Background: Cystic fibrosis (CF) is an inherited autosomal recessive disorder that causes chronic airway disease. In addition to genetic factors, environmental factors may affects the clinical phenotype of CF. In our study, the presence of aeroallergen sensitivity in our patients with CF and its effects on clinical findings were evaluated. Materials and Methods: Demographic characteristics, clinical and laboratory findings, skin prick test (SPT) results, and Modified Shwachman-Kulczycki (MSK) scores of patients diagnosed with CF followed in the Pediatric Respiratory and Allergy Clinic of Dokuz Eylul University Faculty of Medicine were evaluated. Results: We evaluated 51 patients with CF with a median age of 10 (6-18) years. The mean MSK score of the patients was 72.54±11.50, and the mean predictive value of forced expiratory volume (FEV1) in the first second of 41 patients was 80.43±19.50. According to SPT, aeroallergen sensitivity was detected in 17 (33.3%). The frequency of bacterial colonization and bronchiectasis was higher, MSK scores were lower in AF-sensitive patients (p≤0.01). However, there was no similar difference in other allergen sensitivities. MSK scores and predictive FEV1 values of 25 (49%) patients with bacterial colonization were significantly lower than those without colonization (p=0.001, p=0.005, respectively). Conclusion: Aeroallergen sensitivity was detected in approximately 1/3 of CF patients. Although it has been emphasized in studies that environmental factors may have an impact on lung functions and clinical conditions in CF, the effect of allergens other than AF sensitivity may be less important compared to other environmental factors such as the presence of bacterial colonization. Keywords: Cystic fibrosis, atopy, children, asthma, Aspergillus fumigatus, Pseudomonas aeruginosa

Refractory/relapsed acute myeloid leukemia is an advanced hematological malignancy with a poor prognosis in pediatric. The therapeutic options are limited and has been slow development of therapies for this age group. A combination of Venetoclax and Azacitidine therapy in newly diagnosed elderly patients with acute myeloid leukemia and refractory/relapsed disease has achieved impressive results. Whether similar results can be attained in pediatric patients is unknown. We present a case of adolescent girl with acute myeloid leukemia secondary to myelodysplastic syndrome, who was deemed unfit to undergo conventional chemotherapy and, was treated instead with the Venetoclax and Azacitidine.

Reverse transcription recombinase polymerase amplification assays combined with the fluorescence detection platform (qRT-RPA) and lateral flow biosensor (LFB RT-RPA) were developed and validated for rapid detection of porcine EMCV. The primers and probes were designed based on the highly conserved region of 3D gene of porcine EMCV. The optimal reaction condition of qRT-RPA and LFB RT-RPA assay was at 42 °C for 20 min. The assays were highly specific to EMCV and no cross-reactions were observed with other 7 porcine viruses. With the 10-fold sieral diluted EMCV genomic RNA as template, the limit of detection of the qRT-RPA assay was 1.0×10 2 copies and the limit of detection of LFB RT-RPA was 1.0×10 1 copies. A total of 92 samples collected from EMCV inoculated mice (24), control mice (8) and pigs showing reproductive failures (60) were examined using developed RT-RPA and a described qRT-PCR, and the diagnostic agreement between qRT-RPA (23/92), LFB RT-RPA (25/92) and qRT-PCR (23/92) was 100% and 97.83, respectively. The performances of the developed RT-RPA assays were comparable to a qRT-PCR, while the RPA assays needed less time and easy to perform to obtain the positive results and LFB RT-RPA was higher sensitive than the qRT-PCR. The developed EMCV RT-RPA assays are rapid, reliable and easy to perform, which provide an attractive and promising tool for effective detection of EMCV in low-resource settings.

Abstract: Objective: To investigate the histopathologically, diagnostic measure and prognosis of Struma Ovarii (SO). Design and Setting:From Jan.2009 to Jan.2022, the general clinical data, results of laboratory examinations, surgical and histopathological test results of 11 patients, age 25-66 years, mean45.5 years old, with struma ovary in the department of Gynecoloy in The Affiliated Hospital of Jiangnan University, were analyzed retrospectively. Population or Sample：1 Struma Ovarii (SO) cases. Methods: Methods Clinical data of 11 Struma Ovarii (SO) cases were retrospectively studied, analyzed the histopathologically, diagnostic measure and prognosis of (SO). In this study, the procedure followed in line with our hospital customized ethical standards, and with the signing of informed consent in clinical research which obtained a informed consent from the patients. Results: The clinical manifestations of these patients were pelvic mass, bloating, breathing difficulty, peritoneal dropsy, pelvic mass and the CA125 levels may be elevated. Conclusions: Struma Ovarii is a highly specific ovarian teratoma, mostly benign. Struma Ovarii is rare in clinical because its no obvious clinical feature and characteristics preoperative and intraoperative diagnosis was difficult. Its preoperative misdiagnosis rate is high but the malignant transformation rate is very low, prognosis good for most of patients. Intraoperative frozen histopathological examination for early diagnosis can avoid unnecessary surgery to expand. Serial measurement of serum thyroglobulin is a sensitive and cost-effective follow-up tool. A period of at least 10 years is recommended.

Objective:To assess current quality of postnatal care in tertiary hospital in Lahore to identify areas for further improvement.Design:It was descriptive cross-sectional study which employed quantitative method to collect and analyze data.Setting:Lady Aitchison Hospital-a tertiary hospital in Lahore.Population:Ninety-six maternities admitted in wards of Lady Aitchison hospital during December 2021 to January 2022.Method:After IRB approval, consent was taken from mothers selected by random sampling and interviewed using Donabedian framework performa.Outcome Measures:Satisfaction with structure,process and outcome of delivery in postpartum mothers were assessed.Results:Among 96 mothers,56% were below 25 years of age,39% had secondary education,with more than one child(71%) and 57% visited for the first time.Majority of mothers,were given medicine timely(82%) and found attitude(85%) and information(83%) provided by healthcare workers helpful.Their subjective satisfaction rate with staff was 90%.However,there was lack of proper guidelines and facilities for examination,limited counselling of mothers regarding neonatal care and substandard interior of hospitals.Vital steps such as neonatal and maternal abdominopelvic,general and wound examination were left out in upto 30%. Information regarding danger signs of mothers and neonates was not given to 69% and information on family planning was given in only 28%.Contentment with infrastructure of hospital was subpar and it was suggested that sanitary conditions of washrooms and paraphernalia i.e.heaters and beds needed improvement.Conclusions:This study suggests that although patients were satisfied by services of healthcare workers,the infra-structure of hospital can be upgraded to provide better quality facilities in terms of air-conditioning,washrooms and well-designed areas for extensive examination of breast,pelvis,abdomen and neonates with introduction of WHO guidelines for postnatal care.

Immunohistochemical markers are associated with treatment outcome in adults with classical Hodgkin Lymphoma (cHL). Studies in children are scarce and inconsistent. We investigated in 67 children with cHL, whether the expression of CD15, CD30, PAX5, PD-1, PD-L1, CD68, CD163 and TARC is associated with the event-free survival (EFS) and the interim remission status. Low expression of PD-L1 was significantly associated with complete remission at interim PET-scan. There was no association between marker expression and EFS. Our data suggest a difference between pediatric and adult cHL. This underlies the importance of future research into specific molecular drivers in pediatric cHL.

Alkuraya-Kucinskas syndrome is a neurodevelopmental disorder due to mutation in KIAA1109 gene. We report a case of optic pathway tumor in a child with novel variant of KIAA1109. A plausible mechanism of gliomagenesis is considered based on influence of KIAA1109 on regulation of phosphatidyl inositol phosphorylation.

We report the case of a 10-year-old girl with an Askin Tumor who had a history of Acute Lymphoblastic Leukemia. Seven years after the diagnosis of ALL, her family detected a mass on her left chest wall. An ultrasound-guided tru-cut needle biopsy was performed and the diagnosis of a primitive neuroectodermal tumor of the chest wall (Askin Tumor) was finalized with histologic and genetic analysis. The risk of secondary cancer is three to 10 times higher in childhood cancer survivors than the general population. Patients who have several different types of cancers should be tested for hereditary cancer syndromes.

CASE REPORT

Conclusion The cervical pessary can extend the gestational week of short-cervix twin pregnancy without clinical symptoms, reduce the premature birth rate before 34 weeks of gestation, improve pregnancy outcome, reduce neonatal mortality, reduce necrotizing enterocolitis incidence, neonatal sepsis incidence, and improve neonatal outcome. For patients with a cervical length less than 38mm, a cervical pessary can be performed to extend the gestational week. For patients with a cervical length less than 25mm, a cervical pessary can effectively prolong the gestational age and improve the maternal and fetal outcomes. The cervical pessary is safe for patients with twin pregnancies. Suggest that twin-preganct-patients with CL<38mm should consider take cervical pessary in advance. In terms of long-term efficacy, there is no evidence of cervical support placement on the long-term maternal prognosis. In terms of economic benefits, cervical support is better than vaginal progesterone, but this conclusion still needs more research to prov

Aim: Vaccines have been mainly described to provide cardioprotective effects with rare reports showing rare association with myopericarditis. However, vaccines have not been well studied regarding its effects on heart rhythm disorders. Methods: we used vaccine adverse event reporting system (VAERS) between 1990-2021 to search for atrial fibrillation and other less prevalent arrhythmia. Disproportionality signal analysis was conducted by measuring reporting odds ratio (ROR) with 95% confidence interval (CI). Results: Over 1,300,000 adverse events were reported between 1990-2021. Among these events, atrial fibrillation was reported 2149 times in association with various vaccines. 90% of atrial fibrillation was associated with COVID-19 vaccines with ROR of 13.18 (CI 95%: 11.3 to 15.4) (P<0.0001). Interestingly, influenza vaccines, polyvalent polysaccharide pneumococcal (PPSV23) vaccine, pneumococcal 13-valent (PCV13) vaccine, zoster vaccine, and tetanus-containing vaccines were significantly associated with reduced atrial fibrillation. Finally, our analysis showed that COVID-19 vaccines were associated with much higher incidence of other cardiac arrhythmias compared with other vaccines. Conclusions: While vaccines have not been linked to heart rhythm disorders, the introduction of COVID-19 vaccines in 2020 showed significant association with atrial fibrillation. This study showed unprecedent detrimental effect of COVID-19 vaccines on atrial fibrillation and warrants the need to take that into consideration when prescribing COVID-19 vaccines.

Objective: To assess the impact of applying published fetal growth references or standards in the Chinese mainland population and to compare their ability to predict newborns small- for- gestational- age (SGA). Design: Retrospective observational study. Setting: A tertiary hospital in Shenzhen, a Chinese city with the most immigrants. Population: All pregnant women (n=106,455) who booked for prenatal care with ultrasound measurements for fetal biometry between 2012 and 2019. Methods: A fractional polynomial regression model was applied to construct Shenzhen fetal growth chart ranges for HC, BPD, AC, and FL. The differences between Shenzhen charts and published charts were quantified by calculating the Z-score. Main outcome measures: The impact of applying these published charts was quantified by calculating the proportions of fetuses with biometric measurements below the 3rd centile of these charts. The sensitivity and area under the receiver operating curves of published charts to predict neonatal SGA (birthweight <10th centile) were assessed. Results: Following selection, 169,980 scans of fetal biometry contributed by 41,032 pregnancies with reliable gestational age were analyzed. When using Hadlock references (<3rd), the proportions of small heads and short femurs were as high as 8.9% and 6.6% in late gestation, respectively. The Intergrowth-21st standards matched those of our observed curves better than other charts. When using AC<10th centile, all of these references were poor at predicting neonatal SGA. Conclusion: Applying Hadlock references could possibly misclassify a large proportion of fetuses as SGA. Conversely, applying the Intergrowth-21st standard appears to be a safe option in mainland China.

Separation of light hydrocarbon mixtures and extraction of C3H8 and C2H6 from CH4 are of significant importance in natural gas purification and upgrade. Microporous carbon adsorbents are promising in light hydrocarbons separation, but to fabricate uniform ultramicropores to boost separation selectivity remains challenging. Herein, we fabricated a series of poly(vinylidene chloride) resins-derived ultramicroporous carbon adsorbents with relatively uniform pore size (5.2-5.3 Å) by activator-free pyrolysis. The optimal C-PVDC-800 exhibited record-high IAST selectivity of C3H8/CH4 (3387) and C2H6/CH4 (75) as well as Henry’s selectivity of C3H8/CH4 (369) among all reported adsorbents under ambient conditions, combined with ultrahigh uptake of C3H8 (3.9 mmol g-1, 0.05 bar) and C2H6 (2.67 mmol g-1, 0.10 bar) at low partial pressures and 298 K. More importantly, fast gas adsorption kinetics were realized, favorable in fixed-bed adsorption applications. Breakthrough experiments and cycling tests further confirm the superb separation performance of extraction of C3H8 and C2H6 from CH4.

The efficiency of air separation is tested using three different small scale cryogenic distillation columns. The performance of a random packed column is compared to the performance of two microchannel distillation (MCD) columns that use thin wicking structures and gas flow channels to achieve process intensification. The MCD columns tested include a plate-type layered (PTL) column and an additively manufactured porous honeycomb (AMPH) column. For columns with 25.4 cm of active height and run under similar conditions, the packed, PTL, and AMPH columns achieved approximate height equivalent of a theoretical plate (HETP) values of 5.5, 3.7, and 3.2 cm for nitrogen, and 5.9, 4.9, and 3.3 cm for argon. The AMPH column can produce up to 0.4 SLM of 90+% purity oxygen with 12 W of cooling lift. These results demonstrate the feasibility of using additive manufacturing to construct MCD devices and pave a way for constructing novel MCD designs.

Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), previously known as “Baboon Syndrome,” is diagnosed if four or more of the following criteria are met: symmetry, involvement of at least one intertriginous zone, erythema of the gluteal, inguinal, or axillary region, systemic exposure to a drug, and lack of systemic toxicity. A first ever case of SDRIFE after HSCT is presented who was initially treated for multiple recurrences of acute skin graft versus host disease. SDRIFE should be considered in the differential diagnosis of refractory GvHD and is easily treatable by avoiding the offending medication

Background. Fermentation of lactose in milk by bacteria and yeasts naturally present in kefir grains produces a beverage that has been suggested to have cardiovascular benefit. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of this kefir beverage on cardiometabolic risk factors. Methods. Literature search utilised PubMed, Scopus, ISI Web of Science, and Google Scholar for the articles published from inception until June 2021. Cardiometabolic risk indices extracted included insulin and insulin resistance (HOMA_IR), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood sugar (FBS), haemoglobin A1c (HbA1c) and body weight (BW). In total, six RCTs (314 subjects) were selected for the meta-analysis. Inverse-variance weighted mean difference (WMD) with a 95% confidence interval (CI) was calculated for the mean changes in TC, TG, HDL-C, LDL-C, FBS, HbA1c and BW compared to baseline. A random effects model was used to estimate the pooled WMD. Results. Kefir intake significantly reduced fasting insulin (WMD:-3.69 micro-IU/mL,95% CI:-6.30 to -1.07,p=0.006,I2=0.0%) and HOMA-IR (WMD:-2.56,95%CI:-3.82 to-1.30, p<0.001,I2=19.4%). No effect on TC (WMD:-9.30mg/dL,95%CI:-20.00 to 1.39,p=0.088), TG (WMD:-1.35 mg/dL,95%CI:-13.28 to 10.58,p=0.824), HDL-c (WMD:0.70mg/dL, 95%CI:-1.30 to 2.71,p=0.491), LDL-C (WMD:-0.71mg/dL, 95%CI:-13.16 to 11.72, p=0.910), FBS (WMD: -2.73 mg/dL, 95%CI: -7.56 to 2.09,p=0.267), HbA1c (WMD:-0.58 %, 95%CI: -1.79 to 0.61,p=0.339) or body weight (WMD:-0.78 kg, 95%CI: -2.75 to 1.19,p=0.439) were found for kefir treatment. Conclusion. Kefir has a beneficial effect on decreasing insulin resistance; however, no effect was seen on BW, FBS, HbA1C or the lipid profile.

A document by Nabil Chems Eddine. Click on the document to view its contents.

Background: The multifactorial etiology of pediatric cancer is poorly understood. Environmental factors occurring during embryogenesis can disrupt epigenetic signaling, resulting in several diseases after birth, including cancer. Studies have reported associations between assisted reproductive technologies, such as in vitro fertilization (IVF), and birth defects, imprinting disorders and other perinatal adverse events. IVF can result in methylation changes in the offspring and a link with pediatric cancer has been suggested. Procedure: In this study, we investigated the peripheral blood methylomes of eleven patients conceived by IVF who developed cancer in childhood. Methylation data of patients and paired sex/aged controls were obtained using the Infinium MethylationEPIC Kit (Illumina), which interrogates ~850K CpG sites. Results: We identified 43 differentially methylated regions (DMR) in patients, 26 of them hypermethylated, and 17 hypomethylated. The most significant DMR was a hypermethylated genomic segment located in the promoter region of LHX6, a transcription factor involved in embryogenesis. Conclusion: The hypermethylation of the LHX6 promoter region, that was identified in this study, has been found in several cancer types. Further studies are required to evaluate the potential relevance of LHX6 promoter hypermethylation for tumorigenesis in children conceived by IVF.

Predation regimes on many oceanic islands are known to be weak. Evidence gathered in the 1970s and 1980s shows that Antillean anoles live at higher densities on fewer resources, grow more slowly, reproduce later, and live longer than mainland counterparts. Living at high densities should select for the ability to subsist on minimum resource levels, the definition of a superior resource competitor. These results imply that island anoles, and by inference, birds, experience low predation but intense competition, whereas mainland species experience the opposite. Further support is found in the phenomenon of community saturation in Antillean birds, an unexpected finding underlain by hyperdispersed body size ratios within avian foraging guilds, low alpha diversity and low species packing within guilds, all being evidence that these guilds are structured by competition. Islands should thus not be regarded as havens for weak competitors, but rather as refuges from predation. It follows that intense predation regimes prevent island species from colonizing mainlands, and that competition and/or low resource levels prevent mainland species from colonizing islands. These predictions are experimentally testable with lizards and if confirmed, could set island biogeography on a new course.

Introduction: In order to provide refined effects analysis of health communication intervention, this study aims to measure and compare the impact on the knowledge and protective attitudes and behavior intentions(KAP) towards canine rabies of interventions that use the local TV net(V1) and WeChat platform (V2) delivering a short video, and cartoon pamphlet(P). Materials and Methods: The study used a between-subject design involving repeated measures of rabies-related KAP. 800 randomly selected villagers were randomly allocated into four intervention groups (V1, V2, P and V2+P) and one control. The content of video and pamphlet covered topics about rabies prevention, route of transmission, and so on. The pamphlet was given door to door once immediately after the pretest. One day after the pretest, the same video was posted one time through WeChat platform, and was broadcasted via local TV net two times each day in consecutive fifteen days. A validated questionnaire was used to capture demographic and KAP information. Ordinary Least Squares regression was used to contrast the effects of interventions. Results: Our results indicate that overall V2 outperforms V1 but underperforms P at improving KAP scores. Our results suggest that a combined intervention of V2 and P can result in higher scores than any of the two in isolation. The impact on the knowledge, protective attitudes and behavior intentions scores is revealed in a decreasing sequence. Conclusion: This study demonstrated that health communication modes based on V1, V2, P and a combination of the two are all effective to improve rabies-related KAP in the short term. These findings provide a scientific basis for the implementation of health communication intervention toward rabies and further studies are needed to investigate the long term and other social media message elements benefits of these interventions on the reduction of rabies incidence in humans.

There is a new type of nanofluid called ternary hybrid nanofluid that can be used to improve heat flow. This study investigates effects of magnetic field, mass suction with ohmic heating towards stagnation region of stretching/shrinking cylinder of polymer based ternary hybrid nanofluid flows in two dimensions with different shapes aspect. Under the imposed assumptions, equations governing the flow will be modelled. It is feasible to convert nonlinear partial differential equations that are not exactly solvable via similarity transformation to a system of ordinary differential equations, which are solved numerically. The combination of Runge–Kutta-IV and shooting method in Mathematica has been shown to have a substantial impact on the prevalence of heat exchange and the mobility parameters of ternary hybrid nanofluids. The number of nanoparticles with suction enhances heat transfer and skin friction coefficient. Graphs and tables demonstrated the influence of many factors such as suction, Reynold number, nanoparticles volume fraction, magnetic field, Eckert number, stretching/shrinking on temperature, velocity, skin friction and local heat transfer rate coefficients curves. To verify the findings, a contrast study was undertaken between the current research and previously published results for a specific instance, and excellent agreement was discovered.

Objective: The purpose of this study was to develop a predictive model for cesarean delivery after induction of labor (IOL) in twin pregnancy. Design: Retrospective cohort study Setting: University hospital. Population: Twin pregnancy who underwent IOL from 2005 to 2018 Methods: The study population was randomly divided into the training and test sets at a ratio of 2:1. Three-fold cross-validation (CV) with 100 times repetitions was applied to select the best model. Main outcome measure to develop and validate a prediction model for cesarean delivery after IOL in twin pregnancies. Results: A total of 1,703 twin pregnancies were analyzed, including 1,356 women in the development cohort of the SNUH database and 347 women in the external validation cohort of the SNUBH database. In the development cohort, the clinical variables that were different between the successful and failed IOL groups were included in the logistic regression analysis, and the final prediction model, composed of five variables (maternal age, maternal height, parity, cervical effacement, and summated birth weight of both twins), was selected with an AUROC of 0.742 (95% confidence interval [CI], 0.700-0.785) and 0.733 (95% CI, 0.671-0.794) in the training set and test set, respectively. A nomogram for predicting the risk of cesarean delivery after IOL in twin pregnancies was also developed. Conclusion: A prediction model to provide information and evaluate the risk of cesarean delivery after IOL in twin pregnancies was developed. Keywords Twin pregnancy, induction of labor, cesarean section, prediction model

Abstract: This work sheds light on the centralized nature of ocean governance and the symptomatic expenses borne by marine natural capital and smaller scale ocean users alike, such as artisanal fishermen. Considering the weak representation on the topic within formal academic circles, phenomena are primarily thread from grey and secondary sources into a supportive theoretical work regarding oceanic spatial appropriation from the federal governments of the world’s coastal states. It is argued that the marginalization of the world’s coastal poor and ecological depletion in part result from the top-down nature of managing marine resources, and that the fate of nearly all sea life is in large part at the hands of geopolitical relationships.

The evolution of the concept of PBB is analyzed over time since it appeared as protracted bronchitis1, later protracted bacterial bronchitis (PBB)2, and finally its “clinical” version3, which avoids the need to perform fiberoptic bronchoscopy in children. However, this deviates in a significant manner from the principle on which the concept is based, giving rise to the idea of a disease that only affects children with the main characteristic of bacteriological isolation from lower airways. On the other hand, the clinical diagnosis of PBB is made by excluding other diseases through so-called “pointers to specific cough (primarily for chronic cough)”1 with a posterior reference of signs and symptoms called specific cough pointers2 and finally, in 2020, “Pointers to presence of specific cough”.4 Comments are then made on how asthma (and early wheezing) and posterior nasal drip syndrome are ruled out as important causes of chronic and recurrent cough in children. In conclusion, the causes of acute and chronic cough in children, with a few exceptions, are quite comparable to the causes of cough in adults. Therefore, an easy and more accurate way of diagnosing cough in children could be to reconsider our concepts of so-called cough pointers, upper airway cough syndrome, and asthma (and early wheezing) in children.