Search

Background We recently described the tumor immune microenvironment (TIME) in oral squamous cell carcinomas (OSCC) from Sudan by assessing the core of the lesions. However, the invasive tumor front (ITF) is the most active part of OSCC lesions; thus, TIME should also be characterized at the ITF in this patient cohort. Objectives We aimed to evaluate patterns of immune cell infiltration at the ITF in a cohort of OSCC patients from Sudan previously investigated at the tumor center and their association with clinicopathological parameters. Methods This study was performed on a prospective cohort of 22 OSCC patients attending Khartoum Dental Teaching Hospital with a median follow-up of 48 months. Inflammatory infiltrate densities of CD4-, CD8-, FoxP3-, CD20-, CD66b-, M1 (CD80/CD68)-, M2 (CD163/CD68)-, and PD-L1-positive cells were assessed at the ITF by immunohistochemistry, followed by digital quantitative analysis at the stromal and epithelial compartments separately. Histopathological parameters such as the worst pattern of invasion, differentiation, and tumor budding (TB) were also assessed. Correlations between clinicopathological parameters and survival analysis were investigated using SPSS. Results All inflammatory cell subsets investigated were found to be higher in the stromal compartment as compared to the epithelial one, except for the PD-L1+ subset. Stromal infiltration with the CD8+ cell subset was associated with low TB. Kaplan–Meier analyses identified higher epithelial and stromal CD4+ cell subsets. The presence of PD-L1 was found to be associated with unfavorable overall survival. Further, Cox's regression analysis using an age- and tumor-stage-adjusted model identified epithelial PD-L1 expression at the ITF as the only independent prognosticator. Conclusions Epithelial PD-L1 expression at the ITF was found to be an independent prognostic biomarker for OSCC in a cohort of Sudanese patients. publishedVersion

The relative merits of the drug-coated balloon (DCB) versus uncoated balloon (UCB) angioplasty in endovascular intervention for patients with symptomatic lower extremity peripheral arterial disease (PAD) remains controversial.Online databases were queried with various combinations of keywords to identify relevant articles. Net adverse events (NAEs) and its components were compared using a random effect model to calculate unadjusted odds ratios (ORs).A total of 26 studies comprising 26,845 patients (UCB: 17,770 and DCB: 9075) were included. On pooled analysis, DCB was associated with significantly lower odds of NAE (OR: 0.47, 95% confidence interval [CI]: 0.36-0.61), vessel restenosis (OR: 0.46, 95% CI: 0.37-0.57), major amputation (OR: 0.68, 95% CI: 0.47-99), need for repeat target lesion (OR: 0.38, 95% CI: 0.31-0.47) and target vessel revascularization (OR: 0.62, 95% CI: 0.47-0.81) compared with UCB. Similarly, the primary patency rate was significantly higher in patients undergoing DCB angioplasty (OR: 1.44, 95% CI: 1.19-1.75), while the odds for all-cause mortality (OR: 0.96, 95% CI: 0.85-1.09) were not significantly different between the two groups. A subgroup analysis based on follow-up duration (6 months vs. 1 vs. 2 years) followed the findings of the pooled analysis with few exceptions.The use of DCB in lower extremity PAD intervention is associated with higher primary patency, lower restenosis, lower amputation rate, and decreased need for repeat revascularization with similar all-cause mortality as compared to UCB.

Background Tumor immune infiltrate has been explored in oral squamous cell carcinoma (OSCC), but studies on simultaneous characterization of multiple immune cell subtypes separately in stromal and intraepithelial tumor compartments are limited. Objectives We aimed to investigate the immune cell infiltrate in OSCC by using immunohistochemistry (IHC) for a panel of inflammatory cells in stromal and epithelial tumor compartments for a better characterization of the tumors. Methods Thirty-six OSCC lesions and nine normal oral mucosa (NOM) samples from patients attending Khartoum Dental Teaching Hospital, Sudan were investigated for presence of tumor infiltrating lymphocytes, tumor-associated macrophages, tumor-associated neutrophils, and PD-L1 positive cells in the inflammatory infiltrate by single and double IHC. Digital quantitative analysis (Aperio Technologies Inc.) was performed separately for stromal and epithelial compartments. Results OSCC cases displayed a higher inflammatory infiltrate in the associated stroma, but not in the epithelial compartment when compared to NOM. The immunosuppressive type of inflammatory infiltrate, that is, T regulatory cells (FoxP3+ cells) was identified to be significantly higher in the epithelial compartment of tumors with advanced clinical state. An immunoscore developed by combining intraepithelial FoxP3+ and CD4+ cells was found significantly higher in lesions from elderly patients, localized at toombak dipping-related sites, poorly differentiated OSCCs, or with loco-regional lymph node spreading. Conclusions Despite heavy immune cell infiltration in tumor-associated stroma, the majority of OSCCs in this cohort displayed a low intraepithelial immune infiltration. An immunoscore based on combined CD4 and FoxP3 intraepithelial expression may serve as an indicator of advanced tumor progression and should be further investigated for its use as potential prognostic biomarker in OSCC. publishedVersion

Title. Jordanian nurses’ knowledge and practice of breast self-examination. Aim. This paper is a report of a study to evaluate the knowledge and practice of Jordanian nurses in relation to breast self-examination. Background. Studies have shown that women who have learned about breast self-examination have positive attitudes toward breast cancer and practise breast self-examination more frequently, and that nurses who teach their clients about methods of early detection and breast self-examination are more knowledgeable about breast cancer screening and breast self-examination techniques than those who do not. Therefore, it is important to understand nurses’ knowledge about breast cancer and its early detection. Methods. A cross-sectional design was used, with a convenience sample of 347 Registered Nurses at three large cities in Jordan (response rate 95%). Data collection took place in 2005 using a self-administrated questionnaire with three parts and based on the American Cancer Society’s guidelines: demographics, knowledge, and practice of breast self-examination. Results. Nurses reported high levels of knowledge of breast self-examination (M = 7·6, sd. 2·7). A high proportion of nurses reported doing breast self-examination in the past 12 months (85%), but only 17·7% reported doing so on a monthly basis. None of the demographic characteristics was found to be associated with the practice of breast self-examination. Conclusion. More health education about monthly breast self-examination and prevention strategies is needed for nurses and their women patients, especially for Arabic women.

Summary Aim: To determine efficacy and safety of intravenous micafungin vs. intravenous fluconazole in the treatment of oesophageal candidiasis. Methods: A total of 523 patients ≥16 years with documented oesophageal candidiasis were randomized (1:1) in this controlled, non-inferiority study to receive either micafungin (150 mg/day) or fluconazole (200 mg/day). Response was evaluated clinically and endoscopically. Post-treatment assessments were performed at 2 and 4 weeks after discontinuation of therapy. Results: Median duration of therapy was 14 days. For the primary end-point of endoscopic cure, treatment difference was −0.3% (micafungin 87.7%, fluconazole 88.0%). Documented persistent invasive disease at the end of therapy was reported in 2.7% and 3.9% of patients, respectively. Both 84.8% of micafungin and 88.7% of fluconazole patients remained recurrence free at 4-weeks post-treatment. The overall therapeutic response rate was 87.3% for micafungin and 87.2% for fluconazole. The incidence of drug-related adverse events was 27.7% for micafungin and 21.3% for fluconazole. Six (2.3%) micafungin- and two (0.8%) fluconazole-treated patients discontinued therapy; rash was the most common event leading to discontinuation. Conclusion: Intravenous micafungin (150 mg daily) is well tolerated and as efficacious as intravenous fluconazole (200 mg daily) in the primary treatment of oesophageal candidiasis, achieving high rates of clinical and endoscopic cure.

The thermal conductivity, diffusivity and specific heat of multi phase polymeric materials such as polystyrene and polymethylmethacrylate are reported. With emphasis on the thermal properties of such materials, a variety of implementation and classification regarding heat conduction will be highlighted. These properties were measured using dynamic methods namely; the transient plane source named also Gustafsson probe (TPS), the dynamic plane source (DPS) and the pulse transient technique (PTT), for measurements of thermal effusivity, thermal conductivity, thermal diffusivity and specific heat of solids One of the advantages considering these techniques is the possibility to extract all thermophysical parameters, the thermal conductivity, thermal diffusivity and specific heat from one single transient recording. Dynamic methods use a probe that is technically a resistive element, as the heat source. The first two TPS and DPS employ this probe as both heat source and temperature sensor. The later method PTT, for temperature sensing, uses a thermocouple placed apart of the heat source. A description of the main features and the principles on which these methods are based will be highlighted.

Sesame is one of the earliest condiments and crops grown for edible oil. Sesame is consumed directly as sweetmeat, a “peanut butter-like” product, a candy ingredient, bread condiments, and snack foods. The world production of sesame is about 2,000,000 metric tons. China and India are the largest producers but internally consume their production. Sudan is the largest exporter of seed. Sesame contains 50% oil, which is highly resistant to oxidation, and 25% protein, which has a unique balance of amino acids. Dehulling of sesame for human consumption is important since the hull contains 2–3% oxalic acid, which chelates calcium and has a bitter flavor. Dehulled, defatted meal contains 60% protein, is bland, and contains limited qualities of flatulence-causing sugars and high quantities of phytic acid. Aqueous processing yields isolated protein containing 72% protein and recovers 56% of the seed protein. Sesame protein is very stable to heat and contains large quantities of methionine. Sesame meal has a PER of about 1.35. Sesame is low in lysine and requires supplementation or can be blended with soy protein to give PERs nearly equivalent to casein. Sesame protein is composed of nearly 80% α-globulin and 20% β-globulin. Limited attempts have been made to characterize these 2 fractions. Sesame protein has low solubility that limits food applications in its native form. Sesame protein performs better than other oilseeds in baking applications. Production of sesame is limited to countries where labor is plentiful and inexpensive until indehiscent varieties and/or improved mechanical harvesting techniques are developed. However, intense breeding and engineering research programs are in progress.