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The dynamics of the glucose-insulin regulatory system are highly nonlinear and must be understood to be controlled effectively. Bifurcation analysis and multiobjective nonlinear model predictive control (MNLMPC) are performed on a glucose-insulin dynamic model. MATCONT was used for the bifurcation analysis, and for the MNLMPC calculations, the optimization language PYOMO is used in conjunction with the solvers IPOPT and BARON. The bifurcation analysis revealed a Hopf bifurcation point and a limit point. A Hopf bifurcation point is a tipping point where a system that was behaving steadily suddenly starts to oscillate or cycle on its own, like a machine that begins to vibrate instead of staying still. A limit point is a tipping point at which pushing a system a little further suddenly causes it to jump to a completely different state, rather than changing smoothly. MNLMC converged on the Utopia solution. The Hopf bifurcation point, which leads to an unwanted limit cycle, is eliminated by an activation factor. A limit cycle is a repeating pattern of behavior that a system naturally settles into over time, like a steady heartbeat or a clock that keeps ticking. The limit point (which causes multiple steady-state solutions from a singular point enables the Multiobjective nonlinear model predictive control calculations to converge to the Utopia point (the best possible solution) in the model. A Utopia solution in multi-objective nonlinear model predictive control is an ideal operating point at which all goals are simultaneously perfectly optimized.

Background: Cervical Cancer poses a significant global health challenge, especially in lowresource settings. It is a significant health problem worldwide, with over half a million new cases diagnosed each year, accounting for approximately 6.6% of all gynecological Cancer cases and over 300,000 deaths each year. In Zambia, it is the leading cause of mortality and morbidity among women. The number of cases has increased by approximately 40%. This study explored the lived experiences of Cervical Cancer patients undergoing chemotherapy at the Cancer Diseases Hospital in Lusaka, Zambia, focusing on their subjective experiences. By examining their journeys through chemotherapy, the study aimed to highlight the subtle complexities in which treatment impacts patients’ lives and well-being.  Methods and procedures: Employing a qualitative descriptive phenomenological study design, in-depth interviews were conducted with 10 participants with diverse demographics. The sample size was determined by data saturation and saturation was reached at 10. Ethical protocols were ensured, and Study approval was obtained from UNZABREC and the National Health Research Authority. Thematic analysis was conducted on audio-recorded interviews with cervical cancer patients, ensuring confidentiality and accuracy while discerning significant patterns and themes in their narratives. Results/findings: Emotional experiences ranged from anxiety to gratitude. Psychological challenges encompassed coping mechanisms, stress management, emotional adjustments, and treatment-related fears. Socially, community support, workplace accommodations, and healthcare provider roles were key. Physical experiences revealed side effects managed through coping strategies. Financial challenges significantly impacted individuals and families.  Conclusions and recommendations: The study revealed that cervical cancer patients undergoing chemotherapy face complex challenges spanning emotional, psychological, social, physical, and financial domains, underscoring the imperative for comprehensive patient-centered care. Recommendations suggest focusing on financial aid for cancer patients and tackling treatment expenses and insurance issues. The Cancer Diseases Hospital should establish multidisciplinary teams for holistic care, and enhance patient education efforts. Nurses should adopt strategies integrating cultural competence and patient-centered care to address diverse challenges during chemotherapy. These aim to enhance the well-being and care quality of Cervical Cancer patients.

Spinal muscular atrophy is an autosomal recessive neuromuscular disorder characterized by progressive muscle weakness and atrophy. It is one of the most common single-gene disorders with an incidence rate of approximately 1 in 10,000 live births. The clinical manifestations are progressive hypotonia and muscle weakness due to the degeneration of alpha neurons in the anterior horn cells of the spinal cord and motor nuclei in the lower brain stem. Depending on the severity of the symptoms, SMA has five subtypes. Supportive measures can be offered for respiratory, gastrointestinal, and musculoskeletal complications. Carrier testing for all couples is recommended and this can be done by Multiplex Ligation-dependent Probe Amplification (MLPA). Prenatal diagnosis can be offered to carrier couples. Therapies must be given within the newborn period for maximum benefit and before the loss of motor neurons. It is achieved by identifying the SMA babies through Newborn screening. Several new FDA-approved drugs can reduce the progression of symptoms in SMA. However, they cannot offer a definite cure. Clinical follow-up and Neurological assessment demonstrate that SMA children can attain developmental milestones after receiving treatment, which is never normally attained in untreated cases. In utero SMA treatment with Zolgensma would enhance the survival rate and favorable neurological outcomes in the future. Base editing and Gene editing with CRISPR-Cas technologies to target the mutations and restore functional and stable SMN protein levels are the future hopes for a permanent cure of SMA.

Aim of this work is to analyze the coronavirus viral surface properties related the pattern of electrical features. This chemical physical property is relevant and crucial to set profile of diffusion, severity of disease, efficacy of therapeutic strategy and in order to search new way to fight COVID-19 and the NEW VARIANT. The phenomena of immune evasion and the different pattern of efficacy towards variants of some vaccine or some antibodies combination produce the need to verify if considering the electrical feature of viral surface can be a right tool or not. As result of this research it is possible to submit to the scientist that the viral surface properties and electrical feature can be an element to be considered in various preventive or treatment measure. The specificity of action of some vaccine or antibodies seem to tell us that also the aspecific methods are useful. A specific chemico physical factors can influence the electrical charges viral surface behavior. Hpertonic saline solution, humidity, electrical charge barrier in mask are simply example of the effect. That can be obtained action on viral surface chemico -physical properties.

The present article extends the PVSG-WHO criteria into a simplified set of Rotterdam and European Clinical, Molecular and Pathological (RCP/ECMP) criteria to diagnose and classify the myeloproliferative neoplasms (MPNs). The crude WHO criteria still miss the masked and early stages of ET and PV. Bone marrow histology has a near to 100% sensitivity and specificity to distinguish thrombocythemia in BCR/ABL positive CML and ET, and the myelodysplastic syndromes in RARS-T and 5q-minus syndrome from BCR/ABL negative thrombocythemias in myeloproliferative disorders (MPD). The presence of JAK2V617F mutation with increased erythrocytes above 6x1012/L and hematocrit (>0.51 males and >0.48 females) is diagnostic for PV obviating the need of red cell mass measurement. About half of WHO defined ET and PMF and 95% of PV patients are JAK2V617F positive. The combination of molecular marker screening JAK2V617F, JAK2 exon 12, MPL515 and CALR mutations and bone marrow pathology is 100% sensitive and specific for the diagnosis of latent, early and classical ECMP defined MPNs. The translation of WHO defined ET, PV and PMF into ECMP criteria have include the platelet count above 350 x109/l, mutation screening and bone marrow histology as inclusion criteria for thrombocythemia in various MPNs. According to ECMP criteria, ET comprises three distinct phenotypes of true ET, ET with features of early (“forme fruste” PV), and ET with a hypercellular erythrocythemic, megakaryocytic granulocytic myeloproliferation (EMGM or masked PV). The ECMP criteria clearly differentiate early erythrocythemic, prodromal and classical PV from congenital polycythemia and idiopathic or secondary erythrocytosis. The burden of JAK2V617F mutation in heterozygous ET and in homozygous PV is of major clinical and prognostic significance. JAK2 wild type MPL515 mutated normocellular ET and MF lack PV features in blood and bone marrow. JAK2/MPL wild type hypercellular ET associated with primary megakaryocytic granulocytic myeloproliferation (PMGM) is the third distinct CALR mutated MPN. The translation of WHO into ECMP criteria for the classification of MPNs have a major impact on prognosis assessment and best choice for first line non-leukemogenic approach to postpone potential leukemogenic myelopsuppressive agents as long as possible in ET, PV and PMGM patients.

Antibiotic resistance is a growing global crisis, straining healthcare systems and leaving us with limited options to combat drug-resistant bacteria. This retrospective, cross-sectional study examines the prevalence of antibiotic resistance patterns among urinary tract infections (UTIs) in Al-Shifa Hospital’s medical departments in comparison with non-medical departments using data from microbiology laboratory archives over a one-year period. From the examined urine cultures about 25% were obtained from internal medicine departments and double the number was obtained from non-medical departments. The positive rate was around 35% and about two-thirds of the samples were collected from female patients. Among all departments, Enterobacteriaceae spp. were found to be the most frequently isolated uropathogens, accounting for 80% of cases. However, resistance rates varied depending on the specific organism and antibiotic used. For instance, E. coli showed a resistance rate of only 5% against meropenem, while amoxicillin-clavulanic acid exhibited a resistance rate exceeding 95%.Importantly, the study revealed a significant disparity in resistance rates between medical and non-medical departments, specifically concerning third-generation cephalosporins. In internal medicine departments, resistance rates were alarmingly high, with cefotaxime, ceftriaxone, and ceftazidime showing resistance rates of 75%, 75% and 66.5% respectively. In contrast, non-medical departments displayed lower resistance rates, approximately 60%, 60% and 40%, respectively.In summary, this research sheds light on the escalating problem of antibiotic resistance in UTIs and emphasizes the discrepancy in resistance rates between medical and non-medical departments. Urgent efforts are required to address this issue and find effective solutions to prevent the rise of untreatable bacterial infections.

The presence of heavy metals (HMs) on Earth is essential to all forms of life. These metals are essential for plant and animal development but can have numerous negative effects on the living environment. In this review, we looked at where HMs come from, why they are harmful, and how they affect plants. Articles indexed in Google Scholar, PubMed, Research Gate, Science Direct, and a few books on heavy metals were consulted for this study. Heavy metals are essential for plant development and growth. According to this analysis, the hazardous effects of HMs are on the rise all throughout the globe, and this trend may be attributed mostly to human activity. Because of its impact on agricultural productivity and environmental changes, soil pollution caused by HMs is among the most crucial elements. Plants have evolved very sophisticated defense systems to deal with these environmental challenges. The threat that HM stress poses to plants has attracted a lot of attention worldwide because it could stunt agriculture’s long-term expansion. In spite of their importance for plants, this study found that HMs pose a significant threat to plant life. The novelty of this review lies in its detailed examination of both the beneficial and detrimental roles of HMs, providing a balanced perspective often overlooked in current literature. The significance of this work is underscored by its potential to inform sustainable agricultural practices and environmental management strategies, as it highlights the delicate balance required to harness the benefits of HMs while mitigating their risks. Despite their necessity for plant development, this review underscores the significant risks HMs pose to plant health and ecosystems.Less than 10 cases have been reported in the literature of the association of germline BRCA1 and Squamous cell Carcinoma – the esophagus. The article focuses on the probable pathogenesis of BRCA1 mutation with non-classic malignancies and the response of Poly adenosine diphosphate ribose polymerase inhibitors (PARP) inhibitors in such a scenario. We report an unusual manifestation of the BRCA1 gene with second primary oesophageal squamous cell cancer occurring five years later to triple-negative breast cancer.

This study examines the intricate interplay among poverty, unemployment, education, and rural-urban migration in Nigeria, employing both quantitative and qualitative analyses. Quantitative data were analyzed using SPSS software, computing descriptive and inferential statistics such as regression analysis. Quantitative findings reveal income inequality, with many individuals earning below average. Education emerges as a key determinant of economic opportunities, with higher education associated with better outcomes. Moreover, poverty and unemployment exhibit a strong positive correlation with adverse outcomes, emphasizing the need for targeted interventions. Qualitative insights delve into the motivations behind rural-urban migration, shedding light on the economic drivers compelling individuals to seek opportunities in urban areas. Participants’ narratives uncover the challenges faced by migrants, from housing to accessing essential services. Additionally, the role of remittances in sustaining sending communities is highlighted, underscoring their significance. This study underscores the multidimensionality of poverty, unemployment, and migration and emphasizes the need for holistic, evidence-based approaches to promote inclusive development. Recommendations include investments in education, job creation, social safety nets, income inequality reduction, and support for migrant integration. These measures can contribute to equitable economic growth and improved well-being in Nigeria.

Sarcoidosis is a multisystem disease of unknown origin that is characterized by non-caseating epithelioid granuloma formation within various organs, mainly the lungs [1]. The objective of this study is the analysis of sarcoidosis patients affected by pulmonary manifestation alone or extrapulmonary expression.

A 66-year-old patient, diagnosed κ light chains MM with t(11;14), presented before second cycle with bendamustine-dexamethasone. A complete remission was initially obtained with bortezomib-cyclophosphamide-dexamethasone and autologous HSCT. After relapse, he was successively treated with bortezomib-dexamethasone, carfilzomib-dexamethasone, daratumumab-dexamethasone and benda-mustine-dexamethasone.