Definition of bulky disease in early stage diffuse large B-cell lymphoma in computed tomography on coronal and transverse planes

BackgroundIn early stage diffuse large B-cell lymphoma (ESDLBL), tumor bulkiness is an important determinant of treatment and prognosis. Tumor bulk is usually measured on transverse computed tomography (CT) plane and variably defined from 5 to 10 cm.ObjectivesOur study aims to investigate the prognostic significance of bulky disease measured on CT coronal and transverse planes and to evaluate the outcome of patients with bulky disease.MethodsPatients with ESDLBL and treated with rituximab, cyclophosphamide, doxorubicin, and prednisolone (RCHOP) with or without radiotherapy were included. Receiver Operating Characteristic (ROC) analysis was used to identify the optimal tumor dimension that correlated with progression, relapse, or death. Correlation between different variables and progression-free survival (PFS) and overall survival (OS) were analyzed using log-rank (Mantel–Cox) test and Cox proportional hazard models.ResultsA total of 127 patients with a median age of 47 (range: 18–90) years were included. Eighty-two (64.6%) patients treated with combined modality treatment (CMT) [RCHOP + radiotherapy]. After a median follow-up of 40 (range: 2–114) months, 3-year PFS and OS were 83.9% (95% CI: 76.759%–89.981%), and 80.6% (95% CI: 72.499%–87.531%), respectively. Tumor dimension of >7.5 cm measured on either CT plane was the optimal cutoff point to define bulky disease. Three-year PFS and OS were inferior in the group of patients with no bulky disease on transvers plane (n = 84) but had bulky disease on coronal plane (n = 9,10.7%); (94.2% vs. 75%, p = 0.017 and 90.5% vs. 56.3%, p = 0.002), as well as in patients with no bulky disease on coronal plane (n = 89), but had bulky disease on transverse plane (n = 14, 15.7%); (94.1% vs. 62.3%, p < 0.001, and 90.4% vs. 63.5%, p = 0.002). Compared to RCHOP alone, 3-year PFS and OS were better in patients with bulky disease treated with CMT (78% vs. 52.5%, p = 0.018 and 81.8% vs. 38.7%, p = 0.003) but not in patients with non-bulky disease (96.2% vs. 93%, p = 0.691 and 87.6% vs. 91.5%, p = 0.477).ConclusionIn ESDLBL, measurement of tumor mass on transverse and coronal CT planes may help in better identification of patients with bulky disease. The use of CMT was associated with better survival outcomes in patients with bulky disease

Factors affecting middle eastern countries' intention to use financial technology

Financial technology, also known as Fintech, continues to transform the financial services sector globally. Fintech adoption has been delayed in some places, particularly in the Middle East, despite the potential positive benefits. This study investigates the mediating effect of perceived ease of use on the relationship between seamless transactions, financial risk, legal risk, security risk, perceived risk, and the intention to use financial technology in Middle Eastern countries. Data was collected from 500 respondents from five Middle Eastern countries (Jordan, Kuwait, Saudi Arabia, Qatar, and the United Arab Emirates) using a structured questionnaire, and partial least squares structural equation modelling (PLS-SEM) was used to test the research model. The findings demonstrate that perceived ease of use strongly mediates the links between seamless transactions, financial risk, legal risk, security risk, perceived risk, and the intention to use financial technology. The study shed light on the significance of perceived ease of use in influencing people's intention to utilize financial technology as well as the function it serves in minimizing the effects of perceived risks. The findings of this study could be useful for financial technology companies operating in Middle Eastern countries, policymakers, and researchers interested in the adoption of financial technology

The effect of multiple micronutrient fortified milk consumption on vitamin D status among school-age children in rural region of Morocco.

Vitamin D deficiency is a health problem in both developed and developing countries. The aim of this study was to determine the effect of multivitamin fortified milk consumption on vitamin D status among children living in the mountainous region of Morocco. 7 to 9 years old children (n=239; 49% of girls vs 51% of boys) have participated in a double blind longitudinal study, where they were divided in two groups: a fortified group who received daily 200 mL of fortified Ultra-High Temperature (UHT) milk enriched with 3μg of vitamin D3 and a non-fortified group who received 200 mL of non-fortified UHT milk with a natural abundance of vitamin D3 (about 1.5µg). Blood samples were collected three times (at baseline, after 4 and 9 months). The average weight, height and BAZ of participants were 22.8±2.6 kg, 121.5±5.2 cm and -0.2±0.6 kg/m² respectively. At baseline, 47.5% of children had a concentration of 25-hydroxyvitamin D (25(OH)D) below 50 nmol/L. At the end of the study the prevalence of vitamin DThe accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Effects of Breastfeeding on Maternal Body Composition in Moroccan Lactating Women during Twelve Months after Birth Using Stable Isotopic Dilution Technique

Background: Exclusive breastfeeding during the first six months of an infant’s life is an important factor for their optimal growth and health. Breastfeeding also has maternal benefits and can assist with postpartum weight loss. As shown by previous studies, postpartum weight retention can contribute to obesity. Objective: To quantify the human milk and evaluate the effect of breastfeeding on maternal weight loss during the 12 months postpartum. Method: This study included 70-mother–baby pairs. Infants’ intake of human milk and water from other sources, as well as the body composition of the mothers, were measured at the 1st, 3rd, 6th, 9th and 12th month postpartum by using the deuterium oxide dose-to-mother technique. Results: There was a significant change in the mothers’ body composition between the first and twelfth months in exclusive breastfeeding women compared to not-exclusive ones. Similarly, the difference between the quantities of human milk intake was highly significant in exclusive breastfeeding women compared to women who were not exclusively breastfeeding. Conclusion: Our results showed that exclusive breastfeeding for twelve months has a significant effect on postpartum weight loss among Moroccan women and that it is an effective way to control overweight and obesity among lactating women