Stage Migration Research Articles

Modeling Toxoplasma gondii-gut early interactions using a human microphysiological system.

Oral transmission of parasites via environmentally resistant cyst stages in contaminated food or water is a common route of human infection, but there are no effective vaccines available for any enteric parasitic infection. Our knowledge of parasite cyst stage conversion and interaction with the intestinal tract is limited. Here, we investigate infection dynamics of Toxoplasma gondii cyst-stage in murine jejunum and human intestinal microphysiological systems. We focus on parasite ingress, replication, and conversion of the cyst stage to the rapidly replicating dissemination stage. In vivo bioluminescent imaging of mice fed cysts revealed spots of infection throughout the jejunum and ileum, which were selected for further analyses. Immunostaining showed parasite migration and replication predominantly in the stroma, with minimal replication in enterocytes. We recapitulated bradyzoite infection in human intestinal microphysiological systems and showed stage conversation and migration through collagen. This integrated approach elucidates complex host-parasite interactions, highlighting the value of microphysiological systems in advancing understanding and identifying potential therapeutics.

Experimental trichuriasis: Changes in the immune response and bacterial translocation during acute phase development illustrated with 3D model animation.

Trichuriasis, a well-known type of soil-transmitted helminthiasis, is a neglected gastrointestinal nematode disease predominantly affecting children in tropical regions and is caused by Trichuris trichiura. The potential zoonotic transmission of this disease is indicated by its presence in nonhuman primates. Chronic infection leads to mucosal damage, bacterial translocation, and intense inflammatory infiltration; however, the progression of these processes remains poorly understood. This study tracks the acute phase of experimental trichuriasis, providing detailed insights into nematode tissue migration stages, inflammatory infiltration, cytokine production, and 2D/3D imaging of the bacterial translocation process. We showed a mixed immune response (Th1, Th2, and Th17) initiated by larval-induced lesions in the intestine tissue and modulated by L4 larvae and adult worms in the cecum, with systemic changes observed in the mesenteric lymph nodes, peritoneal macrophages, and spleen. Despite the disruption of the intestinal mucosa within the first 10 days post-infection (d.p.i.), bacterial invasion becomes evident only after the development of the nematode into the L3 larval stage (17 d.p.i.), intensifying with lesions caused by the L4 larvae (22 d.p.i.) and adult worms (35 d.p.i.). Our multidimensional approach, which incorporates microscopy tools, micro-CT, physiological evaluations, tissue/organ assessments, and immunological parameters, demonstrates the ability of larvae to breach the intestinal mucosa, further indicating the timing of extensive bacterial infiltration. Additionally, a 3D animation illustrates how adult worm attachment mechanisms may facilitate bacterial translocation. This study provides significant insights into the immunological and pathological mechanisms of trichuriasis progression, highlighting the complex interplay among host immune responses, the gut microbiome, and parasite survival strategies, all of which are crucial aspects for future therapeutic development.

Cloud Migration Framework: Transitioning from On-Premises to Azure Cloud for Improved System Reliability and Scalability

This article examines the transition from on-premises IT infrastructure to the Microsoft Azure cloud platform, aimed at enhancing the reliability, flexibility, and scalability of information systems. The purpose of the study is to analyze the migration process from an on-premises network to the Microsoft Azure cloud platform. The article explores the stages of migration, including the assessment of the current infrastructure, the design of an architecture based on cloud technologies, and the implementation of monitoring tools and process automation. The methodology is based on theoretical principles, practical recommendations, and examples of successful migrations. The findings demonstrate that transitioning to the Azure platform improves system availability and reliability through its distributed infrastructure and automated resource management tools. Cloud technologies enable organizations to scale computing power flexibly, adapting to changing demands. Azure also offers integration with other cloud services, expanding the functional capabilities of the ecosystem. This article will be useful for IT professionals, IT managers, cloud solution architects, and developers interested in efficient migration and optimization of IT structures. The conclusion emphasizes that a well-planned cloud transition can reduce operational costs, improve system resilience, and enhance the competitiveness of IT systems, thereby supporting organizational goals.

Profiling host- and parasite-derived miRNAs associated with Strongylus vulgaris infection in horses.

The equine bloodworm, Strongylus vulgaris, is a common and highly pathogenic parasite in horses due to its migratory life cycle involving the intestinal arteries. Current diagnostic techniques cannot detect the prepatent migrating stages of S. vulgaris, highlighting the need for new biomarkers. Parasites release microRNAs (miRNAs) into their environment, which could potentially be detectable in host blood samples. Additionally, host miRNA expression patterns may change in response to infection. This study aimed to identify miRNAs associated with S. vulgaris infection by profiling the horse's miRNA response in the larval predilection site, the Cranial Mesenteric Artery (CMA) and examining the circulating parasite and horse-derived miRNAs in plasma of S. vulgaris-infected horses. Plasma samples were collected from 27 horses naturally infected with S. vulgaris and 28 uninfected horses. Arterial tissue samples from the CMA and Aorta were collected from a subset (n = 12) of the infected horses. Small RNA sequencing (small RNAseq) of a subset of the plasma samples (n = 12) identified miRNAs of interest, followed by quantitative real-time PCR (qPCR) evaluation of selected miRNAs in plasma from a larger cohort of horses. Small RNAseq detected 138 parasite-derived and 533 horse-derived miRNAs in the plasma samples. No difference in parasite-derived miRNA abundance was found between the infected and uninfected horses, but 140 horse-derived miRNAs were significantly differentially abundant between the two groups. When evaluated by qPCR, none of the selected parasite-derived miRNAs were detectable in plasma, but seven horse-derived miRNAs were confirmed differentially abundant in plasma between the two groups. Seven horse-derived miRNAs were differentially expressed in CMA tissue affected by migrating S. vulgaris compared with unaffected aortic tissue, with Eca-Mir-223-3p (Log2FC: 4.74) and Eca-Mir-140-3p (Log2FC: -3.64) being most differentially expressed. A receiver operating characteristic curve analysis suggested that Eca-Mir-486-5p and Eca-Mir-140-3p had the best diagnostic performance for distinguishing between infected and uninfected horses, with areas under the curve (AUC) of 0.78 and 0.77, respectively. Notably, Eca-Mir-140-3p was associated with age, and correcting for interaction with age increased the AUC to 0.96. In conclusion, several horse-derived miRNAs were associated with S. vulgaris infection and could differentiate between infected and uninfected horses based on their plasma abundance. However, the levels of these miRNAs were influenced by other factors (i.e age, breed), complicating their use as biomarkers. Parasite-derived miRNA abundance did not differ between S. vulgaris infected horses and those infected with other parasites using small RNAseq and were below detection limits of qPCR.

Effect of High Temperature on PGC Migration in an Early Stage of White Shrimp

Effect of High Temperature on PGC Migration in an Early Stage of White Shrimp

Surgical options for advanced renal cell carcinoma.

Detection of advanced renal cell carcinoma (RCC) is not uncommon, although there has been a stage migration due to frequent use of abdominal imaging allowing early detection of renal masses. Since open IVC thrombectomy was introduced in 1972, minimally invasive approaches such as laparoscopic approach, hand-assisted approach and robotic approach have been adopted. While robotic surgery has potential benefits to improve perioperative outcomes, and our experience with robotic surgery has grown significantly over the last decade, open surgery at an academic center remains the standard of care in this setting. In the setting of metastatic RCC, cytoreductive nephrectomies have been discussed for many years but their indications are unclearly defined, although cytoreductive nephrectomy can be considered in patients with disease largely limited to the kidney or on-going or impending symptomatic disease. Significant advances have been made in systematic therapy for RCC which will eventually lead to the evolution of neoadjuvant and adjuvant therapy in patients with advanced RCC. The surgical management of advanced RCC is a major and complex undertaking but has shown to be feasible and effective.

68Ga-DOTATATE PET/CT in the Initial Staging of Well-Differentiated Gastroenteropancreatic and Non-Gastroenteropancreatic Neuroendocrine Tumors: Results of a Prospective Registry

Background and Objectives: At diagnosis, the initial staging of well-differentiated neuroendocrine tumors (WD NETs) aids in treatment planning. The somatostatin receptor (SSTR)-PET has been recommended for staging of WD NETs although limited data are available on its impact on non-gastroeneteropancreatic (GEP) NETs. The main purpose of this study was to compare the stage migration after the addition of SSTR-PET to the workup of patients at the initial staging of GEP NETs to those with non-GEP NETs, and its potential impact on patient management. Methods: This prospective study included patients with WD NETs at initial staging. Demographic data, results of conventional and SSTR-PET staging, and SUVmax were recorded. Three panels of experts assessed the potential impact of SSTR-PET to management. Results: There were 482 patients, including 376 with gastroenteropancreatic (GEP) NETs and 106 non-GEP NETs with a median SUVmax of 34.7 [Q1, Q3: 22.8, 59.1]) and 19.0 [Q1, Q3: 7.9, 39.8]), respectively; p < 0.001. The discordant M-stage was recorded in 111/473 patients (23.5%). PET suggested a higher stage in 78/369 GEP NETs (21.1%), including the detection of extrahepatic metastatic disease in 42/114 (36.8%) patients with liver metastases only on CI. For non-GEP NETs, PET suggested a higher stage in 10/104 (9.6%) and CI suggested a higher stage in 15/104 (14.4%), with CI detecting liver metastases more frequently. The potential impact to management for patients with discordant M-stage was scored as moderate to high between 57/101 (56.4%) and 79/101 (78.2%) of patients. Conclusions: One in five patients are upstaged following SSTR-PET, more frequently with GEP NETs than others. SSTR-PET identifies extrahepatic metastatic disease in >1/3 of patients with presumed liver-only metastases on CI. Stage migration following SSTR-PET may result in frequent moderate or significant management change.

Dissecting Tumor Size Underestimation in Pancreatic Cancer: A Comparative Analysis of Preoperative Treatments.

Tumor size (TS) in pancreatic ductal adenocarcinoma (PDAC) is one of the most important prognostic factors. However, discrepancies between TS on preoperative images (TSi) and pathological specimens (TSp) have been reported. This study aims to evaluate the factors associated with the differences between TSi and TSp. We retrospectively analyzed patients with PDAC who underwent surgery at our institution between January 2010 and November 2023. TS discrepancy (TSD[%]) was defined as ([TSp - TSi]/TSp) × 100. Using logistic regression, we generated a receiver operating characteristic (ROC) curve to define the cutoff for TSi underestimation predicting clinical tumor (T) stage migration. Univariate and multivariate analyses were performed to evaluate predictors of TSi underestimation. Of the 231 patients, 99 (42%) patients received preoperative chemotherapy. The ROC curve determined a TSD underestimation cutoff of 25.9%. The number of TSp > TSi cases was 185 (80%), and TSi underestimation was present in 117 (51%) patients. T stage migration rates were 76%, 26%, and 50% in clinical stage (c) T1, cT2, cT3, respectively, among the patients with chemotherapy, and 93%, 33%, and 14%, respectively, in those without chemotherapy. Multivariate analyses revealed that independent predictors of TSi underestimation were posterior surface invasion in the patients with preoperative chemotherapy and anterior surface invasion in those without chemotherapy. TS was more commonly underestimated than overestimated, and cT1 rarely corresponded to pathological (p)T1. The factors contributing to TSi underestimation differed between patients with and without preoperative chemotherapy. Therefore, these two groups should be considered separately for accurate TSi evaluation.

Structural Transformation and Degradation of Cu Oxide Nanocatalysts during Electrochemical CO2 Reduction.

The electrochemical CO2 reduction reaction (CO2RR) holds enormous potential as a carbon-neutral route to the sustainable production of fuels and platform chemicals. The durability for long-term operation is currently inadequate for commercialization, however, and the underlying deactivation process remains elusive. A fundamental understanding of the degradation mechanism of electrocatalysts, which can dictate the overall device performance, is needed. In this work, we report the structural dynamics and degradation pathway of Cu oxide nanoparticles (CuOx NPs) during the CO2RR by using in situ small-angle X-ray scattering (SAXS) and X-ray absorption spectroscopy (XAS). The in situ SAXS reveals a reduction in the size of NPs when subjected to a potential at which no reaction products are detected. At potentials where the CO2RR starts to occur, CuOx NPs are agglomerated through a particle migration and coalescence process in the early stage of the reaction, followed by Ostwald ripening (OR) as the dominant degradation mechanism for the remainder of the reaction. As the applied potential becomes more negative, the OR process becomes more dominant, and for the most negative applied potential, OR dominates for the entire reaction time. The morphological changes are linked to a gradual decrease in the formation rate for multicarbon products (C2H4 and ethanol). Other reaction parameters, including reaction intermediates and local high pH, induce changes in the agglomeration process and final morphology of the CuOx NPs electrode, supported by post-mortem ex situ microscopic analysis. The in situ XAS analysis suggests that the CuOx NPs reduced into the metallic state before the structural transformation was observed. The introduction of high surface area carbon supports with ionomer coating mitigates the degree of structural transformation and detachment of the CuOx NPs electrode. These findings show the dynamic nature of Cu nanocatalysts during the CO2RR and can serve as a rational guideline toward a stable catalyst system under electrochemical conditions.

Oogenesis in Shabout Barbus grypus Heckel , 1843

The female Shabout were collected as samples from Dijla river in Baghdad. The oocyte developmental stages were divided in to nine stages, based on nucleus structure , cellular inclusions and ovarian follicle structure ,they are:-( Oogonia stage , Early Perinucleolar Stage , Advanced Perinucleolar Stage , Cortical Alveoli Stage , Primary Yolk Stage , Secondary Yolk Stage , Tertiary Yolk Stage , Migratory Nucleus Stage , Hydration Stage(

Aesthetic evaluation underpinning brand love relationship development: an activation likelihood estimation meta-analysis and multivariate analysis.

Brand love is a crucial construct in marketing strategies. Building brand love can generate stable profits for enterprises. Although the marketing literature points out that aesthetic factors contribute to establishing the relationship as a trigger, to what stage of the relationship do they influence the minds of consumers? The present study attempts to reveal the involvement of aesthetic experiences in brand love developmental dynamics. Using the activation likelihood estimation method, we address this issue by assessing overlapping brain regions between brand love at each stage and aesthetic experiences. We adopted three major meta-analytic decoding analysis modules to objectively interpret these brain regions, namely, Neurosynth, NeuroQuery, and the Behavioral Analysis plugin (BrainMap platform). Moreover, we performed a correspondence analysis to identify relationships of mental processes between aesthetic experiences and brand love in each developmental stage of brand love. Our results suggest that the same neural mechanism and mental processes may be underlaid between brand love and aesthetic experiences across all stages. Although reward- and emotion-related mental processes are commonly underlaid between brand love at the first-half stage and aesthetic experiences, exteroceptive and interoceptive signals may drive those mental processes between the early and migration stages of brand love, respectively, and aesthetic experiences. Overlapping regions of brand love at the stable stage and aesthetic experiences may be associated with semantic processing. We demonstrate that several brain regions overlapped between brand love and aesthetic experiences across all the brand love developmental stages. Therefore, aesthetic experiences might be associated with the mental processes of brand love development through all the developmental stages. Our results suggest that aesthetic experiences are essential elements for developing brand-love relationships. Our findings indicate that marketers should recognize that aesthetic experiences play a crucial role in building a bond between brands and consumers, not only when choosing brands. Thus, marketers need to design visual strategies from the view of nurturing brand-love relationships.

Prognostic impact of the N2 subclassification and stage migration in the ninth edition of the TNM classification in surgically resected lung cancer.

In the ninth edition of the TNM classification of lung cancer, N2 is subdivided into single-station (N2a) and multiple-station involvement (N2b), and some stage changes are made to stage II-III. This study aimed to validate the new classification and determine the effect of stage migration and vice versa on the prognosis of each pathological stage due to these changes. A total of 1,754 patients with surgically resected lung cancer were included. Clinical characteristics of patients at each new pathological N (pN) status were compared. Overall survival (OS) was evaluated according to the new pN status and pathological stages. The OS of pN2a patients tended to be superior to that of pN2b patients without significance (p=0.083). Several patient characteristics, including clinical N status, were not significantly different between pN2a and pN2b. The OS of the downstaged patients (T1N1M0 from IIB to IIA, T1N2aM0 from IIIA to IIB, and T3N2aM0 from IIIB to IIIA) was not significantly different from that of other patients in the same stages (p=0.376, p=0.630, and p=0.970, respectively). The OS of the upstaged patients (T3N2bM0 from IIIA to IIIB) was significantly better than that of other patients in the same stage (p<0.001). The 5-year OS rates of stages IIIA and IIIB were 63.3% and 49.4% in the eighth edition and 58.9% and 54.3% in the ninth edition, respectively. Although the N2 subclassification had some impact on survival stratification, it was difficult to predict the subdivided pN2 status, preoperatively. The OS difference in stage III was smaller in the ninth edition than in the eighth edition, due to the complex effects of stage migration and vice versa.

Cervical cancer stage distribution and survival outcomes in Africa: a systematic review and meta-analysis.

Cervical cancer is a leading cause of cancer-related deaths among women, with a disproportionate burden in sub-Saharan Africa. Understanding the cervical cancer stage and outcomes is crucial for developing effective interventions and reducing its burden. We aimed to undertake a systematic review and meta-analysis of cervical cancer stage distribution and survival outcomes in Africa. We searched MEDLINE, Embase, PubMed, Cochrane Library, Clarivate Analytics Web of Science, and the World Health Organization African Index Medicus database for publications in all languages from the inception of databases to July 2021. A total of 144 studies published between 1978 and 2021 from 33 African countries were included, encompassing 55,747 patients. We revealed that 53.3% (95% CI 50.9 to 55.6) of cervical cancer cases in Africa were diagnosed at late stages (stage III-IV). This proportion varied significantly across countries and regions, ranging from 7.7% to 86.3%. The study also highlighted disparities by Human Development Index (HDI) grouping, with low HDI countries exhibiting higher proportions of late-stage diagnoses (56.0%, 95% CI 51.6 to 60.4) compared with medium (51.2%, 95% CI 47.5 to 54.9) and high (50.7%, 95% CI 47.0 to 54.5) HDI countries. Notably, there was no stage migration observed over time (p = .53). The median overall survival was 24.0 months (interquartile range, 19.2-39.4). These stage and outcomes data highlight the need for expanding cervical cancer screening and treatment and are crucial for policymakers to develop evidence-based strategies aimed at accelerating the elimination of cervical cancer in Africa. Additionally, standardized data collection and reporting are needed to facilitate better monitoring of cervical cancer outcomes across countries.

Healthcare provision for displaced people in transit: Analyses of routinely collected data from INTERSOS clinics at the Ukrainian border with Moldova and Poland.

The Russian military invasion of Ukraine has sparked Europe's largest forced displacement since World War II, bringing about significant health vulnerabilities for migrants and refugees. European health information systems lack comprehensive data coverage, especially in underrepresented migration stages like transit. This study aims to address this gap by analyzing data from INTERSOS clinics at the Moldovan and Polish borders with Ukraine to identify the common health conditions prompting people to seek healthcare services during transit. From 6th March to 31st May 2022, this cross-sectional study observed migrants and refugees receiving INTERSOS services at two mobile clinics in Moldova, and a facility in Poland. We analyzed data by age, sex, nationality, and reported disease frequencies and care provided. This study used routinely collected data from 1756 patients. The majority of the adult population seeking healthcare were females (76.5 %), 26.1 % were children and 18.7 % were older individuals. Noncommunicable diseases (NCDs) were the primary reason for seeking healthcare at these clinics, with 23.3 % of the study population being diagnosed with at least one chronic disease, and 3.4 % of people having multimorbidity. Mental and behavioural disorders were diagnosed in 12.6 % of the population, and somatoform disorders and related stress (F40-F48) in 10.8 %. Our study indicates the diversity of forcibly displaced populations and the corresponding diversity of their healthcare needs. In the shadow of a forced displacement crises triggered by the conflict in Ukraine, there is an urgent need to give more attention to subgroups of the population that are often neglected in humanitarian crises. These include older adults, females, and ethnic minorities. Additional attention should also be given to NCDs and sexual and reproductive health (SRH) care needs, especially given the high numbers of older adults and females in this population. Early medical support, psychological first aid and interventions in transit centers that promote survivor resilience and recovery are required. Our findings shed light on the healthcare needs of forcibly displaced populations during transit, a stage often overlooked in migration health research. They underscore the diverse healthcare needs of forcibly displaced populations, emphasizing the necessity for humanitarian aid programs to acknowledge and address this diversity. Accessing data on displaced populations' healthcare needs in transit can help the preparing and planning of healthcare services for these populations in host or destination countries. Ensuring objective anonymization and preventing patient re-identification are essential, particularly in safeguarding refugee privacy and data protection to avoid the misuse of their data.

Fibroblast Growth Factor 8 enhances the chondrogenesis of trunk neural crest cells: a possible gene regulatory network.

The neural crest (NC) is an embryonic cell population with high migratory capacity. It contributes to forming several organs and tissues, such as the craniofacial skeleton and the peripheral nervous system of vertebrates. Both pre-migratory and post-migratory NC cells are plastic, adopting multiple differentiation paths by responding to different inductive environmental signals. Cephalic neural crest cells (CNCCs) give rise to most of the cartilage and bone tissues in the head. On the other hand, the mesenchymal potential of trunk neural crest cells (TNCCs) is sparsely detected in some animal groups. The mesenchymal potential of TNCCs can be unveiled through specific environmental conditions of NC cultures. In this study, we present evidence that FGF8 treatment can foster increased chondrogenic differentiation of TNCCs, particularly during treatment at the migratory stage. Additionally, we conducted a transcriptomic analysis of TNCCs in the post-migratory stage, noting that exogenous FGF8 signaling can sustain multipotent status and, possibly, at the same time, a pro-cartilage regulatory gene network. Our results provide a more comprehensive understanding of the mechanisms underlying chondrogenic differentiation from TNCCs.

Predictors of Understaging with EUS and PET-CECT in Early Esophageal Carcinoma

BackgroundThe clinicoradiological staging for esophageal cancer is fraught with variable accuracy, potentially depriving patients who have been understaged of the benefit of neoadjuvant therapy, which has been shown to improve long-term survival in locally advanced malignancies. It is imperative to identify these high-risk tumors for tailored treatment.MethodsRetrospective analysis of a prospective database of patients undergoing esophagectomy for carcinoma esophagus between 2011 and 2019. Patients with clinicoradiological early-stage esophageal carcinoma (T1/2 and N0), staged with EUS and fluoro-deoxy-glucose positron emission tomography with contrast-enhanced computed tomography (FDG PET-CECT), and undergoing upfront surgery were included. Demographic profile, staging, perioperative outcomes, and follow-up data were extracted from electronic records and analyzed using SPSS 26.0.ResultsDuring this period, we performed 1496 esophagectomies, of which 68 patients (4.5%) underwent upfront surgery for early-stage tumors. The overall concordance between clinical and surgical staging was 55.8%. The positive predictive value (PPV) of EUS for T1, T2, and N0 was 81.6%, 46.7%, and 82.4%, respectively, with 10.2% and 17% upstaging to T3 and N + , respectively. On multivariate analysis, T2 on EUS and tumors longer than 3.5 cm and having standardized uptake value (SUVmax) > 3.05 on FDG PET were strong predictors of stage migration. The 3-year overall survival (OS) of the entire cohort was 74.2%, while those who were understaged had a worse outcome, with a 3-year survival of 48.2%.ConclusionEndoscopic T2 stage, length more than 3.5 cm, and SUVmax more than 3.05 are associated with significant understaging and hence should be considered for neoadjuvant therapy.

Adjuvant rituximab and elevated intratumoural CD8 expression are associated with sustained disease control after radiotherapy in a randomised trial of systemic therapy in early-stage follicular lymphoma

We report extended follow-up of TROG99.03, a randomised phase III trial in early-stage follicular lymphoma (ESFL) including new information on the role of adjuvant rituximab and translational studies. Patients with ESFL were randomised to involved field radiotherapy (IFRT) or IFRT plus 6-cycles cyclophosphamide/vincristine/prednisolone (IFRT+CVP). From 2006 rituximab was added to IFRT+CVP (IFRT+R-CVP). Clinical and multi-omic parameters were evaluated. Findings were validated in two independent ESFL cohorts (99 and 60 patients respectively). Between 2000 and 2012, 150 (75 per arm) patients were recruited. 48% were positron emission tomography (PET)-staged. By protocol, at median follow-up 11.3-years, progression-free survival (PFS) remained superior for IFRT+(R)CVP vs. IFRT (hazard ratio [HR]=0.60, 95% CI=0.37-0.98, p=0.043; 10-year PFS 62% vs. 43%) respectively. Although no significant difference in overall survival was observed (HR=0.44, 95% CI=0.16-1.18, p=0.11, 10-year OS 95% vs. 84%), patients receiving IFRT+(R)CVP experienced fewer composite (histological transformation and death) events (p=0.045). PFS of IFRT+R-CVP-treated patients compared with all other treatments lacking rituximab (IFRT alone plus IFRT+CVP) was superior (HR=0.36, 95% CI=0.13-0.82, p=0.013). Amongst PET-staged patients, PFS differences between IFRT+R-CVP vs. IFRT were maintained (HR=0.38, 95% CI=0.16-0.89, p=0.027) indicating benefit distinct from stage migration. FL-related mutations and BCL2-translocations were not associated with PFS. However, by multivariate analysis elevated CD8A gene expression in diagnostic biopsy tissue was independently associated with improved PFS (HR=0.45, 95% CI=0.26-0.79, p=0.037), a finding confirmed in both ESFL validation cohorts. CD8A gene expression was raised (p=0.02) and CD8+ T-cell density higher within follicles in ESFL vs. advanced-stage FL (p=0.047). Human leucocyte antigen class I specific neoantigens were detected in 43% of patients, suggesting neoantigen-specific CD8+ T-cells have a role in confining the spread of the disease. Adjuvant R-CVP and elevated intratumoural CD8 expression were independently associated with sustained disease control after radiotherapy in ESFL. Cancer Council Victora; National Health and Medical Research Council; Leukaemia Foundation; Mater Foundation.

Occurrence and molecular phylogeny of Fasciola species in camels of southwestern Iraq.

Fasciola spp. are important trematodes of public health concern in various animals, including camels. This study aimed to determine the occurrence of liver flukes in camels, to determine the molecular confirmation of Fasciola, and to perform phylogenetic analysis of study isolates to identify the species of Fasciola. In total, 107 slaughtered camels were inspected to collect liver flukes that were examined molecularly using polymerase chain reaction (PCR) to confirm Fasciola species. Then, the study isolates were sequenced, submitted to the National Center for Biotechnology Information (NCBI) database, and analyzed phylogenetically to identify the species of each study isolate. Liver flukes were detected in 17.67% of the camels. Regarding the migratory stages of the collected worms, juvenile worms (73.91%) were significantly more prevalent than adult worms (26.09%). Regarding the risk factors, a significantly greater occurrence rate and risk of infection was detected in Al-Najaf compared with Al-Muthanna, as well as in younger camels (1-4 years) compared with older camels. Although the occurrence rate of liver flukes was insignificantly different between females (9.38%) and males (6.98%), females appeared to be at a significantly higher risk of infection than males. Molecularly, 33.33% of the worm samples were positive for species in the Fasciola genus. Phylogenetic analysis of all positive PCR products (total no = 19) confirmed that 63.16% of the local Fasciola spp. isolates were related to the NCBI-Basic Local Alignment Search Tool (NCBI-BLAST) Saudi Arabian Fasciola hepatica isolate at an identity range of 95.94%-99%; while 36.84% of the local Fasciola spp. isolates were related to the NCBI-BLAST Iranian F. gigantica isolate at an identity range of 97.73%-99%. This study found a 17.67% occurrence of Fasciola spp. in camels, with juvenile worms being more common than adult worms. Molecular analysis revealed that 63.16% of the isolates were related to F. hepatica from Saudi Arabia, while 36.84% matched F. gigantica from Iran. Younger camels and those from Al-Najaf were at higher risk, highlighting the need for targeted control measures.

PENYELENGGARAAN MIGRASI RETENSI DATA REKAM MEDIS ELEKTRONIK RSUD NGUDI WALUYO WLINGI BLITAR

In the era of digitalization, hospitals in Indonesia face challenges in migrating electronic medical record data from the old system to the new system. At Ngudi Waluyo Wlingi Blitar Regional Hospital, an efficient and effective electronic medical record data migration process is the main issue that needs to be addressed to ensure the successful implementation of the Looker Studio web-based system. This research uses descriptive quantitative methods. This research shows that although the process of migrating electronic medical record data at Ngudi Waluyo Wlingi Blitar Regional Hospital is generally successful, there are several technical and training obstacles that must be corrected. This research aims to identify the challenges faced, the effectiveness of the procedures implemented, and the impact of implementing an electronic medical record system on the efficiency and accuracy of medical data storage. Recommendations for improvement include increasing training for officers, strengthening IT infrastructure, and more detailed planning for future data migration stages.

Regional variation in leatherback dive behavior in the northwest Atlantic

Understanding the movement patterns and behaviors of a migratory species across all stages of migration is critical to informing successful conservation management strategies. While the movement patterns of northwestern Atlantic leatherbacks Dermochelys coriacea have been widely studied, there is still a need to understand area-specific behaviors. We collected and analyzed dive data from 52 satellite-tagged leatherbacks that inhabited documented or proposed foraging areas: the northeastern Gulf of Mexico (NEGOM), the Mid-Atlantic Bight (MAB), and southern New England (SNE). We fit generalized linear mixed models (GLMMs) to these data to determine area-specific dive metrics and their relationship to several environmental variables. The most notable result from the GLMMs revealed area-specific relationships between dive behavior and sea surface temperature (SST). As SST increased, leatherbacks in the NEGOM and MAB were observed to increase their surface duration and decrease dive duration, while the opposite trend was observed off SNE. Additionally, leatherbacks in the NEGOM performed more deep dives to cooler waters with rising SSTs. Our results suggest that leatherbacks in the NEGOM are performing thermoregulatory dive behavior that may reduce time available for feeding, potentially inhibiting foraging success relative to the MAB and SNE. These findings offer a deeper comprehension of leatherback movement ecology in each area, provide critical information needed for population assessments and management, and highlight areas of conservation concern in a warming climate.