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Hana Qasim,1,2 Alaa Rahhal,3 Ahmed Husain,4 Abdelkarim Alammora,5 Khaled Alsa’ed,5 Ahmed Abdelghafar Masaad Alsayed,5 Baha Faiyoumi,5 Leen Maen AbuAfifeh,5 Mohammad Abu-Tineh,1 Awni Alshurafa,1 Mohamed A Yassin1 1Hematology-Oncology Department, National Centre for Cancer Care & Research, Doha, Qatar; 2Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO, USA; 3MSc Pharmacy Department, Hamad Medical Corporation, Doha, Qatar; 4Infectious Disease Department, Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar; 5Internal Medicine Department, Hamad Medical Corporation, Doha, QatarCorrespondence: Hana Qasim; Khaled Alsa’ed, Email Hanaa.qasem1@gmail.com; KAlsaed@hamad.qaBackground: Immune thrombocytopenia (ITP) is a blood disorder in which antibodies coating platelets cause platelet destruction in the spleen with a resultant low platelet count and an increased tendency for bleeding. Coronavirus disease 2019 (COVID-19) is an illness caused by SARS-CoV-2. Though pneumonia and respiratory failure are major causes of morbidity and mortality, multisystemic complications were identified, including hematological ones. Several ITP relapse cases post-mRNA SARS-CoV-2 vaccines have been reported, and different pathophysiological theories have been proposed.Purpose: The objective of this study is to identify the causal relationship between mRNA COVID-19 vaccines and ITP relapse, to highlight the longer-term effect of these vaccines on the platelet count more than 6 months after receiving the vaccine, and to identify if there is a statistical difference between Comirnaty and Spikevax vaccines on ITP relapse rate.Patients and Methods: In this retrospective study, 67 patients with known ITP were followed before and after receiving the mRNA COVID-19 vaccine. The follow-up parameters included platelet counts when available and bleeding symptoms. All patients were adults over 18 years old, with no other identified causes of thrombocytopenia. Forty-seven patients received the Comirnaty vaccine, and 20 patients received the Spikevax vaccine.Results: Data analysis showed 6% ITP relapse in the first 3 months, and a 10% relapse rate 3– 6 months after receiving one of the mRNA COVID-19 vaccines, with no statically significant difference between the two vaccines.Conclusion: mRNA COVID-19 vaccines increase the risk of ITP relapse and can lead to a prolonged reduction in platelet count in a proportion of ITP patients, with no statistically significant difference between Comirnaty and Spikevax vaccines.Keywords: ITP, vaccine, relapse, COVID-19

Fateen Ata,1 Alaa Rahhal,2 Lujain Malkawi,3 Phool Iqbal,4 Ibrahim Khamees,5 Mousa Alhiyari,5 Zohaib Yousaf,6 Hana Qasim,7 Awni Alshurafa,8 Sundus Sardar,9 Saad Javed,10 Liam Fernyhough,8,11 Mohamed Yassin8 1Department of Endocrinology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; 2Department of Clinical Pharmacy, Hamad Medical Corporation, Doha, Qatar; 3Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 4Department of Internal Medicine, Metropolitan Hospital, New York, NY, USA; 5Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; 6Department of Internal Medicine, Reading Hospital - Tower Health, West Reading, PA, USA; 7Department of Internal Medicine, UMKC School of medicine, Kansas, MO, USA; 8Department of Medical Oncology /Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; 9Department of Medicine, Division of Nephrology, Pennsylvania State University College of Medicine, Hershey Medical Center, Hershey, PA, USA; 10Department of Internal Medicine, Icahn school of medicine at Mount Sinai/Queens Hospital Center, New York, NY, USA; 11Department of Medical Education, Weill Cornell Medicine – Qatar, Doha, QatarCorrespondence: Fateen Ata, Department of Endocrinology, Hamad general hospital, Doha, Qatar, Po Box 3050, Tel +974 6655176, Email docfateenata@gmail.com; FAta@hamad.qa Mohamed Yassin, Department of Medical Oncology /Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar, Tel +974 5503739, Email Yassinmoha@gmail.comAbstract: Sickle cell disease (SCD) is a genetic disease influenced by ethnicity and regional differences in its clinical course. Recent advances in the management of SCD with newer therapies are being introduced to the Western population. However, many of these treatments are yet to be used in the Arabic SCD population. Understanding the genetic variations of SCD regionally is essential to anticipate the utilization of new treatments. This systematic review’s main objective is to pool the available data on the genetic composition of SCD in the Arabic population. Data for 44,034 patients was extracted from 184 studies (11 case reports, 8 case series, 56 retrospectives, 107 prospective observational studies, and 2 clinical trials) using PubMed, Scopus, and Google Scholar. Male (49%) and female (51%) patients were equally reported wherever gender was available (N=13105). Various SCD genotypes were reported in a total of 14,257 patients, including Hb SS (77%) Hb Sβ 0 (9.9%), and Hb Sβ+ (7.2%), while the rest of the genotypes, including HbSC, HbSD, HbSE, HbSO Arab, Hb S/α-Thal, Hb Sβ 0 + α-Thal, and HBS Oman were individually reported in < 4% of the cases. Major SCD complications in the Arab population included pain crises (48.25%) followed by neurological complications (33.46%), hepatobiliary complications (25.53%), musculoskeletal complications (24.73%), and hemolytic anemia (23.57%). The treatments reported for SCD included hydroxyurea (20%), blood transfusion (14.32%), and Deferasirox (3.03%). We did not find the use of stem cell transplantation or newer treatments such as L-Glutamine, Voxelotor, Crizanlizumab, or gene therapy reported in any of the studies included in our review. This review highlights the genetic makeup of SCD in Arab countries and its common phenotypic manifestations and will help direct further research on SCD in this region, especially concerning genetic therapy.Systematic Review Registration: The protocol has been registered in the International Prospective Register of Systematic Reviews(PROSPERO):CRD42020218,666. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=218666.Keywords: sickle cell disease, genotypes, SCD, sickle cell anemia, Arab

La transformation numérique dans le secteur de la construction, axée sur le BIM, suscite un intérêt croissant pour la maintenance des bâtiments. Notre recherche vise à développer et valider une méthode de maintenance prévisionnelle basée sur un jumeau numérique du bâtiment, mettant l’accent sur les équipements énergétiques. Notre méthodologie comprend la création d’une ontologie pour organiser les données et leur intégration à l’aide d’une base de données orientée graphe (GDB). Cette approche améliore l’interopérabilité BIM grâce aux Linked Data et au développement des outils de maintenance prévisionnelle des installations énergétiques, incluant la détection et le diagnostic des anomalies (FDD). Une série de questions de maintenance a été identifiée pour valider l’approche, démontrant la capacité de l’ontologie à répondre à des questions complexes liées à la maintenance. Bien que la recherche présente des limites, notamment dans l’évaluation complète de l’efficacité de l’ontologie, l’implémentation de la GDB et les perspectives des méthodes de FDD laissent entrevoir des avancées prometteuses pour l’amélioration des processus de maintenance et d’exploitation des bâtiments.

Sustained low-efficiency dialysis (SLED) is usually performed over 6–12 h among hemodynamically unstable patients. Conduction of 4-h SLED may spare time and manpower during hospitalization. Therefore, we conducted a retrospective observational study to explore the appropriateness and clinical outcomes of 4-h SLED among critically ill patients admitted to our center from 1/06/2016 to 1/06/2020. Renal parameters including blood urea nitrogen, serum creatinine, sodium, phosphorus, potassium, and bicarbonate were determined on the day of dialysis before SLED and within 24 h after SLED, and clinical outcomes including, acute kidney injury (AKI) recovery, in-hospital mortality, 30-day mortality, 180-day mortality, and re-admission with AKI, were evaluated. Of the 304 patients included, 69.4% were male. The majority of patients were from the Middle East (65.8%), followed by 28.6% from Asia. Four-hour SLED resulted in a significant improvement in the renal parameters. Recovery from AKI was observed in 25.4%, in-hospital mortality rate was 48.7%, while the 30- and 180-day mortality outcomes were 3.2 and 9.6%, respectively, and re-admission with AKI was observed in 16.9%. Our findings suggest that 4-h SLED significantly improved renal parameters and was associated with favorable clinical outcomes in terms of survival and AKI recovery, suggesting possible utilization of SLED shorter than 6 h in the acute settings to preserve time and manpower for procedures.

Dans l’écosystème numérique de la construction, comprenant les croisement disciplinaires et technologiques du Building Information Management (BIM), cet article propose une analyse des requêtes d’information effectuées, afin de mener à bien trois missions d’évaluation d’un projet: l’estimation du coût de la construction, la planification 5D du chantier et l’estimation du coût du fonctionnement du bâtiment. Notre recherche s’appuie sur un cadre expérimental d’un projet collaboratif, mené en BIM, trois années consécutives de 2019 à 2021. Les résultats de l’enquête menée sont exposés et ils permettent de spécifier les requêtes d’information, dans le cadre de collaborations BIM, là où la gestion de l’information est au coeur des problématiques actuelles.

Suite à la mise en place de trois expériences et observations en laboratoire, nous tentons de déterminer le type, la fonction et la valeur ajoutée des annotations numériques, dans la résolution d’un problème sur chantier. Dans cet article, nous explorons la problématique des annotations numériques en phase d’éxecution. Nous décrivons la méthodologie de mise en place des expériences d’annotations (condition papier, condition numérique 2D et condition numérique 3D). Enfin, nous présentons des résultats et conclusions intéressantes pour la spécification d’un outil de revue de projet, dédicacé au chantier.

Cell-based therapies face challenges, including poor cell survival, immune rejection, and integration into pathologic tissue. We conducted an open-label phase 1/2a clinical trial to assess the safety and preliminary efficacy of a subretinal implant consisting of a polarized monolayer of allogeneic human embryonic stem cell-derived retinal pigmented epithelium (RPE) cells in subjects with geographic atrophy (GA) secondary to dry age-related macular degeneration. Postmortem histology from one subject with very advanced disease shows the presence of donor RPE cells 2 years after implantation by immunoreactivity for RPE65 and donor-specific human leukocyte antigen (HLA) class I molecules. Markers of RPE cell polarity and phagocytosis suggest donor RPE function. Further histologic examination demonstrated CD34+ structures beneath the implant and CD4+, CD68+, and FoxP3+ cells in the tissue. Despite significant donor-host HLA mismatch, no clinical signs of retinitis, vitreitis, vasculitis, choroiditis, or serologic immune response were detected in the deceased subject or any other subject in the study. Subretinally implanted, HLA-mismatched donor RPE cells survive, express functional markers, and do not elicit clinically detectable intraocular inflammation or serologic immune responses even without long-term immunosuppression.

PURPOSE: To report 1-year follow-up of a phase 1/2a clinical trial testing a composite subretinal implant having polarized human embryonic stem cell (hESC)-derived retinal pigment epithelium (RPE) cells on an ultrathin parylene substrate in subjects with advanced non-neovascular age-related macular degeneration (NNAMD). METHODS: The phase 1/2a clinical trial included 16 subjects in two cohorts. The main endpoint was safety assessed at 365 days using ophthalmic and systemic exams. Pseudophakic subjects with geographic atrophy (GA) and severe vision loss were eligible. Low-dose tacrolimus immunosuppression was utilized for 68 days in the peri-implantation period. The implant was delivered to the worst seeing eye with a custom subretinal insertion device in an outpatient setting. A data safety monitoring committee reviewed all results. RESULTS: The treated eyes of all subjects were legally blind with a baseline best-corrected visual acuity (BCVA) of ≤ 20/200. There were no unexpected serious adverse events. Four subjects in cohort 1 had serious ocular adverse events, including retinal hemorrhage, edema, focal retinal detachment, or RPE detachment, which was mitigated in cohort 2 using improved hemostasis during surgery. Although this study was not powered to assess efficacy, treated eyes from four subjects showed an increased BCVA of >5 letters (6-13 letters). A larger proportion of treated eyes experienced a >5-letter gain when compared with the untreated eye (27% vs. 7%; P = not significant) and a larger proportion of nonimplanted eyes demonstrated a >5-letter loss (47% vs. 33%; P = not significant). CONCLUSIONS: Outpatient delivery of the implant can be performed routinely. At 1 year, the implant is safe and well tolerated in subjects with advanced dry AMD. TRANSLATIONAL RELEVANCE: This work describes the first clinical trial, to our knowledge, of a novel implant for advanced dry AMD.