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Weeds are considered one of the most serious problems limiting global agricultural production. As a result, chemical herbicides have been extensively used for weed control. However, overuse of synthetic herbicides, has resulted in public concerns over the effect of herbicides on the health of the ecosystems and humans. In the food system, innovative approaches are needed to foster sustainable practices that preserve biodiversity, conserve habitats, and mitigate climate change factors. Thus, alternatives are required to control the weeds. This study aimed to determine the impact of some wild plants’ (Citrullus colocynthis, Euphorbia retusa, Retama raetam, Artemisia monosperma, Tamarix gallica, and Artemisia judaica) allelopathic potentials (at rates of 0, 15, 25, 35, and 50 g/L) on seed germination of selected local weeds (Portulaca oleracea, Amaranthus retroflexus, and Chloris barbata) collected from different locations in Tabuk region, Saudi Arabia. GC-MS analysis was used to evaluated the main compounds in the wild plants under study. The experimental design was completely randomized block design (CRBD) with three replicates. According to the results, phytochemical screening of the wild plants using GC-MS analysis showed a wide range of phytochemicals. Amaranthus retroflexus exhibited the highest germination rate in the control group. In addition, applying 5 g/L and 20 g/L of Citrullus colocynthis extracts had no discernible effect on the rate of germination of A. retroflexus seed; however, they were able to reduce the germination rate as compared to the control. As the extract concentration of Artemisia monosperma rose to 20 g/L, the germination rate of A. retroflexus dropped. Neither 35 g L-1 nor 50 g L-1 of A. monosperma extract inhibited the germinate of A. retroflexus. The germination rate of Portulaca oleracea decreased with increasing extract concentration of C. colocynthis. The extract of C. colocynthis at 50 g/L had the lowest rate. The germination rate of Chloris barbata decreased with increasing extract concentration of C. colocynthis. The highest germination rate of C. barbata was observed in control, followed by 5g/L, while no germination was observed at 20, 35, and 50 g/L of C. colocynthis extracts. A. retroflexus’s root length shrank when the extract concentration of C. colocynthis rose. A. retroflexus’s control sample had the most extended root length, followed by 5 and 20 g/L, respectively. C. colocynthis at 35 and 50 g/L showed no root elongation as this treatment inhibited radicle protrusion. High concentration of d-Glycero-d-galacto-heptose and pentane in C. colocynthis aqueous extract may be the cause of C. colocynthis’ ability to inhibit Chloris barbata germination. The entire C. barbata plant length decreased when treated with 5 g/L of C. colocynthis extract. No growth was seen at any of the higher C. colocynthis concentrations (20, 35, and 50 g/L). The present work revealed that cultivating allelopathic crops like the selected studied wild plants from the Tabuk region has a promising future as an antagonistic species in a biological weed control program or combined with integrated weed management in agricultural food production.

Hamza A Alsayouf,1 Haitham Talo,1 Marisa L Biddappa,1 Mohammad Qasaymeh,2 Shadi Qasem,3 Emily De Los Reyes4 1Kids Neuro Clinic and Rehab Center, Dubai, United Arab Emirates; 2Pediatric Neurology, Dent Neurological Institute, Amherst, NY, USA; 3Pathology and Laboratory Medicine, University of Kentucky College of Medicine, Lexington, KY, USA; 4Pediatric Neurology, Nationwide Children’s Hospital and Ohio State University, Columbus, OH, USACorrespondence: Hamza A AlsayoufKids Neuro Clinic and Rehab Center, Dubai Healthcare City, Dubai, United Arab EmiratesTel +97 145570326Email leeamra1000@gmail.comPurpose: Autism spectrum disorder (ASD) is a debilitating neurodevelopmental disorder with high heterogeneity and no clear common cause. Several drugs, in particular risperidone and aripiprazole, are used to treat comorbid challenging behaviors in children with ASD. Treatment with risperidone and aripiprazole is currently recommended by the Food and Drug Administration (FDA) in the USA for children aged 5 and 6 years and older, respectively. Here, we investigated the use of these medications in younger patients aged 4 years and older.Patients and Methods: This retrospective case series included 18 children (mean age, 5.7 years) with ASD treated at the Kids Neuro Clinic and Rehab Center in Dubai. These patients began treatment with risperidone or aripiprazole at the age of 4 years and older, and all patients presented with comorbid challenging behaviors that warranted pharmacological intervention with either risperidone or aripiprazole.Results: All 18 children showed objective improvement in their ASD core signs and symptoms. Significant improvement was observed in 44% of the cases, and complete resolution (minimal-to-no-symptoms) was observed in 56% of the cases as per the Childhood Autism Rating Scale 2-Standard Test (CARS2-ST) and the Clinical Global Impression (CGI) scales.Conclusion: Our findings indicate that the chronic administration of antipsychotic medications with or without ADHD medications is well tolerated and efficacious in the treatment of ASD core and comorbid symptoms in younger children when combined with standard supportive therapies. This is the first report to suggest a treatment approach that may completely resolve the core signs and symptoms of ASD. While the reported outcomes indicate significant improvement to complete resolution of ASD, pharmacological intervention should continue to be considered as part of a multi-component intervention in combination with standard supportive therapies. Furthermore, the findings support the critical need for double-blind, placebo-controlled studies to validate the outcomes.Keywords: risperidone, aripiprazole, antipsychotic, comorbid challenging behaviors

Weeds are considered one of the most serious problems limiting global agricultural production. As a result, chemical herbicides have been extensively used for weed control. However, overuse of synthetic herbicides, has resulted in public concerns over the effect of herbicides on the health of the ecosystems and humans. In the food system, innovative approaches are needed to foster sustainable practices that preserve biodiversity, conserve habitats, and mitigate climate change factors. Thus, alternatives are required to control the weeds. This study aimed to determine the impact of some wild plants’ (Citrullus colocynthis, Euphorbia retusa, Retama raetam, Artemisia monosperma, Tamarix gallica, and Artemisia judaica) allelopathic potentials (at rates of 0, 15, 25, 35, and 50 g/L) on seed germination of selected local weeds (Portulaca oleracea, Amaranthus retroflexus, and Chloris barbata) collected from different locations in Tabuk region, Saudi Arabia. GC-MS analysis was used to evaluated the main compounds in the wild plants under study. The experimental design was completely randomized block design (CRBD) with three replicates. According to the results, phytochemical screening of the wild plants using GC-MS analysis showed a wide range of phytochemicals. Amaranthus retroflexus exhibited the highest germination rate in the control group. In addition, applying 5 g/ L and 20 g/L of Citrullus colocynthis extracts had no discernible effect on the rate of germination of A. retroflexus seed; however, they were able to reduce the germination rate as compared to the control. As the extract concentration of Artemisia monosperma rose to 20 g/L, the germination rate of A. retroflexus dropped. Neither 35 g L-1 nor 50 g L-1 of A. monosperma extract inhibited the germinate of A. retroflexus. The germination rate of Portulaca oleracea decreased with increasing extract concentration of C. colocynthis. The extract of C. colocynthis at 50 g/L had the lowest rate. The germination rate of Chloris barbata decreased with increasing extract concentration of C. colocynthis. The highest germination rate of C. barbata was observed in control, followed by 5g/L, while no germination was observed at 20, 35, and 50 g/L of C. colocynthis extracts. A. retroflexus’s root length shrank when the extract concentration of C. colocynthis rose. A. retroflexus’s control sample had the most extended root length, followed by 5 and 20 g/L, respectively. C. colocynthis at 35 and 50 g/L showed no root elongation as this treatment inhibited radicle protrusion. High concentration of d-Glycero-d-galacto-heptose and pentane in C. colocynthis aqueous extract may be the cause of C. colocynthis’ ability to inhibit Chloris barbata germination. The entire C. barbata plant length decreased when treated with 5 g/L of C. colocynthis extract. No growth was seen at any of the higher C. colocynthis concentrations (20, 35, and 50 g/L). The present work revealed that cultivating allelopathic crops like the selected studied wild plants from the Tabuk region has a promising future as an antagonistic species in a biological weed control program or combined with integrated weed management in agricultural food production. [ABSTRACT FROM AUTHOR]

Hepatitis means inflammation of the liver, and hepatitis B is a common and dangerous liver disease caused by the Hepatitis B Virus (HBV) of the DNA hepadnavirus family. In 2010, the World Health Organization (WHO) considered hepatitis B infection a major health problem worldwide. One way of transmitting this disease is a transmission from a carrier mother to a child. This study aimed to investigate the presence of HBV surface antigen in pregnant women referred to Kasra Al-Aini Hospital in Cairo. This study was a cross-sectional descriptive study that was performed on pregnant women. One thousand pregnant women were selected with their consent to participate in this study, and after preparing a blood sample, an Enzyme-linked Immunosorbent Assay kit, used for Hepatitis B Virus surface antigen detection, a questionnaire containing questions about socio-individual characteristics. Among 1000 samples, 13 samples were equal to 1.3% had HBsAg positive. No significant relationship was found between the prevalence of HBs Ag in the city and rural location, education, occupation, age, and history of abortion in pregnant women. History of dialysis in pregnant women, tattooing, and type of job of the pregnant woman was not considered risk factors. However, injection drug users, history of previous surgery, and blood transfusion can be considered suspicious factors (P=0.05). The prevalence of hepatitis B infection in pregnant women in Cairo was 1.3, which is lower than the study statistics in most parts of the world. However, to evaluate this amount more accurately, there is a need to conduct a study with a higher sample size. [ABSTRACT FROM AUTHOR]

Introduction Feedback from placement supervisors has shown that podiatry students are often overwhelmed and lack confidence when placed in complex clinical environments such as high risk foot clinics. Existing literature suggests that student anxiety on placement can reduce the value of learning attained. It is therefore logical that observation-only placement, in the earlier phases of learning, may assist with bridging the gap between theoretical learning and practical application. Currently, limited exists evidence to support this supposition. Methods and materials 3rd year podiatry students attended a half-day observation at a high risk foot clinic and subsequently completed an online survey following the placement to evaluate their experience. This evaluation was consistent with Levels I/II of Kirkpatrick's four levels of analysis, examining the degree to which participants found the placement relevant to their learning (Level I), and acquired the intended knowledge,and confidence (Level II). Results 88% of students agreed that they felt more confident in their clinical abilities, and 94% of students agreed that their understanding of podiatrists' scope of practice was improved following the observational placement. Conclusions Inclusion of observational placements within the pre-clinical phase of allied health degrees should be considered as they improve student confidence and can be helpful in consolidation of learning. [ABSTRACT FROM AUTHOR]

Legitimate defense is a justifiable and e xcusable factor. T h e basis fo r allo wing mu rder as a le gitimate defense can be found in the theory of human dignity and the symmetry of the right to life / the de nial of the right to life; According to this theory, Scottish law is based on stricter rules than Iranian law regar ding the admission of another murder i n the capacity of self - defense. Adopting a strong retreat rule, acc epting the defendant's only conventi onal mistake in dealing with the attack is necessary t o repel it. T he illegitimacy of murder in the def ense of property, the monopolization of the license to commit rape by a victi m of rape, and its non - extension to other sexual offenses are among t h e hallmarks of S cotland's strict approach. In contrast, the Iranian criminal legislature, by improperly removing the c ondition of appropriateness and using alternative but vague terms by observing the defense steps, adheres to other criteria of defense legitimacy, such as the current or imminent encroachment, the need for one-sided defense and the excessive defense order. Has specified. This is despite the fact that in current Scottish law, or the imminent encroachment, along with some other criteria, is considered an element of necessity in legitimate defense. Despite Scotland's stricter approach to determining the territory of self-defense, the rules of self-defense in Iranian and Scottish law lack the necessary comprehensiveness.

In the Information age, those societies will move in the path of growth and continuous development that their cycle of knowledge and innovation have boom and greater durability. In the meantime, universities and centers of higher education, as main site of generating knowledge, play an important role in growth and development of a country; though, it’s essential to study and pathology the system of generating knowledge in university and the quality of its researches continuously to be protected from probable harm. Theses are one of the most important sources of generating science in universities, if the process of compilation and evaluation goes right, we can be hopeful about universities generating science. However, this process take place in a team includes: student, supervisor professor, advisor professor, and referee professor, in some cases we see social loafing phenomena occurring in this group, so researchers put their purpose on identifying critical factors affecting social loafing and apply Exploratory mixed methods study and Qualitative content analysis in qualitative section, use survey method and structural equation modeling in quantitative section to identify effective factors on social loafing. After achieving theoretical adequacy in interviewing experts and accomplishing Qualitative content analysis for interviews, proceed to distribute the questionnaire with survey method and grouping 14 effective factors on social loafing in compiling theses of Social Science in tow category : team based (including members of the profound lack of interest, time limit of Members, inappropriate subject matter related to the lack of expertise of teachers, lack of communication within the team, conservative members, number of members, their perceptions errors) and meta-team-based factors (such as lack of teamwork in the country, the University’s policies, procedures thesis distribution, optimal lack of supervision, lack of resources provided by the university research, materialistic approach to science and unscientific behavior) have achieved.

هدفت هذه الدراسة إلى الكشف عن الغضب حالة وسمة عند طلبة جامعة اليرموك، وإلى التعرف على المتغيرات ذات العلاقة بالغضب حالة وسمة.تم تطبيق أدوات الدراسة على عينة مكونة من (1016) طالباً وطالبة من طلبة جامعة اليرموك.وقد خلصت الدراسة إلى أن الغضب كان سمة عند طلبة الجامعة، كما أوضحت النتائج وجود علاقة ارتباطية قوية بين الغضب حالة والغضب سمة حيث بلغ معامل الارتباط فيها (0.69)، كما أوضحت نتائج الدراسة أن متغيرات الدراسة المستقلة لم تكن جميعها ذات علاقة بالغضب حالة وبالغضب سمة، حيث اتضح أن متغير عادة التدخين ومتغير الحالة الصحية ومتغير المعدل التراكمي هي المتغيرات التي فسرت معظم التباين في الغضب حالة والغضب سمة، حيث فسرت جميعها (3.6%) هو من التباين في الغضب حالة، فقد فسر متغير عادة التدخين (1.6%) من التباين، وفسر متغير الحالة الصحية (1.2%) من التباين، في حين فسر متغير المعدل التراكمي (0.70%) من التباين. بينما فسرت (3.8%) من التباين في الغضب سمة، فقد فسر متغير عادة التدخين (1.7%) من التباين، وفسر متغير الحالة الصحية (1.2%) من التباين، في حين فسر متغير المعدل التراكمي (0.90%) من التباين.واستنادا إلى النتائج التي توصلت إليها الدراسة تم اقتراح بعض التوصيات منها ضرورة إقامة المحاضرات والندوات واللقاءات التي نتناول موضوعات تتعلق بمشكلة الغضب عند الطلاب وأساليب التعامل معها.

Inhibition of the kynurenine pathway of tryptophan metabolism during gestation can lead to changes in synaptic transmission, neuronal morphology and plasticity in the rat hippocampus. This suggests a role for the kynurenine pathway in early brain development, probably caused by kynurenine modulation of N-methyl-d-aspartate (NMDA) glutamate receptors which are activated by the tryptophan metabolite quinolinic acid and blocked by kynurenic acid. We have now examined samples of neocortex and cerebellum of adult animals to assess the effects of a prenatally administered kynurenine-3-monoxygenase inhibitor (Ro61-8048) on protein and mRNA expression, dendritic structure and immuno-histochemistry. No changes were seen in mRNA expression using quantitative real-time polymerase chain reaction. Changes were detected in the expression of several proteins including the GluN2A subunit, unco-ordinated-5H3 (unc5H3), doublecortin, cyclo-oxygenase, sonic hedgehog and Disrupted in schizophrenia-1 (DISC1), although no differences in immunoreactive cell numbers were observed. In the midbrain, dependence receptor expression was also changed. The numbers and lengths of individual dendritic regions were not changed but there were significant increases in the overall complexity values of apical and basal dendritic trees. The data support the hypothesis that constitutive kynurenine metabolism plays a critical role in early, embryonic brain development, although fewer effects are produced in the neocortex and cerebellum than in the hippocampus and the nature of the changes seen are qualitatively different. The significant changes in DISC1 and unc5H3 may be relevant to cerebellar dysfunction and schizophrenia respectively, in which these proteins have been previously implicated. [ABSTRACT FROM AUTHOR]

This paper presents a comprehensive framework for mission planning and execution with a heterogeneous multi-robot system, specifically designed to coordinate unmanned ground vehicles (UGVs) and unmanned aerial vehicles (UAVs) in dynamic and unstructured environments. The proposed architecture evaluates the mission requirements, allocates tasks, and optimizes resource usage based on the capabilities of the available robots. It then executes the mission utilizing a decentralized control strategy that enables the robots to adapt to environmental changes and maintain formation stability in both 2D and 3D spaces. The framework's architecture supports loose coupling between its components, enhancing system scalability and maintainability. Key features include a robust task allocation algorithm, and a dynamic formation control mechanism, using a ROS 2 communication protocol that ensures reliable information exchange among robots. The effectiveness of this framework is demonstrated through a case study involving coordinated exploration and data collection tasks, showcasing its ability to manage missions while optimizing robot collaboration. This work advances the field of heterogeneous robotic systems by providing a scalable and adaptable solution for multi-robot coordination in challenging environments.

Varicella zoster virus (VZV) is an enveloped, linear double-stranded DNA virus. It belongs to the Herpesviridae family and can manifest as primary varicella infection or secondary infection, also known as herpes zoster. Varicella pneumonia is an uncommon but potentially life-threatening complication of primary varicella infection. It mainly affects adults, and, if left untreated, the mortality rate is high. We report two cases involving adult male patients who presented with a generalized widespread vesicular rash compatible with primary varicella. Each patient had a different clinical presentation; the first patient had respiratory symptoms, while the second patient did not. Chest radiographs of both patients showed bilateral infiltrates. Treatment was initiated with the administration of intravenous acyclovir with a very good response. This report of two cases highlights the importance of early detection and prompt treatment of varicella-related complications, especially in higher-risk patients, to reduce morbidity and mortality and improve overall clinical outcomes. We also aim to reinforce the importance of immunization, which would aid in reducing the incidence of vaccine-preventable diseases such as varicella and its life-threatening complications., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Qasem et al.)

Giant cell arteritis (GCA), more common in Northern European populations, has limited data in Arabcountries. Our study reports GCA's clinical manifestations in Jordan and reviews published research on GCA across Arab nations. In this retrospective analysis, GCA patients diagnosed from January 2007 to March 2019 at a Jordanian academic medical center were included through referrals for temporal artery biopsy (TAB). A comprehensive search in PubMed, Scopus, and the DOAJ (Directory of Open Access Journals) databases was conducted to identify all relevant English-language manuscripts from Arab countries on GCA without time limitations. Among 59 diagnosed GCA patients, 41 (69.5%) were clinically diagnosed with a negative TAB, and 19 (30.5%) had a positive result. Females comprised 74.6% (n = 44) with 1:3 male-female ratio. The mean age at diagnosis was 67.3 (± 9.5) years, with most presenting within two weeks (n = 40, 67.8%). Headache was reported by 54 patients (91.5%). Elevated ESR occurred in 51 patients (78%), with a mean of 81 ± 32.2 mm/hr. All received glucocorticoids for 13.1 ± 10 months. Azathioprine, Methotrexate, and Tocilizumab usage was 15.3% (n = 9), 8.5% (n = 5), and 3.4% (n = 2), respectively. Remission was observed in 57.6% (n=34), and 40.7% (n = 24) had a chronic clinical course on treatment. Males had higher biopsy-based diagnoses (p = .008), and biopsy-diagnosed patients were older (p = .043). The literature search yielded only 20 manuscripts originating in the Arab world. The predominant study types included case reports and retrospective analyses, with only one case series and onecase-control study., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This article introduces the Social-Emotional Nurturing and Skill Enhancement System (SENSES-ASD) as an innovative method for assisting individuals with autism spectrum disorder (ASD). Leveraging deep learning technologies, specifically convolutional neural networks (CNN), our approach promotes facial emotion recognition, enhancing social interactions and communication. The methodology involves the use of the Xception CNN model trained on the FER-2013 dataset. The designed system accepts a variety of media inputs, successfully classifying and predicting seven primary emotional states. Results show that our system achieved a peak accuracy rate of 71% on the training dataset and 66% on the validation dataset. The novelty of our work lies in the intricate combination of deep learning methods specifically tailored for high-functioning autistic adults and the development of a user interface that caters to their unique cognitive and sensory sensitivities. This offers a novel perspective on utilising technological advances for ASD intervention, especially in the domain of emotion recognition., Competing Interests: Tawfik Al-Hadhrami is an Academic Editor for PeerJ., (© 2024 Abu-Nowar et al.)

Trabecular bone score (TBS) assesses trabecular microarchitecture at the lumbar spine and was shown to improve fracture risk prediction compared to bone mineral density (BMD) alone. We investigated whether lumbar degenerative changes (DC) affect TBS and TBS-adjusted 10-year fracture risk assessment (tool) (FRAX) estimates. All patients who underwent BMD and TBS measurements via dual-energy X-ray absorptiometry at our institution between 1/7/2020 and 1/10/2020 were retrospectively evaluated. We identified all patients who had DC in 1 or 2 vertebrae (out of L1-L4) with a BMD T score > 1 unit higher than the remaining 2 to 3 adjacent vertebrae. TBS and BMD were compared between the vertebrae with and without DC. Change in TBS as well as FRAX estimates for major osteoporotic (MOP) and hip fractures after exclusion of the degenerative vertebrae were also determined. Of the 356 eligible patients, 94 met the inclusion criteria. The mean TBS of vertebrae without DC was not significantly different from that of L1 to L4 (1.31 ± 0.12 vs 1.32 ± 0.12, respectively, P = .11). The FRAX estimates after exclusion of the degenerative vertebrae were statistically significantly higher than for L1 to L4 for both MOP and hip fractures (P = .04 and P = .01, respectively). However, the differences were very small. The mean 10-year MOP FRAX estimate after exclusion of degenerative vertebrae was 7.67% ± 4.50% versus 7.55% ± 4.36% for L1 to L4 and the mean 10-year hip FRAX estimate after exclusion of degenerative vertebrae was 2.06% ± 2.01% versus 2.02% ± 1.98% for L1 to L4. Lumbar DC have a statistically significant but only small effect on TBS-adjusted FRAX making it unnecessary to exclude the degenerative vertebrae when computing TBS., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Abstract: Klatskin tumor, also known as hilar cholangiocarcinoma, was clearly demonstrated in this case report by contrasting 68 Ga-FAPI and 18 F-FDG PET/CT in the same patient. This instance exemplifies a false-negative 18 F-FDG PET/CT for the main tumor site, despite positive 68 Ga-FAPI uptake at the same location., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

We present two cases of immunocompetent individuals diagnosed with nontuberculous infections of the hand caused by organisms rarely seen in the clinical setting: Mycobacterium heckeshornense and Mycobacterium chelonae. In the first case, a 50-year-old male presented with tenosynovitis of left long finger. He was subsequently found to have a Mycobacterium heckeshornense infection that was resolved with multiple surgeries and a long-term regimen of several antibiotics. The second case was a 29-year-old female with a history of a trivial hand injury infected with Mycobacterium chelonae. She was successfully treated with surgical debridement and antibiotics over the course of eight months. It is important to recognize the increasing prevalence of these two species of bacteria as human pathogens that can result in infections of the extremities even in immunocompetent individuals. (Journal of Surgical Orthopaedic Advances 32(1):055-058, 2023).

Background: Leptomeningeal failure (LMF) represents a devastating progression of disease following resection of brain metastases (BrM). We sought to identify a biomarker at time of BrM resection that predicts for LMF using mass spectrometry-based proteomic analysis of resected BrM and to translate this finding with histochemical assays., Methods: We retrospectively reviewed 39 patients with proteomic data available from resected BrM. We performed an unsupervised analysis with false discovery rate adjustment (FDR) to compare proteomic signature of BrM from patients that developed LMF versus those that did not. Based on proteomic analysis, we applied trichrome stain to a total of 55 patients who specifically underwent resection and adjuvant radiosurgery. We used competing risks regression to assess predictors of LMF., Results: Of 39 patients with proteomic data, FDR revealed type I collagen-alpha-1 (COL1A1, P  = .045) was associated with LMF. The degree of trichrome stain in each block correlated with COL1A1 expression ( β  = 1.849, P  = .001). In a cohort of 55 patients, a higher degree of trichrome staining was associated with an increased hazard of LMF in resected BrM (Hazard Ratio 1.58, 95% CI 1.11-2.26, P  = .01)., Conclusion: The degree of trichrome staining correlated with COL1A1 and portended a higher risk of LMF in patients with resected brain metastases treated with adjuvant radiosurgery. Collagen deposition and degree of fibrosis may be able to serve as a biomarker for LMF., (© The Author(s) 2023. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.)

Tissue engineering is one of the hot topics in recent research that needs special requirements. It depends on the development of scaffolds that allow tissue formation with certain characteristics, carbon nanotubes (CNTs)-collagen composite attracted the attention of the researchers with this respect. However, CNTs suffer from low water dispersibility, which hampered their utilization. Therefore, we aim to functionalize CNTs non-covalently with pyrene moiety using an appropriate hydrophilic linker derivatized from polyethylene glycol (PEG) terminated with hydroxyl or carboxyl group to disperse them in water. The functionalization of the CNTs is successfully confirmed by TEM, absorption spectroscopy, TGA, and zeta potential analysis. 3T3 cells-based engineered connective tissues (ECTs) are generated with different concentrations of the functionalized CNTs (f-CNTs). These tissues show a significant enhancement in electrical conductivity at a concentration of 0.025%, however, the cell viability is reduced by about 10 to 20%. All ECTs containing f-CNTs show a significant reduction in tissue fibrosis and matrix porosity relative to the control tissues. Taken together, the developed constructs show great potential for further in vivo studies as engineered tissue., (© 2022. The Author(s).)

Primary amyloidosis of the ureter is a rare disease that is difficult to distinguish from urothelial carcinoma. Only 50 cases of primary ureter amyloidosis have been reported since it was first described in 1937. Of these, only five cases of ureter amyloidosis with osseous metaplasia were reported. In this study, we report the clinical presentation of ureter primary amyloidosis that presented as a mass with osseous metaplasia. The aim of this study is to provide clinicians with knowledge about the clinical/radiologic manifestation that raise the suspicion of amyloidosis, bearing in mind the importance of differentiating it from other "malignant" processes., (© 2021 Published by Elsevier Inc.)

Near-fatal asthma (NFA) is a life-threatening condition that represents the most severe clinical phenotype of asthma and can progress to fatal asthma. Patients with NFA do not respond adequately to conventional medical therapy and urgent intervention is needed to provide adequate oxygenation by invasive mechanical ventilation. While mechanical ventilation is a potentially life-saving intervention, it could cause lung injury, barotrauma, and dynamic hyperinflation due to high ventilator settings resulting in hemodynamic instability. Extracorporeal membrane oxygenation (ECMO) provides full respiratory support with adequate gas exchange in patients with NFA and improves survival rate. We present a case of a young female patient who presented with NFA, and her clinical condition was worsening despite invasive positive pressure mechanical ventilation., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Manasrah et al.)

Temporal artery biopsy (TAB) is one of the diagnostic tools to confirm the diagnosis of giant cell arteritis (GCA). We aim to evaluate the clinical and technical determinants of a positive biopsy. Demographics, clinical, technical, and laboratory data of all TAB's performed between 2007 and 2019 at a single academic medical center. 107 biopsies performed for 103 patients were included; 72.9% were female, and 27.1% were male. The mean age at the time of biopsy was 67.1 ± 9.3 years. One biopsy was excluded for lack of arterial tissue content. Of the remaining 106, 19.6% were positive. The length of the biopsy and the number of arterial cross-sections were not significantly associated with its result. A positive biopsy was seen more in patients with low albumin (p = 0.010) and hypothyroidism (p = 0.017) but less in those with prior glucocorticoids treatment (p = 0.028). Predictors of a positive biopsy included male gender [OR 4.029, 95% CI (1.330-12.209), p = 0.014]; elevated ESR [OR 3.998, 95% CI (1.908-6.787), p = 0.023]; polymyalgia rheumatica (PMR) symptoms [OR 5.121, 95% CI (2.094-9.872), p = 0.001]; and advancing in age (6.5% per every additional year), [OR 1.065, 95% CI (1.005-1.130), p = 0.033]. 53.7% of the patients were eventually diagnosed with GCA; 39.2% of them were based on positive biopsy. In conclusion, old age, male gender, elevated ESR, and PMR symptoms increase the odds of positive TAB. Technical factors, such as biopsy length and the number of cross-sections, did not influence eventual biopsy results, highlighting the pivotal role of the clinical presentation of the patients in selecting patients for TAB., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Maternal Group B Streptococcus (GBS)/ Streptococcus agalactiae colonization rates vary worldwide; however, no such recent data are available from the United Arab Emirates (UAE)., Objective: The objective of this study was to determine the prevalence of GBS colonization among pregnant women attending an antenatal clinic of a hospital in Ras Al Khaimah, UAE, along with the antibiotic sensitivity pattern, the clinical profile and pregnancy (maternal and fetal) outcome., Methods: This prospective observational study routinely offered rectovaginal swab for GBS to all women attending the antenatal clinic at 35-37 weeks of pregnancy between January and December 2019. MASTASTREP kit and Vitek-2 identification system was used for culture and identification. Women with positive cultures were followed up for any maternal and neonatal complications and the use of intrapartum antibiotic prophylaxis (IAP)., Results: A total of 2295 women were included, of which 158 (6.9%) had positive cultures for GBS colonization. The carriage rate was higher in women without any risk factors for early-onset GBS disease (EOGBS) ( P < 0.01). The GBS isolates were about 97% susceptible to linezolid and vancomycin, 90% to benzyl penicillin and 95% to ampicillin. Resistance to trimethoprim/sulfamethoxazole, clindamycin, erythromycin, and levofloxacin were about 77%, 57%, 57%, and 10%, respectively. Urinary tract infection in GBS colonized women were more common in those aged ≤30 years ( P = 0.009). Fetal outcome was favorable in women receiving IAP for GBS colonization. No neonate had culture proven EOGBS., Conclusion: The prevalence of GBS colonization in pregnant women as well as the overall maternal and neonatal complications is low in Ras Al Khaimah, UAE. IAP is effective in preventing early-onset sepsis in newborn, and thus should be initiated in those with GBS colonization. The cultured GBS showed sensitivity to most antibiotics., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Saudi Journal of Medicine & Medical Sciences.)

Pulmonary malignancies are known to have high prevalence and mortality. They are associated with different paraneoplastic syndromes, especially pulmonary carcinomas, because they are more common than pulmonary sarcomas. We present a case of a 56-year-old African American male who was admitted to our institution with a three-month history of a dry cough, progressive shortness of breath, and two to three days of right arm swelling. He had extreme leukocytosis (WBC count of 106,500 cells/mm 3 ). Computed tomography (CT) scan of the thorax demonstrated an irregular, thick-walled 14-cm lung mass occupying the middle and upper hemithorax. CT-guided biopsy of the mass confirmed the diagnosis of lung sarcoma., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Al Sbihi et al.)

Background: The incidence of brain metastasis continues to increase as therapeutic strategies have improved for a number of solid tumors. The presence of brain metastasis is associated with worse prognosis but it is unclear if distinctive biomarkers can separate patients at risk for CNS related death., Methods: We executed a single institution retrospective collection of brain metastasis from patients who were diagnosed with lung, breast, and other primary tumors. The brain metastatic samples were sent for RNA sequencing, proteomic and metabolomic analysis of brain metastasis. The primary outcome was distant brain failure after definitive therapies that included craniotomy resection and radiation to surgical bed. Novel prognostic subtypes were discovered using transcriptomic data and sparse non-negative matrix factorization., Results: We discovered two molecular subtypes showing statistically significant differential prognosis irrespective of tumor subtype. The median survival time of the good and the poor prognostic subtypes were 7.89 and 42.27 months, respectively. Further integrated characterization and analysis of these two distinctive prognostic subtypes using transcriptomic, proteomic, and metabolomic molecular profiles of patients identified key pathways and metabolites. The analysis suggested that immune microenvironment landscape as well as proliferation and migration signaling pathways may be responsible to the observed survival difference., Conclusion: A multi-omics approach to characterization of brain metastasis provides an opportunity to identify clinically impactful biomarkers and associated prognostic subtypes and generate provocative integrative understanding of disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Su, Song, Qasem, O’Neill, Lee, Furdui, Pasche, Metheny-Barlow, Masters, Lo, Xing, Watabe, Miller, Tatter, Laxton, Whitlow, Chan, Soike and Ruiz.)

Marijuana is the most commonly used illicit recreational drug in the United States. Growing public support for marijuana law reform has resulted in a significant increase in its use. The harmful pulmonary consequences of chronic marijuana smoking are less researched and discussed than those of tobacco smoking. We present a case of recurrent spontaneous pneumothorax in a patient with heavy, persistent marijuana abuse who has no past medical or surgical histories and denied smoking cigarettes or other illicit substance use., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Manasrah et al.)

This is a case of a 71-year-old smoker man who presented with four days of gross hematuria, which turned to be caused by eosinophilic cystitis (EC) proven by bladder biopsy. EC is a rare clinical and pathological inflammatory condition of the bladder with an unknown exact cause. It can present with hematuria, urinary frequency, dysuria, and suprapubic pain. Sometimes, the presentation can mimic urinary tract infection (UTI) or malignancy, especially in older patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Al Sbihi et al.)

Background: Appendiceal mucinous neoplasm (AMN) with peritoneal metastasis is a rare but deadly disease with few prognostic or therapy-predictive biomarkers to guide treatment decisions. Here, we investigated the prognostic and biological attributes of gene expression-based AMN molecular subtypes., Methods: AMN specimens (n = 138) derived from a population-based subseries of patients treated at our institution with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) between 05/2000 and 05/2013 were analyzed for gene expression using a custom-designed NanoString 148-gene panel. Signed non-negative matrix factorization (sNMF) was used to define a gene signature capable of delineating robustly-classified AMN molecular subtypes. The sNMF class assignments were evaluated by topology learning, reverse-graph embedding and cross-cohort performance analysis., Results: Three molecular subtypes of AMN were discerned by the expression patterns of 17 genes with roles in cancer progression or anti-tumor immunity. Tumor subtype assignments were confirmed by topology learning. AMN subtypes were termed immune-enriched (IE), oncogene-enriched (OE) and mixed (M) as evidenced by their gene expression patterns, and exhibited significantly different post-treatment survival outcomes. Genes with specialized immune functions, including markers of T-cells, natural killer cells, B-cells, and cytolytic activity showed increased expression in the low-risk IE subtype, while genes implicated in the promotion of cancer growth and progression were more highly expressed in the high-risk OE subtype. In multivariate analysis, the subtypes demonstrated independent prediction power for post-treatment survival., Conclusions: Our findings suggest a greater role for the immune system in AMN than previously recognized. AMN subtypes may have clinical utility for predicting CRS/HIPEC treatment outcomes.

We sought to identify candidate biomarkers for early brain metastasis (BM) recurrence in patients who underwent craniotomy followed by adjuvant stereotactic radiosurgery. RNA sequencing was performed on eight resected brain metastasis tissue samples and revealed B-cell related genes to be highly expressed in patients who did not experience a distant brain failure and had prolonged overall survival. To translate the findings from RNA sequencing data, we performed immunohistochemistry to stain for B and T cell markers from formalin-fixed parffin-embedded tissue blocks on 13 patients. CD138 expressing plasma cells were identified and quantitatively assessed for each tumor sample. Patients' tumor tissues that expressed high levels of CD138 plasma cells (N = 4) had a statistically significant improvement in OS compared to low levels of CD138 (N = 9) (p = 0.01). Although these findings are preliminary, the significance of CD138 expressing plasma cells within BM specimens should be investigated in a larger cohort. Immunologic markers based on resection cavity analysis could be predictive for determining patient outcomes following cavity-directed SRS.

Ovarian cancer (OvCa) exhibits a specific predilection for metastasis to the omentum. Our earlier studies highlighted the tumour-suppressor effect of secreted protein acidic and rich in cysteine (SPARC) in OvCa through multi-faceted roles inhibiting cancer cell interactions within the peritoneal milieu. The goal of this study is to investigate the role of SPARC in OvCa interactions with omental adipocytes and its role in OvCa colonization in the omentum. We employed multi-pronged approach using primary omental adipocytes from Sparc knockout mice, genetically engineered human omental adipocytes in 3D co-cultures with OvCa cells, as well as treatment with recombinant SPARC protein. We show that SPARC suppresses multistep cascade in OvCa omental metastasis. SPARC inhibited in vivo and adipocyte-induced homing, proliferation, and invasion of OvCa cells. SPARC suppressed metabolic programming of both adipocytes and OvCa cells and exerted an inhibitory effect of adipocyte differentiation and their phenotypic switch to cancer-associated phenotype. Mechanistic studies revealed that this effect is mediated through inhibition of cEBPβ-NFkB-AP-1 transcription machinery. These findings define a novel and functionally important role of SPARC in OvCa and not only bridge the knowledge gap but highlight the need to consider SPARC protein expression in therapeutic development.

Text classification is one domain in which the naive Bayesian (NB) learning algorithm performs remarkably well. However, making further improvement in performance using ensemble-building techniques proved to be a challenge because NB is a stable algorithm. This work shows that, while an ensemble of NB classifiers achieves little or no improvement in terms of classification accuracy, an ensemble of fine-tuned NB classifiers can achieve a remarkable improvement in accuracy. We propose a fine-tuning algorithm for text classification that is both more accurate and less stable than the NB algorithm and the fine-tuning NB (FTNB) algorithm. This improvement makes it more suitable than the FTNB algorithm for building ensembles of classifiers using bagging. Our empirical experiments, using 16-benchmark text-classification data sets, show significant improvement for most data sets.

Background: Few studies have examined combined or alternating treatment algorithms in eosinophilic esophagitis., Aims: We conducted a retrospective cohort study to ascertain the efficacy and adherence to a combined and alternating treatment approach with topical corticosteroids and 2-food elimination diet for pediatric EoE., Methods: Patients were prescribed a 2-food elimination diet (milk and soy) and topical corticosteroid (fluticasone or oral viscous budesonide) for 3 months, after which the steroid was discontinued and 2-food elimination diet continued for 3 months. An EGD was performed at baseline, 3 and 6 months. Clinical, endoscopic, and histologic data were extracted from electronic medical records. Nonparametric tests assessed adherence and outcomes., Results: Twenty-nine eosinophilic esophagitis cases were included (mean age 11.5 years, 61% male). Complete adherence to combined therapy and 2-food elimination diet alone was 75 and 79%, respectively. Median eosinophil counts decreased from 51 to 2 eosinophils/hpf (p < 0.001) after combined treatment and rebounded to 31 (p = 0.07) after 2FED alone. Dysphagia improved after both the combined and 2-food elimination diet alone treatment approaches (52 vs. 11% and 10%; p = 0.001, 0.005). Nonsignificant improvements in endoscopic findings were documented across the length of follow-up., Conclusions: An initial combined treatment approach resulted in significant improvements in symptoms and histologic findings. While symptomatic improvements continued with 2-food elimination diet alone, the histologic improvement was not maintained. While loss to follow-up may obscure the efficacy of 2-food elimination diet alone, a combined/alternating treatment approach merits assessment in a larger prospective study.

Background: Treatment options are limited for large, unresectable brain metastases., Objective: To report a single institution series of staged stereotactic radiosurgery (SRS) that allows for tumor response between treatments in order to optimize the therapeutic ratio., Methods: Patients were treated with staged SRS separated by 1 mo with a median dose at first SRS of 15 Gy (range 10-21 Gy) and a median dose at second SRS of 14 Gy (range 10-18 Gy). Overall survival was evaluated using the Kaplan-Meier method. Cumulative incidences were estimated for neurological death, radiation necrosis, local failure (marginal or central), and distant brain failure. Absolute cumulative dose-volume histogram was created for each treated lesion. Logistic regression and competing risks regression were performed for each discrete dose received by a certain volume., Results: Thirty-three patients with 39 lesions were treated with staged radiosurgery. Overall survival at 6 and 12 mo was 65.0% and 60.0%, respectively. Cumulative incidence of local failure at 6 and 12 mo was 3.2% and 13.3%, respectively. Of the patients who received staged therapy, 4 of 33 experienced local failure. Radiation necrosis was seen in 4 of 39 lesions. Two of 33 patients experienced a Radiation Therapy Oncology Group toxicity grade > 2 (2 patients had grade 4 toxicities). Dosimetric analysis revealed that dose (Gy) received by volume of brain (ie, VDose(Gy)) was associated with radiation necrosis, including the range V44.5Gy to V87.8Gy., Conclusion: Staged radiosurgery is a safe and effective option for large, unresectable brain metastases. Prospective studies are required to validate the findings in this study.

OBJECTIVE There are a variety of salvage options available for patients with brain metastases who experience local failure after stereotactic radiosurgery (SRS). These options include resection, whole-brain radiation therapy, laser thermoablation, and repeat SRS. There is little data on the safety and efficacy of repeat SRS following local failure of a prior radiosurgical procedure. This study evaluates the clinical outcomes and dosimetric characteristics of patients who experienced tumor recurrence and were subsequently treated with repeat SRS. METHODS Between 2002 and 2015, 32 patients were treated with repeat SRS for local recurrence of ≥ 1 brain metastasis following initial SRS treatment. The Kaplan-Meier method was used to estimate time-to-event outcomes including overall survival (OS), local failure, and radiation necrosis. Cox proportional hazards analysis was performed for predictor variables of interest for each outcome. Composite dose-volume histograms were constructed for each reirradiated lesion, and these were then used to develop a predictive dosimetric model for radiation necrosis. RESULTS Forty-six lesions in 32 patients were re-treated with a second course of SRS after local failure. A median dose of 20 Gy (range 14-22 Gy) was delivered to the tumor margin at the time of repeat SRS. Local control at 1 year was 79% (95% CI 67%-94%). Estimated 1-year OS was 70% (95% CI 55%-88%). Twelve patients had died at the most recent follow-up, with 8/12 patients experiencing neurological death (as described in Patchell et al.). Eleven of 46 (24%) lesions in 11 separate patients treated with repeat SRS were associated with symptomatic radiation necrosis. Freedom from radiation necrosis at 1 year was 71% (95% CI 57%-88%). Analysis of dosimetric data revealed that the volume of a lesion receiving 40 Gy (V 40Gy ) was the most predictive factor for the development of radiation necrosis (p = 0.003). The following V 40Gy thresholds were associated with 10%, 20%, and 50% probabilities of radiation necrosis, respectively: 0.28 cm 3 (95% CI 3%-28%), 0.76 cm 3 (95% CI 9%-39%), 1.60 cm 3 (95% CI 26%-74%). CONCLUSIONS Repeat SRS appears to be an effective salvage option for patients with brain metastases experiencing local failure following initial SRS treatment. This series demonstrates durable local control and, although rates of radiation necrosis are significant, repeat SRS may be indicated for select cases of local disease recurrence. Because the V 40Gy is predictive of radiation necrosis, limiting this value during treatment planning may allow for a reduction in radiation necrosis rates.

Breast cancer is the most common cancer in women and the second leading cause of cancer deaths in women. Over 90% of breast cancer deaths are attributable to metastasis. Our lab has recently reported that AKT activates heat shock factor 1 (HSF1), leading to epithelial-to-mesenchymal transition in HER2-positive breast cancer. However, it is unknown whether the AKT-HSF1 pathway plays an important role in other breast cancer subtypes, breast cancer stem cells, or breast cancer growth and metastasis. Herein, we showed AKT and HSF1 to be frequently co-activated in breast cancer cell lines and specimens across different subtypes. Activated AKT (S473) and HSF1 (S326) are strongly associated with shortened time to metastasis. Inhibition of the AKT-HSF1 signaling axis using small molecule inhibitors, HSF1 knockdown or the dominant-negative HSF1 mutant (S326A) reduced the growth of metastatic breast cancer cells and breast cancer stem cells. The combination of small molecule inhibitors targeting AKT (MK-2206) and HSF1 (KRIBB11) resulted in synergistic killing of breast cancer cells and breast cancer stem cells across different molecular subtypes. Using an orthotopic xenograft mouse model, we found that combined targeting of AKT and HSF1 to significantly reduce tumor growth, induce tumor apoptosis, delay time to metastasis, and prolong host survival. Taken together, our results indicate AKT-HSF1 signaling mediates breast cancer stem cells self-renewal, tumor growth and metastasis, and that dual targeting of AKT and HSF1 resulted in synergistic suppression of breast cancer progression thereby supporting future testing of AKT-HSF1 combination therapy for breast cancer patients., Competing Interests: CONFLICTS OF INTEREST The authors have no conflicts of interest to declare.

Background: Brain metastases from gynecologic primary cancers are rare events, but they can be a cause of morbidity and mortality when they occur., Methods: This is a single institution retrospective study on patients with brain metastases from gynecologic primary cancer who received Gamma Knife stereotactic radiosurgery (SRS). Between 2000 and 2013, a total of 33 patients with brain metastases from gynecologic primary including cervical (n=2), endometrial (n=6) and ovarian cancers (n=25) were treated with SRS at our institution. Electronic medical records were reviewed to determine survival, patterns of failure and cause of death., Results: Overall survival at 1, 2 and 5 years for the entire population was 47.1%, 21.7%, and 14.5%, respectively. There was no difference in survival between the primary cancers (log-rank p = 0.33). 36.4% patients died of neurologic death. Local failure at 1 and 2 years for the entire population was 10.4% and 14.3%, respectively. There was no difference in local failure between the primary cancers. Distant brain failure at 1, 2 and 5 years for the entire population was 20.6%, 27.7%, and 31.3%, respectively. On multivariate Cox Proportional Hazards analysis, age was the only predictor of overall survival (HR = 1.03, p = 0.01). Ovarian cancer patients had decreased risk of distant brain failure (HR = 0.17, p=0.005), whereas cervical cancer patients had an increased risk of distant brain failure (HR = 35.7, p = 0.001)., Conclusions: SRS represents a feasible treatment option for patients with brain metastases from gynecologic cancer. Younger age is a positive prognostic factor. Ovarian cancer patients have lower risk of distant brain failure.

Breast cancer (BC) results in ~40,000 deaths each year in the United States and even among survivors treatment of the disease may have devastating consequences, including increased risk for heart disease and cognitive impairment resulting from the toxic effects of chemotherapy. Aptamer-mediated drug delivery can contribute to improved treatment outcomes through the selective delivery of chemotherapy to BC cells, provided suitable cancer-specific antigens can be identified. We report here the use of capillary electrophoresis in conjunction with next generation sequencing to develop the first vitronectin (VN) binding aptamer (VBA-01; Kd 405 nmol/l, the first aptamer to vitronectin (VN; K d = 405 nmol/l) , a protein that plays an important role in wound healing and that is present at elevated levels in BC tissue and in the blood of BC patients relative to the corresponding nonmalignant tissues. We used VBA-01 to develop DVBA-01, a dimeric aptamer complex, and conjugated doxorubicin (Dox) to DVBA-01 (7:1 ratio) using pH-sensitive, covalent linkages. Dox conjugation enhanced the thermal stability of the complex (60.2 versus 46.5 ° C) and did not decrease affinity for the VN target. The resulting DVBA-01-Dox complex displayed increased cytotoxicity to MDA-MB-231 BC cells that were cultured on plasticware coated with VN (1.8 × 10 -6 mol/l) relative to uncoated plates (2.4 × 10 -6 mol/l), or plates coated with the related protein fibronectin (2.1 × 10 -6 mol/l). The VBA-01 aptamer was evaluated for binding to human BC tissue using immunohistochemistry and displayed tissue specific binding and apparent association with BC cells. In contrast, a monoclonal antibody that preferentially binds to multimeric VN primarily stained extracellular matrix and vessel walls of BC tissue. Our results indicate a strong potential for using VN-targeting aptamers to improve drug delivery to treat BC.