Monitoring Activity and Gait in Children (MAGIC) using digital health technologies.

BACKGROUND: Digital health technologies (DHTs) can collect gait and physical activity in adults, but limited studies have validated these in children. This study compared gait and physical activity metrics collected using DHTs to those collected by reference comparators during in-clinic sessions, to collect a normative accelerometry dataset, and to evaluate participants' comfort and their compliance in wearing the DHTs at-home. METHODS: The MAGIC (Monitoring Activity and Gait in Children) study was an analytical validation study which enrolled 40, generally healthy participants aged 3-17 years. Gait and physical activity were collected using DHTs in a clinical setting and continuously at-home. RESULTS: Overall good to excellent agreement was observed between gait metrics extracted with a gait algorithm from a lumbar-worn DHT compared to ground truth reference systems. Majority of participants either "agreed" or "strongly agreed" that wrist and lumbar DHTs were comfortable to wear at home, respectively, with 86% (wrist-worn DHT) and 68% (lumbar-worn DHT) wear-time compliance. Significant differences across age groups were observed in multiple gait and activity metrics obtained at home. CONCLUSIONS: Our findings suggest that gait and physical activity data can be collected from DHTs in pediatric populations with high reliability and wear compliance, in-clinic and in home environments. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04823650 IMPACT: Digital health technologies (DHTs) have been used to collect gait and physical activity in adult populations, but limited studies have validated these metrics in children. The MAGIC study comprehensively validates the performance and feasibility of DHT-measured gait and physical activity in the pediatric population. Our findings suggest that reliable gait and physical activity data can be collected from DHTs in pediatric populations, with both high accuracy and wear compliance both in-clinic and in home environments. The identified across-age-group differences in gait and activity measurements highlighted their potential clinical value.

Waldenström macroglobulinemia: a review of pathogenesis, current treatment, and future prospects.

Waldenström macroglobulinemia (WM) is a chronic B-cell lymphoproliferative disorder characterized by lymphoplasmacytic cell overgrowth in the bone marrow and increased secretion of IgM immunoglobulins into the serum. Patients with WM have a variety of clinical outcomes, including long-term survival but inevitable recurrence. Recent advances in disease knowledge, including molecular and genetic principles with the discovery of MYD88 and CXCR4 mutations, have rapidly increased patient-tolerable treatment options. WM patients may benefit from chemotherapy regimens that include rituximab-based regimens, alkylating drugs, proteasome inhibitors, monoclonal antibodies, and drugs targeting Bruton tyrosine kinase inhibitors. In light of these advancements, patients can now receive treatment customized to their specific clinical characteristics, focusing on enhancing the depth and durability of their response while limiting the adverse effects. Despite the rapidly developing therapeutic armament against WM, a lack of high-quality evidence from extensive phase 3 trials remains a significant challenge in the research. We believe clinical outcomes will keep improving when new medicines are introduced while preserving efficacy and minimizing toxicity.

Investigating the role of bentonite clay with different soil amendments to minimize the bioaccumulation of heavy metals in Solanum melongena L. under the irrigation of tannery wastewater.

Wastewater from tanneries is a major source of heavy metals in soil and plants when used for crop irrigation. The unavoidable toxicological effects of this contamination, however, can be minimized through two independent steps discussed in the present study. In the first step, a batch sorption experiment was conducted in which Cr was adsorbed through bentonite clay. For this purpose, DTPA extraction method was used to analyze Cr concentration in the soil after regular time intervals (0.5, 1, 2, 6, 8, 9, 10.5, 11.5, and 20.3 h) which reduced Cr concentration from 38.542 mgL-1 for 30 min to 5.6597 mgL-1 for 20.3 h, respectively, by applying 1% bentonite. An increase in the contact time efficiently allowed soil adsorbent to adsorb maximum Cr from soil samples. In the second step, a pot experiment was conducted with 10 different treatments to improve the physiological and biochemical parameters of the Solanum melongena L. irrigated under tanneries' wastewater stress. There were four replicates, and the crop was harvested after 30 days of germination. It was seen that the application of wastewater significantly (P < 0.01) reduced growth of Solanum melongena L. by reducing root (77%) and shoot (63%) fresh weight when compared with CFOP (Ce-doped Fe2O3 nanoparticles); chlorophyll a and b (fourfolds) were improved under CFOP application relative to control (CN). However, the deleterious effects of Cr (86%) and Pb (90%) were significantly decreased in shoot through CFOP application relative to CN. Moreover, oxidative damage induced by the tannery's wastewater stress (P < 0.01) was tolerated by applying different soil amendments. However, results were well pronounced with the application of CFOP which competitively decreased the concentrations of MDA (95%), H2O2 (89%), and CMP (85%) by efficiently triggering the activities of antioxidant defense mechanisms such as APX (threefold), CAT (twofold), and phenolics (75%) in stem relative to CN. Consequently, all the applied amendments (BN, BT, FOP, and CFOP) have shown the ability to efficiently tolerate the tannery's wastewater stress; results were more pronounced with the addition of CFOP and FOP+BT by improving physiological and biochemical parameters of Solanum melongena L. in an eco-friendly way.

Histiocytic Sarcoma Secondary to Gastrointestinal Stromal Tumors: A Literature Review.

Histiocytic sarcoma (HS) is a rare tumor that may result from the transdifferentiation of preexisting hematolymphoid neoplasms in a subset of patients. There are instances of correlation or concurrence between HS and a number of cancers, particularly B-cell-associated hematopoietic tumors. Only three cases of HS occurring subsequent to or concurrently with gastrointestinal stromal tumors (GIST) have been recorded. Our main objective was to give an overview of demographics, clinical signs and symptoms, histopathological findings, and immunohistochemical and molecular analysis when HS develops secondary to or concurrently with GIST. A search of PubMed, Google Scholar, and ScienceDirect was undertaken using Medical Subject Headings (MeSH) keywords. According to the findings of our review, there were two males (66.6%) and one female (33.3%). The average age of patients at presentation was 59.6 years. On the immunohistochemistry, three patients were positive for cluster of differentiation (CD) 68 (100%), two patients were positive for CD 163 (67%), one patient was positive for leukocyte common antigen (LCA) (33%), and only one patient was positive for CD 4, CD 10, CD 31, CD 45, human leukocyte antigen (HLA)-DR, lysozyme, and vimentin (33%). On molecular investigation, the gastric mass of only one patient (33.33%) contained a KIT mutation on exon 11. Emperipolesis was observed in one patient (33.33%) on histological examination. Our study provides an important overview of the available literature and gives insight into important diagnostic markers of HS when it occurs secondary to or concurrently with GIST.

PEG capped methotrexate silver nanoparticles for efficient anticancer activity and biocompatibility.

BACKGROUND: Nanocarriers endow tremendous benefits to the drug delivery systems depending upon the specific properties of either component. These benefits include, increase in the drug blood retention time, reduced efflux, additional toxicity and targeted delivery. Methotrexate (MTX) is clinically used for cancer treatment. Higher dosage of MTX results in hepatic and renal toxicity. In this study methotrexate silver nanoparticles (Ag-MTX) coated with polyethylene glycol (PEG) are synthesized and characterized. Their anticancer activity and biocompatibility is also evaluated. RESULTS: Ag-MTX nanoparticles are synthesized by chemical reduction method. They are characterized by Ultraviolet-Visible Spectroscopy and Fourier Transform Infrared Spectroscopy. Average size of PEG coated Ag-MTX nanoparticles (PEG-Ag-MTX nanoparticles) is 12nm. These particles exhibited improved anticancer activity against MCF-7 cell line. Hemolytic activity of these particles was significantly less than MTX. CONCLUSION: PEG-Ag-MTX nanoparticles are potential nanocarrier of methotrexate which may offer MTX based cancer treatment with reduced side effects. In-vivo investigations should be carried out to explore them in detail.

Symmetrical peripheral digital gangrene following severe Plasmodium falciparum malaria-induced disseminated intravascular coagulopathy.

Symmetrical peripheral digital gangrene is a life-changing complication, caused by a pro-thrombotic life-threatening disease, such as disseminated intravascular coagulopathy (DIC) secondary to systemic infection. We describe the unusual case of a woman who developed symmetrical peripheral digital gangrene following DIC because of malaria. While initial treatment led to cure of the infection, in this report we describe also the subsequent management of symmetrical peripheral digital gangrene.