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This work presents a numerical model to analyse the hygro-thermal behaviour of wooden bridge members. A multi-Fickian hygro-thermal model, previously implemented by some of the authors, is extended by including the dependency of wood sorption on temperature above and below zero degrees Celsius to predict moisture, temperature and relative humidity in wood under Northern European climates. The performance of the model in the presence of protective paints is particularly investigated. The finite element analysis based on the proposed model simulates the hygro-thermal behaviour of a glue-laminated beam of Älsvbacka Bridge located in Skellefteå (North of Sweden). The beam, coated by paints and claddings, was monitored by using wireless sensors in a previous research. Comparisons with the available measurements reveal that the numerical model is able to predict the moisture content in locations sheltered from rain and sun with moisture levels below the fibre saturation point. A study of the influence of different protective paints shows that the maximum and minimum moisture content at various depths along horizontal paths of the beam cross section, as well as the moisture gradients in different seasonal periods, are strongly affected by the type of paint. The proposed numerical approach is a promising tool to facilitate sensor-based monitoring techniques and to optimize the choice of protective paints for improved performance of timber bridges and other wooden structures under variable climates.

Large numbers of passengers and large amounts of goods are transported by air every year. This attracts the interest of terrorists, which poses high demands on aerodrome security. Technological solutions, and rules and regulations, have been widely implemented to detect security threats, but there is also a need for leading security indicators. Safety culture and climate have been identified as such leading indicators. The aim of this study was to develop and test a questionnaire instrument to measure aerodrome security climate. The development contained an expert focus group, expert panel, two pilot tests at four and five airports, respectively, and one full-scale study at nine Swedish commercial airports. The final instrument comprised 12 dimensions grounded in previous safety culture and climate research, and targeting three organizational levels. It had good psychometric properties and was validated against compliant as well as participative security behavior. We believe ADSECQ is suitable to evaluate the aerodrome security climate standard, pinpoint security climate areas for improvement, and evaluate the effect of interventions.

Rural communities are often characterised by having decreased access to infrastructure and resources to engage in physical activity when compared to urban centres. Subjective experiences of and val...

Identifying design variations that strike the balance between environmental, energy and cost can be aided using multi-objective optimization. From the resulting Pareto-solutions, selecting a single optimal solution remains a challenge. Thus, research is still needed to increase the practical use of optimization for architectural, engineering and construction (AEC) practitioners. This paper presents the use of an optimization approach where the results and an environmental assessment are discussed with AEC practitioners. The method was tested in two case studies: a prestige tourist cottage and a multifamily residential building. Different superstructures, insulation materials and windows were varied for the cottage’s envelope whilst evaluating life-cycle energy and cost. In addition, the environmental impact in terms of CO2 emissions was evaluated for the initial and optimal design suggestions for the two different superstructures. For the residential building, the insulation material thickness and the windows were varied for its evaluation of life-cycle energy and cost. For the cottage, a report was written and then read by the practitioners and used as a base for future decisions. For the residential building, the results were presented orally for the practitioners. In both cases, it was possible to communicate the overarching results of the optimizations through visual plots, although future research should find ways to also explain the detailed results. Godkänd;2020;Nivå 0;2020-05-05 (alebob);Konferensartikel i tidskrift

Chlamydia trachomatis (CT) is an obligate intracellular, Gram-negative bacterium that causes a variety of infections in both humans and animals. It is the causative agent of one of the most common sexually transmitted infections (STIs) with sequelae such as pelvic inflammatory disease, ectopic pregnancy, and infertility. Furthermore, Chlamydia infections have been epidemiologically linked to cervical cancer (CC) in patients with human papillomavirus (HPV) coinfection. However, a molecular mechanism linking Chlamydia to CC is yet to be established, and we still do not know if more aggressive diagnosis and treatment of Chlamydia could possibly lead to lower incidences of CC and associated mortality. Since CC is a leading cause of death among women worldwide, and HPV infection alone is insufficient to cause cancer, our goal was to determine the link between Chlamydia, HPV, and CC. This literature review aimed to understand the pathologic model of CC and how Chlamydia might induce or promote carcinogenesis alone or alongside HPV. In addition, we compared multiple studies attempting to associate Chlamydial infection with CC in different populations and aimed to determine whether there is an epidemiological correlation or not.

Chronic kidney disease-associated pruritus (CKD-aP), also known as uremic pruritus, has been associated with increased mortality and lower quality of life among patients with chronic kidney disease (CKD). The relentless nature of the condition is mainly due to its diverse and complex etiologies, which are still being studied. Despite the introduction of many agents to treat it, the resolution rates of CKD-aP still remain unsatisfactory. This study sought to review the lesser-known/novel treatments and establish a relationship between their mechanism of action and the proposed etiologies implicated in CKD-aP. We also discuss the role of dialysis modification in managing CKD-aP. A decent proportion of the reviewed studies have proposed that the agents analyzed in them act through hampering inflammation. Interestingly, the results of two agents alluded to the role of dysbiosis in CKD-aP. The addition of hemoperfusion to the dialysis regimen of patients with CKD-aP improved the severity of their symptoms. The featured treatments could be tried in patients with intractable symptoms. However, additional research is needed to confirm the findings reported in these studies. A better understanding of the pathologic mechanisms is required to help guide the development of agents that can better treat CKD-aP.

Stockholm vatten och avfall (SVOA) är Stockholms ledande vatten- och avfallsbolag. Varje dag berör verksamheten 1.5 miljoner invånare och företag i Stockholm. De erbjuder idag flertalet olika tjänster för att tillfredsställa alla boende i Stockholms stad. För att bli mer tillgängliga ville de ha hjälp att ta fram en stadsnära insamling i form av en mobil återvinningscentral. Tjänsten/produkten ska baseras på deras befintliga tjänst Pop-up återbruk och ett tidigare kandidatexamensarbete som gjordes 2019. Syftet var att nå ut till fler användare och bli mer tillgänglig genom att befinna sig närmare de boende i stockholm. Arbetet började med informationssökning, sortera och kategorisera det underlag som SVOA skickade. Vidare gjordes studiebesök hos de olika tjänsterna samt intervjuer med personal på tjänsterna och de ansvariga. Utifrån all research som sammanställdes landade det i att SVOA behöver en tjänst som är modulär, som marknadsför och som täcker många behov men inte alla samtidigt. För att kunna begränsa insamlingen på goda grunder togs därför primära och sekundära fraktioner fram, där de primära är grovavfall, återbruk och elektronik. Med all research i ryggsäcken var det dags att gå vidare till konceptgenereringen som delades upp i många små steg. När det blev känt att en lastbil inte var ett krav undersöktes fler alternativ på fordon, där släp slutligen valdes att gå vidare med och där den främsta anledningen var priset. Därefter gjordes en kravspecifikation med krav baserade på SVOAs tankar, researchen samt utifrån att släp valdes. Kravspecifikationen användes sedan som utvärderingsredskap då koncepten ställdes mot varandra. Först togs det fram tre koncept på antalet öppningar/fronter släpet skulle ha, sedan hur insidan skulle se ut vid transport respektive stopp, för att sedan landa i tre slutgiltiga koncept på utsidan av släpet. På utsidan gjordes även volymmodeller för att få en uppfattning om utrymme och känsla. Under mötet med en tillverkare från Westbay valdes det koncept som drar ner både pris och vikt på släpet, ett standardsläp med en bakramp som fälls ner och en sidolucka som fälls upp. Av tillverkaren skickades även offert med specifikationer och priser. Vidare utvecklades konceptet på en mer grundlig nivå där alla komponenter bestämdes vilket även genererade en kostnadskalkyl för hela släpet, den grafiska designen utformades och namnvalet “Mobila insamlingen” gjordes. Den Mobila insamlingen är en modulär lösning som med hjälp av statistik och kännedom om de områden den ska besöka därefter går att anpassa för vilken typ av insamling som ska prioriteras. Arbetet avslutades med en brainstorming med idéer på vidareutveckling av denna produkt i form av en tjänst. Tankar kring hur tjänsten skulle kunna kopplas till en app och på så sätt locka fler användare diskuterades likväl som hur SVOA skulle kunna tänka för att pressa ner priset ännu mer. Stockholm Vatten och Avfall (Stockholm Water and Waste, SVOA) is Stockholm's leading water and waste management company. Every day, its activities affect 1.5 million residents and businesses in Stockholm. Today, they offer a wide range of services to satisfy all residents in the city of Stockholm. In order to become more accessible, they wanted help to develop a citywide collection service in the form of a mobile recycling center. The service/product will be based on their existing service Pop-up återbruk (Pop-up recycling) and a previous bachelor thesis done in 2019. The aim was to reach out to more users and become more accessible by being closer to the residents of Stockholm. The work started with research, sorting and categorizing the material sent by SVOA. In addition, study visits were made to the various services and interviews were conducted with staff at the services and those responsible. Based on all the research that was compiled, it landed in the fact that SVOA needs a service that is modular, that markets and that covers many needs but not all at the same time. Therefore, in order to limit collection based on believable grounds, primary and secondary fractions were developed, the primary ones being bulky waste, recycling and electronics. With all the research in the backpack, it was time to move on to concept generation, which was divided into many small steps. When it became known that a truck was not a requirement, more options on vehicles were explored, with trailers finally chosen to go ahead with and the main reason being the price. A requirements specification was then made with requirements based on SVOA's thoughts, the research and the selection of moving forward with trailers. The requirements specification was then used as an evaluation tool as the concepts were compared against each other. First, three concepts were developed based on the number of openings/fronts the trailer would have, then how the inside would look during transport and stopping and then three final concepts on the outside of the trailer were developed. On the outside, volume models were also made to get an idea of space and feel. During the meeting with a manufacturer from Westbay Solutions, an expert manufacturing company of trailers, the concept that reduces both the price and weight of the trailer was chosen. A standard trailer with a rear ramp that folds down and a side hatch that folds up. The manufacturer also sent a quote with specifications and prices. Further, the concept was developed at a more detailed level where all components were determined which also generated a cost estimate for the whole trailer, the graphic design was created and the name "Mobila insamlingen ''(Mobile Collector) was chosen. Mobila insamlingen is a modular solution that can then be adapted to the type of collection to be prioritized, using statistics and knowledge of the areas it will visit. The work ended with a brainstorming session with ideas on further development of this product in the form of a service. Thoughts on how the service could be linked to an app and thus attract more users were discussed as well as how SVOA could think to push the price down even further.

The VElocity foR Direct particle Identification spectrometer (VERDI) is a 2E-2v fission spectrometer that allows the measurement of the total mass distribution of secondary fission fragments with a resolving power of 1-2 u. It consists of two time-of-flight (ToF) arms, with one Micro Channel Plate (MCP) detector and up to 32 Silicon PIPS (Passive Implanted Planar Silicon) detectors per arm. The MCPs provide the start timing signals and the PIPS detectors provide both the energy and the stopping ToF signals. In real conditions, the PIPS signals are affected by the formation of plasma from the interaction between the heavy ions and the detector material. The plasma contributes to a reduction in signal amplitude, resulting in a Pulse Height Defect (PHD), and introduces a signal delay, known as Plasma Delay Time (PDT). An experiment to characterize the PDT and PHD was performed at the LOHENGRIN recoil separator of the Institut Laue Langevin (ILL). Characteristic fission fragments from the 239Pu(n,f) reaction were separated based on their A/Q and E/Q ratios, allowing the measurement of a wide range of energies from 21 to 110 MeV and masses between 80 and 149 u. Six PIPS detectors were characterized to study their individual responses to the PDT and PHD effects. The signals were recorded in a digital acquisition system to completely exploit the offline analysis capabilities. Achieved combined timing and energy resolutions for fission fragments varied between 72(2) ps and 100(4) ps and 1.4% - 2% (FWHM), respectively. Preliminary PHD and PDT data are presented from the masses A=85, 95, 130 and 143. The PHD trends are strongly correlated with both the ion energy and mass. The PDT, on the other hand, shows a strong variation as a function of the ion kinetic energy but a smaller dependence on the ion mass.

The demands on managers seem to have increased as a consequence of management reforms. This study evaluates interventions aimed at improving working conditions and performance of managers in the Swedish public sector by changing organizational conditions. Six intervention organizations were compared to 34 reference organizations. Organizational conditions relevant for managerial work were surveyed and the results presented to the management teams who decided on the action plans and implemented changes. Fidelity to the intentions and contextual circumstances were documented. A psychometrically tested questionnaire was used for pre- and post-measurements of effects among a sample of 303 managers. The results showed that the interventions were associated with changes in managers’ quality of work and performance. The evaluation design made it possible to show that organizational conditions can be changed in order to improve the operations managers’ situation if there is fidelity to the intentions and support from the strategic level management.

Machine learning systems are deployed in critical settings, but they might fail in unexpected ways, impacting the accuracy of their predictions. Poisoning attacks against machine learning induce adversarial modification of data used by a machine learning algorithm to selectively change its output when it is deployed. In this work, we introduce a novel data poisoning attack called a \emph{subpopulation attack}, which is particularly relevant when datasets are large and diverse. We design a modular framework for subpopulation attacks, instantiate it with different building blocks, and show that the attacks are effective for a variety of datasets and machine learning models. We further optimize the attacks in continuous domains using influence functions and gradient optimization methods. Compared to existing backdoor poisoning attacks, subpopulation attacks have the advantage of inducing misclassification in naturally distributed data points at inference time, making the attacks extremely stealthy. We also show that our attack strategy can be used to improve upon existing targeted attacks. We prove that, under some assumptions, subpopulation attacks are impossible to defend against, and empirically demonstrate the limitations of existing defenses against our attacks, highlighting the difficulty of protecting machine learning against this threat., Comment: May12 update: add sever + backdoor defenses, comparison to witches' brew attack, better comparison to related work, transferability of representations for cmatch

Somatic

Diabetic nephropathy is becoming a more predominant cause of end-stage renal disease, as the prevalence of diabetes mellitus worldwide is on the rise. In this systematic review, we aimed to define the role of endothelin receptor antagonists, in the prevention and treatment of diabetic nephropathy, in addition to determining their safety. For this review, PubMed, Google Scholar, and Cochrane Library databases, in addition to ClinicalTrials.gov, were searched for publications in the last 20 years. We included 14 studies, seven randomized control trials, and seven post hoc analyses in this paper. Atrasentan decreased albuminuria, reduced blood pressure, and improved lipid profiles with more manageable fluid overload-related adverse events than avosentan and bosentan. Overall, endothelin receptor antagonists, in combination with renin-angiotensin-aldosterone system inhibitors, effectively reduce albuminuria and prevent the progression of diabetic kidney disease. However, more extensive clinical trials still need to be conducted to confirm these relationships and to learn more about the specific factors affecting their efficacy in individual patients.

Chronic obstructive pulmonary disease (COPD) is an obstructive and progressive airway disorder that is linked with a significant loss in daily physical activity as well as psychological issues that contribute to the patient's impairment and poor health-related quality of life. Over the last two decades, however, the research and application of nonpharmacologic therapies such as lung rehabilitation have been expedited with increasing evidence of systemic events in COPD patient groups and their nugatory impact on their functioning pulmonary rehabilitation (PR). It is a key part of integrated treatment for COPD and other chronic breathing disorders and is helpful in supporting the recovery of patients following COPD hospitalization. In this paper, we summarize current evidence regarding the effectiveness of PR in the management of chronic COPD. A systematic review was carried out during June 2021, searching databases PubMed, Google Scholar, and EBSCO. The authors extracted qualitative data, and then the author's names, year, study type, methodology, and the result were reported. The search of the aforementioned databases returned a total of 127 studies that were included for title, abstract, and full-text screening, and nine studies were enrolled for final data extraction. PR alleviates tiredness and dyspnea, improves emotional function, and increases the ability to do daily activities. These benefits are relatively extensive and substantial clinically. Rehabilitation acts as an important component of COPD management and helps to improve the quality of life and training linked to health.

Among the autoimmune (AI) diseases, systemic lupus erythematosus (SLE) is known to mimic various disease processes and this can lead to under-diagnosis of macrophage activation syndrome (a dire complication). We aimed at performing a systematic review to identify trigger factors that could lead to the development of macrophage activation syndrome (MAS) in patients with SLE as well as identify factors that can affect mortality. We searched the following databases to extract relevant articles: PubMed, ScienceDirect, Cochrane library, Pro-Quest, and Google Scholar. We used search terms including but not limited to hemophagocytic syndromes OR hemophagocytic lymphohistiocytosis OR macrophage activation syndrome OR HLH OR secondary hemophagocytic lymphohistiocytosis AND systemic lupus erythematosus OR SLE. We screened the articles first by titles and abstracts and later by full text. After the application of our eligibility criteria, we identified eight studies to include in our final synthesis. The studies showed that lupus flare itself, as well as, time to onset and high systemic lupus erythematosus disease activity index (SLEDAI) scores, were major risk factors that led to the development of MAS. In addition, infections followed by drugs, underlying malignancy, and pregnancy were other potential trigger factors identified. Studies also detected that MAS development led to high intensive care unit (ICU) admissions and in-hospital mortalities with C-reactive protein (CRP) levels, age, presence of infection, leukopenia, thrombocytopenia, MAS throughout the hospital stay, and high liver function tests (LFTs) as signs of poor prognosis. Additionally, ferritin levels, LFTs, and triglyceride levels formed an important part of diagnostic criteria. However, our review was limited due to the absence of prospective studies and heterogeneity in the studies seen. More studies need to be done to identify various factors leading to hemophagocytic lymphohistiocytosis (HLH) in autoimmune diseases with validated criteria for MAS secondary to autoimmune diseases.

Hypothyroidism is a widespread condition in the United States, affecting approximately 5% of the adult population. Although the clinical use of levothyroxine is well understood, its effect on preventing dementia is not well established. While the exact role of thyroid hormones in the adult brain is unknown, it is apparent that poor thyroid function can lead to mood swings, cognitive impairment, and other psychiatric symptoms. Most studies demonstrate an association between thyroid health and cognition, specifically slow processing of information, decreased effectiveness of executive functions, and lack of learning. This study aims to review the effect of levothyroxine on dementia. We searched electronic databases such as PubMed, Google Scholar, Science Direct, Cochrane, gray literature, and the references of included articles to find relevant articles. Two investigators independently identified eligible studies, screened title/abstract, and extracted data. We identified a total of 319 citations through a database search with six studies (case-control, longitudinal, cross-sectional, randomized controlled trials) meeting the inclusion criteria. Studies with moderate to low risk of bias were evaluated using their respective quality check tools. Five of six studies showed a positive impact of levothyroxine (LT-4) on dementia. According to these studies, the plausible rationale behind the reversal of memory with LT-4 treatment is restoring thyroid-stimulating hormone (TSH), thyroxine (T4) levels, and gamma-aminobutyric acid (GABA) concentrations. People with abnormal thyroid function should be screened for cognitive dysfunction using specific neurocognitive tests and start treatment with LT-4 regardless of symptom presentation. Multi-dose randomized placebo-controlled intervention studies are recommended to assess the effect of LT-4 on lowering the risk of dementia in hypothyroid patients.

Testosterone replacement therapy (TRT) has become increasingly popular over the years and there has been an increasing debate on whether testosterone replacement should be offered to older men due to its association with cardiovascular events. In this study, we evaluated the risk of myocardial infarction (MI) associated with TRT in hypogonadal men through a meta-analysis. We carried out the analysis by following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and conducted a literature search utilizing the following databases: Google Scholar, PubMed, Science Direct, Cochrane Library trials, and ClinicalTrials.gov. The search strategy resulted in a total of 782 articles, after applying our inclusion and exclusion criteria. Six observational studies and two randomized controlled trials (RCTs) were included for the analysis. A total of 55,806 hypogonadal men with baseline testosterone levels

Tuberculosis (TB) is the most common etiology of constrictive pericarditis in the developing world. In this study, we collected currently available data to evaluate the outcomes following pericardiectomy in patients with constrictive tuberculous pericarditis. We retrieved electrical databases, including PubMed and PubMed Central, from 1985 AD and onwards. We included articles that had more than 80% TB as the etiology and articles with mixed etiologies. Pooled analysis was done in Review Manager (RevMan) version 5.2 (The Nordic Cochrane Centre, Copenhagen). and Stata Statistical Software, Release 16 ( StataCorp LLC, College Station, TX). We compared the mortality in patients after pericardiectomy due to TB with other etiologies. In-hospital mortality versus one-year mortality was analyzed in studies with constrictive pericarditis of mixed etiologies. We also compared pre-operative New York Heart Association (NYHA) grade to post-operative NYHA grade one year after pericardiectomy. We calculated the pooled mean of postoperative hospital stay, postoperative intensive care unit (ICU) stay, and in-hospital mortality. A total of 12 articles and 859 patients were included in the final analysis. Pericardiectomy was performed mostly on middle-aged men with or without previous comorbidity. Total pericardiectomy was the preferred surgical procedure performed on a mean of 93% of patients. The pooled analysis shows a significant decrease in all-cause mortality in patients with TB as compared to other etiologies (pooled risk ratios (RR) 0.34 CI [0.12,1.01] I2 = 61%) and a lower but insignificant in-hospital mortality in comparison to one-year mortality in studies with mixed etiologies (RR 0.59 [0.11,3.11] I2= 61%). There was a significant improvement in the NYHA grade of the patients one year following pericardiectomy (RR 8.04, CI [5.20,12.45], I2= 0%). The mean postoperative hospital stay and the postoperative ICU stay were calculated and reported in terms of days. The mean postoperative hospital stays in studies with more than 80% of TB cases is 13.34 (10.21, 16.47) with a mean standard deviation of 4.46 (2.87, 6.05). The mean postoperative ICU stay is 1.93 (1.47, 2.39), with a mean standard deviation of 3.26 (2.51, 4.00), and the mean in-hospital mortality is 0.07 (0.02, 0.12). Similarly, the mean postoperative hospital stay in studies with mixed etiologies is 19.40 (11.93, 26.87) with a mean standard deviation of 8.26 (4.21, 12.52). The mean postoperative ICU stay is 3.52 (1.93, 5.10) with a mean standard deviation of 2.34 (1.36, 3.32). The mean in-hospital mortality is 0.06 (0.04, 0.08). There is significant heterogeneity along with a number of methodological concerns, and therefore, generalization of the data should be done with caution, and a randomized controlled trial in the future may be beneficial.

Gastric cancer (GC) is one of the most aggressive malignancies, currently ranking third among cancers leading to death worldwide. Despite the recent advancements in GC research, it is most often diagnosed during the terminal stages and with limited treatment modalities contributing to its poor prognosis and a lower survival rate. Much research has provided conflicting results between a vitamin D deficient status and the development of GC. Vitamin D is a well-known and essential hormone classically known to regulate calcium and phosphate absorption, enabling adequate mineralization of the skeletal system. However, the function of vitamin D is multidimensional. It possesses unique roles, including acting as antioxidants or immunomodulators while crossing the cell membrane, performing several intracellular functions, participating in gene regulation, and controlling the proliferation and invasion of cancer cells, including those of GC. In light of this, it is imperative to analyze the causes of GC, review the factors that can be used to enhance the effectiveness of treatments, and discover the tools to determine prognosis, reduce mortality, and prevent GC development. In this review, we have summarized recent investigations on multiple associations between vitamin D and GC, emphasizing genetic associations, vitamin D receptors, and the prevalence of hormone deficiency in those developing this aggressive malignancy.

The term "myocardial infarction with nonobstructive coronary arteries (MINOCA)" refers to a condition characterized by clinical signs and symptoms consistent with acute myocardial infarction (AMI) (as defined by the third universal definition of infarction) and coronary arteries that are angiographically normal or nearly normal. A prominent source of morbidity and mortality in patients with antiphospholipid syndrome (APS) is thrombotic events. To evaluate whether there is a relation between APS and MINOCA in this research, we did an extensive assessment of the existing research in this field. According to the data, APS was associated with microvascular thrombosis, aberrant lipid metabolism, hypertension, and abnormalities of the coagulation cascade, among other conditions. Based on the available data, we discovered evidence that suggests a relationship between MINOCA and APS patients. It is vital to raise awareness of this concern among the general public. Also required is the development and implementation of diagnostic and targeted treatment guidelines for patients with APS and MINOCA.

Hydroxyurea (HU) or hydroxycarbamide is a cytotoxic antimetabolite widely used to treat Philadelphia chromosome-negative Myeloproliferative Neoplasms (Ph-MPN) like Polycythemia Vera (PV), Essential Thrombocythemia (ET), and Primary Myelofibrosis (PMF). Patients with Ph-MPN are at an increased risk of Non-melanoma skin cancers (NMSC). The cause of this finding remains uncertain. In this systematic review, we would like to know if chronic use of HU in this population is responsible for the sudden onset of NMSC. The results obtained will help the patients and clinicians with early diagnosis of cutaneous lesions and in optimizing the current treatment options for MPN. We conducted a multi-database literature search, applied eligibility criteria and quality assessment tools to the studies extracted, with an intention to include only fair to high-quality articles. We analyzed six observational studies and four traditional reviews. Two out of 10 studies concluded that no relationship exists between the incidence of NMSC and HU. The remaining eight studies indicated the association. According to these studies, the possible risk factors include old age, excessive exposure to sunlight, higher doses, and prolonged HU therapy duration. Ultraviolet (UV) radiation and HU play a combined role in carcinogenesis. Periodic dermatologic screening is essential in these patients. Prompt biopsy and accurate diagnosis can prevent the progression of cancer and decrease the associated morbidity and mortality. True incidence and causation cannot be ascertained due to the scarcity of research on this topic. Multi-center prospective studies in large groups of Ph-MPN patients are recommended to determine the temporal relationship between NMSC and HU treatment.

Osteosarcoma (OS) is the most common primary bone cancer affecting children and young adults, most often occurring at the metaphysis of long bones. At present, treatment with combinations of surgery and chemotherapy for the localized OS has only brought minuscule improvements in prognosis. In comparison, the advanced, metastatic, or recurrent forms of OS are often non-responsive to chemotherapy, adding to the dire need to develop new and efficient therapies. The question of interest investigated in this systematic review is whether immunotherapy can play a meaningful role in improving the clinical outcomes of children with OS. This article aims to summarize the preclinical and clinical research conducted thus far on potential therapeutic avenues for pediatric OS using immunotherapy, including methods like checkpoint inhibition, adoptive cellular therapy with T-cells, chimeric antigen receptor T (CAR-T), and natural killer (NK) cells. It also highlights the influence of the innate and adaptive immune system on the tumor microenvironment, allowing for OS progression and metastasis. This systematic review contains 27 articles and analyses of multiple clinical trials employing immunotherapeutic drugs to 785 osteosarcoma participants and over 243 pediatric patients. The articles were obtained through PubMed, PubMed Central, and ClinicalTrials.gov and individually assessed for quality using the Assessment of Multiple Systematic Reviews (AMSTAR) checklist and the Cochrane risk-of-bias tool. The reviews reveal that immunotherapy's most significant impact on pediatric OS includes combining immune checkpoint blockers with traditional chemotherapy and surgery. However, due to the bimodal distribution of this aggressive malignancy, these studies cannot precisely estimate the overall effect and any potential life-threatening adverse events following therapy in children. Further research is required to fully assess the impact of these immunotherapies, including more extensive multinational clinical trials to focus on the pediatric population.

Measurement of estrogen receptor content in human breast cancer has become a valuable tool to predict the response of a tumor to endocrine manipulations. The aim of this study was to see whether steroid receptor assay could also be used to predict the value of endocrine therapy in human prostatic carcinoma. Biopsies from 25 primary tumors were analyzed with regard to quantity of methyltrienolone (a synthetic androgen) binding to the receptor 20 specimens were receptor-positive and 5 were receptor-negative. The correlation between receptor content and response to endocrine treatment was approximately approximately equal to 80%. The steroid receptor profiles of 5 lymph node metastases were also analyzed. 4/5 contained methyltrienolone receptors and 2/5 contained progestin receptors. 3/5 were glucocorticoid receptor-positive while all specimens were estrogen receptor-negative.

Cystic fibrosis (CF) is an autosomal recessive disease primarily affecting the respiratory system and gastrointestinal system. The life expectancy of patients with CF has significantly improved due to medical advancement and the effective use of screening techniques. However, new challenges have emerged. Particularly those involving cardiovascular pathology. This study aims to provide a better understanding of the different mechanisms that cause cardiovascular complications in patients with CF, which would help find an efficient treatment that not only prolongs survival but also improves their quality of life. This study extensively reviews different theories such as right ventricular hypertrophy due to lung pathology, ventricular interdependence, the association of nutritional deficiencies and severe cystic fibrosis transmembrane conductance regulator (CFTR) genotypes with myocardial fibrosis, effects of hypoxia, recurrent infections, and systemic inflammation of the heart and blood vessels that explain the direct or indirect involvement of the cardiovascular system in CF. For this review, 258 articles were retrieved from PubMed and Google Scholar. Out of which, a total of 12 high-quality articles were selected using appropriate quality assessment tools and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The result of this study suggests that early detection of cardiovascular dysfunction can improve the survival rate of the patient. Furthermore, this study could aid future researchers in the exploration of various best screening modality techniques for the early detection of cardiovascular dysfunction.

Objectives:: Children and adolescents with amelogenesis imperfecta (AI) have extensive treatment needs, but costs have not been explored previously. We calculated the costs of prosthetic rehabilitation and analyzed whether costs of treatment begun in early adolescence are lower compared with in early adulthood. Methods: : Data from the dental records of 25 patients with AI and 25 age- and sex-matched controls were analyzed. Patients were followed for a mean period of 12.3 +/- 1.5 years. Number of dental visits, dental treatment costs, and indirect costs were calculated during three time periods, before, during and after prosthetic therapy. Swedish national reference prices for general and specialist dental care were used. Results: : The mean number of visits was significantly higher in the AI group: 43.3 +/- 19.7 (controls: 17.5 +/- 19.8; p < .001). Mean total costs were 8.5 times higher for patients with AI: (sic)16,257 +/- 5,595 (controls: (sic)1,904 +/- 993). Mean number of crowns made in patients with AI was 12 +/- 7 (range 1 - 31). Indirect costs were significantly higher in the AI group and constituted 22% of the total costs. After crown therapy, costs between groups ceased to differ significantly. Calculations of total costs in the hypothetical scenario (discount rate at 3% annually) were (sic)18,475 for prosthetic rehabilitation began at age 12 years compared with (sic)20,227 if treatment began at 20 years of age. Conclusions: : Prosthetic rehabilitation costs for children and adolescents with AI can be high. Early crown therapy is associated with lower costs and a lower number of dental visits. Clinical Implications: Early crown therapy in children and adolescents with severe AI is a cost-reducing treatment associated with few complications and reduced need of dental care during adolescence compared with treatment begun at age 20.