Acute Cholecystitis Is a Common Complication after Allogeneic Stem Cell Transplantation and Is Associated with the Use of Total Parenteral Nutrition

AbstractThe incidence and risk factors for acute cholecystitis after allogeneic hematopoietic stem cell transplantation (HSCT) are not well defined. Of 644 consecutive adult transplants performed at our institution between 2001 and 2011, acute cholecystitis occurred in the first year of transplant in 32 patients (5.0%). We conducted 2 retrospective case-control studies of this population to determine risk factors for cholecystitis after HSCT and to evaluate the performance of different methods of imaging to diagnosis cholecystitis in patients undergoing HSCT compared with non-HSCT patients. In the HSCT population, development of cholecystitis was associated with an increased 1-year overall mortality rate (62.5% versus 19.8%, P < .001). The risk of developing cholecystitis was higher in patients who received total parenteral nutrition (TPN) (adjusted odds ratio, 3.41; P = .009). There was a trend toward more equivocal abdominal ultrasound findings in HSCT recipients with acute cholecystitis compared with nontransplant patients (50.0% versus 30.6%, P = .06). However, hepatobiliary iminodiacetic acid (HIDA) scans were definitively positive for acute cholecystitis in most patients in both populations (80.0% of HSCT recipients versus 77.4% of control subjects, P = .82). In conclusion, acute cholecystitis is a common early complication of HSCT, the risk is increased in patients who receive TPN, and it is associated with high 1-year mortality. In HSCT recipients with findings suggestive of acute cholecystitis, especially those receiving TPN, early use of HIDA scan may be considered over ultrasound

In Quest of Educational Quality in the UAE

Quality assurance started as a corporate-related process in the 1960s but later became a highly sought-after objective in educational and academic contexts. The growing interest in quality assurance has been the result of government and business expectations, as well as competition in the higher education marketplace. One such growing market for quality assurance is the United Arab Emirates, where public formal education has only existed since the 1970s. This chapter focuses on the quest for what can be considered as the Holy Grail within the context of each of the previous chapters in this edited book, namely, quality education. The chapter offers a synopsis of the fast-paced developments and ongoing activities in quality assurance in education in the United Arab Emirates. Federal and emirate-based initiatives will be presented and discussed while reflecting on lessons learned and offering recommendations whenever possible

Human spermbots for patient-representative 3D ovarian cancer cell treatment

Cellular micromotors are attractive for locally delivering high concentrations of drug, and targeting hard-to-reach disease sites such as cervical cancer and early ovarian cancer lesions by non-invasive means. Spermatozoa are highly efficient micromotors perfectly adapted to traveling up the female reproductive system. Indeed, bovine sperm-based micromotors have shown potential to carry drugs toward gynecological cancers. However, due to major differences in the molecular make-up of bovine and human sperm, a key translational bottleneck for bringing this technology closer to the clinic is to transfer this concept to human material. Here, we successfully load human sperm with Doxorubicin (DOX) and perform treatment of 3D cervical cancer and patient-representative ovarian cancer cell cultures, resulting in strong anticancer cell effects. Additionally, we define the subcellular localization of the chemotherapeutic drug within human sperm, using high-resolution optical microscopy. We also assess drug effects on sperm motility and viability over time, employing sperm samples from healthy donors as well as assisted reproduction patients. Finally, we demonstrate guidance and release of human drug-loaded sperm onto cancer tissues using magnetic microcaps, and show the sperm microcap loaded with a second anticancer drug, camptothecin (CPT), which unlike DOX is not suitable for directly loading into sperm due to its hydrophobic nature. This co-drug delivery approach opens up novel targeted combinatorial drug therapies for future applications. © 2020 The Royal Society of Chemistry

Cosmic Evolution Early Release Science (CEERS) survey: The colour evolution of galaxies in the distant Universe

The wavelength-coverage and sensitivity of JWST now enables us to probe the rest-frame UV - optical spectral energy distributions (SEDs) of galaxies at high-redshift ($z>4$). From these SEDs it is, in principle, through SED fitting possible to infer key physical properties, including stellar masses, star formation rates, and dust attenuation. These in turn can be compared with the predictions of galaxy formation simulations allowing us to validate and refine the incorporated physics. However, the inference of physical properties, particularly from photometry alone, can lead to large uncertainties and potential biases. Instead, it is now possible, and common, for simulations to be \emph{forward-modelled} to yield synthetic observations that can be compared directly to real observations. In this work, we measure the JWST broadband fluxes and colours of a robust sample of $5<z<10$ galaxies using the Cosmic Evolution Early Release Science (CEERS) Survey. We then analyse predictions from a variety of models using the same methodology and compare the NIRCam/F277W magnitude distribution and NIRCam colours with observations. We find that the predicted and observed magnitude distributions are similar, at least at $58$ the distributions differ somewhat, though our observed sample size is small and thus susceptible to statistical fluctuations. Likewise, the predicted and observed colour evolution show broad agreement, at least at $5<z<8$. There is however some disagreement between the observed and modelled strength of the strong line contribution. In particular all the models fails to reproduce the F410M-F444W colour at $z>8$, though, again, the sample size is small here.Comment: 11 pages, 10 figures, submitted to MNRA

Extremely Red Galaxies at z = 5-9 with MIRI and NIRSpec:Dusty Galaxies or Obscured Active Galactic Nuclei?

We study a new population of extremely red objects (EROs) recently discovered by the James Webb Space Telescope (JWST) based on their NIRCam colors F277W − F444W &gt; 1.5 mag. We find 37 EROs in the Cosmic Evolution Early Release Science Survey (CEERS) field with F444W &lt; 28 mag and photometric redshifts between 5 &lt; z &lt; 7, with median z = 6.9 − 1.6 + 1.0 . Surprisingly, despite their red long-wavelength colors, these EROs have blue short-wavelength colors (F150W − F200W ∼ 0 mag) indicative of bimodal spectral energy distributions (SEDs) with a red, steep slope in the rest-frame optical, and a blue, flat slope in the rest-frame UV. Moreover, all these EROs are unresolved, point-like sources in all NIRCam bands. We analyze the SEDs of eight of them with MIRI and NIRSpec observations using stellar population models and active galactic nucleus (AGN) templates. We find that dusty galaxies or obscured AGNs provide similarly good SED fits but different stellar properties: massive and dusty, log M ⋆ / M ⊙ ∼ 10 and A V ≳ 3 mag, or low mass and obscured, log M ⋆ / M ⊙ ∼ 7.5 and A V ∼ 0 mag, hosting an obscured quasi-stellar object (QSO). SED modeling does not favor either scenario, but their unresolved sizes are more suggestive of AGNs. If any EROs are confirmed to have log M ⋆ / M ⊙ ≳ 10.5, it would increase the pre-JWST number density at z &gt; 7 by up to a factor ∼60. Similarly, if they are QSOs with luminosities in the L bol &gt; 1045-46 erg s−1 range, their number would exceed that of bright blue QSOs by more than three orders of magnitude. Additional photometry at mid-infrared wavelengths will reveal the true nature of the red continuum emission in these EROs and will place this puzzling population in the right context of galaxy evolution.</p

Spectroscopic verification of very luminous galaxy candidates in the early universe

During the first 500 million years of cosmic history, the first stars and galaxies formed and seeded the cosmos with heavy elements. These early galaxies illuminated the transition from the cosmic "dark ages" to the reionization of the intergalactic medium. This transitional period has been largely inaccessible to direct observation until the recent commissioning of JWST, which has extended our observational reach into that epoch. Excitingly, the first JWST science observations uncovered a surprisingly high abundance of early star-forming galaxies. However, the distances (redshifts) of these galaxies were, by necessity, estimated from multi-band photometry. Photometric redshifts, while generally robust, can suffer from uncertainties and/or degeneracies. Spectroscopic measurements of the precise redshifts are required to validate these sources and to reliably quantify their space densities, stellar masses, and star formation rates, which provide powerful constraints on galaxy formation models and cosmology. Here we present the results of JWST follow-up spectroscopy of a small sample of galaxies suspected to be amongst the most distant yet observed. We confirm redshifts z > 10 for two galaxies, including one of the first bright JWST-discovered candidates with z = 11.4, and show that another galaxy with suggested z ~ 16 instead has z = 4.9, with strong emission lines that mimic the expected colors of more distant objects. These results reinforce the evidence for the rapid production of luminous galaxies in the very young Universe, while also highlighting the necessity of spectroscopic verification for remarkable candidates.Comment: Submitted to Natur