Immunotherapy: The next generation of cancer treatment

Immunotherapy is a method of cancer treatment that uses the patient's immune system to attack the tumor cells more effectively. Cancer is the second leading cause of death worldwide. Most types of cancer are treated using a combination of chemotherapy, radiation, and surgery. Recently, immunotherapy has become a standard treatment for patients with various types of cancer. Lung cancer is one of the deadliest types of solid cancer. Recently, there has been a renewed interest in using immunotherapy to treat lung cancer after seeing positive results using immune checkpoint inhibitors. Indolent B-cell non-Hodgkin lymphoma establishes key interactions with the immune microenvironment to ensure survival and prevent antitumor immune activation. However, several immunotherapy approaches have been developed to boost these effects. The last decade witnessed several treatment options for patients with chronic lymphocytic leukemia, first-line treatment and second-line treatment after relapse. Immunotherapy has several different types and ways of treating cancer by targeting the immune system, not the tumor itself. The adoptive T-cell transfer is a new area of transfusion medicine. Adoptive cell therapy provides an additional treatment option for patients. Immune checkpoint inhibitors have emerged as one of the most promising therapeutic options for patients in the history of cancer treatment. This group of drugs releases the brakes of the immune system. Monoclonal antibodies are being used for the treatment of various diseases. As of March 2017, the United States Food and Drug Administration (FDA) has approved approximately 60 therapeutic Monoclonal antibodies. Oncolytic virus therapy has recently been recognized as a promising new therapy. Oncolytic viruses are genetically engineered or naturally occurring viruses that selectively replicate in and kill cancer cells. Cancer vaccines are designed to promote tumor-specific immune responses and prevent or treat cancer. Immune System Modulators Drugs activate the immune system and become more powerful and able to destroy cancer cells.  Due to the development of unique therapies based on the activation of immunotherapy mechanisms against cancer growth made in recent years, we have witnessed advancements in cancer treatment options. However, most patients with advanced-stage of cancer remain with almost no treatment options

Layer-by-Layer Coating of Single-Cell Lacticaseibacillus rhamnosus to Increase Viability Under Simulated Gastrointestinal Conditions and Use in Film Formation

Probiotics and prebiotics are widely used as functional food ingredients. Viability of probiotics in the food matrix and further in the digestive system is still a challenge for the food industry. Different approaches were used to enhance the viability of probiotics including microencapsulation and layer-by-layer cell coating. The of aim of this study was to evaluate the viability of coated Lacticaseibacillus rhamnosus using a layer-by-layer (LbL) technique with black seed protein (BSP) extracted from Nigella sativa defatted seeds cakes (NsDSC), as a coating material, with alginate, inulin, or glucomannan, separately, and the final number of coating layers was 3. The viable cell counts of the plain and coated L. rhamnosus were determined under sequential simulated gastric fluid (SGF) for 120 min and simulated intestinal fluid (SIF) for 180 min. Additionally, the viability after exposure to 37, 45, and 55 C for 30 min was also determined. Generally, the survivability of coated L. rhamnosus showed significant (p   0.05) improvement (<4, 3, and 1.5 logs reduction for glucomannan, alginate and inulin, respectively) compared with plain cells ( 6.7 log reduction) under sequential exposure to SGF and SIF. Moreover, the cells coated with BSP and inulin showed the best protection for L. rhamnosus under high temperatures. Edible films prepared with pectin with LbL-coated cells showed significantly higher values in their tensile strength (TS) of 50% and elongation at the break (EB) of 32.5% than pectin without LbL-coated cells. The LbL technique showed a significant protection of probiotic cells and potential use in food application

Synthesis of phased cylindrical ARC antennas arrays

5 p.International audienceThis paper describes a new approach to synthesize cylindrical antenna arrays controlled by the phase excitation, to synthesize directive lobe and multilobe patterns with steered zero. The proposed method is based on iterative minimization of a function that incorporates constraints imposed in each direction. An 8-element cylindrical antenna has been simulated and tested for various types of beam configurations

Functionality of Films from Nigella sativa Defatted Seed Cake Proteins Plasticized with Grape Juice: Use in Wrapping Sweet Cherries

The main aim of this work is to improve the functionality of Nigella sativa protein concentrate (NSPC) films by using grape juice (GJ). The film’s mechanical, antioxidant, and antimicrobial activities were evaluated. The obtained results showed, for the first time, that GJ at concentrations of 2%–10% (v/v) are able to act as plasticizer for the NSPC films with promising film properties. The results showed that the tensile strength and Young’s modulus of NSPC films were reduced significantly when the GJ increased. However, the NSPC films prepared with 6% GJ observed a higher elongation at break compared with other films. Moreover, the obtained films showed very interesting and promising results for their antioxidant and antimicrobial properties compared with the control films. The sweet cherries wrapped with NSPC film showed that the TSS (Brix) was significantly lower compared to the control, after 10 days of storage. However, the titratable acidity, pH value, and L* of all cherries, either wrapped or not, was not significantly different in all storage times. On the other hand, hue angle was significantly lower after 10 days of storage at −18 °C compared with control films. GJ has a multi-functional effect for protein-based films as plasticizer, antioxidant, and antimicrobial function

Beliefs about illness and treatment decision modelling during ill-health in Arabic families

Background: The use of self-prescribed antibiotics and other unproven herbal remedies is common in the Arab world. Understanding how family members decide to manage illness is an important priority for health care providers. Purpose: This paper presents a new model that can be viewed as an extension to the Health Belief Model and help clarifies the cognitive processes families use to manage illness in an Arab family in Jordan. It aims to generate an understanding of family beliefs about the causes of illness and appraisal of how best to manage illness in an Arab family. Methods: A qualitative approach using a family interview method was used to collect data. Twenty-five families participated in semi-structured interviews designed to elicit representational models of illness and treatment-decisions. Results: Thematic analysis revealed two forms of intertwined beliefs: core beliefs (fatalistic) and secondary beliefs (biomedical, supernatural and situational beliefs). Four key elements were identified as underpinning the involvement of family in treatment decision: perceived threat of illness, efficacy of treatment option, cost or availability and family prior experience. Conclusion: An understanding of the health belief model and related cognitive appraisal processes used by families may assist health care providers to engage with and overcome some of the social, cultural, and structural variables that could influence how family members decide to manage illness in Jordan

Cost analysis of the education of students in School of Public Health, Kerman University of Medical Sciences, Iran, using activity-based costing model

Background & Objective: Quantifying real costs in total and per student is one of the key objectives of budgeting in long-term plans for higher education sector; without any doubt, this will improve the performance of universities. However, the evidences and experiences in this regard are very limited within Iran. The purpose of this study was to estimate and analyze all costs of a school (as a model) compatible with activity-based costing in the logics of operating budgeting. Methods: Having reviewed all available relevant documents of School of Public Health, Kerman University of Medical Sciences in one academic year (2010-11), real costs were extracted and categorized. In the same time, all available facilities (classes, laboratories, library, computer rooms, and common rooms), human resources, students, and infrastructures of the school were surveyed. The cost data were grouped into five sections: training costs, research costs, administrative costs, current supportive costs, and maintenance/development costs. Results: The total cost of School of Public Health was 24, 726 million Iranian Rial (IRR) consisted of 18,850 IRR for teaching costs, 1,894 IRR for research costs, 2,519 IRR for administrative costs and 1,463 IRR for maintenance and current costs. The total per student cost was 31.11 IRR. The total per postgraduate student cost was 2.5 times more than of undergraduate students. Conclusion: A main part of the costs, particularly salaries, is out of hand of direct managers of the school. These costs are usually hidden, and are not presented in costs at the school level. It seems that fixed salary of academic staff inflated human costs, while it is suggested that with a better educational management, the system could increase their responsibilities, and improve their productivities. Our computation, as a model, may help medical universities around the country to create a clear picture of their costs in line with the rules of operating budgeting. Keywords Cost per student educational costs operating budget economics of education educational plannin

Exploring Renal Malignancies in Saudi Arabia: Insights from a Tertiary Care Center Study

This retrospective study aims to describe the characteristics of renal cell carcinoma (RCC) in Saudi Arabia, in terms of epidemiology, clinical presentation, tumor subtype, Fuhrman grade, tumor size and stage, and overall survival. A total of 431 adult patients with a histopathological diagnosis of RCC between 2015 and 2023 were included in the analysis. Most patients (72.4%) had clear cell tumors, followed by chromophobe (15.1%) and papillary (12.5%) subtypes. In males, papillary RCC (85.2%) was more common compared to clear cell (59.8%) and chromophobe (67.7%) subtypes. Significant differences were observed in median body mass index (BMI) across tumor subtypes, and papillary tumor patients exhibited the highest incidence of hematuria (33.3%) compared to other subtypes. The Fuhrman grade also varied significantly among RCC types. Survival times were found to be lower for patients with papillary tumors. No significant difference was observed based on patients’ nationality. This study can inform clinical decision-making on patient prognosis and management as well as public health efforts aimed at reducing the alarming rise of RCC incidence

The benefit of co-targeting PARP-1 and c-Met on the efficacy of radiotherapy in wild type BRAF melanoma

Melanoma is known to be a radioresistant cancer. Melanoma radioresistance can be due to several factors such as pigmentation, antioxidant defenses and high Deoxyribonucleic acid (DNA) repair efficacy. However, irradiation induces intracellular translocation of RTKs, including cMet, which regulates response to DNA damage activating proteins and promotes DNA repair. Accordingly, we hypothesized that co-targeting DNA repair (PARP-1) and relevant activated RTKs, c-Met in particular, may radiosensitize wild-type B-Raf Proto-Oncogene, Serine/Threonine Kinase (WTBRAF) melanomas where RTKs are often upregulated. Firstly, we found that PARP-1 is highly expressed in melanoma cell lines. PARP-1 inhibition by Olaparib or its KO mediates melanoma cell sensitivity to radiotherapy (RT). Similarly, specific inhibition of c-Met by Crizotinib or its KO radiosensitizes the melanoma cell lines. Mechanistically, we show that RT causes c-Met nuclear translocation to interact with PARP-1 promoting its activity. This can be reversed by c-Met inhibition. Accordingly, RT associated with the inhibition of both c-Met and PARP-1 resulted in a synergistic effect not only on tumor growth inhibition but also on tumor regrowth control in all animals following the stop of the treatment. We thus show that combining PARP and c-Met inhibition with RT appears a promising therapeutic approach in WTBRAF melanoma

Gasless Trans-Umbilical Laparoscopically-Assisted Appendectomy in the Pediatric Population: An Early Experience

Background: The aim of this study is to determine the feasibility and safety of the single-port gasless trans-umbilical laparoscopically-assisted appendectomy in the pediatric age group at a single center in a tertiary university hospital in Jordan. Methods: Between April 2018 and July 2019, the surgical records of all patients aged between 0 and 13 years treated with trans-umbilical laparoscopic-assisted appendectomy TULAA for a suspected appendicitis following a clinical, laboratory and ultrasound findings were reviewed retrospectively. Baseline characteristics, white blood cell count, operative time, intraoperative findings, need for additional trocars or for conversion, length of hospital stay and surgical complications were reported.Results: 36 cases were included in the study, 23 (64%) were completed successfully using the gasless TULAA technique. Gas insufflation was needed in 10 (28%) cases and only 3 (8%) had to be converted to the three-port laparoscopic appendectomy technique. There was no significant difference between the gaseous and gasless groups in terms of baseline characteristics, BMI, surgery duration, postoperative recovery period or length of stay. However, the group of patients who needed gas insufflation to complete the procedure had a higher white blood cell count compared to the gasless group. The surgery was completed successfully by senior general surgery residents in 27 (75%) cases while the consultant’s intervention was needed in the remaining cases. The gasless TULAA group were less likely to require complex analgesia (i.e., IV analgesia) compared to the gasless group (OR=0.683).Conclusions: Gasless TULAA is a feasible procedure that can be performed safely by surgical residents as an initial approach for all grades of acute appendicitis in the pediatric age group

Nursing Students’ Perceptions of Using Branching Simulation: A Qualitative Descriptive Study

Previous intervention studies have shown that branching simulation (BS) unfolds the complex multidimensional aspects of challenging health problems. The present study aimed to examine graduate nursing students’ perceptions of using BS in professional training. This study used a qualitative descriptive design with semi-structured interviews with a sample of 20 graduate nursing students. Four main themes emerged from the results: (a) BS as a support to students’ professional training, (b) BS leads to changes in clinical practice, (c) whether BS is a stressful learning experience, and (d) BS versus traditional lecturing. The participating students perceived BS as a valid learning tool that enables them to improve their critical thinking and decision-making skills, self-confidence, practical and theoretical preparation, and multidisciplinary teamwork and collaboration. Despite the identified advantages of BS, future research is needed to examine the effectiveness of incorporating BS in nursing practice