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This study explores student-teacher interactions, highlighting discussions with associate teachers about educational challenges. It examines the impact of cooperative learning and internet resources on feedback exchange among students and teachers, also noting their active involvement in school activities. The research identifies a keen interest in developing educational situation management skills for teaching Islamic education and focuses on effectively utilising educational tools like the Internet. Furthermore, the study underscores the importance of a comprehensive theoretical framework encompassing Arabic and Islamic education requirements within the school context. The findings reveal multifaceted dimensions of student-teacher engagement, learning strategies, and skill enhancement in practical education. [ABSTRACT FROM AUTHOR]

Statistical pattern recognition has emerged as a promising and practical technique for data-based health monitoring of civil structures. This paper intends to detect nonlinearity changes resulting from damage by some simple but e ective signal analysis methods. The primary idea behind these methods is to use measured time-domain vibration signals based on exploratory data analysis without applying any feature extraction. First, statistical moments and central tendency measurements on the basis of the theory of exploratory data analysis are considered as damage indicators to monitor their changes and detect any substantial variations in measured vibration signals. Subsequently, cross correlation and convolution methods are proposed to measure the similarity and overlap between the measured signals of the undamaged and damaged conditions. The main innovation of this study is the capability of the proposed signal analysis methods for implementing nonlinear damage detection without any feature extraction. Numerical and experimental models of civil structures are employed to demonstrate the e ectiveness and performance of the proposed methods. Results show that nonlinearity changes caused by damage lead to reductions in the values of cross correlation and convolution methods. Moreover, some statistical criteria are applicable tools for the global structural health monitoring. [ABSTRACT FROM AUTHOR]

The purpose of the presented study was to identify the effect of using the e-mind maps strategy at the academic achievement level in learning Arabic vocabulary skills among six-grade primary male students in Iben Al-Atheer School for Intermediate Education in Kuwait in the 2017/2018 school year. The sample of the study consisted of 60 male students, equally divided into two groups, experimental and control ones. The result of the study indicated that there were statistically significant differences between the mean scores of the experimental group and the control one in the post achievement level test scale in favor of the experimental group. The effect size of using mind maps was high. There were statistically significant differences between the mean scores of the experimental and control group scores in the post achievement test of the Arabic vocabulary learning in favor of the experimental group. The study concludes with recommendations for future mind-mapping in other contexts. [ABSTRACT FROM AUTHOR]

Background and Objective: Knowledge of resting metabolic rate and body composition is important for defining appropriate nutritional, energy balance and weight control. The purpose of this study was to compare resting metabolic rate (RMR) and body composition in young sedentary males after aerobic and resistance exercise training. Materials and Methods: Twenty eight sedentary male students were randomly assigned to participate in one of the following groups: endurance program (n=8), resistance program (n=10) and control group (n=10). The exercise training programs consisted of 6 weeks and 3 sessions of aerobic (running, by intensity 65% to 85% of HRmax) and resistance (11 exercises, 3 sets, 10 to 12 repetitions, 65% of 1RM) training per week. Before and after training, resting metabolic rate, body composition and VO2max were determined for each participant. Within- group differences were analyzed by using student t-test. One way ANOVA was used for between -group differences. Results: Results demonstrated that RMR increased significantly in resistance training while decreased significantly in endurance training. There was not any significant difference in RMR of the control group (p≤0.05). When RMR was normalized to FFM (kcal.kg FFM-1day-1), there were no significant improvement in RMR for any of the three groups. Total factors involved in body composition decreased significantly at the end of aerobic training. With resistance training, there was a significant decrease in FFM and BMI (p≤0.05). Conclusion: This study indicates that weight loss programs are more dependent on the amount of energy expenditure during the exercises than on the type of training. The findings support that there is not much difference in using aerobic or resistance training to increase resting metabolic rate and weight loss. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the feasibility of computed tomography (CT)- and fluoroscopy-guided percutaneous screw fixation for the treatment of low-grade isthmic spondylolisthesis in adults.Methods: Ten consecutive adult patients (four men and six women; mean age: 57.1 [range, 44-78 years]) were prospectively treated by percutaneous screw fixation for low-grade (six grade 1 and four grade 2) isthmic spondylolisthesis of L5. For each patient, two 4.0-mm Asnis III cannulated screws were placed to fix the pars interarticularis defects. All procedures were performed under local anaesthesia by using CT and fluoroscopy guidance. Post-operative outcome was assessed using the visual analogue scale and Oswestry Disability Index (ODI) scores.Results: The procedure time ranged from 45 to 60 min. The mean screw length was 27 mm (range, 24-32 mm). The VAS and ODI measurements ± SD decreased from 7.8 ± 0.9 preoperatively to 1.5 ± 1.1 at the last 2-year follow-up, and from 62.3 ± 17.2 to 15.1 ± 6.0, respectively (P < 0.001 in both cases). Neither slip progression nor screw failure was noted.Conclusions: This feasibility study showed that CT- and fluoroscopy-guided percutaneous screw fixation could be a rapid, safe and effective method of treating low-grade isthmic spondylolisthesis.Key Points: CT- and fluoroscopy-guided percutaneous screw fixation of isthmic spondylolisthesis is feasible. It could become an effective method to treat low-grade isthmic spondylolisthesis. Percutaneous trans-isthmic screw fixation can be performed under local anaesthesia. This new technique can be performed as an outpatient procedure. [ABSTRACT FROM AUTHOR]

Chimeric antigen receptor (CAR) T cell therapy is an engineered cell therapy where T cells are isolated and genetically modified to contain a synthetic CAR with specificity to a tumor cell antigen. Upon antigen binding, the CAR T cell will initiate signaling cascades that result in lysis of the associated tumor cell. Cytokine release syndrome (CRS) is the primary toxicity associated with CAR T cell therapy and remains a prominent safety issue with currently available commercial products. CRS is driven by interaction of the CAR T cells with endogenous monocytes and macrophages, which can lead to immune cell overactivation and an increase in certain cytokines to supraphysiological levels. Identifying the potential of any given CAR construct to drive toxicities in vivo should be assessed in preclinical models prior to human trials. While there are in vivo mouse models available for this purpose, these are often complex xenograft models available in few centers. Thus, there is a need to develop an in vitro assay for measuring the CRS potential of CAR T cells. The assay described here is a preclinical tool for assessing the propensity of any given CAR construct to produce potentially CRS-driving cytokines following tumor cell and monocyte interactions. This article provides a detailed protocol for target cell preparation and isolation of monocytes from peripheral blood mononuclear cells (PBMCs) autologous to the CAR T cells, as well as protocols for seeding the three cell types in a co-culture assay and collecting/analyzing the cytokines produced via an ELISA or multiplex bead array. © 2023 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: Preparation of K562 target cells Basic Protocol 2: Isolation of monocytes from autologous PBMCs Basic Protocol 3: Seeding of CAR T cells, monocytes, and K562 cells in 96-well plates Basic Protocol 4: Analysis of co-culture supernatants by single-cytokine ELISA Alternate Protocol: Analysis of co-culture supernatants by multiplex cytokine bead array., (© 2023 The Authors. Current Protocols published by Wiley Periodicals LLC.)

Germline inactivating variants of CDH1 are causative of hereditary diffuse gastric cancer (HDGC), a cancer syndrome characterized by an increased risk of both diffuse gastric cancer and lobular breast cancer. Because loss of function mutations are difficult to target therapeutically, we have taken a synthetic lethal approach to identify targetable vulnerabilities in CDH1 -null cells. We have previously observed that CDH1 -null MCF10A cells exhibit a reduced rate of endocytosis relative to wildtype MCF10A cells. To determine whether this deficiency is associated with wider vulnerabilities in vesicle trafficking, we screened isogenic MCF10A cell lines with known inhibitors of autophagy, endocytosis, and sphingolipid metabolism. Relative to wildtype MCF10A cells, CDH1 -/- MCF10A cells showed significantly greater sensitivity to several drugs targeting these processes, including the autophagy inhibitor chloroquine, the endocytosis inhibitors chlorpromazine and PP1, and the sphingosine kinase 1 inhibitor PF-543. Synthetic lethality was confirmed in both gastric and mammary organoid models of CDH1 loss, derived from CD44 -Cre/ Cdh1 fl/fl /tdTomato mice. Collectively, these results suggest that both sphingolipid metabolism and vesicle trafficking represent previously unrecognised druggable vulnerabilities in CDH1 -null cells and may lead to the development of new therapies for HDGC.

Toll-like receptors (TLRs) are evolutionarily conserved molecules that specifically recognize common microbial patterns, and have a critical role in innate and adaptive immunity. Although TLRs are highly expressed by innate immune cells, particularly antigen-presenting cells, the very first report of a human TLR also described its expression and function within T-cells. Gene knock-out models and adoptive cell transfer studies have since confirmed that TLRs function as important costimulatory and regulatory molecules within T-cells themselves. By acting directly on T-cells, TLR agonists can enhance cytokine production by activated T-cells, increase T-cell sensitivity to T-cell receptor stimulation, promote long-lived T-cell memory, and reduce the suppressive activity of regulatory T-cells. Direct stimulation of T-cell intrinsic TLRs may be a relevant mechanism of action of TLR ligands currently under clinical investigation as cancer immunotherapies. Finally, chimeric antigen receptor (CAR) T-cells afford a new opportunity to specifically exploit T-cell intrinsic TLR function. This can be achieved by expressing TLR signaling domains, or domains from their signaling partner myeloid differentiation primary response 88 (MyD88), within or alongside the CAR. This review summarizes the expression and function of TLRs within T-cells, and explores the relevance of T-cell intrinsic TLR expression to the benefits and risks of TLR-stimulating cancer immunotherapies, including CAR T-cells., Competing Interests: Competing interests: RP and RW are employees of the Malaghan Institute of Medical Research, a registered charity and sponsor of a trial of chimeric antigen receptor T-cells incorporating a TLR2-derived domain; none of the authors have a proprietary or intellectual property interest in the product; no other competing interests to declare., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background & Aims: Rhus coriaria L. (Sumac) is a popular spice/herb with several biological functions owing to its antioxidant and insulin-like activities. Many clinical trials have indicated the potent anti-diabetic property of sumac but the results on few glycemic indices were inconclusive. Hence, this systematic review and meta-analysis were aimed to investigate sumac supplementation effect on glycemic indices., Methods: Systematically searched was performed by two independent reviewers using online databases including: PubMed, Scopus, web of science, EMBASE from inception until November 2020. Data were pooled using a random-effects model and weighted mean difference (WMD) with 95 % confidence intervals (CI)., Results: A total of 6 potentially relevant clinical trials met the inclusion criteria with total of 278 participants. Random-effects meta-analysis suggested no significant effects on the levels of fasting blood glucose [-7.08 mg/dl, 95 % CI: -14.85 to 0.70,P = 0.07, I 2 = 59.8 %], glycosylated hemoglobin (HbA1c) [-0.48 %, 95 % CI: -1.01 to -0.04, P = 0.07, I 2 = 0.0 %], homeostatic model assessment for insulin resistance (HOMA-IR) [-0.97, 95 % CI: -1.96 to 0.02, P = 0.05, I 2 = 83.8 %], and insulin [-2.94 Hedges' g, 95 % CI: -6.67 to 0.80, P = 0.12, I 2 = 83.1 %] following supplementation with sumac powder., Conclusion: This meta-analysis showed no significant effects on any glycemic indices following supplementation with sumac powder., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Although the effectiveness of percutaneous radiologic gastrojejunostomy (PRGJ) has been reported, a detailed description of the indications and clinical effectiveness of temporary PRGJ is still limited., Purpose: To evaluate the clinical effectiveness and technical feasibility of temporary PRGJ using the modified Chiba-needle technique with single gastropexy., Material and Methods: Temporary PRGJ using the modified Chiba-needle technique with single gastropexy was performed in 27 consecutive patients (19 men, 8 women; mean age = 61 years; age range = 32-77 years) for esophageal perforation (n = 18) or postoperative gastroparesis (n = 9). Outcomes analyzed included the technical and clinical success, procedure-related complications, and the tube indwelling period., Results: Technical and clinical success was achieved in all 27 patients. All the tubes were electively removed 19-364 days (mean indwelling period = 104 days) after confirmation of the possibility of oral intake. Asymptomatic pneumoperitoneum occurred in 2/27 (7.4%) patients as minor complications and was resolved spontaneously by the time of the one-week follow-up. There were no major complications. During the follow-up period, a total of 11 tube changes were performed in seven patients for an elective tube change within a six-month interval (n = 5) or because of tube occlusion (n = 6)., Conclusion: Temporary PRGJ using the modified Chiba-needle technique with a single gastropexy was clinically effective and technically feasible in patients with esophageal perforation or gastroparesis. It can provide adequate enteral nutrition during its temporary placement.

Purpose: Boarding is a common problem in the emergency department (ED) and is associated with poor health care and outcome. Imam Khomeini Hospital is the main healthcare center in Urmia, a metropolis in the northwest of Iran. Due to the overcrowding and high patient load, we aim to characterize the rate, cause and consequence of boarding in the ED of this center., Methods: All medical records of patients who presented to the ED of Imam Khomeini Hospital from August 1, 2017 to August 1, 2018 were retrospectively analyzed. Patients with uncompleted records were excluded. Boarding was defined as the inability to transfer the admitted ED patients to a downstream ward in ≥2 h after the admission order. Demographic data, boarding rate, mortality and triage levels (1-5) assessed by emergency severity index were collected and analyzed. The first present time of patients was classified into 4 ranges as 0:00-5:59, 6:00-11:59, 12:00-17:59 and 18:00-23:59. Descriptive, parametric and non-parametric statistical tests were performed and the risk of boarding was determined by Pearson Chi-square test., Results: Demographic data analysis showed that 941 (58.5%) male and 667 (41.5%) female, altogether 1608 patients were included in this study. Five patients (0.3%) died. The distribution of patients with the triage levels 1-5 was respectively 79 (4.9%), 1150 (71.5%), 374 (23.3%), 4 (0.2%) and 0 (0%). Most patients were of level 2. Only 75 (4.7%) patients required intensive care. The majority of patients (84.2%) were presented at weekdays. The maximum patient load was observed between 12:00-17:59. Of the 1608 patients, 340 (21.1%) experienced boarding within a mean admission time of 13.70 h. Among the 340-boarded patients, 20.1% belonged to surgery, 12.1% to orthopedics, 10.9% to neurosurgery and 10.3% to neurology. The boarding rate was higher in females, patients requiring intensive care and those with low triage levels. Compared with the non-boarded, the boarded patients had a higher mean age., Conclusion: The boarding rate is higher in the older and female patients. Moreover, boarding is dependent on the downstream ward sections: patients requiring surgical management experience the maximum boarding rate., (Production and hosting by Elsevier B.V.)

Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant cancer syndrome that is characterised by a high prevalence of diffuse gastric cancer and lobular breast cancer. It is largely caused by inactivating germline mutations in the tumour suppressor gene CDH1, although pathogenic variants in CTNNA1 occur in a minority of families with HDGC. In this Policy Review, we present updated clinical practice guidelines for HDGC from the International Gastric Cancer Linkage Consortium (IGCLC), which recognise the emerging evidence of variability in gastric cancer risk between families with HDGC, the growing capability of endoscopic and histological surveillance in HDGC, and increased experience of managing long-term sequelae of total gastrectomy in young patients. To redress the balance between the accessibility, cost, and acceptance of genetic testing and the increased identification of pathogenic variant carriers, the HDGC genetic testing criteria have been relaxed, mainly through less restrictive age limits. Prophylactic total gastrectomy remains the recommended option for gastric cancer risk management in pathogenic CDH1 variant carriers. However, there is increasing confidence from the IGCLC that endoscopic surveillance in expert centres can be safely offered to patients who wish to postpone surgery, or to those whose risk of developing gastric cancer is not well defined., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The CDH1 gene, encoding the cell adhesion protein E-cadherin, is one of the most frequently mutated genes in gastric cancer and inactivating germline CDH1 mutations are responsible for hereditary diffuse gastric cancer syndrome (HDGC). Using cell viability assays, we identified that breast (MCF10A) and gastric (NCI-N87) cells lacking CDH1 expression are more sensitive to allosteric AKT inhibitors than their CDH1 -expressing isogenic counterparts. Apoptosis priming and total apoptosis assays in the isogenic MCF10A cells confirmed the enhanced sensitivity of E-cadherin-null cells to the AKT inhibitors. In addition, two of these inhibitors, ARQ-092 and MK2206, preferentially targeted mouse-derived gastric Cdh1 -/- organoids for growth arrest. AKT protein expression and activation (as measured by phosphorylation of serine 473) were differentially regulated in E-cadherin-null MCF10A and NCI-N87 cells, with downregulation in the normal breast cells, but upregulation in the gastric cancer cells. Bioinformatic analysis of the TCGA STAD dataset revealed that AKT3 , but not AKT1 or AKT2 , is upregulated in the majority of E-cadherin-deficient gastric cancers. In conclusion, allosteric AKT inhibitors represent a promising class of drugs for chemoprevention and chemotherapy of cancers with E-cadherin loss.

Aims: This meta-analysis study was carried out to assess the effects of coenzyme Q10 supplementation on body weight and body mass index of patients in randomized controlled clinical trial studies., Materials and Methods: A comprehensive systematic search of literature was performed through ISI web of sciences, PubMed, Scopus and Cochrane library databases up to February 2018 which was supplemented by manual search of the references list of included studies. From a total of 1579 identified articles, only 17 trials with 14 and 14 effect-sizes were included for pooling the effects of co-enzyme Q10 supplementation on body weight and body mass index, respectively., Results: Results of random-effect size meta-analysis showed that supplementation with coenzyme Q10 had no significant decreasing effects on body weight (WMD: 0.28 kg; 95% CI = -0.91, 1.47; P = 0.64) and BMI (WMD: -0.03; 95% CI = -0.4, 0.34; P = 0.86) of study participants. Subgroup analysis revealed that dosage of Q10 and trial duration could not differ the results of Q10 supplementation., Conclusion: Results of this meta-analysis study failed to show any beneficial effect of coenzyme Q10 supplementation on body weight and BMI of patients in clinical trial studies., (Copyright © 2019. Published by Elsevier Ltd.)

Background Endovascular treatment has become a significant therapeutic option for the management of intractable bleeding in gynecologic malignancies. However, the endovascular treatment types were almost never mentioned when active bleeding from different arteries was identified. Purpose To present angiographic details and evaluate clinical efficacy of endovascular treatments to control active vaginal bleeding in uterine cervical cancer patients treated with radiotherapy. Material and Methods In this retrospective study, six, consecutive cervical cancer patients treated with radiotherapy who underwent endovascular treatment for active vaginal bleeding were included. Angiographic findings, endovascular treatment details, and clinical outcomes were obtained. Results Ten endovascular procedures were technically successful, in which bleeding arteries were the internal iliac artery/its branches (n = 5), external iliac artery (EIA) (n = 3), uterine artery (n = 1), and superior rectal artery (n = 1), and bleeding manifested as contrast extravasation (n = 6), pseudoaneurysm (n = 1), or both (n = 3). Three of the four repeated procedures showed different bleeding sites from the primary ones. Stent graft was inserted to preserve the patency of the bleeding EIA in two patients. For another EIA rupture, both proximal and distal embolization were performed, followed by femoral-to-femoral bypass to preserve blood flow. Bleeding control within one month was achieved in 80% (8/10). One minor complication, mild transient pelvic pain, occurred in one patient. Conclusions Various endovascular treatment was feasible and effective to control active vaginal bleeding from cervical cancer. Repeated procedures showed commonly different bleeding foci and stent graft insertion was effective for preserving the patency of the large bleeding artery.

Background and aims: Cervical cancer is the fourth most common cancer in women worldwide and the 13th in Jordan. The cervical smear (Pap smear) is a simple approach to detect pre-cancerous cervical lesions. The aim of this study was to evaluate the prevalence of abnormal cervical smears in women seen at the Early Detection/Community Outreach clinic of King Hussein Cancer Center (KHCC). Materials and Methods: In this retrospective study, reports of routine cervical Pap smears performed in the pathology department at KHCC from January 2007 to December 2016, were reviewed. During this period, a total of 5,529 routine smears were assessed for epithelial abnormalities and histopathological grading. Results: A total of 210 (3.8%) abnormal Pap smears were found, with atypical squamous cell of undetermined significance (ASC-US) reported in 110 (52.4%) cases, atypical glandular cells of undermined significance (AGUS) in 58 (27.6%), low grade squamous intra-epithelial lesion (LSIL) in 27 (12.9%) and high grade intra-epithelial lesion (HSIL) in 13 (6.2%). Only single cases of ASC-H and squamous cell carcinoma were reported. The available biopsies showed benign findings in 70.1% of cases, low grade squamous intraepithelial lesions in 11.5% and high grade squamous intraepithelial lesions in 18.4%. Conclusions: The low epithelial cell abnormality (EPCA) prevalence illustrated in this study argues against introduction of population-based HPV testing and vaccination. It calls for a more cost-effective measures in a country with limited resources, where a more widely available Pap-smear testing might suffice., (Creative Commons Attribution License)

Bone metastases are detected at initial diagnosis of cancer in 25% of cases and bone metastases are common in the course of a majority of cancer types. The spine and proximal long bones are the most affected sites. Knowledge of the basic radiological semiology is important to make the proper diagnosis of metastasis(s) bone(s), especially in situations in which the clinical context is not suggestive of metastases (such as cases where bone metastases are inaugural or cases of peripheral solitary metastasis). Tumor aggressiveness can be assessed at the level of the cortical bone and periosteum. Lodwick criteria are useful for the diagnosis of malignancy and tumor aggressiveness at initial diagnosis on plain radiographs, which are very important in the context of bone metastases. A CT scanner is required to confirm the malignancy of a bone lesion. MRI is complementary to the scanner including for the assessment of bone marrow involvement and tumor extensions.

Objective: The aim of this study was to evaluate CT- and fluoroscopy-guided percutaneous screw fixation by radiologists in the management of acetabular roof fractures., Subjects and Methods: Fifty-two consecutive adult patients with a nondisplaced and isolated acetabular roof fracture were prospectively treated by an interventional radiologist who made a percutaneous screw fixation under CT and fluoroscopy guidance. All these procedures were performed under local anesthesia. The postoperative follow-up ranged from 36 to 48 months., Results: For each patient, two 6.5-mm Asnis III screws were inserted to fix the roof acetabular fracture. The mean procedure time was 45 minutes (range, 30-90 minutes). No complications were observed. Follow-up CT showed evidence of fracture healing. No evidence of secondary displacement, degenerative changes, or screw failure was noted. Using the rating system of D'Aubigne and Postel, all patients had excellent results., Conclusion: The results of our study showed that nondisplaced acetabular roof fractures could be successfully treated by a minimally invasive technique with an excellent long-term outcome.