Presenting historical and physical examination data, and initial laboratory tests carry significant predictive ability in discriminating variceal versus nonvariceal sources of bleeding.

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Introduction: Immune checkpoint inhibitors (ICIs) are recommended for various types of cancer. On the other hand, these ICIs may cause immune-related adverse events (irAEs). Lichen sclerosus (LS) and lichen planus (LP) are two distinct phenotypes of irAEs that occur in a subset of patients treated with ICIs. These adverse effects have a detrimental effect on the patient’s quality of life and treatment phases; however, the clinical evaluation and assessment of LS and LP remain uncertain. This study aims to assess and evaluate the risk of LS and LP associated with the use of ICIs via a systematic review of the literature and the USA FDA Adverse Events FAERS database. Method: The study searched electronic databases such as PubMed, Medline, Cochrane, and Google Scholar for case reports on immune-checkpoint-inhibitor-associated lichen sclerosus and lichen planus published in English between inception and 31 December 2021. The FDA’s adverse event reporting system (FAERS) database was also analyzed. Results: Thirty-eight case reports and two retrospective studies with a total of 101 patients, in addition to the FAERS data, were evaluated. More cases involved lichen planus (78.9%) than lichen sclerosis (21%). Nivolumab and pembrolizumab were most frequently reported with LS and LP, among other ICIs. Thirty-six out of thirty-eight patients with LS or LP experienced complete remission, while two patients experienced partial remission. Most of the cases had an excellent response to corticosteroids (92.1%), while the remainder had moderate (5.2%) and poor (2.6%) responses. Additionally, the reporting odds ratio (ROR) of the FAERS database indicated a favorable association for ICIs, the risk of LP, and LS. A stronger association was uniquely found between nivolumab and pembrolizumab. Conclusion: There have been published case reports for these adverse events. Healthcare providers should be aware of the possibility of lichen sclerosis and lichen planus developing in patients receiving ICIs which could necessitate hospitalization or discontinuation. Regulatory agencies are advised to monitor the risks as a potential safety signal.

This study concerns with the Process intensification deal with the complex fluids in mixing processes of many industries and its performance is based on the flow of fluid, magnetohydrodynamic (MHD) heat and mass transfer. This paper proposes a dynamic control model based on adaptive-network-based fuzzy inference system (ANFIS), weighted logistic regression and robust relevance vector machine (RRVM). Suitable similarity variables are applied to convert the flow equations into higher order ordinary differential equations and solved numerically. The surface-contour plots are utilized to visualize the influence of active parameters on velocity, thermal, nanoparticles concentration and motile microorganism’s density. The hybrid-learning algorithm comprised of gradient descent and least-squares method is employed for training the ANFIS. A novel RRVM is presented to predict the endpoint. RRVM solves the problem of sensitivity to outlier characteristic of classical relevance vector machine (RVM), thus obtaining higher prediction accuracy. The key idea of the proposed RRVM is to introduce individual noise variance coefficient to each training sample. In the process of training, the noise variance coefficients of outliers gradually decrease so as to reduce the impact of outliers and improve the robustness of the model. To compare the proposed RRVM and other methods with outliers, the Monte Carlo simulation study has been performed. The simulation results showed that, based on mean squared error (MSE), mean absolute error (MAE), root mean squared error (RMSE) and coefficient of determination (R^2) criteria, the proposed RRVM give better performance than other methods when the data contain outliers. While when the dataset does not contain outliers, the results showed that the classical RVM is more efficient than other methods.

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Systemic Lupus Erythematosus (SLE) is a multi systemic multi factorial autoimmune disease. Organ's damage and failure may occur during life time.Severe SLE presentations may lead to life threatening complications even at younger age. Therefore, general populations need to increase their awareness about SLE to reduce SLE complications. The purpose of this study to assess the levels of SLE awareness and the barriers that affect the SLE awareness among Qassim University members, Saudi Arabia, 2022. The items of the questionnaire used in this study includes socio demographic characteristics, source of SLE information, knowledge about the symptoms and treatment of SLE, assessment about the awareness toward SLE and barriers to SLE awareness. Sample size that has been collected during this study was 206 participants. The overall mean awareness score was 3.08 out of 10 points with a poor awareness level compromising of 82.3% while only 17.7% had good awareness. Factors associated with increased awareness were being a female or being a medical student, etc.