Search results for: end stage kidney disease

Authors: A. F. Suleimanov, A. B. Saduakassova, V. S. Pokrovsky, D. V. Vinnikov

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Relevance: Epithelial ovarian cancer (EOC) is the most lethal gynecological malignancy, with relapse occurring in about 70% of advanced cases with poor prognoses. The aim of the study was to evaluate functional visceral fat activity (VAT) evaluated by ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) as a predictor of metastases in epithelial ovarian cancer (EOC). Materials and methods: We assessed 53 patients with histologically confirmed EOC who underwent ¹⁸F-FDG PET/CT after a surgical treatment and courses of chemotherapy. Age, histology, stage, and tumor grade were recorded. Functional VAT activity was measured by maximum standardized uptake value (SUVₘₐₓ) using ¹⁸F-FDG PET/CT and tested as a predictor of later metastases in eight abdominal locations (RE – Epigastric Region, RLH – Left Hypochondriac Region, RRL – Right Lumbar Region, RU – Umbilical Region, RLL – Left Lumbar Region, RRI – Right Inguinal Region, RP – Hypogastric (Pubic) Region, RLI – Left Inguinal Region) and pelvic cavity (P) in the adjusted regression models. We also identified the best areas under the curve (AUC) for SUVₘₐₓ with the corresponding sensitivity (Se) and specificity (Sp). Results: In both adjusted-for regression models and ROC analysis, ¹⁸F-FDG accumulation in RE (cut-off SUVₘₐₓ 1.18; Se 64%; Sp 64%; AUC 0.669; p = 0.035) could predict later metastases in EOC patients, as opposed to age, sex, primary tumor location, tumor grade, and histology. Conclusions: VAT SUVₘₐₓ is significantly associated with later metastases in EOC patients and can be used as their predictor.

Keywords: ¹⁸F-FDG, PET/CT, EOC, predictive value

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Authors: Abdolreza Esmaeilzadeh, Maryam Erfanmanesh, Sousan Ghasemi, Farzaneh Mohammadi

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Background: Hepatitis C Virus (HCV), a public health problem, is an enveloped, single-stranded RNA virus and a member of the Hepacivirus genus of the Flaviviridae family. Liver cancer, cirrhosis, and end-stage liver are the outcomes of chronic infection with HCV. HCV isolates show significant heterogeneity in genetics around the world. Therefore, determining HCV genotypes is a vital step in determining prognosis and planning therapeutic strategies. Materials and Methods: Serum samples of 136 patients were collected and analyzed for anti-HCV antibodies using ELISA (The enzyme-linked immunosorbent assay) method. Then, positive samples were exposed to RT-PCR, which was performed under standard condition. Afterwards, they investigated for genotyping using allele-specific PCR (AS-PCR), and HCV genotype 2.0 line probe assay (LiPA). Results: Samples indicated 216 bp bands on 2% agarose gel. Analyses of the results demonstrated that the most dominant subtype was 3a with frequency of 38.26% in Zanjan Province followed by subtypes of 1b, 1a, 2, and 4 with frequencies of 25.73%, 22.05%, 5.14%, and 4.41%, respectively. The frequency of unknown HCV genotypes was 4.41%. Conclusions: According to the results, it was found that HCV high prevalent genotype in Zanjan is subtype 3a. Analysis of the results provides identification of certain HCV genotypes, and these valuable findings could affect the type and duration of the treatment.

Keywords: anti-HCV antibody, Hepatitis C Virus (HCV), genotype, RT-PCR, AS-PCR

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Authors: Aussara Panya, Nunghathai Sawasdee, Mutita Junking, Chatchawan Srisawat, Kiattawee Choowongkomon, Pa-Thai Yenchitsomanus

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Dengue virus (DENV) infection is a global public health problem with approximately 100 million infected cases a year. Presently, there is no approved vaccine or effective drug available; therefore, the development of anti-DENV drug is urgently needed. The clinical reports revealing the positive association between the disease severity and viral titer has been reported previously suggesting that the anti-DENV drug therapy can possibly ameliorate the disease severity. Although several anti-DENV agents showed inhibitory activities against DENV infection, to date none of them accomplishes clinical use in the patients. The surface envelope (E) protein of DENV is critical for the viral entry step, which includes attachment and membrane fusion; thus, the blocking of envelope protein is an attractive strategy for anti-DENV drug development. To search the safe anti-DENV agent, this study aimed to search for novel peptide inhibitors to counter DENV infection through the targeting of E protein using a structure-based in silico design. Two selected strategies has been used including to identify the peptide inhibitor which interfere the membrane fusion process whereby the hydrophobic pocket on the E protein was the target, the destabilization of virion structure organization through the disruption of the interaction between the envelope and membrane proteins, respectively. The molecular docking technique has been used in the first strategy to search for the peptide inhibitors that specifically bind to the hydrophobic pocket. The second strategy, the peptide inhibitor has been designed to mimic the ectodomain portion of membrane protein to disrupt the protein-protein interaction. The designed peptides were tested for the effects on cell viability to measure the toxic to peptide to the cells and their inhibitory assay to inhibit the DENV infection in Vero cells. Furthermore, their antiviral effects on viral replication, intracellular protein level and viral production have been observed by using the qPCR, cell-based flavivirus immunodetection and immunofluorescence assay. None of tested peptides showed the significant effect on cell viability. The small peptide inhibitors achieved from molecular docking, Glu-Phe (EF), effectively inhibited DENV infection in cell culture system. Its most potential effect was observed for DENV2 with a half maximal inhibition concentration (IC50) of 96 μM, but it partially inhibited other serotypes. Treatment of EF at 200 µM on infected cells also significantly reduced the viral genome and protein to 83.47% and 84.15%, respectively, corresponding to the reduction of infected cell numbers. An additional approach was carried out by using peptide mimicking membrane (M) protein, namely MLH40. Treatment of MLH40 caused the reduction of foci formation in four individual DENV serotype (DENV1-4) with IC50 of 24-31 μM. Further characterization suggested that the MLH40 specifically blocked viral attachment to host membrane, and treatment with 100 μM could diminish 80% of viral attachment. In summary, targeting the hydrophobic pocket and M-binding site on the E protein by using the peptide inhibitors could inhibit DENV infection. The results provide proof of-concept for the development of antiviral therapeutic peptide inhibitors to counter DENV infection through the use of a structure-based design targeting conserved viral protein.

Keywords: dengue virus, dengue virus infection, drug design, peptide inhibitor

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Authors: Sokratis Koskinakis, Georgia Frakolaki, Magdalini Krokida

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Regular consumption of omega-3 fatty acid-rich lipids is said to provide a wide range of health benefits, including prevention of inflammation, cardiovascular disease, diabetes, arthritis, and ulcerative colitis. Because of their potential nutritional and health benefits, the omega-3 PUFAs are increasingly being supplemented in functional food products meant to improve human health and wellbeing. However, dietary fortification with PUFAs is difficult due to their low water solubility, tendency to oxidize quickly, and inconsistent bioavailability. These issues can be solved through application of modern encapsulation technologies, which typically entail integrating omega-3 oils into well-designed matrices made from food-grade components. Electrospinning, for example, is an effective encapsulation method for producing sub-micron or nano-scale polymer fibers. For this purpose, various combinations of hydroxypropyl-β-cyclodextrin and cellulose nanocrystals/ nanofibers were assessed for the encapsulation of omega-3 fatty acids through the innovative technology of electrospinning. The encapsulation yield was evaluated through GC-analysis, and the morphology of the final products was assessed through SEM analysis.

Keywords: electrospinning, encapsulation, omega-3 fatty acids, cellulose nanocrystals / nanofibers

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Authors: J. Carlos Kuri, Varun Vij, Raymond J. Turner, Orly Yadid-Pecht

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Celiac disease (CD) is an immune system disorder that is triggered by ingesting gluten. As a gluten-free (GF) diet has become a concern of many people for health reasons, a gold standard had to be nominated. Enzyme-linked immunosorbent assay (ELISA) has taken the seat of this role. However, multiple limitations were discovered, and with that, the desire for an alternative method now exists. Nucleic acid-based aptamers have become of great interest due to their selectivity, specificity, simplicity, and rapid-testing advantages. However, fluorescence-based aptasensors have been tagged as unstable, but lifespan details are rarely stated. In this work, the lifespan stability of a fluorescence-based aptasensor is shown over an 8-week-long study displaying the accuracy of the sensor and false negatives. This study follows 22 different samples, including GF and gluten-rich (GR) and soy sauce products, off-the-shelf products, and reference material from laboratories, giving a total of 836 tests. The analysis shows an accuracy of correctly classifying GF and GR products of 96.30% and 100%, respectively when the protocol is augmented with molecular sieves. The overall accuracy remains around 94% within the first four weeks and then decays to 63%.

Keywords: aptasensor, PEG, rGO, FAM, RM, ELISA

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Authors: A. Y. Mukhtar, J. B. Munyakazi, R. Ouifki

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Over the past few decades, the unprecedented increase in mobility has raised considerable concern about the relationship between mobility and vector-borne diseases and malaria in particular. Thus, one can claim that human mobility is one of the contributing factors to the resurgence of malaria. To assess human mobility on malaria burden among hosts, we formulate a movement-based model on a network of patches. We then extend human multi-group SEIAR deterministic epidemic models into a system of stochastic differential equations (SDEs). Our quantitative stochastic model which is expressed in terms of average rates of movement between compartments is fitted to time-series data (weekly malaria data of 2011 for each patch) using the maximum likelihood approach. Using the metapopulation (multi-group) model, we compute and analyze the basic reproduction number. The result shows that human movement is sufficient to preserve malaria disease firmness in the patches with the low transmission. With these results, we concluded that the sensitivity of malaria to the human mobility is turning to be greatly important over the implications of future malaria control in South Sudan.

Keywords: basic reproduction number, malaria, maximum likelihood, movement, stochastic model

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Authors: Clinton Adas

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Industrial animal farming contributes to numerous problems that humans face, and among these, antimicrobial resistance (AMR) has been identified by the World Health Organisation as a real possibility for the 21st Century. While numerous factors contribute to AMR, one of them is industrial animal farming and its effect on the food chain and environment. In 2017, livestock were given around 73% of all antibiotics worldwide to make them grow faster for profit purposes, to prevent illness caused by unhealthy living conditions, and to treat disease when it breaks out. Many of the antibiotics used provide little benefit to animals, and most are the same as those used by humans - including many deemed critical to human health that should be used sparingly. AMR contributes to millions of illnesses, and in 2019 was responsible for around 4.95 million deaths worldwide. It costs Europe around nine billion euros per year, while it costs the United States (US) around 20 billion dollars per year. While not a simple or quick solution, one way to begin to address the challenge of AMR and other harms from this type of farming is to focus on animal welfare as part of a One Health and Welfare approach, as better welfare requires less antibiotics usage, which may begin to break the cycle.

Keywords: animal and human welfare, industrial animal farming, antimicrobial resistance, one health and welfare, sustainable development goals

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Authors: Beatrice Adeoye

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Studies have associated social and demographic characteristics as strong determinants of utilization of health care services; however, not much has been done to explore the dynamics of these variables in Nigeria. This empirical study explores the link between demographic factors and the future use of health care services in Nsukka, southeast Nigeria. A total of 543 respondents were selected using multi-stage sampling technique. The findings of the study showed that majority (56.9%) of the respondents were female while 43.1% were male. More of the respondents were married (50.3%) while 41.80/0 of the respondents were between ages 26-35. Testing the demographic characteristics regarding where people will prefer to go first for treatment with multiple regression, It is only Sex as a demographic variable that indicates positive association for future occurrence to where people will prefer to go first for treatment with 0.08 significance. Age and education indicates no association considering their level of significance. This result shows that sex is one of the determinant factors of where and when people will go for treatment. This is pointing out the realities regarding African society where in the family setting, it is the father that dictates the cause of action. Also to buttress these findings, cross tabulating age with who determines where and when to go for treatment, findings show that majority (58.9%) within age 26-35 said their spouses decide on where and when to go for treatment. Findings showed that patriarchy still plays an important role in the utilization of health care delivery among the people studied.

Keywords: Demographic characters, Determinant, Health Care, treatment, self-medication, symptom,

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Authors: Humberto Foyaca Sibat, Lourdes de Fátima Ibañez Valdés

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Background Cysticercosis (Ct) is a preventable and eradicable zoonotic parasitic disease secondary to a cestode infection by the larva form of pig tapeworm Taenia solium (Ts), mainly seen in people living in developing countries. When the cysticercus is in the brain parenchymal, intraventricular system, subarachnoid space (SAS), cerebellum, brainstem, optic nerve, or spinal cord, then it has named neurocysticercosis (NCC), and the often-clinical manifestations are headache and epileptic seizures/epilepsy among other less frequent symptoms and signs. In this study, we look for a manuscript related to the role played by oligodendrocytes in the pathogenesis of NCC. We review this issue and formulate some hypotheses regarding its role and the role played in the pathogenesis of calcified NCC and epileptic seizures, and secondary epilepsy. Method: We searched the medical literature comprehensively, looking for published medical subject heading (MeSH) terms like "neurocysticercosis", "pathogenesis of neurocysticercosis", "comorbidity in NCC"; OR "oligodendrocytes"; OR "oligodendrocyte precursor cells(OPC/NG2)"; OR "epileptic seizures(ES)/Epilepsy(Ep)/NCC" OR "oligodendrocytes(OLG)/ES/Ep”; OR "calcified NCC/OLG"; OR “OLG Ca2+.” Results: All selected manuscripts were peer-reviewed, and we did not find publications related to OLG/NCC.

Keywords: oligodendrocytes, neurocysticercosis, oligodendrocytes, oligodendrocyte precursor cell, KG2, calcified neurocysticercosis, cellular calcium influx.

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Authors: Lianzhong Zhang, Chao Huang

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Sea-land segmentation is a basic step in many tasks such as sea surface monitoring and ship detection. The existing sea-land segmentation algorithms have poor segmentation accuracy, and the parameter adjustments are cumbersome and difficult to meet actual needs. Also, the current sea-land segmentation adopts traditional deep learning models that use Convolutional Neural Networks (CNN). At present, the transformer architecture has achieved great success in the field of natural images, but its application in the field of radar images is less studied. Therefore, this paper proposes a sea-land segmentation method based on the transformer architecture to strengthen edge supervision. It uses a self-attention mechanism with a gating strategy to better learn relative position bias. Meanwhile, an additional edge supervision branch is introduced. The decoder stage allows the feature information of the two branches to interact, thereby improving the edge precision of the sea-land segmentation. Based on the Gaofen-3 satellite image dataset, the experimental results show that the method proposed in this paper can effectively improve the accuracy of sea-land segmentation, especially the accuracy of sea-land edges. The mean IoU (Intersection over Union), edge precision, overall precision, and F1 scores respectively reach 96.36%, 84.54%, 99.74%, and 98.05%, which are superior to those of the mainstream segmentation models and have high practical application values.

Keywords: SAR, sea-land segmentation, deep learning, transformer

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Authors: Akhilesh G. Naik, Dipankar Pal

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In today’s scenario, the complexity of digital signal processing (DSP) applications and various microcontroller architectures have been increasing to such an extent that the traditional approaches to multiplier design in most processors are becoming outdated for being comparatively slow. Modern processing applications require suitable pipelined approaches, and therefore, algorithms that are friendlier with pipelined architectures. Traditional algorithms like Wallace Tree, Radix-4 Booth, Radix-8 Booth, Dadda architectures have been proven to be comparatively slow for pipelined architectures. These architectures, therefore, need to be optimized or combined with other architectures amongst them to enhance its performances and to be made suitable for pipelined hardware/architectures. Recently, Vedic algorithm mathematically has proven to be efficient by appearing to be less complex and with fewer steps for its output establishment and have assumed renewed importance. This paper describes and shows how the Vedic algorithm can be better suited for pipelined architectures and also can be combined with traditional architectures and algorithms for enhancing its ability even further. In this paper, we also established that for complex applications on DSP and other microcontroller architectures, using Vedic approach for multiplication proves to be the best available and efficient option.

Keywords: Wallace Tree, Radix-4 Booth, Radix-8 Booth, Dadda, Vedic, Single-Stage Karatsuba (SSK), Looped Karatsuba (LK)

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Authors: Gabor Kiraly

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Wine regions are based on equilibria between climate, soil, grape varieties, and farming expertise that define the special character and quality of local vine farming and wine production. Changes in climate conditions may increase risk of destabilizing this equilibrium. Adaptation decisions, including adjusting practices, processes and capitals in response to climate change stresses – may reduce this risk. However, farmers’ adaptive behavior are subject to a wide range of factors and forces such as links between climate change implications and production, farm - scale adaptive capacity and other external forces that might hinder them to make efficient response to climate change challenges. This paper will aim to study climate change adaptation practices and strategies of grape growers in a way of applying a complex and holistic approach involving theories, methods and tools both from environmental and social sciences. It will introduce the field of adaptation studies as an evidence - based discourse by presenting an overview of examples from wine regions where adaptation studies have already reached an advanced stage. This will serve as a theoretical background for a preliminary research with the aim to examine the feasibility and applicability of such a research approach in the Hungarian context.

Keywords: climate change, adaptation, viticulture, Hungary

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Authors: Aishwarya Venkat, Anastasia Marshak, Ryan B. Simpson, Elena N. Naumova

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Livestock ownership is simultaneously linked to improved nutritional status through increased availability of animal-source protein, and increased risk of enteric infections through higher exposure to contaminated water sources. Agrarian and agro-pastoral households, especially those with cattle, goats, and sheep, are highly dependent on seasonally various environmental conditions, which directly impact nutrition and health. This study explores global spatiotemporally explicit evidence regarding the relationship between livestock ownership, enteric infections, and malnutrition. Seasonal and cyclical fluctuations, as well as mediating effects, are further examined to elucidate health and nutrition outcomes of individual and communal livestock ownership. The US Agency for International Development’s Demographic and Health Surveys (DHS) and the United Nations International Children's Emergency Fund’s Multi-Indicator Cluster Surveys (MICS) provide valuable sources of household-level information on anthropometry, asset ownership, and disease outcomes. These data are especially important in data-sparse regions, where surveys may only be conducted in the aftermath of emergencies. Child-level disease history, anthropometry, and household-level asset ownership information have been collected since DHS-V (2003-present) and MICS-III (2005-present). This analysis combines over 15 years of survey data from DHS and MICS to study 2,466,257 children under age five from 82 countries. Subnational (administrative level 1) measures of diarrhea prevalence, mean livestock ownership by type, mean and median anthropometric measures (height for age, weight for age, and weight for height) were investigated. Effects of several environmental, market, community, and household-level determinants were studied. Such covariates included precipitation, temperature, vegetation, the market price of staple cereals and animal source proteins, conflict events, livelihood zones, wealth indices and access to water, sanitation, hygiene, and public health services. Children aged 0 – 6 months, 6 months – 2 years, and 2 – 5 years of age were compared separately. All observations were standardized to interview day of year, and administrative units were harmonized for consistent comparisons over time. Geographically weighted regressions were constructed for each outcome and subnational unit. Preliminary results demonstrate the importance of accounting for seasonality in concurrent assessments of malnutrition and enteric infections. Household assets, including livestock, often determine the intensity of these outcomes. In many regions, livestock ownership affects seasonal fluxes in malnutrition and enteric infections, which are also directly affected by environmental and local factors. Regression analysis demonstrates the spatiotemporal variability in nutrition outcomes due to a variety of causal factors. This analysis presents a synthesis of evidence from global survey data on the interrelationship between enteric infections, malnutrition, and livestock. These results provide a starting point for locally appropriate interventions designed to address this nexus in a timely manner and simultaneously improve health, nutrition, and livelihoods.

Keywords: diarrhea, enteric infections, households, livestock, malnutrition, seasonality

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Authors: Deawan Rakin Ahamed Remal, Sinthia Chowdhury, Sharun Akter Khushbu, Sheak Rashed Haider Noori

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Native Speech to text synthesis has its own leverage for the purpose of mankind. The extensive nature of art to speaking different accents is common but the purpose of communication between two different accent types of people is quite difficult. This problem will be motivated by the extraction of the wrong perception of language meaning. Thus, many existing automatic speech recognition has been placed to detect text. Overall study of this paper mentions a review of NSTTR (Native Speech Text to Text Recognition) synthesis compared with Text to Text recognition. Review has exposed many text to text recognition systems that are at a very early stage to comply with the system by native speech recognition. Many discussions started about the progression of chatbots, linguistic theory another is rule based approach. In the Recent years Deep learning is an overwhelming chapter for text to text learning to detect language nature. To the best of our knowledge, In the sub continent a huge number of people speak in Bangla language but they have different accents in different regions therefore study has been elaborate contradictory discussion achievement of existing works and findings of future needs in Bangla language acoustic accent.

Keywords: TTR, NSTTR, text to text recognition, deep learning, natural language processing

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Authors: Victor Arokia Doss, Kuberapandian Dharaniyambigai, K. Julia Rose Mary

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Advanced Glycation End (AGE) products are the end products due to the reaction between excess reducing sugar present in diabetes and free amino group in protein lipids and nucleic acids. Thus, non-enzymic glycation of molecules such as hemoglobin, collagen, and other structurally and functionally important proteins add to the pathogenic complications such as diabetic retinopathy, neuropathy, nephropathy, vascular changes, atherosclerosis, Alzheimer's disease, rheumatoid arthritis, and chronic heart failure. The most common non-cross linking AGE, carboxymethyl lysine (CML) is formed by the oxidative breakdown of fructosyllysine, which is a product of glucose and lysine. CML is formed in a wide variety of tissues and is an index to assess the extent of glycoxidative damage. Thus we have constructed a mathematical and computational model that predicts the effect of temperature differences in vivo, on the formation of CML, which is now being considered as an important intracellular milieu. This hybrid model that had been tested for its parameter fitting and its sensitivity with available experimental data paves the way for designing novel laboratory experiments that would throw more light on the pathological formation of AGE adducts and in the pathophysiology of diabetic complications.

Keywords: advanced glycation end-products, CML, mathematical model, computational model

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Authors: Abhijith N. V., Abhijit Pattnayak, Deepak Kumar

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Nowadays, a group of alloys, namely high entropy alloys (HEA), because of their excellent properties. However, the fabrication of HEAs requires multistage techniques, especially mill-ing, sieving, compaction, sintering, inert media, etc. These processes are laborious, costly, time-oriented, and unsuitable for commercial application. This study adopted a single-stage process-based HVOF thermal spray to develop HEA coating on SS304L substrates. The wear behavior of the deposited HEA coating was explored under different milling time durations (5h, 10h, and 15h, respectively). The effect of feedstock preparation, microstructure, surface chemistry, and mechanical and metallurgical properties on wear resistance was also investigated. The microstructure and composition of both coating and feedstock were evaluated by scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) analysis. Finally, the phase distribution was correlated by X-ray diffraction (XRD ) analysis. The results showed that 15h milled powder coating indicated better tribological than the base substrate and 5h,10h milled powder coating. A chemically stable Body Centered Cubic (BCC) solid solution phase was generated within the 15h milled powder-coated system, which resulted in superior tribological properties.

Keywords: high entropy alloys coating, wear mechanism, HVOF coating, microstructure

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Authors: Amel Benatallah, Michel Marie, Faical Ghozlane

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Bluetongue (BT) is a major concern of veterinary services and a real threat to the sheep population. Epidemiological situation of blue tongue has revealed that in 2000, the serotype 2 (BTV2) was isolated and identified. The vector of BTV has affected 10 provinces out of 48 provinces in the country. As a result, 28 outbreaks were reported with 191 cases including 29 deaths. In 2006, the vector of the FCO has still hit Algeria, but this time with another serotype, the BTV 1. The latter was responsible for the resurgence of the disease in 11 provinces (29 outbreaks with 265 reported cases and 36 deaths).The same serotype (BTV1) was isolated and identified in 2008 in two provinces (2 outbreaks with 15 cases revealing 5 deaths) , in 2009 in 5 provinces (19 outbreaks with 78 reported cases and 20 deaths). In addition, 2010 and 2011 saw the resurgence of the same serotype (BTV1) respectively in 9 (46 outbreaks with 131 cases including and 25 deaths) and 7 provinces (16 outbreaks with 63 reported cases and 6 deaths). Serological and entomological surveys were conducted in Algeria during the period from 2000 to 2007 in order to identify the different BTV strains of existing FCO in Algeria in addition to vector Culicoides Imicola and to study the ecology of this vector to limit its movement in the country.

Keywords: blue tongue, serotype, vectors, culicoides imicola, BTV, FCO

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Authors: Caroline Seo, Jennifer Stephens, Kirstin H. Heinrich

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Background: Clostridiodes (formerly Clostridium) difficile infection (CDI) is an anaerobic, spore-forming bacterium with manifestations including diarrhea, pseudomembranous colitis and toxic megacolon. Despite general understanding that CDI may be associated with marked burden on patients’ health, there has been limited information available on the humanistic burden of CDI. The objective of this literature review was to summarize the published data on the humanistic burden of CDI globally, in order to better inform future research efforts and increase awareness of the patient perspective in this disease. Methods: A comprehensive literature review of the past 15 years (2002-2017) was conducted using MEDLINE, Embase and Cumulative Index of Nursing and Allied Health Literature. Additional searches were conducted from conference proceedings (2015-2017). Articles selected were studies specifically designed to examine the humanistic burden of illness associated with adult patients with CDI. Results: Of 3,325 articles or abstracts identified, 33 remained after screening and full text review. Sixty percent (60%) were published in 2016 or 2017. Data from the United States or Western Europe were most common. Data from Brazil, Canada, China and Spain also exist. Thirteen (13) studies used validated patient-reported outcomes instruments, mostly EQ-5D utility and SF-36 generic instruments. Three (3) studies used CDI-specific instruments (CDiff32, CDI-DaySyms). The burden of CDI impacts patients in multiple health-related quality of life (HRQOL) domains. SF-36 domains with the largest decrements compared to other GI diarrheal diseases (IBS-D and Crohn’s) were role physical, physical functioning, vitality, social functioning, and role emotional. Reported EQ-5D utilities for CDI ranged from 0.35-0.42 compared to 0.65 in Crohn’s and 0.72 in IBS-D. The majority of papers addressed physical functioning and mental health domains (67% for both). Across various studies patients reported weakness, lack of appetite, sleep disturbance, functional dependence, and decreased activities of daily lives due to the continuous diarrhea. Due to lack of control over this infection, CDI also impacts the psychological and emotional quality of life of the patients. Patients reported feelings of fear, anxiety, frustration, depression, and embarrassment. Additionally, the type of disease (primary vs. recurrent) may impact mental health. One study indicated that there is a decrement in SF-36 mental scores in patients with recurrent CDI, in comparison to patients with primary CDI. Other domains highlighted by these studies include pain (27%), social isolation (27%), vitality and fatigue (24%), self-care (9%), and caregiver burden (0%). Two studies addressed work productivity, with 1 of these studies reporting that CDI patients had the highest work productivity and activity impairment scores among the gastrointestinal diseases. No study specifically included caregiver self-report. However, 3 studies did provide mention of patients’ worry on how their diagnosis of CDI would impact family, caregivers, and/or friends. Conclusions: Despite being a serious public health issue there has been a paucity of research on the HRQOL among those with CDI. While progress is being made, gaps exist in understanding the burden on patients, caregivers, and families. Future research is warranted to aid understanding of the CDI patient perspective.

Keywords: burden, Clostridiodes, difficile, humanistic, infection

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Authors: Muhammad Mohsan, Mehboob Ur-Rahman, Sana Zulfiqar, Shumila Ashfaq

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Brown Rust (Puccinia triticina), also known as leaf rust, pose a serious threat to wheat cultivation in the world. Nine candidate wheat lines/mutants were subjected to rust inoculation, lodging and aphid population in vivo conditions. Four lines/mutants (E-284, E-505, 2008-6 MR and 2008-14MR) were found resistant to leaf rust attack. Two lines (PGMB 15-29 and 2011-1 MR) displayed moderately resistant reactions against the disease. Three lines/mutants were depicted as susceptible to leaf rust. The lowest population of aphids, i.e., 16.67, was observed on 2008-14MR. Three lines/mutants (NN1-47, NN1-89 and PGMB 15-29) were found under zero level of lodging. The presence and absence of different leaf rust-resistant genes like Lr13, Lr34, Lr46 and Lr67 were assessed with the help of molecular markers. All the wheat lines/mutants were found loaded with leaf rust-resistant genes such as Lr13 and Lr 34, while Lr46 and Lr67 were found in 66% of wheat lines/mutants. The resistant source can be exploited in the breeding program to develop rust, aphid and lodging with race-nonspecific resistant wheat variety.

Keywords: wheat, leaf rust, lodging, aphid

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Authors: María Molinos-Senante, Giulia Romano

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This paper aims at investigating the effect of ownership in the efficiency assessment of municipal solid waste management. In doing so, the Data Envelopment Analysis meta-frontier approach integrating unsorted waste as undesirable output was applied. Three different clusters of municipalities have been created on the basis of the ownership type of municipal waste operators. In the second stage of analysis, the paper investigates factors affecting efficiency, in order to provide an outlook of levers to be used by policy and decision makers to improve efficiency, taking into account different management models in force. Results show that public waste management firms have better performance than mixed and private ones since their efficiency scores are significantly larger. Moreover, it has been demonstrated that the efficiency of waste management firms is statistically influenced by the age of population, population served, municipal size, population density and tourism rate. It evidences the importance of economies of scale on the cost efficiency of waste management. This issue is relevant for policymakers to define and implement policies aimed to improve the long-term sustainability of waste management in municipalities.

Keywords: data envelopment analysis, efficiency, municipal solid waste, ownership, undesirable output

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Authors: Behnoush Sabayan, Ali Alidadi, Saeid Ebarhimi, N. M. Bakhshani

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Hemodialysis (HD) patients are at a high risk of atherosclerotic and vascular disease; also little information is available for the HD impact on brain structure of these patients. We studied the brain abnormalities in HD patients. The aim of this study was to investigate the effect of long term HD on brain structure of HD patients. Non-contrast MRI was used to evaluate imaging findings. Our study included 80 HD patients of whom 39 had less than six months of HD and 41 patients had a history of HD more than six months. The population had a mean age of 51.60 years old and 27.5% were female. According to study, HD patients who have been hemodialyzed for a long time (median time of HD was up to 4 years) had small vessel ischemia than the HD patients who underwent HD for a shorter term, which the median time was 3 to 5 months. Most of the small vessel ischemia was located in pre-ventricular, subcortical and white matter (1.33± .471, 1.23± .420 and 1.39±.490). However, the other brain damages like: central pons abnormality, global brain atrophy, thinning of corpus callosum and frontal lobe atrophy were found (P<0.01). The present study demonstrated that HD patients who were under HD for a longer time had small vessel ischemia and we conclude that this small vessel ischemia might be a causative mechanism of brain atrophy in chronic hemodialysis patients. However, additional researches are needed in this area.

Keywords: Hemodialysis Patients, Duration of Hemodialysis, MRI, Zahedan

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Authors: W. S. Thulasitha, N. Umasuthan, G. I. Godahewa, Jehee Lee

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In fish, innate immune defense is the first immune response against microbial pathogens which consists of several antimicrobial components. Galectins are one of the carbohydrate binding lectins that have the ability to identify pathogen by recognition of pathogen associated molecular patterns. Galectins play a vital role in the regulation of innate and adaptive immune responses. Rock bream Oplegnathus fasciatus is one of the most important cultured species in Korea and Japan. Considering the losses due to microbial pathogens, present study was carried out to understand the molecular and functional characteristics of a galectin in normal and pathogenic conditions, which could help to establish an understanding about immunological components of rock bream. Complete cDNA of rock bream galectin like protein B (rbGal like B) was identified from the cDNA library, and the in silico analysis was carried out using bioinformatic tools. Genomic structure was derived from the BAC library by sequencing a specific clone and using Spidey. Full length of rbGal like B (contig14775) cDNA containing 517 nucleotides was identified from the cDNA library which comprised of 435 bp in the open reading frame encoding a deduced protein composed of 145 amino acids. The molecular mass of putative protein was predicted as 16.14 kDa with an isoelectric point of 8.55. A characteristic conserved galactose binding domain was located from 12 to 145 amino acids. Genomic structure of rbGal like B consisted of 4 exons and 3 introns. Moreover, pairwise alignment showed that rock bream rbGal like B shares highest similarity (95.9 %) and identity (91 %) with Takifugu rubripes galectin related protein B like and lowest similarity (55.5 %) and identity (32.4 %) with Homo sapiens. Multiple sequence alignment demonstrated that the galectin related protein B was conserved among vertebrates. A phylogenetic analysis revealed that rbGal like B protein clustered together with other fish homologs in fish clade. It showed closer evolutionary link with Takifugu rubripes. Tissue distribution and expression patterns of rbGal like B upon immune challenges were performed using qRT-PCR assays. Among all tested tissues, level of rbGal like B expression was significantly high in gill tissue followed by kidney, intestine, heart and spleen. Upon immune challenges, it showed an up-regulated pattern of expression with Edwardsiella tarda, rock bream irido virus and poly I:C up to 6 h post injection and up to 24 h with LPS. However, In the presence of Streptococcus iniae rbGal like B showed an up and down pattern of expression with the peak at 6 - 12 h. Results from the present study revealed the phylogenetic position and role of rbGal like B in response to microbial infection in rock bream.

Keywords: galectin like protein B, immune response, Oplegnathus fasciatus, molecular characterization

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Authors: Mohsina Akhter

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Cancer has become a wide spread disease around the globe and takes many lives every year. Different treatments are being practiced but all have potential side effects with somewhat less specificity towards target sites. Pseudomonas aeruginosa is known to secrete a protein azurin with special anti-cancer function. It has unique cell penetrating peptide comprising of 18 amino acids that have ability to enter cancer cells specifically. Reported function of Azurin is to stabilize p53 inside the tumor cells and induces apoptosis through Bax mediated cytochrome c release from mitochondria. At laboratory scale, we have made recombinant azurin through cloning rpTZ57R/T-azu vector into E.coli strain DH-5α and subcloning rpET28-azu vector into E.coli BL21-CodonPlus (DE3). High expression was ensured with IPTG induction at different concentrations then optimized high expression level at 1mM concentration of IPTG for 5 hours. Purification has been done by using Ni+2 affinity chromatography. We have concluded that azurin can be a remarkable improvement in cancer therapeutics if it produces on a large scale. Azurin does not enter into the normal cells so it will prove a safe and secure treatment for patients and prevent them from hazardous anomalies.

Keywords: azurin, pseudomonas aeruginosa, cancer, therapeutics

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Authors: Yadollah Hezarjaribi, Mahdie Yari Esboi

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In this paper, a novel MEMS capacitive pressure sensor with small size and high sensitivity is presented. This sensor has the separated clamped square diaphragm and the movable plate. The diaphragm material is polysilicon. The movable and fixed plates and mechanical coupling are gold. The substrate and diaphragm are pyrex glass and polysilicon, respectively. In capacitive sensor the sensitivity is proportional to deflection and capacitance changes with pressure for this reason with this design is improved the capacitance and sensitivity with small size. This sensor is designed for low pressure between 0-60 mmHg that is used for medical application such as treatment of an incurable disease called glaucoma. The size of this sensor is 350×350 µm2 and the thickness of the diaphragm is 2µm with 1μ air gap. This structure is designed by intellisuite software. In this MEMS capacitive pressure sensor the sensor sensitivity, diaphragm mechanical sensitivity for polysilicon diaphragm are 0.0469Pf/mmHg, 0.011 μm/mmHg, respectively. According to the simulating results for low pressure, the structure with polysilicon diaphragm has more change of the displacement and capacitance, this leads to high sensitivity than other diaphragms.

Keywords: glaucoma, MEMS capacitive pressure sensor, square clamped diaphragm, polysilicon

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Authors: Shu-Ching Chiu, Shu-Fang Chang

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The World Health Organization (WHO) has been actively developing intervention programs to deal with geriatric frailty. In its White Paper on Healthcare Policy 2020, the Department of Health, Bureau of Health Promotion proposed that active aging and the prevention of disability are essential for elderly people to maintain good health. The paper recommended five main policies relevant to this objective, one of which is the prevention of frailty and disability. Scholars have proposed a number of different criteria to diagnose and assess frailty; no consistent or normative standard of measurement is currently available. In addition, many methods of assessment are recursive, which can easily result in recall bias. Due to the relationship between frailty and physical fitness with regard to co-morbidity, it is important that academics optimize the criteria used to assess frailty by objectively evaluating the physical fitness of senior citizens. This study used a review of the literature to identify fitness indicators suitable for measuring frailty in the elderly. This study recommends that measurement criteria be integrated to produce an optimized predictive value for frailty score. Healthcare professionals could use this data to detect frailty at an early stage and provide appropriate care to prevent further debilitation and increase longevity.

Keywords: frailty, aging, physical fitness, optimized criteria, healthcare

Procedia PDF Downloads 349

Authors: Jose A. Alvarez Aldegunde, Adrian Fernandez Sanchez, Matthew D. Menden, Bernardo Vila Rodriguez

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Up to five statistical pre-processings have been carried out considering the pollutant records of the stations present in Cartagena de Indias, Colombia, also taking into account the childhood asthma incidence surveys conducted in hospitals in the city by the Health Ministry of Colombia for this study. These pre-processings have consisted of different techniques such as the determination of the quality of data collection, determination of the quality of the registration network, identification and debugging of errors in data collection, completion of missing data and purified data, as well as the improvement of the time scale of records. The characterization of the quality of the data has been conducted by means of density analysis of the pollutant registration stations using ArcGis Software and through mass balance techniques, making it possible to determine inconsistencies in the records relating the registration data between stations following the linear regression. The results obtained in this process have highlighted the positive quality in the pollutant registration process. Consequently, debugging of errors has allowed us to identify certain data as statistically non-significant in the incidence and series of contamination. This data, together with certain missing records in the series recorded by the measuring stations, have been completed by statistical imputation equations. Following the application of these prior processes, the basic series of incidence data for respiratory disease and pollutant records have allowed the characterization of the influence of pollutants on respiratory diseases such as, for example, childhood asthma. This characterization has been carried out using statistical correlation methods, including visual correlation, simple linear regression correlation and spectral analysis with PAST Software which identifies maximum periodicity cycles and minimums under the formula of the Lomb periodgram. In relation to part of the results obtained, up to eleven maximums and minimums considered contemporary between the incidence records and the particles have been identified taking into account the visual comparison. The spectral analyses that have been performed on the incidence and the PM2.5 have returned a series of similar maximum periods in both registers, which are at a maximum during a period of one year and another every 25 days (0.9 and 0.07 years). The bivariate analysis has managed to characterize the variable "Daily Vehicular Flow" in the ninth position of importance of a total of 55 variables. However, the statistical correlation has not obtained a favorable result, having obtained a low value of the R2 coefficient. The series of analyses conducted has demonstrated the importance of the influence of pollutants such as PM2.5 in the development of childhood asthma in Cartagena. The quantification of the influence of the variables has been able to determine that there is a 56% probability of dependence between PM2.5 and childhood respiratory asthma in Cartagena. Considering this justification, the study could be completed through the application of the BenMap Software, throwing a series of spatial results of interpolated values of the pollutant contamination records that exceeded the established legal limits (represented by homogeneous units up to the neighborhood level) and results of the impact on the exacerbation of pediatric asthma. As a final result, an economic estimate (in Colombian Pesos) of the monthly and individual savings derived from the percentage reduction of the influence of pollutants in relation to visits to the Hospital Emergency Room due to asthma exacerbation in pediatric patients has been granted.

Keywords: Asthma Incidence, BenMap, PM2.5, Statistical Analysis

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Authors: Michael Josef Schwerer

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Background: Analyzing any aircraft accident is mandatory based on the regulations of the International Civil Aviation Organization and the respective country’s criminal prosecution authorities. Legal medicine investigations are unavoidable when fatalities involve the flight crew or when doubts arise concerning the pilot’s aeromedical health status before the event. As a result of frequently tremendous blunt and sharp force trauma along with the impact of the aircraft to the ground, consecutive blast or fire exposition of the occupants or putrefaction of the dead bodies in cases of delayed recovery, relevant findings can be masked or destroyed and therefor being inaccessible in standard pathology practice comprising just forensic autopsy and histopathology. Such cases are of considerable risk of remaining unsolved without legal consequences for those responsible. Further, no lessons can be drawn from these scenarios to improve flight safety and prevent future mishaps. Aims and Methods: To learn from previously unsolved aircraft accidents, re-evaluations of the investigation files and modern molecular pathology studies were performed. Genetic testing involved predominantly PCR-based analysis of gene regulation, studying DNA promotor methylations, RNA transcription and posttranscriptional regulation. In addition, the presence or absence of infective agents, particularly DNA- and RNA-viruses, was studied. Technical adjustments of molecular genetic procedures when working with archived sample material were necessary. Standards for the proper interpretation of the respective findings had to be settled. Results and Discussion: Additional molecular genetic testing significantly contributes to the quality of forensic pathology assessment in aviation mishaps. Previously undetected cardiotropic viruses potentially explain e.g., a pilot’s sudden incapacitation resulting from cardiac failure or myocardial arrhythmia. In contrast, negative results for infective agents participate in ruling out concerns about an accident pilot’s fitness to fly and the aeromedical examiner’s precedent decision to issue him or her an aeromedical certificate. Care must be taken in the interpretation of genetic testing for pre-existing diseases such as hypertrophic cardiomyopathy or ischemic heart disease. Molecular markers such as mRNAs or miRNAs, which can establish these diagnoses in clinical patients, might be misleading in-flight crew members because of adaptive changes in their tissues resulting from repeated mild hypoxia during flight, for instance. Military pilots especially demonstrate significant physiological adjustments to their somatic burdens in flight, such as cardiocirculatory stress and air combat maneuvers. Their non-pathogenic alterations in gene regulation and expression will likely be misinterpreted for genuine disease by inexperienced investigators. Conclusions: The growing influence of molecular pathology on legal medicine practice has found its way into aircraft accident investigation. As appropriate quality standards for laboratory work and data interpretation are provided, forensic genetic testing supports the medico-legal analysis of aviation mishaps and potentially reduces the number of unsolved events in the future.

Keywords: aviation medicine, aircraft accident investigation, forensic pathology, molecular pathology

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Authors: Surajit Chattopadhyay

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Accelerated expansion of the current universe is well-established in the literature. Dark energy and modified gravity are two approaches to account for this accelerated expansion. In the present work, we consider scalar field models of dark energy, namely, tachyon and DBI essence in the framework of chameleon Brans-Dicke cosmology. The equation of state parameter is reconstructed and the subsequent cosmological implications are studied. We examined the stability for the obtained solutions of the crossing of the phantom divide under a quantum correction of massless conformally invariant fields and we have seen that quantum correction could be small when the phantom crossing occurs and the obtained solutions of the phantom crossing could be stable under the quantum correction. In the subsequent phase, we have established a correspondence between the NHDE model and the quintessence, the DBI-essence and the tachyon scalar field models in the framework of chameleon Brans–Dicke cosmology. We reconstruct the potentials and the dynamics for these three scalar field models we have considered. The reconstructed potentials are found to increase with the evolution of the universe and in a very late stage they are observed to decay.

Keywords: dark energy, holographic principle, modified gravity, reconstruction

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Authors: Daniella Arieli

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As human population is ageing, globally, we are faced with the need to find solutions for the care of older people who have reached the stage of needing full-time nursing care. Basically, there are two basic alternatives: 1. moving the individual to an institutional setting, a care home, or other form of residency, and 2. Arranging care for them in their own home, what is known as “ageing in place”. As ageing in place is becoming popular in many parts of the world, there is a need to understand its’ everyday consequences for all the involved parties: the care recipient, her/his family members and the live-in care workers. This is crucial because choosing home care means that the role of the care recipient’s relatives becomes very demanding and requires a level of support and responsibility that is often beyond what families can offer. This is particularly challenging when the older person faces dementia. While most Western countries offer a range of social services, many citizens around the world find the care provided by governments and associated social support structures insufficient. Individuals and families find themselves in the position of having to take on the responsibility themselves and find a path for the care of frail members, while facing considerable personal burdens and challenging dilemmas. The aim of this work is to discuss those challenges. The study is based on an ethnographic study of home care for older people in Israel.

Keywords: aging in place, family caregivers, policy making, qualitative research

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Authors: Finbarr Murphy, Wei Xu, Xian Xu

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The embedding of digital technologies in the global economy has attracted increasing attention from economists. With a large and detailed dataset, this study examines the specific case where consumers have a choice between offline and digital channels in the context of insurance purchases. We find that digital channels screen consumers with lower unobserved risk. For the term life, endowment, and disease insurance products, the average risk of the policies purchased through digital channels was 75%, 21%, and 31%, respectively, lower than those purchased offline. As a consequence, the lower unobserved risk leads to weaker information asymmetry and higher profitability of digital channels. We highlight three mechanisms of the risk screening effect: heterogeneous marginal influence of channel features on insurance demand, the channel features directly related to risk control, and the link between the digital divide and risk. We also find that the risk screening effect mainly comes from the extensive margin, i.e., from new consumers. This paper contributes to three connected areas in the insurance context: the heterogeneous economic impacts of digital technology adoption, insurer-side risk selection, and insurance marketing.

Keywords: digital economy, information asymmetry, insurance, mobile application, risk screening

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