Search results for: amblyopia diagnostic criterion

Authors: Jessica Neri, Elena Faccio

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In Europe, except for Denmark and Malta, the legal gender change and the stages of the possible process of gender transition are bound to the diagnosis of a gender identity disorder. The requirement of the evaluation of a mental disorder might have many implications on trans people’s self-representations, interpersonal relations in different social contexts and the therapeutic relations with clinicians during the transition. Psychopathological language may contribute to define the individual’s reality from normative presuppositions with value implications related to the dominant cultural principles. In an effort to mark the boundaries between sanity and pathology, it concurs to the definition of the management procedures of the constructed diversities and deviances, legitimizing the operational practices of particular professional figures. The aim of this research concerns the analysis of the diagnostic category of gender dysphoria contained in the last edition of the Diagnostic and Statistical Manual of Mental Disorders. In particular, this study focuses on the relationship between the implicit and explicit assumptions related to the expressions of gender non-conformity, that sustain the language and the criteria characterizing the Manual, and the possible implications on people’s narratives of transition. In order to achieve this objective two main research methods were used: historical reconstruction of the diagnostic category in the different versions of the Manual and content analysis of that category in the present version. From the historical analysis, in the medical and psychiatric field gender non-conformity has been predominantly explicated by naturalistic perspectives, naming it ‘transsexualism’ and collocating it in the category of gender identity disorder. Currently, pathological judged experiences are represented by gender dysphoria, described in the DSM-5 as the distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender, specifying that there must be ‘evidence’ of this. Implicit theories about gender binary, parallelism between gender identity, sex and sexuality and the understanding of the mental health and the subject’s agency as subordinated to the expert knowledge, can be found in the process of designation of the category. A lack of awareness of the historical, social and political aspects connected to the cultural and normative dimensions at the basis of these implicit theories, can be noticed and data given by culture and data given by supposed -biological or psychological- nature, are often confused. This reductionist interpretation of gender and its presumed diversities legitimize the clinician to assume the role of searching and orienting, in a correctional perspective, the biographical elements that correspond to him specific expectations, with no space for other possibilities and identity configurations for people in transition. This research may contribute to the current critical debate about the epistemological foundation of the psychodiagnosis, emphasizing the pragmatic effects on the individuals and on the psychological practice in its wider social context. This work also permits to underline the risks due to the lack of awareness of the processes of social construction of the diagnostic system and its essential role of defence of the values that hold up the symbolic universe of reference.

Keywords: diagnosis, gender dysphoria, narratives, social constructionism

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Authors: Cherifi Katia, Al-Hawat Marie-Lynn, Tricou Leo-Paul, Lamontagne Stephanie, Tran Minh, Ngu Amy Ching Yie, Manrique Gabriela, Guirguis Natalie, Machuca Parra Arturo Israel, Matoori Simon

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Diabetic foot ulcers (DFUs) are a serious and prevalent complication of diabetes. Current diagnostic options are limited to macroscopic wound analysis such as wound size, depth, and infection. Molecular diagnostics promise to improve DFU diagnosis, staging, and assessment of treatment response. Here, we developed a rapid and easy-to-use fluorescent pH-sensing bandage for wound diagnostics. In a fluorescent dye screen, we identified pyranine as the lead compound due to its suitable pH-sensing properties in the clinically relevant pH range of 6 to 9. To minimize the release of this dye into the wound bed, we screened a library of ionic microparticles and found a strong adhesion of the anionic dye to a cationic polymeric microparticle. These dye-loaded microparticles showed a strong fluorescence response in the clinically relevant pH range of 6 to 9 and a dye release below 1% after one day in biological media. The dye-loaded microparticles were subsequently encapsulated in a calcium alginate hydrogel to minimize the interaction of the microparticles with the wound tissue. This pH-sensing diagnostic wound dressing was tested on full-thickness dorsal wounds of mice, and a linear fluorescence response (R2 = 0.9909) to clinically relevant pH values was observed. These findings encourage further development of this pH-sensing system for molecular diagnostics in DFUs.

Keywords: wound ph, fluorescence, diagnostics, diabetic foot ulcer, wound healing, chronic wounds, diabetes

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Authors: A. F. Huseynov, N. T. Mardanov, J. Y. Nakhchivanski

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This practical research is aimed to improve the management quality and efficiency of public administration agencies providing e-services. The monitoring system developed will provide continuous review of the websites compliance with the selected indicators, their evaluation based on the selected indicators and ranking of services according to the quality criteria. The responsible departments in the government agencies were surveyed; the questionnaire includes issues of management and feedback, e-services provided, and the application of information systems. By analyzing the main affecting factors and barriers, the recommendations will be given that lead to the relevant decisions to strengthen the state agencies competencies for the management and the provision of their services. Component 1. E-services monitoring system. Three separate monitoring activities are proposed to be executed in parallel: Continuous tracing of e-government sites using built-in web-monitoring program; this program generates several quantitative values which are basically related to the technical characteristics and the performance of websites. The expert assessment of e-government sites in accordance with the two general criteria. Criterion 1. Technical quality of the site. Criterion 2. Usability/accessibility (load, see, use). Each high-level criterion is in turn subdivided into several sub-criteria, such as: the fonts and the color of the background (Is it readable?), W3C coding standards, availability of the Robots.txt and the site map, the search engine, the feedback/contact and the security mechanisms. The on-line survey of the users/citizens – a small group of questions embedded in the e-service websites. The questionnaires comprise of the information concerning navigation, users’ experience with the website (whether it was positive or negative), etc. Automated monitoring of web-sites by its own could not capture the whole evaluation process, and should therefore be seen as a complement to expert’s manual web evaluations. All of the separate results were integrated to provide the complete evaluation picture. Component 2. Assessment of the agencies/departments efficiency in providing e-government services. - the relevant indicators to evaluate the efficiency and the effectiveness of e-services were identified; - the survey was conducted in all the governmental organizations (ministries, committees and agencies) that provide electronic services for the citizens or the businesses; - the quantitative and qualitative measures are covering the following sections of activities: e-governance, e-services, the feedback from the users, the information systems at the agencies’ disposal. Main results: 1. The software program and the set of indicators for internet sites evaluation has been developed and the results of pilot monitoring have been presented. 2. The evaluation of the (internal) efficiency of the e-government agencies based on the survey results with the practical recommendations related to the human potential, the information systems used and e-services provided.

Keywords: e-government, web-sites monitoring, survey, internal efficiency

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Authors: Katarzyna Lubecka, Kirsty Flower, Megan Beetch, Lucinda Kurzava, Hannah Buvala, Samer Gawrieh, Suthat Liangpunsakul, Tracy Gonzalez, George McCabe, Naga Chalasani, James M. Flanagan, Barbara Stefanska

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Hepatocellular carcinoma (HCC), the most prevalent type of primary liver cancer, is the second leading cause of cancer death worldwide. Late onset of clinical symptoms in HCC results in late diagnosis and poor disease outcome. Approximately 85% of individuals with HCC have underlying liver cirrhosis. However, not all cirrhotic patients develop cancer. Reliable early detection biomarkers that can distinguish cirrhotic patients who will develop cancer from those who will not are urgently needed and could increase the cure rate from 5% to 80%. We used Illumina-450K microarray to test whether blood DNA, an easily accessible source of DNA, bear site-specific changes in DNA methylation in response to HCC before diagnosis with conventional tools (pre-diagnostic). Top 11 differentially methylated sites were selected for validation by pyrosequencing. The diagnostic potential of the 11 pyrosequenced probes was tested in blood samples from a prospective cohort of cirrhotic patients. We identified 971 differentially methylated CpG sites in pre-diagnostic HCC cases as compared with healthy controls (P < 0.05, paired Wilcoxon test, ICC ≥ 0.5). Nearly 76% of differentially methylated CpG sites showed lower levels of methylation in cases vs. controls (P = 2.973E-11, Wilcoxon test). Classification of the CpG sites according to their location relative to CpG islands and transcription start site revealed that those hypomethylated loci are located in regulatory regions important for gene transcription such as CpG island shores, promoters, and 5’UTR at higher frequency than hypermethylated sites. Among 735 CpG sites hypomethylated in cases vs. controls, 482 sites were assigned to gene coding regions whereas 236 hypermethylated sites corresponded to 160 genes. Bioinformatics analysis using GO, KEGG and DAVID knowledgebase indicate that differentially methylated CpG sites are located in genes associated with functions that are essential for gene transcription, cell adhesion, cell migration, and regulation of signal transduction pathways. Taking into account the magnitude of the difference, statistical significance, location, and consistency across the majority of matched pairs case-control, we selected 11 CpG loci corresponding to 10 genes for further validation by pyrosequencing. We established that methylation of CpG sites within 5 out of those 10 genes distinguish cirrhotic patients who subsequently developed HCC from those who stayed cancer free (cirrhotic controls), demonstrating potential as biomarkers of early detection in populations at risk. The best predictive value was detected for CpGs located within BARD1 (AUC=0.70, asymptotic significance ˂0.01). Using an additive logistic regression model, we further showed that 9 CpG loci within those 5 genes, that were covered in pyrosequenced probes, constitute a panel with high diagnostic accuracy (AUC=0.887; 95% CI:0.80-0.98). The panel was able to distinguish pre-diagnostic cases from cirrhotic controls free of cancer with 88% sensitivity at 70% specificity. Using blood as a minimally invasive material and pyrosequencing as a straightforward quantitative method, the established biomarker panel has high potential to be developed into a routine clinical test after validation in larger cohorts. This study was supported by Showalter Trust, American Cancer Society (IRG#14-190-56), and Purdue Center for Cancer Research (P30 CA023168) granted to BS.

Keywords: biomarker, DNA methylation, early detection, hepatocellular carcinoma

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Authors: Rupali Bhatia, Deepthi Nair, Geetika Khanna, Seema Singhal

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Introduction: Genital tract tuberculosis is a chronic disease (caused by reactivation of organisms from systemic distribution of Mycobacterium tuberculosis) that often presents with low grade symptoms and non-specific complaints. Patients with genital tuberculosis are usually young women seeking workup and treatment for infertility. Infertility is the commonest presentation due to involvement of the fallopian tubes, endometrium and ovarian damage with poor ovarian volume and reserve. The diagnosis of genital tuberculosis is difficult because of the fact that it is a silent invader of genital tract. Since tissue cannot be obtained from fallopian tubes, the diagnosis is made by isolation of bacilli from endometrial tissue obtained by endometrial biopsy curettage and/or aspiration. Problems are associated with sampling technique as well as diagnostic modality due to lack of adequate sample volumes and the segregation of the sample for various diagnostic tests resulting in non-uniform distribution of microorganisms. Moreover, lack of an efficient sampling technique universally applicable for all specific diagnostic tests contributes to the diagnostic challenges. Endometrial sampling plays a key role in accurate diagnosis of female genital tuberculosis. It may be done by 2 methods viz. endometrial curettage and endometrial aspiration. Both endometrial curettage and aspirate have their own limitations as curettage picks up strip of the endometrium from one of the walls of the uterine cavity including tubal osteal areas whereas aspirate obtains total tissue with exfoliated cells present in the secretory fluid of the endometrial cavity. Further, sparse and uneven distribution of the bacilli remains a major factor contributing to the limitations of the techniques. The sample that is obtained by either technique is subjected to histopathological examination, AFB staining, culture and PCR. Aim: Comparison of the sampling techniques viz. endometrial biopsy curettage and endometrial aspiration using different laboratory methods of histopathology, cytology, microbiology and molecular biology. Method: In a hospital based observational study, 75 Indian females suspected of genital tuberculosis were selected on the basis of inclusion criteria. The women underwent endometrial tissue sampling using Novaks biopsy curette and Karmans cannula. One part of the specimen obtained was sent in formalin solution for histopathological testing and another part was sent in normal saline for acid fast bacilli smear, culture and polymerase chain reaction. The results so obtained were correlated using coefficient of correlation and chi square test. Result: Concordance of results showed moderate agreement between both the sampling techniques. Among HPE, AFB and PCR, maximum sensitivity was observed for PCR, though the specificity was not as high as other techniques. Conclusion: Statistically no significant difference was observed between the results obtained by the two sampling techniques. Therefore, one may use either EA or EB to obtain endometrial samples and avoid multiple sampling as both the techniques are equally efficient in diagnosing genital tuberculosis by HPE, AFB, culture or PCR.

Keywords: acid fast bacilli (AFB), histopatholgy examination (HPE), polymerase chain reaction (PCR), endometrial biopsy curettage

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Authors: Chen Zhang, Nan Chen

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High-dimensional process monitoring becomes increasingly important in many application domains, where usually the process distribution is unknown and much more complicated than the normal distribution, and the between-stream correlation can not be neglected. However, since the process dimension is generally much bigger than the reference sample size, most traditional nonparametric multivariate control charts fail in high-dimensional cases due to the curse of dimensionality. Furthermore, when the process goes out of control, the influenced variables are quite sparse compared with the whole dimension, which increases the detection difficulty. Targeting at these issues, this paper proposes a new nonparametric monitoring scheme for high-dimensional processes. This scheme first projects the high-dimensional process into several subprocesses using random projections for dimension reduction. Then, for every subprocess with the dimension much smaller than the reference sample size, a local nonparametric control chart is constructed based on the spatial rank test to detect changes in this subprocess. Finally, the results of all the local charts are fused together for decision. Furthermore, after an out-of-control (OC) alarm is triggered, a diagnostic framework is proposed. using the square-root LASSO. Numerical studies demonstrate that the chart has satisfactory detection power for sparse OC changes and robust performance for non-normally distributed data, The diagnostic framework is also effective to identify truly changed variables. Finally, a real-data example is presented to demonstrate the application of the proposed method.

Keywords: random projection, high-dimensional process control, spatial rank, sequential change detection

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Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

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The translation of healthcare technologies is an expensive, complex affair, current healthcare challenges in Asian countries and their efforts to meet Millennium Development Goals (MDGs), necessitates continuous technology advancement to save countless lives, improve the quality of life and for socio-economic development. India’s consistently improving global innovation index (57) demonstrates its innovation potential, but access to health care is asymmetric and lacks priority in India. Therefore, there is utmost need of a robust translation system for point-of-care (POC) solutions, inexpensive, low-maintenance, reliable, and easy-to-use diagnostic technologies. Few cases of POC technologies viz. Elisa based diagnostic kits for regional viral disease, a device for detection of cancerous lesions were studied to understand the process and challenges involved in their translation. Accordingly, the entire translation ecosystem was summarized proposing a nexus of various actors such as technology developer, technology transferor technology receiver, funding entities, government/regulatory bodies and their effect on translation of different medical technologies. This study highlights the role and concerns pertaining to these actors for POC such as unsystematic and unvalidated research roadmap, low profit preposition, unfocused approach of up-scaling, low market acceptability and multiple window regulatory framework, etc. This provides an opportunity to devise solutions to overcome problem areas in translation path.

Keywords: healthcare technologies, point-of-care solutions, public health, translation

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Authors: Luiz Carlos Wrobel, Matjaz Hribersek, Jure Marn, Jurij Iljaz

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Dynamic thermography has been clinically proven to be a valuable diagnostic technique for skin tumor detection as well as for other medical applications such as breast cancer diagnostics, diagnostics of vascular diseases, fever screening, dermatological and other applications. Thermography for medical screening can be done in two different ways, observing the temperature response under steady-state conditions (passive or static thermography), and by inducing thermal stresses by cooling or heating the observed tissue and measuring the thermal response during the recovery phase (active or dynamic thermography). The numerical modelling of heat transfer phenomena in biological tissue during dynamic thermography can aid the technique by improving process parameters or by estimating unknown tissue parameters based on measured data. This paper presents a nonlinear numerical model of multilayer skin tissue containing a skin tumor, together with the thermoregulation response of the tissue during the cooling-rewarming processes of dynamic thermography. The model is based on the Pennes bioheat equation and solved numerically by using a subdomain boundary element method which treats the problem as axisymmetric. The paper includes computational tests and numerical results for Clark II and Clark IV tumors, comparing the models using constant and temperature-dependent thermophysical properties, which showed noticeable differences and highlighted the importance of using a local thermoregulation model.

Keywords: boundary element method, dynamic thermography, static thermography, skin tumor diagnostic

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Authors: Shima Mahmoudi, Babak Pourakbari, Setareh Mamishi, Mostafa Teymuri, Majid Marjani

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Although cytokine analysis has greatly contributed to the understanding of tuberculosis (TB) pathogenesis, data on cytokine profiles that might distinguish progression from latency of TB infection are scarce. Since PE/PPE proteins are known to induce strong humoral and cellular immune responses, the aim of this study was to evaluate the diagnostic potential of interleukin-2 (IL-2) as biomarker after specific antigen stimulation with PE35 and PPE68 for the discrimination of active and latent tuberculosis infection (LTBI). The production of IL-2 was measured in the antigen-stimulated whole-blood supernatants following stimulation with recombinant PE35 and PPE68. All the patients with active TB and LTBI had positive QuantiFERON-TB Gold in Tube test. The level of IL-2 following stimulation with recombinant PE35 and PPE68 were significantly higher in LTBI group than in patients with active TB infection or control group. The discrimination performance (assessed by the area under ROC curve) for IL-2 following stimulation with recombinant PE35 and PPE68 between LTBI and patients with active TB were 0.837 (95%CI: 0.72-0.97) and 0.75 (95%CI: 0.63-0.89), respectively. Applying the 12.4 pg/mL cut-off for IL-2 induced by PE35 in the present study population resulted in sensitivity of 78%, specificity of 78%, PPV of 78% and NPV of 100%. In addition, a sensitivity of 81%, specificity of 70%, PPV of 67% and 87% of NPV was reported based on the 4.4 pg/mL cut-off for IL-2 induced by PPE68. In conclusion, peptides of the antigen PE35 and PPE68, absent from commonly used BCG strains, stimulated strong IL-2- positive T cell responses in patients with LTBI. This study confirms IL-2 induced by PE35 and PPE68 as a sensitive and specific biomarker and highlights IL-2 as new promising adjunct markers for discriminating of LTBI and Active TB infection.

Keywords: IL-2, PE35, PPE68, tuberculosis

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Authors: Regina R. Gunawan, Indwiani Astuti, H. Raden Danarto

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Cancer is the leading cause of death worldwide. Cancer is caused by mutations that alter the function of normal human genes and give rise to cancer genes. MicroRNA (miRNA) is a small non-coding RNA that regulates the gen through complementary bond towards mRNA target and cause mRNA degradation. miRNA works by either promoting or suppressing cell proliferation. miRNA level expression in cancer may offer another value of miRNA as a biomarker in cancer diagnostic. miRNA-21 is believed to have a role in carcinogenesis by enhancing proliferation, anti-apoptosis, cell cycle progression and invasion of tumor cells. Hsa-miR-21-5p marker has been identified in Prostate Cancer (PCa) and Benign Prostatic Hyperplasia (BPH) patient’s urine. This research planned to explore the diagnostic performance of miR-21 to differentiate PCa and BPH patients. In this study, urine samples were collected from 20 PCa patients and 20 BPH patients. miR-21 relative expression against the reference gene was analyzed and compared between the two. miRNA expression was analyzed using the comparative quantification method to find the fold change. miR-21 validity in identifying PCa patients was performed by quantifying the sensitivity and specificity with the contingency table. miR-21 relative expression against miR-16 in PCa patient and in BPH patient has 12,98 differences in fold change. From a contingency table of Cq expression of miR-21 in identifying PCa patients from BPH patient, Cq miR-21 has 100% sensitivity and 75% specificity. miR-21 relative expression can be used in discriminating PCa from BPH by using a urine sample. Furthermore, the expression of miR-21 has higher sensitivity compared to PSA (Prostate specific antigen), therefore miR-21 has a high potential to be analyzed and developed more.

Keywords: benign prostate hyperplasia, biomarker, miRNA-21, prostate cancer

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Authors: Merilin Ivanova Ivanova, Kalin Dimitrov Atanasov, Stefan Petrov Enchev

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Backgroud: Neuromyelitis optica spectrum disorder, also known as Devic’s disease, is a relapsing demyelinating autoimmune inflammatory disorder of the central nervous system associated with anti-aquaporin 4 (AQP4) antibodies that can manifest with devastating secondary neurological deficits. Most commonly affected are the optic nerves and the spinal cord-clinically this is often presented with optic neuritis (loss of vision), transverse myelitis(weakness or paralysis of extremities),lack of bladder and bowel control, numbness. APS is a core clinical entity of NMOSD and adds to the clinical representation the following symptoms: intractable nausea, vomiting and hiccup, it usually occurs isolated at onset, and can lead to a significant delay in the diagnosis. The condition may have features similar to multiple sclerosis (MS) but the episodes are worse in NMO and it is treated differently. It could be relapsing or monophasic. Possible complications are visual field defects and motor impairment, with potential blindness and irreversible motor deficits. In severe cases, myogenic respiratory failure ensues. The incidence of reported cases is approximately 0.3–4.4 per 100,000. Paediatric cases of NMOSD are rare but have been reported occasionally, comprising less than 5% of the reported cases. Objective: The case serves to show the difficulty when it comes to the diagnostic processes regarding a rare autoimmune disease with non- specific symptoms, taking large interval of rimes to reveal as complete clinical manifestation of the aforementioned syndrome, as well as the necessity of multidisciplinary approach in the setting of а general paediatric department in аn emergency hospital. Methods: itpatient's history, clinical presentation, and information from the used diagnostic tools(MRI with contrast of the central nervous system) lead us to the conclusion .This was later on confirmed by the positive results from the anti-aquaporin 4 (AQP4) antibody serology test. Conclusion: APS is a common symptom of NMOSD and is considered a challenge in a differential-diagnostic plan. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing thorough physical examinations are essential if we are to reduce and avoid misdiagnosis.

Keywords: neuromyelitis, devic's disease, hiccup, autoimmune, MRI

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Authors: M. Gerasimou, S. Mantzoukis, P. Christodoulou, N. Varsamis, G. Kolliopoulou, N. Zotos

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Purpose: Microbial infection of the blood is a serious condition where bacteria invade the bloodstream and cause systemic disease. In such cases, blood cultures are performed. Blood cultures are a key diagnostic test for intensive care unit (ICU) patients. Material and method: The BacT/Alert system, which measures the production of carbon dioxide with metabolic organisms, is used. The positive result in the BacT/Alert system is followed by culture in the following selective media: Blood, Mac Conkey No 2, Chocolate, Mueller Hinton, Chapman and Sabaureaud agar. Gram staining method was used to differentiate bacterial species. The microorganisms were identified by biochemical techniques in the automated Microscan (Siemens) system and followed by a sensitivity test on the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by a Kirby Bauer-based test. Results: In 2017 the Laboratory of Microbiology received 3347 blood cultures. Of these, 170 came from the ICU. 116 found positive. Of these S. epidermidis was identified in 42, A. baumannii in 27, K. pneumoniae in 12 (4 of these KPC ‘Klebsiella pneumoniae carbapenemase’), S. hominis in 8, E. faecium in 7, E. faecalis in 5, P. aeruginosa in 3, C. albicans in 3, S. capitis in 2, K. oxytoca in 2, P. mirabilis in 2, E. coli in 1, S. intermidius in 1 and S. lugdunensis in 1. Conclusions: The study of epidemiological data and microbial resistance phenotypes is essential for the choice of therapeutic regimen for the early treatment and limitation of multivalent strains, while it is a crucial factor to solve diagnostic problems.

Keywords: blood culture, bloodstream, infection, intensive care unit

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Authors: A. Ozel

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The ductile to brittle transition temperature is a very important criterion that is used for selection of materials in some applications, especially in low-temperature conditions. For that reason, in this study transition temperature of as-cast and austempered unalloyed ductile iron in the temperature interval from -60 to +100 degrees C have been investigated. The microstructures of samples were examined by light microscope. The impact energy values obtained from the experiments were found to depend on the austempering time and temperature.

Keywords: Austempered Ductile Iron (ADI), Charpy test, microstructure, transition temperature

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Authors: Vanphanom Sychareun, Viengnakhone Vongxay, Kongmany Chaleunvong, Pascale Hancart Petitet

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Background: Lao PDR still has challenges in preventing and managing health against risk of emerging and re-emerging diseases, particularly HIV/AIDS, tuberculosis and malaria among pregnant women. Community-based intervention for mothers requires more evidences on awareness of such diseases and access to rapid diagnostic tests. The study aims to determine the awareness of pregnant women regarding HIV, TB and Malaria, the access to rapid diagnostic test of such diseases among pregnant women of local community and their factors related. Method: This is a cross sectional study using quantitative approach to explore the awareness of pregnant women on HIV/AIDS/TB and Malaria in Savannakhet province, Lao PDR in three remote districts (Phin, Thapangthong and Atsaphone) of Savannakhet province. The study targeted group was pregnant women at the community level. Sample size for primary data collection of pregnant women was 189. Face-to-face administered questionnaires were applied. Descriptive and inferential statistics were applied to determine the associated factors with awareness of pregnant women on HIV/AIDS/TB and Malaria. This study is under the HEALTH project/ Expertise France. Result: Most of our participants were pregnant at 28 – 42 weeks (50.3%); ranged 4 – 38 weeks. Mean age of pregnant women was 24.3 years old (range: 14 - 48 years old); 15.9% of whom were at age below 19 years. Around 94.2% of respondents works were farming, 54.5% were illiterate, 74.0% were Mon-Kmer ethnic, and 60% had income lower than average. Only 56.6% that have access to ANC, 39.1% started the access to ANC during the first trimester and only 19.6% had visited the ANC for at least four times. Almost pregnant women (and 92.1% and 93.1%) had low to moderate knowledge of HIV and TB respectively, while three-fourth of pregnant women (74.6%) had low to moderate knowledge of malaria. Slightly higher than half of participants (53.4% and 52.9%) had easy access to HIV and TB respectively ; while 72.5% had easy access to malaria. Majority of participants knew where to get tested for malaria (73.5%) and TB (54.5%), but 73.5% did not know where to get tested for HIV. Very few pregnant women (1.6%, 2.1% and 8.5%) experienced having tested for HIV/TB/malaria. respectively. Factors associated with awareness on HIV were occupation as staff, business (OR:5.9; 95% CI:1.2-28.1), upper secondary education (OR: 14.6; 95% CI:3.1-69.2); Mone-Khmer ethnic (OR: 0.4, 95% CI: 0.2-0.8); and attending ANC more than 4 times (OR:4.1, 95%:1.7-9.7). Factors associated with awareness on TB were occupation as staff, business (OR:2.4; 95% CI: 0.7-8.0), upper secondary education (OR: 6.2; 95% CI: 1.9-20.5); Mone-Khmer ethnic (OR: 0.5, 95% CI:0.3-0.9); attending ANC more than 4 times (OR:2.8, 95%:1.2-6.4). Factors associated with awareness on malaria were upper secondary education (OR: 18.1; 95% CI: 2.3-142.9); Mone-Khmer ethnic (OR: 0.2, 95% CI:0.1-0.4); attending ANC more than 4 times (OR:3.6, 95%:1.5-8.8). Conclusion: A very low awareness on HIV, TB and malaria among pregnant women in rural community of Savannakhet triggers the requirement of comprehensive public health intervention on awareness and access to prevention against emerging diseases for all pregnant women. Future intervention should focus on providing more knowledge to pregnant women during ANC and encouraging them to attend ANC more than 4 times.

Keywords: pregnant women, HIV, tuberculosis, malaria, awareness, Laos

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Authors: Simona Pileviciene

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On 24th January 2014, Lithuania notified two primary cases of African swine fever (ASF) in wild boars. The animals were tested positive for ASF virus (ASFV) genome by real-time PCR at the National Reference Laboratory for ASF in Lithuania (NRL), results were confirmed by the European Union Reference Laboratory for African swine fever (CISA-INIA). Intensive wild and domestic animal monitoring program was started. During the period of 2014-2017 ASF was confirmed in two large commercial pig holding with the highest biosecurity. Pigs were killed and destroyed. Since 2014 ASF outbreak territory from east and south has expanded to the middle of Lithuania. Diagnosis by PCR is one of the highly recommended diagnostic methods by World Organization for Animal Health (OIE) for diagnosis of ASF. The aim of the present study was to compare singleplex real-time PCR assays to a duplex assay allowing the identification of ASF and internal control in a single PCR tube and to compare primers, that target the p72 gene (ASF 250 bp and ASF 75 bp) effectivity. Multiplex real-time PCR assays prove to be less time consuming and cost-efficient and therefore have a high potential to be applied in the routine analysis. It is important to have effective and fast method that allows virus detection at the beginning of disease for wild boar population and in outbreaks for domestic pigs. For experiments, we used reference samples (INIA, Spain), and positive samples from infected animals in Lithuania. Results show 100% sensitivity and specificity.

Keywords: African swine fewer, real-time PCR, wild boar, domestic pig

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Authors: Mojtaba Mirmontazemi, Habibollah Dadgar

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Bone is the most common metastasis site in some advanced malignancies, such as prostate and breast cancer. Bone metastasis generally indicates fewer prognostic factors in these patients. Different radiological and molecular imaging modalities are used for detecting bone lesions. Molecular imaging including computed tomography, magnetic resonance imaging, planar bone scintigraphy, single-photon emission tomography, and positron emission tomography as noninvasive visualization of the biological occurrences has the potential to exact examination, characterization, risk stratification and comprehension of human being diseases. Also, it is potent to straightly visualize targets, specify clearly cellular pathways and provide precision medicine for molecular targeted therapies. These advantages contribute implement personalized treatment for each patient. Currently, NaF PET/CT has significantly replaced standard bone scintigraphy for the detection of bone metastases. On one hand, 68Ga-PSMA PET/CT has gained high attention for accurate staging of primary prostate cancer and restaging after biochemical recurrence. On the other hand, FDG PET/CT is not commonly used in osseous metastases of prostate and breast cancer as well as its usage is limited to staging patients with aggressive primary tumors or localizing the site of disease. In this article, we examine current studies about FDG, NaF, and PSMA PET/CT images in bone metastases diagnostic utility and assess response to treatment in patients with breast and prostate cancer.

Keywords: skeletal metastases, fluorodeoxyglucose, sodium fluoride, molecular imaging, precision medicine, prostate cancer (68Ga-PSMA-11)

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Authors: Tanka Nath Dahal

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Community-based forestry is seen as a promising instrument for sustainable forest management (SFM) through the purposeful involvement of local communities. Globally, forest area managed by local communities is on the rise. However, transferring management responsibilities to forest users alone cannot guarantee the sustainability of forest management. A monitoring tool, that allows the local communities to track the progress of forest management towards the goal of sustainability, is essential. A case study, including six forest user groups (FUGs), two from each three community-based forestry models—community forestry (CF), buffer zone community forestry (BZCF), and collaborative forest management (CFM) representing three different physiographic regions, was conducted in Nepal. The study explores which community-based forest management model (CF, BZCF or CFM) is doing well in terms of sustainable forest management. The study assesses the overall performance of the three models towards SFM using locally developed criteria (four), indicators (26) and verifiers (60). This paper attempts to quantify the sustainability of the models using sustainability index for individual criteria (SIIC), and overall sustainability index (OSI). In addition, rating to the criteria and scoring of the verifiers by the FUGs were done. Among the four criteria, the FUGs ascribed the highest weightage to institutional framework and governance criterion; followed by economic and social benefits, forest management practices, and extent of forest resources. Similarly, the SIIC was found to be the highest for the institutional framework and governance criterion. The average values of OSI for CFM, CF, and BZCF were 0.48, 0.51 and 0.60 respectively; suggesting that buffer zone community forestry is the more sustainable model among the three. The study also suggested that the SIIC and OSI help local communities to quantify the overall progress of their forestry practices towards sustainability. The indices provided a clear picture of forest management practices to indicate the direction where they are heading in terms of sustainability; and informed the users on issues to pay attention to enhancing the sustainability of their forests.

Keywords: community forestry, collaborative management, overall sustainability, sustainability index for individual criteria

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Authors: Mounia El Jaouhari, Mira Goral, Samir Diouny

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Introduction: Previous research has indicated that language impairments are recognized as a feature of many neurodegenerative disorders, including non-language-led dementia subtypes such as Alzheimer´s disease (AD). In this preliminary study, the focal aim is to quantify the semantic content of naming and connected speech samples of Moroccan patients diagnosed with AD using two tasks taken from the culturally adapted and validated Moroccan version of the Boston Diagnostic Aphasia Examination. Methods: Five individuals with AD and five neurologically healthy individuals matched for age, gender, and education will participate in the study. Participants with AD will be diagnosed on the basis of the Moroccan version of the Diagnostic and Statistial Manual of Mental Disorders (DSM-4) screening test, the Moroccan version of the Mini Mental State Examination (MMSE) test scores, and neuroimaging analyses. The participants will engage in two tasks taken from the MDAE-SF: 1) Picture description and 2) Naming. Expected findings: Consistent with previous studies conducted on English speaking AD patients, we expect to find significant word production and retrieval impairments in AD patients in all measures. Moreover, we expect to find category fluency impairments that further endorse semantic breakdown accounts. In sum, not only will the findings of the current study shed more light on the locus of word retrieval impairments noted in AD, but also reflect the nature of Arabic morphology. In addition, the error patterns are expected to be similar to those found in previous AD studies in other languages.

Keywords: alzheimer's disease, anomia, connected speech, semantic impairments, moroccan arabic

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Authors: Nadhiya N. Subramony, Jenifer Vaughan, Lesley E. Scott

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In South Africa, the World Health Organisation estimated 454000 new cases of Mycobacterium tuberculosis (M.tb) infection (MTB) in 2015. Disseminated tuberculosis arises from the haematogenous spread and seeding of the bacilli in extrapulmonary sites. The gold standard for the detection of MTB in bone marrow is TB culture which has an average turnaround time of 6 weeks. Histological examinations of trephine biopsies to diagnose MTB also have a time delay owing mainly to the 5-7 day processing period prior to microscopic examination. Adding to the diagnostic delay is the non-specific nature of granulomatous inflammation which is the hallmark of MTB involvement of the bone marrow. A Ziehl-Neelson stain (which highlights acid-fast bacilli) is therefore mandatory to confirm the diagnosis but can take up to 3 days for processing and evaluation. Owing to this delay in diagnosis, many patients are lost to follow up or remain untreated whilst results are awaited, thus encouraging the spread of undiagnosed TB. The Xpert® MTB/RIF (Cepheid, Sunnyvale, CA) is the molecular test used in the South African national TB program as the initial diagnostic test for pulmonary TB. This study investigates the optimisation and performance of the Xpert® MTB/RIF on bone marrow aspirate specimens (BMA), a first since the introduction of the assay in the diagnosis of extrapulmonary TB. BMA received for immunophenotypic analysis as part of the investigation into disseminated MTB or in the evaluation of cytopenias in immunocompromised patients were used. Processing BMA on the Xpert® MTB/RIF was optimised to ensure bone marrow in EDTA and heparin did not inhibit the PCR reaction. Inactivated M.tb was spiked into the clinical bone marrow specimen and distilled water (as a control). A volume of 500mcl and an incubation time of 15 minutes with sample reagent were investigated as the processing protocol. A total of 135 BMA specimens had sufficient residual volume for Xpert® MTB/RIF testing however 22 specimens (16.3%) were not included in the final statistical analysis as an adequate trephine biopsy and/or TB culture was not available. Xpert® MTB/RIF testing was not affected by BMA material in the presence of heparin or EDTA, but the overall detection of MTB in BMA was low compared to histology and culture. Sensitivity of the Xpert® MTB/RIF compared to both histology and culture was 8.7% (95% confidence interval (CI): 1.07-28.04%) and sensitivity compared to histology only was 11.1% (95% CI: 1.38-34.7%). Specificity of the Xpert® MTB/RIF was 98.9% (95% CI: 93.9-99.7%). Although the Xpert® MTB/RIF generates a faster result than histology and TB culture and is less expensive than culture and drug susceptibility testing, the low sensitivity of the Xpert® MTB/RIF precludes its use for the diagnosis of MTB in bone marrow aspirate specimens and warrants alternative/additional testing to optimise the assay.

Keywords: bone marrow aspirate , extrapulmonary TB, low sensitivity, Xpert® MTB/RIF

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Authors: Ashique Mahmud, MD. Ataul Gani Osmani, Shoria Sharmin

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In the first quarter of the twenty-first century, the most substantial global concern is environmental contamination, and it has gained the prioritization of both the national and international community. Keeping in mind this crucial fact, this study conducted different statistical and econometrical methods to identify whether the gross national income of the country has a significant impact on electricity production from nonrenewable sources and different air pollutants like carbon dioxide, nitrous oxide, and methane emissions. Besides, the primary objective of this research was to analyze whether the environmental Kuznets curve hypothesis holds for the examined variables. After analyzing different statistical properties of the variables, this study came to the conclusion that the environmental Kuznets curve hypothesis holds for gross national income and carbon dioxide emission in Bangladesh in the short run as well as the long run. This study comes to this conclusion based on the findings of ordinary least square estimations, ARDL bound tests, short-run causality analysis, the Error Correction Model, and other pre-diagnostic and post-diagnostic tests that have been employed in the structural model. Moreover, this study wants to demonstrate that the outline of gross national income and carbon dioxide emissions is in its initial stage of development and will increase up to the optimal peak. The compositional effect will then force the emission to decrease, and the environmental quality will be restored in the long run.

Keywords: environmental Kuznets curve hypothesis, carbon dioxide emission in Bangladesh, gross national income in Bangladesh, autoregressive distributed lag model, granger causality, error correction model

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Authors: Abhimanyu Thakur, Youngjin Lee

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Glioma is a lethal brain cancer whose early diagnosis and prognosis are limited due to the dearth of a suitable technique for its early detection. Current approaches, including magnetic resonance imaging (MRI), computed tomography (CT), and invasive biopsy for the diagnosis of this lethal disease, hold several limitations, demanding an alternative method. Recently, extracellular vesicles (EVs) have been used in numerous biomarker studies, majorly exosomes and microvesicles (MVs), which are found in most of the cells and biofluids, including blood, cerebrospinal fluid (CSF), and urine. Remarkably, glioma cells (GMs) release a high number of EVs, which are found to cross the blood-brain-barrier (BBB) and impersonate the constituents of parent GMs including protein, and lncRNA; however, biophysical properties of EVs have not been explored yet as a biomarker for glioma. We isolated EVs from cell culture conditioned medium of GMs and regular primary culture, blood, and urine of wild-type (WT)- and glioma mouse models, and characterized by nano tracking analyzer, transmission electron microscopy, immunogold-EM, and differential light scanning. Next, we measured the biophysical parameters of GMs-EVs by using atomic force microscopy. Further, the functional constituents of EVs were examined by FTIR and Raman spectroscopy. Exosomes and MVs-derived from GMs, blood, and urine showed distinction biophysical parameters (roughness, adhesion force, and stiffness) and different from that of regular primary glial cells, WT-blood, and -urine, which can be attributed to the characteristic functional constituents. Therefore, biophysical features can be potential diagnostic biomarkers for glioma.

Keywords: glioma, extracellular vesicles, exosomes, microvesicles, biophysical properties

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Authors: H. Dakhlaoui, D. Ruelland, Y. Tramblay, Z. Bargaoui

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To evaluate the impact of climate change on water resources at the catchment scale, not only future projections of climate are necessary but also robust rainfall-runoff models that are able to be fairly reliable under changing climate conditions. This study aims at assessing the robustness of three conceptual rainfall-runoff models (GR4j, HBV and IHACRES) on five basins in Northern Tunisia under long-term climate variability. Their robustness was evaluated according to a differential split sample test based on a climate classification of the observation period regarding simultaneously precipitation and temperature conditions. The studied catchments are situated in a region where climate change is likely to have significant impacts on runoff and they already suffer from scarcity of water resources. They cover the main hydrographical basins of Northern Tunisia (High Medjerda, Zouaraâ, Ichkeul and Cap bon), which produce the majority of surface water resources in Tunisia. The streamflow regime of the basins can be considered as natural since these basins are located upstream from storage-dams and in areas where withdrawals are negligible. A 30-year common period (1970‒2000) was considered to capture a large spread of hydro-climatic conditions. The calibration was based on the Kling-Gupta Efficiency (KGE) criterion, while the evaluation of model transferability is performed according to the Nash-Suttfliff efficiency criterion and volume error. The three hydrological models were shown to have similar behaviour under climate variability. Models prove a better ability to simulate the runoff pattern when transferred toward wetter periods compared to the case when transferred to drier periods. The limits of transferability are beyond -20% of precipitation and +1.5 °C of temperature in comparison with the calibration period. The deterioration of model robustness could in part be explained by the climate dependency of some parameters.

Keywords: rainfall-runoff modelling, hydro-climate variability, model robustness, uncertainty, Tunisia

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Authors: Jarmila Štěpánová, Martin Kudláček, Lukáš Jakubec

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The people with spinal cord injury are one of the least sport active members of our society. Their hypoactivity is determined by primary injury, i.e., the loss of motor function, the injured part of the body is connected with health complications and social handicap. Study performs one part of the standardization process of semi-structured interview PARA-SCI.CZ (Czech version of the Physical Activity Recall Assessment for People with Spinal Cord Injury), which measures the type, frequency, duration, and intensity of physical activity of people with spinal cord injury. The study focused on persons with paraplegia who use a wheelchair as their primary mode of mobility. The aim of this study was to perform a process to determine the criterion validity of PARA-SCI.CZ. The actual physical activity of wheelchair users was monitored during three days by using accelerometers Actigraph GT3X fixed on the non-dominant wrist, and semi-structured interview PARA-SCI.CZ. During the PARA-SCI.CZ interview, participants were asked to recall activities they had done over the past 3 days, starting with the previous day. PARA-SCI.CZ captured frequency, duration, and intensity (low, moderate, and heavy) of two categories of physical activity (leisure time physical activity and activities of a usual day). Accelerometer Actigraph GT3X captured duration and intensity (low and moderate + heavy) of physical activity during three days and nights. The study presented three potential recalculations of measured data. Standardization process of PARA-SCI.CZ is essential to critically approach issues of health and active lifestyle of persons with spinal cord injury in the Czech Republic. Standardized PARA-SCI.CZ can be used in practice by physiotherapists and sports pedagogues from the field of adapted physical activities.

Keywords: physical activity, lifestyle, paraplegia, semi-structure interview, accelerometer

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Authors: J. Fox, J. Randhawa, M. Chan, L. Campbell, A. Weakely, D. J. Harvey, S. Tomaszewski Farias

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Early identification of individuals at risk for conversion to dementia provides an opportunity for preventative treatment. Many older adults (30-60%) report specific subjective cognitive decline (SCD); however, previous research is inconsistent in terms of what types of complaints predict future cognitive decline. The purpose of this study is to identify which specific complaints from the Everyday Cognition Scales (ECog) scales, a measure of self-reported concerns for everyday abilities across six cognitive domains, are associated with: 1) conversion from a clinical diagnosis of normal to either MCI or dementia (categorical variable) and 2) progressive cognitive decline in memory and executive function (continuous variables). 415 cognitively normal older adults were monitored annually for an average of 5 years. Cox proportional hazards models were used to assess associations between self-reported ECog items and progression to impairment (MCI or dementia). A total of 114 individuals progressed to impairment; the mean time to progression was 4.9 years (SD=3.4 years, range=0.8-13.8). Follow-up models were run controlling for depression. A subset of individuals (n=352) underwent repeat cognitive assessments for an average of 5.3 years. For those individuals, mixed effects models with random intercepts and slopes were used to assess associations between ECog items and change in neuropsychological measures of episodic memory or executive function. Prior to controlling for depression, subjective concerns on five of the eight Everyday Memory items, three of the nine Everyday Language items, one of the seven Everyday Visuospatial items, two of the five Everyday Planning items, and one of the six Everyday Organization items were associated with subsequent diagnostic conversion (HR=1.25 to 1.59, p=0.003 to 0.03). However, after controlling for depression, only two specific complaints of remembering appointments, meetings, and engagements and understanding spoken directions and instructions were associated with subsequent diagnostic conversion. Episodic memory in individuals reporting no concern on ECog items did not significantly change over time (p>0.4). More complaints on seven of the eight Everyday Memory items, three of the nine Everyday Language items, and three of the seven Everyday Visuospatial items were associated with a decline in episodic memory (Interaction estimate=-0.055 to 0.001, p=0.003 to 0.04). Executive function in those reporting no concern on ECog items declined slightly (p <0.001 to 0.06). More complaints on three of the eight Everyday Memory items and three of the nine Everyday Language items were associated with a decline in executive function (Interaction estimate=-0.021 to -0.012, p=0.002 to 0.04). These findings suggest that specific complaints across several cognitive domains are associated with diagnostic conversion. Specific complaints in the domains of Everyday Memory and Language are associated with a decline in both episodic memory and executive function. Increased monitoring and treatment of individuals with these specific SCD may be warranted.

Keywords: alzheimer’s disease, dementia, memory complaints, mild cognitive impairment, risk factors, subjective cognitive decline

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Authors: Lydia Novozhilova, Vladimir Urazhdin

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An optimization problem for reinforced thin-walled vessels under uniform external pressure is considered. The conventional approaches to optimization generally start with pre-defined geometric parameters of the vessels, and then employ analytic or numeric calculations and/or experimental testing to verify functionality, such as stability under the projected conditions. The proposed approach consists of two steps. First, the feasibility domain will be identified in the multidimensional parameter space. Every point in the feasibility domain defines a design satisfying both geometric and functional constraints. Second, an objective function defined in this domain is formulated and optimized. The broader applicability of the suggested methodology is maximized by implementing the Support Vector Machines (SVM) classification algorithm of machine learning for identification of the feasible design region. Training data for SVM classifier is obtained using the Simulation package of SOLIDWORKS®. Based on the data, the SVM algorithm produces a curvilinear boundary separating admissible and not admissible sets of design parameters with maximal margins. Then optimization of the vessel parameters in the feasibility domain is performed using the standard algorithms for the constrained optimization. As an example, optimization of a ring-stiffened closed cylindrical thin-walled vessel with semi-spherical caps under high external pressure is implemented. As a functional constraint, von Mises stress criterion is used but any other stability constraint admitting mathematical formulation can be incorporated into the proposed approach. Suggested methodology has a good potential for reducing design time for finding optimal parameters of thin-walled vessels under uniform external pressure.

Keywords: design parameters, feasibility domain, von Mises stress criterion, Support Vector Machine (SVM) classifier

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Authors: V. Kuzhandai Velu, R. Ramesh

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Background and objectives: Acute myocardial infarction (AMI) is the most common cause of mortality and morbidity. Over the last decade, microRNAs (miRs) have emerged as a potential marker for detecting AMI. The current study evaluates the kinetics and importance of miRs in the differential diagnosis of ST-segment elevated MI (STEMI) and non-STEMI (NSTEMI) and its correlation to conventional biomarkers and to predict the immediate outcome of AMI for arrhythmias and left ventricular (LV) dysfunction. Materials and Method: A total of 100 AMI patients were recruited for the study. Routine cardiac biomarker and miRNA levels were measured during diagnosis and serially at admission, 6, 12, 24, and 72hrs. The baseline biochemical parameters were analyzed. The expression of miRs was compared between STEMI and NSTEMI at different time intervals. Diagnostic utility of miR-1, miR-133, miR-208, and miR-499 levels were analyzed by using RT-PCR and with various diagnostics statistical tools like ROC, odds ratio, and likelihood ratio. Results: The miR-1, miR-133, and miR-499 showed peak concentration at 6 hours, whereas miR-208 showed high significant differences at all time intervals. miR-133 demonstrated the maximum area under the curve at different time intervals in the differential diagnosis of STEMI and NSTEMI which was followed by miR-499 and miR-208. Evaluation of miRs for predicting arrhythmia and LV dysfunction using admission sample demonstrated that miR-1 (OR = 8.64; LR = 1.76) and miR-208 (OR = 26.25; LR = 5.96) showed maximum odds ratio and likelihood respectively. Conclusion: Circulating miRNA showed a highly significant difference between STEMI and NSTEMI in AMI patients. The peak was much earlier than the conventional biomarkers. miR-133, miR-208, and miR-499 can be used in the differential diagnosis of STEMI and NSTEMI, whereas miR-1 and miR-208 could be used in the prediction of arrhythmia and LV dysfunction, respectively.

Keywords: myocardial infarction, cardiac biomarkers, microRNA, arrhythmia, left ventricular dysfunction

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Authors: Aneta Binkowska, Grzegorz Michalak, Slawomir Pilip, Lukasz Bondaruk, Daniel Celinski, Robert Slotwinski

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Post-traumatic mortality rates are still very high and show an increasing tendency. Early identification of patients at high risk of severe complications has a significant impact on treatment outcomes. The aim of the study was to better understand the early pathological inflammatory response to injury and infection and to determine the usefulness of the assessment of TNF-α and sTNFR1 concentrations in the peripheral blood as early indicators of severe post-traumatic complications. The study was carried out in a group of 51 patients after trauma treated in the ED, including 32 patients that met inclusion criteria for immunological analysis. Patients were divided into two groups using the ISS scale (group A with ISS ≥20, group B with ISS <20). Serum levels of TNF-α and sTNFR1 were determined after admission to the ED and after 3, 6, 12 and 24 hours. The highest TNF-α and sTNFR1 concentrations in both groups were recorded at admission and were significantly higher in group A compared to group B (A vs B TNF-α 2.46 pg/ml vs 1.78 pg/ml; sTNFR1 1667.5 pg/ml vs 875.2 p<0.005). The concentration of sTNFR1 in patients with severe complications was significantly higher compared to patients without complications and preceded clinical symptoms of complications ( C+ vs C- 1561.5 pg/ml vs 930.6 pg/ml). Spearman's correlation showed a statistically significant positive correlation between the baseline concentrations of IL-6 (r=0.38, p<0.043) and sTNFR1 (r=0.59, p=0.001) and the ISS scores. The high diagnostic sensitivity calculated from the ROC (receiver operating characteristic) curves was found for the concentrations of both cytokines: TNF α (AUC=0.91, p=0.004) and sTNFR1 (AUC=0.86, p=0.011). Elevated levels of sTNFR1, determined in the peripheral blood shortly after injury, is significantly associated with the occurrence of later complications, which in some patients lead to death. In contrast, high levels of TNF-α shortly after injury are associated with high mortality.

Keywords: cytokine, SIRS, MODS, trauma

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Authors: Xu Yifei, Le Yining, Yang Qingluan, Tu Yanjie

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Objective: This study aims to investigate the distribution features of Traditional Chinese Medicine (TCM) syndromes and syndrome elements in Epstein-Barr virus-associated diseases and then explores the relations between TCM syndromes or syndrome elements and laboratory indicators of Epstein-Barr virus-associated diseases. Methods: A cross-sectional study of 70 patients with EBV infection was described. We assessed the diagnostic information and laboratory indicators of these patients from Huashan Hospital Affiliated to Fudan University between November 2017 and July 2019. The disease diagnosis and syndrome differentiation were based on the diagnostic criteria of EBV-associated diseases and the theory of TCM respectively. Confidence correlation analysis, logistic regression analysis, cluster analysis, and the Sankey diagram were used to analyze the correlation between the data. Results: The differentiation of the 4 primary TCM syndromes in the collected patients was correlated with the indexes of immune function, liver function, inflammation, and anemia, especially the relationship between Qifen syndrome and high lactic acid dehydrogenase level. The common 11 TCM syndrome elements were associated with the increased CD3+ T cell rate, low hemoglobin level, high procalcitonin level, high lactic acid dehydrogenase level, and low albumin level. Conclusion: The changes in immune function indexes, procalcitonin, and liver function-related indexes in patients with EBV-associated diseases were consistent with the evolution law of TCM syndromes. This study provides a reference for judging the pathological stages of these kinds of diseases, predicting their prognosis, and guiding subsequent treatment strategies based on TCM syndrome type.

Keywords: EBV-associated diseases, traditional Chinese medicine syndrome, syndrome element, diagnostics

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Authors: Surabhi Agrawal Kohli, Sunita Gupta, Esha Khanuja, Parul Garg, P. Gupta

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Background: Adenomyosis is a common gynaecological condition that affects the menstruating women. Uterine enlargement, dysmenorrhoea, and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. Classically it was thought, compared with ultrasonography, when adenomyosis is suspected, MRI enables more accurate diagnosis of the disease. Materials and Methods: 172 subjects were enrolled after an informed consent that had complaints of HMB, dyspareunia, dysmenorrhea, and chronic pelvic pain. Detailed history of the enrolled subjects was taken, followed by a clinical examination. These patients were then subjected to TVS where myometrial echo texture, presence of myometrial cysts, blurring of endomyometrial junction was noted. MRI was followed which noted the presence of junctional zone thickness and myometrial cysts. After hysterectomy, histopathological diagnosis was obtained. Results: 78 participants were analysed. The mean age was 44.2 years. 43.5% had parity of 4 or more. heavy menstrual bleeding (HMB) was present in 97.8% and dysmenorrhea in 93.48 % of HPE positive patient. Transvaginal sonography (TVS) and MRI had a sensitivity of 89.13% and 80.43%, specificity of 90.62% and 84.37%, positive likelihood ratio of 9.51 and 5.15, negative likelihood ratio of 0.12 and 0.23, positive predictive value of 93.18% and 88.1%, negative predictive value of 85.29% and 75% and a diagnostic accuracy of 89.74% and 82.5%. Comparison of sensitivity (p=0.289) and specificity (p=0.625) showed no statistically significant difference between TVS and MRI. Conclusion: Prevalence of 30.23%. HMB with dysmenorrhoea and chronic pelvic pain helps in diagnosis. TVS (Endomyometrial junction blurring) is both sensitive and specific in diagnosing adenomyosis without need for additional diagnostic tool. Both TVS and MRI are equally efficient, however because of certain additional advantages of TVS over MRI, it may be used as the first choice of imaging. MRI may be used additionally in difficult cases as well as in patients with existing co-pathologies.

Keywords: adenomyosis, heavy menstrual bleeding, MRI, TVS

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Authors: Sahar Heidary, Ramin Ghasemi Shayan

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The recent coronavirus disease 2019 (COVID-19) occurrence has carried considerabletrials to the world health system, comprising the training of dental and maxillofacial radiology (DMFR). DMFR will keep avital role in healthcare throughout this disaster. Severe acute breathing disease coronavirus 2 (SARS-CoV-2), the virus producing the current coronavirus disease 2019 (COVID-19) pandemic, is not only extremely contagious but can make solemn consequences in susceptible persons comprising dental patients and dental health care personnel (DHCPs). Reactions to COVID-19 have been available by the Cores for Infection Switch and Inhibition and the American Dental Association, but a more detailed answer is necessary for the harmless preparation of oral and maxillofacial radiology. Our goal is to evaluation the existing information just how the illness threatens patients and DHCPs and how to define which patients are possible to be SARS-CoV-2 infected; study how the usage of private shielding utensils and contamination control measures based on recent top observes, and knowledge can decrease the danger of virus spread in radiologic trials; and scrutinize how intraoral radiography, with its actually superior danger of scattering the infection, might be changed by extraoralradiographic methods for definite diagnostic jobs. In the pandemic, teleradiology has been extensively recycled for diagnostic determinations of COVID-19 patients, for discussions with radiologists in crisis cases, or managing of distance among radiology clinics. Dentists can have the digital radiographic images of their emergency patients through online service area also by electronic message or messaging applications to view in their smart phones, laptops, or other electronic devices.

Keywords: radiology, dental, oral, COVID-19, infection

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