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•Patients with limited (<5 disease sites) pre-CART B-cell NHL are at high risk of local relapse/progression.•BRT before CART for patients with R/R NHL and limited disease (<5 involved sites) improves outcomes without causing significant toxicities.

This randomized clinical trial study aims to compare ultrasound‐guided versus non‐guided Dextrose 10% injections in patients suffering from internal derangement in the temporomandibular joint (TMJ). The study population included 22 patients and 43 TMJs suffering from unilateral or bilateral TMJ painful clicking, magnetic resonance imaging (MRI) proved disc displacement with reduction (DDWR), refractory to or failed conservative treatment. The patients were divided randomly into two groups (non‐guided and ultrasound (US)‐guided groups). The procedure involved injection of 2 mL solution of a mixture of 0.75 mL 0.9% normal saline solution, 0.3 mL 2% lidocaine and 0.75 mL dextrose 10% using a 25G needle in the joint and 1 mL intramuscular injection to the masseter muscle at the most tender point. The Visual Analogue Score (VAS) was used to compare joint pain intensity over four different periods, beginning with pre‐injection, 1‐, 2‐, and 6‐months postinjection. Twenty‐two patients 5 males (n = 5/22, 22.7%) and 17 females (n = 17/22, 77.2%) were included in this study. The mean age was 27.3 ± 7.4 years (30.2 ± 7.0) for the non‐guided group and 24.3 ± 6.9 for the US‐guided group. The dextrose injection reduced intensity over time in both groups with statistically significant improvement (Pvalue <.05) at 2 and 6 months in both groups. There was no statistically significant difference in VAS assessment between both groups. Intra‐articular injection of dextrose 10% for patients with painful clicking and DDWR resulted in reduced pain intensity in both US‐guided and non‐guided groups with significant symptomatic improvement over time in both groups. US guidance allowed accurate anatomical localization and safe procedure with a single joint puncture.

CD19 CAR T-cell (CAR-T) therapy is commonly administered to patients with relapsed or refractory large B-cell lymphomas (LBCL), but salvage or bridging therapy can sometimes lead to a complete response (CR) prior to infusion. Limited studies have assessed the outcomes of patients infused in CR. A total of 134 patients with LBCL in CR prior to CAR-T infusion were identified from the CIBMTR registry, with median prior lines of therapy of 3 (range 2–9). At two years post-infusion, the probability of progression-free survival was 43.5% (95% CI 34.4–52.8) and the probability of overall survival was 63.8% (95% CI 54.4–72.6). The cumulative incidence rates of non-relapse mortality and relapse/progression at two years were 9.2% (95% CI 4.5–15.4) and 47.3% (95% CI 38.2–56.6), respectively. The rate of grade 3 or higher cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were 2.2% and 8.2%, respectively. In summary, CAR-T in heavily pretreated patients with LBCL who are in CR following two or more lines of prior therapy demonstrate that a subset of patients may remain free of progression at two years. Additionally, the toxicity profile was impressive with very low rates of grade 3 CRS and ICANS.

•Autologous and allogeneic hematopoietic cell transplantation are both effective consolidative strategies in patients with Hepatosplenic T Cell Lymphoma.•Median overall survival and progression free survival for the entire cohort were 78.5 months (95% CI: 25-NR) and 54 months (95% CI: 18 to 75), respectively.•No significant differences in OS or PFS we seen when comparing autologous and allogeneic HCT groups.•Pts with less than CR at time of transplant had better median overall survival with allogeneic hematopoietic cell transplantation compared to autologous hematopoietic cell transplantation (65 mo versus 7 mo, P< .001).

The rapid expansion of networks has given rise to numerous challenges and issues. In recent years, one idea that has captivated researchers is segregating the forwarding and control levels, which emerged with software-defined networking (SDN) frameworks. Despite centralised management and network administration advantages, SDN networks have encountered several issues, with safety and reliability being the most prominent. This paper proposes a comprehensive robust security architecture for SDN networks that consists of modular components. Each module addresses a specific security challenge, and by integrating these security solutions, we aim to establish a cohesive security framework for SDN. Furthermore, we propose a robust security algorithm capable of effectively mitigating critical security attacks such as DDoS, ARP, and MITM. Our approach involves developing a multi-level security algorithm to counteract most DDoS attacks, while also devising a real-time algorithm specifically designed to handle ARP attacks, including request-replay-ARP DoS attacks.

Introduction: Over the last few decades, there has been an increase in the use of a minimally invasive (MIS) approach for complex hernias involving component separation. A robotic platform provides better visualization and mobilization of tissues for component separation. We aim to assess the outcomes of open and robotic-assisted approaches for large VHR utilizing the ACHQC national database. Methods: A retrospective review of prospectively collected data from the Abdominal Core Health Quality Collaborative (ACHQC) was performed to include all adult patients who had primary and incisional midline ventral hernias larger than 10 cm and underwent elective open and robotic hernia repairs with mesh from January 2013 to March 2023. Univariate and multivariate analyses were performed comparing Open and Robotic approaches. Results: The ACHQC database identified 5,516 patients with midline hernias larger than 10 cm who underwent VHR. The open group (OG) had 4,978 patients, and the robotic group (RG) had 538. The RG had a higher median BMI (33.3 kg/m2(IQR 29.8–38.1) vs 32.7 (IQR 28.7–36.6) (p&lt; 0.001). Median hernia width was 15 cm (IQR 12–18) in the OG and 12 cm in the RG (10–14) (p &lt; 0.001). Sublay positioning of the mesh was the most common. The fascial closure was higher in the RG (524; 97% versus 4,708; 95%—p= 0.005). Median Length of Stay (LOS) was 5 days (IQR 4–7) in the OG and 2 days (IQR 1–3) in the RG (p &lt; 0.001). The readmission rate was higher in the OG (n= 374; 7.5% vs n= 16; 3%; p &lt; 0.001). 30-day SSI were higher in the OG (343; 6.9%% vs 14; 2.6%; p &lt; 0.001). Logistic regression analysis identified diabetes (OR 1.6; CI 1.1–2.1; p= 0.006) and BMI (OR 1.04, CI 1.02–1.06; p &lt; 0.001) as predictors of SSIs, while the robotic approach was protective (OR 0.35, CI 0.17–0.64; p= 0.002). For SSO, logistic regression showed BMI (OR 1.04, CI 1.03–1.06; p &lt; 0.001) and smoking (OR 1.8, CI 1.3–2.4; p &lt; 0.001) as predictors Robotic approach was associated with lower readmission rates (OR .04, CI 0.2–0.6; p &lt; 0.001). Conclusion: A robotic approach improves early 30-day outcomes compared to an open technique for large VHR. There was no difference in SSO at 30 days.

This article addresses indoor environment mapping by employing the synthetic aperture radar (SAR) technique at millimeter wave (mmWave) frequencies. The mmWave-based SAR can provide a high-resolution map, for example, of an emergency scenario like a burning room. The high-resolution map drives a new era of SAR applications such as object detection, classification, characterization, and precise localization. A major requirement at high frequencies is the precise knowledge of SAR trajectory, where radar sensors are mounted on a mobile platform such as a drone or unmanned aerial vehicle (UAV). State-of-the-art localization methods such as global positioning system (GPS)-aided inertial measurement units (IMUs) are not valid due to limited coverage and accuracy. One of the primary solutions could be the SAR assisted with an indoor localization system, which is exploited in the work. The presented indoor localization system comprises two types of passive chipless frequency-coded tags, based on dielectric resonators (DRs) and frequency-selective surfaces. In this work, first, the proposed method of integrating SAR and localization systems is evaluated in a single-tag environment. Further, a version of a room equipped with a multitag system is considered for real-time applications, and a successful demonstration of indoor environment mapping for the frequency spectrum of 75–110 GHz is presented.

Background: Consumption of energy drinks (EDs) has increased exponentially among younger generations, and this increase is projected to continue.Objectives: This study aimed to examine the prevalence, knowledge level, intake patterns, and consumer experience of consuming EDs among university students in Jordan.Methods: A cross-sectional study of 467 students from 29 universities was conducted by a webbased questionnaire. Descriptive analyses, chi-square tests, and logistic regression were performed, with a p-value of ≤0.05 indicating significance.Results: The prevalence of EDs was 40.1% among university students. Over half (62.7%) of students had poor knowledge of EDs. The most significant determinants identified were male (OR=2.18; 95%CI: 1.14-4.15), undergraduate (OR: 4.01; 95% CI: 1.70-9.72), in a nonmedical discipline (OR=2.92; 95% CI: 1.56-5.44), smoker (OR=9.91;95%Cl: 5.30-18.54) and having a poor knowledge level (OR=40.46;95%CI: 14.33-114.27). Students mainly consumed Red Bull, and the majority consumed 1-2 can(s) daily. Students were more likely to consume EDs during exams to mainly stay awake. The major side effects experienced by this sample were increased urination and headache. No changes in mental or physical performance, weight, appetite, and sleeping pattern were observed among the majority of respondents.Conclusion: Consumption of EDs was moderate among university students. Gender, study course, study year, smoking, and knowledge level were determinants of their intake.

Purpose: This study aimed to assess the influence of the community-based campaign on weight loss and healthy lifestyle adoption among Bahrain's adult population. Design/methodology/approach: A cross -sectional self-reported online questionnaire completed in February 2021. The survey evaluated the impact of the community-based campaign health program which includes (exercise, diet plan and psychological eating behavior) weight reduction using social media platforms. The authors employed data from young and middle-aged healthy adults (n = 842) between the ages of 18-55 years, of both sexes. The intervention group (n = 842) was made up of the supporters of the voluntary community initiative called Obesity does not Suit Me (n = 194), and the control group (n = 648) was made up of non-followers of the campaign. Findings: The study showed a statistically significant difference among the followers of the community-based campaign health program in the following parameters: 3.90-4.23 kg less, 1.46-1.59 difference in BMI and 0.05-0.06 WHR. All changes were of low effect size. Originality/value: Diet and exercise had significant impact on weight, BMI and WHR among the followers of the community campaign. However, more research is required for sponsorship to increase the motivation and rewards for the community campaign.

Background As Acute Care Surgery and shift-based models increase in popularity, there is evidence of better outcomes for many types of emergency general surgery patients. We explored the difference in outcomes for patients with acute biliary disorders, treated by either Acute Care Surgery (ACS) model or traditional call model (TRAD) during the same period.Methods Retrospective review of patients undergoing laparoscopic cholecystectomy for acute biliary disease 2017-2018. Demographics, clinical presentation, operative details, and outcomes were compared.Results Demographics, clinical presentation, and complication rates were similar between groups. Time from surgical consult to operating room (Δ = −15.34 hours [−24.57, −6.12], P= .001), length of stay (Δ = −1.4 days [−2.45, −.35], P= .009), and total charges were significantly decreased in ACS group compared to TRAD (Δ$2797.76 [−4883.12, −712.41], P= .009).Conclusions Acute biliary disease can be managed successfully in an ACS shift-based model with reduced overall hospital charges and equivalent outcomes.

Repeating l- and d-chiral configurations determine polylactide (PLA) stereochemistry, which affects its thermal and physicochemical properties, including degradation profiles. Clinically, degradation of implanted PLA biomaterials promotes prolonged inflammation and excessive fibrosis, but the role of PLA stereochemistry is unclear. Additionally, although PLA of varied stereochemistries causes differential immune responses in vivo, this observation has yet to be effectively modeled in vitro. A bioenergetic model was applied to study immune cellular responses to PLA containing >99% l-lactide (PLLA), >99% d-lactide (PDLA), and a 50/50 melt-blend of PLLA and PDLA (stereocomplex PLA). Stereocomplex PLA breakdown products increased IL-1β, TNF-α, and IL-6 protein levels but not MCP-1. Expression of these proinflammatory cytokines is mechanistically driven by increases in glycolysis in primary macrophages. In contrast, PLLA and PDLA degradation products selectively increase MCP-1 protein expression. Although both oxidative phosphorylation and glycolysis are increased with PDLA, only oxidative phosphorylation is increased with PLLA. For each biomaterial, glycolytic inhibition reduces proinflammatory cytokines and markedly increases anti-inflammatory (IL-10) protein levels; differential metabolic changes in fibroblasts were observed. These findings provide mechanistic explanations for the diverse immune responses to PLA of different stereochemistries and underscore the pivotal role of immunometabolism in the biocompatibility of biomaterials applied in medicine.

We isolated a highly colistin-resistant Escherichia coli, strain 58, from fresh chicken wings in Lebanon. Here, we performed in-depth phenotypic and genomic analyses to identify the resistome of the isolate, focusing on the determinants that encoded colistin resistance.

Predicting the photovoltaic (PV) output power is essential for the power grid's secure, stable, and economical operation. Additionally, there are large numbers of meteorological variables that potentially affect the solar output of PV panels. Hence, identifying the most relevant parameters that influenced the PV output power is necessary for achieving accurate predictions and reducing the time-consuming and costly to acquire these parameters. With this main objective, four artificial intelligence techniques [Multilayer Feed-Forward Neural Network (MFFNN), Cascade Feed-forward Neural Network (CFNN), Radial Basis Function Neural Network (RBFNN), and Elman neural network (ENN)] were employed to identify the most influencing input parameters for prediction of the energy output of PV system. To develop the models, the mean daily average temperature, minimum and maximum temperatures, wet-bulb temperature, relative humidity, global solar radiation, and wind speed were used as potential inputs to solar output prediction models. The data set covers 12 operating months (01 January–31 December 2020). 57 models with various combinations of inputs were proposed and used to train the models to find the combination of inputs to determine the mean daily energy output of the PV system. The reliability of utilized models was examined by correlation coefficient (R), mean absolute error (MAE), and root mean square error (RMSE). The results indicate that MFFNN#19, CFNN#12, ENN#24, and RBFNN#32 with the combination of [Tmax, RH], [Ta, GSR], [Tw, GSR] and [D, Tmin], respectively, are the best models for solar output of the system. Moreover, a comparison of the performances of the artificial intelligence techniques with the quadratic model and multiple linear regression has been reported in this study. The results demonstrate that the ENN#24 model with the combination of [Tw, GSR] generated superior results than the other models in terms of the R-squared, RMSE, and MAE, showing the ability of the model to estimate the PV output power.

Oppressive heat drove Motaz Barzaq to the beach to construct a home like no other. [ABSTRACT FROM AUTHOR]

The linear sequence of DNA provides invaluable information about genes and their regulatory elements along chromosomes. However, to fully understand gene function and regulation, we need to dissect how genes physically fold in the three-dimensional nuclear space. Here we describe immuno-OligoSTORM, an imaging strategy that reveals the distribution of nucleosomes within specific genes in super-resolution, through the simultaneous visualization of DNA and histones. We combine immuno-OligoSTORM with restraint-based and coarse-grained modeling approaches to integrate super-resolution imaging data with Hi-C contact frequencies and deconvoluted micrococcal nuclease-sequencing information. The resulting method, called Modeling immuno-OligoSTORM, allows quantitative modeling of genes with nucleosome resolution and provides information about chromatin accessibility for regulatory factors, such as RNA polymerase II. With Modeling immuno-OligoSTORM, we explore intercellular variability, transcriptional-dependent gene conformation, and folding of housekeeping and pluripotency-related genes in human pluripotent and differentiated cells, thereby obtaining the highest degree of data integration achieved so far to our knowledge.

•Cytopenias represent significant adverse events of chimeric antigen receptor (CAR) T cell therapy.•Increased exposure to rituximab pre-CAR T cell therapy is associated with persistent anemia and thrombocytopenia post-CAR T cell therapy.•An increased number of prior lines of therapy is associated with persistent lymphopenia and anemia post-CAR T cell therapy.

Purpose: Medical students have a higher risk of developing psychological issues, such as feeding and eating disorders (FEDs). In the past few years, a major increase was observed in the number of studies on the topic. The goal of this review was to estimate the prevalence risk of FEDs and its associated risk factors in medical students. Methods: Nine electronic databases were used to conduct an electronic search from the inception of the databases until 15thSeptember 2021. The DerSimonian–Laird technique was used to pool the estimates using random-effects meta-analysis. The prevalence of FEDs risk in medical students was the major outcome of interest. Data were analyzed globally, by country, by research measure and by culture. Sex, age, and body mass index were examined as potential confounders using meta-regression analysis. Results: A random-effects meta-analysis evaluating the prevalence of FEDs in medical students (K = 35, N = 21,383) generated a pooled prevalence rate of 17.35% (95% CI 14.15–21.10%), heterogeneity [Q = 1528 (34), P = 0.001], τ2= 0.51 (95% CI 0.36–1.05), τ= 0.71 (95% CI 0.59–1.02), I2= 97.8%; H= 6.70 (95% CI 6.19–7.26). Age and sex were not significant predictors. Body mass index, culture and used research tool were significant confounders. Conclusion: The prevalence of FEDs symptoms in medical students was estimated to be 17.35%. Future prospective studies are urgently needed to construct prevention and treatment programs to provide better outcomes for students at risk of or suffering from FEDs. Level of evidence: Level I, systematic review and meta-analysis.

Multiple clinical trials have assessed de-escalation strategies from combined modality therapy (CMT) to chemotherapy-alone for the treatment of early-stage classical Hodgkin lymphoma (cHL), confirming similar outcomes. The application of these data to the real-world is limited, however. We conducted a retrospective, multicenter cohort study comparing CMT vs chemotherapy-alone in patients with early-stage cHL (stage IA-IIB) treated between January 2010 and December 2020. Positron emission tomography (PET) scans after chemotherapy cycle 2 (PET2) were independently reviewed by a nuclear radiologist (Deauville score ≥4, positive; ≤3, negative). Patient outcomes were compared by using an intention-to-treat analysis. Among 125 patients (CMT, n = 63; chemotherapy-alone, n = 62) with a median follow-up of 59.8 months (95% CI, 48.6-71.0), no differences in overall survival were observed (5-year overall survival, CMT 98.0% vs chemotherapy-alone 95.1%; log-rank test, P = .38). However, there was reduced progression-free survival (PFS) with chemotherapy-alone among all patients (2-year PFS, CMT 95.1% vs chemotherapy-alone 75.3%; log-rank test, P = .005) and in those with bulky (n = 43; log-rank test, P < .001), unfavorable (n = 81; log-rank test, P = .002), or PET2-positive (n = 15; log-rank test, P = .02) disease. No significant differences in PFS were seen for patients with non-bulky (log-rank test, P = .35), favorable (log-rank test, P = .62), or PET2-negative (log-rank test, P = .19) disease. Based on our real-world experience, CMT seems beneficial for patients with early-stage cHL, especially those with PET2-positive and unfavorable disease. Chemotherapy-alone regimens can lead to comparable outcomes for patients with favorable, non-bulky, or PET2-negative disease. We conclude that although results seen in clinical trials are replicated in certain patient subgroups, other subgroups not fitting trial criteria do poorly when radiotherapy is excluded.

Multiple clinical trials have assessed de-escalation strategies from combined modality therapy (CMT) to chemotherapy-alone for the treatment of early-stage classical Hodgkin lymphoma (cHL), confirming similar outcomes. The application of these data to the real-world is limited, however. We conducted a retrospective, multicenter cohort study comparing CMT vs chemotherapy-alone in patients with early-stage cHL (stage IA-IIB) treated between January 2010 and December 2020. Positron emission tomography (PET) scans after chemotherapy cycle 2 (PET2) were independently reviewed by a nuclear radiologist (Deauville score ≥4, positive; ≤3, negative). Patient outcomes were compared by using an intention-to-treat analysis. Among 125 patients (CMT, n = 63; chemotherapy-alone, n = 62) with a median follow-up of 59.8 months (95% CI, 48.6-71.0), no differences in overall survival were observed (5-year overall survival, CMT 98.0% vs chemotherapy-alone 95.1%; log-rank test, P= .38). However, there was reduced progression-free survival (PFS) with chemotherapy-alone among all patients (2-year PFS, CMT 95.1% vs chemotherapy-alone 75.3%; log-rank test, P= .005) and in those with bulky (n = 43; log-rank test, P< .001), unfavorable (n = 81; log-rank test, P= .002), or PET2-positive (n = 15; log-rank test, P= .02) disease. No significant differences in PFS were seen for patients with non-bulky (log-rank test, P= .35), favorable (log-rank test, P= .62), or PET2-negative (log-rank test, P= .19) disease. Based on our real-world experience, CMT seems beneficial for patients with early-stage cHL, especially those with PET2-positive and unfavorable disease. Chemotherapy-alone regimens can lead to comparable outcomes for patients with favorable, non-bulky, or PET2-negative disease. We conclude that although results seen in clinical trials are replicated in certain patient subgroups, other subgroups not fitting trial criteria do poorly when radiotherapy is excluded.

Incidental findings (IFs) are unintentional discoveries that are unrelated to the original imaging goal. Imaging exams of persons with suspected intracranial disorders may reveal IFs in the paranasal sinuses (PNS). The current investigation aims to determine the frequency and features of unexpected discoveries in the PNS in persons who have had brain computed tomography (CT) scans for suspected intracranial abnormalities.

Disordered eating (DE) refers to eating behaviors that limit food choices, reduce or exaggerate food intake, cause physical discomfort, create a sense of loss of control, or lead to negative emotions like shame or guilt. The DE label does not signify the presence of a diagnosed mental health disorder, but, rather, describes self-reported, regular eating patterns that psychiatrists consider to fall into the at-risk category for an eating disorder. In this review, we performed a search of academic databases to find all relevant studies that measured the frequency of self-reported DE in athletes. We analyzed 177 studies involving over 70,000 athletes in total. In this study, DE was defined as a score above cut-off on validated screening tests for problematic eating behaviors. Our goal was to estimate the prevalence of DE in athletes globally and to determine the factors that increase risk. We found that approximately 1 in 5 athletes (19%) endorsed DE behaviors such as, among others, restrictive dieting, bingeing, and purging. These behaviors were seen most commonly in indoor sports like gymnastics and less commonly in the context of outdoor sports. Rates were highest in female athletes, older athletes, athletes with high body mass index (BMI) scores, and those from Eastern countries and cultures. Australia had the highest rates (over 50%), while rates were lowest in Iceland. We suggest the development of screening tests specifically tailored and applicable to athletes. In addition, we recommend raising public awareness of the health effects of nutrition in sports.

The sea does not symbolize freedom in 2024. [ABSTRACT FROM AUTHOR]

Human rights now seem out of reach. [ABSTRACT FROM AUTHOR]

Gaza's people have no option than to burn books. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to translate and test the content validity and reliability of an English questionnaire used in the American food and health survey.Methods: The questionnaire was developed using 6 stages, then examined for test–retest. A total of 672 participants were recruited for validation and reliability. Validity test was performed using a correlation coefficient to measure the linear correlation between 2 questions at one given time. Moreover, the Kaiser-Meyer-Olkin, Measure of Sampling Adequacy, and Bartlett’s Test of Sphericity were performed to statistically determine the suitability for conducting exploratory factor analysis. Furthermore, reliability tests using Cronbach α was used to estimate the reliability coefficient properties of the translated scale. Finally, the most important correlated questions was plotted using a color-coded correlogram.Results: The test–retest reliability of all tested items was significantly correlated. The reliability test for all questions was 0.9. The cross-correlation test showed that all questions of the translated questionnaire were correlated significantly (P< .05) indicating reliability of the questionnaire.Conclusion: The tested questionnaire is applicable and may be used in population-based studies to raise awareness regarding health, food consumption, nutrition, and food safety among people in Jordan and/or other Arab countries.