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Abstract Background Pectus carinatum may be a major issue for adolescent patients, as chest-wall malformations can have a negative impact on body image and induce self-esteem disorders. Bracing has become the first line treatment for adolescent patients whose anterior chest wall is still flexible. The main obstacle is the tolerability of the bracing device along with the patient’s compliance to the device. The aim of this study was to examine the quality of life of adolescent patients treated with bracing to correct pectus carinatum in our institution. From November 2021 to July 2023, 28 patients with pectus carinatum were treated with bracing therapy in our chest wall deformities unit. We used a bivalve brace, manufactured with computer-aided design. All patients were asked to answer a multiple-choice questionnaire designed to assess how bracing therapy impacts their daily life, treatment compliance, and overall satisfaction. Patients who wore the brace for at least 3 months, and at least 5 days per week and 10 h per day, are defined as compliant with the bracing protocol. Results The mean age of the patients was 14 ± 1.36 years. Patients wore the brace for an average of 10.1 ± 6.9 months in the compliance group (n = 18), and 2.2 ± 2.5 months in the non-compliance group (n = 10). Our results show that compliant patients are fairly satisfied of the comfort of the brace, with a limited impact of the device on their daily activities and social life. However, non-compliant patients report the following dissatisfactions regarding the brace: higher pain scores, difficulty in breathing, and issues sleeping with the brace. The compliant patients noted a significant improvement in the appearance of their chest, and were satisfied with the appearance of their chest. The non-compliant patients did not notice any changes. Conclusions Compliant patients treated with a bi-valve brace for pectus carinatum seem to have a good quality of life with a limited impact on their daily life and social activities. The bi-valve brace also seems to be an effective therapy in compliant patients.

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Introduction Membranopathies encompass haemolytic disorders arising from genetic variants in erythrocyte membrane proteins, including hereditary spherocytosis and stomatocytosis. Congenital dyserythropoietic anaemia type II (CDA II) is associated with the SEC23B gene and can exhibit phenotypic similarities to membranopathies. Current treatment options for these conditions, apart from splenectomy, are primarily supportive. Mitapivat, a novel pyruvate kinase (PK) activator, has demonstrated efficacy in increasing haemoglobin levels and reducing haemolysis in patients with PK deficiency, thalassemia, sickle cell disease and a mouse model of hereditary spherocytosis.Methods and analyses Safety and efficacy of mitapivat sulfate in adult patients with erythrocyte membranopathies (SATISFY) is a prospective, multicentre, single-arm phase two trial involving approximately 25 adult patients (≥18 years) diagnosed with a membranopathy or CDA II. During the 8-week dose escalation period, subjects will receive an initial dose of 50 mg mitapivat two times per day and may increase to 100 mg two times per day at week 4 based on the safety and changes in haemoglobin levels. Patients tolerating mitapivat well may be eligible to continue in two consecutive 24-week fixed dose periods.The primary objective of this study is to evaluate the safety of mitapivat, assessed through the occurrence of treatment-emergent adverse events. Secondary objectives include assessing the effects of mitapivat on haemoglobin levels, haemolysis, erythropoiesis, patient-reported outcome measures and spleen size.SATISFY aims to assess the safety and efficacy of mitapivat in adult patients with red blood cell membranopathies and CDA II, with the aim of establishing proof-of-concept in patients living with these rare conditions.Ethics and dissemination NCT05935202/CTIS:2023-503271-24-01. Findings will be published in peer-reviewed journals.Trial registration number Clinicaltrials.gov, NCT05935202. CTIS:2023-503271-24-01. Registered 07-July-2023. Protocol number: 2.1. https://clinicaltrials.gov/study/NCT05935202.

In this work, the adsorption mechanism of phenol on activated carbon from aqueous solutions was investigated. Batch experiments were performed as a function of adsorbent rate, solution temperature, phenol initial concentration, stirring speed, and pH. The optimal operating condition of phenol adsorption were: mass/volume ratio of 0.6 g.L−1, temperature of 20 °C and stirring speed of 300 rpm. The equilibrium data for the adsorption of phenol were analyzed by Langmuir, Freundlich, and Temkin isotherm models. It was found that the Freundlich and Temkin isotherm models fitted well the phenol adsorption on the activated carbon and that the adsorption process is favorable. The Langmuir equilibrium isotherm provides a maximum adsorption of 156.26 mg.g−1 at 20 °C. The pseudo-first-order, pseudo-second-order, intraparticle diffusion, and Boyd models were used to fit the kinetic data. The adsorption kinetics data were well described by the pseudo-second-order model. The kinetic was controlled by the external diffusion by macropore and mesopore, as well as by the micropore diffusion. The thermodynamic study revealed the exothermic and spontaneous nature of phenol adsorption on activated carbon with increased randomness at the solid-solution interface. On the other hand, a very large model based on the optimization parameters of phenol adsorption using k-nearest neighbor coupled with the gray wolf optimizer algorithm was launched to predict the amount of phenol adsorption. The KNN_GWO model showed an advantage in giving more precise values related to very high statistical coefficients (R = 0.9999, R2 = 0.9998 and R2adj = 0.9998) and very low statistical errors (RMSE = 0, 0070, MSE = 0.2347 and MAE = 0.2763). These advantages show the efficiency and performance of the model used.

The aim of this study was to characterize a large series of 154 patients with acute promyelocytic leukemia (median age, 53 years; range, 18-90 years) and evaluate real-life outcome after up-front treatment with arsenic trioxide and all-trans retinoic acid. All patients were included in the prospective NAPOLEON registry (NCT02192619) between 2013 and 2019. The acute promyelocytic leukemia was de novo in 91% (n=140) and therapy-related in 9% (n=14); 13% (n=20) of the patients were older than 70 years. At diagnosis bleeding/hemorrhage was present in 38% and thrombosis in 3%. Complete remission was achieved in 152 patients (99%), whereas two patients (1%) experienced induction death within 18 days after starting therapy. With a median follow-up of 1.99 years (95% confidence interval: 1.61-2.30 years) 1-year and 2-year overall survival rates were 97% (95% confidence interval: 94-100%) and 95% (95% confidence interval: 91-99%), respectively. Age above 70 years was associated with a significantly shorter overall survival (P

Introduction: Myelodysplastic Syndromes (MDS) and Chronic Myelomonocytic Leukemia (CMML) are clonal myeloid malignancies, characterized by bone marrow failure leading to cytopenias (and possible myeloproliferation for CMML) and a high propensity to evolve to Acute Myeloid Leukemia (AML). Objective and Methods: The aim of our retrospective study was to evaluate the clinical and hematological features; the prevalence of MDS subtypes, R‐IPSS, and the outcome of 106 Armenian MDS/CMML patients diagnosed over the 2008–2020 period in a single Armenian Hematology center and compare them to French MDS patients included in the GFM registry. Results: Median age in the Armenian cohort was 64 years (range 19–84) and 55% were males. The main MDS subtypes were MDS‐MLD (29.2%) and MDS‐SLD (27.3%), the least frequent was del 5q (0.9%). By comparison, a higher prevalence of MDS‐MLD, MDS‐EB2, and MDS‐RS was found in the French cohort. Armenian patients' cohort generally had poor access to standard MDS treatment and 42.3% of the patients were transfusion dependent. Overall survival, however, did not significantly differ between Armenian and French cohorts. Conclusion: Our study stresses issues regarding epidemiology, access to diagnosis, difficulties of risk stratification, and access to treatment. [ABSTRACT FROM AUTHOR]

In the high plains of setif, calcareous rock, the main component of Djebel Zdimm, has contributed to the installation of very diverse saxicolous lichenic vegetation which is of great biological and phytogeographic interest because of its presence in a semi-arid steppe with a dry season extended for more than five months. The elaboration of a first list of lichens of Djebel Zdimm allowed us to identify 55 saxicolous species identified and reported for the first time in a steppe ecosystem, 5 of which are new to Algeria : Acarospora nitrophila H. Magn., Myriolecis invadens (H. Magn.) Śliwa, Zhao Xin et Lumbsch, Melanelia stygia (L.) Essl, Squamarina concrescens (Müll. Arg.) Poelt et Verrucaria sphaerospora Anzi. This study not only contributes to complete the lack of knowledge about the lichen flora of Algeria but also to the conservation and protection of the biological diversity of this steppe ecosystem in the face of climate change.

High-risk myelodysplastic syndrome/acute myeloid leukemia patients have a very poor survival after azacitidine failure. Guadecitabine (SGI-110) is a novel subcutaneous hypomethylating agent which results in extended decitabine exposure. This multicenter phase II study evaluated the efficacy and safety of guadecitabine in high-risk myelodysplastic syndrome and low blast count acute myeloid leukemia patients refractory or relapsing after azacitidine. We included 56 patients with a median age of 75 years [Interquartile Range (IQR) 69-76]. Fifty-five patients received at least one cycle of guadecitabine (60 mg/m2/d subcutaneously days 1-5 per 28-day treatment cycles), with a median of 3 cycles (range, 0-27). Eight (14.3%) patients responded, including two complete responses; median response duration was 11.5 months. Having no or few identified somatic mutations was the only factor predicting response (P=0.035). None of the 11 patients with TP53 mutation responded. Median overall survival was 7.1 months, and 17.9 months in responders (3 of whom had overall survival >2 years). In multivariate analysis, IPSS-R (revised International Prognostic Scoring System) score other than very high (P=0.03) primary versus secondary azacitidine failure (P=0.01) and a high rate of demethylation in blood during the first cycle of treatment (P=0.03) were associated with longer survival. Thus, guadecitabine can be effective, sometimes yielding relatively prolonged survival, in a small proportion of high-risk myelodysplastic syndrome/low blast count acute myeloid leukemia patients who failed azacitidine. (Trial registered at clinicaltrials.gov identifier: 02197676)