Induction Phase Research Articles

Assessment as learning through digital portrayal

Pre-service teachers are expected to acquire the knowledge, skills, and competencies necessary to enter school effectively at the end of the teacher education program. Given the complexity of the teaching profession and the challenges associated with the induction phase, students should be supported in developing awareness of their exit professional profile. This paper aims to understand the experience of 206 last-year students engaged in an Assessment as Portrayal activity tasked with creating a multimedia representation of themselves as teacher-researchers. A qualitative analysis of the analytical sheets was conducted to understand the characteristics of the teacher-researcher they have acquired as professional posture, the overall benefits they have gained and the influence of educational technologies during the task development. The results highlight how, through Assessment as Learning, students activated self-assessment and metacognitive processes, leading them to develop an awareness of areas of the teaching profession often not considered relevant before, such as reflective and research skills. In this perspective, the approach of Assessment as Portrayal implemented through educational technologies, contributed to elaborating and conveying a unified self-representation as a teacher-researcher. Given the significant cognitive engagement required of students, further studies could explore using artificial intelligence to support students in activating metaphorical thinking.

PLC/HMI Based Portable Workbench for PLC and Digital Logic Learning and Application Development

A Programmable logic controller (PLC) uses the digital logic circuits and their operating concepts in its hardware structure and its programming instructions and algorithms. Therefore, the deep understanding of these two items is staple for the development of control applications using the PLC. This target is only possible through the practical sensing of the various components or instructions of these two items and their applications. In this work, a user-friendly and re-configurable ladder, digital logic learning and application development design and testing platform has been designed and implemented using a Programmable Logic Controller (PLC), Human Machine Interface panel (HMI), four magnetic contactors, one Single-phase power line controller and one Variable Frequency Drive (VFD) unit. The PLC role is to implement the ladder and digital logic functions. The HMI role is to establish the virtual circuit wiring and also to drive and monitor the developed application in real time mode of application. The magnetic contactors are to play the role of industrial field actuators or to link the developed application control circuit to another field actuator like three phase induction motor. The Single -phase power line controller is to support an application like that of the soft starter. The VFD is to support induction motor driven applications like that of cut-to-length process in which steel coils are uncoiled and passed through cutting blade to be cut into required lengths. The proposed platform has been tested through the development of 14 application examples. The test results proved the validity of the proposed platform.

Synthesis of long-chain polyester polymers and their properties as crude oil pour point depressant.

Using acrylic acid advanced ester and styrene as raw materials, the long-chain polyester polymer, polyacrylic acid advanced ester-styrene pour point depressant (P-PPD), was synthesized by molecular design, and its structure was characterized by infrared spectroscopy and nuclear magnetic resonance. In addition, this study experimentally investigated the effect of P-PPD on the phase equilibrium and induction time of natural gas hydrate inhibitors in deionized water (DW) and crude oil/water (O/W) systems, respectively. Polyvinylpyrrolidone (PVP) and mono ethylene glycol (EG) were selected as representatives of kinetic hydrate inhibitor (KHIs) and thermodynamic hydrate inhibitor (THIs), respectively. The results exhibit that P-PPD played a sight role in the phase equilibrium of hydrate, while the addition of P-PPD significantly prolonged the induction time of methane hydrate both in O/W + PVP, OW + EG and O/W + PVP + EG system, indicating that the addition of as-synthesized PPD has a synergistic inhibition effect on the nucleation ability of methane hydrate and can prevent hydrate from formatting during oil and gas transport process, and thus guarantee the flow assurance. The findings of this work will provide a data reference for the hybrid use of hydrate inhibitors and pour point depressants in oil and gas transport.

Venetoclax in combination with a pediatric-inspired regimen for the treatment of newly diagnosed adults with Philadelphia chromosome-negative acute lymphoblastic leukemia.

BCL-2 protein overexpression, common in B-cell acute lymphoblastic leukemia (B-ALL), including the Philadelphia (Ph)-like subtype, mediates leukemic cell survival. We treated 24 patients with 14 days of BCL-2 inhibitor, venetoclax, 400 mg daily (dose level 1) during induction and consolidation cycles combined with the CALGB 10403 regimen in newly diagnosed adults with Ph-negative B-ALL. Median age was 31 (range: 18-53) years, 92% were Hispanic, and 12 (50%) patients had Ph-like ALL. No dose limiting toxicity occurred in the phase 1 part. Median times to neutrophil and platelet count recovery were 20 and 21 days from start of induction, respectively. The most common grade ≥3 treatment-related adverse events were leukopenia (96%), neutropenia (83%), anemia (83%), thrombocytopenia (79%), lymphopenia (71%), hyperbilirubinemia (38%), and elevated ALT (33%). One patient with non-Ph-like ALL died from asparaginase-associated pancreatitis, and 23 (96%) patients achieved complete remission (CR) or CR with incomplete count recovery (CRi) following induction with or without extended induction phase. Of 22 patients who started consolidation, 20 (91%) achieved negative minimal residual disease status (MRD-) (.

Core mechanism for the stability preparation of lithium slag-based SOD zeolite: Evolution of trans-crystallization nucleation/growth kinetics of crystals

SOD nano-zeolite has been widely applied in the separation of small gas molecules since these advantages comprise a high-density framework and favorable acid/alkali resistance. Moreover, the bottleneck for the lithium sector can be ameliorated by industrializing the manufacture of SOD zeolite (SLS) from the hazardous waste lithium slag (LS). However, the stability in industrial production is restricted owing to the ambiguous nature of the lattice nucleation/transformation mechanism. Herein, it was discovered that the highest relative crystallinity (98.8 %) of SLS with a layered spherical structure could be achieved under the crystallization condition of heating at 95 °C for 8 h. The nucleation and growth mechanisms of SLS crystals demonstrated a three-dimensional crystal growth pattern characterized by sporadic and transient nucleation, which is essentially consistent with that of crystallization kinetics. Specifically, the activation energies of the induction, transformation and crystallization phases were 41.33, 27.99 and 46.99 kJ·mol−1, respectively, implying that the directional induction of the transition phase is crucial for obtaining SLS with high crystallinity. Two nucleation processes can also be observed in the transformation stage, involving homogeneous nucleation and polymorphic transformation. Our study explored the crystallization and assembly mechanism of SLS crystals, providing a well-defined concept for the regulation of stability preparation.

Rutin reduces inflammation and fibrosis via TGF-β/SMAD pathways in IgA nephropathy induced rats.

Rutin is a flavonoid glycoside obtained from the plant Ruta graveolens. It was known to have immunosuppressant activities. This study was focused on effect of rutin against immunoglobulin A (IgA) nephropathy. IgA nephropathy was induced in Sprague-Dawley rats with various inducing agents described in text. During the later part of the induction phase, rutin was administered. Control group rats did not receive any treatment or inducing agent, induced group rats received only the inducing agents, whereas treatment group received the inducing agents as well as rutin. During the study, various biochemical parameters pertaining to kidney function were evaluated and also, the expression of proteins and cytokines responsible for inflammation and fibrosis were assessed. The effect of rutin in IgA nephropathy was promising as treatment with rutin reduced the deposition of IgA in the glomeruli of rats. Along with this we also tried to establish the probable mechanism of action of rutin and based on the summary of the results it was concluded that rutin reduced the inflammation and fibrosis related to IgA nephropathy by inhibiting the TGF-β/SMAD pathways and ultimately reducing the expression of α-smooth muscle actin (α-SMA). Comprehending all the above consideration, it may be safely said that that rutin alleviated inflammation and also fibrosis mediated by IgA, by suppressing the transforming growth factor-β (TGF-β) activities through suppressor of mothers against decapentaplegic pathways and reduced the epithelial-to-mesenchymal transition by downregulating the α-SMA which is a marker for fibrosis.

Impact of Antibacterials on the Quality of Anticoagulation Control in Patients Initiating Warfarin Therapy.

Warfarin interacts with antibacterials to prolong the prothrombin time international normalized ratio (PT-INR) and increase the risk of bleeding. Patients initiating warfarin therapy often undergo precise dosage adjustments; however, the clinical implications of these interactions with antibacterials remain unclear. This study aimed to clarify the effect of antibacterials on PT-INR during the warfarin induction phase. This was a retrospective, observational study. Patients who were newly treated with warfarin after cardiovascular surgery were included. The primary endpoint was the comparison of the maximum PT-INR and time in therapeutic range (TTR) after warfarin initiation between the antibacterial-treated (ABx) and non-treated (non-ABx) groups. The maximum PT-INR was significantly higher in the ABx group (which included β-lactams, glycopeptides, quinolones, tetracyclines, and aminoglycosides) than in the non-ABx group (median [interquartile range] 2.37 [2.03-2.71] vs. 2.08 [1.93-2.33]; P = 0.005); however, the TTR did not differ significantly (65% [44-76] vs. 71% [43-85]; P = 0.150). The odds ratio for maximum PT-INR >2.6 with antimicrobial therapy was 2.51 (95% confidence interval 1.21-5.21). Antibacterial therapy was a risk factor for a maximum PT-INR >2.6. However, there was no association with the TTR, which is a marker of good outcomes. This was due to the strict warfarin dosing regimen according to the algorithm, which immediately and appropriately adjusted for PT-INR overexpansion. Antibacterials have been suggested to increase PT-INR during the induction phase of warfarin. However, with strict dose adjustments, the clinical impact on the PT-INR and TTR is likely limited.

Use of esketamine for tracheoscopic drug injection: a randomized controlled trial

BackgroundSufentanil may induce hypotensive bradycardia and other adverse reactions in elderly patients during anesthesia, while esketamine exhibits sedative and analgesic effects with minimal impact on respiration and circulation. The objective of this study was to investigate the impact of these two anesthetics on vital signs in patients undergoing bronchoscopy and lavage under general anesthesia.MethodThis study was a randomized controlled trial with a parallel design. A total of 100 patients aged ≥60 years with ASAI or II who were undergoing bronchoscopy and lavage were randomly assigned to two groups: group A (esketamine, n = 50) and group B (sufentanil, n = 50). During anesthesia induction, both groups received intravenous infusion of propofol at a dose of 1.5 mL/kg and atracurium. In group A, esketamine at a dose of 0.3 mg/kg was injected; in group B, sufentanil at a dose of 0.2 μg/kg was injected intravenously. Subsequently, a laryngeal mask was inserted and connected to an anesthesia machine for mechanical ventilation. Anesthesia maintenance involved continuous intravenous infusion of propofol at a dose of 3 mL/kg. The mean arterial pressure (MAP), heart rate (HR), and blood oxygen saturation (SpO2) were recorded at various time points: before anesthesia injection (T0), after laryngeal mask insertion (T1), 5 min after the operation started (T2), 15 min after the operation started (T3), and before the end of the operation (T4). Additionally, the recovery time was recorded.ResultsThe blood pressure of patients in the esketamine group exhibited higher levels compared to those in the sufentanil group at multiple time points during the operation, while maintaining a more stable intraoperative blood pressure and shorter postoperative recovery time than that observed in the sufentanil group. The blood pressure and heart rate of patients in the esketamine group exhibited significant fluctuations after laryngeal mask implantation compared to pre-anesthesia induction, with a statistically significant increase observed. Conversely, no significant changes were observed in the sufentanil group. The heart rate and oxygen saturation showed no significant differences between the two groups, nor did the amount of propofol administered during the procedure.ConclusionThe utilization of esketamine during the induction phase of bronchoscopy and lavage under general anesthesia can enhance hemodynamic stability and reduce the occurrence of hypotension, thereby facilitating postoperative anesthetic recovery.

A plain language summary of the final analysis of the GRIFFIN study of daratumumab plus lenalidomide, bortezomib, and dexamethasone for people with newly diagnosed multiple myeloma.

This summary describes the final analysis of the GRIFFIN study. In this study, participants were newly diagnosed with a type of blood and bone marrow cancer called multiple myeloma, had never received any treatment, and were able to undergo an autologous stem cell transplant. The GRIFFIN study looked at adding the drug daratumumab (D) to a combination of standard treatments called RVd (lenalidomide [R], bortezomib [V], and dexamethasone [d]) during the treatment phases induction and consolidation, followed by daratumumab and lenalidomide (D-R) maintenance. Participants also received an autologous stem cell transplant to further help reduce multiple myeloma. The GRIFFIN study looked at whether D-RVd followed by D-R maintenance was better at killing multiple myeloma cells compared with RVd on its own followed by R maintenance on its own, and if treatments were safe. This summary also describes results from 2 other GRIFFIN publications: one that looked at participants with certain multiple myeloma characteristics or demographic factors that are associated with worse outcomes, and another that looked at how treatments impacted the participants' quality of life. At the time of the final analysis of GRIFFIN, participants who were treated with D-RVd followed by D-R maintenance had very low (undetectable) levels of multiple myeloma cells and multiple myeloma markers (biological signs) and were more likely to be alive without the multiple myeloma getting worse or coming back compared with participants who received standard RVd treatment followed by R maintenance. There was also a pattern of similar benefits achieved by participants who were at risk for worse outcomes. Additionally, participants who received D-RVd treatment followed by D-R maintenance reported less pain, less fatigue (extreme tiredness), and greater improvements in their ability to conduct daily physical activities. While some side effects (unwanted or unexpected effects of treatment) were higher with D-RVd, side effects in both groups were as expected, and adding daratumumab did not reduce a participant's ability to handle treatment. Results of the GRIFFIN study showed that D-RVd treatment followed by D-R maintenance was better at treating multiple myeloma than the standard treatment of RVd followed by R maintenance in adults with a new diagnosis of multiple myeloma who were able to receive an autologous stem cell transplant, with no unexpected side effects of treatment.Clinical Trial Registration: NCT02874742 (GRIFFIN) (ClinicalTrials.gov).

The Association Between the Perception of Exercise Benefits and Barriers and Exercise Self-Efficacy During the Induction Phase of Dialysis in Patients with End-Stage Kidney Disease: A Cross-Sectional Study

Background/Objectives: The physical function of patients with chronic kidney disease gradually declines as kidney function deteriorates, and this decline becomes more pronounced after the initiation of dialysis. Encouraging the development of exercise habits from the initiation phase of dialysis is crucial. Increased exercise self-efficacy is essential for establishing these habits. However, the related factors at this stage are unclear. This study hypothesized that perceptions of exercise benefits and barriers are related to exercise self-efficacy and aimed to investigate this association. Methods: This single-center, cross-sectional study included 72 patients and assessed the stages of exercise behavior change, perceptions of exercise benefits and barriers, and exercise self-efficacy. Multiple regression analysis was used to examine the association between exercise self-efficacy and perceptions of the benefits and barriers of exercise. Results: Perceptions of exercise benefits were still significantly associated with self-efficacy for exercise after adjustment for age, gender, history of cardiovascular disease, diabetic kidney disease, living alone, employment, and physical function (β = 0.474, p < 0.001). Similarly, perceptions of exercise barriers were also significantly associated with self-efficacy for exercise (β = −0.410, p = 0.001). A subgroup analysis that only examined participants without exercise habits revealed a similar association. Conclusions: Perceptions of exercise benefits and barriers may be associated with exercise self-efficacy in patients with end-stage kidney disease during the initiation phase of dialysis. As patients are temporarily hospitalized during this phase, it provides an opportunity for intervention. Exercise education and supportive environments during hospitalization may enhance perceptions of exercise benefits, reduce perceptions of exercise barriers, and improve exercise self-efficacy.

Mechanical thrombectomy by stent retriever for the treatment of arterial ischemic stroke in a pediatric patient with acute lymphoblastic leukemia: A case report

Introduction: Arterial ischemic stroke (AIS) caused by occlusion of large vessels in childhood is a devastating rare condition that can contribute to long-term disabilities. Childhood leukemia is identified as a recognized risk factor for ischemic strokes. Mechanical thrombectomy is standard of care for large vessel occlusions in adults. However, there are still no definite recommendations regarding application and outcomes of endovascular thrombectomy and the devices used for pediatric patients with arterial ischemic stroke. Case presentation: We report a 13-year-old female with acute lymphoblastic leukemia who developed AIS due to thrombosis in the left internal carotid and proximal middle cerebral artery in the induction phase of treatment. The patient underwent successful mechanical thrombectomy via Solumbra by using “Embolus Retriever with Interlinked Cages (ERIC)” stent retriever and Sofia plus catheter which resulted in successful recanalization of ICA and MCA. Discussion: Selected pediatric patients with AIS due to large vessel occlusions can benefit from mechanical thrombectomy. Although the recently published literature demonstrated the efficacy and safety of MT in children, strong guideline recommendations are still absent. At present, the last AHA/ASA guidelines for early management of AIS recommends intravenous thrombolysis and endovascular therapy in adults, whereas controversy still exists in children. An urgent approach within the defined therapeutic time frame and a multidisciplinary team specialized in pediatric stroke with professional trained interventional neuroradiologist is essential for achieving optimal results. Conclusion: Mechanical thrombectomy provides promising results with high rates of arterial recanalization and favorable outcomes in pediatric patients with AIS.

Corticosteroid Use in Randomized Clinical Trials of Biologics and Small Molecules in Inflammatory Bowel Disease: A Systematic Review.

This systematic review aims to elucidate the use of corticosteroids in randomized clinical trials (RCTs) evaluating biologics and small molecules for inflammatory bowel disease (IBD). We analyzed corticosteroid use during both the induction and maintenance phases, highlighting areas needing standardization and improvement in clinical research. We selected placebo-controlled phase 3 RCTs involving adults with moderate to severe IBD. These studies included detailed reports on corticosteroid use during induction and maintenance phases, with clinical remission and/or corticosteroid-free clinical remission (CSF-CR) as primary endpoints. Initially, 324 studies were identified and refined to 26 RCTs after screening. Analysis revealed variability in corticosteroid administration. Over time, corticosteroid use showed a decreasing trend (Spearman ρ = -0.42, P = .045). Studies allowing higher corticosteroid doses (up to 40mg/day of prednisone or equivalent) reported a higher proportion of corticosteroid users (51.8%, range: 42.9%-61%) compared to those excluding patients on doses >20mg/day (37.5%, range: 31.6%-51.8%; P = .007) or >30mg/day (41.1%, range: 29.6%-53.7%; P=.023). Trials with mandatory tapering protocols showed a narrower gap between overall clinical remission and CSF-CR rates, with an average difference of 6% in the group without mandatory tapering and 1.2% in the group with forced tapering (T-test P=.038; Cohen's d ≈ 1.1). This review highlights the variability in corticosteroid use across RCTs and its impact on evaluating new IBD therapies. Standardizing tapering protocols and defining CSF-CR are essential for accurate outcomes.

Metabolic and histopathological impact of local resource food consumption on blood markers in rats previously subjected to moderate acute malnutrition

Malnutrition is caused by dietary and nutritional imbalances that can have an impact on blood parameters and vital organs. The use of local agricultural resources for adapted diets appears to be an effective solution to post-weaning infant malnutrition. The aim of this study was to evaluate the effectiveness of four newborn diets made from local agricultural resources in improving biochemical, hematological, and histological parameters in rats that had previously experienced mild acute malnutrition. A total of 42 juvenile male rats, with an average age of 80 ±5 days and an average weight of 103.46 ± 5.10 g, were divided into six groups. Each group consisted of seven rats, with two control groups (LTC and LSA) and four experimental groups (LAR1A, LAR1B, LAR2A, and LAR2B). The experiment had three distinct phases: an initial adaptation period lasting 5 days, followed by a phase of inducing malnutrition lasting 19 days, and finally a phase of nutritional rehabilitation lasting 14 days. At the conclusion of the malnutrition induction and nutritional rehabilitation phases, blood samples were collected and used to evaluate biochemical and haematological markers. Kidneys and liver were removed for histological analysis.The findings revealed that the period of inducing malnutrition had a detrimental impact on several parameters, such as urea, triglyceride, total protein, C-reactive protein, albumin, ALAT, ASAT, WBC, hemoglobin, hematocrit, and MCV. Nevertheless, the ingestion of LAR diet derived from indigenous ingredients successfully returned all of these blood markers to the required levels for rats. Furthermore, histological examinations demonstrated that there were no kidney or liver abnormalities at the end of the trial.The LAR diets have rehabilitative effects on the biochemical and haematological parameters of rats. This suggests that these diets can be used therapeutically to treat moderate acute malnutrition and meet the nutritional needs of children aged 6 to 36 months.

Ischemia-induced endogenous Nrf2/HO-1 axis activation modulates microglial polarization and restrains ischemic brain injury.

Cerebral ischemic stroke accounts for more than 80% of all stroke cases. During cerebral ischemia, reactive oxygen species produced in the ischemic brain induce oxidative stress and inflammatory responses. Nrf2 is a transcription factor responsible for regulating cellular redox balance through the induction of protective antioxidant and phase II detoxification responses. Although the induction of endogenous Nrf2/HO-1 axis activation has been observed in the ischemic brain, whether ischemia-induced endogenous Nrf2/HO-1 axis activation plays a role in modulating microglia (MG) phenotypes and restraining ischemic brain injury is not characterized and requires further exploration. To investigate that, we generated mice with Nrf2 knockdown specifically in MG to rigorously assess the role of endogenous Nrf2 activation in ischemic brain injury after stroke. Our results showed that MG-specific Nrf2 knockdown exacerbated ischemic brain injury after stroke. We found that Nrf2 knockdown altered MG phenotypes after stroke, in which increased frequency of inflammatory MG and decreased frequency of anti-inflammatory MG were detected in the ischemic brain. Moreover, we identified attenuated Nrf2/HO-1 axis activation led to increased CD68/IL-1β and suppressed CD206 expression in MG, resulting in aggravated inflammatory MG in MG-specific Nrf2 knockdown mice after stroke. Intriguingly, using type II diabetic preclinical models, we revealed that diabetic mice exhibited attenuated Nrf2/HO-1 axis activation in MG and exacerbated ischemic brain injury after stroke that phenocopy mice with MG-specific Nrf2 knockdown. Finally, the induction of exogenous Nrf2/HO-1 axis activation in MG through pharmacological approaches ameliorated ischemic brain injury in diabetic mice. In conclusion, our findings provide cellular and molecular insights demonstrating ischemia-induced endogenous Nrf2/HO-1 axis activation modulates MG phenotypes and restrains ischemic brain injury. These results further strengthen the therapeutic potential of targeting Nrf2/HO-1 axis in MG for the treatment of ischemic stroke and diabetic stroke.

Clinical insights into Invasive Aspergillosis in Mexican children with cancer

Abstract Background In the last years Invasive Aspergillosis (IA) has become the most frequent invasive fungal infection (IFI) affecting children with hematological malignancies. This complication results in the delay of cancer treatment and/or poor prognosis mainly due to late diagnosis and late start of antifungal treatment. Therefore, antifungal prophylaxis and preemptive approaches have been proposed for these patients based on risk factors and local epidemiological data. For this reason, we performed a unicenter, descriptive and prospective study to determine the frequency and clinical course of IA in hospitalized cancer patients with fever and neutropenia. Methods we included events of fever and neutropenia of hospitalized patients with cancer and either with persistent febrile neutropenia (PFN: fever for >96h with total neutrophil count of <500cells/mm3) or profound prolonged neutropenia (PPN: total neutrophil count of <500cells/mm3 for >7 days). Informed consent was requested prior inclusion and follow up of these events was performed with weekly measurement of serum galactomannan antigen (until the recovery of neutrophil count), lung computed tomography (CT) and/or sinus and/or central nervous system (CNS) imaging, depending on clinical findings, and if feasible bronchoscopy to obtain bronchioalveolar lavage (BAL) samples. Clinical and laboratory data were obtained; with this information diagnosis of IA was classified as possible, probable, and proven, according to the EORTC/MSG guidelines. This protocol was approved by the hospital’s research and ethics committees (INP 041/2021). For data analysis categorical variables were presented as frequencies and numerical variables as median and range. Statistical analysis was made with X2 and U Mann Whitney tests. Results Seventy events were included, 14 (20%) had IA diagnosis; 2 possible, 11 probable and 1 proved. Median of age was 10.2y (5.5 – 17) and 64.3% were male. Acute lymphoblastic leukemia was the main oncologic diagnosis (71.4%), 35.7% during induction phase; followed by acute myeloblastic leukemia (21.4%). 92.9% of events with IA presented as PFN (p=0.001) with a fever duration of 3.5 days (1-8) (p=0.004). Pulmonary disease was evident in all events with IA, two had disseminated infection. In 5/14 events serum galactomannan antigen was positive in the first measurement. Only 8 events underwent bronchoscopy: BAL was positive in 6 and 4 had positive culture with Aspergillus spp. Lung CT scan showed different findings, lobar/segmental consolidation and nodule with halo sign were the most common; 85.7% of cases presented with more than one radiological sign (p=0.003). Voriconazole monotherapy was given to 78.5% of IA cases and 21.4% required combined antifungal therapy (added caspofungine or liposomal amphotericin B) due to disseminated disease or severe clinical course. Intensive care admission resulted with statistical significance for the events with diagnosis of IA (64.3% p= 0.019). Within the IA events survival at 60 days was of 78.6%. Conclusion Frequency of IA was high among our high risk cancer patients. This study demonstrates the importance of a complete work up for invasive fungal infection in high-risk patients with persistent febrile neutropenia. The information obtained is of great use for the implementation of pre-emptive approaches and antifungal prophylaxis in this patient population.

Bacteremias in Hemato-Oncological Pediatric Patients: Clinical and Microbiological Characteristics

Abstract Background In haemato-oncologic patients bacteremia is frequent increasing mortality rates, therefore surveillance and close follow up is essential to optimize treatment. The use of invasive devices used frequently in this population increases the incidence of infections by gram-positive microorganisms (currently gram-negative bacilli have been added). Therefore, we propose the characterization the microorganisms to identify the epidemiologic conditions, and the areas of improvement to establish improvement care strategies for this population. Methods We conducted a retrospective study at the haemato-oncologic diseases service at the National Medical Center “20 de Noviembre”. Prevalence of bacteremia in pediatric patients with cancer and neutropenia in Mexican population, which ranges from 8% to 36%, assuming that our results could be similar to higher percentage, employing a proportion formula with a study population of 65 patients. Results It was demonstrated in our population studied that in all cases of bacteremia, patients were in depth neutropenia at diagnosis. The most prevalence phase of chemotherapy was Induction phase (69.2%), with Total XV ST Jude protocol. The clinical data revealed the following frequencies in 100% of the patients: Fever (92%), Tachycardia (72%), Shivering and piloerection (65%), Elevated acute-phase reactants PCT (51%), CPR (32%), and Tachypnea (28%). Cases of Central Line-associated Bloodstream Infection (CLABSI) was reported in 86.2%, affecting individuals with vascular devices. The predominant microbiological isolate in our patients was Escherichia coli ESBL (31%), followed by Klebsiella pneumoniae (18%), and Pseudomonas aeruginosa (13.8%), Staphylococcus epidermidis (11%). Other bacteria were identified at even lower frequencies, such as Stenotrophomonas maltophilia (5%), Klebsiella oxytoca (5%), Staphylococcus aureus (3%), Serratia marcescens (3%), Enterococcus faecalis (3%), and Enterobacter cloacae (3%). The least observed in our population was the identification of Acinetobacter baumannii (2%). The different outcomes recorded in our sample were highly consistent, with a resolution rate of infection in 97% of cases and 3% of cases resulting in death attributable to bacteremia (Table 1). Conclusion The low mortality found in this study may be due to the early initiation of empirical antibiotic treatment in “golden hour”, a protocol carried out in our Center, as well as the identification of severity scales.

Use of Data from a Fever Registry (FEVEREG) to Identify Quality Improvement Opportunities in a Third-Level Hospital in Panama

Abstract Background Infectious diseases in childhood cancer patients are frequent and increase the morbimortality of these patients. Hospital del Niño doctor José Renán Esquivel initiated data collection in a registry of fever and neutropenia (FEVEREG) to evaluate outcomes and management of these diseases and identify opportunities for quality improvement. The objective of this study is to describe data collected to date. Methods Data was collected through a data collection instrument (CRF) using Trial Master platform. It was analyzed with R Data Analytics (version 4.3.2) and descriptive statistics summarized. Only patients who were admitted due to the febrile episode or were hospitalized when fever started were included. Results From Sept 2021 to October 2023, we captured 138 episodes in 70 patients, with a mean age of 8 years (range 0-15) and a similar percentage of female and male patients. The most common diagnosis was acute lymphoblastic leukemia (57.14%) and the episodes occurred more during the induction phase (24%) and in patients with a relapse protocol (31.5%). The time of administration of the antibiotic varied depending on the patient location at fever onset. 44% of outpatients (46/105) received the first dose of antibiotic more than 4 hours after the onset of fever, while hospitalized patients received this dose in the first hour in 64% of cases (21/33). Time from registration of outpatients until the first dose of antibiotic was an average of 71 minutes, with 60% of the patients receiving the antibiotic during the first 60 minutes. In 45.8% of the episodes, a blood culture was taken before starting the antibiotic. The febrile neutropenia algorithm was followed on 64.5% of the days evaluated, with the main cause of deviation being treatment to the focus of infection (55%) followed by clinical decision (41%). Bacteremia occurred in 26% of episodes (20/78) and 14% of episodes had documented viral infection (11/78). The most frequently isolated bacteria in blood was Pseudomonas aeruginosa (13/33, 39.3%). Approximately 4% of the episodes (6/138) were admitted to the intensive care unit and died, half from septic shock and half from progressive disease. The average length of hospital stay was 12 days. Conclusion Data from FEVEREG has suggested opportunities for quality improvement in time to antibiotics and use of guideline compliant antibiotics (antimicrobial stewardship).

Comprehensive analysis of AHL genes in Malus domestica reveals the critical role of MdAHL6 in flowering induction

AT-hook motif nuclear localized (AHL) genes are crucial in various biological processes, yet the AHL gene family in apples has remained largely unexplored. In this study, we isolated 36 MdAHL genes from the apple genome and grouped them into two distinct clades. We characterized the gene structure, conserved motifs, protein biochemical properties, and promoter regions of the MdAHL genes. Transcriptional analysis revealed that MdAHL genes are preferentially and predominantly expressed in flowers and leaves. Notably, during the floral induction phase, the MdAHL6 gene exhibited remarkably high transcriptional activity. Overexpression of MdAHL6 resulted in shortened hypocotyls and delayed flowering by regulating hypocotyl- and floral-related genes. Y1H, EMSA, GUS activity, and molecular docking assays revealed that MdAHL6 directly binds to AT-rich regions, inhibiting the expression of FLOWERING LOCUS T (MdFT). Furthermore, Y2H, pull-down, and BiFC assays demonstrated a physical interaction between MdAHL6 and the class II knotted-like transcription factor MdKNOX19, which significantly enhances the inhibitory effect of MdAHL6 on MdFT expression. This comprehensive initial analysis unveils the critical role of the MdKNOX19-MdAHL6-MdFT module in flowering induction and lays a theoretical foundation for future functional exploration.

Preparation of the sandwiched PS-SiO2-PVAc-SiO2 electrospinning fiber membrane with super-hydrophobic and self-cleaning and its performance in oil-water emulsion separation

Oil-water emulsion separation could improve the efficiency of oil resources and reduce environmental pollution. The efficiency of oil-water separation was directly affected by the surface hydrophobicity of the membrane and its reliability and reusability. Therefore, the construction of a reliable and reusable super-hydrophobic surface was very important. In this research, the EFM with sandwich structure of PS-SiO2-PVAc-SiO2 was easily fabricated by a three times liquid phase induction process and heat treatment. The PS-SiO2-PVAc-SiO2 EFM was first formed by a triple liquid phase induction process, then the EFM was heat-treated, the PVAc, which is a heat-sensitive material, resulting in SiO2 nanoparticles being welded onto PS fibers. The rolling contact angle experiment at an inclination of 8° proved that the PS-SiO2-PVAc-SiO2 EFM has super-hydrophobic properties. Meanwhile, the PS-SiO2-PVAc-SiO2 EFM showed excellent stability and reliability of super-hydrophobic properties after the EFM was washed or taped. In addition, the PS-SiO2-PVAc-SiO2 EFM had self-cleaning function and fine oil-water separation property. The oil-water separation efficiency was over 99.50 % and the flow rate was 68 L/m2h. After 5 times of oil-water separation, the flux and separation efficiency did not decrease significantly, which proved that the PS-SiO2-PVAc-SiO2 EFM could be reusable.

Evaluation of the level of tumor necrosis factor-alpha and lactate dehydrogenase in acute lymphoblastic leukemia patients

Abstract: BACKGROUND: Acute lymphoblastic leukemia (ALL) is an abnormal clonal proliferation of early hemopoietic precursor cells in bone marrow (BM). There are certain cytokines like tumor necrosis factor alpha ( TNF-α) which plays a crucial role in the development and progression of malignant process, and other enzymes like lactate dehydrogenase (LDH) which has prognostic value. OBJECTIVE: The aims of this study were to evaluate the level of serum TNF-α and LDH in ALL patients at diagnosis and post-induction chemotherapy. PATIENTS, MATERIALS, AND METHODS: This was an observational–analytical study, which was done in Ibn-Sina Teaching Hospital in the period between May 2023 and November 2023. It included 22 newly diagnosed patients with ALL. All patients underwent complete blood count, bone marrow examination, flowcytometry, serum TNF-α and LDH at diagnosis and post induction chemotherapy. RESULTS: In 22 patients with ALL, at diagnosis, the means of serum TNF-α (97.89 ± 52.945 ng/l), serum lactate dehydrogenase(1138.94 ± 430.10 IU/l), and percentage of blasts cells in BM (0.742 ± 0.181) in B-ALL. The means of serum TNF-α (165.33 ± 23.437 ng/l), serum lactate dehydrogenase (1633.33 ± 497.426 iu/l), and percentage of blasts cells in BM (0.816 ± 0.125) in T-ALL were statistically higher than those among the controls (s.TNF-a (18.09 ± 6.795 ng/l), s.LDH (142.59 ± 61.626 IU/l), and percentage of blasts cells in BM 0.0 ± 0.0) with P = 0.000 for all parameters mentioned, respectively. After induction phase chemotherapy in B-cell ALL , there were a significant reduction noted for serum TNF-α (29.26 ± 18.648 ng/l) and LDH levels (245.47 ± 154.592 IU/l) and a significant decrease in the percentage of blasts cells (0.07 ± 0.060).also in T-cell ALL there were a significant reduction noted for serum TNF-a (26.00 ± 11.135 ng/l) serum LDH (347.66 ± 160.300 IU/l) and percentage of blasts cells in bone marrow (0.06 ± 0.046). All of the postchemotherapy acute leukemia cases with lower TNF-α levels had complete remission (100%). CONCLUSIONS: There were significant increases in serum TNF-α and LDH in ALL patients at diagnosis; while after induction, there was a significant reduction in their levels. Complete remission from the disease was associated with lower levels of serum TNF-α in newly diagnosed patients.