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This meta-analysis consolidates various related studies to identify patterns in the impact of feeding algae on performance aspects, including milk fat, milk protein, and carcass yield in several ruminant species, such as cattle, sheep, and goats. The data were collected from 67 articles that examined factors such as the type of algae (macro- and microalgae), algal species, and animal breed. Barki sheep, Moghani sheep, and Zaraibi goats demonstrated an increased average daily gain (P < 0.05) when fed with both macro- and microalgae. Conversely, sheep such as Canadian Arcott and Ile-de-France showed adverse effects on the feed conversion ratio (FCR) (P < 0.05). Elevated FCR values were observed across castrated and young animals (P < 0.05). Algae extract notably increased the hot carcass weight (P < 0.001), particularly among Moghani sheep (P < 0.001). Raw algae significantly reduced the milk fat content (P < 0.001), particularly in cattle and sheep (P < 0.001). A decrease in milk fat was particularly noticeable in lactating females of Assaf sheep, Damascus goats, and Holstein cows (P < 0.001). Overall, algae inclusion tended to decrease the milk protein content (P < 0.05), leading to reduced milk production (P < 0.001) with cumulative algae feeding in Assaf sheep. However, conjugated linoleic acid (CLA; C18:2 c9,t11-CLA and C18:2 c12,t10-CLA) and docosahexaenoic acid (DHA; C22:6n-3) mostly increased in meat and milk from Holstein cow, Assaf sheep, Dorset sheep, and Ile-de-France sheep (P < 0.01). This meta-analysis highlights the necessity for additional research aimed at optimizing the sustainable use of algae in feed for ruminants, despite the demonstrated improvements in performance and the levels of CLA and DHA found in meat and milk.
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Ração Animal , Dieta , Carne , Microalgas , Leite , Alga Marinha , Animais , Microalgas/química , Ração Animal/análise , Leite/química , Leite/metabolismo , Alga Marinha/química , Dieta/veterinária , Carne/análise , Ovinos/fisiologia , Ovinos/crescimento & desenvolvimento , Cabras/fisiologia , Bovinos/fisiologia , Feminino , Fenômenos Fisiológicos da Nutrição AnimalRESUMO
Livestock production significantly contributes to greenhouse gas (GHG) emissions particularly methane (CH4) emissions thereby influencing climate change. To address this issue further, it is crucial to establish strategies that simultaneously increase ruminant productivity while minimizing GHG emissions, particularly from cattle, sheep, and goats. Recent advancements have revealed the potential for modulating the rumen microbial ecosystem through genetic selection to reduce methane (CH4) production, and by microbial genome editing including CRISPR/Cas9, TALENs (Transcription Activator-Like Effector Nucleases), ZFNs (Zinc Finger Nucleases), RNA interference (RNAi), Pime editing, Base editing and double-stranded break-free (DSB-free). These technologies enable precise genetic modifications, offering opportunities to enhance traits that reduce environmental impact and optimize metabolic pathways. Additionally, various nutrition-related measures have shown promise in mitigating methane emissions to varying extents. This review aims to present a future-oriented viewpoint on reducing methane emissions from ruminants by leveraging CRISPR/Cas9 technology to engineer the microbial consortia within the rumen. The ultimate objective is to develop sustainable livestock production methods that effectively decrease methane emissions, while maintaining animal health and productivity.
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Sistemas CRISPR-Cas , Edição de Genes , Gases de Efeito Estufa , Gado , Metano , Rúmen , Metano/metabolismo , Animais , Rúmen/microbiologia , Rúmen/metabolismo , Edição de Genes/métodos , Gases de Efeito Estufa/metabolismo , Bovinos , Cabras , Consórcios Microbianos , Ovinos , Bactérias/metabolismo , Bactérias/genética , Bactérias/classificação , Microbioma Gastrointestinal , Ruminantes/microbiologiaRESUMO
Tetanus remains a considerable cause of mortality among undervaccinated mothers and their infants following unhygienic deliveries, especially in low-income countries. Strategies of the maternal and neonatal tetanus elimination (MNTE) initiative, which targets 59 priority countries, include strengthening antenatal immunization of pregnant women with tetanus toxoid-containing vaccines (TTCVs); conducting TTCV supplementary immunization activities among women of reproductive age in high-risk districts; optimizing access to skilled birth attendants to ensure clean deliveries and umbilical cord care practices; and identifying and investigating suspected neonatal tetanus cases. This report updates a previous report and describes progress toward MNTE during 2000-2022. By December 2022, 47 (80%) of 59 priority countries were validated to have achieved MNTE. In 2022, among the 50 countries that reported coverage with ≥2 doses of TTCV among pregnant women, 16 (32%) reported coverage of ≥80%. In 2022, among 47 validated countries, 26 (55%) reported that ≥70% of births were assisted by skilled birth attendants. Reported neonatal tetanus cases worldwide decreased 89%, from 17,935 in 2000 to 1,995 in 2021; estimated neonatal tetanus deaths decreased 84%, from 46,898 to 7,719. However, the global disruption of routine immunization caused by the COVID-19 pandemic impeded MNTE progress. Since 2020, reported neonatal tetanus cases have increased in 18 (31%) priority countries. Integration of MNTE strategies into priority countries' national postpandemic immunization recovery activities is needed to achieve and sustain global elimination.
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Erradicação de Doenças , Saúde Global , Toxoide Tetânico , Tétano , Humanos , Tétano/prevenção & controle , Tétano/epidemiologia , Tétano/mortalidade , Feminino , Gravidez , Recém-Nascido , Saúde Global/estatística & dados numéricos , Toxoide Tetânico/administração & dosagem , Programas de Imunização , Mortalidade Infantil/tendênciasRESUMO
Farmers are using municipal wastewater either treated or untreated for irrigation because of limited fresh water resources. Wastewater extensively used for irrigation purposes is enriched with many nutrients. The reuse of wastewater is imposing a negative impact on human health and the ecosystem. It is a need of the day to identify and assess issues of the reuse of wastewater. In the current experiment, impact of organic/inorganic amendments was studied to mitigate the toxic effects of pollutants present in wastewater. Soil was brought from the site having consistent use of wastewater and different treatments were applied as per plan. The experiment has 28 treatments with 04 replications. Nine different amendments were used at 3 varying levels. Incubation time of 30 days was given after the addition of all treatments. The results of the study showed the application of FYM @ 5.0% w/w soil reduced soil pH (7.44), EC (2.16 dS m-1), SAR (8.14), lead (8.48 mg kg-1), cadmium (1.14 mg kg-1), nickel (10.55 mg kg-1) and arsenic (2.03 mg kg-1) when compared with control and other treatments. Usage of compost and horse waste followed FYM. On the basis of this study, it is recommended that wastewater can be used for irrigation purpose after treating with FYM preferably and compost in general.
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Poluentes do Solo , Solo , Águas Residuárias , Águas Residuárias/química , Águas Residuárias/toxicidade , Poluentes do Solo/análise , Poluentes do Solo/química , Poluentes do Solo/toxicidade , Solo/química , Irrigação Agrícola/métodos , Compostagem/métodos , Poluentes Químicos da Água/química , Poluentes Químicos da Água/análise , Concentração de Íons de Hidrogênio , Arsênio/análise , Arsênio/toxicidadeRESUMO
Background Liver surgery is a major and challenging procedure for the surgeon, the anesthetist, and the patient. The objective of this study was to evaluate the postoperative nonhepatic complications of patients undergoing liver resection surgery with perioperative factors. Methods We retrospectively analyzed 79 patients who underwent liver resection surgeries at the Shaukat Khanum Memorial Cancer Hospital and Research Centre in Lahore, Pakistan, from July 2015 to December 2022. Results The mean age at the time of surgery was 53 years (range: 3-77 years), and the mean BMI was 26.43 (range: 15.72-38.0 kg/m2). Of the total patients, 44.3 % (n = 35) had no comorbidities, 26.6% (n=21) had one comorbidity, and 29.1% (n=23) had two or more comorbidities. Patients in whom the blood loss was more than 375 ml required postoperative oxygen inhalation with a significant relative risk of 2.6 (p=0.0392) and an odds ratio of 3.5 (p=0.0327). Similarly, patients who had a surgery time of more than five hours stayed in the hospital for more than seven days, with a statistically significant relative risk of 2.7 (p=0.0003) and odds ratio of 7.64 (p=0.0001). The duration of surgery was also linked with the possibility of requiring respiratory support, with a relative risk of 5.0 (p=0.0134) and odds ratio of 5.73 (p=0.1190). Conclusion Patients in our cohort who had a prolonged duration of surgery received an increased amount of fluids, and a large volume of blood loss was associated with prolonged stay in the ICU (>2 days), hospital admission (>7 days), ICU readmission, and increased incidence of cardiorespiratory, neurological, and renal disturbances postoperatively.
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Graphene nanoplatelets (GrNs) emerge as promising conductive fillers to significantly enhance the electrical conductivity and strength of cementitious composites, contributing to the development of highly efficient composites and the advancement of non-destructive structural health monitoring techniques. However, the complexities involved in these nanoscale cementitious composites are markedly intricate. Conventional regression models encounter limitations in fully understanding these intricate compositions. Thus, the current study employed four machine learning (ML) methods such as decision tree (DT), categorical boosting machine (CatBoost), adaptive neuro-fuzzy inference system (ANFIS), and light gradient boosting machine (LightGBM) to establish strong prediction models for compressive strength (CS) of graphene nanoplatelets-based materials. An extensive dataset containing 172 data points was gathered from published literature for model development. The majority portion (70%) of the database was utilized for training the model while 30% was used for validating the model efficacy on unseen data. Different metrics were employed to assess the performance of the established ML models. In addition, SHapley Additve explanation (SHAP) for model interpretability. The DT, CatBoost, LightGBM, and ANFIS models exhibited excellent prediction efficacy with R-values of 0.8708, 0.9999, 0.9043, and 0.8662, respectively. While all the suggested models demonstrated acceptable accuracy in predicting compressive strength, the CatBoost model exhibited exceptional prediction efficiency. Furthermore, the SHAP analysis provided that the thickness of GrN plays a pivotal role in GrNCC, significantly influencing CS and consequently exhibiting the highest SHAP value of + 9.39. The diameter of GrN, curing age, and w/c ratio are also prominent features in estimating the strength of graphene nanoplatelets-based cementitious materials. This research underscores the efficacy of ML methods in accurately forecasting the characteristics of concrete reinforced with graphene nanoplatelets, providing a swift and economical substitute for laborious experimental procedures. It is suggested that to improve the generalization of the study, more inputs with increased datasets should be considered in future studies.
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[This corrects the article DOI: 10.7759/cureus.58941.].
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Hemophilia A (HA) is a genetic disorder of hemostasis associated with a deficiency or reduced activity of clotting factor VIII (FVIII). This disorder remains unacceptably underdiagnosed in India. Early diagnosis and appropriate management of HA can substantially prevent morbidity and mortality. Currently, HA is managed with regular replacement therapy using standard or extended half-life FVIII concentrates or non-factor drug products. The challenges associated with FVIII concentrates include plateauing of drug effect, issues with its administration and adherence to treatment, breakthrough bleeds, and the development of inhibiting antibodies against administered clotting factors. Emicizumab is a bispecific antibody, launched in India in April 2019, for managing patients with HA. To investigate the role of emicizumab in Indian patients with HA, opinions were sought from 13 eminent hematologists and experts from India on the effectiveness of emicizumab in preventing all bleeds, spontaneous bleeds, perioperative bleeds, and intracranial hemorrhage; resolving target joints; and reducing the rate of hospitalizations and fatality associated with HA in children and adults, with or without inhibitors. The benefits of emicizumab over traditional FVIII concentrates include the subcutaneous route of delivery, less frequent dosing, and a lack of inhibitor development, in addition to providing sustained hemostasis without in-depth monitoring. It is a safe and effective management option for all HA patients, especially for patients with certain archetypes, such as those with inhibitors, those with high annualized bleed rates, those living far away from hemophilia care centers, pediatric patients and infants with intravenous access challenges, and those with a history of life-threatening bleeding events.
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Path planning and control of a mobile robot, in a dynamic environment, has been an important research topic for many years. In this paper an algorithm for autonomous motion of a mobile robot is proposed, with mecanum wheels, to reach a goal while avoiding obstacles through the shortest path in a dynamic environment. The proposed method uses a hybrid Aâ and a velocity obstacle algorithms for path planning and obstacle avoidance. The Aâ algorithm is implemented to explore the shortest path from starting position to the goal while avoiding all the static obstacles. However, in real time applications the dynamic obstacles need to be avoided, therefore, for such a case velocity obstacle algorithm is unified with the Aâ algorithm. Initially, the proposed algorithm is verified through simulations. Then it is implemented using experimental setup in real time environment using single and multiple static obstacles as well as on a dynamic obstacle. It can be observed that the robot reaches the goal, effectively by avoiding static and dynamic obstacles. Moreover, the performance of the proposed work is evaluated through qualitative comparison between proposed method and recently published work, showing that the proposed algorithm is gives better features than existing work. In the end, the possible application of mobile robot having mecanum wheels with proposed path planning method is also given in the paper.
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Gene therapy is a particularly useful treatment for nervous system genetic diseases, including those induced especially by infectious organisms and antigens, and is being utilized to treat Hodgkin's disease (HD). Due to the possible clonal relationship between both disorders, immunotherapy directed against CD20 positive cells may be a more effective treatment in patients with persistent HD and NHL. HL growth can be inhibited both in vitro and in vivo by AdsIL-13Ralpha2. High-dose treatment combined with stem cell transplantation has been effective in treating HIV-negative lymphoma that has progressed to high-risk or relapsed disease. For therapy, LMP2-specific CTL will be used. Furthermore, it is possible to view the cytotoxicity of genetically modified adenoviruses that express proteins such as p27Kip1, p21Waf1, and p16INK4A as a foundational element for (2,5)-derived ALCL genetic treatment for Hodgkin's disease.
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Transplante de Células-Tronco Hematopoéticas , Doença de Hodgkin , Humanos , Doença de Hodgkin/genética , Doença de Hodgkin/terapia , ImunoterapiaRESUMO
In contemporary times, geopolitical risk, and natural resources prices are susceptible due to the Russian-Ukraine conflict. In the meantime, emerging economies are struggling to explore the factors that could reduce ecological challenges and enhance environmental management. This research aims to analyze several economic, environmental, political, and institutional variables to ascertain their influence on greenhouse gas emissions in China. Covering the latest period from 1990 to 2022, various time series tests, including normality, stationarity, and cointegration tests. The results confirm that the variables studied have a stable pattern over time and are connected in the long run. The non-normal distribution of variables leads to opt novel moment quantile regression, where the results are tested for robustness via parametric approaches. The empirical results asserted that economic growth, natural resource prices, and trade significantly enhance ecological challenges (emissions). However, globalization, geopolitical risk, and institutional quality significantly reduce such environmental challenges. The results are robust, and both unidirectional and bidirectional causal associations confirm the importance of these variables in environmental management. Based on the results, this study recommends engagement in environmentally-friendly trading, investment in clean and green energy, and strengthening institutional quality for the region's environmental recovery.
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Dióxido de Carbono , Conservação dos Recursos Naturais , Ucrânia , Dióxido de Carbono/análise , Desenvolvimento Econômico , China , Federação Russa , Energia RenovávelRESUMO
BACKGROUND: Patients with paraneoplastic syndromes (PNS) are excluded from clinical trials involving immune checkpoint inhibitors (ICIs) due to safety concerns. Moreover, real-world data on efficacy and safety is scarce. METHODS: In this retrospective study, data were collected on patients with PNS and solid tumors receiving ICI between 2015 and 2022 at nine institutions. Patients were classified into: Cohort 1 (pre-existing PNS before ICI initiation), cohort 2 (PNS during ICI treatment), and cohort 3 (PNS after ICI discontinuation). Patients with metastatic non-small cell lung cancer (NSCLC) (mNSCLC) from cohort 1 were matched to patients who were PNS-free at each institution up to a 1:3 ratio for age, sex, type of ICI, use of concurrent chemotherapy, and number of lines of systemic therapy prior to ICI initiation. Kaplan-Meier method was used to assess overall survival (OS) and time-to-next treatment (TTNT). RESULTS: Among 109 patients with PNS treated with ICIs, median age at ICI initiation was 67 years (IQR: 58-74). The most represented cancer type was NSCLC (n=39, 36%). In cohort 1 (n=55), PNS exacerbations occurred in 16 (29%) patients with median time to exacerbation after ICI of 1.1 months (IQR: 0.7-3.3). Exacerbation or de novo PNS prompted temporary/permanent interruption of ICIs in 14 (13%) patients. For cohort 2 (n=16), median time between ICI initiation and de novo PNS was 1.2 months (IQR: 0.4-3.5). Treatment-related adverse events (trAEs) occurred in 43 (39%) patients. Grade ≥3 trAEs occurred in 18 (17%) patients. PNS-directed immunosuppressive therapy was required in 55 (50%) patients. We matched 18 patients with mNSCLC and PNS (cohort 1) to 40 without PNS, treated with ICIs. There was no significant difference in OS or TTNT between patients with mNSCLC with and without PNS, although a trend was seen towards worse outcomes in patients with PNS. TrAEs occurred in 6/18 (33%) and 14/40 (35%), respectively. Grade ≥3 trAEs occurred in 4 (22%) patients with PNS and 7 (18%) patients without PNS. CONCLUSIONS: Exacerbations of pre-existing PNS occurred in 29% of patients treated with ICIs and both exacerbations and de novo PNS occur early in the ICI course. TrAE from ICIs were similar between patients with and without PNS. Our data suggest that pre-existing PNS should not preclude consideration of ICI therapy although patients may not derive the same clinical benefit compared with patients without PNS.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Síndromes Paraneoplásicas , Humanos , Pessoa de Meia-Idade , Idoso , Inibidores de Checkpoint Imunológico/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Estudos Retrospectivos , Neoplasias Pulmonares/tratamento farmacológico , Síndromes Paraneoplásicas/tratamento farmacológico , Síndromes Paraneoplásicas/etiologiaRESUMO
OBJECTIVES: To design and develop a classifier, named Sewing Driving Training based Optimization-Deep Residual Network (SDTO_DRN) for hand gesture recognition. METHODS: The electrical activity of forearm muscles generates the signals that can be captured with Surface Electromyography (sEMG) sensors and includes meaningful data for decoding both muscle actions and hand movement. This research develops an efficacious scheme for hand gesture recognition using SDTO_DRN. Here, signal pre-processing is done through Gaussian filtering. Thereafter, desired and appropriate features are extracted. Following that, effective features are chosen using SDTO. At last, hand gesture identification is accomplished based on DRN and this network is effectively fine-tuned by SDTO, which is a combination of Sewing Training Based Optimization (STBO) and Driving Training Based Optimization (DTBO). The datasets employed for the implementation of this work are MyoUP Dataset and putEMG: sEMG Gesture and Force Recognition Dataset. RESULTS: The designed SDTO_DRN model has gained superior performance with magnificent results by delivering a maximum accuracy of 0.943, True Positive Rate (TPR) of 0.929, True Negative Rate (TNR) of 0.919, Positive Predictive Value (PPV) of 0.924, and Negative Predictive Value (NPV) of 0.924. CONCLUSIONS: The hand gesture recognition using the proposed model is accurate and improves the effectiveness of the recognition.
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Eletromiografia , Gestos , Mãos , Eletromiografia/métodos , Humanos , Mãos/fisiologia , Redes Neurais de Computação , Reconhecimento Automatizado de Padrão/métodos , Algoritmos , Músculo Esquelético/fisiologia , Movimento/fisiologia , Processamento de Sinais Assistido por ComputadorRESUMO
In this study, we investigate the interactions of a hybrid nanofluid on a curved surface that is being stretched. The magnetic field is perpendicular to the flow and interacts with a mixture of molybdenum disulfide and argentum nanoparticles suspended in pure water, forming a hybrid nanomaterial. Our investigation considers heat transport analysis under different conditions, such as magnetohydrodynamic, Darcy-Forchheimer porous medium flow, Joule heating, and a convective boundary condition. We employ numerical and statistical methods to study the problem's intricacies comprehensively. Our findings indicate that Darcy-Forchheimer flow includes viscous and inertial forces, which results in higher flow rates and reduced skin friction. Additionally, the convective boundary condition leads to uniform temperature distribution within the hybrid material due to rapid internal heat transfer relative to surface resistance, significantly increasing the heat transfer rate.
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Activation of NLRP3 (NOD-like receptor family, pyrin domain-containing protein 3) has been associated with multiple chronic pathologies, including diabetes, atherosclerosis, and rheumatoid arthritis. Moreover, histone deacetylases (HDACs), specifically HDAC6 is required for the NLRP3 inflammasome to assemble and activate. Thus, NLRP3 serves as an attractive target for the development of novel therapeutic approaches. Several companies are now attempting to develop specific modulators of the NLRP3 inflammasome, but only a handful of small molecules of NLRP3 inflammasome inhibitors, such as MCC950 and Tranilast, are currently available for clinical use. However, their use is limited due to severe side effects and short half-lives. Thus, the repurposing of FDA-approved drugs with NLRP3 inhibitory activity is needed. The present study was aimed at repurposing preexisting drugs that might act as safe and effective NLRP3 inhibitors. A library of 2,697 FDA-approved drugs was screened for binding with NLRP3 (PDB: 7ALV) using Glide (Schrödinger). The top seven FDA-approved drugs with potential binding affinities were selected based on docking scores and subjected to ADMET profiling using pkCSM and SwissADME. The binding of the ADMET-favorable FDA-approved drugs to NLRP3 was validated using MMGBSA (Prime) and Molecular Dynamics (Desmond) in the Schrödinger suite. ADMET profiling revealed that of the seven best docking drugs, empagliflozin and citicoline had good drug-likeness properties. Moreover, MMGBSA analysis and molecular dynamics demonstrated that empagliflozin and citicoline exhibited stable ligand-NLRP3 interactions in the presence of solvents. This study sheds light on the ability of various FDA-approved drugs to act as NLRP3 inhibitors.Communicated by Ramaswamy H. Sarma.
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Destruction of the tumor (cancerous) cells may be caused by live viruses, which have replicative ability and replicate selectively in tumor cells, known as oncolytic virotherapy. In comparison of conservative cancer therapy, tumor-selective replicating viruses have more advantages. These viruses have introduced new methodologies for the human cancer treatment. Numerous strategies are used in development of virotherapeutics. Virotherapy is not unusual concept, but modern advances in technology of genetic modification of oncolytic viruses have improved the ability of targeting tumor cells more specifically, it triggered the development of novel ammunition to fight cancer. An effective virotherapeutic approach with oncolytic viruses exhibits the feasibility and safety under clinical approach. New strategies are being explored to overcome basic obstacles and challenges in virotherapy. Administration of oncolytic viruses, logically, will successfully augment new treatments against many kinds of tumors. Some encouraging antitumor responses shown by combination therapy are provoking strong immunity against established cancer. Chief developments in oncolytic virotherapy have seen in past several years. Significant understandings have been provided by findings on the interface among immune comebacks and viruses, whereas potential results have shown in clinical trials.
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Neoplasias , Terapia Viral Oncolítica , Vírus Oncolíticos , Humanos , Terapia Viral Oncolítica/métodos , Neoplasias/terapia , Vírus Oncolíticos/genética , Terapia CombinadaRESUMO
In this review, there is a complete description of the classes of arboviruses, their evolutionary process, virus characterization, disease transmission methods; it also describes about the vectors involved in transmission and their mood of transmission, both biologically as well as non-biologically and, about host, the resistance mechanism in host, and artificial methods of preventing those viral transmissions. Arboviruses transmitted to hosts by some vectors such as mosquitoes, ticks, etc. The virus replicates in the host can be prevented by some host resistance mechanisms like RNA interference (RNAi), which degrade virus RNA by its antiviral activity, insect repellents, IGRs, and PI technology.
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Arbovírus , Humanos , Animais , Arbovírus/genética , Replicação Viral , Interferência de RNA , Evolução Biológica , Mosquitos VetoresRESUMO
Neuroblastoma is a malignant tumor of neuroblasts, immature nerve cells found in several areas of the body. It usually affects children under age of 5. As usual, the tumor has ability to grow rapidly and to expand vastly which ultimately leads to death. Mostly, management decisions can be drawn by the prediction of the stage of the disease as well as age at the time of its diagnosis. There are four main stages of neuroblastoma, and treatment is according to the low and high risk of the disease. Several cytotoxic agents along with other therapies (antibody therapy, gene therapy, and even immunological therapies, antiangiogenic therapy, etc.) are used. Immunotherapy also has an important treatment option used nowadays for neuroblastoma. The discovery of major neuroblastoma-predisposition gene anaplastic lymphoma kinase cause somatic transformation or gene strengthening in diagnosed neuroblastoma. Promising new antiangiogenic strategies have also been introduced for the treatment of neuroblastoma with multiple mylomas. To manage numerous myelomas and cancers, including neuroblastoma, bone marrow transplantation and peripheral blood stem cell transplantation may be used.