bluuebunny/crossref_metadata_2025 huggingface dataset:
Systemic Inflammatory Reaction to Intravitreal Bevacizumab: A Case Report
Authors: Burridge Samuel , Stratton Richard , Asaria Riaz
Published: June 2021

IntroductionTo present a case of systemic inflammatory reaction, with associated pleural and pericardial effusions, following intravitreal bevacizumab for retinal macroaneurysm. Case presentationA 73 year old female was commenced on monthly intravitreal bevacizumab injections for right eye macroaneurysm and associated macular oedema. Eight days following her third injection, the patient was admitted to hospital with a history of fever, rigors, arthralgia and vomiting. Admission blood tests demonstrated mild thrombocytopaenia and raised inflammatory markers. A CT chest revealed small pericardial and pleural effusions. The patient improved without treatment and was later discharged from hospital. As intravitreal bevacizumab treatment continued, the patient developed two further episodes of fever and vomiting, with both episodes occurring approximately nine days following each injection. The patient then underwent outpatient medical review by infectious disease and rheumatology specialists, at which time the recurrent episodes of systemic inflammation were diagnosed as secondary to intravitreal bevacizumab.ConclusionsThough rare, patients can develop serious and potentially life-threatening systemic adverse effects from intravitreal anti-VEGF treatment. Ophthalmologists should always enquire about systemic side effects; in this way, adverse effects may be recognised sooner and a change or cessation of therapy considered.
Adjustable Robust Optimization for Multi-Period Water Allocation in Droughts under Uncertainty
Authors: Shuai Yuhong , Yao Liming
Published: June 2021

Optimal, rational water resource allocation can go some way to overcoming water deficiencies; however, its achievement is complex due to conflicting hierarchies and uncertainties, such as water availability (WA) and water demand (WD). This study developed a robust water withdrawal scheme for arid and semi-arid regions that balanced the trade-offs between the sub-areas and water use participants, ensured sustainable regional system development, and guaranteed robust solutions for future uncertainties. A bi-level affinely adjustable robust counterpart (AARC) programming framework was developed, in which the regional authority as the leader allocates water to the sub-areas to maximize the intra- and intergenerational equity, and the sub-areas as the followers allocate water to their respective water departments to maximize their economic benefits and minimize water shortages. This method used affine functions between the decision variables (water allocation amount) and the uncertain parameters (WA, WD) to deal with the computationally intractable (NP-hard) robust counterpart for the multi-period water resources management. To illustrate the applicability and feasibility of this framework, a case study from Neijiang, China, is given. This model can assist regional authorities develop more robust water resource allocation solutions for multi-period planning responses to uncertain water deficiencies.
Mutation Effect Investigation on Cytochrome C552 Protein Instability and Electron Transfer Improvement in the Acidithiobacillus Ferrooxidans Bacteria Respiratory Chain
Authors: Shojapour Mahnaz , Fatemi Faezeh , Shasaltaneh Marzieh Dehghan , Farahmand Somayeh
Published: June 2021

Cytochrome c552 (Cyc1) is a protein in the electron transport chain of the Acidithiobacillus ferrooxidans (Af) bacteria which obtain their energy from oxidation Fe2+ to Fe+3. The electrons are directed through Cyc2, RCY (rusticyanin), Cytochrome c552, and Cox aa3 proteins to O2. Cytochrome c552 protein consists of two chains, A and B. In the present study, a new mutation (E121D) in the A chain of cytochrome c552 protein was selected due to electron receiving from Histidine 143 of RCY. Then, the changes performed in the E121D mutant were evaluated by MD simulations analyzes. Cytochrome c552 and RCY proteins were docked by a Patchdock server. By E121D mutation, the connection between the two chains in Cytochrome c552 was enhanced by an additional hydrogen bond between Zn1388 and aspartate 121. Asp 121 in chain A gets farther from Zn 1388 in chain B. Therefore, the aspartate gets closer to Cu 1156 of the RCY leading to the higher stability of the RCY/Cytochrome c552 complex. Further, an acidic residue (Glu121) becomes a more acidic residue (Asp121) and improving the electron transfer to Cytochrome c552 protein. The results of RMSF analysis showed further ligand flexibility in mutation. This leads to fluctuation of the active site and increases redox potential at the mutation point and the speed of electron transfer. This study also predicts that in all respiratory chain proteins, electrons probably enter the first active site via glutamate and exit through the second active site of each respiratory chain protein and through histidine.
The Study Designing A Sustainable Financing Model For Health Promotion Services In Iran
Authors: Javadinasb Hamideh , Nazari Aslan , Pourmohammadi Kimia , Yousefi Ali Reza , Hayati Ramin
Published: June 2021

Background: Sustainable financing for Health Promotion Services (HPS) has always been challenged and attracted the attention of health domain politicians. This study was conducted to aim at designing a sustainable health financing model for HPS in IranMethods: This combined study was conducted in two phases. First, the published comparative study of sustainable financing for HPS and comprehensive study of the related current documents with this subject from 2005 to 2017 were used. In the second phase, the qualitative interviews for Iran’s current situation and capacities for sustainable health financing of HPS and Focus Group Discussion (FGD) meetings for finalized the aforementioned model were used.Results: The rules and advantages of levying sin tax, the related stakeholders in sustainable health financing, challenges and solutions of gathering, pooling, and purchasing of sustainable financial resources have been extracted.Conclusion: According to the results, there is no political and national commitment to executing sustainable health financing regulations in Iran. Lack of necessary infrastructures for their execution, resistance, and disagreement of harmful good industries are the barriers to executing these regulations. The model was suggested establishing a health promotion foundation and the permanent law for execution necessity and legitimacy of receiving public budget, sin tan, health tax, and duties will be provided.
A Lightweight Certificateless Aggregate Ring Signature Scheme for Privacy-preserving in Smart Grids
Authors: Wang Huiwen , Wang Liangliang , Wen Mi , Chen Kefei , Luo Yiyuan
Published: June 2021

There exists a problem of user privacy leakage in the smart grids (SGs) that malicious attackers may intercept or tamper with electricity data and associate the stolen data with real users to commit crimes. Besides, node equipment resources in the SGs are limited. Aiming at the problems above, most of the existing privacy-preserving schemes apply aggregate signature to ensure the integrity of message and improve communication efficiency. However, they cannot realize the anonymity of users to block link attacks, and most of the aggregate signature verification has a high computational cost. Therefore, we propose a certificateless aggregate ring signature (CLARS) scheme based on computational Diffie-Hellman problem and decisional Diffie-Hellman problem. Our scheme is suitable for privacy-preserving in SGs. In this scheme, certificateless cryptosystem is used to avoid key escrow and certificates management problems and ring signature is used to ensure the unconditional anonymity of users. In addition, our scheme is proved to be unforgeability and unconditional anonymity under adaptively chosen message attacks against Type I and Type II adversaries in the random oracle model. Compared with previous certificateless aggregate signature (CLAS) schemes, our CLARS scheme has lower computational cost, which only needs two pairing operations.
Ecological Risk Index and Their Associated Health Risk Evaluation of Toxic Heavy Metals in Cultivated Vegetable and Cereal in Different Peri-Urban Regions of an Indian Metropolitan City, Lucknow
Authors: Kumar Pradeep , Rawat Dipti , Kumar Sunil , Singh Rana Pratap
Published: June 2021

The present study investigates the phytoaccumulation factor (PF), Ecological risk index (ERI), and carcinogenic risk factor (CRs) of toxic heavy metals (THMs) i.e. As, Cd, Cr, Pb, and Ni in the agricultural soil, irrigation water, vegetables and cereals samples collected from peri-urban regions of Lucknow. The level of these metals was within the maximum allowable concentration (MAC) (FAO/WHO 2011) in agricultural soil while it was higher in irrigation water. The phytoaccumulation factor of Cd and Ni was very high in the edible parts of vegetable and cereal samples which show that they might have entered through metal-contaminated irrigation water even if not available in the soil. The contamination coefficient (ifC) and Ecological risk factor (ifE) of metals was detected in the range of low risk in all agricultural soil, whereas Ecological risk index of metals was found in the moderate risk which indicated a mild impact on the agro-ecosystem. The carcinogenic risk potential of metals was found more than the requisite value of 10-4 in tomato, spinach, and wheat samples. This study indicates that the metals possess a moderate ecological risk and high carcinogenic risk potential through the consumption of metal-contaminated vegetables and cereals grown and sold in peri-urban regions and food markets.
The bone flare phenomenon during the treatment of bone metastases of lung adenocarcinoma
Authors: Shi Jianhua , Chen Guimin , Xu Tianhui , Wang Xiuxiu , Ruan Junxia , Liu Shuoxin , Sun Shengqiang , Li Yupeng , Zhang Jinping , Ma Chunling
Published: June 2021

Background The bone flare phenomenon, defined as an increase in bone lesion activity, is a kind of benign bone change in response to ongoing tumor treatment. The purpose of this study was to investigate the time, incidence, and clinical significance of bone flare in lung adenocarcinoma patients with bone metastases, as well as to observe the levels of serum alkaline phosphatase ALP and serum calcium Ca^2+ in patients with bone flare phenomenon.Methods Fifty-seven patients with advanced lung adenocarcinoma who participated in the anti-tumor clinical trials from December 2017 to December 2019 in Linyi Cancer Hospital were included in the study. The CT (computed tomography, CT) images, serum ALP and Ca^2+ from all patients were analyzed retrospectively.Results Among a total of 57 patients, 28 were male, and 29 were female. The median age was 62 years (33–75 years), and 30 of them had bone metastases at baseline. Forty-six EGFR negative patients received platinum-based dual-drug chemotherapy or bevacizumab or combined with PD-1 antibody inhibitors, and 11 EGFR positive patients received targeted EGFR inhibitors. The bone flare was detected in 7 out of 30 patients with bone metastases at baseline (5 patients in the combined chemotherapy group and two patients in the targeted treatment group). The incidence of bone flare was 23.33% (7 / 30). The median time was 45 days after treatment (from 41 days to 120 days), and most of them occurred in the early stages of the treatment.
Pseudocitrobacter Anthropi Reduces Heavy Metal Uptake and Improves Phytohormones and Antioxidant System in Glycine Max L.
Authors: Husna Husna , Hussain Anwar , Shah Mohib , Hamayun Muhammad , Iqbal Amjad , Murad Waheed , Irshad Muhammad , Qadir Muhammad , Kim Ho-Youn
Published: June 2021

Heavy metal contamination due to anthropogenic activities is a great threat to modern humanity. A novel and natural technique of bioremediation using microbes for detoxification of HMs while improving plants' growth is the call of the day. In this study, exposing soybean plants to different concentrations (i.e., 10 and 50 µg/mL) of chromium and arsenic showed a severe reduction in agronomic attributes, higher ROS production, and disruption in the antioxidant system. Contrarily, rhizobacterial isolate C18 inoculation not only rescued host growth, but also improved the production of nonenzymatic antioxidants (i.e., flavonoids, phenolic and proline contents) and enzymatic antioxidants (i.e., CAT, APX, POD, and DPPH), higher ROS scavenging, and lower ROS accumulation. Thereby, lowering secondary oxidative stress and subsequent damage. The strain was identified using 16S rDNA sequencing, and was identified as Pseudocitrobacter anthropi. Additionally, the strain can endure metals up to 1200 µg/mL and efficient in detoxifying the effect of Cr and As, by regulating phytohormones (IAA 59.02 μg/mL and GA 101.88 nM/mL) and solubilizing inorganic phosphates, making them excellent phytostimulant, biofertilizers, and heavy metal bio-remediating agent.
An enhanced surrogate-assisted differential evolution for constrained optimization problems
Authors: Garcia Rafael de Paula , de Lima Beatriz Souza Leite Pires , Lemonge Afonso Celso de Castro , Jacob Breno Pinheiro
Published: June 2021

The application of Evolutionary Algorithms (EAs) to complex engineering optimization problems may present difficulties as they require many evaluations of the objective functions by computationally expensive simulation procedures. To deal with this issue, surrogate models have been employed to replace those expensive simulations. In this work, a surrogate-assisted evolutionary optimization procedure is proposed. The procedure combines the Differential Evolution method with a Anchor -nearest neighbors ( –NN) similarity-based surrogate model. In this approach, the database that stores the solutions evaluated by the exact model, which are used to approximate new solutions, is managed according to a merit scheme. Constraints are handled by a rank-based technique that builds multiple separate queues based on the values of the objective function and the violation of each constraint. Also, to avoid premature convergence of the method, a strategy that triggers a random reinitialization of the population is considered. The performance of the proposed method is assessed by numerical experiments using 24 constrained benchmark functions and 5 mechanical engineering problems. The results show that the method achieves optimal solutions with a remarkably reduction in the number of function evaluations compared to the literature.
Different hotspot p53 mutants exert distinct phenotypes and predict outcome of colorectal cancer patients
Authors: Hassin Ori , Nataraj Nishanth Belugali , Shreberk-Shaked Michal , Aylon Yael , Yaeger Rona , Fontemaggi Giulia , Mukherjee Saptaparna , Maddalena Martino , Mallel Giuseppe , Gershon Anat , Grosheva Inna , Feldmesser Ester , Golani Ofra , Blandino Giovanni , Kelsen David , Yarden Yosef , Oren Moshe
Published: June 2021

Colorectal cancer (CRC) is the third most common cancer worldwide. The TP53 gene is mutated in approximately 60% of all CRC cases. Sporadic CRC is characterized by high prevalence of TP53 hotspot missense mutations. In particular, over 20 percent of all TP53-mutated CRC tumors carry either the p53R175H structural mutant or the p53R273H DNA contact mutant. Importantly, clinical data analysis suggests that CRC tumors harboring p53 R273 mutations are more prone to progress to metastatic disease than those with R175 mutations, in association with decreased survival. By combining in vitro CRC cell line models and human CRC data mining, we identified a unique transcriptional signature orchestrated by p53R273H, implicating activation of oncogenic signaling pathways and predicting worse patient outcome. Concordantly, p53R273H selectively promotes rapid CRC cell spreading, migration and invasion in vitro and metastasis in vivo. Mechanistically, the transcriptional output of p53R273H is associated with, and presumably driven by, its preferential binding to regulatory elements of R273 signature genes. Together, this demonstrates that different TP53 missense mutations contribute differently to cancer progression, and that p53R273H possesses distinct gain-of-function activities in CRC that bear on disease course and possibly on patient management strategy. Given that practically all current analytical cancer gene panels include TP53, elucidation of the differential impact of distinct TP53 mutations on disease features is expected to make information on TP53 mutations more actionable and holds potential for better precision-based medicine.
Meta-analysis of Salt Valproate Prevent Switch Associated with Antidepressants in Chinese Depressive Patients
Authors: Shen Dong , Lv Wangqiang , Sun Fengli , Weidong Jin
Published: June 2021

Objective: to study the efficacy of valproate in preventing switch rate related to antidepressant in depressive patients. Methods: The related literature were searched in Chinese Biomedical Database(CBM), China National Knowledge Infrastructure(CNKI) , WANFANG database,and Chinese Social Sciences Citation Index(CSSCI) from 1 January 2005 to 1 January 2020 The rate of switch between groups was synthesized and discussed.Result:A total of 549 subjects were included in 7 studies,in which in 279 cases are in combination group and 270 cases are in group of monotherapy by antidepressant . The results showed switch rate of valproate group was 0.11%,switch rate of antidepressant group was 11.11%, which was very different (OR=0.13 ,95% CI: 0.05–0.35) and also indicated that valproate reduced switch rate was 99%[ (11.11%-0.11%)/11.11%]. In sodium valproate group, switch rate was 0%，while switch rate in antidepressant was 5.7%( OR=0.18,95%CI=0.04-0.84,Z=2.18,P=0.03). In magnesium valproate group, switch rate was 2.2%,while switch rate in antidepressant was16.92% ( OR=0.11,95%CI=0.03-0.39,Z=3.47, P=0.0005).Conclusion:The salt valproate can reduced switch rate related to antidepressant in depressive patients.
Ceramic Material based Optical Antenna for Multiband Photonics Applications
Authors: Sharma Anand , Prajapati Yogendra Kumar , Tripathi Devendra Kumar
Published: June 2021

In this article, design and development of a multiband ceramic material-based Optical antenna is discussed. Square shaped aperture is utilized to excited silicon based dielectric resonator. This type of excitation system provides the capability to create triple hybrid mode (HEM11δ, HEM12δ and HEM11δ+2) inside the cylindrical shaped ceramic material. Due to this feature, the proposed aerial is operating over diverse frequency bands i.e. 117.5-140 THz, 158-165.5 THz and 175.2-190.5 THz respectively. Stable radiation characteristics as well as good value of gain (about 4.0 dBi) makes the proposed Nano-radiator applicable for hyper spectral imaging system (125 THz) and VLC for wireless LAN (160/180THz).
Factors Associated With Body Image Satisfaction Among Palestinian University Female Students, Cross-Sectional Study
Authors: Alwafa Reem Abu , Badrasawi Manal
Published: June 2021

Background

Eating disorders and body dysmorphic disorder are linked to poor body image. People with these diseases commonly lack the ability to objectively assess body shape, size, or attractiveness. This study aimed to investigate the relationship between body image, eating disorders, lifestyle, social pressure, and social media engagements in female university students in Palestine.
Method:

A sample of 905 female undergraduate students from Palestinian universities was included in the study. Arabic validated Body Appreciation Scale (BAS-2) was used to measure body satisfaction. Early screening of eating disorders was conducted using the Arabic validated A-SCOFF tool. One-way ANOVA, independent t-test, Chi-square, Spearman rho correlation test, and simple linear regression tests were used to evaluate the relationships between study variables.
Results

The sample had a high level of body image satisfaction, with a mean score of 4.22 ± 0.74. It was found that eating disorders (p < .001), higher BMI (p < .001), following models or celebrities on social media (p < .01), following models or celebrities nutritional advice (p < .05), family and friends pressure (p < .001), dieting (p < .001), and daily phone hours (p < .01) were associated with lower body satisfaction. While physical activity (p < .05) was associated with higher body satisfaction.
Conclusion

Body image among female university students is influenced by lifestyle, social pressure, and social media. To promote awareness about the impact of these variables on body dissatisfaction, which can lead to eating disorders, educational and supporting programs must be undertaken.
Evaluation of Asymptomatic Bacteruria Management Before and After Antimicrobial Stewardship Program Implementation: Retrospective Study
Authors: Alghamdi Ahlam , Almajed Majed , Alalawi Raneem , Alganame Amjad , Alanazi Shorooq , Alghamdi Ghaida , Alharthi Salman , Alghamdi Isra
Published: June 2021

BackgroundThe Infectious Diseases Society of America (IDSA) recommends against screening for and/or treating asymptomatic bacteriuria (ASB). This study aims to evaluate the inappropriate use of antibiotics in ASB before and after Antimicrobial Stewardship Program implementation and advance towards its appropriate use. MethodWe performed a retrospective study of patients diagnosed with ASB from 2016 to 2019 at a tertiary hospital in Saudi Arabia. This study included hospitalized patients ≥18 years old who had a positive urine culture with no signs or symptoms of urinary tract infection and were on antibiotics for asymptomatic bacteriuria. We excluded pregnant women, solid organ transplant patients, patient on active chemotherapy, and patients about to undergo urological surgery.ResultsA total of 716 patients with a positive urine culture were screened . Among these, we identified 109 patients with ASB who were enrolled in our study. The rate of inappropriate antibiotic use was 95% during the study period. The implementation of the Antimicrobial Stewardship Program was associated with a significant reduction in the use of carbapenems (P = 0.04) and an increase in the use of cephalosporins (P = .099687). However, overprescribing antimicrobial agents was a concern in both eras. Approximately 90% of the microorganisms identified were gram-negative bacteria. Of those, 38.7% were multidrug-resistant strains. ConclusionThe urine culture order in ASB is considered relatively small number; however, it showed a high rate of the inappropriate use of antibiotics when there is an order of urine culture in both era. ASP ought to focus on targeting the ordering physician, promoting awareness and/or organizational interventions that appear to reduce the incidence of overtreatment.
Oxidative and Salt Stresses Alter the 26S Proteasome Holoenzyme and Associated Protein Profiles in Arabidopsis Thaliana
Authors: Bonea Diana , Noureddine Jenan , Gazzarrini Sonia , Zhao Rongmin
Published: June 2021

Background: The 26S proteasome, canonically composed of multi-subunit 19S regulatory (RP) and 20S core (CP) particles, is crucial for cellular proteostasis. Proteasomes may be re-modeled, activated, or re-localized and this regulation is critical for plants in response to environmental stresses. The proteasome holoenzyme assembly and dissociation are therefore highly dynamic in vivo. However, the stoichiometric changes of the plant proteasomes and how proteasome associated chaperones vary under common abiotic stresses have not been systematically studied.Results: Here, we studied the impact of abiotic stresses on proteasome structure, activity, and interacting partners in Arabidopsis thaliana. We analyzed available RNA expression data and observed that expressions of proteasome coding genes varied substantially under stresses; however, the protein levels of a few key subunits did not change significantly within 24 hours. Instead, a switch in the predominant proteasome complex, from 26S to 20S, occurs under oxidative or salt stress. Oxidative stress also reduced the cellular ATP content and the association of HSP70-family proteins to the 20S proteasome, but enhanced the activity of cellular free form CP. Salt stress, on the other hand, did not affect cellular ATP level, but caused subtle changes in proteasome subunit composition and impacted bindings of assembly chaperones. Analyses of an array of T-DNA insertional mutant lines highlighted important roles for several putative assembly chaperones in seedling establishment and stress sensitivity. We also observed that knockout of PBAC1, one of the a-ring assembly chaperones, resulted in hypersensitivity and tearing of the seed coat during sterilization. Conclusions: Our study revealed an evolutionarily conserved mechanism of proteasome regulation during oxidative stress, involving dynamic regulation of the holoenzyme formation and associated regulatory proteins, and we also identified a novel role of the PBAC1 proteasome assembly chaperone in seed coat development.
The Evolution Characteristics of Different Deformation Modes of Shear Slip Surface Based on Acoustic Emission Measurements
Authors: Xie Qiang , wu zhihui , Ban Yuxin , Fu Xiang , Cao Zhilin , Sun Weichen , Chen Bolin
Published: June 2021

To investigate the acoustic emission (AE) precursor detection of landslide failures, a model test aiming at reproducing the typical shear surface deformation of different landslide modes was designed. The evolution characteristics of the AE signals were analyzed in terms of AE count, cumulative AE count, AE correlation diagrams, and corresponding time-frequency properties. The test results show that for the progressive deformation mode, the AE count experiences a low-level period, an active period and a rapid increase period, and the distribution of correlation diagram hits concentrates in a relatively small scale and then gradually scatters. There is low frequency signals firstly and then high frequency signals, and the energy proportion of the high-frequency signals shows an increasing tendency. For the sudden deformation mode, the magnitude of AE count increases sharply, leading to the cumulative AE count curve rises steeply, and correlation diagram hits distribution turns into relatively scattering rapidly. Furthermore, the high frequency signals and high energy proportion appear much earlier than that of the progressive deformation mode. For steady deformation mode, however, the acoustic emission activity is quite active in the initial stage, the cumulative AE count curve rises sharply and then maintains relatively flat trend, and correlation diagram hits distribution scatters firstly, then the signal hits distribution begins to concentrate in a relatively small scale. There are intensive high-frequency hits and high energy proportion earlier, and later they tend to decay in response to smaller magnitudes of movement. Comprehensive use of multiple features can help identify landslide deformation patterns more accurately under complex natural conditions, which may provide a promising reference for the field warning monitoring of the diverse landslide failures.
Rethinking the Economic Costs of Hospitalisation for Malaria: Accounting for the Comorbidities of Malaria Patients in Western Kenya
Authors: Watts Caroline , Atieli Harrysone , Alacapa Jason , Lee Ming-Chieh , Zhou Guofa , Githeko Andrew , Yan Guiyun , Wiseman Virginia
Published: June 2021

BackgroundMalaria causes significant mortality and morbidity in sub-Saharan Africa, especially among children under five years of age and places a huge economic burden on individuals and health systems. While this burden has been assessed previously, few studies have explored how malaria comorbidities affect inpatient costs. This study in a malaria endemic area in Western Kenya, assessed the total treatment costs per malaria episode including comorbidities in children and adults.MethodsTotal economic costs of malaria hospitalisations were calculated from a health system and societal perspective. Patient-level data were collected from patients admitted with a malaria diagnosis to a county-level hospital between June 2016 and May 2017. All treatment documented in medical records were included as health system costs. Patient and household costs included direct medical and non-medical expenses, and indirect costs due to productivity losses.ResultsOf the 746 patients admitted with a malaria diagnosis, 64% were female and 36 % were male. The mean age was 14 years (median 7 years). The mean length of stay was three days. The mean health system cost per patient was Kenyan Shilling (KSh) 4,288 (USD 42.0) (95% confidence interval (CI) 95%CI KSh 4,046-4,531). The total household cost per patient was KSh 1,676 (USD 16.4) (95%CI KSh 1,488-1,864) and consisted of: KSh 161 (USD1.6) medical costs; KSh 728 (USD 7.1) non-medical costs; and KSh 787 (USD 7.7) indirect costs. The total societal cost (health system and household costs) per patient was KSh 5,964 (USD 58.4) (95%CI KSh 5,534- 6,394). Almost a quarter of patients (24%) had a reported comorbidity. The most common malaria comorbidities were chest infections, diarrhoea, and anaemia. The inclusion of comorbidities compared to patients with-out comorbidities led to a 46% increase in societal costs (i.e. health system costs increased by 43% and patient and household costs increased by 54%). ConclusionsThe economic burden of malaria is increased by comorbidities which are associated with longer hospital stays and higher medical costs to patients and the health system. Understanding the full economic burden of malaria is critical if future malaria control interventions are to protect access to care, especially by the poor.
Telemedicine application in patient with Diabetes, Hypertension and Rheumatoid arthritis：A systematic review and meta-analysis
Authors: Ma Yue , Zhao Yan , Zhao Chongbo , Lu Jiahong , Jiang Hong , Cao Yanpei , Xu Yafang
Published: June 2021

Background: Under the global epidemic condition，the telemedicine was widely used in the world, especially in the period of long-term care and treatment. The aim of study is to verify the effectiveness of telemedicine in the management of chronic disease by using scientific methods such as hypertension, diabetes, rheumatoid arthritis by using Meta-analysis and systematic review methods. The purpose of this study was to systematic review of the effect of telemedicine in chronic disease, so as to provide inspiration for chronic disease management in the future.Methods: Article searching were performed using Web of Science, PubMed, MEDLINE, EMBASE and other library or database to retrieve articles which published from database and library establishment to October 31st, 2020. Literature quality assessment, systematic review and Meta-analysis were then performed.Results: 12 articles were included in the literature quality assessment (7 diabetes,3 hypertensions,2 rheumatoid arthritis), the article included in this study is of high quality. There are 7 articles included in the Meta-analysis, the result shows there have effect in glycosylated hemoglobin after 12 months of intervention (95%CI=-1.53, -0.16; Z=2.42; P=0.02), compare with 6 months (95%CI=-1.32, -0.01; Z=1.99; P=0.05). It also showed that there was no significant difference in fasting blood glucose after 6 months of intervention (95%CI=-1.19,0.21; Z=1.37; P=0.17). Both systolic blood pressure (95%CI=-12.79, -3.69; Z=3.55; P= 0.0004) and diastolic blood pressure (95%CI=-9.90, -0.43; Z=2.14; P= 0.03) showed statistically significant. Moreover, we also found positive influence of telemedicine about good behaviors and rehabilitation for rheumatoid arthritis patients.Conclusion: The results showed that telemedicine had a positive effect on the management of diabetes, hypertension and rheumatoid arthritis, especially on the management of glycosylated hemoglobin and blood pressure. Telemedicine technologies have great promotion to access the medical services and improve the quality of care, especially for people with chronic diseases.
Chitosan-Glutathione Nanoparticles Modify Hepatic Cellular Response on Bovine Precision-cut Liver Slices Treated With Zilpaterol and Clenbuterol.
Authors: Olmos Sofìa Piña , Hernández Mariana Dolores , Torres Roberto Díaz , Bribiesca J. Efrén Ramírez , Arellano Raquel López , Noguera Patricia Ramírez
Published: June 2021

Zilpaterol and clenbuterol are two β-adrenergic agonist drugs used on animal production. Both drugs have anabolic effects with advantages on carcass yield. Meanwhile, zilpaterol is approved for animal feed in authorized countries; clenbuterol is a banned substance due to the risk of toxicity; however, it is still being used at unknown dose levels in many farm species. Therefore, the use and abuse of these substances should be closely monitored, considering the clenbuterol ability and the not proven yet of zilpaterol to produce reactive oxygen (ROS) and nitrogen species. Regarding glutathione which is the main intracellular antioxidant and plays detoxification functions on liver metabolism; case study is a primary interest to know the capacity of chitosan-glutathione nanoparticles (CS/GSH-NP) as a complementary source of exogenous GSH to modify the oxide-reduction status on bovine precision-cut liver slice cultures exposed to clenbuterol and zilpaterol. A single drug assay was performed in the first instance by adding clenbuterol, zilpaterol, chitosan nanoparticles (CS-NP), and CS/GSH-NP. Then combinate drug assay was carried out by testing clenbuterol and zilpaterol combined with CS-NP or CS/GSH-NP. The results showed that both agonist β-adrenergic modify in a dose-dependent manner oxide-reduction response through ROS generation, glutathione peroxidase activity, and intracellular GSH content; and de release of liver enzymes associated with hepatocellular damage like gamma glutamyl-transpeptidase, aspartate aminotransferase, alanine aminotransferase. The exogenous GSH delivered by nanoparticles could be used to modulate these markers.
Early changes in quantitative ultrasound imaging parameters during neoadjuvant chemotherapy to predict recurrence in patients with locally advanced breast cancer
Authors: Bhardwaj Divya , Dasgupta Archya , DiCenzo Daniel , Brade Stephen , Fatima Kashuf , Quiaoit Karina , Trudeau Maureen , Gandhi Sonal , Eisen Andrea , Wright Frances , Look-Hong Nicole , Curpen Belinda , Sannachi Lakshmanan , Czarnota Gregory
Published: June 2021

Background: This study was conducted in order to explore the use of quantitative ultrasound (QUS) based higher-order texture derivatives in predicting recurrence for patients with locally advanced breast cancer (LABC) early during neoadjuvant chemotherapy (NAC). Methods: Eighty-three patients with LABC were scanned with 7 MHz ultrasound before starting NAC (week 0) and during treatment (week 4). Spectral parametric maps were generated corresponding to tumor volume. Twenty-four textural features (QUS-Tex1) were determined from parametric maps acquired using grey-level co-occurrence matrices (GLCM) for each patient, which were further processed to generate 64 texture derivatives (QUS-Tex1-Tex2), leading to a total of 95 features from each time points. Analysis was carried out on week 4 data and compared to baseline (week 0) data. ∆Week 4 data was obtained from the difference in QUS parameters, texture features (QUS-Tex1), and texture derivatives (QUS-Tex1-Tex2) of week 4 data and week 0 data. Patients were divided into two groups based on their clinical status: recurrence and no-recurrence. Machine learning algorithms using k-nearest neighbor (k-NN) and support vector machines (SVM) were used to generate radiomic models. Results:  With a median follow up of 69 months (range 7-118 months), 28 patients had disease recurrence. The k-NN classifier was the best performing algorithm at week 4 with sensitivity, specificity, accuracy, and area under curve (AUC) of 87%, 75%, 81%, and 0.83, respectively. The inclusion of texture derivatives (QUS-Tex1-Tex2) in week 4 QUS data analysis led to the improvement of the classifier performances. The AUC increased significantly from 0.70 (without texture derivatives) to 0.83 (with texture derivatives). The most relevant features in separating the two groups were higher-order texture derivatives obtained from scatterer diameter and acoustic concentration-related parametric images.  Conclusion: This is the first study highlighting the utility of QUS radiomics in the prediction of recurrence during the treatment of LABC. It reflects that the ongoing treatment-related changes can predict clinical outcomes with higher accuracy as compared to pretreatment features alone.  Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT00437879 .Registry name: Clinicaltrials.gov.Date of registration: 20th February 2007URL: https://clinicaltrials.gov/ct2/show/study/NCT00437879
Healthcare Professionals’ Perceptions of Childhood Obesity in Iquitos, Peru: A Qualitative Study
Authors: Lai Jo F. , Clarke Joanne , Wildt Gilles , Meza Graciela , Addo Miriam A. , Gardiner Esme , Khanna Divya
Published: June 2021

Background: Childhood obesity is an urgent worldwide concern associated with increased morbidity in adulthood. Healthcare professionals (HCPs) are well placed to influence childhood obesity trends and implement interventions. English-language studies regarding HCPs’ perceptions of childhood obesity are limited to high-income countries. Peru is an upper-middle-income country with regional disparities in childhood obesity prevalence. This qualitative study aims to explore HCPs’ perceptions of childhood obesity in Iquitos, Peru, where prevalence is relatively low.Methods: Twenty-one HCPs with child healthcare experience were purposively recruited from two primary healthcare centres. Semi-structured, individual interviews were conducted with a translator and audio recorded. Transcribed data were analysed using thematic analysis.Results: Eight themes were identified and divided into four categories: (1) HCPs’ perceptions and attitudes towards childhood obesity (level of concern regarding childhood obesity, perceived consequences of childhood obesity); (2) Factors which HCPs perceive to be important in the development of childhood obesity (parental factors, contextual factors); (3) HCPs’ perceptions of their role in childhood obesity prevention and management (educating parents about childhood obesity, regular monitoring of child growth); and (4) Barriers and facilitators in childhood obesity prevention and management (in healthcare, in schools). Conclusions: HCPs had a low level of concern regarding childhood obesity in Iquitos and prioritised undernutrition. Parental factors were perceived to be the most influential in the development of childhood obesity. HCPs perceived themselves to have minimal influence due to prevailing positive views of excess weight and difficulties engaging parents. Educating parents about childhood obesity was felt to be essential to prevention and management although regular monitoring of child growth and home healthcare visits were viewed as useful additional measures. This study can help to inform the development of targeted public health strategies which are sensitive to local contexts and could prevent the upward childhood obesity trends evident elsewhere in Peru.
Bacteroidetal cold-active and promiscuous esterases play a significant role in global polyethylene terephthalate (PET) degradation
Authors: Zhang Hongli , Dierkes Robert , Pérez-García Pablo , Weigert Sebastian , Sternagel Stefanie , Hallam Steven , Schott Thomas , Juergens Klaus , Vollstedt Christel , Chibani Cynthia , Danso Dominik , Buchholz Patrick , Pleiss Jürgen , Almeida Alexandre , Hocker Birte , Schmitz Ruth , Chow Jennifer , Streit Wolfgang
Published: June 2021

Polyethylene terephthalate (PET) is an important synthetic polymer accumulating in nature and recent studies have identified microorganisms capable of degrading PET. While the majority of known PET hydrolases originate from the Actinobacteria and Proteobacteria, here we describe the first functional PET-active enzymes from the Bacteroidetes phylum. Using a PETase-specific Hidden-Markov-Model (HMM)-based search algorithm we identified two promiscuous and cold-active esterases derived from Aequorivita sp. (PET27) and Chryseobacterium jeonii (PET30) acting on PET foil and powder. Notably, one of the enzymes (PET30) was able to hydrolyze PET at temperatures between 4° - 30°C with a similar turnover rate compared to the well-known Ideonella sakaiensis enzyme (IsPETase).
PET27 and PET30 homologues were detected in metagenomes encompassing a wide range of different global climate zones. Additional transcript abundance mapping of marine samples imply that these enzymes and source organisms play a significant role in the long-term degradation of microplastic particles and fibers.
Optimal Value of CA19-9 Determined by KRAS-Mutated Circulating Tumor DNA Contributes to the Prediction of Prognosis in Pancreatic Cancer Patients
Authors: Watanabe Fumiaki , Suzuki Koichi , Tamaki Sawako , Abe Iku , Endo Yuhei , Takayama Yuji , Ishikawa Hideki , Kakizawa Nao , Saito Masaaki , Futsuhara Kazushige , Noda Hiroshi , Konishi Fumio , Rikiyama Toshiki
Published: June 2021

Despite the acceptance of carbohydrate antigen 19-9 (CA19-9) as a valuable predictor for the prognosis of pancreatic ductal adenocarcinoma (PDAC), controversy remains with regards to its cutoff. Our previous study showed a significant correlation between CA19-9 levels and the presence of KRAS-mutated ctDNA in the blood of patients with PDAC. Based on this correlation, we investigated the optimal cutoff value of CA19-9 before surgery. Continuous CA19-9 values and KRAS-mutated ctDNAs were monitored in 22 patients with unresectable PDAC who underwent chemotherapy between 2015 and 2017. Receiver operating characteristic curve analysis identified 949.7 U/mL of CA19-9 as the cutoff value corresponding to the presence of KRAS-mutated ctDNA. The median value of CA19-9 was 221.1 U/mL. These values were then verified for their prognostic values of recurrence-free survival (RFS) and overall survival (OS) in 60 patients who underwent surgery between 2005 and 2013. Multivariate analysis revealed that 949.7 U/mL of CA19-9 was an independent risk factor for OS and RFS in these patients (P=0.001 and P=0.010, respectively), along with lymph node metastasis (P=0.008 and P=0.017), but the median CA19-9 level was not (P=0.150 and P=0.210). The optimal CA19-9 level contributes to the prediction of prognosis in patients with PDAC before surgery.
A Novel Mutation KCNJ11 R136C Caused KCNJ11-MODY
Authors: Chen Yaning , Hu Xiaodong , Cui Jia , Zhao Mingwei , Yao Hebin
Published: June 2021

A young female patient, diagnosed with diabetes mellitus at the age of 28 years old in 2009, carries KCNJ11 R136C by whole-exome sequencing and her daughter doesn’t carry this mutation. Bioinformatics software predicted that the 136th amino acid is highly conservative and deleterious. And KCNJ11 R136C can result in the change of channel port structure of KATP channel. So she was diagnosed as KCNJ11-MODY.
Radiation-induced Fibrosarcoma of the Larynx: a Case Report and Review of Literature
Authors: Gong Wei , Huang Donghai
Published: June 2021

Background: Radiation-induced sarcoma (RIS) is a rare complication following radiotherapy of head and neck carcinoma. It occurs mostly within the limits of the irradiated area and always suggests a poor prognosis. Case summary: Herein, we reported one case of a 61-year-old male with laryngeal squamous cell carcinoma (SCC), who had a history of surgery and radiotherapy. In 2014, this patient was admitted in our hospital for increasing hoarseness five years after surgery and radiotherapy. Finally, the patient was diagnosed as fibrosarcoma and was given total laryngectomy, the patient was died in August 2019 within following up. In addition, the clinical and pathological characteristics of similar cases and their probable tumorgenesis were also reviewed. Conclusion: RIS is increasingly important. They usually occur mostly within the limits of the irradiated area. SCC is the most common malignant tumour in the head and neck region, and radiotherapy is a primary adjuvant therapy method. For patients receiving radiotherapy, physicians should follow up more carefully for early detection the RISs. For sarcomas occurring in head and neck region, especially RIS, complete surgical resection is the primary treatment. The choice of radiotherapy and chemotherapy should be more cautious. The prognosis of primary sarcomas or RISs is still controversial. No matter primary sarcomas or RISs, we believe that complete surgical resection should be considered as a top priority in surgery.
Assessment of Knowledge toward Scabies, its Transmission and Prevention among Syrian Refugees in North of Jordan
Authors: Seetan Khaled , Rashdan Yasser , Alsharei Adel , Bashir Sharaf Al , Almadani Abdallah , Alqa'dan Mousa , Momani Ashraf Ashraf Al , Rubbai Yousef , Samarah Hashem Al
Published: June 2021

Background: Scabies is one of the prevalent dermatological conditions, accounting for a substantial proportion of skin diseases in developing countries. It represents a significant health challenge when an outbreak appears in homecare and refugee camps as it may lead to enormous morbidity and high treatment costs. Because scabies can be easily prevented through education, the purpose of this study was to assess the level of scabies knowledge among Syrian refugees in Jordan's northern region. Methodology: This cross-sectional study was conducted among Syrian refugees who attend a primary health center in northern Jordan, Ramtha from March 2021 to April 2021. The targeted population was adult Syrian refugees, above the age of 18. Two thousand participants were included in this study using simple random selection. The study questionnaire included questions about socio-demographic characteristics and knowledge questions such as: ever hearing about scabies, causes of scabies, signs and symptoms of scabies and its way of transmission. The data was analyzed using (SPSS) version 25. Results: Females with a mean age of 37.9 years old comprised the majority of the participants. The majority of the participants was married and had intermediate levels of education. The level of knowledge about scabies was poor among the majority of the respondents (N=1259); 321 respondents had moderate knowledge, while only 650 had good knowledge. A statistically significant association was found between knowledge score and all demographic characteristics, including gender, marital status, income and educational level.Conclusion: The general knowledge about Scabies among Syrian refugees is relatively low, with 1259 out of 2000 participants having a poor knowledge score. Health education for refugees is needed to improve their knowledge and help implement prevention programs.
Image Denoising to enhance Character Recognition using Deep Learning
Authors: ruata Vanlal , Hussain J.
Published: June 2021

In this paper, we proposed implementing a Deep Convolutional Neural Network. A relationship between a noisy character image to its clean counter-part are mapped using Deep Convolutional Neural Network.The overall process is divided into two stages: noise type classification and image denoising. Firstly, the noise type classification identifies the types of noise, and based on this noise type, a particular denoising model is selected, which increases the image denoising performance. The denoising network inputs a noisy image and a target of its clean corresponding image during the training. After the mapping function is trained, the generated model performs character image denoising. Then, on each band, a trained mapping function perform image denoising irrespective of the other band. Finally, each block is assembled to generate a clean image. In this paper, the MNIST and Char74K dataset of handwritten digits diluted with artificial noise divided into ten types are used for experimentation.. Our experimental results show that the proposed techniques perform better image denoising ascompared to the existing methods, both in terms of image noise type classification and image denoising. The overall Character recognition accuracy increased by 66% after performing the proposed denoising technique.