Background/Objective: Osteosarcoma treatment incorporates chemotherapy and surgery. Resection of the primary tumor usually occurs after induction chemotherapy. Occasionally, scheduling challenges and medical complications result in delay. The goal of this study is to determine if an increased interval between completion of neoadjuvant therapy and surgical resection correlates with decreased tumor necrosis and inferior outcomes in children and young adults with osteosarcoma. Design/Method: We conducted a retrospective chart review of 121 patients age less than 40 years diagnosed with osteosarcoma treated at a single tertiary medical center between 2000-2022. Inclusion criteria included receipt of two cycles of neoadjuvant methotrexate, cisplatin, and doxorubicin. Association of the interval from completion of induction chemotherapy to resection with tumor necrosis (Spearman’s correlation) and outcomes (multivariable Cox hazard regression) were analyzed. Results: There was no significant correlation between interval length and tumor necrosis. However, patients with an interval greater than 16 days had lower 5-year event free survival (p=0.019). Multivariable adjusted analysis of patients with initially localized disease revealed that each day increase in interval length corresponds with a 1.1 times greater hazard of having an event (95% CI: 1.02 to 1.19; p=0.016). Conclusion: Delays in local control were not associated with tumor necrosis. This is consistent with the hypothesis that tumor necrosis is a biologic marker of a tumor’s sensitivity to chemotherapy and may not be affected by minor regimen aberrations. However, surgical delay from completion of induction chemotherapy may confer worse outcomes. Longer intervals generally confer worse outcomes in patients with initially localized disease.

We show that any bounded smooth helically symmetric solution ( u , h ) in R 3 must be constant vectors. This is an extension of previous result[17, Theorem 1.1] from Navier-Stokes system to MHD system. The proof relies on establishing a Saint-Venant type estimate to characterize the growth of Dirichlet integral of nontrivial solutions.

Xanthogranulomatous Epithelial Tumor: A Case Report with One-Year Follow-UpMuna AbuHejleh1, Ahmed Mounir ElSayed2, Renan Elsadeg Ibrahem3, Asmaa Elhassan Mohamed4, Adham Ammar11Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar; Mabuhejleh@hamad.qa, Aammar1@hamad.qa2Department of Orthopedics Surgery, Hamad Medical Corporation Doha Qatar; Aelsayed7@hamad.qa3Department of Clinical Imaging, Hamad Medical Corporation, Doha Qatar; Radam1@hamad.qa4Oncology Hematology Department, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar; Amohamed2@hamad.qa

Aims: Research on family functioning in psychosis has typically focused on specific family-related factors and their impact on symptomatology, finding strong associations between high expressed emotion and poor outcomes, especially in those with long-term illness. The objective of this review is to examine the impact of a broad range of family-related factors and their relationship with clinical, social, occupational, and relational outcomes in first-episode psychosis (FEP). Method: A systematic search of databases PsycInfo, Pubmed, Embase and CINHAL between 1990 and August 2023 was completed. In total, 1408 articles were screened, and study quality was assessed using the JBI Critical Appraisal Checklists for Analytical Cross-Sectional Studies and Cohort Studies. A narrative synthesis approach was used to analyse the data. Results: Of the 1408 identified articles, 80 full-text articles were screened. Fifteen studies were included for data extraction. The objectives and scope of the selected studies varied considerably. Studies consisted of cross-sectional and prospective cohort designs. Participants consisted of FEP patients and family members, with the patient age range varying from 15.9 to 30.8 (MD=24.5). Significant associations were identified between family factors (high EE, family environment and carer burden) and symptom and social outcomes. Discussion: While findings emphasised the significant impact of family factors on symptomatic and social outcomes, the literature had significant limitations due to the absence of underlying theoretical models and understanding of the dynamics of distress in families within FEP. Future research should seek to develop a model accounting for such processes.

Purpose: To present the prevalence of medicine use for headache in a nationally representative sample of adolescents in Denmark, and to examine the association between poor mental health, frequent headache, and medicine use for headache. Our hypothesis was that poor mental health increases the risk of headache which triggers medicine use for headache. Methods: The Danish arm of the 2022 Health Behaviour in School-aged Children (HBSC) study included 5,767 11-, 13- and 15-year-old students with self-reported data about headache frequency, medicine use for headache, and five indicators of mental health: Life satisfaction, emotional symptoms, loneliness, self-efficacy, and self-esteem. We used multivariate logistic regression analyses to examine whether the indicators of mental health were associated with medicine use for headache and whether inclusion of headache frequency in the statistical models changed the associations. Results: The prevalence of headache at least weekly was 32.7%. In the last month, 42.7% had used medicine for headache. Students with poor mental health had significantly higher rates of headache and significantly higher rates of medicine use for headache. For example, the OR (95% CI) for medicine use for headache was 2.27 (1.90-2.72) among students with low life satisfaction. When headache frequency was included in the statistical models, the associations between poor mental health and medicine use for headache attenuated and became insignificant. For example, the OR for medicine use for headache attenuated to 1.18 (0.96-1.41) among students with low life satisfaction. Conclusions: Poor mental health was associated with medicine use for headache. Poor mental health was also associated with frequent headache. The analyses suggest that frequent headache may be the explanatory factor behind the association between poor mental health and medicine use for headache. There is a need for promotion of rational medicine use among adolescents and mental health promotion may contribute to this effort.

A document by Xiaolong Li. Click on the document to view its contents.

A document by Bishnu Prasad Kandel. Click on the document to view its contents.

Introduction:Beginning in 1940s Dapsone (diaminodiphenyl sulfone or DDS) was used to treat leprosy1.  In early 1950 Lowe reported Dapsone hypersensitivity reaction and it was named by Allday and Barnes2. Dose dependent (pharmacological) adverse effects which includes hemolytic anemia and methemoglobinemia and dose independent (idiosyncratic) adverse effects that includes dapsone hypersensitivity syndrome (DHS) are two types of adverse effects caused by dapsone2. Fever, rash, lymphadenopathy, hepatitis, splenomegaly, hemolytic anemia, atypical lymphocytosis are some features of dapsone hypersensitivity syndrome and they generally occur after patients receive DDS for 5 to 6 weeks2,3.  If DHS is not detected early and managed it can lead to irreversible organ damage and death4. The prevalence of DHS is estimated to be 1.4 % with a fatality rate of 9.9 % 3. We present a case of Dapsone hypersensitivity syndrome who presented to emergency with fever, jaundice, maculopapular rash, deranged LFT and methemoglobinemia following use of dapsone for 5 weeks duration.

Manufacturing workers constantly experience tremendous job stress. However, this group has been rarely assessed in terms of this topic, with few studies having evaluated the research methods used to study job stress and workers' well-being. To address this gap, this study comprehensively analyzed relevant 32 studies that used a variety of study designs, measurement tools, and data collection, sampling, and statistical methods. Cross-sectional and longitudinal were the most common study designs used. Job stress was assessed using existing stress scales and self-reported work conditions. Workers' well-being was assessed using multiple indicators mainly related to physical and mental health. Data were collected by collaborating with local organizations and manufacturers using self- or group-administered questionnaires. Sampling techniques included simple random, cluster, stratified, convenience, and purposive sampling. The three key statistical methods were multiple regression, structural equation modeling, and logistic regression. This study may help to guide future research on the strengths and weaknesses of these research methods and in selecting the one most suited to assessing the management structures of specific manufacturing industries and of the needs of the workers concerned.

This article presents a cryogenic 8-bit successive approximation register (SAR) analog-to-digital converter (ADC) using Nexchip 110 nm 1P6M CMOS technology for the readout of qubits. To mitigate the base freeze-out effect of bipolar junction transistors at cryogenic temperature and the resulting unavailable BJT-based bandgap voltage reference circuits, a V CM -based switching procedure through a capacitive DAC with top-plate sampling split capacitor array was employed. By the adoption of compact cryo-CMOS SPICE model and asynchronous control logic, the ADC achieves an SNDR of 41.56 dB and consumes 2.1 mW while maintaining the Walden FoM of 646 fJ/conv.-step at 4.2 K and 32 MS/s. The converter occupies an active area of 0.106 m m 2 .

Background: Severe acute respiratory infection (SARI) remains one of the leading causes of morbidity and mortality worldwide. Multiple respiratory viral pathogens can cause this infection. Sequencing technologies hold great promise for detecting viral pathogens. This study aimed to develop and validate a method for the multiplex detection of SARI-related viruses (SARS-CoV-2, Influenza A (H1N1, H3N2), Influenza B, human respiratory syncytial virus, human adenoviruses, human enteroviruses, and human parainfluenza viruses) using a nanopore next-generation sequencing method. Methods: Following genome extraction from oropharyngeal swab samples and conventional RT-PCR assays, the libraries were barcoded and sequenced by the MinION flow cell. The sensitivity and specificity were assessed using various serial dilutions of samples and different primer pools, respectively. NGS data analysis, including adaptor trimming, assembly, mapping, and the generation of consensus sequences, was carried out using bioinformatic tools. Finally, the protocol was validated by evaluating with known positive samples. Results: During 12 hours of MinION sequencing, 711,000 reads passed the quality filters (Q-score>7). 11 out of 12 target genes were successfully identified in clinical samples, with more than 90% coverage for most viruses. All the viruses detected by Q30 value of more than 1%. The detection limit was measured for SARS-CoV-2, Influenza A (H1N1, H3N2), Influenza B, and human respiratory syncytial virus. The platform showed 99.9% specificity in detection and was validated by 20 clinical samples. Conclusion: This study developed and validated a novel multiplex detection method that made it possible to identify SARI-related respiratory viruses in a clinical laboratory setting.

Rationale: Erigeron breviscapus （EB）and Erigeron multiradiatus (EM) are the two species of the genus Erigeron (Asteraceae) with extremely close genetic relationships. They were used as the same “meiduoluomi” for the treatment of plague and epidemics in traditional Tibetan medicine. But in traditional Chinese medicine, only EB is used for treatment of cerebrovascular obstruction, hemiplegia due to stroke, coronary artery obstruction, chest congestion, angina pectoris. These two Erigeron species show different effects in different traditional medicines system. Therefore, analyzing the chemical compositions of two species will not only enhance comprehension of their medicinal properties, but also foster the advancement and exploration of novel applications. However, to date, there has been no comprehensive and detailed investigation comparing the constituents of EB and EM. Methods: A methodology for rapid identification of chemical profiles from two Erigeron species was devised through the integration of UHPLC-QTOF-MS/MS and multivariate statistical analysis. Additionally, a UHPLC-PDA method was established to precisely quantify of 11 components. Results: A total of 58 constituents comprising flavonoids, phenolics acids, saponin and long chain fatty acids were elucidated. Thirteen compounds were identified as potential differentiators in chemical profiles among the two Erigeron species. For quantitative assessment, 11 bioactive compounds were simultaneously quantified across 49 batches of Erigeron species samples utilizing UHPLC-PAD with wavelengths of 325 nm, 254 nm, and 266 nm. The method demonstrated excellent precision, linearity, accuracy, repeatability, stability, and recovery. Conclusions: The findings from this study will serve as a reference for quality control, functional activity exploration, and improved clinical application based on the ingredient profiles of the two species. Furthermore, this inaugural investigation into the ingredient profiles of these two species will enhance the potential and optimal utilization of both EB and EM resources.

In this paper the progression of tumor angiogenic factor in a tissue is obtained by the numerical solution of a non-linear three dimensional mathematical model using Method of Lines . This method converts a partial differential equation into a system of ordinary differential equations together with the initial and boundary conditions. As the number of lines is increased, the accuracy of the method increases. The method provides very accurate numerical solutions for linear and non-linear problems in comparison with other existing methods. We provide Matlab-generated figures which present the progression of tumor angiogenic factor in porous media and explain the biological importance of this progression. The computer codes are also given.

Energy networks face challenges in managing and securing the vast data generated by smart grids. Federated Learning (FL) offers a cost-effective, privacy-aware solution for model training, addressing customer privacy and data breach concerns. However, FL is susceptible to adversarial attacks, particularly data poisoning, which can degrade model accuracy. This study introduces a novel data poisoning attack and a mitigation framework for resource-constrained smart grids. We propose the Centroid Based Anomaly Aware Federated Averaging (CBAA-FedAvg) framework, which achieves a Mean Absolute Percentage Error (MAPE) of 2.7%, closely matching baseline performance. CBAA-FedAvg is a lightweight, sustainable solution that minimizes resource consumption through parameter quantization from 32-bit floating point to 8-bit fixed point and dynamic clustering to reduce computational complexity. Additionally, an automatic stopping criterion is employed to optimize convergence, saving energy and time. The framework demonstrates remarkable resilience against data and model adversarial attacks, offering enhanced security and efficiency compared to state-of-the-art alternatives.

not-yet-known not-yet-known not-yet-known unknown Land surface models (LSMs) are used to simulate water and energy fluxes between the land surface and atmosphere. These simulations are useful for water resources management, drought and flood prediction, and numerical climate/weather prediction. However, the usefulness of LSMs are dependent by their ability to reproduce states and fluxes realistically. Accurate measurements of water storage are useful to calibrate and validate LSMs outputs. Geological Weighing Lysimeters (GWLs) are instruments that can provide field-scale estimates of integrated total water storage within a soil profile. We use field estimates of total water storage and subsurface storage to critically evaluate two different land surface models: the Modélisation Environnementale communautaire - Surface Hydrology (MESH) which uses the Canadian Land Surface Scheme (CLASS), and the Structure for Unifying Multiple Modeling Alternatives: (SUMMA). These models have differences in how the processes and properties of the land surface are represented. We attempted to parameterize each model in an equivalent manner, to minimize model differences. Both models were able to reproduce observations of total water storage and subsurface storage reasonably well. However, there were inconsistencies in the simulated timing of snowmelt; depth of soil freezing; total evapotranspiration; partitioning of evaporation between soil evaporation and evaporation of intercepted water; and soil drainage. No one model emerged as better overall, though each model had specific strengths and weaknesses that we describe. Insights from this study can be used to improve model physics and performance.

not-yet-known not-yet-known not-yet-known unknown We previously reported that depolarization of the vascular smooth muscle plasma membrane activates the Ca 2+-dependent proline-rich tyrosine kinase 2 (Pyk2) upstream of the RhoA/Rho-associated kinase (ROCK) pathway leading to phosphorylation of MYPT1 (the myosin-targeting subunit of myosin light chain phosphatase) and the 20 kDa light chain of myosin (LC 20). The resulting sustained elevation of LC 20 phosphorylation then accounts for the tonic contractile response to membrane depolarization. However, the mechanism whereby Pyk2 activates RhoA remains unclear. It is conceivable that Rho guanine nucleotide exchange factors (RhoGEFs) may connect activated Pyk2 to RhoA activation via phosphorylation and activation of its RhoGEF activity. In this study, we investigated activation of RhoA and RhoGEFs in membrane depolarization-induced contraction of rat caudal arterial smooth muscle. Rhosin (10 - 30 µM), a RhoA inhibitor, concentration-dependently inhibited both the phasic and tonic components of the 60 mM K +-induced contractile response of arterial strips. This inhibitory effect of Rhosin was particularly prominent in the tonic component of contraction. On the other hand, Y16 ( 1 - 30 µM), a RhoGEF inhibitor, had little inhibitory effect on 60 mM K +-induced contraction. Moreover, phosphorylation of MYPT1 was increased at Thr697 and Thr855 by 60 mM K + stimulation for 15 min, compared with basal levels of MYPT1 phosphorylation, and this increase in MYPT1 phosphorylation was inhibited in the presence of Rhosin (30 µM), but not Y16 (30 µM). We conclude that Pyk2 activated in response to depolarization-induced Ca 2+ entry may cause activation of Y16-insensitive RhoGEFs and RhoA, resulting in sustained contraction.

not-yet-known not-yet-known not-yet-known unknown Animals that acquire beneficial microbial symbionts from their environment run the risk of acquiring a sub-optimal partner, or no partner at all. The leaffooted bug Leptoglossus zonatus (Coreidae) acquires its Caballeronia (Burkholderiaceae) bacterial symbiont from the environment, presumably from local soil. Despite large contributions to the bug’s fitness, young nymphs must re-acquire the symbiont every generation. To understand how the environmental reservoir of symbiont lineages shapes the insect’s biology, we examined the role of space and time in the distribution of Burkholderia sensu lato (including Caballeronia) strains in the bug and the soil. We compared samples within trees, within plots, within cities and among different cities in the Southwest USA. We also sampled Caballeronia in L. zonatus within a pomegranate orchard over two years. We found high Caballeronia diversity both in soils (29 lineages) and in bugs (26 lineages). Caballeronia lineages were spatially structured among soils and bugs, with fewer shared as distance between samples increased. Where a bug develops, therefore, influences the symbiont strain it acquires, consistent with a process of passive spatial turnover. Also, while some Caballeronia subclade frequencies in bugs approximated frequencies in soils, the coreoid subclade of Caballeronia appeared to be enriched in bugs. Turnover of strains between timepoints remained relatively constant, suggesting that the community composition of hosted Caballeronia is not undergoing directional change over time. Ultimately, understanding how symbiont strains of varying local benefit are distributed in space and time will help us predict how geography and seasonality are related to host fitness in environmentally acquired symbioses.

Background: This study develops a multi-level model of healthcare alliance (HCA) formation in Taiwan’s healthcare sector. We focus on how industry-level environmental factors stimulate government-level institutional changes, ultimately shaping healthcare organizations’ (HCOs) decisions to form HCAs. Methods: A qualitative case study was conducted to explore ten dyadic HCAs. In-depth interviews with 25 key informants were analyzed using a mixed-methods approach, combining in-depth interviews with a theoretical framework of alliance development. Results: Findings reveal a multi-level understanding of HCA formation. Market and technology turbulence drive HCOs to form HCAs for cost reduction and resource development. Government institutional changes, influenced by the pandemic, further motivate HCA formation for legitimacy. However, government-led HCAs prioritize institutional factors, while HCO-led HCAs focus on transaction cost factors and resource-based factors. Conclusion: This study contributes to the literature by integrating theories of transaction cost economics, resource-based view, and institutional theory within the healthcare context. It highlights the importance of a multi-level perspective to understand HCA formation and provides practical implications for healthcare leaders and policymakers.

A document by Athil S. Al-Ezzi. Click on the document to view its contents.

Objectives HPV-positive Oropharyngeal squamous cell carcinoma (OPSCC) and Head and neck carcinoma of unknown primary (HNCUP) is increasing. Despite good prognosis, recurrence rates range from 10- to 25%. Surveillance with clinical controls and imaging are not always reliable. Circulating tumour human papillomavirus DNA (ctHPV-DNA) has emerged as a potential biomarker for treatment evaluation and detection of recurrence. We aimed to investigate the correlation between ctHPV-DNA in HPV+ OPSCC/HNCUP and radiologic tumour burden. Additionally, we sought to assess whether ctHPV-DNA could serve as a tool in treatment evaluation. Design A prospective observational cohort study. Setting This multicenter study involved three otolaryngology units located in central Sweden. We utilised HPV genotype-specific assays for droplet digital PCR (ddPCR) to detect ctHPV-DNA in plasma at diagnosis and follow-up. ctHPV-DNA levels were correlated to radiological tumour burden and radiological response using Kendall Rank correlation coefficient and Kruskal Wallis test. Participants Patients with HPV+ OPSCC/HNCUP undergoing definitive (chemo)radiotherapy. Results Out of 54 patients, 51 were eligible for analyses. At baseline, ctHPV-DNA was detectable in 88%. The majority of patients with a favourable radiological evaluation according to RECIST, had a corresponding undetectable ctHPV-DNA at follow-up. The levels of ctHPV-DNA at baseline correlated with Total Tumour Volume and Nodal Volume (r τ = 0.39, p<0.01, respectively r τ =0.26, p<0.01). Conclusion ctHPV-DNA shows correlation with tumour burden. This study strengthens the role of ctHPV-DNA as a promising biomarker for diagnosing and monitoring HPV-related OPC/HNCUP. With further research on serial plasma sampling, ctHPV-DNA could complement radiological treatment evaluation in HPV+ OPSCC/HNCUP.

The scale of influence of hydrological and thermal conditions on plant disease remains uncertain for most natural plant pathosystems, restricting our ability to predict the potential impacts of climate change. Analysis of the spatiotemporal spread of a fungal rust pathogen across four naturally occurring flax populations over the course of five growing seasons reveals both expected relationships with snow cover, relative humidity and temperature, and a novel footprint of severe drought. This indicates that climate change may have substantial drought-mediated impacts on the spread of plant disease, and points to a need for further research integrating population-level epidemiological studies with mechanistic environmental studies to explore the effects of drought on natural plant epidemics.

Theta burst stimulation (TBS), a form of repetitive transcranial magnetic stimulation (TMS), is capable of non-invasively modulating cortical excitability. TBS is gaining popularity as a therapeutic tool for psychiatric disorders such as depression, in which the dorsolateral prefrontal cortex (DLPFC) is the main therapeutic target. However, the neuromodulatory effects of TBS on prefrontal regions remain unclear. Concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) can assess neuromodulation in non-motor regions using TMS-evoked potentials (TEPs) and event-related synchronisation/desynchronisation (ERS/D). We assessed twenty-four healthy participants (13 males, mean age 25.2±9.9 years) in a single-blinded crossover study design, following intermittent TBS, continuous TBS, and sham applied to the left DLPFC. TEPs and ERS/ERD were obtained at baseline and 2-, 15-, and 30-min post-stimulation. Four TEP components (N40, P60, N100 and P200) and two frequency bands (theta and gamma) were analysed using mixed effects repeated measures models (MRMM). Results indicated no significant effects for any assessed components or frequency bands. Relative to sham, the largest TEP effect size was obtained for the N100 component at 15 minutes post-iTBS (d = -0.50), and the largest frequency effect was obtained for gamma ERS at 15 minutes post-cTBS (d = 0.53). These results were in the same direction but smaller than found in previous studies, suggesting that effect sizes of the neuromodulatory effects of TBS may be lower than previously reported.

Upper extremity deep vein thrombosis (UEDVT) is a complex and increasing health concern, influenced by invasive medical devices and various patient-specific factors. This review synthesizes current understanding and clinical practices in UEDVT management, highlighting the importance of anticoagulation therapy as the cornerstone of treatment. Unfractionated heparin (UFH), warfarin, and low molecular weight heparin (LMWH) are mainstays, with direct oral anticoagulants (DOACs) emerging as effective alternatives. The role of minimally invasive procedures like Percutaneous Mechanical Thrombectomy (PMT) and Catheter-Directed Thrombolysis (CDT) is emphasized for acute thrombus management. Individualized treatment strategies, considering comorbidities and patient preferences, are crucial. Future research is oriented towards personalized medicine, novel thrombolytic agents, and innovative interventional techniques to further improve outcomes in UEDVT.

Introduction:Ingestion of honey that has a toxin called as grayanotoxin causes wild or mad honey poisoning. This toxin is also known as rhodotoxin as it is found in nectar of some rhododendron species mainly found in the mountains of Bhutan, India, Nepal and Turkey. (1) It acts on sodium channel and increases parasympathetic effect. (2) This can lead to nausea, vomiting, dizziness, sweating, altered consciousness, hypotension, bradycardia, cardiac rhythm abnormalities like first-, second-, and third -degree AV block, asystole and sinus bradycardia. (3,4) Wild honey is being used as alternative medicine to treat hypertension, diabetes, peptic ulcer disease, bower disorder, arthritis, flu and as sexual stimulant. (5) We present a case report of wild honey poisoning who presented to emergency with bradycardia and hypotension.