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Case presentation: A 21-year-old woman with a history of eczema presented to the emergency department with a painful rash over the previous three days spreading from her left axilla to herleft arm, left chest and left abdominal wall. The rash consisted of clusters of small, erythematous vesicles on hyperpigmented patches of skin. The patient was treated empirically with intravenous cyclovir for eczema herpeticum with improvement. Polymerase chain reaction testing of the fluid obtained from the rash vesicles later confirmed the presence of herpes simplex virus-1.Discussion: Eczema herpeticum is a cutaneous superinfection with herpes simplex virus on pre- existing sites of eczema. Left untreated, it can have a mortality rate over 50%. Early identification and treatment of this high morbidity condition with antiviral agents is key to improving outcome.

Effects from aging in single cells are heterogenous, whereas at the organ- and tissue-levels aging phenotypes tend to appear as stereotypical changes. The mammary epithelium is a bilayer of two major phenotypically and functionally distinct cell lineages: luminal epithelial and myoepithelial cells. Mammary luminal epithelia exhibit substantial stereotypical changes with age that merit attention because these cells are the putative cells-of-origin for breast cancers. We hypothesize that effects from aging that impinge upon maintenance of lineage fidelity increase susceptibility to cancer initiation. We generated and analyzed transcriptomes from primary luminal epithelial and myoepithelial cells from younger 55 y women. In addition to age-dependent directional changes in gene expression, we observed increased transcriptional variance with age that contributed to genome-wide loss of lineage fidelity. Age-dependent variant responses were common to both lineages, whereas directional changes were almost exclusively detected in luminal epithelia and involved altered regulation of chromatin and genome organizers such as SATB1. Epithelial expression variance of gap junction protein GJB6 increased with age, and modulation of GJB6 expression in heterochronous co-cultures revealed that it provided a communication conduit from myoepithelial cells that drove directional change in luminal cells. Age-dependent luminal transcriptomes comprised a prominent signal that could be detected in bulk tissue during aging and transition into cancers. A machine learning classifier based on luminal-specific aging distinguished normal from cancer tissue and was highly predictive of breast cancer subtype. We speculate that luminal epithelia are the ultimate site of integration of the variant responses to aging in their surrounding tissue, and that their emergent phenotype both endows cells with the ability to become cancer-cells-of-origin and represents a biosensor that presages cancer susceptibility.

Abstract The application of polymer flooding is challenging in harsh temperature and salinity conditions in Middle-Eastern carbonate reservoirs, as they can deteriorate the commonly used polymers such as Hydrolyzed Polyacrylamide (HPAM). One solution to this issue is the use of newly developed Acrylamido-Tertiary-Butyl Sulfonate (ATBS) based polymers, which can endure adverse temperature and salinity conditions. However, they also tend to adsorb onto carbonate rocks with positive surface charge. This study aims to tackle the problem of high polymer retention by employing low-salinity polymer flooding. For that coreflooding experiments were conducted on an ATBS-based polymer in salinities ranging from 400 to 167,000 ppm using fully water-saturated cores and cores at residual oil saturation (Sor). The single-phase retention experiments determined polymer retention values of around 25 µg/g-rock when using diluted brines, which is about half of the retention values (47–56 µg/g-rock) observed with high salinity seawater (43,000 ppm) and formation water (167,000 ppm). Furthermore, the retention of the ATBS-based polymer was further reduced by 50% in the presence of oil compared to the experiments conducted in the absence of oil. The results demonstrated that an optimal salinity threshold of 10,000 ppm and lower yields significant improvements in the efficiency of polymer flooding.

The Arab American community has faced a history of racialization dating back to the late 19th century. The events of 9/11 and the heightened rhetoric of hate during the Trump presidency encouraged anti-Muslim sentiment and increased racial profiling and harassment. This community-based participatory research (CBPR) project uses Photovoice as a methodology to better understand the lived experiences and narratives of Arab Americans in the post-Trump1 era and as a tool for advocacy. The findings from the photo sharing sessions underscore the continued challenge of identity and representation, (in)visibility, and pushing back against anti-Arab/Muslim racism. The findings also highlight religion as a protective factor against structural and systemic racism. Overall, the participants in this study demonstrated their community resilience and navigational capital as they survived and thrived amid racializing experiences and microaggressions. Implications of this work include the need for increased consciousness raising about the lived experiences of the Arab American community and opportunities for allyship and advocacy.

This study aimed to identify the effect of different head positions on hand grip strength (HGS) on account of hand dominance, age, and sex in dentists. A total of 197 dental students (DS) and practitioners (DP) (81 females and 50 males were DS, 10 females and 14 males were (DP) aged 19-63 participated. HGS was measured using a dynamometer, and the head angle was determined with an inclinometer. HGS on both sides was greatest in NHP & displayed least strength in HEP. There was a significant difference in HGS measured in NHP, HFP, and HEP (p < 0.05) for the dominant hand, while the non-dominant hand showed no significant difference (p > 0.05) for female DS. A significant difference was recorded between dominant and non-dominant HGS in each head position (p < 0.05). Significant differences were also found between female and male DP HGS (p < 0.05) and DS (p < 0.05), particularly at HFP and HEP. There was a significant difference noted between female DS and DP HGS, however, HGS for both dominant and non-dominant hands in DP was higher than DS in HEP (p < 0.05), while no significant difference noted for HFP and NHP. Females had the strongest grip in NHP, while males in HFP. HGS influenced by age; DP had stronger grip than DS. In a comparison between male and female DP and DS, males had stronger grip than females across all positions. Hand dominance significantly influences HGS, with the dominant having a stronger hand grip.

This study aimed to investigate the level of metacognitive awareness of STEAM education among primary stage teachers in Jordan. It also aimed to identify the impact of school type, experience, and specialization on the level of Metacognitive awareness. Via purposive sampling, 370 science, computer science, social science and humanities, and mathematics teachers were selected, who already know about the STEAM approach, from public and private schools in Amman and Madaba Governorates. The researcher developed a five-point Likert-type scale to measure metacognitive awareness among primary school teachers about the STEAM approach. The researcher verified the content validity by presenting the instrument to a group of experts in curricula and teaching methods to determine the extent of the clarity and comprehensiveness of the items. The researcher applied the questionnaire to a pilot of 30 from outside the sample to calculate the constructive validity and reliability. The results of the application showed constructive validity ranging between (0.65 and 0.82). The researcher concluded that the level of metacognitive awareness among teachers with 3 years and more experience who work in the private sector is higher than those who work in the public sector. The results also showed no significant difference in the level attributed to the specialization variable. The researcher recommends that the Ministry of Education should prepare a successful education reform process in addition to adopting a unified reform plan with clear educational goals and outcomes.

Tissues comprise ordered arrangements of cells that can be surprisingly disordered in their details. How the properties of single cells and their microenvironment contribute to the balance between order and disorder at the tissue-scale remains poorly understood. Here, we address this question using the self-organization of human mammary organoids as a model. We find that organoids behave like a dynamic structural ensemble at the steady state. We apply a maximum entropy formalism to derive the ensemble distribution from three measurable parameters - the degeneracy of structural states, interfacial energy, and tissue activity (the energy associated with positional fluctuations). We link these parameters with the molecular and microenvironmental factors that control them to precisely engineer the ensemble across multiple conditions. Our analysis reveals that the entropy associated with structural degeneracy sets a theoretical limit to tissue order and provides new insight for tissue engineering, development, and our understanding of disease progression.

Background: Thyroid cancer, the most common endocrine neoplasm, has a strong female predominance. There has been a steady increase in the incidence of thyroid cancer worldwide. This study aimed to investigate the prevalence of thyroid cancer and identify its predominant histological subtypes in the Aljuf region of Saudi Arabia. The study findings and new data obtained will contribute to advancing knowledge about thyroid cancer at the national level. Methods and Results: This retrospective, cross-sectional descriptive study was conducted in Sakaka, Aljouf region, Saudi Arabia. Data from thyroid specimens collected at King Abdul-Aziz Specialist Hospital and Prince Mutaib Hospital between January and December 2022 was analyzed. Among 3102 histopathological samples and 298 cytology samples received in both hospitals, 181 were thyroid specimens: histopathology samples [63(34.8%)] and fine-needle aspiration (FNA) samples for cytological diagnosis [118 (65.2%)]. The age of patients with thyroid disorders ranged from 17 to 69, with a mean age of 38.4 ± (SD)1.2 years. The highest percentage, 76(42%), were in the age group over 40. The majority of patients with thyroid disorders, 139 (76.8%), were women compared to 42(23.2%) men, giving a female-to-male ratio of 3.3: 1. 165(91.2%) of the study population were Saudi patients, while the non-Saudis represented only 16(8.8%) cases. Among 181 thyroid specimens, thyroid cancer was diagnosed in 33 patients (18.2%), benign tumors in 43 patients (23.8%) [follicular adenoma 39 (90.7%) and Hürthle cell adenoma 4 (9.3%)], goiter in 96 (53.0% cases), Hashimoto's thyroiditis in 6 cases (3.3%), and chronic lymphocytic thyroiditis in 3 cases (1.7%). The age of patients with thyroid cancer ranged from 20 to 57 years, with a mean age of 36.9 years. There were 25 (75.8%) females versus 8 (24.2%) males, with a ratio of 3.1:1. Papillary thyroid carcinoma was the most frequent histological subtype among patients with thyroid cancer, accounting for 75.8%, while follicular thyroid carcinoma represented 24.2%. Among 155 cancer cases, thyroid cancer ranked third (21.3%) after breast cancer (26.4%) and colon adenocarcinoma (23.9%). Conclusion: Thyroid pathology, including cancer, is notably prevalent among females and older age groups in the Al-Jouf region. Thyroid carcinoma is the third most diagnosed cancer type after breast carcinoma and colon adenocarcinoma in Al-Jouf in 2022. Papillary thyroid carcinoma is the most frequent histological subtype among Saudi patients with thyroid cancer.

Background This study aimed to examine the prevalence of burnout, determine burnout-related factors, investigate resilience levels, and assess the relationship between burnout and resilience among physical therapy (PT) students at King Saud University (KSU) in Saudi Arabia. Material and Methods This cross-sectional study involved 153 PT students studying at KSU between January and March 2023. The participants completed an online questionnaire, a Maslach Burnout Inventory , and a Brief Resilience Scale . Results Low-to-moderate levels of Emotional Exhaustion (EE) were observed in 85% of the participants and high Depersonalization (DP) levels were reported by 34.2%. Female participants reported higher levels of EE and DP, whereas males had a greater prevalence of low Personal Achievement (PA) levels. Approximately 6.5% of the study participants reported high burnout levels (a combination of high DP, high EE, and low PA). Academic stress, followed by sleeping difficulties and changes in the academic year structure, were the most important factors contributing to higher levels of burnout (75.2%, 56.9%, and 43.8%, respectively). Most study participants around (66.0%) reported normal resilience levels. A significant correlation was detected between resilience and 2 domains of burnout (DP and PA), with the correlation being negative and weak for DP and positive and moderate for PA. Conclusions Overall, low-to-moderate levels of burnout were observed among the PT students who took part. Related factors that contributed to burnout were academic stress, sleeping difficulties, and academic year structure. A normal level of resilience was found to be significantly related to DP and PA but not to EE on the burnout subscales. Higher levels of resilience can be considered to play a protective role against burnout among PT students. Med Pr Work Health Saf. 2024;75(4):343–354

Background: Considering the high prevalence of UI in the rural areas of Jordan and the limited clinical data on its occurrence in central Jordan, this study aims to investigate the prevalence, risk factors, and impact of urinary incontinence (UI) on the quality of life (QoL) of women in central Jordan. Method: This cross-sectional study was conducted from September to December 2022, using online the Incontinence Impact Questionnaire short form (IIQ-7) and Urogenital Distress Inventory short form (UDI-6). Participation was voluntary, and anonymous. Internal consistency was assessed using Cronbach’s α. Results: A total of 128 women participated in the study. More than half of the participants (54.33%, N = 69) experienced UI symptoms. Body mass index was the sole statistically significant factor linked to UI. Obese patients had the highest risk (OR 35, CI 95% 2.577–475.308, p < 0.05) compared to those with a healthy weight. Multivariate regression indicated significant associations of severe UI with smoking and vaginal births with a moderate impact of UI on QoL. Conclusions: The study’s findings emphasize the need for women’s health centers in the center of Jordan to develop comprehensive UI prevention and management programs to improve women’s health and well-being.

Case presentation: A 21-year-old woman with a history of eczema presented to the emergency department with a painful rash over the previous three days spreading from her left axilla to her left arm, left chest and left abdominal wall. The rash consisted of clusters of small, erythematous vesicles on hyperpigmented patches of skin. The patient was treated empirically with intravenous acyclovir for eczema herpeticum with improvement. Polymerase chain reaction testing of the fluid obtained from the rash vesicles later confirmed the presence of herpes simplex virus-1. Discussion: Eczema herpeticum is a cutaneous superinfection with herpes simplex virus on pre-existing sites of eczema. Left untreated, it can have a mortality rate over 50%. Early identification and treatment of this high morbidity condition with antiviral agents is key to improving outcome.

Objective: Multisystem inflammatory syndrome of childhood (MIS-C) is a newly recognized entity associated with COVID-19 in children. The objective was to describe the clinical course for 74 patients diagnosed with this disease. Methods: A multicenter retrospective study including 5 major hospitals in Jordan was conducted. Data from children admitted with confirmed SARS-CoV-2 infection or were in close contact with confirmed cases were collected. Total of 74 patients were diagnosed with MIS-C. Clinical, laboratory, radiological and therapeutic data were collected by retrospective chart review. Results: Fever, abdominal pain, hypoxia and other manifestation occurred. Cardiac findings were less common and did not include coronary findings. Treatments were mainly Corticosteroids and IVIG. No mortality was found in this series but serious disease occurred and some patients were admitted to Pediatric Intensive Care Unit. Conclusions: This study described the epidemiology, clinical course, management, and outcome of MIS-C cases in Jordan. The findings were consistent with what has been described from other regions globally. There was a wide spectrum in the severity of presentation. Abdominal pain was more prevalent and some children were misdiagnosed as surgical acute abdomen.

Women with germline BRCA1 mutations (BRCA1+/mut) have increased risk for hereditary breast cancer. Cancer initiation in BRCA1+/mut is associated with premalignant changes in breast epithelium; however, the role of the epithelium-associated stromal niche during BRCA1-driven tumor initiation remains unclear. Here we show that the premalignant stromal niche promotes epithelial proliferation and mutant BRCA1-driven tumorigenesis in trans. Using single-cell RNA sequencing analysis of human preneoplastic BRCA1+/mut and noncarrier breast tissues, we show distinct changes in epithelial homeostasis including increased proliferation and expansion of basal-luminal intermediate progenitor cells. Additionally, BRCA1+/mut stromal cells show increased expression of pro-proliferative paracrine signals. In particular, we identify pre-cancer-associated fibroblasts (pre-CAFs) that produce protumorigenic factors including matrix metalloproteinase 3 (MMP3), which promotes BRCA1-driven tumorigenesis in vivo. Together, our findings demonstrate that precancerous stroma in BRCA1+/mut may elevate breast cancer risk through the promotion of epithelial proliferation and an accumulation of luminal progenitor cells with altered differentiation.

Medical plants play a crucial role in the pharmaceutical industry due to their natural synthesis of active compounds. Synthetic methods exist, which provide fewer effective molecules compared to those naturally occurring. Catharanthus roseus, a significant medicinal plant, synthesizes vital vinca alkaloids and various secondary metabolites widely used in cancer and hypertension treatment. However, genetic modification using Agrobacterium tumefaciens-mediated transformation, a common method for altering periwinkle plants, suffers from low efficiency and reproducibility. Factors like the Agrobacterium strain can influence transformation efficiency and post-transformation regeneration. This study compares the transformation and regeneration efficiency of three A. tumefaciens strains (LBA4404, EHA105, and GV3101) carrying the GUS gene and kanamycin selection via syringe infiltration in Catharanthus roseus. Molecular variations between mutants were examined using Inter-Simple Sequence Repeat (ISSR) and GUS expression via quantitative Real-Time PCR (qRT-PCR). Results revealed that GV3101 had the highest transformation efficiency (61.1 %) and LBA4404 the lowest (38 %). However, GV3101-infected explants had the lowest regeneration rate (10 %), the obtained mutants from it exhibited the highest GUS expression. ISSR analysis indicated 37 % polymorphism among mutants, highlighting the impact of Agrobacterium strains on plant genetics and potentially on phytochemical compositions. Overall, this study recommends using GV3101 for high transformation efficiency and LBA4404 for superior in vitro regeneration in Catharanthus roseus, suggesting a promising method for efficient gene transformation in this plant species.

Reinforced concrete structures face significant annual expenditures in combating rebar corrosion, with chloride penetration identified as a major contributor. This study employs laser-induced breakdown spectroscopy (LIBS) to quantitatively predict the chloride-induced corrosion rate in such structures. Eighty samples, characterized by known chloride content (ranging from 0 % to 1.0 %), underwent controlled corrosion processes with predetermined degrees measured as bar weight loss. The investigation included two cement types, Type I and Type V, along with samples incorporating pozzolanic materials (FA, SF, and GGBFS,) in addition to plain OPC samples. LIBS was subsequently employed to detect chlorine presence in each concrete sample, recording the corresponding intensity of the chlorine line. After the initial data acquisition, peak analysis was performed to identify the dominant spectral peaks, ensuring that the most relevant signals were isolated. Following this, the intensity of the chloride emission line from the LIBS spectrum was recorded and correlated with its corresponding chloride signal, establishing a quantitative relationship between the LIBS output and chloride presence. A model was then developed to link the LIBS signal intensity to its corresponding chloride concentration in the sample. In parallel, the corrosion rate associated with each specific chloride concentration was measured and then linked to the LIBS-derived chloride concentrations, creating a framework that ties the LIBS output to the actual rebar degradation within the concrete. Comparisons with previous studies demonstrated superior conformity of the developed models. The study also presents optimized parameters for the LIBS setup. Notably, results indicated a high correlation between LIBS intensity and chloride concentration, with the developed model accurately predicting the degree of corrosion.

Effects from aging in single cells are heterogenous, whereas at the organ- and tissue-levels aging phenotypes tend to appear as stereotypical changes. The mammary epithelium is a bilayer of two major phenotypically and functionally distinct cell lineages: luminal epithelial and myoepithelial cells. Mammary luminal epithelia exhibit substantial stereotypical changes with age that merit attention because these cells are the putative cells-of-origin for breast cancers. We hypothesize that effects from aging that impinge upon maintenance of lineage fidelity increase susceptibility to cancer initiation. We generated and analyzed transcriptomes from primary luminal epithelial and myoepithelial cells from younger 55 y women. In addition to age-dependent directional changes in gene expression, we observed increased transcriptional variance with age that contributed to genome-wide loss of lineage fidelity. Age-dependent variant responses were common to both lineages, whereas directional changes were almost exclusively detected in luminal epithelia and involved altered regulation of chromatin and genome organizers such as SATB1. Epithelial expression variance of gap junction protein GJB6 increased with age, and modulation of GJB6 expression in heterochronous co-cultures revealed that it provided a communication conduit from myoepithelial cells that drove directional change in luminal cells. Age-dependent luminal transcriptomes comprised a prominent signal that could be detected in bulk tissue during aging and transition into cancers. A machine learning classifier based on luminal-specific aging distinguished normal from cancer tissue and was highly predictive of breast cancer subtype. We speculate that luminal epithelia are the ultimate site of integration of the variant responses to aging in their surrounding tissue, and that their emergent phenotype both endows cells with the ability to become cancer-cells-of-origin and represents a biosensor that presages cancer susceptibility.

ABSTRACT Previous studies exploring the relationship between dietary potassium and magnesium intake and the risk of type 2 diabetes mellitus (T2DM) have yielded inconsistent results. Objective The present study was designed to compare the effect of magnesium, potassium and both (potassium and magnesium combined) on cholesterol levels and quality of life (QoL) among patients with T2DM. Methods A randomised controlled trial (single blinded) was conducted at The University of Lahore and Lahore Medical Research Center (LMRC). The sample size was 290 patients with T2DM, who were divided into four groups: Group I (T1) that received control/placebo; Group II (T2) and Group III (T3) received magnesium and potassium supplements, respectively; and Group IV (T4) received both magnesium and potassium supplements. Blood samples were taken from all patients before and after 60 days of supplementation to determine the levels of K+, Mg2+ and cholesterol using a chemistry analyzer (photometer 5010 v5+). Results There was a decrease in mean cholesterol levels in all groups after the treatment, with the largest reduction (224.9 ± 61.92 to 163.4 ± 48.38) seen in the T3 group, that received potassium supplements. A significant increase in the social QoL, indicated by a p value change from 0.06 before medical intervention to 0.000 after medical intervention, was observed. p value was significant (

Lineage switch (LS) refers to the immunophenotypic transformation of one leukemia lineage to another (ie, lymphoid to myeloid) with retention of baseline genetics. This phenomenon was originally observed in infants with B-lymphoblastic leukemia (B-ALL) with KMT2A rearrangements following chemotherapy, but is now increasingly being observed as a form of immune escape following targeted therapies among children and adults with B-ALL with and without KMT2A rearrangements. In this report, we present two cases of adolescents with B-ALL harboring CRLF2 rearrangements (Philadelphia-like phenotype) who developed LS to acute myeloid leukemia following CD19 targeted therapy. To our knowledge, these are the first cases of LS to be reported in patients with CRLF2 rearranged acute lymphoblastic leukemia. In addition to raising awareness that this genetic mutation may associate with lineage plasticity, our cases illustrate the importance of multi-modal disease surveillance in the diagnosis of LS.