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Survival rates for people with cancer and quality of life for survivors have increased significantly as a result of innovations in cancer treatment, improvements in early detection, and improved healthcare access. In the United States, 1 in 2 men and 1 in 3 women will be diagnosed with cancer in their lifetime. As more cancer survivors and patients remain in the workforce, employers must evaluate how they can adjust workplace policies to meet employee and business needs. Unfortunately, many people still encounter barriers to remaining in the workplace following a cancer diagnosis for themselves or a loved one. In an effort to explore the impacts of contemporary employment policies on patients with cancer, cancer survivors, and caregivers, NCCN hosted the Policy Summit “Cancer Care in the Workplace: Building a 21st Century Workplace for Cancer Patients, Survivors, and Caretakers” on June 17, 2022. This hybrid event, through keynotes and multistakeholder panel discussions, explored issues regarding employer benefit design, policy solutions, current best and promising practices for return to work, and how these issues impact treatment, survivorship, and caregiving in the cancer community.

Combined advances in haematopoietic cell transplantation (HCT) and intensive care management have improved the survival of patients with haematological malignancies admitted to the intensive care unit. In cases of refractory respiratory failure or refractory cardiac failure, these advances have led to a renewed interest in advanced life support therapies, such as extracorporeal membrane oxygenation (ECMO), previously considered inappropriate for these patients due to their poor prognosis. Given the scarcity of evidence-based guidelines on the use of ECMO in patients receiving HCT and the need to provide equitable and sustainable access to ECMO, the European Society of Intensive Care Medicine, the Extracorporeal Life Support Organization, and the International ECMO Network aimed to develop an expert consensus statement on the use of ECMO in adult patients receiving HCT. A steering committee with expertise in ECMO and HCT searched the literature for relevant articles on ECMO, HCT, and immune effector cell therapy, and developed opinion statements through discussions following a Quaker-based consensus approach. An international panel of experts was convened to vote on these expert opinion statements following the Research and Development/University of California, Los Angeles Appropriateness Method. The Appraisal of Guidelines for Research and Evaluation statement was followed to prepare this Position Paper. 36 statements were drafted by the steering committee, 33 of which reached strong agreement after the first voting round. The remaining three statements were discussed by all members of the steering committee and expert panel, and rephrased before an additional round of voting. At the conclusion of the process, 33 statements received strong agreement and three weak agreement. This Position Paper could help to guide intensivists and haematologists during the difficult decision-making process regarding ECMO candidacy in adult patients receiving HCT. The statements could also serve as a basis for future research focused on ECMO selection criteria and bedside management.

Introduction: Simulation training offers an authentic team-based learning opportunity without risk to real patients. The Educational Corner at the annual congress of the European Branch of Extracorporeal Life Support Organisation (EuroELSO) provided an opportunity for multiple simulation training sessions facilitated by experts from all over the world. Aim: We aimed to review the educational impact of EuroELSO Educational Corner and whether it provides a quality ECLS training to a wide spectrum of multidisciplinary international attendees utilising high and low fidelity simulation, workshops and hands on sessions. Methods: During the congress, 43 sessions were conducted dedicated to ECLS education with identified educational objectives. The sessions focused on management of adults and children on V-V or V-A ECMO. Adult sessions covered emergencies on mechanical circulatory support with management of LVAD and Impella, managing refractory hypoxemia on V-V ECMO, emergencies on ECMO, renal replacement therapy on ECMO, V-V ECMO, ECPR cannulation and performing perfect simulation. Paediatric sessions covered ECPR neck and central cannulation, renal replacement on ECMO, troubleshooting, cannulation workshop, V-V recirculation, ECMO for single ventricle, PIMS-TS and CDH, ECMO transport and neurological injury. Results: The Educational Corner was attended by more than 400 participants over the two congress days. Majority of responders (88%) reported that training sessions met the set educational goals and objectives and that this would change their current practice. Almost all (94%) reported that they received useful information and 95% would recommend the session to their colleagues. Conclusion: The Educational Corner, as an integral component of the annual EuroELSO congress, achieved the set educational goals and provided quality education based on the recipient survey. Structured multidisciplinary ECLS education with standardised curriculum and feedback is an important key step in delivering quality training to an international audience. Standardisation of European ECLS education remains an important focus of the EuroELSO.

Nile tilapia is recognized as a suitable candidate for intensive farming and sustainability of the aquaculture industry. However, one issue limiting Nile tilapia expansion in arid and semi-arid areas is the scarcity of freshwater resources. In this study, the supplementation of synbiotics was investigated to enhance the growth performance, growth-related genes, intestinal health, and immunity of Nile tilapia reared in inland brackish groundwater. Four diets were prepared where the basal diets were mixed with the dietary mixture of probiotics and prebiotics (Synbiotic Lactic Dry®, a blend of Saccharomyces cerevisiae, Lactobacillus acidophilus, Streptococcus faecium, and Bacillus subtilis, mannan oligosaccharides and β-1.3/1.6-D-glucan) at 0, 0.5, 1, and 2 g/kg. After eight weeks, the final weight and weight gain are linearly increasing with increasing the supplementation level of synbiotic. Markedly fish fed 0.5, 1, and 2 g/kg of synbiotic had higher final weight, weight gain, and feed intake and lower feed conversion ratio (FCR) than fish fed synbiotic free diet. The specific growth rate (SGR) was significantly higher in fish fed 1 and 2 g/kg than in fish fed 0 and 0.5 g/kg. The intestine of fish fed on synbiotic shows an increase in intestinal villi density. Further, the intestine of fish fed on synbiotic showed an increase in the length and branching intestinal villi (anterior, middle, and posterior) in a dose-dependent manner. The lysozyme and phagocytic activities were significantly different from the control, while synbiotic supplementation did not affect the phagocytic index. Interestingly, the results showed marked upregulation of ghrelin, IGF-1, and GH genes in fish fed synbiotics at 0.5, 1, and 2 g/kg. In addition, fish fed 2 g/kg had the highest expression of ghrelin, IGF-1, and GH genes. In conclusion, growing Nile tilapia in inland brackish groundwater can be achieved without negative impacts on the growth performance and health status. Supplementing synbiotics (1–2 g/kg) in Nile tilapia feeds enhanced the growth and feed performances, intestinal histomorphological features, growth-related genes, and immune response.

Background: One of the most frequent complications following heart surgery is atrial fibrillation (AF). The most popular diagnostic procedure for evaluating atrial function is echocardiography, however it has certain drawbacks. Originally, 2D echocardiography has been used to measure volumes to determine left atrial function. Objective: to examine the relationship between the development of post-operative AF following isolated CABG and preoperative evaluation of LA function using 2D echocardiography and left atrium 2D speckle tracking strain echocardiography. Patients and Methods: A set of 149 consecutive patients enrolled in a prospective observational study, they admitted to cardio-thoracic surgery department for elective isolated coronary artery bypass grafting surgery, during July 2018 to June 2019. 22 patients were excluded from the study due to bad image quality. Results: Readings of speckle tracking data showed significant less LA reservoir strain (OR 1.75, 95% CI: 0.65-4.69, P≤0001), LA conduit strains (OR 0.6, 95% CI: 0.22-1.62, P=0.31) and LA contractile strain (OR 0.65, 95% CI: 0.24-1.77, P=0.40) in POAF (+). Remaining parameters were non-significant. Also, Age (P=0.03), LA diameter (P=0.04), and LAVI (P=0.03) were the only factors that were identified as potential predictors of POAF in multivariate logistic regression analysis. Conclusion: we concluded that, age, LA size and LAVI are significantly associated with the occurrence of POAF in our patients.

Introduction: Liver tissue malfunction is a severe worldwide health concern that arises from various chronic liver conditions. The goal of this investigation was to look into the anti-fibrotic effect of apigenin (APG), an antioxidant found in various plants, versus thioacetamide (TAA)-triggered hepatic scarring in rats and the potential mechanisms behind it. Methods: TAA was administered thrice weekly (100 mg/kg, i.p.) for two weeks to produce hepatic scarring. APG was administered after TAA for 14 days (5 or 10 mg/kg, orally). Thereafter, hepatic liver enzymes, inflammatory markers, fibrotic indicators, and histopathological changes were evaluated. Results: TAA increased the activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), reduced albumin and total protein, elevated hepatic level of lipid peroxidation, focal adhesion kinase (FAK), hypoxia-inducible factor-1α (HIF-1α), and inflammatory cytokines, decreased interleukin-10 (IL-10), reduced hepatic expression of peroxisome proliferator-activated receptor gamma (PPARγ) and nuclear factor-erythroid factor 2-related factor 2 (Nrf2), and elevated serine-threonine protein kinase (AKT) expression. Furthermore, TAA increased hepatic contents of collagen I, connective tissue growth factor (CTGF), hydroxyproline, and alpha-smooth muscle actin. On the other hand, APG evaded these changes and mitigated the harmful effects of TAA in a dose-dependent way. Histopathological and immunohistochemical observations reinforced these biochemical outcomes. Conclusion: APG can potentially alleviate liver fibrosis mediated via FAK and HIF1 inhibiting signaling pathways.

The present study investigated the effects of different phenol concentrations (200 – 1000 mg L−1) towards Chlorella sp. under different culture conditions (light vs. dark) and NaNO3 concentrations (0 – 0.1 g L−1) using central composite design. Phenol induced hormesis effects on the algal growth and cellular metabolites. Nitrate was identified as a crucial factor for promoting the uptake of phenol by Chlorella cells, while light was a limiting factor for growth, but the phyco-toxicity of phenol was decreased in the dark. The pigment contents were generally increased in the treated cells to protect against the oxidative phenol stress. The incorporation of 200 mg L−1 phenol and 0.05 g L−1 NaNO3 to the illuminated cells markedly promoted biomass and lipid contents to 0.22 g L−1 and 26.26% w/w, which was 44 and 112% higher than the phenol-less control, respectively. Under the same conditions, the increase of phenol concentration to 600 mg L−1, the protein contents were increased to 18.59% w/w. Conversely, the algal cells were able to accumulate more than 60% w/w of soluble carbohydrates under dark conditions at 600 mg L−1 of phenol. Nitrate replete conditions stimulated lipid accumulation at the expense of protein biosynthesis. Furthermore, most of the treatments showed an increase of H2O2 and malonaldehyde contents, especially for the illuminated cells. However, catalase activity tended to increase under dark conditions, especially at low phenol and nitrate concentrations. This study is valuable in indicating the effects of phenol on microalgae by exploiting response surface methodology, which can be applied as a powerful tool in growth monitoring and toxicity assessment.

Background: Traumatic cataract accounts for a large proportion of monocular visual disability and blindness in pediatric populations, especially in developing countries. This study aims to evaluate the axial length and other biometric data changes after penetrating corneal wound in pediatric eyes. Methods: This is a prospective comparative control study carried on thirty children with unilateral penetrating ocular trauma associated with cataract. Patients were classified into 3 groups: Group A (n= 15 eyes) underwent cataract extraction and IOL implantation in same session 6 weeks after trauma, Group B (n= 15 eyes) underwent cataract extraction, and IOL implantation in second session 3 months after trauma and the third one is the control group with 30 contralateral eyes of both groups Results: Regarding axial length, measures were reported to be was (22.882 ± 0.712) mm in group (A) after 6 weeks from the incidence of trauma, while in group (B) it was (22.568 ± 0.881) mm. P-value was insignificant (0.292). After 12 weeks, mean AL in group A was reported to be 23.199 ± 0.724) mm while in group B it was (22.903 ± 1.008) mm with insignificant p value as well (0.362). After 6 weeks, the mean K-readings for group A were found to be 41.184 ± 2.109 while group B were (42.928 ± 2.433). After 12 weeks, the mean K-readings for group A were 41.491 ± 1.729 while group B were (42.797 ± 2.518). Conclusion: Early I/A and anterior vitrectomy recommended for cases with free lens in AC for fear of reaction, while IOL implantation is recommended to wait after stitches removal.

Background: Alzheimer's disease is a neurological disorder that causes brain cells to shrink and die. Aim: Thirteen novel ‘oxathiolanyl’, ‘pyrazolyl’ and ‘pyrimidinyl’ indole derivatives were designed and synthesized as anti-Alzheimer's disease treatment. Method: In vitro enzyme assay was performed against both AChE and BChE enzymes. In addition, antioxidant assay and cytotoxicity on a normal cell line were determined. Molecular docking and dynamic simulations were conducted to confirm the binding mode in both esterases' active sites. In silico absorption, distribution, metabolism, excretion and toxicity studies were also carried out. Results & conclusion: Compounds 5, 7 and 11 exhibited superior inhibitory activity against acetylcholinesterase and butyrylcholinesterase, with IC50 values of 0.042 and 3.003 μM, 2.54 and 0.207 μM and 0.052 and 2.529 μM, respectively, compared with donepezil.

Background Neonatal sepsis remains one of the leading causes of morbidity and mortality among neonates. Objective to evaluate the role of salivary C-reactive protein (CRP) as a diagnostic marker in neonatal sepsis. Methods This case-control study was carried out on 90 neonates including 45 neonates with symptoms and signs suggestive of neonatal sepsis and 45 healthy neonates as controls. All neonates were subjected to full history taking, thorough clinical examination, laboratory investigations including complete blood count (CBC), serum CRP, blood culture, and salivary CRP. Results Septic neonates showed significantly higher salivary CRP compared to controls; it was significantly associated with positive serum CRP, blood culture, and hematological scoring system (HSS). It was significantly higher in neonates who died compared to those who survived. Twenty one cases with positive salivary CRP showed significant positive correlations with the length of the neonatal intensive care unit stay, total white blood cell (WBC) count, mean platelet volume (MPV), neutrophils to lymphocytes ratio (NLR), serum CRP, HSS, significant negative correlations with gestational age, birth weight, APGAR at 1, 5 min, and platelet count. Receiver operating characteristic (ROC) curve for salivary CRP showed that at cut-off value of 0.135 mg/L, the sensitivity was (81.8%) and the specificity was (75.6%) for detecting neonatal sepsis. Conclusion Salivary CRP was significantly higher in the septic group, and was associated with positive serum CRP. Hence, salivary CRP could be considered a novel non-invasive biomarker for diagnosing neonatal sepsis.

A genetic study for the trait of Darwin's tubercle in two ways : first , on a sample consisted of 52 family from Tikrit city in governorate Salah AL-Dein and 125 individual from their sons and 63 family from governorate of Kirkuk and 188 individual from their sons . Secondly , adoption of pedigree analysis method for seven families from governorate of Salah El-Dein and Kirkuk , which confirmed the darwin's tubercle trait is a genetic trait and the presence of tubercle is dominant absence . The results of Presence Darwin's tubercle also revealed different forms : Nodosity tubercle , Enlargement tubercle and Projection. The present study support the truth of single gene locus hypothesis for the inheritance of this trait , in spite of it record the presence of one offspring have darwin's tubercle between two parents do not have darwin's tubercle in one family. The results of the study distribution of phenotypic for the trait showed on a sample consisted of 1415 individual from the citizens of the governorate of Salah Al-Dein (920♂: 495♀) from the original samples (1446) , an elevated percentage of the presence tubercle among the males (99.2%) than the females (98.4%) . The percentage of presence tubercle in the whole population was (98.9%) . Concering the allelic frequency for the gene of darwin's tubercle, the D allele was observed a higher frequency than the d allele in the whole population of the governorate: 0.895, 0.105 for both of them respectively . Expected frequencies of the three genotypes of darwin's tubercle trait , revealed a prevalence of the homozygous (dominant) genotype DD over the homozygous (recessive) and heterozygous genotype in the population of the governorate: 0.801, 0.188, 0.011 for DD , Dd and dd respectively.

Background: Chronic kidney disease is a global health problem for which renal fibrogenesis is the final treatment target. Objective: In our work, we have highlighted two new strategies, nicorandil and Bone marrow-derived mesenchymal stem cells (BM-MSCs), as effective in reversing renal fibrosis induced by partial unilateral ureteral obstruction (PUUO). Methods: The current study included 96 male albino rats randomly divided into four groups, with 24 rats per group; Group I, the control group; Group II, PUUO, where two-thirds of the left ureter was entrenched in the psoas muscle; Group III, same surgical procedure as in Group II for 7 days, and then the rats received 15 mg/kg/day nicorandil once daily for 21 days; and Group IV, same surgical procedure as in Group II for 7 days, and then rats were given 3 × 106 of labeled MSCs injected intravenous, and left for 21 days. Blood and kidney tissues were collected for biochemical, histological, and molecular analyses. Results: Both the nicorandil and BM-MSCs treatment groups could ameliorate kidney damage evidenced by inhibition of MDA elevation and total antioxidant capacity reduction caused by PUUO. Also, there was a significant reduction observed in TNF, TGF, IL6, collagen I, and α-SMA in addition to improvement in histological examination. However, a significant difference was found between the BM-MSCs and nicorandil-treated groups. Conclusion: Our results suggest that BM-MSCs and nicorandil improved renal fibrosis progression through their antiapoptotic, anti-inflammatory, and antifibrotic effects in male albino rats subjected to PUUO, with BM-MSCs being more effective compared to nicorandil.

Background: Periorbital dark circles (PODC) is also recognized as periorbital melanosis, dark eye circles, and infraorbital darkness. It`s a public cosmetic skin disorder with relative darkness of the periorbital areas. This condition affects both sexes, it gets worse by aging which makes people look tired and older, so it has a negative effect on the quality of life, particularly in Women. Methods: This comparative, simple randomized, controlled study was carried out on 30 patients with presented with periorbital dark circles did not receive any treatment 3 months before joining the study. The patients were equally allocated into three groups Group A: treated with bilateral injection of PRP gel, Group B: treated with bilateral intradermal injection of CO2 with carboxytherapy machine and Group C: treated with intradermal injection of vitamin C. All patients received 4 sessions with 2 weeks a part. All patients were subjected to complete history taking, general and dermatological examination and clinical assessment was done for all patients to determine the type of dark circles. Results: The improvement of PODC in Plasma gel injection and carboxytherapy mesotherapy were excellent in (50%) and (40%) in vitamin C group. There was gradual improvement of PODC with time, but recurrence rate of the studied groups after 6 months was 40%, 30%, 60% in group A, B and C respectively, showing higher recurrence rate in group C patients treated with vitamin C mesotherapy. Conclusions: Gel injection, carboxytherapy and vitamin C mesotherapy were effective and safe therapeutic modalities in treatment of PODC.

Background: Asthma is the most widespread chronic paediatric condition, and Mg is one of the body's most plentiful ions. Due to its bronchodilator activity, it is used to treat acute asthma attacks by reversing bronchospasm. Our aim was to study the oral Mg supplementation effect as an adjuvant in the management of asthmatic children in between the attacks of asthma. Methods: This case control study included eighty children, aged from 4 to 17 years old and were grouped into three groups group A, B, and control group. Group A included 40 moderate and severe asthmatic children who received oral Mg supplementation for two months plus ordinary treatment of asthma. Group B involved twenty asthmatic children who were given ordinary asthma treatment only and twenty healthy children with apparently age and sex matched were served as control group. Results: Family history of allergies, serum Mg, pulmonary function tests were statistically significant different between studied groups. There was a negative significant relation between asthma severity and both of serum Mg and pulmonary function tests. A positive significant correlation was found between serum Mg and pulmonary function tests. Conclusion: Serum Mg level and pulmonary function tests were significantly lower in asthmatic children. Children with asthma who were given oral Mg supplementation showed improvement in their pulmonary function tests and serum Mg level and asthma severity.

The aim of the study was to visualize the micromorphology of Amaranthaceous pollen using scanning electron microscopy collected from the Thal Desert. Field collection was conducted from July to September 2021. A total of 14 taxa of the family Amaranthaceae were collected which belong to nine genera. Achyranthes aspera, Aerva javanica, Aerva lanata, Amaranthus graecizans, Amaranthus retroflexus, Amaranthus viridis, Bassia indica, Chenopodium album, Chenopodium ficifolium, Chenopodium murale, Digera muricata, Haloxylon stocksii, Salsola tragus, and Suaeda fruticosa were studied in terms of pollen morphotypes. Pollen were acetolyzed and observed under optical and scanning microscopy. Qualitative and quantitative characters were measured to analyze the pollen to uncover its taxonomic significance. Qualitative characters observed were the shape of pollen in polar and equatorial views; the most frequent shape observed was spheroidal in the polar view, whereas in the equatorial view, prolate spheroidal was the dominant shape. Exine ornamentation is the key characteristic of pollen which is very helpful, and eight different types of ornamentations were observed in collected taxa: smooth sparsely granulate, scabrate-spinulose, microspinulose perforate, microechinate scabrate to metareticulate, granulate, nanospinulate, granulate-spinulose perforate, granulate-perforate echinate, and microechinate perforate. Periporate-type aperture was observed among all taxa. Mesoporia, ektexinous bodies, and tectum features also show variations among Amaranthaceous grains. In quantitative character, A. retroflexus recorded highest in polar view 26.3 μm and the lowest was of C. album 12.2 μm. Highest P/E index ratio was recorded in S. fruticosa (1.12) whereas the lowest for D. muricta (0.94). Exine thickness was highest in S. tragus 2.15 μm and lowest in A. graecizans 0.78 μm. The maximum number of pores was recorded as 32-36 in D. muricata. Artificial taxonomic keys were constructed based on findings that reinforce the importance of the micromorphological ultrastructural diversity of pollen among Amaranthaceous taxa. It was concluded that the descriptions of pollen morphotypes presented greatly contribute to our understanding of desert species identification.

The construction industry is a major user of non-renewable energy and contributor to emission of greenhouse gases, thus requiring to achieve net-zero carbon emissions by 2050. Indeed, construction activities account for 36% of global energy consumption and 39% of global carbon dioxide emissions. Reducing carbon emissions requires adapted government policies, carbon emission analysis and calculation models, and sustainable materials. Here, we review green construction with focus on history, carbon emissions, policies, models, life cycle assessment, and sustainable materials such as biochar, bioplastic, agricultural waste, animal wool, fly ash and self-healing concrete. Analysis of carbon emissions over the building life cycle shows that the construction phase accounts for 20–50% of total carbon emissions. The average ratio of construction phase annual emissions to operation phase emissions is 0.62. We present national policy frameworks and technology roadmaps from the United States of America, Japan, China, and the European Union, highlighting plans to achieve carbon neutrality in the building sector.