2.27]; 10-MSC+HA: 1.2 ± 1.27 [0.67-1.73]; 20-MSC+HA: 1.1 ± 1.28 [0.55-1.64] grades) (P > 0.05) or by treatment by time (P > 0.05). All groups, irrespective of treatment, improved by week 6 by 0.5 ± 0.65 [0.2-0.8] grades (P < 0.05). Although return-to-work rates were not significantly different between treatment groups (P > 0.05), both MSC groups had higher rates of return to the same or higher work levels compared to HA-only (89%, 78%, and 56%, respectively). Main limitations: This study aimed to assess the safety and efficacy of MSC treatment in client-owned horses. It expected higher exercise return rates at 18 weeks for MSC groups (10 or 20 million). However, unexpectedly high returns in the HA group rendered the study underpowered. Based on observed rates, 30 horses per group would be needed for confident conclusions favouring MSCs.

Background: Trimming and shoeing of a horse should be customised to the needs and conformation of the individual which can be challenging. Objectives: To investigate the effects of tailormade three-dimensional (3D) printed plastic shoes on kinematic and kinetic parameters when compared to traditional standard steel shoes. Study design: Pilot study with cross-over design. Methods: Six horses underwent one plastic shoeing cycle, and two steel shoeing cycles (front hooves) of seven weeks in semi-randomised order. Kinematic data (accelerations measured with 3D inertial measurement units on the hooves) and kinetic data (vertical ground reaction forces and hoof balance curves determined using a pressure-force system) were collected in week 1 (W1) and week 7 (W7) of each cycle. Data were analysed using linear mixed effect models. Results: Horses shod with plastic shoes had lower peak decelerations and mean vibration frequencies in the dorsopalmar axis at W1 ([338.9±42.7; 502.2±65.4] m/s 2, p < 0.001 and [193.1±6.0; 223.5±6.3] Hz, p < 0.001) and the proximodistal axis at W7 ([690.9±53.8; 905.1±52.8] m/s 2, p < 0.001 and [172.9±5.4; 199.5±5.6] Hz, p < 0.001) compared to steel shoes. Also, the peak vertical force and vertical impulse were higher at W1 ([7.5±0.3; 6.6±0.3] N/kg, p < 0.001 and [1.53±0.052; 1.35±0.051] N∙s/kg, p = 0.001) and W7 ([7.6±0.3; 6.2±0.3] N/kg, p < 0.001 and [1.53±0.051; 1.22±0.052] N∙s/kg, p < 0.001). Horses shod with plastic shoes had a more equal pressure distribution between the toe-heel region and the medio-lateral region at W1 and W7. Main limitations: The two types of shoes differed in shape (steel: standard; plastic: frog support). Conclusions: Tailormade 3D printed plastic shoes seemed to cause less friction with the hard surface, had a dampening effect on the impact vibrations, and resulted in an increased loading of the front limbs and a more equal pressure distribution compared to steel shoes.

A document by Donia Younus. Click on the document to view its contents.

Comprehensive exploration is necessary for collectively exploring the arms, while still exploiting the optimal arm, in K−armed stochastic bandits, specifically for higher arm spaces like the rescue and surveillance operation where relatively higher exploration of the agent is expected in the search space. Under the case of Multi-armed Bandits (MAB), where K, is relatively higher action dimensions, many exploration algorithms like the epsilon-greedy for example use random and direct exploration, where sub-optimal actions may be chosen frequently, thus increasing regret linearly. In this paper, we study on the theoretical aspects of MaxExp-UCB algorithm, which promotes comprehensive exploration while still having a sub-linear regret growth. We introduce normalized exploration across bandit arms as 2 ln(t) N i (t) • δ(K−1) i̸ =i ⋆ N i (t) , and show that, in case of higher K values, the δ(K−1) i̸ =i ⋆ N i (t) term, becomes smaller, promoting further exploration to ensure a comprehensive search across all available arms in our MAB setting. We also conduct a theoretical study on the on the worst-case upper bound of the term δ(K−1) i̸ =i ⋆ N i (t) and prove that the upper bound is ≤ √ t 2δ(K−1) • (t) ∆•T • ln(t) N i (t). Finally, using the previous-worst case-bound, we derive and analyses the pseudo-regret bound in adapting comprehensive exploration and show that our regret has sub-linear properties. Through this we conclude that, our regret analysis is near to UCB regret bound, indicating the effectiveness of MaxExp-UCB in making near-optimal decisions while promoting comprehensive exploration across K-possible arms in MAB setting.

A major development in the treatment of a rare genetic disease, duchenne muscular dystrophy, has recently been approved by the FDA. Givinostat, a histone-acetylase inhibitor, signifies a new ray of hope for patients with DMD, a progressive and enervating disease. This treatment, given as an oral suspension, was approved for use in patients 6 years and older after promising results were obtained from the phase 3 EPIDYS trial. Givinostat can also cause adverse effects such as thrombocytopenia and hypertriglyceridemia, and should be administered with continuous monitoring.

Climate change is increasing extreme heating events and the potential for disease outbreaks. Whether hosts can adapt to infection with rising temperatures is important for forecasting species persistence. We tested whether warming -- at different host life-stages -- affects the ecological and evolutionary dynamics of resistance in Caenhorabditis elegans infected by a wild bacterial pathogen. We competed genotypes across 10 passages and tracked the spread of resistance in the population. Infection and prolonged warming strongly selected for the resistant genotype. Warming during host development induced plastic defenses against infection, reducing the selective pressure for costly genetic-based resistance. Resistance was lost under ambient temperatures and periodic warming. Selection for resistance was likely weakened at ambient temperatures by the dilution effect, whereby resistant genotype reduced pathogen transmission. Evolutionary dynamics of resistance depend on the balance among pathogen virulence, costs of genetic-based resistance, the dilution effect, and plastic defenses induced by temperature stress.

Environmental gradients are pervasive across ecosystems and play a fundamental role in structuring species distributions and community dynamics. While ecological theory mainly focused on species with distinct preferences for specific niches along the gradient, many natural communities follow an alternative pattern of shared preferences. In such systems, all species prefer the same optimal conditions but differ in their tolerance to harsher environments, according to a growth-tolerance trade-off. Here, we develop a trait-based metacommunity model, based on integrodifference equations, to investigate the development of community structure along a one- dimensional stress gradient with shared preferences. We demonstrate how species interactions, driven by competition, dispersal, and a growth-tolerance trade-off lead to the emergence of patterns such as unimodal diversity distributions and trait lumping. Our model provides a conceptual framework for exploring the processes that shape metacommunities across spatial gradients characterized by shared preferences, offering new insights into this underrepresented class of ecological systems.

Background: Cyclosporine is currently recommended as a third-line therapy for chronic spontaneous urticaria (CSU), while narrowband ultraviolet B (NB-UVB) phototherapy has shown promise. Objective: To compare the efficacy and safety of NB-UVB phototherapy versus cyclosporine in antihistamine-refractory CSU. Methods: This randomized, prospective, non-inferiority study recruited 50 patients with antihistamine-refractory CSU. Participants received either NB-UVB (thrice weekly) or cyclosporine (3 mg/kg/day) for 90 days alongside maximum-regulated doses of antihistamines, with a post-treatment follow-up of 90 days. Primary outcome was the Urticaria Activity Score over 7 days (UAS7), with secondary outcomes including Urticaria Control Test (UCT), Chronic Urticaria Quality of Life (CU-QoL), and biomarkers such as IL-6 and IL-31. Results: Both treatments significantly reduced UAS7 by day 15. NB-UVB provided sustained symptom control post-treatment, while cyclosporine achieved rapid relief but led to rebound flares upon discontinuation. The non-inferiority test showed that NB-UVB was not significantly worse than cyclosporine for UAS7 reduction. Both therapies reduced serum IgE, with IL-6 and IL-31 significantly decreasing in the cyclosporine group. Limitations: Single-center design, short follow-up duration. Conclusions: NB-UVB phototherapy is an effective and well-tolerated alternative to cyclosporine for antihistamine-refractory CSU, offering sustained disease suppression post-treatment. Further research is needed to explore long-term outcomes and broader applicability. Trial Registration: Clinical Trials Registry of India (CTRI/2022/11/047799).

Twelve suckling foals with nasal discharge, aged five to seven months, were treated in field conditions with the application of trimethoprim and sulfadiazine, anthelmintics and macrolids with rifamycins. Five days after clarithromycin with rifampin was administered, one foal died, and a second foal became colicky. The second foal underwent colic surgery and was then euthanised due to severe large colonic oedema. This finding was identical to that of the first non-survived foal. The following day, colic behaviour and colitis were present in additional two foals. These foals did not respond to anti-endotoxemic and supportive therapy, and when circulatory collapse with pleural effusion developed, they were euthanised. The remaining eight foals were diagnosed at the home stable with the same findings. Ultrasound confirmed massive oedema of the large colon, but with only slight changes in the lungs. All remaining foals were managed with transfaunation. Five of the foals improved within twelve hours, and the other three, those with the most severe colon oedema, were treated intensively at the clinic with antibiotics, repeated transfaunation and supportive care. The main symptoms of significant disturbance of the microbiome included colic, colon oedema and, in the worst-affected foals, final stage pleural effusion. Repeated transfaunation significantly improved the health status of the foals and halted the development of the symptoms displayed by the first four foals.

Background: HPV vaccines have only been used in China for 8 years, and routine HPV test is not recommended before HPV vaccination, there is still a need to figure out HPV effectiveness, and the impact of pre-vaccination HPV infection status on the protective effect of HPV vaccines in Chinese women. Methods: From June 2022 to June 2023, women aged 18-50 years without history of cervical or uterine excision were recruited from three medical institutions. Basic characteristics were compared between vaccinated and unvaccinated participants, and inverse probability treatment weighting (IPTW) was used for confounding factors. HPV infection rates and vaccine effectiveness (VE) were calculated, and sub-group analysis in vaccinated women were conducted to explore impact of pre-vaccination HPV infection status. Results: After adjusting for group differences, the VE was observed as 76.1% (95% CI: 58.7%-86.2%) against new HPV16/18 infections among 2,285 participants. Older age and having a master’s degree or higher were protective factors, while increased parity and using oral contraceptives alone were risk factors for HPV16/18 infection. Women with unknown pre-vaccination HPV status had significantly higher post-vaccination rates of hrHPV (RR 4.278, 95% CI: 2.537-7.215) infections compared to those HPV-negative pre-vaccination. However, no significant difference in new hrHPV infection rates was observed between pre-vaccination HPV-negative and HPV-positive women. Conclusion: In addition to HPV vaccination, age, parity, using oral contraceptives alone, and master’s degree or higher were independent influencing factors of HPV16/18 infection. Pre-vaccination HPV infection status did not directly affect the protective effect of the HPV vaccine against uninfected types.

Authors: Latifa Bakiri, PhD, Department of Laboratory Medicine, Medical University of Vienna and Univ.-Prof. Dr. Erwin F. Wagner, PhD, Department of Dermatology and Department of Laboratory Medicine, Medical University of Vienna

Stress can activate physiological changes mediated by the sympathetic nervous system and the hypotalamic-pituitary-adrenal axis, triggering the release of biomarkers such as cortisol and proinflammatory cytokines. Although physiological stress has been studied in relation to different inducers and diseases, there is still a gap regarding the association of academic stress with biological markers. Thus, this study aimed to associate the levels of academic stress against biological markers isolated from saliva from undergraduates’ students. Eighty-one students (53 females and 28 males) were recruited and completed the SISCO inventory to determine their academic stress level. The levels of cortisol, interleukin-1β, C-reactive protein and immunoglobulin A from saliva samples were determined by ELISA assays, and data were analyzed using ANOVA, Pearson correlation tests. A predictor model was estimated by lineal regression.Stress categorization following the SISCO inventory showed that 37% of the students grouped in the low stress level, 35% grouped in the moderate stress level , and 28% in high stress level. Salivary marker levels were similar across all stress categories; however, trends identified-such as decreased cortisol and increased proinflammatory markers in male participants classified in the high stress group, suggesting a possible association between these biomarkers and sex-dependent academic stress. The multivariable model including the 4 biomarkers resulted in R2 = 0.14 with predictions that were roughly within +/- 20% of stress levels. In conclusion, no significance was found in the association of salivary biomarkers with academic stress levels. However, trends were observed with increasing levels of academic stress in men.

Co-Infection with Chikungunya and Malaria: A Case ReportEmmanuel Edwar Siddig 1, Alaa Tajeldeen Habeeb Abdallah2, Yousif Ali3, Claude Mambo Muvunyi 4, Nouh Mohamed 5, Ayman Ahmed 4,5,61 Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan.2 Rufa’a Teaching Hospital3 Sudan Field Epidemiology Training Program, Health Emergencies and Epidemics Control General Directorate, Sudan Federal Ministry of Health, Khartoum 11111, Sudan4 Rwanda Biomedical Center (RBC), Kigali P.O. Box 7162, Rwanda5 Pan-Africa One Health Institute (PAOHI), Kigali 11KG ST203, Rwanda6 Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan.Correspondence: Ayman Ahmed; Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.Tel: +249123997091Email: ayman.ame.ahmed@gmail.comORCID: 0000-0002-9516-9508.

TITLE PAGEType of the Study: Original Research Article

A Rare Clinical Course In Drug-Reaction Eosinophilia And Systemic Symptoms Syndrome (DRESS) : Lung InvolvementDeniz Yılmaz1, Zeynep Şengül Emeksiz1, Gülsüm İclal Bayhan2, Işıl Bilgiç3, Emine Dibek Mısırlıoğlu1

Inverse Synthetic Aperture Radar (ISAR) is a crucial radar imaging technique that relies on the relative motion between the radar and the target to produce high-resolution images. However, traditional ISAR methods are highly sensitive to inaccuracies in estimating rotational parameters, such as roll, pitch, and yaw. Errors in these estimates can result in significant image degradation. In this paper, we present a novel approach for imaging dynamically rotating scenes using a multistatic ISAR setup, where we estimate motion parameters through a Differential Semblance Optimisation (DSO) criterion. This is done by minimising discrepancies between images formed from multiple transmitter-receiver pairs, our method delivers focused images with improved estimates of the yaw rotation parameter of the targets. We demonstrate the effectiveness of this approach through a series of numerical experiments, highlighting its robustness in both noise-free and noisy environments, and discuss its potential for enhancing ISAR imaging in complex scenarios.

This paper proposes a predefined-time (PT) edge vector-based formation maneuver control for underactuated marine vehicles (MVs) with intermittent communication connection (ICC). The control goal is to steer MVs to perform formation translation, scaling, and rotation with predefined convergence time. Unlike the traditional distance/bearing-based methods, the proposed method allows two leaders to flexibly manage the formation, even without requiring followers to know the formation details and maintain constant communication connections with multiple neighbors. Specifically, a novel edge vector-based method is developed for followers to construct the PT guidance law, where the desired offset is replaced by the edge vector between two neighbor positions, thus avoiding dependence on prior formation information. Once the set condition in the designed ICC strategy is satisfied, the communication requirement with multiple neighbors for followers can be reduced to just one, while formation maintenance for followers relies solely on the previous edge vector. To avoid the “explosion of complexity” problem, a PT filter is constructed to obtain the differential signals. A PT disturbance observer is introduced to estimate composite disturbance, and a PT control law is designed to achieve formation maneuvers with the predefined convergence time. Ultimately, the theoretical analysis and simulation results are given to validate the stability and effectiveness of the control system.

Background: Human Papillomavirus (HPV) infection is a major public health concern and the primary cause of cervical cancer worldwide. Understanding the regional distribution of HPV subtypes is crucial for developing effective prevention strategies. Objective: To determine the distribution of HPV subtypes among Kuwaiti and non-Kuwaiti populations in the state of Kuwait and evaluate any significant differences in subtype prevalence between these groups. Methods: A cross-sectional study was conducted analyzing HPV testing results from 234 patients (190 Kuwaiti and 44 non-Kuwaiti) at a tertiary healthcare center in Kuwait. HPV genotyping was performed to identify specific subtypes, and statistical analysis was conducted to compare the distribution between nationalities using chi-square tests. Results: The study identified 36 different HPV subtypes, with HPV-53 (16.24%), HPV-42 (15.38%), HPV-6 (14.96%), HPV-16 (14.53%), and HPV-54 (13.68%) being the most prevalent. Among these, 19 were classified as high-risk.and 17 as low-risk. The distribution analysis between Kuwaiti and non-Kuwaiti populations showed no statistically significant differences in subtype prevalence (p>0.05 for all comparisons). High-risk HPV types were found in both population groups, with HPV-53 being the most common high-risk type. Conclusion: This study reveals a unique pattern of HPV subtype distribution in Kuwait, differing from global patterns where HPV-16 and HPV-18 typically predominate. The lack of significant differences between nationalities suggests that demographic factors may not strongly influence HPV subtype distribution in this population. These findings have important implications for vaccination strategies and screening programs in Kuwait and the broader Gulf region.

Naringenin (NAR) has been shown to regulate gastrointestinal motility disorders. The present study aimed to elucidate the regulatory role of naringenin on autophagy in STC and its underlying mechanism.

Pseudo Prune Belly Syndrome, rare case report1Rabirra Waktola, 1Tajudin Adem,1Tesfaye Nagasa, 2 Merga Daba1Medawolabu Hospital, Dodola, West Arsi, Ethiopia2Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Rabirra Waktola, Medawolabu Hospital, Dodola, West Arsi, Ethiopia. Email: rabirrawak@gmail.com Tel: +251911832617

Title: “Choledochoduodenal fistula arising from pancreatic lymphoma: An exceedingly rare phenomenon”Authors (and institutional affiliations): Dr Shalvin Jassal (BiomedSci, MBBS, MSurg)1Dr Nathan Ip (5th year MBBS student)2Dr Adrian Fox (MBBS, FRACS)1Dr Melanie Crispin (MBBS (Hons), BMedSci, PGDipSurgA, PGDipSurgED, FRACS)11 Upper Gastrointestinal Surgery Unit, Eastern Health, Melbourne, Victoria, Australia2 Monash University, Faculty of Medicine, Nursing and Health Sciences, Clayton, Melbourne, Victoria, AustraliaThe listed authors declare they have no conflicts of interest to disclose. This manuscript has not been published or submitted elsewhere for consideration of publication. There are no further authors to list or acknowledge. Funding: No funding was acquired or sought for the production for this manuscript. Data accessibility statement: All data available has been presented within this manuscript.Keywords: Choledochoduodenal fistula, Biliary Obstruction, Pancreatic Lymphoma, Non-Hodgkin’s Lymphoma, Diffuse Large B-cell LymphomaCorresponding author: Dr Shalvin Jassal jassal.shalvin@gmail.com

AbstractAnatomically Corrected Malposition of the Great Arteries (ACMGA) is an exceedingly rare congenital heart anomaly in which the great arteries emerge in parallel, with an abnormal spatial relationship to the ventricles, despite originating from anatomically corrected chambers. This case report presents a 36-year-old female who was referred for evaluation of dyspnea on exertion and was initially diagnosed with severe pulmonary stenosis (PS). Echocardiography and cardiac magnetic resonance imaging (CMR) confirmed the diagnosis of ACMGA, in which the atrioventricular and ventriculoarterial relationships were concordant, but the great arteries were malposed, with a leftward malposition of the aorta. Transesophageal echocardiography revealed an isolated subaortic conus, as well as severe valvular and subvalvular pulmonary stenosis. The patient was subsequently scheduled for surgical correction. This report highlights the importance of accurate diagnosis and differentiation of ACMGA from other congenital heart defects, as misdiagnosis can lead to inappropriate treatment strategies. Advanced imaging modalities such as CMR play a crucial role in diagnosing this rare condition, especially in adult patients with poor echocardiographic windows.Keywords : anatomically corrected malposition of the great arteries (ACMGA), left malposition of the aorta, isolated subaortic conus, cardiac magnetic resonance imaging (CMR)

Sudden severe hypotension after ultrasound guided femoral nerve block in a fracture neck femur patient: A Case reportOmar Faiz Al Mohamadamin M.D.*, Bhavsar R M.D. Ph.D.*, Thomas Strom M.D. Ph.D.**.*South Jutland Hospital, Aabenraa, Denmark ** Professor, Odense University Hospital, Odense Denmark.

The Tea (Camellia sinensis) clones exhibit striking morphological resemblances, presenting a significant challenge in delineating clear distinctions between them. This study aims to conduct a comparative analysis of the micro morphology of leaf epidermis among thirty-six selected tea clones using both light microscopy and scanning electron microscopy under similar growth conditions. Various leaf epidermal characteristics such as the shape of epidermal cells, patterns of anticlinal walls, types and frequency of stomata, density of trichomes, and size of both upper and lower leaf surfaces were examined across all tea clones. The findings reveal that the size and shape of leaf epidermal cells are largely consistent among all clones. Two primary cell shapes are observed: polygonal and irregular, with varying patterns of anticlinal walls among all clones. The types and frequency of stomata, as well as the density of trichomes, differ across different tea clones. Leaves of all clones exhibit hypostomatic stomata, located solely on the lower leaf surface. Predominantly, anisocytic and anomocytic stomata are present in all tea clones. Trichomes across all clones exhibit a unicellular hair-like structure, albeit with variations in size and density. Immature leaves generally display higher trichome density compared to mature leaves. The analysis of leaf epidermis holds significance for taxonomic purposes and comparative studies. Results indicate that micromorphological characteristics such as epidermal cell shape, stomata type and density, and trichome type and density are pivotal traits for distinguishing and identifying different tea clones.