Familial haemophagocytic lymphohistiocytosis: rare cause of acute liver failure in a neonate--a case report

Familial haemophagocytic lymphohistiocytosis (FHLH) is a rare lifethreatening disorder of the immune system characterized by proliferation and infiltration of hyperactivated macrophages and T-lymphocytes and manifesting as acute illness with prolonged fever, cytopenias, and hepatosplenomegaly. We describe a one-month-old female with FHLH and rapidly progressing liver failure. To conclude, FHLH should be included in the differential diagnosis of acute liver failure in neonates and young infants.Keywords: Familial haemophagocytic lymphohistiocytosis; Acute liver failure; Neonate; Case repor

Vanishing conharmonic tensor of normal locally conformal almost cosymplectic manifold

summary:The main purpose of the present paper is to study the geometric properties of the conharmonic curvature tensor of normal locally conformal almost cosymplectic manifolds (normal LCAC-manifold). In particular, three conhoronic invariants are distinguished with regard to the vanishing conharmonic tensor. Subsequentaly, three classes of normal LCAC-manifolds are established. Moreover, it is proved that the manifolds of these classes are $\eta$-Einstein manifolds of type $(\alpha,\beta)$. Furthermore, we have determined $\alpha$ and $\beta$ for each class

Effect of COVID-19 quarantine on the sleep quality and the depressive symptom levels of university students in Jordan during the spring of 2020

Objectives: This study was designed to assess the effect of COVID-19 home quarantine and its lifestyle challenges on the sleep quality and mental health of a large sample of undergraduate University students in Jordan. It is the first study applied to the Jordanian population. The aim was to investigate how quarantine for several weeks changed the students' habits and affected their mental health. Methods: A cross-sectional study was conducted using a random representative sample of 6,157 undergraduate students (mean age 19.79 ± 1.67 years, males 28.7%) from the University of Jordan through voluntarily filling an online questionnaire. The Pittsburgh Sleep Quality Index (PSQI) and the Center for Epidemiologic Studies-Depression Scale (CES-D) were used to assess sleep quality and depressive symptoms, respectively. Results: The PSQI mean score for the study participants was 8.1 ± 3.6. The sleep quality of three-quarters of the participants was negatively affected by the extended quarantine. Nearly half of the participants reported poor sleep quality. The prevalence of poor sleep quality among participants was 76% (males: 71.5% and females: 77.8%). Similarly, the prevalence of the depressive symptoms was 71% (34% for moderate and 37% for high depressive symptoms), with females showing higher prevalence than males. The overall mean CES-D score for the group with low depressive symptoms is 9.3, for the moderate group is 19.8, while it is 34.3 for the high depressive symptoms group. More than half of the students (62.5%) reported that the quarantine had a negative effect on their mental health. Finally, females, smokers, and students with decreased income levels during the extended quarantine were the common exposures that are significantly associated with a higher risk of developing sleep disturbances and depressive symptoms. Conclusions: Mass and extended quarantine succeeded in controlling the spread of the COVID-19 virus; however, it comes with a high cost of potential psychological impacts. Most of the students reported that they suffer from sleeping disorders and had a degree of depressive symptoms. Officials should provide psychological support and clear guidance to help the general public to reduce these potential effects and overcome the quarantine period with minimum negative impacts

Na⁺ entry through heteromeric TRPC4/C1 channels mediates (-)Englerin A-induced cytotoxicity in synovial sarcoma cells

The sesquiterpene (-)Englerin A (EA) is an organic compound from the plant Phyllanthus engleri which acts via heteromeric TRPC4/C1 channels to cause cytotoxicity in some types of cancer cell but not normal cells. Here we identified selective cytotoxicity of EA in human synovial sarcoma cells (SW982 cells) and investigated the mechanism. EA induced cation channel current (Icat) in SW982 cells with biophysical characteristics of heteromeric TRPC4/C1 channels. Inhibitors of homomeric TRPC4 channels were weak inhibitors of the Icat and EA-induced cytotoxicity whereas a potent inhibitor of TRPC4/C1 channels (Pico145) strongly inhibited Icat and cytotoxicity. Depletion of TRPC1 converted Icat into a current with biophysical and pharmacological properties of homomeric TRPC4 channels and depletion of TRPC1 or TRPC4 suppressed the cytotoxicity of EA. A Na⁺ /K⁺-ATPase inhibitor (ouabain) potentiated EA-induced cytotoxicity and direct Na⁺ loading by gramicidin-A caused Pico145-resistant cytotoxicity in the absence of EA. We conclude that EA has a potent cytotoxic effect on human synovial sarcoma cells which is mediated by heteromeric TRPC4/C1 channels and Na⁺ loading

Developing a Dynamic Web-GIS Based Landslide Early Warning System for the Chittagong Metropolitan Area, Bangladesh

This article aims to develop a Web-GIS based landslide early warning system (EWS) for the Chittagong Metropolitan Area (CMA), Bangladesh, where, in recent years, rainfall-induced landslides have caused great losses of lives and property. A method for combining static landslide susceptibility maps and rainfall thresholds is proposed by introducing a purposely-build hazard matrix. To begin with, eleven factor maps: soil permeability; surface geology; landcover; altitude; slope; aspect; distance to stream; fault line; hill cut; road cut; and drainage network along with a detailed landslide inventory map were produced. These maps were used, and four methods were applied: artificial neural network (ANN); multiple regressions; principal component analysis; and support vector machine to produce landslide susceptibility maps. After model validation, the ANN map was found best fitting and was classified into never warning, low, medium, and high susceptibility zones. Rainfall threshold analysis (1960–2017) revealed consecutive 5-day periods of rainfall of 71–282 mm could initiate landslides in CMA. Later, the threshold was classified into three rainfall rates: low rainfall (70–160 mm), medium rainfall (161–250 mm), and high rainfall (>250 mm). Each landslide was associated with a hazard class (no warning vs. warning state) based on the assumption that the higher the susceptibility, the lower the rainfall. Finally, the EWS was developed using various libraries and frameworks that is connected with a reliable online-based weather application programming interface. The system is publicly available, dynamic, and replicable to similar contexts and is able to disseminate alerts five days in advance via email notifications. The proposed EWS is novel and the first of its kind in Bangladesh, and can be applied to mitigate landslide disaster risks

Management and outcomes of unilateral group d tumors in retinoblastoma

Purpose: Retinoblastoma presents most commonly as advanced unilateral disease, particularly in developing countries for which primary enucleation has been the preferred method of treatment. However, with the evolution of newer treatment modalities including intravitreal chemotherapy, intra-arterial chemotherapy and newer chemotherapeutic combinations, a trend towards more conservative approaches is being observed. Our aim is to evaluate outcomes of group D eyes following conservative and non-conservative treatment options. Patients and Methods: The ocular oncology database was used to identify eyes with unilateral retinoblastoma that fulfilled the International Intraocular Retinoblastoma Classification (IIRC) group D criteria from August 2010 to August 2018 and these were retrospectively reviewed. Overall, 39 eyes were identified. Results: Nineteen (49%) eyes underwent primary enucleation and 20 (51%) received eyeconserving treatment. Eye salvage was possible in 15 (75%) eyes in the attempted salvage group. None of the patient revealed signs of metastasis. All eyes received conventional chemotherapy (carboplatin, vincristine, etoposide) and focal laser therapy. Additional treatment modalities offered included intravitreal chemotherapy, intra-arterial chemotherapy and topotecan. Three (11%) eyes in the primary enucleation group showed high-risk features on histopathology and none developed metastasis. Conclusion: The results of the study seem promising and conservative measures can be adopted in selected unilateral group D eyes

Energy efficient CF-OFDM scheme with single IFFT modulator for broadband wireless devices

In many low-cost mobile device applications, the drawback of high crest factor (CF) may outweigh all the potential benefits of broadband communication systems. Orthogonal frequency division multiplexing (OFDM) is considered to be one of the important multicarrier standards in broadband communication systems. However, high CF is the major problem of OFDM, which may have a deleterious effect on battery lifetime on broadband wireless devices. Therefore, applying a low-complexity high-efficiency technique in recent communications standard will significantly reduce the complexity of those systems and bring down the cost of the system. In this paper, a novel scrambling CF reduction scheme to reduce the CF in OFDM systems is proposed. In this scheme, two re-ordering methods are proposed. Then, a new optimization scheme is introduced in which only a single two-phase sequence need to be applied. Unlike the conventional-partial transmit sequence (C-PTS) scheme which needs Q-IFFT modulators, the proposed scheme requires only a single IFFT modulator. This feature significantly reduces processing time and less computation that leads to reduced complexity. Simulation results demonstrate that the proposed scheme can effectively reduce the complexity compared with the conventional and latest CF reduction scheme and yields good CF performance

Delayed intravitreal anti-vegf therapy for patients during the covid-19 lockdown: An ethical endeavor

Purpose: To assess the impact of Jordanian’s Corona Virus Disease (COVID-19) lockdown on visual acuity and macular thickness in patients with macular edema receiving intravitreal injections, and to assess the ethical endeavor of lockdown among serious sight threatening conditions. Patients and Methods: This retrospective observational study included patients planned for intravitreal injections who did not complete the planned course before the lockdown (ie, before 20th of March 2020). Data included demographics, indication for the intravitreal injection, corrected distance visual acuity (CDVA), and central macular thickness on Optical Coherence Tomography (OCT) before and after the lockdown. Results: One-hundred and sixty-six eyes of 125 patients were studied, 68 (54.4%) patients were males, and the mean (± standard deviation, SD) age was 64.79 (±9.41) years. Mean (±SD) duration of delay in the planned injection was 60.97 (±24.35) days. The change in visual acuity was statistically significant for patients with diabetic macular edema (p= 0.045 improvement), patients with central retinal vein thrombosis (CRVO) (p= 0.05 deterioration), and patients with age-related macular degeneration (AMD) (p= 0.005 deterioration). Of interest, delay of more than 2 months and the previous need for 3 or more injections were significant poor prognostic factors for visual outcome for patients with diabetic macular edema (p=0.027 and 0.045). Conclusion: The impact of delay in the scheduled intravitreal injections resulted in variable outcomes depending on the indication. Triaging the urgency of patients should be based on the indication to support the equity principle of bioethics, where those in need are prioritized against others, depending on potential adverse outcome