ABSTRACT
Cytogenetic abnormalities involving chromosome 16 are found in 5– 8% of acute myeloid leukemia (AML). These are typically a pericentric inversion inv(16)(p13.1q22) or a translocation, t(16;16)(p13.1;q22), involving the MYH11 and CBFB genes localized to chromosome 16p13.1 and 16q22, respectively. In addition, less common rearrangements include deletion of the long arm of chromosome 16, del(16) (q22), and cryptic insertions involving the MYH11 and the CBFB genes with otherwise normal karyotypes. In this report, we present the first AML case with a new translocation involving the CBFB gene. The more common CBFB - MYH11 fusion product resulting from the inversion and/or translocation of chromosome(s) 16 leads to an AML with monocytic and granulocytic differentiation and abnormal eosinophil component with large, purple to violet color eosinophilic granules. This entity typically corresponds to the adult AML-M4Eo in French-American- British (FAB) Classification and now called AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22);CBFB-MYH1 in the new 2017 WHO Classification. Patients may present with myeloid sarcoma at initial diagnosis or at relapse. We present a case of an 80-year-old male with a history of prostate cancer post radiotherapy who was referred for COVID-19 testing. A complete blood count with differential revealed neutropenia and a macrocytic anemia. A bone marrow biopsy and a bone marrow aspirate confirmed a diagnosis of AML with 33% blasts including myeloblasts and promonocytes. Interphase fluorescence in situ hybridization (FISH) analysis with a break-apart probe for CBFB showed an abnormal hybridization pattern consistent with rearrangement of CBFB in 66% of nuclei. Chromosome analysis revealed an abnormal karyotype with two related clones: 47,XY, t(10;16)(p13;q22),+22[4]/48,idem,+8[16]. Sequential GTG-FISH confirmed that the 3’ region of CBFB was translocated to 10p13 in the t(10;16) and the 5’ region remained on 16q. Based on the karyotype, the patient’s bone barrow exhibits clonal evolution having acquired additional chromosome abnormalities (trisomy 22 and trisomy 8). Molecular studies by next generation sequencing showed NRAS p.Gln61Lys mutation with a VAF of 11.21%. No genomic alterations were detected in KIT, KRAS or FLT3 genes. AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22) is associated with a high rate of complete remission and favorable overall survival when treated with intensive consolidation therapy. However, their prognostic advantage may be affected by additional cytogenetic abnormalities and/or other gene mutations. Specifically, trisomy 22, is a frequent abnormality additional to inv(16) detected as a secondary finding which has been associated with an improved outcome when compared to the prognosis associated with inv(16) alone. Furthermore, KIT (in 30–40%), FLT3 (in 14%), NRAS (in 45%) and KRAS (in 13%) mutations are common in this AML type. The prognostic implications of KIT mutation (especially involving exon 8) do not appear to be significantly poor prognostic compared to other AML types. On the other hand FLT3-TKD mutations and trisomy 8 are associated with a worse outcome. The patient is currently receiving Vidaza 75 mg/m2, days 1–7 of a 28 days cycle with Venetoclax mg daily of a 28-day cycle and his clinical prognosis is currently unclear. Further analysis by DNA sequencing may help to characterize the molecular nature of the fusion gene product resulting from the novel t(10;16)(p13;q22). To the best of our knowledge, this is the first reported case of an AML patient with translocation t(10;16)(p13;q22) involving the CBFB gene. Given the rarity and lack of additional information regarding the effects of this abnormality, the prognosis and survival cannot be predicted.
ABSTRACT
Plastic packaging wastes are increasing due to the COVID-19 pandemic as consumers tend to stay home and purchase online. Plastic packaging waste is difficult to break down. It pollutes the environment and then enters the food chain, putting people and wildlife at risk. This paper presents the development of system dynamic models for sustainable plastic supply chain management in Klang Valley, Malaysia. System dynamic models for plastic supply chains, including forward, open-loop and closed-loop supply chains, were developed using Vensim 7.2 PLE software. To estimate the amount of plastic packaging wastes discharged at landfill, these models were simulated using various waste diversion rates. The results indicated that, when all stakeholders in the supply chain recycled 10% of their plastic packaging waste, the total amount of plastic packaging waste going to landfill could be reduced by approximately 65%. However, the means of open-loop and closed-loop supply chains, did not differ much. © 2022, HARD Publishing Company. All rights reserved.
ABSTRACT
Background: The risk of transmission of novel SARS CoronaVirus-2 among health care workers can be reduced using personal protective equipment. It is critical to follow guidelines for appropriate use of protective gear to avoid its wastage. This study aimed to evaluate frontline healthcare workers' understanding of effective donning and doffing of protective equipment in the wake of recent emergence of corona virus disease.Physical impacts due to its prolonged usage were also identified. Material and Methods: A cross sectional survey was conducted targeting frontline health care workers from June till July 2021. Data was analyzed using SPSS version 24. Descriptive analysis was performed for qualitative variables.Chi-square test was utilized to determine association between qualitative variables and p <0.05 was considered to be statistically significant. Results: A total of 204 responses were received. Surgical masks (53.9%), gloves (51.5%), gowns (46.1%) and N95 respirator (40.7%) were most frequently used. Physicians had better knowledge on correct utilization of protective equipment as compared to non-physicians, p<0.001.Only 55.9% and 47.1% participants knew correct donning and doffing sequence respectively.The most prevalent mistakes while doffingwere touching front of mask and potentially contaminated surfaces followed by incorrect doffing sequence.Mostrespondentsmentioned scarcity of protective gear. Around 53% participants did not attend any training session on utilization of personal protective equipment. Prolonged exposure to masks and gloves led to acne, facial marks and itching. Frequent practice of hand hygiene was linked with skin dryness and cracking, p<0.001. Conclusion: We observed lack of expertise in donning and doffing technique. Mostly mistakes occurred during doffing, so interactive workshops are required to train health care workers.Most common dermatological manifestationsdue to use of masks and gloves included acne, facial markings, and itching. Adverse effects of prolonged use of PPE can be avoided by having shorter duration of working hours and giving rest during the shifts.
ABSTRACT
While considering the challenges of online teaching in the current scenario of Covid-19 pandemic, the current study aimed to analyze the effect of student participation, teachers' skills and strategies, teacher training, teaching domain and teaching perception on effectiveness of online teaching. Primary data was used to test the proposed model of the study, data was collected through emails using convenience sampling from university teachers of Pakistan. Structural equation modelling technique was used through SmartPLS (v.3.3.3) to analyze the model of this research. Findings of the current study indicate that student participation, teachers' skills and strategies, teacher's training, teaching domain and teaching perception have a significant positive effect on effectiveness of online teaching. Hence, this study recommends that universities must have to focus on the individual teachers' need to make online teaching more effective. © 2021 IEEE.
ABSTRACT
The history of the world during the pandemic era shows a worse kind of treatment to the effected people. The year 2020 is known as a terrifying year due to pandemics in the world. It badly exposes the healthcare system's weakness especially in the developing countries like Pakistan. Ambulance services played a major role in transporting affected people during pandemics. However, an independent survey shows that around 130 million people have very limited access to these facilities in Pakistan. The majority of the population of Pakistan lives in remote and rural areas and is deprived of these services. In this regard, remote monitoring of patients while they are in transit is very crucial. Considering the importance of providing better healthcare services to patients, we propose a model for remote patient monitoring systems (RPMS) integrated with emergency services in Pakistan. This healthcare model continuously keeps track of people including patients and nearest ambulances (the in-context emergency service and the key resource) for helping patients by transporting them to the appropriate healthcare center, as per needed assistance on the go. It helps reducing response time and yet increasing golden time by directly engaging the ambulance from the nearest location (using spatial and temporal features) and bypassing the call center to save the inevitable consumption of time shattered by conventional method. The represented model may enhance the availability of emergency healthcare facilities by reducing service time and allow efficient use of resources. © 2021 Asian Research Publishing Network (ARPN). All Rights Reserved.
ABSTRACT
The COVID-19 pandemic has directly impacted the electric power industry;the energy sector has experienced huge losses in electricity production. These losses have also affected the reliability of communication and employees’ performance, hence destabilizing the electric power system. This article aims at achieving two objectives. First, analyzing the impact of the COVID-19 pandemic on the communication of performance (human error and human factors) and energy management in electricity production. Second, to develop a conceptual framework model to alleviate effects of the pandemic on the power sector and then improve energy management and human performance. This paper involves investigating the influence of the COVID-19 pandemic on the global production of electricity in the first quarters of 2019 and 2020. A conceptual model was developed based on a case study. Additionally, to ensure reliability, a variable, namely COVID-19, was used as a moderator to examine the effects of the independent and dependent variables. The results show that scores for the internet of things (IoT) with awareness and communication (A&C) and workplace environment management were high with Cronbach’s alpha value of 0.87 for the IoT and 0.89 for A&C. These numbers are important indicators of factors that could affect performance and energy management and should not be overlooked by the top management. The results also indicate that the pandemic has had a direct effect on the electricity production sector, and the conceptual framework model revealed that COVID-19, as a moderator, has a direct effect on the variables that significantly affect the improvement of both energy management and employee performance. The case study’s results confirm the poor performance in power plant maintenance and operation, in which human error would increase especially in Iraqi power plants that have not yet adopted any internationally recognized standards for energy management. This paper contributes to the literature studying COVID-19’s impact on the electricity sector in two ways: first, by developing a model to assist the electricity production sector mitigating effects of the COVID-19 pandemic, and second, by providing a detailed investigation into the pandemic’s impact on the electricity sector’s global production. The findings are hoped to assist researchers and research centers in understanding the general and specific framework to manage the pandemic’s effects on electricity production. © 2021 Tech Science Press. All rights reserved.
ABSTRACT
Objective: The aim of this study is to determine the frequency of depression and anxiety in the patients due to COVID-19. Study Design: Cross-sectional Place and Duration: Conducted at Medicine department of District Headquarter Hospital Timergara for duration of six months from February 2020 to July 2020. Methods: Total 120 patients of both genders presented with covid-19 disease were enrolled in this study. Patients detailed demographics age, sex and BMI index were recorded after taking written consent. Patients aged between 15-60 years of age. Prevalence of depression and anxiety were measured among hospitalized patients. Structural questionnaires were implemented. Complete data was analyzed by SPSS 24.0 version. Results: Mean age of the patients was 25.69 ±8.21 years with mean BMI 23.41±3.34 kg/m2. Out of 120 patients, 70 (58.33%) were males and 50 (41.67%) were females. Prevalence of depression was 50% among the patients and frequency of anxiety was 40% observed. 80 (66.7%) patients were from urban areas and 40 (33.3%) were from rural areas. 100 (83.3%) were married and 20 (16.7%) were unmarried. Conclusion: We concluded in this study that frequency of anxiety and depression among the patients was frequently high. Medically ill patients should develop techniques for rapid diagnosis and treatment of depression and anxiety.
ABSTRACT
In the face of global competition and the coronavirus disease-19 (COVID-19) pandemic, the logistics service providers (LSPs) are facing severe challenges to attain their logistics performance indicators. To continue in such a market place, LSPs need to maintain a dedicated integration relationship with their clients by enhancing client special treatment benefits. The aim of this study is to apply the relational view (RV) theory and the relationship marketing (RM) perspective to examine the moderation effect of special treatment benefits on the link between logistics integration and LSPs' logistics performance (i.e., cost leadership and customer services innovation). Data was collected from 214 Malaysian LSPs, and analysed using partial least squares-structural equation modelling (PLS-SEM). Although the results show that logistics integration has a strong impact on both performances, further analysis shows that a high level of logistics integration has an association with high levels of special treatment benefits (moderating effect), in turn, maintaining performance at a high level. The exploring of the moderation effect of special treatment benefits contributes to the RV theory by incorporating the RM to reflect the moderation effect. Additionally, the study contributes empirically to the field of strategy and RM within the LSPs' industry. Finally, the findings enable LSPs to better allocate resources to ensure more effective value-based strategies that emphasise on client special treatment benefits to develop financial confidence and maintain long-term dedicated relationships, so as to achieve the target outcomes. © 2021 by the authors;licensee Growing Science, Canada
ABSTRACT
Viral infections have gained great attention following the rapid emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic around the globe. Even with the continuous research on developing vaccines and antiviral agents against various viral infections, no specific treatment or vaccine has been approved for many enteric or respiratory viral infections;in addition, the efficiency of currently available treatments is still limited. One of the most reliable and recommended strategies to control viral infections is prevention. Recently, intense studies are focusing on a promising approach for treating/preventing various viral infections using probiotics. As per the World Health Organization (WHO), probiotics can be defined as “live microorganisms which, when administered in adequate amount, confer a health benefit to the host.” The use of probiotics is a simple, cost-effective, and safe strategy to prevent viral infections, specifically;respiratory tract and intestinal ones, by different means such as stimulating the host’s immune response or modulating gut microbiota. In this rapid review, we emphasize the protective effects of probiotics against viral infections and proposed mechanisms for protection that might offer a novel and cost-effective treatment against current and newly discovered viruses like SARS-CoV-2. © 2020 Jehan Abdul-Sattar Salman, Nibras Nazar Mahmood, Ban Oday Abdulsattar, Hussein Adil Abid.