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Summary: In patients with multiple myeloma (MM) not‐eligible for autologous haematopoietic cell transplantation (autoHCT), a simplified frailty index (SFI) identifies frail patients at risk for poor outcomes, but data are limited for transplant‐eligible patients. In this registry‐based retrospective study, we used an adapted version of the SFI to determine the prevalence of frailty in patients ≥65 years of age with MM undergoing autoHCT. Out of 5563 patients, 37.9% of patients were classified as frail and although they had increased non‐relapse mortality (NRM) and inferior overall survival, the NRM at 100 days remained low (<2%) compared with non‐frail patients. [ABSTRACT FROM AUTHOR]

We outline the indications and contraindications of carotid endarterectomy (CEA) and appraise four key areas still debated to this day; shunting versus non-shunting, patch angioplasty (PA) versus primary closure (PC) and local anaesthesia (LA) versus general anaesthesia (GA). Importantly, we compare CEA with Best Medical Therapy (BMT), which is an area that is still largely debated, principally because many of the studies conducted to date do not reflect the era of modern BMT practices, and these outcomes are eagerly awaited. Literature searches were conducted using Pubmed with the keywords 'carotid', and 'endarterectomy', which provided a wide variety of journals and articles. We further stratified our data by using only randomised control trials (RCTs), meta-analyses, and systematic reviews, and then excluded studies with asymptomatic disease, diabetes, and plaque-imaging studies, including studies that did not fit our four desired topics for discussion. For each of the different domain's, results demonstrated similar peri-operative outcomes when comparing shunting vs. non-shunting and modality of anaesthesia and therefore practice still remains dependent on operator experience and preference. Patch-angioplasty reduces the risk of subsequent stroke, transient ischaemic attack (TIA), and re-stenosis compared to PC. In carotid stenosis >50% BMT offers limited benefits without accompanying surgical intervention and BMT alone tends to be advantageous primarily for patients with <50% carotid stenosis. Where CEA is appraised in terms of superiority of the procedural components; the literature does not support wildly contrasting outcomes to change majority practice. However, the area of considerable interest is superiority of BMT to surgical intervention in terms of both carotid artery stenting (CAS) and CEA and more studies need to be conducted in this area. [ABSTRACT FROM AUTHOR]

IntroductionHypervirulent carbapenem-resistant Klebsiella pneumoniae (hv-CRKP) poses an increasing public health risk due to its high treatment difficulty and associated mortality, especially in bone marrow transplant (BMT) patients. The emergence of strains with multiple resistance mechanisms further complicates the management of these infections.MethodsWe isolated and characterized a novel ST11-KL64 hv-CRKP strain from a pediatric bone marrow transplantation patient. Antimicrobial susceptibility testing was performed to determine resistance patterns. Comprehensive genomic analysis was conducted to identify plasmid types, virulence factors, and antimicrobial resistance genes, as well as potential resistance mechanisms associated with mutations and plasmid-mediated variants.ResultsThe isolated hv-CRKP strain exhibited multidrug resistance to carbapenem, tigecycline, and polymyxin. Genomic analysis revealed that the IncHI1B/repB plasmid carried virulence factors (rmpA, ΔrmpA2, iucABCD, iutA), while IncFII/IncR and IncFII plasmids harbored resistance genes [blaCTX-M-65, blaTEM-1B, rmtB, blaSHV-12, blaKPC-2, qnrS1, blaLAP-2, sul2, dfrA14, tet(A), tet(R)]. The coexistence of blaCTX-M-65, blaTEM-1B, blaSHV-12, blaLAP-2,and blaKPC-2 in one hv-CRKP strain is exceptionally rare. Additionally, the Tet(A)-S251A variant in the conjugative plasmid pTET-4 may confer tigecycline resistance. Mutations in MgrB, PhoPQ, and PmrABCDK were identified as potential contributors to increased polymyxin resistance. Interestingly, plasmid-encoded restriction-modification systems and Retron regions were identified, which could potentially confer phage resistance.DiscussionThe combination of virulence and antimicrobial resistance factors in the ST11-KL64 hv-CRKP strain represents a significant challenge for treating immunocompromised pediatric patients. Particularly concerning is the resistance to polymyxin and tigecycline, which are often last-resort treatments for multidrug-resistant infections. The findings highlight the urgent need for effective surveillance, infection control measures, and novel therapeutic strategies to manage such hypervirulent and multidrug-resistant pathogens.

BMT services that are still manual cause customers difficulties in transactions, information services and consultations as a result of ineffective services. The development of BMT has succeeded in becoming a reliable microfinance institution, expected to be a substitute for loan sharking practices that are considered detrimental to MSMEs in prolonged debt. The problem in this service is that BMT services are still manual, causing customers difficulty to transact and the lack of information obtained. The service method carried out is training which aims to provide training to Gampong apparatus and Gampong Panggoi BMT administrators in terms of online-based BMT management to make it easier to transact and get wide information. As a result of this training, Gampong Panggoi has been able to manage BMT Babul Huda Panggoi online. This online management has been able to run information systems and services using technology by not ruling out sharia aspects and safeguarding customer data and applying the precautionary principle.

Background: Despite the significant role of JAK3 in various autoimmune diseases, including graft-versus-host disease (GVHD), there has been a lack of potent and selective JAK3 inhibitors specifically studied for GVHD. In our preclinical investigations, we evaluated a novel JAK3 inhibitor called CS12192, which is already un- dergoing clinical investigation in autoimmune diseases. Methods: We evaluated the efficacy of CS12192 in GVHD through mixed lymphocyte reaction (MLR) in both mouse and human cells, as well as allogeneic bone marrow transplantation (BMT) in a murine model. Results: CS12192, starting at a concentration of 0.5mu*M dose-dependently reduced the intracellular positivity for cytokines TNF-a and IFN-y in C D4+T cells ( p < 0.05 to p < 0.0001 ) and C D8+T cells ( p < 0.01 to p < 0.0001 ) during mouse allogeneic MLR assays. This effect was observed for both single and double positivity of the cy- tokines. Moreover, In MLR assays with three different human donors, CS12192 also demonstrated a dose- dependent reduction in the proportion of IFN-y positive CD4+ T cells (p < 0.0001) and C D8+T cells ( p < 0.01 to p < 0.0001 ) Additionally, it suppressed T cell proliferation in the mouse MLR ( p < 0.05 to p < 0, 1 ) but this effect was observed in only one human donor ( p < 0.001 to p < 0.0001 ). Furthermore, the administration of CS12192 at 40 and 80 mg/kg BID significantly improved the survival rate in the BMT model, resulting in cumulative 62-day survival rates of 88.89% (p < 0.01) and 100% (p < 0.001), respectively, compared with prednisolone (p < 0.05), Conclusions: CS12192 is a novel, potent and selective JAK3 inhibitor demonstrating great potential to mitigate acute GVHD. [ABSTRACT FROM AUTHOR]

Summary: In this study, we investigated whether matched and mismatched multidrug resistance gene (MDR1) genotypes (G2677TA, C1236T and C3435T) were associated with prognosis in patients after allogeneic haematopoietic stem cell transplantation (allo‐HSCT). One hundred patients after transplantation and their donors were enrolled. Matched MDR1 G2677TA donor–recipient was associated with an increased risk of non‐relapse mortality (NRM) (29.5% vs. 6.2%, p = 0.002), poor overall survival (OS) (51.7% vs. 63.8%, p = 0.024) and disease‐free survival (DFS) (38.6% vs. 67%, p = 0.005). There were no differences in OS, DFS or NRM between MDR1 C1236T‐ and C3435T‐matched and ‐mismatched groups. Subgroup analysis suggested that within the matched MDR1 G2677TA group, male gender, haematopoietic cell transplantation‐specific comorbidity index ≥1, serum creatinine >137.2 μmol/L and post‐transplantation thrombocytopenia were associated with poor survival. Our results demonstrated that patients receiving matched MDR1 G2677TA allo‐HSCT experienced a poorer prognosis compared with the mismatched group. The potential mechanism may involve increased expression of P‐glycoprotein, leading to decreased accumulation of antimicrobial agents and ultimately contributing to the progression of inflammation. This identification of MDR1 G2677TA genotype compatibility holds promise as a valuable molecular tool for selecting donors for allo‐HSCT. [ABSTRACT FROM AUTHOR]

Summary Sickle cell disease (SCD) is one of the most common genetic disorders in the world predominantly affecting economically disadvantaged populations. There is a notable discrepancy between the growing adult SCD population and available diagnostic and therapeutic interventions for SCD. Sickle cell hepatopathy (SCH) is an all‐inclusive term to describe the acute and chronic liver manifestations of SCD. The pathophysiology of SCH follows no defined pattern or sequence that poses challenges to clinicians and researchers alike. Evidence is lacking for this underreported disease at various levels from diagnostic to therapeutic options. This paper reviews the basic pathophysiology, clinical features, biochemical and radiological findings of various SCH manifestations and outlines the management of each condition. Old and new therapy options in SCD including hydroxyurea, red blood cell exchange transfusion, ursodeoxycholic acid, voxelotor, l‐glutamine and crizanlizumab have been reviewed to investigate the role of these options in treating SCH. The role of liver transplant, haematopoietic stem cell transplant and gene therapy in SCH patients have been reviewed. [ABSTRACT FROM AUTHOR]

Summary: Therapy‐related acute lymphoblastic leukaemia (tr‐ALL) is a disease entity attributed to previous exposure to chemotherapy and/or radiation for antecedent malignancy. There is observed female predominance for tr‐ALL, likely due to high prevalence and excellent curable rate for non‐metastatic breast cancer as well as the frequent use of carcinogenic agents as part of adjuvant therapy. Here, we reviewed 37 women with diagnosis of ALL following breast cancer treatment with focus on cytogenetic categorization. Philadelphia chromosome positivity (Ph+), KMT2A alterations and other cytogenetic change groups were observed in 32%, 22% and 46% of patients respectively. Median overall survival (OS) and relapse‐free survival (RFS) were 19.4 and 12.9 months, overall while both OS and RFS were superior in tr‐ALL with Ph+ disease compared to KMT2Ar and other cytogenetics respectively. Seventeen (45.9%) patients underwent consolidative allogeneic haematopoietic cell transplantation (alloHCT) in CR1 out of which 4 (24%) relapsed following transplant. Both OS and RFS were superior in the KMT2Ar cytogenetics group following alloHCT. Ph chromosome represents the largest genetic entity of tr‐ALL following breast cancer therapy, and it may be associated with superior survival outcomes while KMT2Ar may be associated with poorer outcomes that can perhaps be mitigated by alloHSCT. [ABSTRACT FROM AUTHOR]

Nutrition is vital to the long-term survival of children undergoing blood and marrow transplantation (BMT), but there is no standardization on how to optimize the nutritional status of these patients. A literature search was performed to evaluate nutritional support approaches currently in practice for pediatric patients who are undergoing BMT. CINAHL, Embase, and Cochrane databases were searched for peer-reviewed articles evaluating nutritional interventions for BMT recipients aged 20 or younger. Nine articles published between 2019 and 2023 were found and reviewed. The nutritional support varied between enteral nutrition, parenteral nutrition, a combination of both, and prophylactic feeding tube placement. The post-transplant outcomes identified as associated with alterations in nutritional regimens included length of stay, date of platelet engraftment, incidence of acute graft-versus-host disease, infection rate, and overall survival. The use of any amount of enteral nutrition compared to parenteral alone was beneficial. Complications during BMT can potentially be decreased via prioritizing enteral nutrition over parenteral. The paucity of literature on this topic highlights an unmet need in the field. Future research should focus on ways to optimize the nutritional support of transplant recipients, including increasing the likelihood of enteral feeding tube placement and utilization. [ABSTRACT FROM AUTHOR]

This research uses the SWOT approach to review Murabaha financing at Baitul Maal Wat Tamwil (BMT). This research is field research, with primary and secondary data sources, such as questionnaires, interviews, and literature. The research sample consisted of 20 people and three informants. Data analysis uses a mixed method approach, quantitatively and qualitatively, with the IFAS, EFAS and SWOT matrices. The research results found that several internal and external factors need to be evaluated, such as public trust, quality leadership, networks and partnerships, excellent and friendly service, practical procedures, and strategic location, which are assets that organizations can utilize to socialize Murabaha financing in the community. Meanwhile, external opportunities such as support from government agencies, a majority Muslim community, and local marketing strategies offer further growth and development potential. However, there are areas for improvement in education and awareness, product and service innovation, limited resources, and local marketing strategies that need to be overcome. Furthermore, threats from many competitors, the same target market, and a low public understanding of Islamic financing exist. This research can be helpful as a reference for future research and then become a reference for BMT in aligning organizational strategy with internal strengths and external opportunities, as well as overcoming existing weaknesses and threats.

The business world is an industrial world that is very supportive of the country's economic recovery. Many Indonesians depend on the business industry, especially the lower class. Kudus City has long been a client of the City of Commerce, to be dependable on the commercial industry for their livelihood. However, the need for support for business development is still minimal. With these problems, BMT and even Islamic banks can become the main channel to support the development of the business sector in the market, which was initially a problem. This study aims to determine the effect of BMT on the welfare of market traders in Kudus City. This research uses descriptive qualitative research. Information was obtained from related journal references. Besides that, it can also be from online media. [ABSTRACT FROM AUTHOR]

Summary: Recent treatment advancements in multiple myeloma have led to significant improvements in patient outcomes. Maintenance therapy following autologous haematopoietic stem cell transplantation (AHCT) is now standard of care and has been demonstrated to prolong and deepen treatment responses. Currently, lenalidomide remains the single agent that has been approved for maintenance post‐AHCT in Europe and the USA which, if tolerated, is continued until disease progression. The treatment landscape is rapidly expanding however, and the optimal personalised maintenance approach for a patient is becoming more complex. Treatment outcomes for patients with high‐risk disease remain poor and choice of maintenance in this population also remains unclear. This review article evaluates up‐to‐date literature regarding established maintenance approaches. It further analyses ongoing studies exploring maintenance regimens using combination and novel agents, approaches to maintenance in patients with cytogenetic high‐risk disease and minimal residual disease response‐adapted strategies that reflect the current evolving treatment paradigm. [ABSTRACT FROM AUTHOR]

Summary: The standard of care for fit, newly diagnosed multiple myeloma patients includes induction therapy followed by consolidative high‐dose chemotherapy with melphalan and autologous stem cell transplant (AHSCT). Intensified preparative regimens, such as busulfan and melphalan (BuMel), have shown promise to lengthen progression‐free survival (PFS). We previously reported that the addition of bortezomib to BuMel improved PFS compared to melphalan alone in CIBMTR‐matched controls. We now integrate the second‐generation protease inhibitor, carfilzomib, before and after BuMel (BuMelCar) in a phase I/II trial with carfilzomib. Patients with NDMM, relapsed/refractory MM (RRMM) and those failing prior AHSCT were eligible. Primary end‐points were safety and tolerability. Secondary end‐points included minimal residual disease negativity rates, PFS and OS. The study enrolled 19 patients. 73% were high risk either due to R‐ISS III status, adverse genetics or relapsed after prior AHSCT. The maximum tolerated dose (MTD) of carfilzomib was determined to be 36 mg/m2. Noted grade 3 toxicities were febrile neutropenia (79%), mucositis (21%) and diarrhoea (16%). The 2‐year PFS for the whole cohort and MTD was 89% and 100% respectively. 80% of all patients and 82% of patients in the MTD cohort achieved MRD negativity. Further studies regarding this regimen are planned. [ABSTRACT FROM AUTHOR]

The challenge facing BMT development is how to reduce the level of non-performing financing (NPF) loans to customers. This study aims to investigate how BMT addresses this NPF challenge by employing a systematic review and meta-analysis of the different outputs available on Behavioral Accounting Research perspective. The specific BMT under examination operates within the West Java region. The research findings reveal that in order to reduce the level of non-performing financing, measures have been taken to prevent the occurrence of high Non-Performing Loans (NPLs), and the roles played by BMT’s management and accountants in reporting have been instrumental, particularly in decision-making. NPF Customer reporting is a form of BMT management responsibility to stakeholders. An interesting finding is that BMT is required to effectively leverage itssocial functionsto mitigate the risk of high NPF. [ABSTRACT FROM AUTHOR]

Background: Blood or marrow transplantation (BMT) survivors carry a high burden of morbidity, yet health care utilization by this vulnerable population remains understudied. Patterns and predictors of various domains of health care utilization in long‐term BMT survivors were evaluated. Methods: Study participants were drawn from the Bone Marrow Transplant Survivor Study (BMTSS). Patients transplanted between 1974 and 2014 at one of three transplant centers who had survived ≥2 years after BMT and were aged ≥18 years at the time of the study were included. A BMTSS survey served as the source of data for health care utilization, sociodemographics, and chronic health conditions. Domains of health care utilization in the 2 years preceding study participation included routine checkups, BMT‐related visits, transplant/cancer center visits, emergency room (ER) visits, hospitalizations, and high health care utilization (≥7 physician visits during the 2 years before the study). Clinical characteristics and therapeutic exposures were abstracted from medical records. Results: In this cohort of 3342 BMT survivors (52% allogeneic), the prevalence of health care utilization declined over time since BMT for both allogeneic and autologous BMT survivors, such that among those who had survived ≥20 years, only 49%–53% had undergone routine checkups, 37%–38% reported BMT‐related visits, and 28%–29% reported transplant/cancer center visits. The presence of severe/life‐threatening conditions and chronic graft‐vs‐host disease increased the odds of health care utilization across all domains. Lower education, lack of insurance, and Hispanic ethnicity were associated with a lower prevalence of routine checkups and/or transplant/cancer center visits. Lower income increased the odds of ER visits but reduced the odds of hospitalizations or high health care utilization. Conclusions: This study identified vulnerable populations of long‐term BMT survivors who would benefit from specialized risk‐based anticipatory care to reduce high health care utilization, ER visits, and hospitalizations. Health care utilization (including routine medical checkups) declines with increasing time since blood or marrow transplantation, except among survivors with severe/life‐threatening chronic health conditions as well as those with chronic graft‐vs‐host disease. Lower education and lack of insurance are associated with lower health care utilization. [ABSTRACT FROM AUTHOR]

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Background Over the past three decades, hematopoietic stem cells transplantation (HSCT)has been widely and increasingly used as standard of care for patients with congenital or acquired hematopoietic disorders. Serious systemic complications, especially pulmonary complications (PCs) both infectious and noninfectious, may occur post transplantation and may be fatal. Objective To study the incidence, types, chronology, probable risk factors as well as outcome of posttransplantation PCs in a cohort of HSCT patients who were followed-up for one year. Methods This is a prospective observational study conducted on 80 HSCT recipients who were followed-up for one year for occurrence of any respiratory symptom. A diagnostic algorithm was then followed to reach etiology of both infectious and noninfectious causes. Results Fourteen (17.5%) patients had pulmonary symptoms, 12 (86%) were due to infections and 2 (14%) were due to noninfectious causes (a case of engraftment syndrome and another of pulmonary embolism), 67% of infectious PCs and all of noninfectious PCs occurred within the first 100 days post HSCT, 60% of infectious PCs were mixed, the most common isolated pathogen was Mycoplasma pneumoniae (60%), PCs related mortality was 21%. Conclusion Post HSCT PCs are common, constituting an important cause for mortality, highlighting the necessity for appropriate clinical diagnosis and management.

BackgroundAllogeneic hematopoietic cell transplantation for hemophagocytic lymphohistiocytosis (HLH) disorders is associated with substantial morbidity and mortality.ObjectiveThe effect of conditioning regimen groups of varying intensity on outcomes after transplantation was examined to identify an optimal regimen or regimens for HLH disorders.MethodsWe studied 261 patients with HLH disorders transplanted between 2005 and 2018. Risk factors for transplantation outcomes by conditioning regimen groups were studied by Cox regression models.ResultsFour regimen groups were studied: (1) fludarabine (Flu) and melphalan (Mel) in 123 subjects; (2) Flu, Mel, and thiotepa (TT) in 28 subjects; (3) Flu and busulfan (Bu) in 14 subjects; and (4) Bu and cyclophosphamide (Cy) in 96 subjects. The day 100 incidence of veno-occlusive disease was lower with Flu/Mel (4%) and Flu/Mel/TT (0%) compared to Flu/Bu (14%) and Bu/Cy (22%) (P < .001). The 6-month incidence of viral infections was highest after Flu/Mel (72%) and Flu/Mel/TT (64%) compared to Flu/Bu (39%) and Bu/Cy (38%) (P < .001). Five-year event-free survival (alive and engrafted without additional cell product administration) was lower with Flu/Mel (44%) compared to Flu/Mel/TT (70%), Flu/Bu (79%), and Bu/Cy (61%) (P = .002). The corresponding 5-year overall survival values were 68%, 75%, 86%, and 64%, and did not differ by conditioning regimen (P = .19). Low event-free survival with Flu/Mel is attributed to high graft failure (42%) compared to Flu/Mel/TT (15%), Flu/Bu (7%), and Bu/Cy (18%) (P < .001).ConclusionsGiven the high rate of graft failure with Flu/Mel and the high rate of veno-occlusive disease with Bu/Cy and Flu/Bu, Flu/Mel/TT may be preferred for HLH disorders. Prospective studies are warranted.

Research aims: The role of human resources in Baitul Maal wat Tamwil (BMT) is vital as it is the main driver of all company activities in achieving its goals. This study, therefore, aims to examine the influence of corporate governance (CG) principles on employee performance in BMT. Design/Methodology/Approach: The object of this study was BMTs in Yogyakarta Province, with the respondents being BMT employees. The data collection technique employed a questionnaire measured by five Likert scales. The data in this study were then processed using the multiple linear regression method. Research findings: The study uncovered that all CG principles, i.e., transparency, accountability, responsibility, independence, and fairness, positively influenced employee performance. Theoretical contribution/Originality: This study contributes to the development of BMT management in Indonesia to start or improve the implementation of corporate governance since it positively impacts employee performance. Practitioner/Policy implication: BMT has challenges related to human resource competence. The organization (BMT) can evaluate the implementation of GCG in its operational activities because it can affect employee performance. Research limitation/Implication: The study only took samples from Yogyakarta Province. The physical distribution of questionnaires also limited the number of samples that could be collected.

Background: Pediatric hematological cancer survivors who undergo hematopoietic stem cell transplantation (HSCT) may experience long‐term neurocognitive impairments. This systematic review aims to assess the neurocognitive outcomes in pediatric hematological cancer survivors at least 5 years post‐HSCT. Methodology: A comprehensive search was conducted in multiple databases, including PubMed, ScienceDirect, Cochrane Library, and ClinicalTrials.gov, until October 2022. Relevant studies assessing the neurocognitive affect after 5 years of HSCT were identified and included in the review. The quality of included studies was assessed using the ROBINS‐I tool to evaluate the risk of bias. Results: A total of five studies met the inclusion criteria and were included in the review. The studies consistently demonstrated adverse effects of HSCT on neurocognitive outcomes in pediatric hematological cancer survivors after 5 years of the treatment. The most prominent impact was observed on global cognitive outcomes, including intelligence, attention, memory, and executive functioning. Specific cognitive domains, such as processing speed and academic achievement, were also significantly affected. Several studies reported a relationship between HSCT‐related factors (e.g., age at transplantation, radiation therapy, graft‐versus‐host disease) and neurocognitive impairments. Conclusion: This systematic review provides evidence of the adverse impact of HSCT on neurocognitive outcomes in pediatric hematological cancer survivors at least 5 years post‐transplantation. The findings highlight the importance of long‐term monitoring and intervention strategies to mitigate these neurocognitive sequelae. Future research should focus on identifying risk factors and developing targeted interventions to optimize the neurocognitive functioning of this vulnerable population. Healthcare professionals involved in the care of pediatric hematological cancer survivors should be aware of these potential long‐term neurocognitive effects and incorporate appropriate assessments and interventions into survivorship care plans. [ABSTRACT FROM AUTHOR]

Background Over the past three decades, hematopoietic stem cells transplantation (HSCT)has been widely and increasingly used as standard of care for patients with congenital or acquired hematopoietic disorders. Serious systemic complications, especially pulmonary complications (PCs) both infectious and noninfectious, may occur post transplantation and may be fatal. Objective To study the incidence, types, chronology, probable risk factors as well as outcome of posttransplantation PCs in a cohort of HSCT patients who were followed-up for one year. Methods This is a prospective observational study conducted on 80 HSCT recipients who were followed-up for one year for occurrence of any respiratory symptom. A diagnostic algorithm was then followed to reach etiology of both infectious and noninfectious causes. Results Fourteen (17.5%) patients had pulmonary symptoms, 12 (86%) were due to infections and 2 (14%) were due to noninfectious causes (a case of engraftment syndrome and another of pulmonary embolism), 67% of infectious PCs and all of noninfectious PCs occurred within the first 100 days post HSCT, 60% of infectious PCs were mixed, the most common isolated pathogen was Mycoplasma pneumoniae (60%), PCs related mortality was 21%. Conclusion Post HSCT PCs are common, constituting an important cause for mortality, highlighting the necessity for appropriate clinical diagnosis and management. [ABSTRACT FROM AUTHOR]

Baitul Mal wat Tamwil (BMT) plays an important role in collecting and managing funds, as well as channeling them to micro-business actors with the principles of justice that are free from usury. However, it was found that members' interest in investment products in cooperatives is still relatively low. This study aims to analyze the intention of BMT members to invest in mudharabah muqayyadah savings by using the Theory of Planned Behaviour (TPB). The sampling method uses cluster random sampling by distributing online questionnaires to all investors in muqayyadah mudharabah deposits whose BMTs are registered with Aksyindo. Data from 191 respondents were analyzed by using Structural Equation Modeling. This research found that all intention determinant variables in TPB namely attitude, subjective norms, and perceived behavioral control have positive and significant effects on the intention to invest in muqayyadah mudharabah savings, while other observed variables, namely knowledge, religious factors, risk and return, and sharia compliance have positive and significant effects on attitudes in investing in muqayyadah mudharabah savings. Based on the findings of this study, it is concluded that the BMT needs to improve the factors that influence the intention to invest in muqayyadah mudharabah savings to overcome the problem of low interest in investing in muqayyadah mudharabah savings. This study can be a consideration for regulators and practitioners to design effective strategies for developing the Islamic financial industry, especially BMTs that are developing in Indonesia. [ABSTRACT FROM AUTHOR]

In 2021 the BMT CTN held the 4th State of the Science Symposium where the deliberations of 11 committees concerning major topics pertinent to a particular disease, modality, or complication of transplant, as well as two committees to consider clinical trial design and inclusion, diversity, and access as cross-cutting themes were reviewed. This article summarizes the individual committee reports and their recommendations on the highest priority questions in hematopoietic stem cell transplant and cell therapy to address in multicenter trials.

This study explored the efficacy of intravenous immunoglobulin (IVIG) prophylaxis in reducing infection‐related hospitalizations (IRHs) in MM patients. This was a retrospective study of MM patients who received IVIG at Taussig Cancer Center between July 2009 and July 2021. The primary endpoint was rate of IRHs per patient‐year on‐IVIG versus off‐IVIG. 108 patients were included. There was a significant difference in the primary endpoint of rate of IRHs per patient‐year on‐IVIG versus off‐IVIG in the overall study population (0.81 vs. 1.08; Mean Difference [MD], −0.27; 95% Confidence Interval [CI], −0.57 to 0.03; p value [P] = 0.04). The subgroup of patients with a 1‐year period of continuous IVIG (49, 45.3%), the subgroup with standard‐risk cytogenetics (54, 50.0%) and the subgroup with 2 or more IRHs (67, 62.0%) all showed a significant reduction in IRHs while on‐IVIG versus off‐IVIG (0.48 vs. 0.78; MD, −0.30; 95% CI, −0.59 to 0.002; p = 0.03) and (0.65 vs. 1.01; MD, −0.36; 95% CI, −0.71 to −0.01; p = 0.02) and (1.04 vs. 1.43; MD, −0.39; 95% CI, −0.82 to 0.05; p = 0.04) respectively. IVIG showed significant benefit in reducing IRHs in the overall population and in multiple subgroups. [ABSTRACT FROM AUTHOR]

Purpose: Total marrow lymphoid irradiation (TMLI) with volumetric modulated arc therapy (VMAT) is challenging due to large treatment fields with multiple isocenters, field matching at junctions, and targets being surrounded by many organs at risk. This study aimed to describe our methodology for safe dose escalation and accurate dose delivery of TMLI treatment with the VMAT technique based on early experience at our center. Materials and methods: Computed tomography (CT) scans were acquired in head-first supine and feet-first supine orientations for each patient with an overlap at mid-thigh. VMAT plans were generated for 20 patients on the head-first CT images with either three or four isocenters in the Eclipse treatment planning system (Varian Medical Systems Inc., Palo Alto, CA) and the treatment was delivered in a Clinac 2100 C/D linear accelerator (Varian Medical Systems Inc., Palo Alto, CA). Results: Five patients were treated with a prescription dose of 13.5 Gy in 9 fractions and 15 patients were treated with an escalated dose of 15 Gy in 10 fractions. The mean doses to 95% of the clinical target volume (CTV) and planning target volume (PTV) were 14.3 ± 0.3 Gy and 13.6 ± 0.7 Gy for the prescription doses of 15 Gy, and 13 ± 0.2 Gy and 12.3 ± 0.3 Gy for the prescription doses of 13.5 Gy, respectively. Mean dose to the lung in both schedules was 8.7 ± 0.6 Gy. The overall time taken to execute the treatment plans was approximately 2 h for the first fraction and 1.5 h for subsequent fractions. The average in-room time of 15.5 h per patient over 5 days leads to potential changes in the regular treatment schedules for other patients. Conclusion: This feasibility study highlights the methodology adopted for safe implementation of TMLI with the VMAT technique at our institution. Escalation of dose to the target with adequate coverage and sparing of critical structures was achieved with the adopted treatment technique. Clinical implementation of this methodology at our center could serve as a practical guide to start the VMAT-based TMLI program safely by others who are keen to start this service. [ABSTRACT FROM AUTHOR]

This research aims to analyze the strengths, weaknesses, opportunities, and threats to the positioning and development strategy of Baitul Maal Wa Tamwil (BMT) in West Java in the Era of the Covid-19 Pandemic. The descriptive qualitative research method was used. The study was conducted at 6 BMTs in the West Java region Technique of data analysis used is SWOT analysis. The results of the calculation of the SWOT matrix produce several alternative strategies, namely utilizing government support for Islamic banking by increasing the types of Sharia products, approaching potential investors even though capital is limited considering the public interest in the Islamic economy is very high, making regional regulations on sharia economics, establishing cooperation and partnerships with other financial institutions to obtain capital, capacity building of human resources, training, and development activities through partnerships with other banks that apply sharia principles. The implications of the results of this research are as input material for the development of new policies, strategies, and efforts to develop BMT both in the pandemic era and after the Covid-19 pandemic and to develop theories for alternative strategies in developing BMT in the Covid-19 pandemic era.

Background Hematopoietic stem cell transplantation (HSCT) is a well-recognized therapeutic procedure; costs limit its widespread use in low and middle income countries (LMIC).Methods Over a 30-year period, we have conducted HSCT in LMIC, making adaptations to the conventional procedures conducted in high-income countries (HIC).Results These salient observations stem from our practice: (1) Start with autologous transplantations in patients with hematological malignancies, specifically multiple myeloma; cell freezing devices are not necessary. (2) Next, consider auto-HSCT in patients with autoimmune diseases. (3) Introduce allogeneic transplants, initially using reduced intensity conditioning regimens. Conducting the HSCT on an outpatient basis is cheaper and safer. (4) Do not build HEPA-filtered rooms nor laminar flow cabins. (5) Do not graft cord blood cells nor start a cord blood blank. (6) Engage in haploidentical transplantations which are more feasible and cost-effective. (7) Matched unrelated donors are extremely expensive. (8) Use generic drugs and biosimilars. (9) Blood product irradiation devices are not necessary. (10) Do not try to reproduce other HSCT programs from HIC; develop your own methods.Conclusions HSCT can be conducted in LMIC with reduced costs and similar efficacy, thus making this therapeutic option affordable for more persons.

Abstract Background Restoring movement after hemiparesis caused by stroke is an ongoing challenge in the field of rehabilitation. With several therapies in use, there is no definitive prescription that optimally maps parameters of rehabilitation with patient condition. Recovery gets further complicated once patients enter chronic phase. In this paper, we propose a rehabilitation framework based on computational modeling, capable of mapping patient characteristics to parameters of rehabilitation therapy. Method To build such a system, we used a simple convolutional neural network capable of performing bilateral reaching movements in 3D space using stereovision. The network was designed to have bilateral symmetry to reflect the bilaterality of the cerebral hemispheres with the two halves joined by cross-connections. This network was then modified according to 3 chosen patient characteristics—lesion size, stage of recovery (acute or chronic) and structural integrity of cross-connections (analogous to Corpus Callosum). Similarly, 3 parameters were used to define rehabilitation paradigms—movement complexity (Exploratory vs Stereotypic), hand selection mode (move only affected arm, CIMT vs move both arms, BMT), and extent of plasticity (local vs global). For each stroke condition, performance under each setting of the rehabilitation parameters was measured and results were analyzed to find the corresponding optimal rehabilitation protocol. Results Upon analysis, we found that regardless of patient characteristics network showed better recovery when high complexity movements were used and no significant difference was found between the two hand selection modes. Contrary to these two parameters, optimal extent of plasticity was influenced by patient characteristics. For acute stroke, global plasticity is preferred only for larger lesions. However, for chronic, plasticity varies with structural integrity of cross-connections. Under high integrity, chronic prefers global plasticity regardless of lesion size, but with low integrity local plasticity is preferred. Conclusion Clinically translating the results obtained, optimal recovery may be observed when paretic arm explores the available workspace irrespective of the hand selection mode adopted. However, the extent of plasticity to be used depends on characteristics of the patient mainly stage of stroke and structural integrity. By using systems as developed in this study and modifying rehabilitation paradigms accordingly it is expected post-stroke recovery can be maximized.

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Human leukocyte antigen (HLA) mismatched unrelated donor transplantation is associated with an increased risk of graft-versus-host disease, graft failure, and infection, which increases post-transplant morbidity and mortality. In this single-center retrospective study, outcomes were evaluated in 30 consecutive children who underwent bone marrow transplantation (BMT) from HLA 1 allele-mismatched (HLA 7/8-matched) unrelated donors with rabbit anti-thymocyte globulin (rATG) as graft-versus-host disease (GVHD) prophylaxis. The 3-year overall survival (OS), event-free survival (EFS), and GVHD-relapse-free survival rates were 91.7% (95% CI 70.5%–91.9%), 88.3% (95% CI 67.5%–96.1%), and 73.9% (95% CI 52.4%–86.8%), respectively. Grade II–IV and III–IV acute GVHD occurred in 10 (33%) and 2 (7.0%) patients, respectively. The 3-year cumulative incidence of chronic GVHD was 7.8%. No fatal viral infections occurred. The study results show the feasibility of HLA 7/8-matched unrelated BMT with ATG to achieve favorable outcomes and acceptable GVHD, especially for patients who lack a fully matched donor. [ABSTRACT FROM AUTHOR]

Background & Objective: Pediatric sub-specialty procedures are usually performed in large hospitals by specialists. We aimed to develop a protocol in pediatric patients undergoing bilateral myringotomies (BMT) or tonsillectomies and/or adenoidectomies (T&A) in a rural community hospital. Methodology: An IRB-approved, prospective study was performed at Lexington Medical Center to examine the safety (S), emergence (E), and efficacy (E) (SEE) of an anesthetic protocol in patients under 7 y of age undergoing BMT or T&A. A non-specialist anesthesiology-based team performed the protocol related to SEE. Results: Out of 60 patients enrolled in the study, 4 (6.6%) desaturated (lowest SpO2 87%), and 6 (10%) had poor quality of emergence from anesthesia. The mean times for induction, emergence, and surgery for BMT were 4.8 ± 1.3, 4.2 ± 2.2, and 3.9 ± 1.0 min respectively. The mean times for induction-intubation, emergence-extubation, and surgery for T&A were 9.0 ± 2.9, 12.1 ± 6.8, and 14.6 ± 5.8 min respectively. Conclusion: The development of a clinical research program and study protocol was achieved for pediatric ENT procedures at a rural hospital. We found that Lexington Medical Center had a low incidence of desaturation, good quality of emergence from anesthesia, and efficacy. [ABSTRACT FROM AUTHOR]

The aim of this research is to analyze the impact of a Public-Private Partnership (PPP) on socio-economic development, which combines the skills and resources of both sectors, thus sharing risks and responsibilities. We studied the case of the BMT (Bejaia Mediterranean Terminal) joint venture, a partnership between the Algerian public company PCB (Port Company of Bejaia) and the private Singaporean group Portek, which started in 2006. This partnership has allowed the improvement of the port activity and the implantation of an efficient system of container processing that meets international standards, through a transfer of knowledge and skills as well as an undeniable socio-economic impact on the region of Bejaia and on the national economy. [ABSTRACT FROM AUTHOR]

Nutrition is vital to the long-term survival of children undergoing blood and marrow transplantation (BMT), but there is no standardization on how to optimize the nutritional status of these patients. A literature search was performed to evaluate nutritional support approaches currently in practice for pediatric patients who are undergoing BMT. CINAHL, Embase, and Cochrane databases were searched for peer-reviewed articles evaluating nutritional interventions for BMT recipients aged 20 or younger. Nine articles published between 2019 and 2023 were found and reviewed. The nutritional support varied between enteral nutrition, parenteral nutrition, a combination of both, and prophylactic feeding tube placement. The post-transplant outcomes identified as associated with alterations in nutritional regimens included length of stay, date of platelet engraftment, incidence of acute graft-versus-host disease, infection rate, and overall survival. The use of any amount of enteral nutrition compared to parenteral alone was beneficial. Complications during BMT can potentially be decreased via prioritizing enteral nutrition over parenteral. The paucity of literature on this topic highlights an unmet need in the field. Future research should focus on ways to optimize the nutritional support of transplant recipients, including increasing the likelihood of enteral feeding tube placement and utilization.

Summary: Germline predisposition to haematological cancers is increasingly being recognised. Widespread adoption of high‐throughput and whole genome sequencing is identifying large numbers of causative germline mutations. Constitutional pathogenic variants in six genes (DEAD‐box helicase 41 [DDX41], ETS variant transcription factor 6 [ETV6], CCAAT enhancer binding protein alpha [CEBPA], RUNX family transcription factor 1 [RUNX1], ankyrin repeat domain containing 26 [ANKRD26] and GATA binding protein 2 [GATA2]) are particularly significant in increasing the risk of haematological cancers, with variants in some of these genes also associated with non‐malignant syndromic features. Allogeneic blood and marrow transplantation (BMT) is central to management in many haematological cancers. Identification of germline variants may have implications for the patient and potential family donors. Beyond selection of an appropriate haematopoietic stem cell donor there may be sensitive issues surrounding identification and counselling of hitherto asymptomatic relatives. If BMT is needed, there is frequently a clinical urgency that demands a rapid integrated multidisciplinary approach to testing and decision making involving haematologists in collaboration with Clinical and Laboratory Geneticists. Here, we present best practice consensus guidelines arrived at following a meeting convened by the UK Cancer Genetics Group (UKCGG), the Cancer Research UK (CRUK) funded CanGene‐CanVar research programme (CGCV), NHS England Genomic Laboratory Hub (GLH) Haematological Oncology Malignancies Working Group and the British Society of Blood and Marrow Transplantation and Cellular Therapy (BSBMTCT). [ABSTRACT FROM AUTHOR]

Copyright of Almujtamae: Jurnal Pengabdian Masyarakat is the property of Universitas Djuanda and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Almujtamae: Jurnal Pengabdian Masyarakat is the property of Universitas Djuanda and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

CHG-based hygiene methods are often a component of daily hygiene bundles to prevent central line-associated blood stream infections (CLABSIs) in pediatric hematology-oncology patients; however, adherence with 2% CHG wipes was inconsistent within our institution, risking infection for immunocompromised patients. A new 4% CHG foam method offers an alternative and is applied while bathing, as opposed to wipes used 1 h after bathing. An initial cohort of 24 high-risk oncology and bone marrow transplant (BMT) patients agreed to use 4% CHG foam in place of wipes, and then answered surveys to describe their experiences. Ninety-two percent preferred foam over wipes and were more likely to use the foam moving forward. CHG foam was then made available as an option to all patients in need of central line care upon admission to the hospital. Hygiene bundles in the electronic medical record were reviewed to measure baseline adherence rates. Random audits by nursing administration prospectively assessed CHG adherence. CLABSI data were collected prospectively with routine quality metric reports. Results were analyzed using run charts and u-charts, respectively. Hematology-Oncology unit adherence rates remained at a higher rate of adherence, and BMT unit adherence rates increased from an average of 55%–81.6% (p < 0.001). Primary CLABSIs remained rare events (average <1/1000 CVL days). On cost analysis, utilizing CHG foam results in an annual savings estimate of $40,000 for a 24-bed unit. In conclusion, 4% CHG foam provides a cost-effective and patient-preferred option for daily hygiene that maintains CLABSI preventative efforts. [ABSTRACT FROM AUTHOR]

Abstract Background Neuronopathic Gaucher Disease (nGD) describes the condition of a subgroup of patients with the Lysosomal Storage Disorder (LSD), Gaucher disease with involvement of the central nervous system (CNS) which results from inherited deficiency of β-glucosylceramidase. Although systemic manifestations of disease are now corrected by augmentation with macrophage-targeted therapeutic enzyme (enzyme replacement therapy, ERT), neurological disease progresses unpredictably as a result of failure of therapeutic enzyme to cross the blood–brain barrier (BBB). Without therapy, the systemic and neurological effects of the disease progress and shorten life: investigators, principally in Sweden and the UK, pioneered bone marrow transplantation (BMT; Haematopoietic Stem Cell Transplantation HSCT) to supply healthy marrow-derived macrophages and other cells, to correct the peripheral disease. Here we report the first long-term follow-up (over 20 years in all cases) of nine patients in the UK and Sweden who underwent HSCT in the 1970s and 1980s. This retrospective, multicentre observational study was undertaken to determine whether there are neurological features of Gaucher disease that can be corrected by HSCT and the extent to which deterioration continues after the procedure. Since intravenous administration of ERT is approved for patients with the neuronopathic disease and ameliorates many of the important systemic manifestations but fails to correct the neurological features, we also consider the current therapeutic positioning of HSCT in this disorder. Results In the nine patients here reported, neurological disease continued to progress after transplantation, manifesting as seizures, cerebellar disease and abnormalities of tone and reflexes. Conclusions Although neurological disease progressed in this cohort of patients, there may be a future role for HSCT in the treatment of nGD. The procedure has the unique advantage of providing a life-long source of normally functioning macrophages in the bone marrow, and possibly other sites, after a single administration. HSCT moreover, clearly ameliorates systemic disease and this may be advantageous—especially where sustained provision of high-cost ERT cannot be guaranteed. Given the remaining unmet needs of patients with neuronopathic Gaucher disease and the greatly improved safety profile of the transplant procedure, HSCT could be considered to provide permanent correction of systemic disease, including bone disease not ameliorated by ERT, when combined with emerging therapies directed at the neurological manifestations of disease; this could include ex-vivo gene therapy approaches.

This study aims to determine the application of the qardhul hasan contract on al-qardh ceria product according to religion moderation. Al-qardh ceria is a benefit financing to finance the productive and consumptive sectors for the poor. This researh uses the type of field research and is descriptive. Data collection uses interviews with information sources from branch leaders, marketing, and members of qardhul hasan financing. The results showed that that the product of al-qardh ceria was not in accordance with Fatwa DSN-MUI No. 19/DSN-MUI/IV/2001. Because in the fatwa, the recipien of al-qardh ceria is only charged an administrative fee. However, in its implementation, members of the qardhul hasan , apart from being charged an administrative fee, memebres are charged a takaful fee.

One of the activities of Non-Bank Islamic Financial Institutions or also known as BMT (Bait al-mal wa al-tamwil) is channeling funds in the form of financing. Any financing based on the principles of Islamic Financial Institutions provided by BMT contains benefits, including the financing of Hajj bailouts. The advantage of this financing is that the process is fast and the requirements are easy. By way of financing haj bailout funds at the BMT UGT Nusantara Surabaya Branch, you can pay installments for an automatic debit account or available at each office, the installment service is automatically deducted from the debit account, which is possible to do in all service offices of the BMT UGT Nusantara Surabaya Branch. Therefore, the researcher intends to analyze how to apply the kafalah contract in financing haj bailouts for BMTs. The method used in this study was to conduct field research using interview techniques. The results of the study concluded that in the contract that underlies the kafalah in financing the haj bailout there are benefits for people who want to go on pilgrimage but are still lacking in funds. So this kafalah contract aims to help the community in financing the pilgrimage in the form of bailout funds.