Advanced Procedures Research Articles

Determination of multiple analytes in urine using label-free SERS coupled with simple sample pretreatments

BackgroundA key restriction of label-free surface-enhanced Raman spectroscopy (SERS) in analysis of objects with complex composition (including with several target analytes) is the competition of mixture components for interaction with SERS-active surface. This leads to poor selectivity of the analysis of such mixtures (e.g., body fluids) and the need to use advanced sample pretreatment procedures such as HPLC or TLC. Therefore, this work aims to develop a set of simple and fast pretreatment steps (dilution, pH correction, etc.) to increase the sorption of the target analyte, reduce the sorption of admixtures, and prevent suppression of the target analyte SERS signal. ResultsWe have developed label-free SERS assay suitable for the determination of three analytes (methotrexate, cephalosporin antibiotic, and creatinine) in one real urine sample as a model matrix with complex and deviating composition. The choice of drugs is justified by the need to monitor their concentration in urine during joint drug treatment of cancer patients with concomitant bacterial infection, while monitoring creatinine concentration helps to evaluate kidney function of the patients. Additionally, three cephalosporin representatives were used in the study to maximize versatility of the assay. As a results, the optimized pretreatment steps enable to eliminate the negative influence of excess of interferences (including other analytes) and achieve precise (≤12% RSD) and accurate (88–111% recovery) determination of several analytes in the therapeutically relevant ranges: 300–3000 μg mL–1 for creatinine, 20–200 μg mL–1 for methotrexate and cephalosporins. SignificanceTherefore, in addition to reporting a new SERS assay for the analysis of body fluids, this study clearly demonstrates the importance of taking into account competitive adsorption processes on the SERS substrate surface. We suggest making this practice mandatory when developing any label-free SERS assay because it enables to maximize the selectivity and accuracy of the analysis as well as to simplify the analysis procedure.

Advancements in minimally invasive endoscopic treatment:Navigating deeper layers for upper gastrointestinal lesion.

The field of minimally invasive endoscopic treatment has seen a continual progression, marked by significant advancements in treatment devices and the refinement of endoscopic techniques. While endoscopic resection has become the standard for treating superficial gastrointestinal neoplasms, a proactive approach becomes imperative when dealing with lesions that extend beyond the submucosal layer and deeper into the muscularis propria. The ongoing evolution of endoscopic closure techniques has facilitated the introduction of advanced procedures such as endoscopic muscularis dissection, endoscopic subserosal dissection, and endoscopic full-thickness resection. This evolution is achieved by the commitment to improve the efficacy and precision in treating challenging lesions. Nevertheless, there is currently a lack of definitive guidelines or consensus regarding the specifics of deeper layer dissection. Drawing from prior research and clinical insights, this review discusses indications, techniques, clinical outcomes, and future perspectives of deeper layer dissection.

A compliance and audit model for tackling tax evasion in Nigeria

Tax evasion remains a significant challenge for Nigeria, undermining economic stability and reducing public revenue. This paper proposes a comprehensive compliance and audit model designed to address tax evasion in Nigeria. The model integrates enhanced compliance strategies, advanced audit procedures, and the strategic use of technology to create a robust framework for tackling tax evasion. The proposed model emphasizes proactive measures to improve taxpayer compliance through targeted education and outreach programs, streamlined reporting processes, and incentivization. On the audit front, it advocates for the adoption of sophisticated audit techniques and technologies, including data analytics and automated systems, to detect and address evasion more effectively. The implementation framework outlines a phased approach involving key stakeholders such as the Federal Inland Revenue Service (FIRS), local tax authorities, and the private sector. By examining domestic and international case studies, the paper highlights successful practices and potential challenges, providing actionable insights for adapting these strategies to the Nigerian context. Evaluation metrics are proposed to assess the model’s effectiveness, with expected outcomes including improved tax revenue, enhanced compliance rates, and strengthened public trust in the tax system. The study concludes with recommendations for further research and policy adjustments to refine and expand the model's application. This approach aims to not only mitigate tax evasion but also contribute to a more transparent and equitable tax system in Nigeria.

Minimally invasive exoscope-assisted coccygectomy: A novel approach for chronic refractory coccydynia

BackgroundThis technical note presents a novel minimally invasive exoscope assisted coccygectomy to treat chronic refractory coccydynia. Traditional treatments often fail to provide adequate relief for this debilitating condition, prompting the need to explore surgical approaches. Case DescriptionA 40-year-old female patient with persistent pain unresponsive to conservative treatments underwent this advanced procedure. Utilizing the Synaptive exoscope-microscope system, the surgery allowed for precise dissection and removal of affected coccygeal segments, with a focus on minimizing skin and soft tissue disruption to optimize wound healing and surgical site pain. ConclusionPostoperative recovery showcased significant pain reduction and improved quality of life, emphasizing the method's potential for better outcomes and fewer complications. Despite the promising results, the limitations of a single-case study necessitate further research to establish long-term effectiveness across a broader patient population.

A probabilistic model to predict specimen geometry effects on fracture toughness in ferritic–pearlitic steels

This work describes a probabilistic framework for cleavage fracture of ferritic–pearlitic steels incorporating experimental measurements of microcrack distribution associated with the cracking of the pearlitic microstructure. A central objective of this study is to explore and further extend application of a probabilistic framework incorporating the statistics of microcracks to predict specimen geometry effects on the fracture toughness distribution for a typical ferritic–pearlitic structural steel. Fracture toughness values for an ASTM A572 Grade 50 structural steel derived from fracture tests using conventional SE(B) specimens with varying thickness and a/W-ratios provide the cleavage fracture resistance data needed to assess specimen geometry effects on the probability distribution of Jc-values. The present exploratory study successfully predicts the measured statistical distribution of cleavage fracture toughness in shallow crack specimens and provides further support of the proposed probabilistic model as a more advanced and effective engineering-level procedure in fracture assessment methodologies.

A Needle's Misdirection: Unravelling Vascular Injuries in Malpositioned Central Venous Catheters and Safe Removal Approaches

Central venous catheters (CVC) are commonly inserted to obtain vascular access. Complications such as vascular injuries arising from malpositioned CVC may occur, and safe surgical removal is required to prevent further complications. We retrospectively reviewed all patients treated in the cardiothoracic surgery department at our institution in the past 10 years for intrathoracic vascular injuries in malpositioned CVC without the need for concurrent cardiac or thoracic surgical procedures. Among the 21 patients in our series, 2 patients (10%) had a single arterial injury, 16 patients (76%) had venous injuries only, and 3 patients (14%) had both arterial and venous injuries. 16 patients (76%) underwent surgery to remove the malpositioned CVC; majority of them underwent sternotomy (n=12, 57%) and 7 of them had repair of blood vessels, and 4 patients (19%) underwent video assisted thoracoscopic surgery (VATS). 2 out of the 5 patients who had their CVC directly removed followed by external compression required emergency sternotomy due to pericardial effusion. In patients with artery or mediastinal vessel injuries, a sternotomy approach was preferred, whereas VATS was chosen when subclavian vessels or brachiocephalic vein injuries were noted. Endovascular procedures are alternatives for high surgical risk patients, but these advanced procedures are currency limited due to high expertise and facilities requirements.

Advanced fine-tuning procedures to enhance DNN robustness in visual coding for machines

Video Coding for Machines (VCM) is gaining momentum in applications like autonomous driving, industry manufacturing, and surveillance, where the robustness of machine learning algorithms against coding artifacts is one of the key success factors. This work complements the MPEG/JVET standardization efforts in improving the resilience of deep neural network (DNN)-based machine models against such coding artifacts by proposing the following three advanced fine-tuning procedures for their training: (1) the progressive increase of the distortion strength as the training proceeds; (2) the incorporation of a regularization term in the original loss function to minimize the distance between predictions on compressed and original content; and (3) a joint training procedure that combines the proposed two approaches. These proposals were evaluated against a conventional fine-tuning anchor on two different machine tasks and datasets: image classification on ImageNet and semantic segmentation on Cityscapes. Our joint training procedure is shown to reduce the training time in both cases and still obtain a 2.4% coding gain in image classification and 7.4% in semantic segmentation, whereas a slight increase in training time can bring up to 9.4% better coding efficiency for the segmentation. All these coding gains are obtained without any additional inference or encoding time. As these advanced fine-tuning procedures are standard-compliant, they offer the potential to have a significant impact on visual coding for machine applications.

Fluorobenzene as new working fluid for high-temperature heat pumps and organic Rankine cycles: Energy analysis and thermal stability test

Industrial high-temperature heat pumps and Organic Rankine Cycles play a pivotal role in reducing CO2 emissions of the industrial sector. While several eco-friendly refrigerants have been explored for subcritical heat pumps below 150 °C, above this threshold only a few fluids can be adopted.In this article, fluorobenzene (C6H5F) is proposed for the first time as a versatile working fluid suitable for both HTHP and ORC systems. Notably, it possesses a near-zero Global Warming Potential, null Ozone Depletion Potential, low cost, and low toxicity. The thermo-chemical stability of fluorobenzene is experimentally investigated with an advanced procedure, simulating the presence of the non-condensable-gases removal system in real plant operating conditions. The yearly rate of unimolecular decomposition is estimated less than 4 % at 350 °C, and even after 400 h of thermal stress no decomposition products have been detected in the liquid phase through Fourier Transform Infrared Spectroscopy.In a direct heat exchange case study, coupled with exhaust gases at 390 °C, fluorobenzene achieves a net power production higher than other commercial fluids adopted in high-temperature units. In subcritical two-stage throttling heat pump condensing at 180 °C fluorobenzene shows a good Coefficient of Performance of 3.25 at 100 °C temperature lift.

Exploring COVID-19 anxiety across demographics: psychometric validation and application of the COVID-19-Anxiety Questionnaire in Arabic

BackgroundThe emergence of the COVID-19 pandemic in 2019 imposed significant shifts in global health, particularly in understanding and addressing anxiety disorders precipitated by pandemic-related stressors. The current study aimed to adapt and validate the COVID-19 Anxiety Questionnaire (C-19 A) for Arabic-speaking populations (C-19 A-A), assessing its structural integrity, concurrent validity, factorial validity, and reliability.MethodsThe data of 571 individuals, including age range, educational history, gender, and marital status, were collected through online platforms. The translation process of C-19 A-A underwent rigorous verification by linguistic and subject matter experts. Several advanced statistical procedures were used to examine the C-19 A-A’s reliability, validity, and measurement invariances across demographic subsets.ResultsThe results indicated robust internal consistency, with a Cronbach’s alpha coefficient of 0.889, confirming the questionnaire’s reliability. Concurrent validity showed significant and positive correlations between C-19-A and FCV-19S (r = 0.77, p < 0.000). EFA revealed a dominant factor explaining 60.4% of the variance, bolstering the questionnaire’s factorial validity. CFA further validated the model’s adequacy across different demographic groups. Specifically, demographic factors such as age, gender, and educational level showed distinct patterns of COVID-19-related anxiety.ConclusionThe validated Arabic version of the C-19 A-A represents a pivotal tool for assessing pandemic-induced anxiety within Arabic-speaking communities. Its deployment enables targeted identification of vulnerable individuals, facilitating tailored health interventions and informing clinical strategies. This research underscores the pivotal role of culturally attuned assessment instruments in shaping effective public health responses and therapeutic interventions aimed at mitigating the psychological sequelae of global health crises.

Improving Cardiopulmonary Resuscitation Quality and Resuscitation Training by Using Real-Time Audiovisual-Assisted Devices.

Context Cardiac arrest occurring outside of a medical facility is a significant cause of death and disability worldwide. In developing nations, it accounts for a notable portion of total mortality, with only a small percentage of those affected surviving beyond the initial emergency department intervention. Despite the critical importance of high-quality cardiopulmonary resuscitation (CPR) in these situations, there has been limited research on the effectiveness of audiovisual feedback devices in improving CPR performance among laypersons or non-medical caregivers. These caregivers, often untrained in advanced medical procedures, play a crucial role in the immediate response to cardiac arrest before professional help arrives. This study aims to address this gap by evaluating the impact of such devices on CPR quality delivered by non-medical individuals. Aim This study aimed to determine whether the use of audiovisual devices would improve cardiopulmonary resuscitation performance among non-medical care providers. Materials and methods Using amultiple-choice questionnaire, an audiovisual aid-based prospective observational study (non-interventional observation study) was conducted at a medical college hospital in Kochi from June 2022 to February 2024. A minimum sample size of 66 was derived from pilot studies, with 95% confidence and 90% power. A total of 146 participants met the inclusion criteria (non-medical personnelof 18-50 years of age). After the exclusion ofpregnant women and non-interested participants, the study participants were analyzed for the quality of cardiopulmonary resuscitation in a mannequin with the help of audiovisual devices.Statistical analysis was conducted using IBM SPSS Statistics for Windows, Version 20 (IBM Corp., Armonk, New York, released in 2011). Categorical variables were expressed as frequency and percentage. McNemar's Chi-square test wasapplied to compare the CPR compression rates with and without the visual feedback device, and the kappa statistic was used to assesshow consistently participants performed within the same compression rate category (less than 100, 100-120, or more than 120 compressions per minute) with and without the feedback device. Results The improvement inCPR quality, which was visualized as a green color in the CPR feedback device, was significant, with 109 participants (74.7%) showing good outcomes. The chest compression rate also significantly improved from 95 to 117 with the use of feedback devices (p -0.011, Kappa - 0.167) among non-medical care providers. While the kappa value suggests that some variability exists in compression rates when switching between with and without feedback, the overall improvement is still noteworthy. Conclusion The majority of participants (74.7%) were able to consistently maintaingreen light in the visual feedback watch, which means their chest compression rate was within optimal range (100-120/min) when using the audiovisual feedback device. This indicated that use of audiovisual devicessignificantly improved compression rates among non-medical care providers andeffectively helped them perform high-quality CPR.

Intraoperative laparoscopic ultrasound during laparoscopic myomectomy: a narrative review.

Intraoperative laparoscopic ultrasound (IOLUS), a dynamic imaging technique, has emerged as a valuable instrument for guiding surgery in various medical specialties. As IOLUS provides accuracy, improved visualization, and real-time guidance, the integration of IOLUS into many surgical procedures has occurred and IOLUS assists surgeons during advanced procedures. Today, laparoscopic myomectomy has become a prominent surgical procedure in gynecology. Despite its benefits, laparoscopic myomectomy presents certain challenges. The risk of residual fibroids is higher in laparoscopic myomectomy compared to abdominal surgery. The limited depth perception and restricted range of motion can also be obstacles for surgeons, especially when dealing with deeply embedded fibroids. IOLUS has the potential to overcome these limitations. In this study, our aim was to conduct a review of the literature concerning the use of IOLUS during laparoscopic myomectomy.

Videourodynamics - role, benefits and optimal practice.

Videourodynamics (VUDS) is an advanced diagnostic procedure that simultaneously combines functional and anatomical evaluation of the lower urinary tract. The goal of this synchronous assessment is to promote accurate diagnosis of the aetiology responsible for patient symptoms, improving therapeutic decision-making. Overall, high-quality VUDS is advocated when other tests such as traditional urodynamics might not provide sufficient data to guide therapy, particularly in patients with complex, persistent or recurrent dysfunctions of the lower urinary tract. Additionally, VUDS is often crucial in the follow-up monitoring of many patients with these dysfunctions. A VUDS study is frequently considered a gold standard in patients with neurogenic lower urinary tract dysfunction, female bladder outlet obstruction or congenital anomalies of the lower urinary tract. Nevertheless, this specialized test should be limited to patients in whom VUDS data add value. Particularly, reliable studies comparing the effect of diagnosis with and without imaging on management outcomes are lacking, and no standardized procedures for undertaking VUDS are available. Additionally, patients should be carefully selected for VUDS evaluation, considering the increased cost and risks associated with radiological imaging. In routine practice, clinicians should balance the additional value of synchronous imaging and the enhanced diagnostic precision of VUDS against the limitations of this approach, which mainly include an uncertain effect of VUDS on final treatment outcomes.

DeepOpt: a deep learning optimized privacy preservation framework for cyber-physical systems

Privacy preservation and security enhancement are the key components of any network architecture due to advanced attack procedures. Cyber-Physical Systems (CPS) also need a mitigation and prevention strategy to deal with cyber threats. The existing approaches majorly deal with attack detection and focus on one or two attacks at a time. With this focus and demand of the CPS, this work proposes a deep learning optimized privacy preservation framework called DeepOpt. This proposed framework prevents the network from attackers and maintains security by classifying multiple attackers simultaneously using deep learning architecture. The proposed framework initializes privacy preservation using the trust-based approach and a hybrid optimization algorithm. In this, the network is divided into different zones, and each zone is secured using trust parameters with additional verification by secure hash function. The hybrid optimization selects the communication path using trust and energy that returns the attack-free path. This proposed architecture is simulated over different network scenarios with or without attacker nodes, and their traces are labeled to train the proposed deep convolutional neural network architecture. Finally, these models are integrated, and their performance is analyzed in different network scenarios and the presence of five different attackers such as blackhole, wormhole, man-in-the-middle attack, spoofing, and distributed denial of service. The simulation results, with improvement in detection accuracy, packet delivery ratio, and other performance factors, indicate the effectiveness of the proposed framework for both prevention and mitigation. Hence, this overall architecture preserves the privacy of CPS even in multifarious dynamic network scenarios.

Nasopharyngeal carriage, antimicrobial susceptibility patterns, and associated factors of Gram-positive bacteria among children attending the outpatient department at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Gram-positive bacteria residing in the nasopharynx can lead to severe illnesses in children, such as otitis media, pneumonia, and meningitis. Despite the potential threat, there is a lack of comprehensive data regarding the carriage rates of these bacteria among children in outpatient departments in the study area. This study aimed to assess the nasopharyngeal carriage, antimicrobial resistance patterns, and associated factors of Gram-positive bacteria among children attending the outpatient department at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A hospital-based cross-sectional study was conducted from May 1, 2023, to August 30, 2023. A total of 424 nasopharyngeal swab samples were collected using sterile nasopharyngeal swabs, inoculated on Blood Agar and Mannitol Salt Agar plates, and identified through colony morphology, Gram stain, and biochemical tests. Antimicrobial susceptibility of the identified bacterial isolates was determined employing both the Kirby-Bauer and modified Kirby-Bauer methods. D-tests were conducted using clindamycin and erythromycin discs to detect inducible clindamycin resistance, while cefoxitin disc tests were utilized to ascertain methicillin resistance. Data entry was executed using Epi-Data version 4.6, and subsequent analysis was performed utilizing SPSS version 25. Bivariable and multivariable logistic regression analyses were employed to identify associated factors. An adjusted odds ratio at a 95% confidence interval with a P-value of < 0.05 was considered statistically significant. The overall nasopharyngeal carriage rate of Gram-positive bacteria was 296/424 (69.8%, 95% CI: 65.3-74.0). Staphylococcus aureus was the most prevalent 122/424 (28.8%), followed by Streptococcus pneumoniae 92/424 (21.7%). Methicillin resistance was observed in 19/122 (15.6%) of S. aureus and 3/60 (5%) of coagulase-negative staphylococcus (CoNS) species. Inducible clindamycin resistance was 10/122 (8.2%) in S. aureus and 4/53 (7.5%) in coagulase-negative staphylococcus species. Multidrug resistance was found in 146/296 (49.3%, 95% CI: 43.6-55.0) of the isolates. Associated factors with a bacterial carriage were large family size (AOR = 3.061, 95% CI: 1.595-5.874, P = 0.001), having siblings under five years old (AOR = 1.991, 95% CI: 1.196-3.313, P = 0.008), indoor cooking (AOR = 2.195, 95% CI: 1.275-3.778, P = 0.005), an illiterate mother (AOR = 3.639, 95% CI: 1.691-7.829, P = 0.001), and hospital visits (AOR = 2.690, 95% CI: 1.405-5.151, P = 0.003). The study found a high nasopharyngeal carriage of Gram-positive bacteria in outpatient children, including notable levels of methicillin-resistant S. aureus and multi-drug-resistant isolates. Clindamycin, rifampin, and erythromycin were the most effective antimicrobials for the tested isolates. Factors contributing to bacterial carriage include visits to healthcare facilities, larger family sizes, having younger siblings, maternal illiteracy, and indoor cooking. This emphasizes the need for methicillin-resistant S. aureus surveillance in pediatric outpatient settings and community health education, especially for children's guardians. Additionally, improving household ventilation by separating kitchens from sleeping areas and regular screening of younger siblings in healthcare environments were recommended to reduce bacterial transmission within family members. The study also called for studies with advanced procedures like minimum inhibitory concentration testing and molecular characterization to better comprehend the resistance patterns and genes in circulating bacteria.

Data Exfiltration Anomaly Detection on Enterprise Networks using Deep Packet Inspection

Advanced persistent threats (APT) are threat actors with the advanced Technique, Tactic and Procedure (TTP) to gain covert control of the computer network for a long period of time. These threat actors are the highest cyber attack risk factor for enterprise companies and governments. A successful attack by the APT threat Actors has the capabilities to do physical damage. APT groups are typically state-sponsored and are considered the most effective and skilled cyber attackers. The final goal for the APT Attack is to exfiltrate victims data or sabotage system. This aim of this research is to exercise multiple Machine Learning Approach such as k-Nearest Neighbors and H20 Deep Learning Model and also employ Deep Packet Inspection on enterprise network traffic dataset in order to identify suitable approaches to detect data exfiltration by APT threat Actors. This study shows that combining machine learning techniques with Deep Packet Inspection significantly improves the detection of data exfiltration attempts by Advanced Persistent Threat (APT) actors. The findings suggest that this approach can enhance anomaly detection systems, bolstering the cybersecurity defenses of enterprises. Consequently, the research implications could lead to developing more robust strategies against sophisticated and covert cyber threats posed by APTs.

Effects of Sales Campaign Strategies on Customer Patronage of Nigeria Breweries Products in Jos South LGA of Plateau State

Customer patronage is borne out of a longing to be focused on a specialist co-op either founded on its administration quality or seen administration esteem. Albeit a few scientists have proposed that what decides a client&amp;apos;s decision of choosing or disparaging items varies from one country to another as well as from one district to another because of contrasts in social, ecological and financial elements. The review analyzed the impacts of deals advancement methodologies on client support of Nigeria distilleries items in Jos South LGA of Level State. The review utilized a semi-organized survey planned with a 5-point Likert scaling. 143 duplicates of the survey were circulated among the respondents, who were sub merchants of Amstel Malt in Jos South LGA of Level State. The information gathered was dissected utilizing various straight relapse. The discoveries delighted that there is a huge connection between deals advancement procedures aspects (premium item, gift, extra-item and scaled down cost) on client support, implying that deals advancement techniques significantly affect client support. The review presumes that Nigeria bottling works ought to build their concentration and keep up with the level of the deals advancement methodologies (premium item, gift, extra-item and scaled down cost), since it impacts client&amp;apos;s support. The review suggests that Nigeria distilleries ought to direct investigations to assess various degrees of allure of the markdown base advancement. Furthermore, that administration ought to execute extra-item methodologies that will empower clients see them as particularly unique and drive most extreme support.

Hospital at home worldwide: Program and clinician characteristics from the World Hospital at Home Congress survey.

Hospital at home (HaH) delivers hospital-level care to acutely ill patients at home as a substitute for brick-and-mortar hospital care. The clinician and program characteristics of HaH programs worldwide are relatively unknown. We sought to describe the world's HaH clinicians and their programs' characteristics. We analyzed a survey administered to all attendees of the 2023 World Hospital at Home Congress. Clinician characteristics included age, years worked in HaH, profession, burnout, and experience. Program characteristics included location, daily census, types of care delivery, and clinical capabilities. Of 670 attendees, about 305 were clinicians and 129 responded (42% response rate for clinicians). The majority of clinicians were 30-49 years old (65.1%), new to the field (70.5% worked less than 10 years), and part-time (18% dedicated >74% effort to HaH). Clinicians reported overall satisfaction with their job and low burnout. About half of programs were in Europe (52.1%), newly operational (44.7% less than 5 years), mostly operated in urban environments (87.2%), and mostly had a daily census of less than 25 patients (62.8%). Most programs operated 7-days per week (88.3%), performed intermittent or continuous remote monitoring (81.4%), used video communication (63.8%), and had some advanced capabilities such as in-home imaging (47.9%) and advanced procedures (23.4%). Visit frequencies to the patient's home were variable: most programs had physicians visit the home, nearly all had nurses visit the home, and fewer performed virtual visits. HaH clinicians and programs have significant similarities but also a fair number of divergent practices, much like brick-and-mortar hospital care. Further standardization of the care model will help to unify the field across the globe.

Advancements in Early Detection and Screening Strategies for Pancreatic Cancer: From Genetic Susceptibility to Novel Biomarkers.

Pancreatic cancer is a rare but lethal cancer due to its biologically aggressive nature, advanced stage at the time of diagnosis, and poor response to oncologic therapies. The risk of pancreatic cancer is significantly higher to 5% in certain high-risk individuals with inherited genetic susceptibility. Screening for pancreatic cancer in these individuals from high-risk groups can help with the early detection of pancreatic cancer as well as the detection of precursor lesions leading to early surgical resection and improved overall outcomes. The advancements in radiological imaging as well as advanced endoscopic procedures has made a significant impact on the early diagnosis, surveillance, and staging of pancreatic cancer. There is also a significant advancement in the development of biomarkers for the early detection of pancreatic cancer, which has also led to the development of liquid biopsy, allowing for microRNA detection in serum and circulating tumor cells. Various societies and organizations have provided guidelines for pancreatic cancer screening and surveillance in high-risk individuals. In this review, we aim to discuss the hereditary risk factors for developing pancreatic cancer, summarize the screening recommendations by different societies, and discuss the development of novel biomarkers and areas for future research in pancreatic cancer screening for high-risk individuals.

Growth parameters of the clupeids Limnothrissa miodon and Stolothrissa tanganicae in northern Lake Tanganyika (Bujumbura sub-basin)

The analysis of growth parameters in fish stocks, such as the asymptotic length (L∞) and the curvature parameter (K), is crucial for the estimation of production rates and total mortality rates in fisheries management. Here, we estimated the growth parameters of the clupeids Limnothrissa miodon and Stolothrissa tanganicae in the northern part of Lake Tanganyika (Bujumbura sub-basin). Both species are important targets of pelagic fisheries, but the available estimates are based on scarce size frequency data, and rarely on size as a function of age data. We provide new estimates of L∞ and K based on size as a function of age data, with age being inferred from otolith weights. Furthermore, we reanalyze several existing length frequency datasets using advanced statistical procedures to test if growth parameters estimated by length frequency analysis are consistent with those obtained from size as a function of age. We found that length frequency analysis consistently underestimates L∞ and overestimates K as compared to length-at-age data. We recommend that length-at-age data are collected at a much broader spatial and temporal scale than currently available to advance our understanding of the growth dynamics of these two sardine species. This will improve the assessment of stock productivity of Lake Tanganyika’s pelagic fisheries and the conservation of these economically important fish species.

Prospective Study of the Recovery of CD4+ T cell Subsets and Their Relationship to the Overall Survival Following Allogeneic Hematopoietic Stem Cell Transplantation.

The immune recovery (IR) following the allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an advancement procedure that fundamentally correlated to the curative success. It is critical to understand the interfering factors in IR to prevent the HSCT-related mortality. The factors influencing CD4+T cell recovery post (HSCT) are not well totally characterized. This work was conducted to analyze the kinetics of CD4+T cell subsets recovery post HSCT, and to correlate their reconstitution with different factors that may influence the overall survival following HSCT. We prospectively evaluated the clinical outcomes and CD4+ T lymphocyte subtypes regeneration kinetics at different time-points of 22 patients with allogeneic HSCT for malignant and non-malignant diseases from 2007 to 2008. Statistics (means, minimal, and maximal values) were used to describe patient baseline characteristics. Results were presented as absolute count of CD4+ T cells, % of naive and memory subsets, and p-values. Thymus-independent pathways were responsible for the rapid recovery of memory CD4+T cells less than 6 months after HSCT. Thymus-dependent pathways were activated between 6 and 12 months in the majority of patients with increasing counts of naive CD4+ T cell. Furthermore, increasing patient age and chronic GVHD predicted the slow naive T cell recovery and also predicted high memory T cell numbers. The proper CD4 + reconstitution was associated with younger age, a non-malignant disease and a lower incidence of acute graft-versus-host disease ≥ grade 2. Additionally, the CD4+ T lymphocytes recovery ≥ 200/µl was associated with a higher overall survival. Different factors affected the IR post the allo-HSCT. The CD4+ count ≥ 200/µl was a simple IR predictor of overall survival and better clinical outcome following allogeneic HSCT.