Insight Into Systemic Lupus Erythematosus: Unveiling Central Retinal Artery Occlusion as an Initial Indicator.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with diverse clinical manifestations. Among these, ocular complications are notably prevalent, affecting up to one-third of patients. One rare but serious ocular complication of SLE is central retinal artery occlusion (CRAO), which can result in significant vision loss. We report a case of a young woman with sudden, painless vision loss in her right eye over two days. Fundoscopy confirmed CRAO, with no light perception in the affected eye and normal vision in the left eye. Physical examination revealed symptoms suggestive of a connective tissue disorder, including malar rash and Raynaud's phenomenon. Laboratory tests confirmed SLE. Despite treatment with methylprednisolone, hydroxychloroquine, aspirin, and nifedipine, the patient's vision did not improve. CRAO in SLE indicates severe retinal vasculopathy and has a poor prognosis. This case highlights the importance of considering SLE in patients with sudden vision loss and systemic symptoms, emphasizing early diagnosis and comprehensive management to prevent severe complications.

Difficult to Pass: Cholangitis With Vertical Band Stenosis.

As techniques have been refined, more patients in the United States have undergone bariatric surgery for weight loss. These surgeries alter the gastrointestinal tract to restrict caloric intake. While most surgeons prefer sleeve gastrectomy and Roux-en-Y gastric bypass, some older procedures, like vertical band gastroplasty, have fallen out of favor due to late complications. In any bariatric procedure, endoscopy can be challenging if indicated due to altered anatomy. Here, we present a case of challenging anatomy due to remote vertical band gastroplasty in a patient presenting with cholangitis, highlighting the effective use of a lumen-apposing metal stent across a vertical band stenosis.

Occurrence, antimicrobial resistance and genomic features of Klebsiella pneumoniae from broiler chicken in Faisalabad, Pakistan.

Introduction: The dissemination of antimicrobial resistance (AMR) in critical priority pathogens is a significant threat. Non-clinical reservoirs of AMR, such as agriculture and food production facilities, may contribute to the transmission of clinically relevant pathogens such as multidrug-resistant (MDR) Klebsiella pneumoniae. There is currently very limited knowledge regarding the population structure and genomic diversity of K. pneumoniae in poultry production in Pakistan. Methods: We explored healthy broilers in a commercial farm from Faisalabad, Pakistan, and identified six K. pneumoniae strains from 100 broiler birds. We characterized the strains, determining clonality, virulence and antimicrobial resistance genes using next generation sequencing. Results: The evaluation of antimicrobial susceptibility revealed that all the strains were MDR. Genomic analysis showed that 3/6 strains belonged to ST152, harbouring acquired resistance aminoglycosides [aadA2, aph(4')-Ia], ß-lactams (blaSHV-187 , blaLAP2 ), fosfomycin (fosA6), tetracycline (tetA), trimethoprim (dfrA12), quinolone (qnrS1), sulphonamides (sul2) and phenicol (floR). All the strains harboured the efflux pump genes oqxA, oqxB, emrR, kpnG, kpnH, kpnF, baeR, mtdB and mtdC. All six strains encoded identical virulence profiles possessing six genes, i.e., ureA, iutA, entB, allS, fimH and mrkD. Phylogenomic analysis of the dominant sequence type (ST152) present in our dataset with publicly available genomes showed that the isolates clustered to strains mainly from human sources and could pose a potential threat to food safety and public health. Discussion: The combination of these findings with antimicrobial use data would allow a better understanding of the selective pressures that may be driving the spread of AMR. This is the first report of MDR K. pneumoniae isolated from broiler hens in Pakistan, and the finding suggests that routine surveillance of WHO critical priority pathogens in such settings would be beneficial to the development of effective control strategies to reduce AMR.

Diuretic and Anti-hyperuricemic Effects of Geranyl Acetate in Rats.

BACKGROUND: Geranyl acetate, a compound found in plant oils, has been studied for its potential effects on renal and cardiovascular ailments. OBJECTIVE: This study aimed to investigate the diuretic and anti-hyperuricemic properties of geranyl acetate in male Wistar rats using a hyperuricemia-induced rat model. METHODS: Molecular docking studies were conducted to assess geranyl acetate's interactions with various targets. in vitro studies were performed to evaluate its scavenging ability and inhibition of xanthine oxidase, urease, and acetylcholinesterase. Subsequently, we administered different doses of geranyl acetate (25, 50, and 100 mg/kg) and a reference drug (furosemide) to the rats to assess their acute and repeated dose diuretic effects over seven days. To understand the diuretic mechanism, we used inhibitors, such as L-- NAME, indomethacin, and atropine, prior to administering geranyl acetate. We also tested the anti-hyperuricemic potential of geranyl acetate on hyperuricemic rats. RESULTS: Molecular docking suggested strong binding between geranyl acetate and nitric oxide synthase. in vitro studies showed significant free radical scavenging activity and and inhibition of acetylcholinesterase, xanthine oxidase, and urease. The 100 mg/kg dose exhibited the most promising diuretic effects, with nitric oxide appearing to influence its action. Uric acid excretion increased at this dose, resembling allopurinol effects. CONCLUSION: Geranyl acetate has demonstrated significant diuretic and anti-hyperuricemic effects, likely influenced by nitric oxide release and inhibition of enzymes, like xanthine oxidase and urease. The findings have suggested potential benefits for individuals with kidney ailments, hypertension, and gout.

A retrospective analysis of tuberculosis in livestock farmers in Lahore district, Pakistan.

INTRODUCTION: Mycobacterium tuberculosis is the main cause of tuberculosis in humans, accounting for numerous illnesses and thousands of fatalities globally. Data regarding the association of various risk factors and TB in livestock farmers in Pakistan is scarce. METHODOLOGY: A retrospective matched case-control study of TB cases was performed in Lahore, Pakistan to investigate the potential risk factors that lead to the development of TB in Pakistani livestock farmers. A total of 170 participants were included in the study. The case was matched with control based on neighborhood and the case-control ratio was kept 1:1. Data were statistically analyzed using R version 4.2.1. Conditional logistic regression was conducted to identify biologically and statistically plausible risk factors associated with the TB outcome among livestock farmers. RESULTS: In univariable analysis, 10 risk factors were identified (p < 0.05). Gender, age, being married, family type, living in a big family, BCG vaccination status, history of smoking, working at a cattle farm, co-housing with cattle at night, , consumption of raw milk. The multivariable model identified four risk factors i.e., consumption of raw milk (Odds Ratio [OR]: 7.7; 95% Confidence Interval [CI]: 1.95-30.68), living in big family (OR: 6.2; 95% CI: 1.25-30.82) and working at cattle farm (OR: 4.2; 95% CI: 1.08-16.56), while gender was found to be a protective factor with OR < 1 (OR: 0.06; 95% CI: 0.01-0.26). CONCLUSIONS: This study demonstrated that sociodemographic risk factors and exposure to infected cattle can influence the development of TB in farmers.

Comparative Meta-Analysis of Triplet vs. Quadruplet Induction Regimens in Newly Diagnosed, Treatment Naïve, Multiple Myeloma.

The use of 4-drug induction regimens for treatment naïve newly diagnosed multiple myeloma (NDMM) is associated with improved depth of response and progression-free survival (PFS). However, head-to-head trials of 4-drug combinations are lacking, and instead, these regimens are typically compared to 3-drug backbones; limiting the ability to discern whether any additional benefit (or toxicity) is simply additive or represents a synergy (or interaction). We conducted a meta-analysis of phase 2 and phase 3 clinical trials that randomized treatment naïve NDMM patients to either a 4-drug or 3-drug induction regimen. We included 11 trials which represented 6509 unique patients. PFS for all trials in the meta-analysis was 54 months with a 4-drug induction and 8.9 months with a 3-drug induction (HR: 0.49; 95% CI: 0.45; 0.54), but there was no benefit to using a 4-drug induction that did not include an anti-CD38 antibody (PFS 4-drug 8.1 months, PFS 3-drug 8.0 months; HR 0.95; 95% CI 0.86; 1.06). Adverse events were more frequent with the quadruplet regimens but were predominately mild. High-grade (≥3) adverse events (AEs) that were more common with 4-drug regimens were infections (RR: 1.34; 95% CI 1.17; 1.54) and thrombocytopenia (RR: 1.39; 95% CI 1.12; 1.74). This study suggests that 4-drug induction regimens which include an anti-CD38 antibody improve efficacy although with additional toxicity in NDMM patients.

Metformin and Atrial Fibrillation: A Systematic Review of Their Association.

Atrial fibrillation (AF) is a common cardiac arrhythmia with a significant impact on patient outcomes and healthcare systems. Given the rising incidence of AF with age and its association with conditions, such as diabetes, there is growing interest in exploring pharmacological interventions that might mitigate AF risk. Metformin, a widely prescribed antihyperglycemic agent for type 2 diabetes mellitus (T2DM), has demonstrated various cardiovascular benefits, including anti-inflammatory and antioxidative properties, leading to speculations about its potential role in AF prevention. This systematic review synthesizes findings from five studies examining the association between metformin use and AF risk in patients with T2DM. The review included a dynamic cohort study, three retrospective cohort studies, and a case report, all sourced from databases, such as PubMed, Embase, and the Cochrane Library. The results are mixed; while some studies suggest that metformin use is linked to a reduced incidence of AF, others report no significant association, particularly in postoperative settings. The largest cohort study highlighted a dose-response relationship, suggesting prolonged metformin use correlates with lower AF risk. Conversely, a case report raised concerns about metformin-induced lactic acidosis potentially triggering AF episodes. The review underscores the heterogeneity in study designs and outcomes, pointing to the need for more robust research to establish causality and clarify underlying mechanisms. Future studies should prioritize prospective designs and explore the pleiotropic effects of metformin on atrial remodeling and electrophysiology to better understand its potential role in AF prevention.

Maximizing Degumming Efficiency for Firmiana simplex Bark Using Deep Eutectic Solvents.

Degumming is a critical process in the purification of natural fibers, essential for enhancing their quality and usability across various applications. Traditional degumming methods employed for natural fibers encounter inherent limitations, encompassing prolonged procedures, excessive energy consumption, adverse environmental impact, and subpar efficiency. To address these challenges, a groundbreaking wave of degumming technique has emerged, transcending these constraints and heralding a new era of efficiency, sustainability, and eco-friendly techniques. This study represents the Firmiana simplex bark (FSB) fiber's delignification by using deep eutectic solvents (DESs). The study explores the application of deep eutectic solvents, by synthesizing different types of DES using a hydrogen bond acceptor (HBA) and four representative hydrogen bond donors (HBDs) for FSB fiber degumming. This study investigates the morphologies, chemical compositions, crystallinities, and physical properties of Firmiana simplex bark fibers before and after the treatment. Furthermore, the effects and mechanisms of different DESs on dispersing FSB fibers were examined. The experimental results showed that choline chloride-urea (CU)-based DES initiates the degumming process by effectively disrupting the hydrogen bond interaction within FSB fibers, primarily by outcompeting chloride ions. Following this initial step, the DES acts by deprotonating phenolic hydroxyl groups and cleaving ß-O-4 bonds present in diverse lignin units, thereby facilitating the efficient removal of lignin from the fibers. This innovative approach resulted in significantly higher degumming efficiency and ecofriendly as compared to traditional methods. Additionally, the results revealed that CU-based DES exhibits the utmost effectiveness in degumming FSB fibers. The optimal degumming conditions involve a precise processing temperature of 160 °C and a carefully controlled reaction time of 2 h yielding the most favorable outcomes. The present study presents a novel straightforward and environmentally friendly degumming method for Firmiana simplex bark, offering a substantial potential for enhancing the overall quality and usability of the resulting fibers. Our findings open new pathways for sustainable fiber-processing technologies.

Vitamin D Receptor (VDR) Gene Polymorphisms and High-Turnover Renal Osteodystrophy or Secondary Hyperparathyroidism in End-Stage Renal Disease: A Systematic Review.

Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are often complicated by high-turnover renal osteodystrophy (HTRO) and secondary hyperparathyroidism (SHPT), characterized by disturbances in mineral metabolism and skeletal abnormalities. Genetic variations within the vitamin D receptor (VDR) gene, known as VDR gene polymorphisms, have been implicated in modulating the susceptibility to HTRO and SHPT. This systematic review aims to evaluate the existing literature on the association between VDR gene polymorphisms and the development of these complications in ESRD and hemodialysis patients. A comprehensive literature search across multiple databases was conducted, and studies investigating VDR gene polymorphisms and HTRO or SHPT in ESRD or hemodialysis patients were included. The included studies examined various VDR gene polymorphisms, such as BsmI, ApaI, TaqI, and FokI, and their associations with clinical outcomes like parathyroid hormone (PTH) levels, bone mineral density, and the development of SHPT or HTRO. The findings suggest that certain VDR gene polymorphisms, notably the ApaI "aa" genotype, BsmI "bb" genotype, TaqI "tt" genotype, and FokI variant, may contribute to the pathogenesis of SHPT and HTRO by affecting PTH levels, bone turnover markers, and vitamin D sensitivity. However, the studies had relatively small sample sizes and were conducted in different populations, limiting generalizability. Further larger-scale studies, functional investigations, and exploration of gene-environment interactions are warranted to elucidate the underlying mechanisms and facilitate personalized treatment approaches for CKD and ESRD patients with mineral and bone disorders.

Assessing the Renal Outcomes of Semaglutide in Diabetic Kidney Disease: A Systematic Review.

Diabetic kidney disease (DKD) is a prevalent microvascular complication of diabetes, posing a significant health burden. Semaglutide, a glucagon-like peptide-1 receptor agonist, has shown promise in mitigating renal outcomes in DKD. This systematic review aimed to evaluate the renal effects of semaglutide in individuals with DKD. A comprehensive literature search identified six eligible studies, including two case reports and four cohorts, from diverse geographic locations. The primary outcomes assessed were changes in estimated glomerular filtration rate (eGFR) and albuminuria. Secondary outcomes included acute kidney injury (AKI) incidence and other renal biomarkers. The impact of semaglutide on eGFR was variable, with some studies reporting decreases and others showing improvements or no significant changes. Albuminuria, however, was more consistently reduced, particularly in patients with macroalbuminuria. Notably, the case reports described semaglutide-associated AKI, including acute interstitial nephritis, highlighting the need for careful monitoring during therapy. Beyond renal outcomes, semaglutide consistently improved glycemic control and promoted weight loss, with generally manageable gastrointestinal side effects. The findings suggest that semaglutide may effectively reduce albuminuria in DKD, potentially slowing disease progression. However, the risk of AKI and the variable impact on eGFR underscore the need for a personalized approach and vigilant monitoring, particularly in patients with advanced CKD. Future large-scale, long-term randomized controlled trials are warranted to definitively assess the renal benefits and risks of semaglutide in DKD.

Discharge Perfection: Assessing Documentation Quality at Mardan Medical Complex, Pakistan (2024 Audit Debut).

Background Patient discharge summaries not only play a vital role in ensuring continuity of care and patient safety but also serve as a communication tool between the primary and tertiary care settings. However, despite their paramount importance, most discharge summaries are either inaccurate or miss essential clinical information, posing considerable danger to patients. This clinical audit assesses the quality of discharge summaries at Mardan Medical Complex, Mardan, Pakistan, to identify areas for improvement. Aim The aim of this study is to assess the discharge summaries of patients at Mardan Medical Complex in Mardan, Pakistan, with a focus on their completeness, accuracy, and timeliness. Methods A cross-sectional, observational, and retrospective study was carried out in the Medical A ward of Mardan Medical Complex, Mardan, Pakistan, from September 2023 to October 2023. Out of the 897 discharge slips, a sample size of 105 participants was determined using Epi Info software. A systematic random sampling technique was used. Data was extracted from the hospital management information system and evaluated using a clinical audit tool based on standard guidelines from the Royal College of Physicians, Islamabad Healthcare Regulatory Authority, and Khyber Pakhtunkhwa Health Care Commission. To analyze the data, descriptive statistics were applied. Results The clinical audit revealed significant deficiencies in discharge summaries. Important patient demographics, such as contact details and safety alerts, were completely absent in 100% of the cases, and 48% of the summaries lacked the father's name. Admission details were similarly inadequate, with nearly all summaries missing critical information like admission time and reasons for admission. Clinical summaries and procedural details were absent in 73% and 87% of the cases, respectively. Discharge planning also showed major gaps, as special instructions according to the primary diagnosis and discharge destination were frequently neglected. Follow-up visits were recommended in only 71% of cases. Additionally, there were significant errors in in-home medication prescriptions, with 61% missing medication doses, 28% missing the route of administration, and 20% lacking the duration of treatment. Conclusions This clinical audit identified critical areas for improvement by revealing significant errors in the quality of discharge summaries at Mardan Medical Complex. It is recommended that standardized discharge slip templates be implemented, healthcare workers receive proper training, and thorough monitoring be conducted before patients are discharged. These measures aim to enhance the standard of documentation. Additionally, regular future clinical audits are essential for tracking the impact of these interventions and ensuring patient safety and continuity of care.

Mobile Health Interventions: A Frontier for Mitigating the Global Burden of Cardiovascular Disease.

Mobile health (mHealth) interventions have emerged as a promising approach for cardiovascular disease (CVD) prevention and management. The proliferation of smartphones and wearable devices enables convenient access to health monitoring tools, educational resources, and communication with healthcare providers. mHealth interventions encompass mobile apps, wearables, and telehealth services that empower users to monitor vital signs, adhere to medication, and adopt healthier lifestyles. Their effectiveness hinges on user engagement, leveraging behavioral science principles and gamification strategies. While mHealth offers advantages such as personalized support and increased reach, it faces challenges pertaining to data privacy, security concerns, and resistance from healthcare providers. Robust encryption and adherence to regulations like the Health Insurance Portability and Accountability Act (HIPAA) are crucial for safeguarding sensitive health data. Integrating mHealth into clinical workflows can enhance healthcare delivery, but organizational adjustments are necessary. The future of mHealth is closely intertwined with artificial intelligence (AI), enabling remote monitoring, predictive algorithms, and data-driven insights. Tech giants are incorporating advanced health-tracking capabilities into their devices, paving the way for personalized wellness approaches. However, mHealth grapples with ethical dilemmas surrounding data ownership, privacy breaches, and inadvertent data capture. Despite its potential, mHealth necessitates a concerted effort to overcome obstacles and ensure ethical, secure, and practical implementation. Addressing technical challenges, fostering standardization, and promoting equitable access are pivotal for unlocking the transformative impact of mHealth on cardiovascular health and reducing the global burden of CVD.

Risk factors associated with influenza A (H1N1)pdm09: a nested case control study of TB patients with ILI in Lahore District, Pakistan.

BACKGROUND: Co-morbidity with respiratory viruses including influenza A, cause varying degree of morbidity especially in TB patients compared to general population. This study estimates the risk factors associated with influenza A (H1N1)pdm09 in TB patients with ILI. METHODS: A cohort of tuberculosis (TB) patients who were admitted to and enrolled in a TB Directly Observed Therapy Program (DOTs) in tertiary care hospitals of Lahore (Mayo Hospital and Infectious Disease Hospital) were followed for 12 weeks. At the start of study period, to record influenza-like illness (ILI), a symptom card was provided to all the participants. Every participant was contacted once a week, in person. When the symptoms were reported by the participant, a throat swab was taken for the detection of influenza A (H1N1)pdm09. A nested case control study was conducted and TB patients with ILI diagnosed with influenza A (H1N1)pdm09 by conventional RT-PCR were selected as cases, while those who tested negative by conventional RT-PCR were enrolled as controls. All cases and controls in the study were interviewed face-to-face in the local language. Epidemiological data about potential risk factors were collected on a predesigned questionnaire. Logistic analysis was conducted to identify associated risk factors in TB patients with ILI. RESULTS: From the main cohort of TB patients (n = 152) who were followed during the study period, 59 (39%) developed ILI symptoms; of them, 39 tested positive for influenza A (H1N1)pdm09, while 20 were detected negative for influenza A (H1N1)pdm09. In univariable analysis, four factors were identified as risk factors (p < 0.05). The final multivariable model identified one risk factor (sharing of towels, P = 0.008)) and one protective factor (wearing a face mask, p = < 0.001)) for influenza A (H1N1)pdm09 infection. CONCLUSION: The current study identified the risk factors of influenza A (H1N1)pdm09 infection among TB patients with ILI.

Artificial intelligence and machine learning in peritoneal dialysis: a systematic review of clinical outcomes and predictive modeling.

BACKGROUND: The integration of artificial intelligence (AI) and machine learning (ML) in peritoneal dialysis (PD) presents transformative opportunities for optimizing treatment outcomes and informing clinical decision-making. This study aims to provide a comprehensive overview of the applications of AI/ML techniques in PD, focusing on their potential to predict clinical outcomes and enhance patient care. MATERIALS AND METHODS: This systematic review was conducted according to PRISMA guidelines (2020), searching key databases for articles on AI and ML applications in PD. The inclusion criteria were stringent, ensuring the selection of high-quality studies. The search strategy comprised MeSH terms and keywords related to PD, AI, and ML. 793 articles were identified, with nine ultimately meeting the inclusion criteria. The review utilized a narrative synthesis approach to summarize findings due to anticipated study heterogeneity. RESULTS: Nine studies met the inclusion criteria. The studies varied in sample size and employed diverse AI and ML techniques, reflecting the breadth of data considered. Mortality prediction emerged as a recurrent theme, demonstrating the significance of AI and ML in prognostic accuracy. Predictive modeling extended to technique failure, hospital stay prediction, and pathogen-specific immune responses, showcasing the versatility of AI and ML applications in PD. CONCLUSIONS: This systematic review highlights the diverse applications of AI/ML in peritoneal dialysis, demonstrating their potential to enhance predictive accuracy, risk stratification, and decision support. However, limitations such as small sample sizes, single-center studies, and potential biases warrant further research and external validation. Future perspectives include integrating these AI/ML models into routine clinical practice and exploring additional use cases to improve patient outcomes and healthcare decision-making in PD.

Burden and factors associated with occupational tuberculosis infection among high-risk workers in Lahore District, Pakistan.

INTRODUCTION: The main objective of the study was to estimate the burden of occupational tuberculosis infection in high-risk occupational workers and to identify risk factors associated with the prevalence of Mycobacterium tuberculosis complex (MTBC). METHODOLOGY: An analytical cross-sectional study was conducted among high-risk occupational workers including veterinarians, abattoir workers, animal handlers, livestock farmers, and microbiology laboratory workers. Sputum samples were collected from 100 participants and polymerase chain reaction (PCR) tests were done to diagnose tuberculosis (TB) infection. Data on potential risk factors was collected in a pre-designed questionnaire. The MTBC prevalence ratio was estimated. Logistic regression analysis was conducted to identify risk factors and the crude odds ratio (OR) was calculated. RESULTS: Among the 100 enrolled high risk occupational workers, the prevalence of MTBC was 46% (95% CI: 35.98-56.25). Living in a joint family (OR 3.85, 95% CI: 1.58-9.37), and use of unpasteurized milk (OR 3.42, 95% CI: 1.4-8.39), were significantly associated with MTBC infection. CONCLUSIONS: Tuberculosis is a significant health burden in high-risk occupational groups, especially animal handlers and laboratory workers, in Lahore, Pakistan. The study also emphasized the need for formal work-related training, and enhanced zoonotic TB awareness among occupational workers.

Hepatitis B Reactivation and Liver Failure Because of COVID-19 Infection.

Coronavirus disease 2019 (COVID-19) has been associated with liver injury incidence reported between 15% and 53%. Viral binding to ACE2 receptors in hepatobiliary cells is believed to cause liver inflammation. The relationship between hepatitis B and COVID-19 is poorly understood, but patients treated with immunosuppressive therapy for COVID-19 are at higher risk of hepatitis B reactivation (HBVr). We present a case of a patient with HBVr because of COVID-19, in the absence of any immunosuppressive treatment, leading to fulminant liver failure and subsequent requiring liver transplantation. Given low incidence, limited data, and no current guidelines, further studies are needed to evaluate the benefit and cost-effectiveness of anti-HBV prophylaxis in a patient with chronic hepatitis B (CHB) and COVID-19. Meanwhile, the American Association for the Study of Liver Diseases guidelines for patients with CHB and immunosuppressant use can be considered for anti-HBV prophylaxis for patients with CHB and COVID-19 to prevent HBVr on a case-by-case basis.

The Glass Wall: Gendered Authorship Disparities in CD 19 and BCMA CAR-T Clinical Trials for Lymphoma and Myeloma.

INTRODUCTION: Existing literature suggests that women are significantly underrepresented in the field of hematology-oncology. Women make up 35.6% of hematologists and data on females as site investigators for pivotal trials and authors in publications of pivotal trials in hematologic malignancies, specifically in the novel niche of Chimeric antigen receptor T cell (CAR-T), is sparse. METHODS: We examined the proportion of women in pivotal trials, screening a total of 2180 studies from PubMed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. 2180 initially searched records were filtered by date (2017-2023) and clinical trial status, yielding 149 records. Following a manual review, we included 15 studies that led to the approval of or anticipated approval of CD19 and BCMA CAR-T therapies in lymphoid and plasma cell malignancies. We examined overall number of female authors, number of lead female authors, and ratio of all authors to female authors in the 15 trials, which were all high impact, cited on average 1314 times. RESULTS: Of the 436 authors assessed, 132 were female, correlating to 29.5% female authorship. The only study with female authorship >50% was ELIANA, a 2017 pediatric study. 7 of the 15 studies had female lead authors; notably, 6 out of 7 of these studies were published in 2021 or later. CONCLUSION: In conclusion, our data suggests gender iniquities for female investigators exist in the field of immune effector cell therapy. We suggest further investigation and strategies to decrease gendered authorship disparities.

Synthesis of surfactant-assisted nickel ferrite nanoparticles (NFNPs@surfactant) to amplify their application as an advanced electrode material for high-performance supercapacitors.

Nickel ferrite nanoparticles (NFNPs) were synthesized in an alkaline medium (pH ∼ 11) using a wet chemical co-precipitation technique. To probe the effect of surfactants on the surface morphology, particle size and size distribution of nanoparticles; two surfactants, namely, cetyl trimethyl ammonium bromide (CTAB) and sodium dodecyl sulphate (SDS), were applied. The native and surfactant-assisted nickel ferrite NPs were characterized using Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), atomic force microscopy (AFM), dynamic light scattering (DLS) and transmission electron microscopy (TEM). The addition of surfactants (CTAB/SDS) effectively controlled the secondary growth of nickel ferrite particles and reduced their size, as examined by XRD, AFM, DLS, SEM and TEM. Characterization technique results affirmed that CTAB is a more optimistic surfactant to control the clustering, dispersion and particle size (∼22 nm) of NFNPs. To identify the impact of ferrite particle size on charge storage devices, their electrochemical properties were studied by using cyclic voltammetry (CV), galvanic charge-discharge (GCD) and electrochemical impedance spectroscopy (EIS) in 1 M KOH electrolyte through three-electrode assembly. NiFe2O4@CTAB showed a specific capacity of 267.1 C g-1, specific capacitance of 593.6 F g-1 and energy density of 16.69 W h kg-1, which was far better than the performances of other synthesized native NFNPs and NiFe2O4@SDS having larger surface areas.

Possible mechanisms to improve sleep spindles via closed loop stimulation during slow wave sleep: A computational study.

Sleep spindles are one of the prominent EEG oscillatory rhythms of non-rapid eye movement sleep. In the memory consolidation, these oscillations have an important role in the processes of long-term potentiation and synaptic plasticity. Moreover, the activity (spindle density and/or sigma power) of spindles has a linear association with learning performance in different paradigms. According to the experimental observations, the sleep spindle activity can be improved by closed loop acoustic stimulations (CLAS) which eventually improve memory performance. To examine the effects of CLAS on spindles, we propose a biophysical thalamocortical model for slow oscillations (SOs) and sleep spindles. In addition, closed loop stimulation protocols are applied on a thalamic network. Our model results show that the power of spindles is increased when stimulation cues are applied at the commencing of an SO Down-to-Up-state transition, but that activity gradually decreases when cues are applied with an increased time delay from this SO phase. Conversely, stimulation is not effective when cues are applied during the transition of an Up-to-Down-state. Furthermore, our model suggests that a strong inhibitory input from the reticular (RE) layer to the thalamocortical (TC) layer in the thalamic network shifts leads to an emergence of spindle activity at the Up-to-Down-state transition (rather than at Down-to-Up-state transition), and the spindle frequency is also reduced (8-11 Hz) by thalamic inhibition.

Comparison of biosimilar filgrastim and originator filgrastim for peripheral blood stem cell mobilization for allogeneic hematopoietic stem cell transplantation.

BACKGROUND: Nivestym, a biosimilar granulocyte colony-stimulating factor (G-CSF) to the originator filgrastim (Neupogen), is now being used for the mobilization of peripheral blood stem cells (PBSC) in allogeneic hematopoietic stem cell transplantation (allo-HSCT). We aim to compare the efficacy of Nivestym and Neupogen for PBSC mobilization in healthy allogeneic donors. METHODS: We conducted a retrospective single-center study including 541 adult allo-HSCT donors receiving Nivestym (January 2013-July 2020), or Neupogen (July 2020-June 2023) for donor PBSC mobilization. Bivariate analysis was conducted using SPSS version 28. Statistical significance was determined at a p-value <.05. RESULTS: Our study included 541 allo-HSCT donors who received Neupogen (n = 345, 64%) or Nivestym (n = 196, 36%) for PBSC mobilization. The median age was 47 years (range 17-76). The median donor weight was 86 kg (95% confidence interval [CI]: 87-91). Donors receiving Neupogen had similar pre-G-CSF white blood cell count, CD34+ percentages, and circulating CD34+ count compared with donors receiving Nivestym. The Neupogen group had similar median PBSC product total neutrophil count, CD34+ percentage, absolute CD34+ count, and infused CD34+ dose compared with the Nivestym group. For donors aged 35 years or younger, the median CD34+ dose was higher in donors who received Neupogen compared with Nivestym (6.9 vs. 6.3 million cells/kg, p = .044). CONCLUSIONS: Nivestym demonstrated similar efficacy for PBSC mobilization compared with Neupogen among allo-HSCT donors. In donors aged 35 years or younger, a slightly lower PBSC product CD34+ count was noted with Nivestym compared with Neupogen.