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Background: Macrocephaly, hypotonia, developmental delay, intellectual disability with delayed expressive speech, behavioral issues, a distinct facial phenotype, radiographic abnormalities, and impaired glucose metabolism are characteristics of the Primrose syndrome. As a result, Primrose syndrome is identified in a proband with typical symptoms and a heterozygous pathogenic mutation in ZBTB20 identified by molecular genetic testing. Case presentation: A seven-year-old girl presented with a history of not speaking consistently, snoring and mouth breathing. The patient was responding to sound and there was presence of adenoid hypertrophy. Four years later, the patient presented with developmental delay, delayed speech and problem sleeping. Whole exome sequencing (WES) was done and the result showed a likely heterozygous pathogenic variant, c.11+1del, in the ZBTB20 gene. As advised, management includes educational programs, physiotherapy, speech therapy, and occupational therapy. Conclusion: Patients must have their growth and development followed every six months, their speech and developmental needs evaluated every six months, their behavioural issues, neurological, and musculoskeletal conditions evaluated at every visit, their brain stem evoked response audiometry evaluated annually, and their thyroid function and insulin-resistant diabetes tested annually. Keywords: Heterozygous, Mutation, ZBTB20, Primrose, syndrome, Jeddah

Objectives: This study aimed to estimate the level of current knowledge regarding breast cancer in Saudi Arabia. We assessed the knowledge of breast cancer risks, the knowledge regarding the BSE and mammogram in Saudi Arabian females using a survey-based study. Methods: A cross-sectional study was conducted using a self-administered survey to assess the knowledge and practice of Saudi women toward Brest cancer examination. Collected data were analyzed using SPSS program. Results: A total number of 499 surveys were collected. The data showed that there was general lack of practice of BSE in the sample only 186 (37%) reported that they practiced regular BSE and only 16 (3%) reported that they went to the clinic for breast examination. Among all participants around 54% had poor overall knowledge of breast cancer 65% had poor knowledge regarding breast cancer risk and 93% had poor knowledge regarding clinical examination. Surprisingly, 56% had good knowledge regarding the clinical picture of breast cancer. Conclusion: This clearly showed that the lack of breast self-examination, mammogram and clinical examination is not a result of total lack of knowledge but due to lack of knowledge regarding risks and examination. This set of data provide a guideline for the focus and planning of future breast cancer awareness campaigns.

Introduction: Small studies from outside of the USA suggest excellent outcomes after surgical resection for hepatocellular carcinoma (HCC) with vascular invasion. The study aims to (1) compare overall survival after surgical resection and systemic therapy among patients with HCC and vascular invasion and (2) determine factors associated with receipt of surgical resection in a US population. Methods: HCC patients with AJCC clinical TNM stage 7th T3BN0M0 diagnosed between 2010 and 2017 from the National Cancer Database were analyzed. Cox and logistic regression analyses identified factors associated with overall survival and receipt of surgical resection. Results: Of 11,259 patients with T3BN0M0 HCC, 325 (2.9%) and 4,268 (37.9%) received surgical resection and systemic therapy, respectively. In multivariable analysis, surgical resection was associated with improved survival compared to systemic therapy (adjusted hazard ratio: 0.496, 95% confidence interval: 0.426–0.578) with a median survival of 21.4 and 8.1 months, respectively. Superiority of surgical resection was observed in noncirrhotic and cirrhotic subgroups and propensity score matching and inverse probability of treatment weighting adjusted analysis. Asians were more likely to receive surgical resection, whereas Charlson comorbidity ≥3, elevated alpha-fetoprotein, smaller tumor size, care in a community cancer program, and the South or West region were associated with a lower likelihood of surgical resection. Conclusion: HCC patients with vascular invasion may benefit from surgical resection compared to systemic therapies. Demographic and clinical features of HCC patients and region and type of treating facility were associated with surgical resection versus systemic treatment.

Introduction Head and neck squamous cell carcinoma HNSCC is responsible for more than of head and neck cancers L amino acid oxidases LAAOs are extensively distributed in the following families of venomous snakes the Viperidae Crotalidae and Elapidae families A number of proteins related to LAAO activity have been found to manifest anti neoplastic antimicrobial or apoptosis inducing activity It can be assumed that that the general mechanism of LAOO toxicity is determined by the generation of cytotoxic H O in varying amounts In short the aim of this study is to ascertain the anticancer effect by way of flowcytometry and real time PCR of LAAO on the HEP cell line after hours hours and hours Materials and methods Once theHEP cell line was propagated and LAAO was added to the culture medium the cells were analyzed after hours hours and hours Results The results of this analysis reveal that LAAO was the root cause of apoptosis in the HEP cell line In addition the apoptosis percentage was directly related to time The p expression increased by time and the inverse was true for bcl expression Conclusion The results reveal that LAAO has a substantial effect on the anticancer activity of the HEP cell line

The $^{23}$Al($p,��$)$^{24}$Si reaction is among the most important reactions driving the energy generation in Type-I X-ray bursts. However, the present reaction-rate uncertainty limits constraints on neutron star properties that can be achieved with burst model-observation comparisons. Here, we present a novel technique for constraining this important reaction by combining the GRETINA array with the neutron detector LENDA coupled to the S800 spectrograph at the National Superconducting Cyclotron Laboratory. The $^{23}$Al($d,n$) reaction was used to populate the astrophysically important states in $^{24}$Si. This enables a measurement in complete kinematics for extracting all relevant inputs necessary to calculate the reaction rate. For the first time, a predicted close-lying doublet of a 2$_2^+$ and (4$_1^+$,0$_2^+$) state in $^{24}$Si was disentangled, finally resolving conflicting results from two previous measurements. Moreover, it was possible to extract spectroscopic factors using GRETINA and LENDA simultaneously. This new technique may be used to constrain other important reaction rates for various astrophysical scenarios.

This study seeks to explain the variation in Japanese official development assistance (ODA) in 35 African countries for the period of 1979 and 1998. It tests for the effects of several new variables not examined previously in the quantitative aid literature on Africa, including human rights, democracy, and varied U.S. strategic and economic interests. The findings suggest that humanitarian interests, as measured by poverty, human rights, democracy, and food insecurity, figure prominently in Japanese aid decisions. In addition, we find that Japan's trade with recipient countries and some U.S. security interests have shaped the pattern of Japanese ODA in Africa, although U.S. economic reform initiatives and oil exports were found to have little effect. While previous studies have emphasized the importance of Japanese national economic interests as determinants of ODA disbursements, our results suggest that humanitarian concern and certain U.S. strategic interests are also important in understanding Japanese...