Steady-State Versus Chemotherapy-Based Stem Cell Mobilization in Multiple Myeloma: A Single-Center Study to Analyze Efficacy and Safety.

Background: High-dose chemotherapy followed by autologous hematopoietic stem cell support is recommended in the treatment of eligible multiple myeloma (MM) patients. The aim of this study was to compare the efficacy and safety of steady-state versus chemotherapy-based stem cell mobilization in our Hungarian patient population. Methods: The subjects were 210 MM patients who underwent stem cell mobilization procedure between 2018 and 2022. Solo granulocyte colony-stimulating factor (G-CSF) was administered in 104 cases, while 106 patients received chemotherapy which was followed by G-CSF administration. We evaluated the ratio of successful mobilizations, the amount of collected stem cells, the incidence of infections and cost-effectivity in the two groups. Results: In the steady-state group, there was a significantly higher need for plerixafor (45% vs. 13%, P < 0.001), unsuccessful stem cell mobilization was more frequent (11% vs. 3%, P = 0.024) and the mean amount of collected stem cells was lower (6.9 vs. 9.8 × 106, P < 0.001) than in the chemotherapy group. However, infections were less frequent (4% vs. 27%, P < 0.001) and the number of days spent in hospital was significantly lower (6 vs. 14 days, P < 0.001). Plerixafor was more frequently administered in those who had received lenalidomide or daratumumab than in those who had been treated with other regimens (41% vs. 23%, P = 0.007 and 78% vs. 23%, P < 0.001, respectively). Conclusions: Steady-state mobilization is a safe method; however, the higher rate of plerixafor administration and unsuccessful attempts may question its superiority to chemomobilization.

Development of natural dye photosensitizers for dye-sensitized solar cells: a review.

Dye-sensitized solar cell (DSSC) is a photovoltaic device that can be produced from natural source pigments or natural dyes. The selection of natural dyes for DSSC application is currently under research. The utilization of natural dye materials that are easy to obtain, cost-effective, and non-toxic can reduce waste during DSSC fabrication. Natural dyes can be extracted from plants through extraction and chromatography methods. The suitability and viability of utilizing natural dyes as photosensitizers in DSSCs can be predicted using appropriate software simulation by varying related parameters to produce high power conversion efficiency. In this context, the purpose of the review is to highlight the evolution of performance improvement in the development of DSSCs with consideration of natural dye extraction and software simulation. This review also focuses on the results of extracting natural dyes from herbal ingredients, which are still very limited in information, and several parts of herbal plants that can be used as natural dye sources in the future of solid-state DSSCs have been identified. Based on the results of this review, the highest efficiency was obtained for the DSSC that used chlorophyll pigments as natural dyes using Peltophorum pterocarpum leaves with 6.07%, followed by anthocyanin pigments as natural dyes using raspberries (black) fruits with 1.5%, flavonoid pigments as natural dyes using Curcuma longa herbs with 0.64%, and flavonoid pigments as natural dyes using Indigofera tinctoria flowers with 0.46%.

One Step Back from Bedside to the Bench-How Do Different Arterial Stiffness Parameters Behave in Relation to Peripheral Resistance?

The investigation of arterial stiffening is a promising approach to estimating cardiovascular risk. Despite the widespread use of different methods, the dynamic nature of measured and calculated stiffness parameters is marginally investigated. We aimed to determine the stability of large artery elasticity parameters assessed via commonly used, ultrasound-based and oscillometric methods in relation to peripheral resistance modulation. A human experimental environment was composed, and fifteen young males were investigated at rest after extremity heating and external compression. Functional vascular parameters were monitored in each session, and several arterial stiffness parameters were analysed. The distensibility coefficient (DC) did not show significant changes during heat provocation and extremity compression, while DC's stability seemed to be acceptable. The same stability of carotid-femoral pulse wave velocity (PWV) was detected with ultrasound measurement (5.43 ± 0.79, 5.32 ± 0.86 and 5.28 ± 0.77, with p = 0.38, p = 0.27 and p = 0.76, respectively) with excellent intersession variability (intraclass correlation coefficient of 0.90, 0.88 and 0.91, respectively). However, the oscillometric PWV (oPWV) did change significantly between the heating and outer compression phase of the study (7.46 ± 1.37, 7.10 ± 1.18 and 7.60 ± 1.21, with p = 0.05, p = 0.68 and p < 0.001, respectively), the alteration of which is closely related to wave reflection, represented by the changes in reflection time. Our results indicate the good stability of directly measured elastic parameters such as DC and PWV, despite the extreme modulation of peripheral resistance. However, the oscillometric, indirectly detected PWV might be altered by physical interventions, which depend on wave reflection. The effective modulation of wave reflection was characterized by changes in the augmentation index, detected using both oscillometry and applanation tonometry. Thus, the environment during oscillometric measurement should be rigorously standardized. Furthermore, our results suggest the dynamic nature of the reflection point, rather than being a fixed anatomical point, proposed previously as aortic bifurcation.

Delayed Diagnosis of Retronychia: How Ultrasound Can Nail the Diagnosis in Clinically Subtle Patients.

A 47-year-old man presented to the dermatologic surgery clinic with a 7-month history of a painful, swollen left great toe after minor trauma. Intermittently, the toe became exquisitely tender such that even weight of a blanket exacerbated pain. The patient initially presented to primary care with purulence and pain, but the culture of expressed purulence revealed normal flora. Condition of the patient did not improve despite evaluation by several medical specialists and multiple rounds of topical antifungal and steroid creams, vinegar soaks, and oral antibiotics.

An update on long-term outcomes of pediatric follicular mucinosis over a 20-year period: a retrospective cohort study.

BACKGROUND: Follicular mucinosis (FM) is a rare disease characterized by mucin accumulation in the follicular unit. FM's etiology is still widely debated since its first description in 1957. Follicular mucinosis is usually reported to be benign in children, although reports of malignant transformation, most commonly mycosis fungoides, exist. The present project aims to demonstrate that children with a diagnosis of follicular mucinosis have positive long-term outcomes and do not develop mycosis fungoides. MATERIALS AND METHODS: This is a retrospective cohort study where patients with a diagnosis of follicular mucinosis ages 22 years and below were identified. Data surrounding the patient's diagnosis of FM, differential diagnosis, treatments, and long-term outcomes were collected. Patients who were lost to follow-up were contacted by phone for an update on the status of their skin and overall health. RESULTS: Out of 14 patients with follow-up information, none developed subsequent mycosis fungoides or other hematologic malignancies. CONCLUSION: Pediatric patients with follicular mucinosis will likely present with limited disease and not experience malignant transformation.

Fragmentation of Different Calcification Growth Patterns in Bicuspid Valves During Balloon Valvuloplasty Procedure.

This study focuses on the calcification development and routes of type-1 bicuspid aortic valves based on CT scans and the effect of the unique geometrical shapes of calcium deposits on their fragmentation under balloon valvuloplasty procedures. Towards this goal, the novel Reverse Calcification Technique (RCT), which can predict the calcification progression leading to the current state based on CT scans, is utilized for n = 26 bicuspid aortic valves patients. Two main calcification patterns of type-1 bicuspid aortic valves were identified; asymmetric and symmetric with either partial or full arcs and circles. Subsequently, a calcification fragmentation biomechanical model was introduced to study the balloon valvuloplasty procedure prior to transcatheter aortic valve replacement implantation that allows better device expansion. To achieve this goal, six representative stenotic bicuspid aortic valves of different calcification patterns were investigated. It was found that the distinct geometrical shape of the calcium deposits had a significant effect on the cracks' initiations. Full or partial circle deposits had stronger resistance to fragmentation and mainly remained intact, yet, arc-shaped pattern deposits resulted in multiple cracks in bottleneck regions. The proposed biomechanical computational models could help assess calcification fragmentation patterns toward improving treatment approaches in stenotic bicuspid aortic valve patients, particularly for the off-label use of transcatheter aortic valve replacement.

Pomalidomide Treatment in Relapsed/Refractory Multiple Myeloma Patients-Real-World Data From Hungary.

Pomalidomide is a third generation immunomodulatory drug in the treatment of refractory and relapsed multiple myeloma patients. Our aim was to investigate the efficacy and safety of pomalidomide therapy in a real world setting. Eighty-six Hungarian patients were included, 45 of whom received pomalidomide ± an alkylating agent, while in 38 of them pomalidomide was combined with a proteasome inhibitor. 56 patients (65%) showed any response to the treatment with 18 complete or very good partial remissions and 38 partial remissions. At a median duration of follow-up of 18.6 months, the median progression-free survival (PFS) was 9.03 months, while the median overall survival (OS) was 16.53 months in the whole cohort. Patients with early stage disease (R-ISS 1 and 2) had better survival results than those with stage 3 myeloma (p = 0.002). Neither the number of prior treatment lines, nor lenalidomide refractoriness had a significant impact on PFS. PFS was found similar between the cohort of patients with impaired renal function and the cohort without kidney involvement. During the study, eight mortal infections and two fatal bleeding complications occurred, however, mild hematologic and gastrointestinal toxicities were identified as the most frequent adverse events. The results of our investigations confirm that pomalidomide is an effective treatment option for relapsed/refractory MM, besides, the safety profile is satisfactory in subjects with both normal and impaired renal function.

Recycling phosphorus and calcium from aquaculture waste as a precursor for hydroxyapatite (HAp) production: a review.

Water contaminated with phosphorus needs to be managed efficiently to ensure that clean water sources will be preserved. Aquaculture plays an essential role in supplying food and generating high revenue. However, the quantity of phosphorus released from aquaculture effluents is among the major concerns for the environment. Phosphorus is a non-renewable, spatially concentrated material essential for global food production. Phosphorus is also known as a primary source of eutrophication. Hence, phosphorus recovery and separation from different wastewater streams are mandatory. This paper reviews the source of phosphorus in the environment, focusing on aquaculture wastewater as a precursor for hydroxyapatite formation evaluates the research progress on maximizing phosphorus removal from aquaculture wastewater effluents and converting it into a conversion. Shrimp shell waste appears to be an essential resource for manufacturing high-value chemicals, given current trends in wealth creation from waste. Shrimp shell waste is the richest source of calcium carbonate and has been used to produce hydroxyapatite after proper treatment is reviewed. There have been significant attempts to create safe and long-term solutions for the disposal of shrimp shell debris. Through the discussion, the optimum condition of the method, the source of phosphorus, and the calcium are the factors that influence the formation of hydroxyapatite as a pioneer in zero-waste management for sustainability and profitable approach. This review will provide comprehensive documentation on resource utilization and product development from aquaculture wastewater and waste to achieve a zero-waste approach.

Blue-black hyperpigmentation on the extremities.

In some cases, diagnosis entails less "what is it?" and more "what caused it?"

Scenario modelling of proxy system in the context of Malaysian food flow management.

The research on food flow network is unpredictable as the approaches employed are more targeted at specific study points, often excluding spatial and temporal changes. The research questions must still address why and how food flow moves in the entire supply chain system. This study aims to investigate the movement of food flow using national statistics, comprising of four main subsystems: agriculture, nutrition, waste, wastewater management, and the environment by using the Material Flow Analysis (MFA) approach. Comprehensive research using primary and secondary data including literature reviews have successfully bridged the knowledge gap on food supply chain management in Malaysia. This article provides new contributions through the considerations of food safety and the opportunity to understand flow issues that are connected to hotspots, closed flow, and economic circulars. Additionally, this study acts as a simple guide for policymakers to manage the imbalances of food supply in certain areas. From the perspective of food waste management, several important strategies were successfully formulated to combat the leakage of food waste flow and financial burden while highlighting the need for local social actors' involvement to fulfil Malaysia's agenda of Sustainable Development Goals.

Social media use in residency recruitment during the COVID-19 pandemic.

To investigate the extent to which dermatology programs use social media to connect with applicants, we conducted a search of all 140 residency programs on Instagram, Facebook, Twitter, and YouTube. Our search revealed 74 (53%) Instagram, 21 (15%) Facebook, 20 (14%) Twitter, and four (3%) YouTube accounts for dermatology programs, with the number of Instagram accounts increasing five-fold from the end of 2019 to present. Our results demonstrate that conditions created during the coronavirus disease 2019 (COVID-19) pandemic accelerated dermatology residency programs' acceptance of social media, particularly Instagram, as a means to communicate and share information with applicants.

Environmental Performance of Small-Scale Seawater Reverse Osmosis Plant for Rural Area Water Supply.

Seawater desalination is an alternative technology to provide safe drinking water and to solve water issues in an area having low water quality and limited drinking water supply. Currently, reverse osmosis (RO) is commonly used in the desalination technology and experiencing significant growth. The aim of this study was to analyze the environmental impacts of the seawater reverse osmosis (SWRO) plant installed in Kampung Pantai Senok, Kelantan, as this plant was the first installed in Malaysia. The software SimaPro 8.5 together with the ReCiPe 2016 database were used as tools to evaluate the life cycle assessment (LCA) of the SWRO plant. The results showed that the impact of global warming (3.90 kg CO2 eq/year) was the highest, followed by terrestrial ecotoxicity (1.62 kg 1,4-DCB/year) and fossil resource scarcity (1.29 kg oil eq/year). The impact of global warming was caused by the natural gas used to generate the electricity, mainly during the RO process. Reducing the environmental impact can be effectively achieved by decreasing the electricity usage for the seawater desalination process. As a suggestion, electricity generation can be overcome by using a high-flux membrane with other suitable renewable energy for the plant such as solar and wind energy.

Oral erosions associated with surreptitious marijuana vaping in an adolescent boy.

A 15-year-old boy presented with painful ulcerations affecting the oral mucosa that were eventually attributed to marijuana vaping. In this case report, we highlight cannabis vaping as a potential cause of oral erosions due to injury and chronic inflammation of the oral mucosa.