Search results for: chronic disease

Authors: Charlie Jeffkins

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Sickle cell disease is a serious life-limiting condition which can reduce the quality of life for many patients. Public Health England (PHE), in partnership with the Sickle Cell Society (SCS), has created guidelines to prevent severe complications from sickle cell disease. Data was collected from Children’s Hospital for Wales between 15/03/21-26/03/21. Methods: A manual search of patient records for children under the care of Rocket Ward and a key term search of online records was used. Results: Penicillin prophylaxis was given at 90 days for 89%, 77% of TCDs scans were done at 2-3 years, and 72% have had a scan in the last year. 53% of patients have had discussions about hydroxycarbamide, whilst 65% have started it. PPV vaccination was documented for 19%. Conclusion: Overall, none of the four standards were reached; however, TCD uptake has improved. There is a need for better documentation of treatment and annual re-audits.

Keywords: paediatric, haematology, sickle cell, audit

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Authors: Imene Soufli, Abdelkrim Hablal, Manel Amri, Moussa Labsi, Rania Sihem Boussa, Nassim Sid Idris, Chafia Touil-Boukoffa

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Crohn’s Disease (CD) is a relapsing–remitting inflammatory bowel disease with a progressive course. The aim of our study was to evaluate the relationship between the immunomarkers: Nitric Oxide (NO), pro-inflammatory cytokines, and blood count-based ratios and the outcome of corticosteroid or anti-TNF-α therapy in patients with complicated Crohn’s Disease. In this context, we evaluated the NLR as the ratio of neutrophil count to lymphocyte count, PLR as the ratio of platelet counts to lymphocyte count, and MLR as the ratio of monocyte count to lymphocyte count in patients and controls. Furthermore, we assessed NO production by the Griess method in plasma along with iNOS and NF-κB expression by immunofluorescence method in intestinal tissues of patients and controls. In the same way, we evaluated plasma TNF-α, IL-17A, and IL-10 levels using ELISA. Our results indicate that blood count-based ratios NLR, PLR, and MLR were significantly higher in patients compared to controls. In addition, increased systemic levels of NO, TNF-α, and IL-17A and colonic expression of iNOS and NF-κB were observed in the same patients. Interestingly, the high ratio of NLR and MLR, as well as NO production, was significantly decreased in treated patients. Collectively, our findings suggest that Nitric Oxide, as well as the blood count-based ratios (NLR, PLR, MLR), could constitute useful immuno-markers in complicated Crohn’s Disease, predicting the response to treatment

Keywords: complicated crohn’s disease, nitric oxide, blood count-based ratios, treatments, pro-inflammatory cytokines

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Authors: Ali Bayram, Burak Uz, Remzi Yiğiter

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The aim of the present study was to investigate the expression levels of homo sapiens nuclear factor of kappa light polypeptide gene enhancer in B-cells 1, transcript variant 1 (NFKB1*1) mRNA in the peripheral blood of patients with Parkinson to elucidate the role in the pathogenesis of Parkinson disease (PD). The study group comprised 50 patients with the diagnosis of PD who have applied to Gaziantep University Faculty of Medicine, and Department of Neurology. 50 healthy individuals without any neuro degenerative disease are included as controls. Ribonucleic acid (RNA) was obtained from blood samples of patient and control groups. Complementary deoxyribonucleic acid (cDNA) was obtained from RNA samples using reverse transcription polymerase chain reaction (RT-PCR) technique. The gene expression of NFKB1*1 in patient/control groups were observed to decrease significantly, and the differences between groups with the Mann-Whitney method within 95% confidence interval (p<0.05) were analyzed. This salient finding provide a clue for our hypothesis that reduced activity of NFKB1*1 gene might play a role, at least partly, in the pathophysiology of PD.

Keywords: Parkinson’s Disease, NFKB1, mRNA expression, RT-PCR

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Authors: Jacintha Menezes, Ramalingam Dharmalingam, Palaiahnakote Shivakumara

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In the recent years, Omani acid lime cultivation and production has been affected by Citrus greening or Huanglongbing (HLB) disease. HLB disease is one of the most destructive diseases for citrus, with no remedies or countermeasures to stop the disease. Currently used Polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) HLB detection tests require lengthy and labor-intensive laboratory procedures. Furthermore, the equipment and staff needed to carry out the laboratory procedures are frequently specialized hence making them a less optimal solution for the detection of the disease. The current research uses hyperspectral imaging technology for automatic detection of citrus trees with HLB disease. Omani citrus tree leaf images were captured through portable Specim IQ hyperspectral camera. The research considered healthy, nutrition deficient, and HLB infected leaf samples based on the Polymerase chain reaction (PCR) test. The highresolution image samples were sliced to into sub cubes. The sub cubes were further processed to obtain RGB images with spatial features. Similarly, RGB spectral slices were obtained through a moving window on the wavelength. The resized spectral-Spatial RGB images were given to Convolution Neural Networks for deep features extraction. The current research was able to classify a given sample to the appropriate class with 92.86% accuracy indicating the effectiveness of the proposed techniques. The significant bands with a difference in three types of leaves are found to be 560nm, 678nm, 726 nm and 750nm.

Keywords: huanglongbing (HLB), hyperspectral imaging (HSI), · omani citrus, CNN

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Authors: Ieva Bruzauskaite, Jovile Raudoniute, Karina Poliakovaite, Danguole Zabulyte, Daiva Bironaite, Ruta Aldonyte

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Introduction: Air pollution is a growing global problem which has been shown to be responsible for various adverse health outcomes. Immunotoxicity, such as dysregulated inflammation, has been proposed as one of the main mechanisms in air pollution-associated diseases. Chronic obstructive pulmonary disease (COPD) is among major morbidity and mortality causes worldwide and is characterized by persistent airflow limitation caused by the small airways disease (obstructive bronchiolitis) and irreversible parenchymal destruction (emphysema). Exact pathways explaining the air pollution induced and mediated disease states are still not clear. However, modern societies understand dangers of polluted air, seek to mitigate such effects and are in need for reliable biomarkers of air pollution. We hypothesise that post-translational modifications of structural proteins, e.g. citrullination, might be a good candidate biomarker. Thus, we have designed this study, where mice were exposed to diesel exhaust and the ongoing protein modifications and inflammation in lungs and other tissues were assessed. Materials And Methods: To assess the effects of diesel exhaust a in vivo study was designed. Mice (n=10) were subjected to everyday 2-hour exposure to diesel exhaust for 14 days. Control mice were treated the same way without diesel exhaust. The effects within lung and other tissues were assessed by immunohistochemistry of formalin-fixed and paraffin-embedded tissues. Levels of inflammation and citrullination related markers were investigated. Levels of parenchymal damage were also measured. Results: In vivo study corroborates our own data from in vitro and reveals diesel exhaust initiated inflammatory shift and modulation of lung peptidyl arginine deiminase 4 (PAD4), citrullination associated enzyme, levels. In addition, high levels of citrulline were observed in exposed lung tissue sections co-localising with increased parenchymal destruction. Conclusions: Subacute exposure to diesel exhaust renders mice lungs inflammatory and modifies certain structural proteins. Such structural changes of proteins may pave a pathways to lost/gain function of affected molecules and also propagate autoimmune processes within the lung and systemically.

Keywords: air pollution, citrullination, in vivo, lungs

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Authors: Malik Abdul Jabbar Zen, Wiwik Misaco Yuniarti, Azisya Amalia Karimasari, Novita Priandini

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Zoonos is as an infectiontransmitted froma nimals to human sand vice versa currently having increased in the last 20 years. The experts/scientists predict that zoonosis will be a threat to the community in the future since it leads on 70% emerging infectious diseases (EID) and the high mortality of 50%-90%. The zoonosis’ spread from animal to human is caused by contaminated food known as foodborne disease. One World One Health, as the conceptual prevention toward zoonosis, requires the crossed disciplines cooperation to accelerate and streamlinethe handling ofanimal-based disease. E-Vet Smart Rapid System is an integrated innovation in the veterinary expertise application is able to facilitate the prevention, treatment, and educationagainst pandemic diseases and zoonosis. This system is constructed by Decision Support System (DSS) method provides a database of knowledge that is expected to facilitate the identification of disease rapidly, precisely, and accurately as well as to identify the deduction. The testingis conducted through a black box test case and questionnaire (N=30) by validity and reliability approach. Based on the black box test case reveals that E-Vet Rapid System is able to deliver the results in accordance with system design, and questionnaire shows that this system is valid (r > 0.361) and has a reliability (α > 0.3610).

Keywords: diagnosis, disease, expert systems, livestock, zoonosis

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Authors: Neelam Singha

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The present work intends to analyze the system dynamics of Hashimoto’s thyroiditis with the assistance of fractional calculus. Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disorder in which the immune system attacks the thyroid gland, which gradually results in interrupting the normal thyroid operation. Consequently, the feedback control of the system gets disrupted due to thyroid follicle cell lysis. And, the patient perceives life-threatening clinical conditions like goiter, hyperactivity, euthyroidism, hyperthyroidism, etc. In this work, we aim to obtain the approximate solution to the posed fractional-order problem describing Hashimoto’s thyroiditis. We employ the Adomian decomposition method to solve the system of fractional-order differential equations, and the solutions obtained shall be useful to provide information about the effect of medical care. The numerical technique is executed in an organized manner to furnish the associated details of the progression of the disease and to visualize it graphically with suitable plots.

Keywords: adomian decomposition method, fractional derivatives, Hashimoto's thyroiditis, mathematical modeling

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Authors: Sadek A. Makhlouf, Hassan M. Nouh

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Bone hydatidosis is an infection in worldwide distribution. Although there is no evidence in literature on Bone Hydatid disease in Libya, we tried to present the first epidemiological study of this disease in Eastern Libya through retrospective study from 1995 to 2013. Our data were collected from 3 hospitals in Eastern Libya particularly the sheep-raising areas with total number of musculoskeletal infection cases of two thousand one hundred ninety-four (2,194). There were five (5) five cases of bone infection, four (4) of it have been diagnosed after more than three (3) months. Our study is comparable to other international study but this type of bone infection need further studies for effective control strategies for all dogs to avoid serious complications that might happened from the delay in diagnosing this type of disease.

Keywords: bone infection, hydatidosis, Eastern Libya, sheep-raising areas

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Authors: Faisal Almalki

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Pyran is a heterocyclic group containing oxygen that possesses a variety of pharmacological effects. Pyran is also one of the most prevalent structural subunits in natural products, such as xanthones, coumarins, flavonoids, benzopyrans, etc. Additionally demonstrating the neuroprotective properties of pyrans is the fact that this heterocycle has recently attracted the attention of scientists worldwide. Alzheimer's Disease (AD) treatment and diagnosis are two of the most critical research objectives worldwide. Increased amounts of extracellular senile plaques, intracellular neurofibrillary tangles, and a progressive shutdown of cholinergic basal forebrain neuron transmission are often related with cognitive impairment. This review highlights the various pyran scaffolds of natural and synthetic origin that are effective in the treatment of AD. For better understanding synthetic compounds are categorized as different types of pyran derivatives like chromene, flavone, xanthone, xanthene, etc. The discussion encompasses both the structure-activity correlations of these compounds as well as their activity against AD. Because of the intriguing actions that were uncovered by these pyran-based scaffolds, there is no question that they are at the forefront of the search for potential medication candidates that could treat Alzheimer's disease.

Keywords: alzheimer’s disease, pyran, coumarin, xanthone

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Authors: Rady A., Elsheshai A., Eltawel M.

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Introduction and Aim of work: Literature suggest that antipsychotic medications may decrease cortisol level, an effect that seems to be more present with second generation antipsychotic. Our study aims at assessing effect of long term use of antipsychotics on cortisol level Subjects and Methods: 30 chronic schizophrenic patients on antipsychotics compared to 20 drug naive schizophrenic patients as regards serum cortisol level Results: Cortisol level was significantly lower in chronic schizophrenic patients receiving antipsychotics compared to drug naive patients (P=0.002 <0.05) Conclusion: Antipsychotic medications seem to have the potential to decrease cortisol level in blood. Among hypothesis proposed in literature is the good control of pseudo stress due to psychotic features.

Keywords: schizophrenia, antipsychotic, cortisol, HPA

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Authors: Shao-Cyuan Yewang, Yu-Wen Chen

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Background: Exercise training is well known to alleviate chronic pain syndromes improve of chronic pain. This study investigated the effect of swimming exercise training on thoracotomy and rib retraction-induced allodynia. Methods: Male Sprague Dawley rats that received animal model of persistent postthoracotomy pain. All rats were divided into three groups: sham operations group (Sham), thoracotomy and rib retraction group (TRR), and TRR with swimming exercise training for 90min/day, 7 days a week for 4 weeks (TRR-SEW). The sham group did not receive retraction of the ribs. Thus, they received a pleural incision. The levels of mechanical and cold allodynia were measured by von Frey and acetone test. Results: In von Frey test, the level of mechanical allodynia in the TRR group was significantly higher than the sham group. The level of mechanical allodynia in the TRR-SEW group was significantly lower than the TRR group. In acetone test, the level of cold allodynia in the TRR group was significantly higher than the sham group. The level of cold allodynia in the TRR-SEW group was significantly lower than the TRR group. Conclusions: These results suggest that swimming exercise training decreases persistent postthoracotomy pain caused by TRR surgery. It may provide one of the new therapeutic effects of swimming exercise training could alleviate persistent postthoracotomy pain.

Keywords: chronic pain, thoracotomy pain, swimming, von Frey test, acetone test

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Authors: M. A. Sohaly, M. A. Elfouly

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Parkinson's disease (PD) is a heterogeneous movement disorder that often appears in the elderly. PD is induced by a loss of dopamine secretion. Some drugs increase the secretion of dopamine. In this paper, we will simply study the stability of PD models as a nonlinear delay differential equation. After a period of taking drugs, these act as positive feedback and increase the tremors of patients, and then, the differential equation has positive coefficients and the system is unstable under these conditions. We will present a set of suggested modifications to make the system more compatible with the biodynamic system. When giving a set of numerical examples, this research paper is concerned with the mathematical analysis, and no clinical data have been used.

Keywords: Parkinson's disease, stability, simulation, two delay differential equation

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Authors: Islam Nowisser, Noha Farag, Mohamed El Azizi

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Helicobacter pylori is a highly important human pathogen which inhabits about 50% of the population worldwide. Infection with this bacteria is very hard to treat, with high probability of recurrence. H. pylori causes severe gastric diseases, including peptic ulcer, gastritis, and gastric cancer, which has been linked to chronic inflammation. The infection has been reported to be associated with high levels of pro-inflammatory cytokines, especially IL-1β and TNF-α. The aim of the current study is to investigate the molecular mechanisms by which H. pylori activates NLRP3 inflammasome and its contribution to Il-1 β production in an innate cellular model. H. pylori PMSS1 and G27 standard strains, as well as the PMSS1 isogenic mutant strain PMSS1ΔVacA and G27ΔVacA, G27ΔCagA in addition to clinical isolates obtained from biopsy samples from the antrum and corpus mucosa of chronic gastritis patients, were used to establish infection in RAW-264.7 macrophages. The production levels of TNF-α and IL-1β was assessed using ELISA. Since expression of these cytokines is often regulated by the transcription factor complex, nuclear factor-kB (NF-kB), the activation of NF-κB in H. pylori infected cells was also evaluated by luciferase assay. Genomic DNA was extracted from bacterial cultures of H. pylori clinical isolates as well as the standard strains and their corresponding mutants, where they were evaluated for the cagA pathogenicity island and vacA expression. The correlation between these findings and expression of the cagA Pathogenicity Island and vacA in the bacteria was also investigated. The results showed IL-1β, and TNF-α production significantly increased in raw macrophages following H. pylori infection. The cagA+ and vacA+ H. pylori strains induced significant production of IL-1β compared to cagA- and vacA- strains. The activation pattern of NF-κB was correlated in the isolates to their cagA and vacA expression profiles. A similar finding could not be confirmed for TNF-α production. Our study shows the ability of H. pylori to activate NF-kB and induce significant IL-1β production as a possible mechanism for the augmented inflammatory response seen in subjects infected with cagA+ and vacA+ H. pylori strains that would lead to the progression to more severe form of the disease.

Keywords: Helicobacter pylori, IL-1β, inflammatory cytokines, nuclear factor KB, TNF-α

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Authors: Caroline Lavratti, Pedro Dal Lago, Gustavo Reinaldo, Gilson Dorneles, Andreia Bard, Laira Fuhr, Daniela Pochmann, Alessandra Peres, Luciane Wagner, Viviane Elsner

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Approximately 1% of the world's population is affected by schizophrenia (SZ), a chronic and debilitating neurodevelopmental disorder. Among possible factors, reduced levels of Brain-derived neurotrophic factor (BDNF) has been recognized in physiopathogenesis and course of SZ. In this context, peripheral BDNF levels have been used as a biomarker in several clinical studies, since this neurotrophin is able to cross the blood-brain barrier in a bi-directional manner and seems to present a strong correlation with the central nervous system fluid levels. The patients with SZ usually adopts a sedentary lifestyle, which has been partly associated with the increase in obesity incidence rates, metabolic syndrome, type 2 diabetes and coronary heart disease. On the other hand, exercise, a non-invasive and low cost intervention, has been considered an important additional therapeutic option for this population, promoting benefits to physical and mental health. To our knowledge, few studies have been pointed out that the positive effects of exercise in SZ patients are mediated, at least in part, to enhanced levels of BDNF after training. However, these studies are focused on evaluating the effect of single bouts of exercise of chronic interventions, data concerning the short- and long-term exercise outcomes on BDNF are scarce. Therefore, this study aimed to evaluate the effect of a concurrent exercise protocol (CEP) on plasma BDNF levels of SZ patients in different time-points. Material and Methods: This study was approved by the Research Ethics Committee of the Centro Universitário Metodista do IPA (no 1.243.680/2015). The participants (n=15) were subbmited to the CEP during 90 days, 3 times a week for 60 minutes each session. In order to evaluate the short and long-term effects of exercise, blood samples were collected pre, 30, 60 and 90 days after the intervention began. Plasma BDNF levels were determined with the ELISA method, from Sigma-Aldrich commercial kit (catalog number RAB0026) according to manufacturer's instructions. Results: A remarkable increase on plasma BDNF levels at 90 days after training compared to baseline (p=0.006) and 30 days (p=0.007) values were observed. Conclusion: Our data are in agreement with several studies that show significant enhancement on BDNF levels in response to different exercise protocols in SZ individuals. We might suggest that BDNF upregulation after training in SZ patients acts in a dose-dependent manner, being more pronounced in response to chronic exposure. Acknowledgments: This work was supported by Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS)/Brazil.

Keywords: exercise, BDNF, schizophrenia, time-points

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Authors: Martina Santobuono, Wing Sze Chan, Elettra D'Amico, Henriette Selck

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Chemicals in modern society are fundamental in many different aspects of daily human life. We use a wide range of substances, including polychlorinated compounds, pesticides, plasticizers, and pharmaceuticals, to name a few. These compounds are excessively produced, and this has led to their introduction to the environment and food resources. Municipal and industrial effluents, landfills, and agricultural runoffs are a few examples of sources of chemical pollution. Many of these compounds, such as pharmaceuticals, have been proven to mimic or alter the performance of the hormone system, thus disrupting its normal function and altering the behavior and reproductive capability of non-target organisms. Antidepressants are pharmaceuticals commonly detected in the environment, usually in the range of ng L⁻¹ and µg L⁻¹. Since they are designed to have a biological effect at low concentrations, they might pose a risk to the native species, especially if exposure lasts for long periods. Hydrophobic antidepressants, like the selective serotonin reuptake inhibitor (SSRI) Sertraline, can sorb to the particles in the water column and eventually accumulate in the sediment compartment. Thus, deposit-feeding organisms may be at particular risk of exposure. The polychaete Capitella teleta is widespread in estuarine organically enriched sediments, being a key deposit-feeder involved in geochemistry processes happening in sediments. Since antidepressants are neurotoxic chemicals and endocrine disruptors, the aim of this work was to test if sediment-associated Sertraline impacts burrowing- and feeding behavior as well as reproduction capability in Capitella teleta in a chronic exposure set-up, which could better mimic what happens in the environment. 7 days old juveniles were selected and exposed to different concentrations of Sertraline for an entire generation until the mature stage was reached. This work was able to show that some concentrations of Sertraline altered growth and the time of first reproduction in Capitella teleta juveniles, potentially disrupting the population’s capability of survival. Acknowledgments: This Ph.D. position is part of the CHRONIC project “Chronic exposure scenarios driving environmental risks of Chemicals”, which is an Innovative Training Network (ITN) funded by the European Union’s Horizon 2020 research and innovation program under the Marie Sklodowska-Curie Actions (MSCA).

Keywords: antidepressants, Capitella teleta, chronic exposure, endocrine disruption, sublethal endpoints, neurotoxicity

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Authors: Amin Mehrabi, Mohsen Salesi, Pourya Pasavand

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Context and objective: The purpose of this research is to study the effect of exercise time (morning/evening) on amount of Troponin T in males' plasma suffering from cardiovascular disease. Method: 15 cardiovascular patients selected as the research subjects. At 7 a.m. pretest blood samples taken from the subjects and they did the exercise protocol in presence of a doctor. Immediately after and 3 hours after that blood measurements done. A week later, the subjects did the same steps at 7 p.m. The SPSS v.20 software used to analyze data. Findings: This study proved that circadian rhythm does not have any effect on the response of myocarditis tissue to exercise and cardiovascular patients allowed to exercise in any times of a day.

Keywords: cardiovascular disease, time of exercise, troponin T (cTnT), myocarditis

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Authors: Fernando L. P. Santos, Luiz G. Lyra, Helenice O. Florentino, Daniela R. Cantane

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Dengue is a febrile infectious disease caused by a virus of the family Flaviridae. It is transmitted by the bite of mosquitoes, usually of the genus Aedes aegypti. It occurs in tropical and subtropical areas of the world. This disease has been a major public health problem worldwide, especially in tropical countries such as Brazil, and its incidence has increased in recent years. Dengue is a subject of intense research. Efficient forms of mosquito control must be considered. In this work, the mono-objective optimal control problem was solved for analysing the dengue disease problem. Chemical and biological controls were considered in the mathematical aspect. This model describes the dynamics of mosquitoes in water and winged phases. We applied the genetic algorithms (GA) to obtain optimal strategies for the control of dengue. Numerical simulations have been performed to verify the versatility and the applicability of this algorithm. On the basis of the present results we may recommend the GA to solve optimal control problem with a large region of feasibility.

Keywords: genetic algorithm, dengue, Aedes aegypti, biological control, chemical control

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Authors: Sultan Mahmud, Qamar Zaman, Travis Esau, Young Chang

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Strawberry powdery mildew (PM) is a serious disease that has a significant impact on strawberry production. Field scouting is still a major way to find PM disease, which is not only labor intensive but also almost impossible to monitor disease severity. To reduce the loss caused by PM disease and achieve faster automatic detection of the disease, this paper proposes an approach for detection of the disease, based on image texture and classified with support vector machines (SVMs) and k-nearest neighbors (kNNs). The methodology of the proposed study is based on image processing which is composed of five main steps including image acquisition, pre-processing, segmentation, features extraction and classification. Two strawberry fields were used in this study. Images of healthy leaves and leaves infected with PM (Sphaerotheca macularis) disease under artificial cloud lighting condition. Colour thresholding was utilized to segment all images before textural analysis. Colour co-occurrence matrix (CCM) was introduced for extraction of textural features. Forty textural features, related to a physiological parameter of leaves were extracted from CCM of National television system committee (NTSC) luminance, hue, saturation and intensity (HSI) images. The normalized feature data were utilized for training and validation, respectively, using developed classifiers. The classifiers have experimented with internal, external and cross-validations. The best classifier was selected based on their performance and accuracy. Experimental results suggested that SVMs classifier showed 98.33%, 85.33%, 87.33%, 93.33% and 95.0% of accuracy on internal, external-I, external-II, 4-fold cross and 5-fold cross-validation, respectively. Whereas, kNNs results represented 90.0%, 72.00%, 74.66%, 89.33% and 90.3% of classification accuracy, respectively. The outcome of this study demonstrated that SVMs classified PM disease with a highest overall accuracy of 91.86% and 1.1211 seconds of processing time. Therefore, overall results concluded that the proposed study can significantly support an accurate and automatic identification and recognition of strawberry PM disease with SVMs classifier.

Keywords: powdery mildew, image processing, textural analysis, color co-occurrence matrix, support vector machines, k-nearest neighbors

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Authors: Cemile Kütmeç Yilmaz, Güler Duru Asiret, Gulcan Bagcivan

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The aim of this study was to evaluate the reliability and validity of the Turkish version of the Carer’s Assessment of Satisfaction Index (CASI-TR). The study was conducted between the dates of June 2016 and September 2017 at the Training and Research Hospital of Aksaray University with the caregiving family members of the inpatients with chronic diseases. For this study, the sample size was calculated as at least 10 individuals for each item (item number (30)X10=300). The study sample included 300 caregiving family members, who provided primer care for at least three months for a patient (who had at least one chronic disease and received inpatient treatment in general internal medicine and palliative care units). Data were collected by using a demographic questionnaire and CASI-TR. Descriptive statistics, and psychometric tests were used for the data analysis. Of those caregivers, 76.7% were female, 86.3% were 65 years old and below, 43.7% were primary school graduates, 87% were married, 86% were not working, 66.3% were housewives, and 60.3% defined their income status as having an income covering one’s expenses. Care recipients often had problems in terms of walking, sleep, balance, feeding and urinary incontinence. The Cronbach Alpha value calculated for the CASI-TR (30 items) was 0,949. Internal consistency coefficients calculated for subscales were: 0.922 for the subscale of ‘caregiver satisfaction related to care recipient’, 0.875 for the subscale of ‘caregiver satisfaction related to themselves’, and 0.723 for the subscale of ‘dynamics of interpersonal relations’. Factor analysis revealed that three factors accounted for 57.67% of the total variance, with an eigenvalue of >1. assessed in terms of significance, we saw that the items came together in a significant manner. The factor load of the items were between 0.311 and 0.874. These results show that the CASI-TR is a valid and reliable scale. The adoption of the translated CASI in Turkey is found reliable and valid to assessing the satisfaction of caregivers. CASI-TR can be used easily in clinics or house visits by nurses and other health professionals for assessing caregiver satisfaction from caregiving.

Keywords: carer’s assessment of satisfaction index, caregiver, validity, reliability

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Authors: Ana Corberan-Vallet, Karen C. Florez, Ingrid C. Marino, Jose D. Bermudez

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In 2016, the Region of the Americas was declared free of measles, a viral disease that can cause severe health problems. However, since 2017, measles has reemerged in Venezuela and has subsequently reached neighboring countries. In 2018, twelve American countries reported confirmed cases of measles. Governmental and health authorities in Colombia, a country that shares the longest land boundary with Venezuela, are aware of the need for a strong response to restrict the expanse of the epidemic. In this work, we apply a Bayesian hierarchical Poisson model with an underlying cluster structure to describe disease incidence in Colombia. Concretely, the proposed methodology provides relative risk estimates at the department level and identifies clusters of disease, which facilitates the implementation of targeted public health interventions. Socio-demographic factors, such as the percentage of migrants, gross domestic product, and entry routes, are included in the model to better describe the incidence of disease. Since the model does not impose any spatial correlation at any level of the model hierarchy, it avoids the spatial confounding problem and provides a suitable framework to estimate the fixed-effect coefficients associated with spatially-structured covariates.

Keywords: Bayesian analysis, cluster identification, disease mapping, risk estimation

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Authors: Arielle Ferdinand

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A plant-based diet focuses on foods from plant sources, limiting or altogether omitting animal products. Some of the most common chronic illnesses seen in primary care are hypertension, hyperlipidemia, and diabetes type II. These common chronic illnesses can often be debilitating, costly, time-consuming, and, when left untreated, can lead to an early death. Treatment and maintenance of care are also labor intensive for the patient. They are often required to have at least four blood pressure checks yearly and a hemoglobin A1C checked quarterly. Though preventative interventions and prevention education should be included in patient visits in the primary care setting, education about dietary interventions, such as a plant-based diet, also yields positive outcomes for patients who already have hypertension, hyperlipidemia, and diabetes mellitus type 2. Evidence will show that incorporating a plant-based diet results in decreased blood pressure, as well as decreased levels of LDL-C, improved post-prandial glucose levels, and a reduction in HbA1C. It is cost-effective for the patient by generally lower grocery costs, and it can either reduce or prevent the need to pay for more office visits and pharmacotherapy. Incorporating this method of dietary changes is an easy intervention during a primary care office visit that would greatly benefit the patient in many ways.

Keywords: plant-based, nutrition, diabetes, hyperlipidemia

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Authors: Septiawan A. Saputro, Purnami Widyaningsih, Sutanto Sastraredja

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Measles is a disease which can spread caused by a virus and has been a priority’s Ministry of Health in Indonesia to be solved. Each infected person can be recovered and get immunity so that the spread of the disease can be constructed with susceptible infected recovered (SIR). To prevent the spread of measles transmission, the Ministry of Health holds vaccinations program. The aims of the research are to derive susceptible vaccinated infected recovered (SVIR) model, to determine the patterns of disease spread with SVIR model, and also to apply the SVIR model on the spread of measles in Indonesia. Based on the article, it can be concluded that the spread model of measles with vaccinations, that is SVIR model. It is a first-order differential equation system. The patterns of disease spread is determined by solution of the model. Based on that model Indonesia will be a measles-free nation in 2186 with the average of vaccinations scope about 88% and the average score of vaccinations failure about 4.9%. If it is simulated as Ministry of Health new programs with the average of vaccinations scope about 95% and the average score of vaccinations failure about 3%, then Indonesia will be a measles-free nation in 2184. Even with the average of vaccinations scope about 100% and no failure of vaccinations, Indonesia will be a measles-free nation in 2183. Indonesia’s target as a measles-free nation in 2020 has not been reached.

Keywords: measles, vaccination, susceptible infected recovered (SIR), susceptible vaccinated infected recovered (SVIR)

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Authors: Eyup Ozkan, Ozkan U. Nalbantoglu, Aycan Gundogdu, Mehmet Hora, A. Emre Onuk

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The human microbiome has been associated with cardiological conditions and this relationship is becoming to be defined beyond the gastrointestinal track. In this study, we investigate the alteration in circulatory microbiota in the context of Coronary Artery Disease (CAD). We received circulatory blood samples from suspected CAD patients and maintain 16S ribosomal RNA sequencing to identify each patient’s microbiome. It was found that Corynebacterium and Methanobacteria genera show statistically significant differences between healthy and CAD patients. The overall biodiversities between the groups were observed to be different revealed by machine learning classification models. We also achieve and demonstrate the performance of a diagnostic method using circulatory blood microbiome-based estimation.

Keywords: coronary artery disease, blood microbiome, machine learning, angiography, next-generation sequencing

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Authors: Bui Phuong Linh, Yuki Sakakibara, Ryuto Tanaka, Elizabeth H. Pigney, Taishi Hashiguchi

Abstract:

Non-alcoholic steatohepatitis (NASH) is a chronic liver disease, often associated with type II diabetes, which sometimes progresses to more serious conditions such as liver fibrosis and hepatocellular carcinoma (HCC). NASH has become an important health problem worldwide, buttherapeutic agents for NASH have not yet been approved, and animal models with high clinical correlation are required. TheSTAM™ mouse shows the same pathological progression as human NASH patients and has been widely used for both drug efficacy and basic research, such as lipid profiling and gut microbiota research. In this study, we analyzed the RNA-seq data of STAM™mice at each pathological stage (steatosis, steatohepatitis, liver fibrosis, and HCC) and examined the clinical correlation at the genetic level. NASH was induced in male mice by a single subcutaneous injection of 200 µg streptozotocin solution 2 days after birth and feeding with high fat dietafter 4 weeks of age. The mice were sacrificed and livers collected at 6, 8, 10, 12, 16, and 20 weeks of age. For liver samples, the left lateral lobe was snap frozen in liquid nitrogen and stored at -80˚C for RNA-seq analysis. Total RNA of the cells was isolated using RNeasy mini kit. The gene expression of the canonical pathways in NASH progression from steatosis to hepatocellular carcinoma were analyzed, such as immune system process, oxidation-reduction process, lipid metabolic process. Moreover, since it has been reported that genetic traits are involved in the development of NASH-HCC, we next analyzed the genetic mutations in the STAM™mice. The number of individuals showing mutations in Mtorinvolved in Insulin signaling increases as the disease progresses, especially in the liver cancer phase. These results indicated a clinical correlation of gene profiles in the STAM™mouse.

Keywords: steatosis, non-alcoholic steatohepatitis, fibrosis, hepatocellular carcinoma, RNA-seq

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Authors: H. C. Chinwenyi, H. D. Ibrahim, J. O. Adekunle

Abstract:

The incubation period is defined as the time from infection with a microorganism to development of symptoms. In this research, two disease models: one with incubation period and another without incubation period were studied. The study involves the use of a  mathematical model with a single incubation period. The test for the existence and stability of the disease free and the endemic equilibrium states for both models were carried out. The fourth order Runge-Kutta method was used to solve both models numerically. Finally, a computer program in MATLAB was developed to run the numerical experiments. From the results, we are able to show that the endemic equilibrium state of the model with incubation period is locally asymptotically stable whereas the endemic equilibrium state of the model without incubation period is unstable under certain conditions on the given model parameters. It was also established that the disease free equilibrium states of the model with and without incubation period are locally asymptotically stable. Furthermore, results from numerical experiments using empirical data obtained from Nigeria Centre for Disease Control (NCDC) showed that the overall population of the infected people for the model with incubation period is higher than that without incubation period. We also established from the results obtained that as the transmission rate from susceptible to infected population increases, the peak values of the infected population for the model with incubation period decrease and are always less than those for the model without incubation period.

Keywords: asymptotic stability, Hartman-Grobman stability criterion, incubation period, Routh-Hurwitz criterion, Runge-Kutta method

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Authors: Gholam Reza Mirzaei

Abstract:

This research aimed to investigate the effectiveness of acceptance and commitment therapy (ACT) in reducing corona disease anxiety in the staff working at Shahid Beheshti Hospital of Shiraz. The current research was a quasi-experimental study having pre-test and post-test with two experimental and control groups. The statistical population of the research included all the staff of Shahid Beheshti Hospital of Shiraz in 2021. From among the statistical population, 30 participants (N =15 in the experimental group and N =15 in the control group) were selected by available sampling. The materials used in the study comprised the Cognitive Emotion Regulation Questionnaire (CERQ) and Corona Disease Anxiety Scale (CDAS). Following data collection, the participants’ scores were analyzed using SPSS 20 at both descriptive (mean and standard deviation) and inferential (analysis of covariance) levels. The results of the analysis of covariance (ANCOVA) showed that acceptance and commitment therapy (ACT) is effective in reducing Corona disease anxiety (mental and physical symptoms) in the staff working at Shahid Beheshti Hospital of Shiraz. The effectiveness of acceptance and commitment therapy (ACT) on reducing mental symptoms was 25.5% and on physical symptoms was 13.8%. The mean scores of the experimental group in the sub-scales of Corona disease anxiety (mental and physical symptoms) in the post-test were lower than the mean scores of the control group.

Keywords: acceptance and commitment therapy, corona disease anxiety, hospital staff, Shiraz

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Authors: Rohit Sane, Snehal Dongre, Pravin Ghadigaonkar, Rahul Mandole

Abstract:

The present study was designed to evaluate efficacy of heart failure reversal therapy (HFRT) that uses herbal procedure (panchakarma) and allied therapies, in chronic heart failure (CHF) patients with low ejection fraction. Methods: This efficacy study was conducted in CHF patients (aged: 25-65 years, ejection fraction (EF) < 30%) wherein HFRT (60-75 minutes) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara(concoction dripping treatment) and basti(enema) was administered twice daily for 7 days. During this therapy and next 30 days, patients followed the study dinarcharya and were prescribed ARJ kadha in addition to their conventional treatment. The primary endpoint of this study was evaluation of maximum aerobic capacity uptake (MAC) as assessed by 6-minute walk distance (6MWD) using Cahalins equation from baseline, at end of 7 day treatment, follow-up after 30 days and 90 days. EF was assessed by 2D Echo at baseline and after 30 days of follow-up. Results: CHF patients with < 30% EF (N=52, mean [SD] age: 58.8 [10.8], 85% men) were enrolled in the study. There was a 100% compliance to study therapy. A significant improvement was observed in MAC levels (7.11%, p =0.029), at end of 7 day therapy as compared to baseline. This improvement was maintained at two follow-up visits. Moreover, ejection fraction was observed to be increased by 6.38%, p=0,012 as compared to baseline at day 7 of the therapy. Conclusions: This 90 day follow up study highlights benefit of HFRT, as a part of maintenance treatment for CHF patients with reduced ejection fraction.

Keywords: chronic heart failure, functional capacity, heart failure reversal therapy, oxygen uptake, panchakarma

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Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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Authors: Yishu Gong, Liangliang Yang, Jianyu Zhang, Zhengyu Chen, Sihong He, Xusheng Zhang, Wei Zhang

Abstract:

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that affects millions of people worldwide and is characterized by cognitive decline and behavioral changes. People living with Alzheimer’s disease often find it hard to complete routine tasks. However, there are limited objective assessments that aim to quantify the difficulty of certain tasks for AD patients compared to non-AD people. In this study, we propose to use speech emotion recognition (SER), especially the frustration level, as a potential biomarker for quantifying the difficulty patients experience when describing a picture. We build an SER model using data from the IEMOCAP dataset and apply the model to the DementiaBank data to detect the AD/non-AD group difference and perform longitudinal analysis to track the AD disease progression. Our results show that the frustration level detected from the SER model can possibly be used as a cost-effective tool for objective tracking of AD progression in addition to the Mini-Mental State Examination (MMSE) score.

Keywords: Alzheimer’s disease, speech emotion recognition, longitudinal biomarker, machine learning

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Authors: Jiangang Shen

Abstract:

Olfactory dysfunction is a common symptom companied by anxiety- and depressive-like behaviors in depressive patients. Chronic stress triggers hormone responses and inhibits the proliferation and differentiation of neural stem cells (NSCs) in the hippocampus and subventricular zone (SVZ)-olfactory bulb (OB), contributing to depressive behaviors and olfactory dysfunction. However, the cellular signaling molecules to regulate chronic stress mediated olfactory dysfunction are largely unclear. Adaptor proteins containing the pleckstrin homology domain, phosphotyrosine binding domain, and leucine zipper motif (APPLs) are multifunctional adaptor proteins. Herein, we tested the hypothesis that APPL2 could inhibit hippocampal neurogenesis by affecting glucocorticoid receptor (GR) signaling, subsequently contributing to depressive and anxiety behaviors as well as olfactory dysfunctions. The major discoveries are included: (1) APPL2 Tg mice had enhanced GR phosphorylation under basic conditions but had no different plasma corticosterone (CORT) level and GR phosphorylation under stress stimulation. (2) APPL2 Tg mice had impaired hippocampal neurogenesis and revealed depressive and anxiety behaviors. (3) GR antagonist RU486 reversed the impaired hippocampal neurogenesis in the APPL2 Tg mice. (4) APPL2 Tg mice displayed higher GR activity and less capacity for neurogenesis at the olfactory system with lesser olfactory sensitivity than WT mice. (5) APPL2 negatively regulates olfactory functions by switching fate commitments of NSCs in adult olfactory bulbs via interaction with Notch1 signaling. Furthermore, baicalin, a natural medicinal compound, was found to be a promising agent targeting APPL2/GR signaling and promoting adult neurogenesis in APPL2 Tg mice and chronic corticosterone-induced depression mouse models. Behavioral tests revealed that baicalin had antidepressant and olfactory-improving effects. Taken together, APPL2 is a critical therapeutic target for antidepressant treatment.

Keywords: APPL2, hippocampal neurogenesis, depressive behaviors and olfactory dysfunction, stress

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