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One key barrier to improving efficacy of personalized cancer immunotherapies that are dependent on the tumor antigenic landscape remains patient stratification. Although patients with CD3+CD8+ T cell-inflamed tumors typically show better response to immune checkpoint inhibitors, it is still unknown whether the immunopeptidome repertoire presented in highly inflamed and noninflamed tumors is substantially different. We surveyed 61 tumor regions and adjacent nonmalignant lung tissues from 8 patients with lung cancer and performed deep antigen discovery combining immunopeptidomics, genomics, bulk and spatial transcriptomics, and explored the heterogeneous expression and presentation of tumor (neo)antigens. In the present study, we associated diverse immune cell populations with the immunopeptidome and found a relatively higher frequency of predicted neoantigens located within HLA-I presentation hotspots in CD3+CD8+ T cell-excluded tumors. We associated such neoantigens with immune recognition, supporting their involvement in immune editing. This could have implications for the choice of combination therapies tailored to the patient’s mutanome and immune microenvironment.

The current work involves the use of flash auto combustion procedure to synthesize nano-ferrites Mn0.6Zn0.4LaxFe2-xO4, (x = 0.00, 0.02, 0.04, 0.06, 0.08, and 0.10) annealing at 500 °C for 4 h. X-ray Diffraction (XRD), Fourier transition infrared spectroscopy (FTIR), and high-resolution transmission electron microscopy (HRTEM) were used to characterize the structural properties of produced samples. Scanning electron microscopy (SEM) was utilized to examine the surface morphology of the samples at various Lanthanum concentrations. From XRD, the spinel cubic structure for all samples with few traces of secondary phase at high La concentrations is assured. The crystallite size is estimated to be in the nanoscale range of 13.16–18.13 nm using the Debye–Scherrer formula. The appearance of characteristic vibrational bands near 460 cm−1 and 563 cm−1, which correspond to the octahedral and tetrahedral sites, respectively, confirms the formation of the spinel structure. SEM micrographs show that the grains are nearly irregular in shape, and the accumulation of La+3 ions at the grain boundaries exerts tensile strength and pressure on the grain itself, reducing the grain size. The particle size estimated by TEM coincides well with the crystallite size determined by XRD. The thermogravimetric analysis, (TGA), was used to investigate the thermal properties of the nanoferrites from room temperature to 1000 °C. In comparison to the other samples, the sample with x = 0.04 has greater thermal stability and the TEM measurement indicates that this sample has the smallest particle size. Therefore, we can assert that the thermal stability improves as the particle size decreases. The magnetic permeability was measured in the temperature range 303–773 K at a fixed frequency of 10 kHz and at various La contents. The sample with x = 0.04 has a minimal permeability value, showing that the separation brought on by La ions has diminished the super exchange contact between magnetic ions.

OBJECTIVE: To assess participant attendance and engagement for an in-person Canadian Ophthalmological Society (COS) annual meeting (2019) compared with a virtual COS annual meeting (2020). DESIGN: Retrospective case-control study of key event metrics of the 2019 and 2020 COS meetings as well as Twitter activity. METHODS: Key annual meeting metrics were collected retrospectively for 2020 virtual meeting and compared with the most recent in-person annual meeting cohort from 2019. Metrics collected included attendance by ophthalmology specialist, geographic distribution of attendees, postevent survey rate, and social media engagement (Twitter). RESULTS: Overall, there was a 7% (n = 60) increase in the number of registrants between 2019 and 2020. The largest change noted was the increase in registrants from British Columbia (n = 78). More ophthalmologists registered for the 2020 meeting than for 2019 meeting (627 versus 592). Of those who registered for the meeting, meeting participation (defined as checking in for the 2019 and logging in for the 2020 meetings) increased from 70% in 2019 to 79% in 2020. There was a 158% (n = 15 000) increase in tweet impressions in 2020 compared with 2019. CONCLUSION: The first COS virtual meeting attracted more participants and was available to a geographically wider audience. Indeed, more professionals from provinces that are geographically further from the traditional COS meeting locations were able to participate in the event. Meeting engagement on a social media platform increased in the virtual meeting in 2020 relative to the in-person meeting in 2019, and possible enablers for increased engagement should be sought and incorporated into future meetings.

Dust accumulation on photovoltaic panels represents a major challenge for the operation of solar panels especially in the regions known by their high rate of dust and low frequency of rain. The objective of this study is to minimize dust accumulation on PV panels operating street light posts using dust shields. A novel dust shield having the same width of the panel, and subtending an angle of 120° with the panel, is proposed for dust mitigation. Numerical simulations are carried out to evaluate the influence of the dust shield on dust accumulation over the panel’s surface. It is found that using a dust shield decreases the dust deposition rate by more than 44%. Moreover, extending the panel’s surface at the lower edge with an extension plate together with the dust shield decreases the dust deposition rate better than using a dust shield only. Also, the effect of adding an air gap between the shield and the added extension plate is investigated, and it is found that the air gap induces air drafts over the panel’s surface, which acts as an air barrier that obstructs the approach of dust particles to the panel’s surface. These drafts get stronger as the air gap thickness increases, accordingly, less particles deposit on the panel. Finally, it is found that using a dust shield with a length smaller than the panel’s length in addition to an extension plate together and increasing the thickness of the air gap is an effective and efficient solution for dust mitigation, such that the percentage decrease in the dust deposition rate that might be more than 88%.

Studies have shown cortical alterations in individuals with autism spectrum disorders (ASD) as well as in individuals with high polygenic risk for ASD. An important addition to the study of altered cortical anatomy is the investigation of the underlying brain network architecture that may reveal brain-wide mechanisms in ASD and in polygenic risk for ASD. Such an approach has been proven useful in other psychiatric disorders by revealing that brain network architecture shapes (to an extent) the disorder-related cortical alterations. This study uses data from a clinical dataset—560 male subjects (266 individuals with ASD and 294 healthy individuals, CTL, mean age at 17.2 years) from the Autism Brain Imaging Data Exchange database, and data of 391 healthy individuals (207 males, mean age at 12.1 years) from the Pediatric Imaging, Neurocognition and Genetics database. ASD-related cortical alterations (group difference, ASD-CTL, in cortical thickness) and cortical correlates of polygenic risk for ASD were assessed, and then statistically compared with structural connectome-based network measures (such as hubs) using spin permutation tests. Next, we investigated whether polygenic risk for ASD could be predicted by network architecture by building machine-learning based prediction models, and whether the top predictors of the model were identified as disease epicenters of ASD. We observed that ASD-related cortical alterations as well as cortical correlates of polygenic risk for ASD implicated cortical hubs more strongly than non-hub regions. We also observed that age progression of ASD-related cortical alterations and cortical correlates of polygenic risk for ASD implicated cortical hubs more strongly than non-hub regions. Further investigation revealed that structural connectomes predicted polygenic risk for ASD (r = 0.30, p

BACKGROUND: The use of a simultaneous resection (SIMR) in patients with synchronous colorectal liver metastases (sCRLM) has increased over the past decades. However, it remains unclear when a SIMR is beneficial and when it should be avoided. The aim of this retrospective cohort study was therefore to compare the outcomes of a SIMR for sCRLM in different settings, and to assess which factors are independently associated with unfavorable outcomes.METHODS: To perform this retrospective cohort study, patients with sCRLM undergoing SIMR (2004-2019) were extracted from an international multicenter database, and their outcomes were compared after stratification according to the type of liver and colorectal resection performed. Factors associated with unfavorable outcomes were identified through multivariable logistic regression.RESULTS: Overall, 766 patients were included, encompassing colorectal resections combined with a major liver resection (n=122), minor liver resection in the anterolateral (n=407), or posterosuperior segments ('Technically major', n=237). Minor and technically major resections, compared to major resections, were more often combined with a rectal resection (29.2 and 36.7 vs. 20.5%, respectively, both P=0.003) and performed fully laparoscopic (22.9 and 23.2 vs. 6.6%, respectively, both P = 0.003). Major and technically major resections, compared to minor resections, were more often associated with intraoperative transfusions (42.9 and 38.8 vs. 20%, respectively, both P = 0.003) and unfavorable incidents (9.6 and 9.8 vs. 3.3%, respectively, both P≤0.063). Major resections were associated, compared to minor and technically major resections, with a higher overall morbidity rate (64.8 vs. 50.4 and 49.4%, respectively, both P≤0.024) and a longer length of stay (12 vs. 10 days, both P≤0.042). American Society of Anesthesiologists grades ≥3 [adjusted odds ratio (aOR): 1.671, P=0.015] and undergoing a major liver resection (aOR: 1.788, P=0.047) were independently associated with an increased risk of severe morbidity, while undergoing a left-sided colectomy was associated with a decreased risk (aOR: 0.574, P=0.013).CONCLUSIONS: SIMR should primarily be reserved for sCRLM patients in whom a minor or technically major liver resection would suffice and those requiring a left-sided colectomy. These findings should be confirmed by randomized studies comparing SIMR with staged resections.

OBJECTIVE: To evaluate the outcomes of patients supported with Impella (CP/5.0) or venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock according to shock phenotype. The primary end point was 30-day survival. METHODS: A retrospective study of patients supported with Impella (CP/5.0) or VA-ECMO between 2010 and 2020 was performed. Patients were grouped according to 1 of 2 shock phenotypes: isolated left ventricular (LV) dysfunction versus biventricular dysfunction or multiple organ failure (MOF). The local practice favors Impella for isolated LV dysfunction and VA-ECMO for biventricular dysfunction or MOF. RESULTS: Among the 75 patients included, 17 (23%) had isolated LV dysfunction. Patients with biventricular dysfunction or MOF had a greater median lactate level compared with those with isolated LV dysfunction (7.9 [2.9-11.8] vs 3.8 [1.1-5.8] mmol/L, respectively). Among patients with isolated LV dysfunction, 30-day survival was 46% for the Impella group (n = 13) and 75% for VA-ECMO (n = 4). Among patients with biventricular dysfunction or MOF, 30-day survival was 9% for the Impella group (n = 11) and 28% for VA-ECMO (n = 47). Patients supported with Impella 5.0 had better 30-day survival compared with those supported with Impella CP, for both shock phenotypes (83% vs 14% and 14% vs 0%, respectively). CONCLUSIONS: In this small cohort, patients supported with Impella for isolated LV dysfunction and VA-ECMO for biventricular dysfunction or MOF had acceptable survival at 30 days. Patients with biventricular dysfunction or MOF who were supported by Impella had the lowest survival rates. Patients with isolated LV dysfunction who were supported with VA-ECMO had good 30-day survival.

Aims The aim of our study was to assess differences in post-ablation atrial fibrillation (AF) recurrence and burden and to quantify the change in LVEF across different congestive heart failure (CHF) subcategories of the DECAAF-II population. Methods and results Differences in the primary outcome of AF recurrence between CHF and non-CHF groups was calculated. The same analysis was performed for the three subgroups of CHF and the non-CHF group. Differences in AF burden after the 3-month blanking period between CHF and non-CHF groups was calculated. Improvement in LVEF was calculated and compared across the three CHF groups. Improvement was also calculated across different fibrosis stages. There was no significant differences in AF recurrence and AF burden after catheter ablation between CHF and non-CHF patients and between different CHF subcategories. Patients with heart failure with reduced ejection fraction (HFrEF) experienced the greatest improvement in EF following catheter ablation (CA, 16.66% ± 11.98, P < 0.001) compared to heart failure with moderately reduced LVEF, and heart failure with preserved EF (10.74% ± 8.34 and 2.00 ± 8.34 respectively, P-value < 0.001). Moreover, improvement in LVEF was independent of the four stages of atrial fibrosis (7.71 vs. 9.53 vs. 5.72 vs. 15.88, from Stage I to Stage IV respectively, P = 0.115). Conclusion Atrial fibrillation burden and recurrence after CA is similar between non-CHF and CHF patients, independent of the type of CHF. Of all CHF groups, those with HFrEF had the largest improvement in LVEF after CA. Moreover, the improvement in ventricular function seems to be independent of atrial fibrosis in patients with persistent AF.

Several existing explanations of the factors that lead some to support or participate in violent extremism provide parts of a useful framework yet do not sufficiently integrate the major causal variables into a truly workable theory of what drives certain individuals toward the violent extremist cause. The 3 Ns theory used here argues that individuals will support or participate in violent extremist groups if the organizations’ goals and activities are expected to help meet personal needs. Individuals are most likely to become ideologically committed to the extremist cause because of its promise to meet their psychological need for significance. But in contexts of armed conflict, extremist groups may be sympathized with or attract active support because they are also the best option for meeting security and sustenance needs. But only meeting physical needs does not draw the same ideological commitment that meeting the need for significance does.

ISIS in Iraq is not riding on the back of a wave of Sunni resentment as it did in 2014. Far from it, Sunni Arab Iraqis are now the most content of the major Iraqi communities. While Iraq faces multiple significant challenges, from very serious economic problems and poverty to the Covid-19 pandemic to the Iraqi state being directly challenged by Iran-aligned militias, it is Iraq’s Sunni Arabs who maintain greater confidence than Shia Arabs and Kurds in the Iraqi state and its policies. While ISIS in Iraq continues to survive, it is not thriving, and its immediate future does not foretell a comeback if there is not a major change in how Sunni Arabs view how they are treated by the Iraqi state. Most importantly, Sunni Arabs believe that the Iraqi state cares about them and their needs more now since any time since the fall of Saddam Hussein.

This chapter summarizes the main findings of the book. It also lays out some main implications from this study. One of the most important takeaways from the study is that ISIS in Iraq is down but not out. While ISIS is not a potent military force in Iraq now, if Iraq’s Sunnis are made to feel marginalized and threatened again, it could breathe new life into the group. Iraq’s largely dysfunctional and underperforming central government does not have the luxury of taking Sunni Iraqi support for granted in the long run. Generational change in Iraq could be an important source of new support for ISIS in the country’s Sunni population, as younger Sunnis who did not experience the degradation and pain of ISIS occupation may come to believe ISIS represents an alternative to poor governance by the central government.

This chapter explores the political and social developments in Iraq from the U.S. invasion in 2003 to the pivotal year of 2011, when U.S. forces withdrew from the country. It was in this time span that the social and political foundations for the rise of ISIS were established. While the rise of ISIS was not inevitable by 2012, the events of that year greatly contributed to the chances of a major Sunni insurgency in Iraq breaking out. Most importantly, after the overthrow of Saddam Hussein in 2003, many Sunni Arabs perceived their exclusion from political and societal power in Iraq and a growing dominance of sectarian Shia political forces. This sense of marginalization and victimization among Sunnis became acute following Prime Minister’s Nouri al Maliki’s efforts to further marginalize Sunnis after the U.S. withdrawal from Iraq in 2011. It was this sense of Sunni grievance that offered the Sunni insurgency the social support it needed to gain traction.

This chapter seeks to understand why ISIS lost the hearts and minds of most of Iraq’s Sunni Arabs between 2014 and 2017. As data collected in several waves of surveys in Iraq show, by the end of 2017, the vast majority of Iraqi Sunni Arabs were desperate to see the end of ISIS. ISIS lost the willingness of the population to cooperate and aid it in its fight against the Iraqi state and its allies. In fact, some brave Sunni Arabs actively worked to undermine ISIS from within its area of occupation. More Iraqi Sunnis tried to avoid ISIS’s ire and welcomed the arrival of the Iraqi Army and its allies as they retook territory from the extremist group.

One of the most asked questions about ISIS during its occupation of large swathes Iraq is this: What was it like to live under the governance of the group? Using data collected from ordinary Iraqis, the chapter attempts to give a picture of everyday life in ISIS-occupied Iraq. Most Sunni Iraqis who experienced the arrival of ISIS, particularly in Mosul, say the group was largely accepted at first, as an alternative to what was viewed as a corrupt, abusive, and sectarian Iraqi state. In retrospect, however, many of the people interviewed about ISIS’s governance thought that although ISIS was superior in some aspects of governance to the Iraqi state, the group largely wore out its welcome through its brutal imposition of an interpretation of sharia that was far more extreme than even relatively conservative Sunni Iraqis were willing to accept.

Nouri al Maliki, Iraq’s prime minister in 2012, was the single most important factor in driving the rise of ISIS in that year. Deeply sectarian, the Shia prime minister turned to marginalizing and intimidating the Sunni Iraqi population with the goal of ensuring the political dominance of Iraq’s Shia majority. The result of Maliki’s efforts was an Iraqi Sunni population that viewed itself as physically threatened and deeply disrespected. ISIS was able to use this Sunni disaffection with the Iraqi state to build a social base of support for a renewed insurgency and conquer significant swathes of territory in Sunni-majority areas of Iraq.

The introduction sets up the research questions that the book explores: What factors conditioned public support and opposition toward ISIS in Iraq? Why did some Iraqi move from passive support for the group and actively participate in the group’s activities, including fighting? The chapter also introduces the argument of the book, namely that ISIS’s rise and fall in Iraq were largely due to the group’s impact on the human needs of Iraqis in the areas where it operated. The group was successful when it was viewed as meeting security, sustenance, and significance needs. It declined when it could no longer provide for those needs.

By leveraging data collected in the years between 2012 and 2018, this chapter seeks to explain why Iraqis came to join and otherwise participate in ISIS. The data used in this chapter come from interviews with captured ISIS foot soldiers and leaders, as well as dozens of focus group interviews with Iraqis who lived in ISIS-occupied areas of Iraq and witnessed firsthand how Iraqis they knew, some from their own families, were drawn into ISIS. The data will show that there was no single path into ISIS for the Iraqis who participated in the organization. The data show that ISIS was a means for Iraqis who joined it to meet needs they faced at the time, be it for security, sustenance, or significance. What is clear is that most Iraqis did not join ISIS out of religious zealotry.

International audience

Background Since the release of the first global hepatitis elimination targets in 2016, and until the COVID-19 pandemic started in early 2020, many countries and territories were making progress toward hepatitis C virus (HCV) elimination. This study aims to evaluate HCV burden in 2020, and forecast HCV burden by 2030 given current trends. Methods This analysis includes a literature review, Delphi process, and mathematical modelling to estimate HCV prevalence (viraemic infection, defined as HCV RNA-positive cases) and the cascade of care among people of all ages (age =0 years from birth) for the period between Jan 1, 2015, and Dec 31, 2030. Epidemiological data were collected from published sources and grey literature (including government reports and personal communications) and were validated among country and territory experts. A Markov model was used to forecast disease burden and cascade of care from 1950 to 2050 for countries and territories with data. Model outcomes were extracted from 2015 to 2030 to calculate population-weighted regional averages, which were used for countries or territories without data. Regional and global estimates of HCV prevalence, cascade of care, and disease burden were calculated based on 235 countries and territories. Findings Models were built for 110 countries or territories: 83 were approved by local experts and 27 were based on published data alone. Using data from these models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global prevalence of viraemic HCV infection of 0.7% (95% UI 0.7-0.9), corresponding to 56.8 million (95% UI 55.2-67.8) infections, on Jan 1, 2020. This number represents a decrease of 6.8 million viraemic infections from a 2015 (beginning of year) prevalence estimate of 63.6 million (61.8-75.8) infections (0.9% [0.8-1.0] prevalence). By the end of 2020, an estimated 12.9 million (12.5-15.4) people were living with a diagnosed viraemic infection. In 2020, an estimated 641 000 (623 000-765 000) patients initiated treatment. Interpretation At the beginning of 2020, there were an estimated 56.8 million viraemic HCV infections globally. Although this number represents a decrease from 2015, our forecasts suggest we are not currently on track to achieve global elimination targets by 2030. As countries recover from COVID-19, these findings can help refocus efforts aimed at HCV elimination. Copyright (C) 2022 Elsevier Ltd. All rights reserved., John C Martin Foundation [2019-G024]; Gilead Sciences [IN-US-987-5808]; AbbVie [4200907861]; ZeShan Foundation [2021-0101-1-CDA-HEP-10]; The Hepatitis Fund; Ministry of Health, Labour and Welfare of Japan [19HC1001], This analysis was funded by a grant from the John C Martin Foundation (2019-G024) through the Polaris Observatory for low-income and middleincome countries. Grants for analyses in high-income countries and territories were provided by Gilead Sciences (IN-US-987-5808) and AbbVie (4200907861). ZeShan Foundation (2021-0101-1-CDA-HEP-10) supported country and regional analyses in Asia and The Hepatitis Fund supported country and regional analyses in Africa. We thank the Epidemiological Research Group on the Burden of Viral Hepatitis and Measures for its Elimination (grant number 19HC1001; led by JT) funded by the Ministry of Health, Labour and Welfare of Japan. We thank the contributors included in the appendix (pp 2-3), who contributed to the country or territory analyses but did not meet authorship requirements.

In the current study, a mathematical model using the MATLAB program was studied depending on the logistic power peak function to simulate the change in the absorbance with the different values of the concentrations of Rhodamine B. There are five parameters that have been applied to the concentration values of this laser dye that are proposed by the logistic power peak function of the seventh degree. To measure the absorption measurements, a range of concentrations from 4.7x10-7 to 3.76x10-6 M was prepared from Rhodamine B and dissolved in deionized water with a peak absorption at 556 nm. A JASCO V-630 spectrophotometer was used to record the spectra of the dye. The intensity is detected using a silicon photodiode (S1337). The results were found that the suggested function approved the relationship between the absorbance and the values of the concentrations with a significant accuracy depending on the high values of the correlation coefficients between the approximated original data which were determined more than 99.2%. The advantages of this function represent by providing parameters, which are used to describe the mathematical processes with high-resolution property profiles.

Due to the high milk production of Holstein cows, many countries have chosen to import semen to improve local dairy herds. This strategy would be more effective if this semen was used in the same environment conditions in which the bulls were selected. If the effect of genotype by environment (G × E) interaction is not considered, the estimated breeding values (EBVs) may vary, potentially reducing the selection response. We evaluate the impact of heat stress on selection for milk yield and composition of Holstein cows using random regression models. To verify the interference of heat stress in milk yield (MY) and composition traits (fat, protein, total saturated, and total unsaturated fatty acids content in milk), temperature-humidity index (THI) on test-day milk records was used. The threshold value to divide the environments using test-day information from Brazilian Holstein cows was 72 units of THI, i.e., 72 represented no heat stress and 72 represented heat stress. Legendre polynomials of second-order (Leg 2) model and two lactation points (33 and 122 DIM) were used to estimate heritabilities and EBVs for five important dairy traits. The heritabilities of milk components and fatty acids were low (0.09-0.29), regardless of lactation period and degree of heat stress, with the exception of protein content (0.30-0.35). Fat content was the only milk component that was reduced according to the degree of heat stress and lactation period. The EBVs tended to decrease in heat stress conditions, thus animals with high genetic potential demonstrated evidence of G × E interaction. However, acclimatization of dairy cows to heat stress in the farm production systems may have been responsible for the low differences among genetic parameters and EBVs with and without heat stress found in this study.

Background Staphylococcus aureus bacteremia (SAB) disproportionately affects Black patients. The reasons for this disparity are unclear. Methods We evaluated a prospectively ascertained cohort of patients with SAB from 1995 to 2020. Clinical characteristics, bacterial genotypes, and outcome were compared among Black and White patients with SAB. Multivariable logistic regression models were used to determine factors independently associated with the outcomes. Results Among 3068 patients with SAB, 1107 (36%) were Black. Black patients were younger (median, 56 years vs 63 years; P < .001) and had higher rates of diabetes (47.5% vs 34.5%, P < .001), hemodialysis dependence (40.0% vs 7.3%, P < .001), and human immunodeficiency virus (6.4% vs 0.6%, P < .001). Black patients had higher rates of methicillin-resistant S. aureus (49.3% vs 44.9%, P = .020), including the USA300 hypervirulent clone (11.5% vs 8.4%, P = .007). White patients had higher rates of corticosteroid use (22.4% vs 15.8%, P < .0001) and surgery in the preceding 30 days (28.1% vs 18.7%, P < .001). Although the median Acute Physiology Score (APS) at the time of initial SAB diagnosis was significantly higher in Black patients (median APS, 9; interquartile range [IQR], 5–14 vs median APS, 7; IQR, 4–12; P < .001), race was not associated with 90-day mortality (risk ratio, 1.02; 95% confidence interval, .93–1.12), and rates of metastatic infection were lower among Black patients (37.2% vs 41.3% White, P = .029). Conclusions Despite differences in Black patients' higher APS on presentation and more risk factors, including a 5 times higher risk of hemodialysis dependence, 90-day mortality among Black and White patients with SAB was similar.

Rapid advancements of genome sequencing (GS) technologies have enhanced our understanding of the relationship between genes and human disease. To incorporate genomic information into the practice of medicine, new processes for the analysis, reporting, and communication of GS data are needed. Blood samples were collected from adults with a PCR-confirmed SARS-CoV-2 (COVID-19) diagnosis (target N = 1500). GS was performed. Data were filtered and analyzed using custom pipelines and gene panels. We developed unique patient-facing materials, including an online intake survey, group counseling presentation, and consultation letters in addition to a comprehensive GS report. The final report includes results generated from GS data: (1) monogenic disease risks; (2) carrier status; (3) pharmacogenomic variants; (4) polygenic risk scores for common conditions; (5) HLA genotype; (6) genetic ancestry; (7) blood group; and, (8) COVID-19 viral lineage. Participants complete pre-test genetic counseling and confirm preferences for secondary findings before receiving results. Counseling and referrals are initiated for clinically significant findings. We developed a genetic counseling, reporting, and return of results framework that integrates GS information across multiple areas of human health, presenting possibilities for the clinical application of comprehensive GS data in healthy individuals.

Nonoperative treatment can be attempted for uncomplicated adhesive small bowel obstruction (ASBO), but carries a risk of delayed surgery. Highlighting initial parameters predicting risk of failure of nonoperative management would be of great interest.Patients initially managed conservatively for uncomplicated ASBO were retrospectively analyzed. Univariate and multivariate analysis were performed to identify predictive failure's factors. Based on the risk factors, a score was created and then prospectively validated in a different patients' population.Among 171 patients included, 98 (57.3%) were successfully managed conservatively. In a multivariate analysis, three independent nonoperative management failure's factors were identified: Charlson Index ≥4 (P = 0.016), distal obstruction (P = 0.009), and maximum small bowel diameter over vertical abdominal diameter ratio0.34 (P = 0.023). A score of two or three was associated with a risk of surgery of 51.4% or 70.3% in the retrospective analysis and 62.2% or 75% in the validation cohort, respectively.This clinical-radiological score may help guide surgical decision-making in uncomplicated ASBO. A high score (≥2) was predictive of failure of nonoperative management. This tool could assist surgeons to determine who would benefit from early surgery.

Borderline ovarian tumours (BOTs) commonly affect young nulliparous women, thus making fertility-preserving approaches more desirable. Women who opt for conservative management should be counselled about disease recurrence. In this retrospective study, the medical records of 57 women with BOT treated at the American University of Beirut Medical Centre between January 1986 and May 2018 were reviewed. Clinical, pathologic, and demographic data were collected and analysed to identify variables associated with poor clinical outcomes including advanced disease and risk of recurrence. Younger and nulliparous women were more likely to undergo fertility-sparing surgery. The open approach was adopted for women with larger adnexal masses and was associated with more blood loss with a mean difference of 172 mL (95% CI [110-235]

This research is concerned with performing computational fluid dynamics (CFD) simulations to investigate the air flow and dust deposition behavior around a ground-mounted solar PV panel. The discrete phase model (DPM) is adopted to model the gas-solid flow. The influence of the wind speed, the dust particle size, and the dust material on the dust deposition rate was investigated based on the environment of Cairo, Egypt. The wind speeds range between 1 and 11.5 m/s with an average of 3.7 m/s. It is found that increasing the wind speed decreases the dust deposition rate. For wind speeds higher than 2 m/s, it is found that increasing the dust particle diameter or the dust density increases the dust deposition rate. For wind speeds lower than 2 m/s, it is found that there is a critical particle size before which increasing the dust density causes dust deposition rate to increase and after which increasing the dust density decreases the dust deposition. The maximum percentage of deposition rate equals 10.8% and occurs for the dolomite dust material at a wind speed of 2 m/s and particles diameter of 150 μm.

We aimed to compare the prognostic value of a quantitative CT severity score with several laboratory parameters, particularly C-reactive protein, Procalcitonin, Neutrophil to lymphocyte ratio, D-dimer, ferritin, lactate dehydrogenase, lactate, troponin and B-type Natriuretic Peptide in predicting in-hospital mortality.This was a retrospective chart review study of COVID-19 patients who presented to the Emergency Department of a tertiary care center between February and December 2020. All patients ≥18 years old who tested positive for the COVID-19 real-time reverse transcriptase polymerase chain reaction and underwent CT imaging at presentation were included. The primary outcome was the prognostic ability of CT severity score versus biomarkers in predicting in-hospital mortality.The AUCs were: D-dimer (AUC: 0.67 95% CI = 0.57-0.77), CT severity score (0.66, 95% CI = 0.55-0.77), LDH (0.66, 95% CI = 0.55-0.77), Pro-BNP (0.65, 95% CI = 0.55-0.76), NLR (0.64, 95% CI = 0.53-0.75) and troponin (0.64, 95% CI = 0.52-0.75). In the stepwise logistic regression, age (OR = 1.07 95% CI = 1.05-1.09), obesity (OR = 2.02 95% CI = 1.25-3.26), neutrophil/lymphocyte ratio (OR = 1.02 95% CI = 1.01-1.04), CRP (OR = 1.01 95% CI = 1.004-1.01), lactate dehydrogenase (OR = 1.003 95% CI = 1.001-1.004) and CT severity score (OR = 1.17 95% CI = 1.12-1.23) were significantly associated with in-hospital mortality.In summary, CT severity score outperformed several biomarkers as a prognostic tool for covid related mortality. In COVID-19 patients requiring lung imaging, such as patients requiring ICU admission, patients with abnormal vital signs and those requiring mechanical ventilation, the results suggest obtaining and calculating the CT severity score to use it as a prognostic tool. If a CT was not performed, the results suggest using LDH, CRP or NLR if already done as prognostic tools in COVID-19 as these biomarkers were also found to be prognostic in COVID-19 patients.

PurposeThis study refines theory of social capital by nesting it within a cultural context. More specifically, it aims at describing, explaining, and predicting the role of wasta, a social capital concept, as a moderator in the relationship between employees' ethical idealism and work engagement in Lebanon.Design/methodology/approachBased on a survey questionnaire translated from English into Arabic, 317 responses were collected from employees in Lebanon. Confirmatory factor analysis and hierarchical regression analysis were employed to test the hypothesized relationships among the examined variables.FindingsEthical idealism was found to be positively related to work engagement, and wasta was found to moderate the relationship between ethical idealism and work engagement. Work engagement levels of employees who displayed high levels of ethical idealism were less influenced by the negative effect of wasta than work engagement levels of employees who displayed low levels of ethical idealism.Practical implicationsHuman resource managers, international negotiators, and global executives in Lebanon may use the findings of this study to update corporate human resources systems, such as employee recruitment and selection, handbooks, orientation, training programs, and performance appraisal, to better address employee attitudes toward the practice of wasta.Originality/valueThe study adds ethical idealism as an antecedent of work engagement, demonstrating the significant impact that wasta, with its positive and negative characteristics, has on the engagement of employees from the Arab world.

PURPOSE OF REVIEW: The aim of this scoping review is to identify and summarize findings published in the literature over the past 5 years related to methods for assessment of bone loss in anterior shoulder instability. RECENT FINDINGS: Of the 113 clinical studies included in this review, 76 reported a cutoff for glenoid bone loss when determining the patients indicated for one of the many stabilization procedures investigated. Bone loss on the glenoid side was evaluated most commonly with three-dimensional computed tomography (3D CT), and either linear or surface area–based methods were employed with the use of a best-fit circle. When combined with plain CT, the two methods comprise up to 70% of the reported measurement techniques for glenoid bone loss (79 of 113 studies). On the humeral side, Hill-Sachs lesions were assessed more heterogeneously, though plain CT or 3D CT remained the methods of choice in the majority of studies (43 of 68, 63.2%). Lastly, the glenoid track was assessed by 27 of 113 studies (23.9%), again most commonly with 3D CT (13 studies) and plain CT (seven studies). SUMMARY: The assessment of glenoid and humeral bone loss is essential to treatment decisions for patient with recurrent anterior shoulder instability. Glenoid bone loss is most commonly assessed using cross-sectional imaging, most often 3D CT, and some variation of a best-fit circle applied to the inferior portion of the glenoid. Hill-Sachs lesion assessment was also commonly done using three-dimensional imaging; however, there was more variability in assessment methods across studies and there is an obvious need to unify the approach to humeral bone loss assessment for the purposes of improving treatment decisions and to better assess on-track and off-track lesions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12178-022-09773-4.

This is the description of the case of a 42-year-old male who presented with a growing, painless lump on his anterior leg. The diagnosis of a rare tumor called hibernoma was suspected after inspection of the radiologic findings. The unusual location of the tumor resulted in superficial peroneal nerve entrapment. The tumor was excised and the diagnosis of hibernoma was confirmed by histopathology. Surgery resulted in foot drop that was successfully treated with a tibialis posterior tendon transfer. Our case illustrates a rare tumor in an unusual location that can be challenging for clinicians to discern and to properly treat.

Allopolyploidy is considered as a principal driver that shaped angiosperms’ evolution in terms of diversification and speciation. Despite the unexpected high frequency of polyploidy that was recently discovered in the coniferous genus Juniperus, little is known about the origin of these polyploid taxa. Here, we conducted the first study devoted to deciphering the origin of the only hexaploid taxon in Juniperus along with four of its closely related tetraploid taxa using AFLP markers with four primers combinations. Phylogenetic analysis revealed that the 10 studied species belong to 2 major clusters. J. foetidissima appeared to be more related to J. thurifera, J. sabina, and J. chinensis. The Bayesian clustering analysis showing a slight variation in genetic admixture between the studied populations of J. foetidissima, suggesting an allopolyploid origin of this species involving J. thurifera and J. sabina lineages, although a purely autopolyploidy origin of both J. thurifera and J. foetidissima cannot be ruled out. The admixed genetic pattern revealed for J. seravschanica showed that the tetraploid cytotypes of this species originated from allopolyploidy, whereas no clear evidence of hybridization in the origin of the tetraploid J. thurifera and J. chinensis was detected. This study provides first insights into the polyploidy origin of the Sabina section and highlights the potential implication of allopolyploidy in the evolution of the genus Juniperus. Further analyses are needed for a more in-depth understanding of the evolutionary scenarios that produced the observed genetic patterns.

Heterozygous mutation targeting proline 95 in Serine/Arginine-rich Splicing Factor 2 (SRSF2), associates with V617F mutation in Janus Activated Kinase 2 (JAK2) in some myeloproliferative neoplasms (MPNs), most commonly primary myelofibrosis. To explore Srsf2P95H interaction with Jak2V617F, we generated Cre-inducible knock-in mice expressing these mutants under control of the stem cell leukemia (Scl) gene promoter. In transplantation experiments, Srsf2P95H unexpectedly delayed myelofibrosis induced by Jak2V617F and decreased TGFβ1 serum level. Srsf2P95H reduced the competitiveness of transplanted Jak2V617F hematopoietic stem cells while preventing their exhaustion. RNA sequencing of sorted megakaryocytes identified an increased number of splicing events when the two mutations were combined. Focusing on JAK/STAT pathway, Jak2 exon 14 skipping was promoted by Srsf2P95H, an event detected in patients with JAK2V617F and SRSF2P95 co-mutation. The skipping event generates a truncated inactive JAK2 protein. Accordingly, Srsf2P95H delays myelofibrosis induced by the thrombopoietin receptor agonist Romiplostim in Jak2 wildtype animals. These results unveil JAK2 exon 14 skipping promotion as a strategy to reduce JAK/STAT signaling in pathological conditions.

International audience; Contact Tracing (CT) is an old, recognized epidemiological tool, and since a digital variant is now within reach, a variety of smartphone-based solutions have been rapidly developed and deployed since 2020, with mixed results and amid controversies. Yet, achieving reliable and effective digital CT at large scale is still an open problem. In this work, we contribute with an open source software platform on top of which various CT solutions can be quickly developed and tested. More specifically, we design PEPPER, which jointly leverages Bluetooth Low Energy (BLE) and Ultra Wide Band (UWB) radios for contact detection, combined with the DESIRE privacy-preserving CT protocol. We show that PEPPER+DESIRE can operate on cheap physical tokens based on low-power microcontrollers, opening new use-cases with less personal, potentially disposable devices, that could be more widely used. We also evaluate the complementarity of Bluetooth and UWB in this context, via experiments mimicking various scenarios relevant for CT. Compared to BLE-only CT, we show that UWB can decrease false negatives (e.g., in presence of human body occlusion), meaning that more actual contacts will be found, a key benefit from an epidemiological viewpoint. Our results suggest that, while PEPPER+DESIRE improves precision over state-of-the-art, further research is required to harness UWB-BLE synergy for CT in practice. To this end, our open source platform (which can run on an open-access testbed) provides a useful playground for the research community.

Background Consensus on the best surgical strategy for the management of synchronous colorectal liver metastases (sCRLM) has not been achieved. This study aimed to assess the attitudes of surgeons involved in the treatment of sCRLM. Methods Surveys designed for colorectal, hepato-pancreato-biliary (HPB), and general surgeons were disseminated through representative societies. Subgroup analyses were performed to compare responses between specialties and continents. Results Overall, 270 surgeons (57 colorectal, 100 HPB and 113 general surgeons) responded. Specialist surgeons more frequently utilized minimally invasive surgery (MIS) than general surgeons for colon (94.8% vs. 71.7%, p p p = 0.005). In patients with an asymptomatic primary, the liver-first two-stage approach was preferred in most respondents’ centres (59.3%), while the colorectal-first approach was preferred in Oceania (83.3%) and Asia (63.4%). A substantial proportion of the respondents (72.6%) had personal experience with minimally invasive simultaneous resections, and an expanding role for this procedure was foreseen (92.6%), while more evidence was desired (89.6%). Respondents were more reluctant to combine a hepatectomy with low anterior (76.3%) and abdominoperineal resections (73.3%), compared to right (94.4%) and left hemicolectomies (90.7%). Colorectal surgeons were less inclined to combine right or left hemicolectomies with a major hepatectomy than HPB and general surgeons (right: 22.8% vs. 50% and 44.2%, p = 0.008; left: 14% vs. 34% and 35.4%, p = 0.002, respectively). Conclusion The clinical practices and viewpoints on the management of sCRLM differ between continents, and between and within surgical specialties. However, there appears to be consensus on a growing role for MIS and a need for evidence-based input. Graphical abstract