Search results for “Sensitivity”

Baroreflex Sensitivity, Cardiac and Kidney Remodeling and Deterioration in Vasoactive Substances Content in Blood in Experimental Model of Renovascular Hypertension. Action of Natural Flavone, Luteolin

This study aimed to analyze pharmacological actions of phenolic compound luteolin on the renal and cardiac hypertrophy, blood pressure (BP), baroreflex sensitivity (BRS), levels of epoxyeicosatrienoic acids (EETs), prostaglandin E-2 (PGE-2) and endothelin-1 (E1) in plasma in the 2 kidney - 1 clip (2K-1C) model of renovascular hypertension (RVH). All animals, were randomized into 2 groups: control (normal) I - sham-operated, II- RVH male Wistar rats, which after 4 weeks of surgical intervention secondly randomized to control II group, treated 0.1% dimethyl sulphoxide (DMSO) and main group - with luteolin in 15 DMSO, 3 mg/kg body weight, intraperitonially, during 2 weeks. ET-1, EETs and PGE2 levels investigated in carotid artery blood plasma and analyzed using ELISA kits. All data statistically analyzed using the SPSS-10.0 program. In RVH rats BP increased by 32%, cardiac and right kidney hypertrophy and reduction in parasympathetic component of BRS by 40% and sympathetic by 39%. The plasma level of total trans-EETs and PGE2 in RVH rats decreased by 44% and 50% respectively, while the level of ET-1 increased by 67%. Two weeks treatment with luteolin lowered BP, improved parasympathetic, without marked changes in sympathetic component of BRS. Deremodeling of cardiac and renal hypertrophy under prolonged treatment with luteolin accompanied with increasing in the level of EETs by 44%, PGE-2 by 50% and markedly reducing of plasma content of ET-1 (by 60%). Inhibition of EET hydrolase using low doses of luteolin provides beneficial cardio and renoprotective action in experimental model of RVH.

Cross-Reactivity between COX-2 Inhibitors in Patients with Cross-Reactive Hypersensitivity to NSAIDs

The safety of cyclooxygenase (COX)-2 inhibitors has been tested in patients who had cross-reactive hypersensitivity reactions (HSRs) to nonsteroidal anti-inflammatory drugs (NSAIDs). However, these studies have been mainly done before the current classification of NSAID hypersensitivity and cross-reaction between COX-2 inhibitors has been rarely reported.We aimed to assess tolerability of COX-2 inhibitors and to evaluate the cross-reactivity between them in cross-reactive phenotype of NSAID hypersensitivity. The diagnosis was based on clinical features, reliable history of HSRs to at least two chemically different NSAIDs, and/or positive provocation tests with implicated NSAIDs in 151 patients. Single-blind, oral challenges with 1/4 and 3/4 divided doses of placebo, nimesulide, meloxicam, and celecoxib, as COX-2 inhibitors, were performed. The most common cross-reactive phenotype was NSAID-induced urticaria/angioedema (56.3%). Positive reactions to meloxicam, nimesulide, and celecoxib challenges were observed in 23/140 (16.4%), 7/33 (21.2%), and none of six patients, respectively. Overall, 24 patients were tested with two, one was tested with three COX-2 inhibitors. Six (31.6%) of 19 patients with meloxicam intolerance reacted to nimesulide provocation. Nimesulide, meloxicam, and celecoxib appeared safe alternatives in cross-reactive phenotypes of NSAID hypersensitivity. Although celecoxib has the most favorable tolerability, cross-reactivity among COX-2 inhibitors seems to be possible.

Determining the Efficiency of Fuzzy Logic EOQ Inventory Model with Varying Demand in Comparison with Lagrangian and Kuhn-Tucker Method Through Sensitivity Analysis

This paper considers an EOQ inventory model with varying demand and holding costs. It suggests minimizing the total cost in a fuzzy related environment. The optimal policy for the nonlinear problem is determined by both Lagrangian and Kuhn-tucker methods and compared with varying price-dependent coefficient. All the input parameters related to inventory are fuzzified by using trapezoidal numbers. In the end, a numerical example discussed with sensitivity analysis is done to justify the solution procedure. This paper primarily focuses on the aspect of Economic Order Quantity (EOQ) for variable demand using Lagrangian, Kuhn-Tucker and fuzzy logic analysis. Comparative analysis of there methods are evaluated in this paper and the results showed the efficiency of fuzzy logic over the conventional methods. Here in this research trapezoidal fuzzy numbers are incorporated to study the price dependent coefficients with variable demand and unit purchase cost over variable demand. The results are very close to the crisp output. Sensitivity analysis also done to validate the model.

Retraction: Efficacy of BCG Vaccine and Role of Non Specific Sensitivity Due to Atypical Mycobacteria

RETRACTED: Efficacy of BCG Vaccine and Role of Non Specific Sensitivity Due to Atypical Mycobacteria

This article has been retracted on December 28, 2018. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2577-137X.ji-25-5837) This paper attempts to summarizes possible reasons for BCG trial failure in India. It also lists out some of the important controversies and questions raised with regards to BCG trial in the context of Non Specific sensitivity. It emphasizes on the fact, that Tuberculin test does not accurately reflect individual’s responded immunologically to mycobacterium, it only indicates nature of immune response that has been elicited in an infected individual. The dynamics of tuberculin reaction needs to be understood through immunological considerations. Categorization of Tuberculin test results factoring in immunological considerations,will have great implication on the interpretation of tuberculin test and therefore on the estimation of annual risk of infection of tuberculosis.

Identification of insulin-sensitive obese vs. insulin resistant obese postmenopausal women: Evaluation of surrogate indices of insulin sensitivity.

Introduction. Obesity often coexists with insulin resistance, which is related to cardiometabolic risk. However, some obese individuals exhibit comparable insulin sensitivity (IS) to that of normal-weight subjects, a state associated with a reduced cardiometabolic risk. We aimed to determine the efficacy of a panel of surrogate markers of insulin sensitivity (IS) for the identification of insulin sensitive obese (ISO) vs. insulin resistant obese (IRO) with similar total fat mass (FM) and body mass index (BMI). Methods. This is a cross-sectional analysis among 144 overweight and obese post-menopausal women. IS was determined by the hyperinsulinemic-euglycemic clamp (HEC) and by surrogate indices such as Matsuda index, the simple index assessing insulin sensitivity using oral glucose tolerance test (SIisOGTT), Abdul-Ghani liver IS index, HOMA-IR and Abdul-Ghani muscle IR index. Results. When using upper and lower quartiles values or the median as cut-off for IS determined by the reference HEC to define ISO vs. IRO, Matsuda index, SIisOGTT and Abdul-Ghani indices classification identified ISO vs. IRO individuals with similar FM and BMI. With HOMA-IR, the two groups were similar for FM and had borderline significant difference in BMI. Using, receiver operating characteristic curves, Matsuda index AUC was similar to that of SIisOGTT and both indices AUCs were significantly higher than Abdul-Ghani indices AUCs. The best cut-off value for the Matsuda index was 2.5 (83.1% specificity, 54.2% sensitivity) and 0.25 for SIisOGTT (64.8% specificity, 70.8% sensitivity). Conclusion. Whole body IS indices, Matsuda and SIisOGTT indices seem to be reliable indices for the identification of ISO vs. IRO individuals.

Contact Hypersensitivity to Lavender Oil in Hungary: A Multicentre Survey 2013-2014

Background: Lavender has been used for centuries, but its exposure has become part of the everyday life in our days. It is used in the alternative medicine, and as a flavouring component in soaps, cosmetics and in food products (chocolate, ice-cream, spices). The increasing number of exposures resulted the appearance of hypersensitivity- reactions. Objectives: A survey on the prevalence of lavender hypersensitivity was conducted by the Contact Dermatitis Work-Group of the Hungarian Dermatological Society in a multicentre, prospective study. Patients and Methods: 1509 consecutivedermatological patients of 7 dermatological centres were involved in this study. Results were based on the analyses of age distribution and characteristic clinical signs of the patients, on symptoms-localization, and on relevance of positive skin lavender oil test results as well as other associated contact hypersensitivities. Results: We detected 8 patients with lavender hypersensitivity (0.53%). Typical localisations of skin symptoms were face, eyelids and hands. Associated hypersensitivity to fragrance and balsam components were not detected. Conclusion: The lavender hypersensitivity of our patients couldn’t be detected by fragrance screening allergens.The use of lavender oil in cosmetics and foods is very popular. The different types of contacts may result further increase of the sensitivity rate worldwide.

Apomorphine Subcutaneous Infusion is More Efficient Than foslevodopa/foscarbidopa Subcutaneous Infusion in the Treatment of Advanced Parkison´s Disease for the Spanish National Health System

Objectives Motor fluctuations and non-motor disorders not manageable by first-line treatments in advanced Parkinson's disease require continuous dopaminergic stimulation strategies such as subcutaneous infusions of apomorphine (APO) or foslevodopa/foscarbidopa (FLD/FCD). A Budget Impact Analysis (BIA) was performed to estimate the cost difference between both treatments assuming equivalent clinical efficacy and safety. Material and methods The efficacy results of pivotal clinical trials at 12 and 52 weeks of treatment and the safety profile of APO vs FLD/FCD were compared, based on latest scientific publications and other available clinical data. A comparative BIA was performed, based on estimated annual drug treatment costs at Spanish published prices. Results The efficacy of APO (16 h/day) and FLD/FCD (24 h/day) in reduction of OFF hours (2.47 vs 2.75, 12 weeks; 3.66 vs 3.50, 52 weeks; respectively) and increase of ON hours without disabling dyskinesias (2.77 vs 2.72, 12 weeks; 3.31 vs 3.80, 52 weeks; respectively) could be considered clinically equivalent, as well as their safety profiles. However, a significant discrepancy is observed in the costs of the aforementioned alternatives. Considering published prices and the average dose reported in the literature, in Spain the annual cost of APO would be €13,980 compared to €55,198 for FLD/FCD. Consequently, the financial resources required for the treatment of FLD/FCD would enable the treatment of approximately three to four patients with APO. The BIA indicated the potential for annual savings in more than €2,500 million, considering a total target population of over 60,000 patients per year. Finally, an univariant sensitivity analysis was performed, considering a scenario in which the hospital acquisition cost of FLD/FCD decreased between 20%-30% (€44,159- €38,638/year). In this scenario, the total annual savings range between €1,875-€1,532 million per year. Conclusions Overall APO is more efficient than FLD/FCD, as it provides similar clinical efficacy at a lower treatment cost. The selection of an appropriate treatment option is to be determined by clinical criteria and patient characteristics, but cost evaluation should be considered to select the most cost-effective therapeutic option.

The Dose Modulates the Body’s Physiology: Literature Review

The body interacts with endogenous and exogenous molecules through various receptor networks at the cellular and organismal levels by which the different physiological processes of the organ systems get activated. Life could no longer exist without the body’s interaction with these signaling molecules. The number of molecules interacted with a receptor type within the body determines the efficiency of biological processes that would determine the biochemistry and anatomy behind the basic body functions. The dose plays a complex role in multiple physiological processes by modulating the natural processes of the different biological systems. It is always connected to the physiological and anatomical aspects of the biological sciences in which it manifests the biological sensitivity that would determine the efficiency of biological responses of the body systems. There are always physiologic and non-physiologic doses for every compound administered into the biological systems. The does that facilitated the body to manifest that biological sensitivity which has maintained the physiological processes of the body systems was noted as physiologic dose, whereas the dose that has suppressed the biological sensitivity of the body that became inefficient in maintaining the physiological processes of the different biological systems was termed non-physiologic dose. It is important to adjust the dose or dosage based on physical and biological factors such as the efficiency of the different organ systems, body weight, and the timing of the dose triggering a biological response to maintain the natural processes of the body systems. This means that integrated biological data is required in order to be able to identify the physiologic and non physiologic doses for biological or pharmacological use.

Mathematical Modelling of Typhoid Fever Transmission Dynamics and Intervention Impact in Harare, Zimbabwe (2018–2020)

Background Typhoid fever remains a significant public health issue in Harare City, Zimbabwe, exacerbated by recurrent outbreaks between 2018 and 2020. Key challenges, including inadequate water supply and sanitation infrastructure, high population density, and limited healthcare access, have intensified the disease burden. Understanding the key transmission drivers and assessing the impact of various interventions are essential for informing policy and health strategies. Objectives This study aimed to: 1: To predict future trends in typhoid fever cases Harare City typhoid hot areas. 2: To develop a mathematical model to simulate the spread of typhoid fever incidence under different intervention scenarios and recommend evidence-based strategies for reducing the disease burden in Harare City. Methods A dynamic compartmental SIR-based model, adapted from the Pitzer Vaccine Effectiveness (VE) framework, was employed to simulate disease transmission. This model accounted for both short-cycle (human-to-human) and long-cycle (environmental) transmission pathways. Data from Harare City (2018–2020) were used for model calibration and forecasting, and sensitivity analysis was performed to assess the impact of different intervention levels. Findings The model identified inadequate sanitation, contaminated water sources, and low health- seeking behaviors as primary drivers of typhoid transmission. In the absence of interventions, the model projected a sustained high rate of transmission. However, treatment and WASH interventions could reduce the disease burden by 50–60%, while combined strategies incorporating vaccination and education led to an 80% reduction in cases. Sensitivity analysis indicated that treatment and WASH interventions were particularly impactful at moderate coverage levels. Conclusion Mathematical modeling effectively demonstrated the multifactorial drivers of typhoid fever transmission in Harare. Integrated interventions that combine WASH, vaccination, treatment, and education present the most promising approach for long-term control of the disease. The findings offer a solid, data-driven foundation for public health decision-making and resource allocation.

Diagnostic Performance of Smear Microscopy and Xpert MTB/RIF Versus MGIT Culture in Republic of Congo

In the Republic of the Congo, tuberculosis (TB) remains a major public health concern. Although the GeneXpert MTB/RIF assay is the WHO-recommended first-line diagnostic test, smear microscopy is still used for treatment monitoring and in facilities where molecular testing is limited. Evaluating the diagnostic accuracy of smear microscopy compared to GeneXpert and MGIT culture is essential to guide diagnostic strategies and strengthen TB control in the country. A cross-sectional study was conducted among 92 presumptive pulmonary TB patients at Makelekele Hospital. Sputum samples were analyzed by smear microscopy, GeneXpert MTB/RIF, and MGIT culture. Sensitivity, specificity, positive and negative predictive value were calculated for smear microscopy and GeneXpert, using culture as the reference standard. Culture detected more Mycobacterium tuberculosis than microscopy (49% vs. 32%, P<0.001). Smear microscopy showed a sensitivity of 58% (95% CI: 43–71%) and specificity of 92% (95% CI: 80–97%). GeneXpert detected more MTB (62% vs. 49%, P<0.001) with a sensitivity of 98% (95% CI: 89–100%) and specificity of 72% (95% CI: 58–83%). GeneXpert showed superior sensitivity for TB detection, while microscopy remained specific. Expanding GeneXpert testing across the Republic of the Congo will improve TB management.

Vulnerabilities in Environment and Health Due to Climate Change and Extreme Hydrological Events: Determinants for Risk Reduction

This short communication/mini-review immensely emphasizes human health to explicate and elucidate management of the global scourge associated with the determinants and impact of vulnerabilities to extreme hydrologic events and climate change in the absence of risk reduction and their concomitant sequelae. The most effective approach for risk reduction associated with biodiversity, environmental, and health vulnerabilities due to climate change and extreme hydrological events, an ecological framework must take into cognizance exposure, vulnerability, and resilience. This framework emphasizes the significance of understanding the inextricable linkage between ecosystems and human communities are exposed and susceptible to hazards, sensitivity to these hazards, and capacity to cope, adapt and recuperate. Risk reduction incorporates structurally attenuating exposure, strengthening resilience, and sustainably enhancing overall vulnerability management. Extreme weather and climate-associated incidents impinge on human health with consequential morbidity, mortality and socioeconomic challenges and constraints. Climate change and extreme event have altered the frequency, intensity, geographic distribution, and propensity as drivers for change in the future. The indicted variables include hydrological events, such as precipitation, floods and droughts as well as heat waves, wildfires, global warming, extreme temperatures, and hurricanes. The pathways inextricably-linked with extreme events to economic dissipation, human health prognosis and outcomes remain inexplicably diverse and complex; and thus, difficult to predict due to their emergence and reemergence from local, societal and environmental factors which influence disease burden.

Trading on Impulse: The Role of ADHD, Impulsivity, and Gender in Financial Risk and Investment Outcomes

Background Attention-deficit/hyperactivity disorder (ADHD) in adulthood is increasingly recognized not only as a psychiatric condition but also as a trait with behavioral and occupational implications—particularly in high-stakes, fast-paced financial environments. Traits such as impulsivity, sensation seeking, and altered reward sensitivity may influence decision-making among individuals engaged in stock trading or high-risk investment professions. Objective This systematic review and meta-analytic synthesis aims to investigate the relationship between ADHD, impulsivity, gender differences, and financial risk behavior, with a particular focus on decision-making outcomes in real or simulated trading contexts. Methods Seventeen peer-reviewed studies published between 2008 and 2025 were included. Studies employed behavioral experiments, fMRI paradigms, neurochemical analysis (e.g., glutamate levels), and ecological financial assessments to examine impulsive traits and investment behaviors among adults with and without ADHD. Both clinical samples and occupational cohorts (e.g., brokers, retail investors) were analyzed. The analysis followed PRISMA 2020 guidelines. Results ADHD symptoms—particularly impulsivity and reward hypersensitivity—were associated with increased delay discounting, higher risk-taking, and diminished cognitive control in financial tasks. Neuroimaging data revealed hypoactivation in prefrontal control regions and hyperactivation in reward-related circuits (e.g., ventral striatum). Gender-stratified analyses showed that males with ADHD displayed stronger preference for immediate rewards, higher portfolio turnover, and greater volatility. Preliminary evidence also suggests an overrepresentation of ADHD traits in high-frequency trading roles. Conclusion ADHD-related impulsivity significantly modulates financial risk behavior, particularly in high-stakes and fast-paced contexts such as trading. A convergence of behavioral, neurobiological, and ecological findings suggests that males with ADHD are disproportionately prone to rapid, high-risk financial decisions, whereas females may demonstrate greater regulatory control. These insights underscore the need for gender-sensitive interventions, occupational screening, and tailored psychoeducation. As financial environments become increasingly automated and fast-paced, understanding the neurocognitive vulnerabilities of individuals with ADHD may not only protect personal outcomes but also enhance systemic financial stability.

Antibiotic-Resistant Urinary Tract Infection in a Bahamian Woman: A Case Report

Bacterial resistance to antibiotics is becoming a major public health challenge in the Bahamas. Indiscriminate use of antibiotics by medical practitioners is a major contributor to this problem. We describe a 53-year-old woman who presented with symptoms of a urinary tract infection. Empiric treatment with first- and second-line antibiotics, namely trimethoprim-sulfamethoxazole and ciprofloxacin, respectively, were ineffective in clearing the infection. After culture and sensitivity testing via minimum inhibitory concentration analysis, nitrofurantoin proved to be the only effective oral antibiotic.

Prevalence and Antifungal Susceptibility of Candida species from patients attending Rivers State University Teaching Hospital, Nigeria

The development of medical therapy and patients profile has led to a rise in the incidence of nosocomial fungal infection. The frequency of candidiasis has surged worldwide, and the prevalent of healthcare diseases are now Candida species. Candida species causes a range of human infections known as Candidiasis. The non-albicans Candida (NAC) species have recently superseded Candida albicans as significant opportunistic pathogens. The study was conducted to determine the prevalence and antifungal susceptibility of Candida species isolated from various Clinical samples in Rivers State University Teaching Hospital, Port Harcourt, Nigeria. A total of 206 clinical specimens from male and female patients of all ages were sampled in the Department of Microbiology, Rivers State University Teaching Hospital, Port Harcourt, to investigate suspected Candida infections. The isolation and identification of Candida species was done by culture on SDA, Gram stain, sugar fermentation and phylogenetic profiling. Antifungal susceptibility pattern was done by Disc Diffusion method using Fluconazole, Ketoconazole, Miconazole, Nystatin and Itraconazole. The results showed that out of 206 specimens, 44 isolates (21.4%) were identified, with the majority (56.82%) from high vaginal swabs (HVS), followed by urine (31.82%) and oral swabs (11.36%). The age of patients ranged from four months to 73 years giving a Mean Age 1.86+ 0.344, with females (85.4%) outnumbering males (13.6%). Prevalence of Candida spp revealed Candida albicans (50%), Candida krusei (18.2%), Candida parapsilosis(11.4%), Candida glabrata and Candida tropicalis (9.1%) respectively and Candida pelliculosa (2.2%), with C. albicans being the most prevalent. The antifungal susceptibility testing among the azoles showed that Fluconazole (79.5%) and Ketoconazole (77.3%) were most sensitive agents against isolates from HVS, urine and oral swabs respectively and Itraconazole (34.1%) was most resistant especially to those from oral swabs. This study highlights the increasing prevalence of NAC species over Candida albicans and the growing resistance of Candida isolates to commonly used antifungal drugs. Diagnosis of these species of Candida and sensitivity to antifungal agents are critical components to treatment, particularly for patients with severe underlying illnesses who are hospitalized.

A Cross Sectional Analysis of Frailty and Markers of Frailty in Young People Living with HIV/AIDS

Background Frailty is an ageing-associated state linked to poor prognostic outcomes. Chronic inflammation due to HIV-infection, AIDS-related infections. and the adverse effects of antiretroviral therapy (ART) all contribute to frailty in people living with HIV/AIDS (PLHA). Frailty has been comprehensively studied in populations comprising predominantly of Caucasian PLHA. However, there remains a dearth of such data in Indian populations, especially in younger PLHA. Methodology This cross-sectional study aimed to estimate the prevalence of frailty in PLHA (18 - 50 years) who had been on ART for 24-60 months and identify markers linked to frailty. Frailty was assessed in 152 subjects using the Fried frailty-index. Parameters measured included the mid-upper arm and calf circumferences, pain-severity (using the Brief Pain Inventory), highly-sensitivity C-reactive protein, d-dimer, and interleukin-6. Results The prevalence of frailty and pre-frailty were 6.58% and 23.02%, respectively. Reduced grip strength and self-reported exhaustion were associated with frailty (15.79% and 13.16%, respectively). Low calf-circumference and mid-upper arm circumference were not significantly associated with frailty/pre-frailty. The prevalence of pain was 21.7% and both pain severity and pain interference were significantly associated with frailty/pre-frailty. CD-4 counts at the time of assessment showed an inverse association with frailty. Elevated C-reactive protein (CRP of 0.04 associated with 0.49 probability of frailty (95% CI 0.40 – 0.59), CRP of 0.12 associated with 0.63 probability of frailty (95% CI 0.47 – 0.76)). D-dimer levels were not significantly associated with frailty /pre-frailty. Conclusion In this first-of-its-kind study on frailty in young PLHA (mean age 37 years) from the Indian sub-continent, the prevalence of frailty and pre-frailty was 6.58% and 23.02%, respectively. Multivariate analysis showed a strong association of frailty with pain severity, CD4 count at time of assessment, hs-CRP levels and duration of ART.

Comparative Analysis of Five Commercial RT-PCR Diagnostic Assay for Detection of Covid-19

SARS-CoV-2 real-time reverse-transcription PCR (rRT-PCR) is the most effective testing system available to combat COVID-19, given the absence of any specific treatment or vaccine. Moreover, numerous SARS-CoV-2 rRT-PCR kits have been approved under emergency-use-authorization (EUA) worldwide. In this article, we present a comparison of important performance features among five commercial RT-PCR assays. A total of consecutive nasopharyngeal (NPS) samples and oropharyngeal (OP) swabs were collected from 50 COVID-19 patients to analyze sensitivity and specificity. The results showed variations in sensitivity among all the RT-PCR kits examined. The Pishtaz teb assays demonstrated the highest positive percent agreement (PPA) of 95.2% (40/42), followed by Covitech (90.5% - 38/42), DaAn Gene (83.3% - 35/42), Sansure (66.66% - 28/42), and Power check of SARS- CoV-2 panel (64.3% - 27/42). Conversely, all five molecular assays demonstrated a negative percent agreement (NPA) of 100% (8/8). These findings provide a technical baseline for assessing the performance of five distinct commercial PCR assays for detecting SARS-CoV-2. They could prove practical and useful for laboratories seeking to purchase any of these assays for further clinical validation. Highlights ·Compared five COVID-19 RT-PCR kits approved and available by Iran Ministry of Health. ·Pishtaz teb's kit identified the highest number of positive clinical samples.

Detection of carbapenem resistance mechanisms among Avian Pathogenic Escherichia coli (APEC) isolated from broiler chickens

Background The emergence and spread of carbapenem-resistant gram-negative bacteria pose a serious threat to human health. Currently, little is known about the molecular mechanisms underlying carbapenem -resistance and their prevalence among APEC in Egypt. The aim of this study was to detect APEC in clinically diseased broiler chickens collected from broilers farms located at Dakahalia governorates, asses their virulence –associated genes, detect the antimicrobial susceptibility of recovered isolates and to detect genes encoding carbapenemase resistant. Methods A total of 100 organ tissue samples subjected to conventional culture technique for isolation of E. coli. The confirmed E. coli were subjected to disc diffusion method for detection their susceptibility to antimicrobials. Polymerase chain reaction (PCR) was used for detection of APEC virulence genes (hlyA, iutA, ompT, iss, iroN) and six carbapenem- resistant genes namely, blaIMP, blaVIM, blaKPC, blaOXA-48 blaGES and blaNDM,. Results Forty isolates were confirmed to be E. coli  among them, three or more APEC virulence- genes were detected from all isolates. The hlyA gene was detected in 90% (36/40), iroN in 95% (38/40), ompT in 97.5% (39/40), iutA in 92.5% (35/40) and iss was detected in 95% (38/40) of APEC isolates The tested isolates exhibited a remarkable resistance to ampicillin (97.5%), cefuroxime (92.5%), clindamycin (90%), chloramphenicol (62.5%), doxycycline (45%), amikacin (25%) and ciprofloxacin (12.5%). While, the retrieved isolates displayed 100 % sensitivity against imipenem, meropenem, ertapenem, ceftazidime and colistin. Concerning carbapenemase-encoding genes, blaIMP, blaVIM, blaKPC, blaOXA-48, blaGES  couldn’t be detected among the E. coli isolates, while, blaNDM was confirmed in three isolates . Conclusion The detection of NDM as one of the carbapenem resistant genes reveals that the resistant strains are not only capable of infecting humans, but that carbapenams- resistant E. coli (CREC)  has also started to pose a threat to poultry farm and other livestock animals. This may give rise to worries that these food-carrying creatures could infect humans or colonize them.

A review of ultrasound for the diagnosis of acute appendicitis in adults

Acute appendicitis is one of the most common surgical emergencies globally, with a lifetime incidence of 8.6% in men and 6.7% in women. While acute appendicitis should be managed promptly to reduce the morbidity associated with perforated appendicitis, morbidity from negative appendicectomy is similar to morbidity from uncomplicated appendicitis. Computer tomography is widely used to aid in the diagnosis of acute appendicitis, however, is costly, often has a slow turn around time, and is associated with exposure to ionising radiation. In contrast, ultrasound is cheap, widely available, requires minimal patient preparation, and does not require exposure to ionising radiation. Ultrasonography is becoming increasingly used for adult patients in emergency settings. The literature has estimated the sensitivity of ultrasound for acute appendicitis in adult patients as between 39-96.4%. The sensitivity and specificity of ultrasound for the diagnosis of acute appendicitis is significantly increased when the appendix is visualised. In cases of a non visualised appendix, indirect ultrasound signs can improve the sensitivity to 93.9% and specificity to 85.7%. The variation in sensitivity and specificity for ultrasound in the diagnosis of acute appendicitis in adults may be due to multiple factors. Ultrasonographer experience, a retrocaecal appendix and obesity have all been described. Given the availability, cost and potential to reduce the rate of negative appendicectomy, ultrasound should be considered as the first line imaging modality for adult patients presenting with suspected AA.

Evaluation of selection indices for heat tolerance and their correlation with yield in some chickpea (Cicer Arietinum L.) genotypes of sudan

The major a biotic stresses affecting chickpea production are high and low temperature, drought and salinity. Heat stress is a major a biotic stress factor, constraining chickpea production worldwide. This study was conducted to identifying chickpea genotypes combining heat tolerance and high yield potential and to study correlation among the heat tolerance indices. The genotypes were tested under different field-growing conditions, normal sown (non – heat stress) and late sown (heat stress) at two locations, Merowe and Gezira during winter season 2018/2019. The trials were laid out in alpha lattice design with three replications. Eight heat tolerance indices, which were most frequently used in plant breeding including, geometric mean productivity (GMP), yield index (YI), mean productivity (MP), stress susceptibility index (SSI), stress tolerance index (STI), tolerance index (TOL), sensitivity heat index (SHI) and relative heat index (RHI) were calculated based on seed yield under heat stress (Ys) and non – heat stress (Yp) conditions. Under both environments, the results from combined analysis of variance showed that there were highly significant differences among the genotypes for all traits studies. There were highly significant differences observed among the tested chickpea genotypes response to heat stress. Seed yield in stress (Ys) condition was positive and highly significant correlated with geometric mean productivity, yield index, stress tolerance index and relative heat index. The Ys was negative and highly significant correlated with stress susceptibility index and sensitivity heat index. Seed yield in non-stress (Yp) condition was positive and significant correlated with geometric mean productivity, yield index, stress tolerance index and tolerance index. The results of this research showed that the six indices, GMP, YI, SSI, STI, SHI and RHI can be used as optimal indicators for screening heat tolerant chickpea genotypes. Nine genotypes including four released improved varieties (Shiekh Mohamed, Wad Hamid, Salwa and Hwata) and five genotypes (no. 11, 4, 26, 30 and 34) are most stable chickpea genotypes for heat tolerance and can be further used in breeding program. These genotypes can be used in the chickpea national breeding program to develop varieties with improved heat tolerance in Sudan. Genotype no. 11 (FLIP 08-59 C) was release by Sudan national variety release committee for commercial production under the name Elbarkal in September 2022 to will be grown in Gezira, River Nile and Northern States of Sudan.

The Impact of Chest Computed Tomography in A Covid-19 Reference Hospital - First Wave - Distrito Federal - Brazil

Objectives To evaluate the diagnostic accuracy of chest CT for the diagnosis of COVID-19 associated with the clinical presentation and in relation to the PCR-RT. Sensitivity, specificity, positive predictive value and negative predictive value, gender, age group and degree of lung involvement will be evaluated. Methods We evaluated 1545 patients with chest CT, delineating the age range and degree of lung involvement, and 306 patients with chest CT and PCR-RT. Results Of the 1545 examinations, 53% were men and 47% were women, there was greater involvement in the 50-59 age group. In the pulmonary study, 55.05% were COVID-19. In the degree of lung involvement 37.70% were mild, 35.76% were moderate, and 26.54% were severe. In the distribution by age, there was a greater involvement between 50-59 years with 56% between moderate (27.6%) and severe (28.0%). Between tomography and PCR-RT, the sensitivity was 68.8%, specificity 59.5%, accuracy 91.3%, with prevalence 31.9%, positive predictive value 44.3% and negative predictive value 80.3%, in females, sensitivity 55.3%, positive predictive value 37.1%, negative predictive value 75.3%, in males, sensitivity 81.6%, positive predictive value 50, 6 and negative predictive value 86.6%.The sensitivities are different between the genders with p of 0.005 and specificity of 0.938, with age effect, starting at 45 years we have a p of 0.057 that decreases to 0.006 at 80 years for sensitivity and specificity. Conclusions The sensitivity and accuracy of CT scan in relation to PCR-RT was significant. Sensitivity increases with prevalence and in the older age group and in men.

Can Alveolar-Arterial Oxygen Pressure Difference be used to Diagnose Acute Respiratory Distress Syndrome in Pneumonia Patients?

Alveolar-arterial oxygen pressure difference (P(Aa)O2) can reflect pulmonary ability to exchange oxygen; it shows good correlation with the oxygenation index (OI), which is important in diagnosing acute respiratory distress syndrome (ARDS). This study explored the ability of P(Aa)O2 in diagnosing ARDS in pneumonia patients. Methods We selected patients with community-acquired pneumonia and sepsis in the intensive care unit (ICU) of the People’s Hospital of Qiandongnan Miao and Dong Autonomous Prefecture; we measured P(Aa)O2 and the OI under anoxic conditions upon their admittance to the ICU. We divided the patients into ARDS and non-ARDS groups. We compared the differences in P(Aa)O2 and OI; we analyzed the correlation between P(Aa)O2 and ARDS. To assess the diagnostic ability of P(Aa)O2 for ARDS, we drew the receiver operating characteristic (ROC) curve. Result We found that P(Aa)O2 in the ARDS group was greater than in the non-ARDS group (t = 8.875, P <0.001); the OI in the ARDS group was smaller than in the non-ARDS group (t = –6.956, P <0.001). There was a positive correlation between P(Aa)O2 and ARDS (r = 0.718, P <0.001). The area under the ROC curve for P(Aa)O2 in the diagnosis of ARDS was 0.931 (0.873–0.988); the cutoff value was 214.70 mmHg, the sensitivity was 89.50%, and the specificity was 85.00%. Conclusion We conclude that P(Aa)O2 is a good reference index in diagnosing ARDS.

The Evolution of the Enzyme Immunoassay/Enzyme-Linked Immunosorbent Assay

50 years ago the Enzyme Immunoassay Enzyme-Linked Immunosorbent Assay, mostly known as ELISA was developed. This is a powerful but simple method that is very widely used in the diagnostic practice, as well as in biomedical research. During this time a number of ELISA modification were developed that significantly increased its properties, especially the senstivity, such as avidin-biotin assay, immuno-PCR, nano-ELISA and finally, the digital ELISA. This short review describes the principles of ELISA and the evolution from a conventional assay to the modern ultra-sensitive method. Most of the immunological methods have two components: antigen and antibody. The high specificity of their interaction gives a possibility to detect one of them if other one is included in the reaction as a specific partner. The simplest method for antigen detection in the presence of the antibody is immune diffusion (radial immune diffusion in that case), which practically the formation of precipitate of the “antigen-antibody” complex, when the target antigen diffuses from well into agarose containing the specific antibody. Unfortunately, this assay, as well as other traditional methods, like hemagglutination or complement fixation, have a low sensitivity and are unwieldy.

Antimicrobial Resistance: A Situational Analysis in the Deido Health District, Douala, Cameroon

Background The rapid and ongoing spread of antimicrobial-resistant organisms threatens the ability to successfully prevent, control, or treat a growing number of infectious diseases in developed and developing countries. This study was designed to convey more insight on the profile of antimicrobial resistance and the capacity of laboratories conducting antimicrobial susceptibility testing in Cameroon. Methods A multicentre cross-sectional study was conducted from October 2019 to March 2020 in the Deido Health District. Laboratories that carry out culture and sensitivity testing within the Deido Health District were identified and assessed to determine their capacity as well as the quality of results from microbiological investigations. Information on antimicrobial susceptibility of various isolates was collected using tablet phones in which the study questionnaires had been incorporated. Results Gaps identified in antimicrobial susceptibility testing that cut across laboratories included; insufficient standard operating procedures, inadequate records on personnel training and competency assessment, lack of safety equipment such as biosafety cabinet, stock out and non-participation in external quality assurance program. The turnaround time for antimicrobial susceptibility testing ranged from 3 – 7 days. Out of the 1797 samples cultured, 437(24.3%) had at least one isolate. A total of 15 different isolates were identified with Candida albicans being the most frequent 178 (40.7%), followed by Escherichia coli 80(18.3%). Among the 15 classes of antimicrobial drugs used in this study, the overall resistance of the isolates showed that five classes had class median resistance above 40% (Cephalosporins, Penicillins, Beta-lactam, Macrolides, and Polyenes). Conclusion This study has shown the need to develop a coordinated national approach to fight antimicrobial resistance. Scaling-up of antimicrobial susceptibility testing will, therefore, require strengthening the microbiology units of laboratory systems as well as ensuring the use of laboratory data for decision making.  

A Model-Based Estimation of Annual Long-Term Care Costs in Germany Following Post-Operative Cognitive Dysfunction (POCD) in Elderly Patients

Acute post-operative delirium (POD) and long-term post-operative cognitive dysfunction (POCD) are frequent and associated with increased mortality, dependency on care giving and institutionalization rates. The POCD-related cost burden on the German long-term care insurance provides an indication for the savings potential from risk-adapted treatment schemes. Comprehensive estimates have not been assessed or published so far. A model-based cost-analysis was designed to estimate POCD-related costs in the long-term care insurance. Comprehensive analysis of inpatient operations and procedures (OPS-codes) served as the base for case number calculations, which were then used as input to the actual cost model. POCD-incidence rates were obtained from the BioCog study. Various sensitivity analyses were performed to assess uncertainty of the model results. Total POCD related annual costs in the German long-term care insurance account for approximately 1.6 billion EUR according to the base case of our analysis. Total annual costs for all POCD cases depend on surgery numbers, incidence rates, other assumptions, and uncertain input parameters. The financial burden to the long-term care insurance is substantial, even in a conservative scenario of the cost model. Variability of results stems from uncertain assumptions, POCD-incidence rates and from uncertain patient numbers who are undergoing surgery and are therefore at risk to develop POCD.

Exponential Parsimony to Generate Herd Immunity Against SARS- CoV2 Cybernetically Restricting Doxastic and Desiderative Logics

We Hypothesize that It should be intuitively inferred that the behavior of the pandemics corresponds to the prediction of the Maxwell Boltzmann distribution, which is a direct function of population density. In a higher organizational metalevel, it is analogous to the Brownian movement effect, in which the possibility of being observed is determined by the observational power of the instrument. In this case, it corresponds to the sensibility and sensitivity of the probe as well as the prevalence of the arbitrary states. The states are formally considered as a partition in probability theory; both in the Kolmogorov and frequentist approach. All these become subsumed to the Bayes theorem applied to recursive conditional probability.

Exponential Parsimony to Generate Herd Immunity Against SARS- CoV2 Cybernetically Restricting Doxastic and Desiderative Logics

We Hypothesize that It should be intuitively inferred that the behavior of the pandemics corresponds to the prediction of the Maxwell Boltzmann distribution, which is a direct function of population density. In a higher organizational metalevel, it is analogous to the Brownian movement effect, in which the possibility of being observed is determined by the observational power of the instrument. In this case, it corresponds to the sensibility and sensitivity of the probe as well as the prevalence of the arbitrary states. The states are formally considered as a partition in probability theory; both in the Kolmogorov and frequentist approach. All these become subsumed to the Bayes theorem applied to recursive conditional probability.

Investigating the level of Safety Considerations in Radiology Centers (North of Iran): Cross –Sectional Study

Background and Purpose Providing health care is the basic right of people(1). Diagnostic radiology is one of the main procedures in health care services and proper benefiting from this technology is brought only under well planning and management(1). Supervision of the available condition and its comparison with the recommended standards is a key role in assessing assurance from the benefit of these instruments (2). Data show that more than 80% of patients referring to these hospitals need radiology image (3).Improper service causes repetition of radiography and even wrong diagnosis, as a results threatening health of the patients (3) lack of protective barrier leads to the exposure of the staff to X-ray which is obviously carcinogen us (4). It happens that the instruments are not working properly, like of symmetry in X-ray field, defects in collimators, lack of adjusting ray field and X-ray, low quality or defective developing machine, lack of proper protective barrier, using low quality film and drugs, lack of protective barrier for children, all of which cause severe hazards for the patients and staff (4). Materials and Methods The crucial aim of medical services is to provide the public with their needs which are very important. The sensitivity of such services is to such an extent that in case of lack of care, the hazards are too high. In evaluation of health services, the first thing is to evaluate the device used. Methods, efficiency, profits and their combination for prevention and eradication of diseases are also important. Therefore to gain this goal, it is necessary the obtain results comparable with recommended standards. The purpose of this study was to access the conditions of radiology units at Mazandaran University hospitals and compare them with the standards of ICRU NCRP and ICRP. Radiology unit is the most expensive section of any hospital for its instruments, manpower and space provided. In a study conducted in 51centers on radiology staff, radiography room and protective barrier, ray leakage, the outcome were 89%, 82%, 77% and 37% respectively. It was found that the condition of these centers regarding the protective barriers is very unsuitable due to unawareness of the leakage (5, 6).Considering the mentioned necessities, in this study, the condition of radiography centers affiliated to the Mazandaran University of Medical Sciences was studied for the type and the rate of problem, in order to provide a proper solving method. Results Data were collected through, observation, interviewing and filling questionnaire. Results show that, the situations of the radiology units are for from international standard, to such an extent that it is matched clout 50%. Conclusion The results showed that, none of the dark rooms are standard, and do not have proper alarm signal. In 63% of these units there no tiling system about staff protection from radiation. Defects in radiography room, protective barrier and lack looking rays were 60%, 51% and 47% respectively. Referring to the obtained data, periodic supervision, and obeying of the standards are necessary.

Mathematical Modeling of Covid-19

Background The novel coronavirus (COVID-19) suddenly appeared in Wuhan, Hubei since December 2019, and quickly swept across China, then the whole world. Today, after more than 100 days of fighting against the virus, China's epidemic has been effectively controlled, but when we looking at the entire world, the novel coronavirus has rampaged globally, especially in the United States and many European countries. This paper mainly studies the impact of COVID-19 outbreaks at Hubei Province and the United States, fits the given data and predicts future trends. Methods Based on the theoretical basis of traditional differential equations and SIR infectious disease model1, and combined with the actual situation to improve the model. Hubei Province is modeled in different time periods, and the effects of birth rate and natural mortality on the model are analyzed. Since the birth rate and natural mortality in the United States in recent years cannot be found, the epidemic situation in the United States can only be analyzed based on the absence of births and natural deaths. Finally, we used Netlogo2 to establish a closed environment (Small World), and combined with known data to conduct simulation experiments on COVID-19 infection. Findings Through the analysis of given data through the SIR model, it is found that before the Chinese government has taken comprehensive measures to cure patients (before 10 February), the number of patients in Hubei Province will reach the peak at the end of February, and will gradually decline thereafter, and on 20 March, the epidemic will be effectively controlled in the future, which coincides with the fact that Wuhan closed the last mobile cabin hospital on 10 March. On the other hand, after the Chinese government tried its best to cure the patients (after 21 February), the number of patients continued to decline over time and will reach 0 in mid-April, which is also consistent with the actual data. According to the factors of birth and natural death, the sensitivity analysis of the above model found that when the epidemic situation is at its peak, it has little effect on the curve, but when the epidemic situation gradually flattens, it still has a certain effect on the trend of the curve. Finally, looking at the situation in the United States, due to the high transmission rate, the number of patients in the United States continues to rise and is expected to reach its maximum in mid-June. We also use Netlogo to simulate the environment in which the virus spread, and find that the general trend of the curves is also consistent with the actual curves. Interpretation The Chinese government has taken various measures to deal with the novel coronavirus pneumonia, including the establishment of two temporary hospitals and dozens of sheltered hospitals, the temporary transformation of university dormitories into isolation rooms345, the closure of Wuhan, the ban on the movement of people and so on. These measures have helped to reduce the spread of the virus and greatly increased the patient's cure rate. But the US government ’s actions are not as effective as China’s, not only because the government ’s actions are inappropriate and untimely, and the people’s opposition to isolation has not subsided. As a result, the virus has spread widely in the United States. More than one million people have been infected with the virus, and tens of thousands of people have died from COVID-196.

Entrance Surface Dose (ESD) Measurement During Pediatric Chest X-Rays

Introduction Given the high radiation tissue sensitivity of pediatric patients, it is necessary to monitor their received dose in order to optimize radiation protection. The first aim of this study was to evaluate of the entrance surface dose (ESD) in pediatric patients undergoing chest x-ray at the main hospital of Dezful, Iran. The second aim was to compare our results with the established dose reference levels (DRL). Materials and Methods The studied population included 204 pediatric patients less than 15 year who were referred to chest x-ray. A calibrated dose area product meter (DAP-meter) with permanent installation on x-ray unit was used to radiation dose measurements. For each patient, the demographic data, exposure parameters and the dose read by DAP-meter were recorded and ESD was calculated using standard mathematical formula. Results The average value of ESD was 119 μGy in patients less than 15 years. This value was 51.3, 122.3, 131.5 and 171.2 μGy for the age groups less than 1 year, 1 to 5 year, 5 to 10 year and 10 to 15 year, respectively. A statistical significant difference was seen between ESD values ​​in different age groups (P<0.001), whereas no statistical difference was seen between ESD values in ​ girls and boys (P =0.993). Conclusion Pediatric patients in hospital investigated (except age group less than 1 year) are subjected to unnecessary radiation exposure, especially due to use of non-optimize x-ray protocols.

Use of Microfluidic Assays to Develop Reliable and Economic Nucleic Acid Application Technologies, Employing MicroRNAs for the Diagnostic Screening of Colon Cancer in Human Stool in Low-Resource Settings

Isolation methods that employ readily-available inexpensive supplies on the open market, which are reliable, as well as economical, such as nucleic acid amplification techniques (NAAT) based on microfluidic technology in low-resource research settings (LRRS) that meets the ASSURED guidelines are essential to develop a noninvasive diagnostic colon cancer screen in stool using micro(mi)RNA molecules. A combination of a microfluidic-based MiRNA stool test with a reliable rolling circle amplification/detection method applied to the quantification of miRNA molecules, result in an affordable sensitive and specific isothermal method for the noninvasive quantitative detection of miRNAs in LRRS. Scientists and engineers have become interested in miRNAs, and they have intensified their efforts to apply emerging simple detection tools to the important bioanalytical challenge of quantifying these small 18-26 nt long molecules. Some of the proposed approaches incorporate novel material, such as simple centrifuges and methods based on microfluidic technology, while others utilize the interesting biological properties of these molecules, such as forming branched RCA structures, allowing for the detection of these biomarker molecules at an attomolar "aM" concentration level, using low cost extraction and isothermal amplification methods in LRRS. We have been interested in studying colorectal cancer (CRC) because it is the 3rd most common malignancy worldwide, and stool can be obtained noninvasively from the patients. We have focused in this research on colon cancer (CC) because it is more common in the USA than rectal cancer (RC). The innovation of our approach lies in the exploratory use of an affordable, quantitative miRNA profiling in noninvasive stool samples in LRRS, whose extracted fragile total RNA is stabilized shortly after excretion from stool by commercially available kits, so it does not ever fragment, followed by quantitative standardized analytical tests that are neither labor intensive, nor require expensive instrumentation, in order to develop apanel of novel miRNA genes for the noninvasive diagnostic screening of early left and right sporadic colon cancers, more economically, and with higher sensitivity and specificity than any other colon cancer screening test currently available on the market. To show the clinical sensitivity and specificity of the proposed quantitative miRNA test using simple methodologies in LRRS,the miRNA results are to be correlated with FOBT, colonoscopy, and pathology data. Standardization establishes test’s performance criteria (sample selection, optimal sample running conditions, preservation and storage), in order to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in low-resource laboratory settings worldwide.

Aerobic Plate Count of Contaminants and Molecular Characterization of Eschereichia Coli in Raw Chicken Meat in Ismailia, Egypt

A total number of 100 samples from ten random broiler chicken carcasses (breast and thigh) were collected from an automatic poultry slaughtering plant in Ismailia city, Egypt. The mean values of Enterobacteriacae count were 5.9x104±9.7x103 cfu/g and 7.1x 104 ± 1.1x104 cfu/g for chicken breast and thigh samples respectively. The prevalence of E.coli were 12% and 9% breast and thigh samples examined, respectively. They are serologically identified as 33.35 and 22.2% O157:H7 (EHEC) , 16.6% and 11.1% O114:H21(EPEC), 16.6% and 33.3 %O127:H6 (ETEC) , 0% and 0% O126 (ETEC) and 33.3% and 0% O26 (EHEC) for breast and thigh samples, respectively. The incidence of E.coli O157:H7 was 100% in both serological and PCR methods from biochemical positive E.coli samples. Culture is specific and cheap whereas PCR is sensitive and expensive, hence, we recommend both culture and molecular methods, which improve sensitivity and specificity, to enhance detection of foodborne pathogens including E.coli.

Use of Microfluidic Assays to Develop Reliable and Economic Nucleic Acid Application Technologies, Employing MicroRNAs for the Diagnostic Screening of Colon Cancer in Human Stool in Low-Resource Settings

Isolation methods that employ readily-available inexpensive supplies on the open market, which are reliable, as well as economical, such as nucleic acid amplification techniques (NAAT) based on microfluidic technology in low-resource research settings (LRRS) that meets the ASSURED guidelines are essential to develop a noninvasive diagnostic colon cancer screen in stool using micro(mi)RNA molecules. A combination of a microfluidic-based MiRNA stool test with a reliable rolling circle amplification/detection method applied to the quantification of miRNA molecules, result in an affordable sensitive and specific isothermal method for the noninvasive quantitative detection of miRNAs in LRRS. Scientists and engineers have become interested in miRNAs, and they have intensified their efforts to apply emerging simple detection tools to the important bioanalytical challenge of quantifying these small 18-26 nt long molecules. Some of the proposed approaches incorporate novel material, such as simple centrifuges and methods based on microfluidic technology, while others utilize the interesting biological properties of these molecules, such as forming branched RCA structures, allowing for the detection of these biomarker molecules at an attomolar "aM" concentration level, using low cost extraction and isothermal amplification methods in LRRS. We have been interested in studying colorectal cancer (CRC) because it is the 3rd most common malignancy worldwide, and stool can be obtained noninvasively from the patients. We have focused in this research on colon cancer (CC) because it is more common in the USA than rectal cancer (RC). The innovation of our approach lies in the exploratory use of an affordable, quantitative miRNA profiling in noninvasive stool samples in LRRS, whose extracted fragile total RNA is stabilized shortly after excretion from stool by commercially available kits, so it does not ever fragment, followed by quantitative standardized analytical tests that are neither labor intensive, nor require expensive instrumentation, in order to develop apanel of novel miRNA genes for the noninvasive diagnostic screening of early left and right sporadic colon cancers, more economically, and with higher sensitivity and specificity than any other colon cancer screening test currently available on the market. To show the clinical sensitivity and specificity of the proposed quantitative miRNA test using simple methodologies in LRRS,the miRNA results are to be correlated with FOBT, colonoscopy, and pathology data. Standardization establishes test’s performance criteria (sample selection, optimal sample running conditions, preservation and storage), in order to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in low-resource laboratory settings worldwide.  

Spectroscopic Kernel Quality from a Symbiotic Corn Production

The management of the inoculation of a plant’s roots, by means of biofertilizers (BF) containing arbuscular mycorrhizal (AM) fungi, is aimed at inducing modifications of the quality of the seeds. It is here shown that a seed-soil treatment can be elicited in the fingerprints of a symbiotic treatment using Near Infra Red (NIR)-SCiO  NIR-SCiO spectra collections of single kernels: overall, a sensitivity of 73% and a specificity of 73% have been achieved, thus suggesting that it may be possible to assign the symbiotic origin of corn from just twenty kernels, provided that the dataset is adequately representative of the cultivar and AM. A global correlation study has shown a positive general trend (R2 0.45) of quality vs. quantity, in the sense that an increase in yield corresponded to an increase in the spectral differences between the symbiotic spectra and the control ones, but the inverse was also true, as a result of the parasitic behaviour of the BF treatments. The efficacy of the symbiosis can be back predicted from the NIR spectra; in fact, around 90% of the positive yield outcome results were discriminated from the negative ones. A reduction in the foliar pH (R2 0.37) and an increase in the foliar protein (R2 0.43) were observed as immediate phenotypic signs of a productive symbiosis. The commercial raw composition of the kernels appeared to only be affected slightly by the BF treatments; thus, till now uncharted secondary compounds of the maize kernels are involved, as supported by animal performances.

Mathematical Modeling and Epidemic Prediction of COVID-19 and its Significance to Epidemic Prevention and Control Measures

Background Since receiving unexplained pneumonia patients at the Jinyintan Hospital in Wuhan, China in December 2019, the new coronavirus (COVID-19) has rapidly spread in Wuhan, China and spread to the entire China and some neighboring countries. We establish the dynamics model of infectious diseases and time series model to predict the trend and short-term prediction of the transmission of COVID-19, which will be conducive to the intervention and prevention of COVID-19 by departments at all levels in mainland China and buy more time for clinical trials. Methods Based on the transmission mechanism of COVID-19 in the population and the implemented prevention and control measures, we establish the dynamic models of the six chambers, and establish the time series models based on different mathematical formulas according to the variation law of the original data. Findings The results based on time series analysis and kinetic model analysis show that the cumulative diagnosis of pneumonia of COVID-19 in mainland China can reach 36,343 after one week (February 8, 2020), and the number of basic regenerations can reach 4.01. The cumulative number of confirmed diagnoses will reach a peak of 87,701 on March 15, 2020; the number of basic regenerations in Wuhan will reach 4.3, and the cumulative number of confirmed cases in Wuhan will reach peak at 76,982 on March 20. Whether in Mainland China or Wuhan, both the infection rate and the basic regeneration number of COVID-19 continue to decline, and the results of the sensitivity analysis show that the time it takes for a suspected population to be diagnosed as a confirmed population can have a significant impact on the peak size and duration of the cumulative number of diagnoses. Increased mortality leads to additional cases of pneumonia, while increased cure rates are not sensitive to the cumulative number of confirmed cases. Interpretation Chinese governments at various levels have intervened in many ways to control the epidemic. According to the results of the model analysis, we believe that the emergency intervention measures adopted in the early stage of the epidemic, such as blocking Wuhan, restricting the flow of people in Hubei province, and increasing the support to Wuhan, had a crucial restraining effect on the original spread of the epidemic. It is a very effective prevention and treatment method to continue to increase investment in various medical resources to ensure that suspected patients can be diagnosed and treated in a timely manner. Based on the results of the sensitivity analysis, we believe that enhanced treatment of the bodies of deceased patients can be effective in ensuring that the bodies themselves and the process do not result in additional viral infections, and once the pneumonia patients with the COVID-19 are cured, the antibodies left in their bodies may prevent them from reinfection COVID-19 for a longer period of time.

Using Prostatic Fluid Levels of Zinc to Bromine Concentration Ratio in Non-Invasive and Highly Accurate Screening for Prostate Cancer

Prostate specific antigen (PSA) does not provide the high reliability and precision that is required for an accurate screening for prostate cancer (PCa). The aim of our study was to search for a simple, rapid, direct, preferably non-invasive, and highly accurate biomarker and procedure for the screening for PCa. For this purpose the levels of bromine (Br) and zinc (Zn) were prospectively evaluated in expressed prostatic fluid (EPF). Also Zn/Br concentration ratio was calculated for EPF samples, obtained from 38 apparently healthy males and from 33, 51, and 24 patients with chronic prostatitis (CP), benign prostatic hyperplasia (BPH) and PCa, respectively. Measurements were performed using an application of energy dispersive X-ray fluorescent (EDXRF) microanalysis developed by us. It was found that in the EPF of cancerous prostates the levels of Zn and Zn/Br were significantly lower in comparison with those in the EPF of normal, inflamed, and hyperplastic prostates. It was shown that “Sensitivity”, “Specificity” and “Accuracy” of PCa identification using the Zn and Zn/Br levels in the EPF samples were all significantly higher than those resulting from of PSA tests in blood serum. It was concluded that the Zn and Zn/Br levels in EPF, obtained by EDXRF, is a fast, reliable, and non-invasive diagnostic tool that can be successfully used by local, non-urologist physicians at the point-of-care to provide a highly effective PCa screening and as an additional confirmatory test before a prostate gland biopsy.

Role of Tie2, CD14, Angiopoietin as Angiogenetic Markers in Hepatocellular Carcinoma Complicating Hepatitis C Virus Infection

Background Identifying biomarkers for early detection of hepatocellular carcinoma (HCC) remains quite challenging. In this study we aimed to estimate the number of TIE2-expressing monocytes (TEMs) cells, which display pro-tumoral activities and are defined as CD14+, TIE2+, and angiopoietin-2; and its potential use as a possible diagnostic marker in HCC patients complicating HCV induced cirrhosis. Methods Current study was conducted on 112 patients. They were divided into two groups: Group I (78 patients) with HCC complicating HCV induced cirrhosis; and group II chronic hepatitis C patients (34 patients). Both groups were compared to (age and sex-matched) healthy persons as group III (38 persons). Result The number of the circulating TEMs: CD14+ and TIE2+ monocytes were significantly higher in the peripheral blood of HCC patients than HCV LC patients and healthy controls, sensitivity and specificity for HCC diagnosis were respectively: CD14 (89.7%, 83.3%), TIE 2 (76.9%, 83.3%), and Ang-2 (76.9%, 66.7%). Moreover, analysis of the P-value and the odd’s ratio showed that CD14 has the highest predictive value for HCC. Conclusion Our results suggest that TEMs and Ang-2can be used as diagnostic markers for HCC, especially among the high-risk group of patients.

Prospects of Integrating Caviaculture and Fish Farming in the Western Region of Cameroon

This study was conducted within three months at the University of Dschang Research and Application Farm (5°44’-5°36’ et 5°44’-5°37’ LN ; 10°06’-9°94’ et 10°06’-9°85’ LE). The main objective was to evaluate the integration perspectives of caviaculture and fishery. Specifically, the study was aimed at evaluating the production of guinea pig dungs, its bromatological composition and appreciating the nitrogen/phosphorus ratio in other to determine the adequate quantities of manure for a proper fertilization of fish ponds. Hence, 96 guinea pigs weighing averagely 390 ± 110g each were randomly distributed into two comparable lots (floor covered with litter and floor without litter) and were subjected to 8 feeds (5 grasses and 3 legumes). Each lot had 6 repetitions of 8 individuals. The animals were fed three times daily within 30 days. The dungs of guinea pigs were collected after three days between 6 and 8am during the experimental period. They were then selected and weighed using and electric balance of 0.1g sensitivity. At the end of the study, the following results were obtained: a guinea pig of 390 ± 110 g in confinement produced between 51.7 ± 0.4 to 60.5 ± 0.7g (fresh weight) of dung per day. The bromatological analysis of these dungs showed that they are made of organic material (80.0%), dry matter (94.3%), crude protein (10.7%), ash (19.9%) and nitrogen (22.7%). These results attesting the richness of these dungs helped in estimating the quantities (103.4g to 206.8g) of dung/day/100m2 for the breeding of 2 to 4 guinea pigs per fish pond of 100 m2 for an integrated breeding (guinea pig-fish).

Validity of the Titmus Vision Screener: A Comparison with the Snellen Chart

Given limited knowledge regarding validity of the Titmus vision screener, we sought to compare visual acuity measurements obtained from the Titmus with that from the Snellen chart and assess the validity properties of the Titmus as a screening instrument to detect vision impairment. Visual acuity was measured in 150 participants recruited from an academic ophthalmology practice, using the Snellen chart as well as the Titmus vision screener. Visual acuities from the Titmus and Snellen were compared and validity of the Titmus vision screener was assessed by computing sensitivity and specificity. Using Snellen visual acuity as the reference standard, the sensitivity of the Titmus vision screener to detect vision impairment, defined as visual acuity worse than 20/40, was 92% (95% CI (72.5, 98.6)) and the specificity was 64% (95% CI (57.9, 70.1)). Comparisons of the precise visual acuity level revealed poor agreement between the two methods (weighted Kappa: 0.15, 95% CI (0.08, 0.21)). Visual acuities obtained from the Titmus were, on average, two lines worse than Snellen visual acuities. ((logMAR Snellen – logMAR Titmus) = - 0.19 ± 0.29, 95% confidence interval (CI) (-0.23, -0.16)). Titmus vision screener is a sensitive tool to detect visual impairment. However high false positive results and poor agreement with Snellen limits its widespread use in clinical applications.

A Rare Cause of Fever of Unknown Origin: Reverse Shapiro’s Syndrome

Reverse Shapiro’s syndrome is described as unexplained hyperthermia coexisting with agenesis of the corpus callosum. Its pathophysiology dwells on the role of dopaminergic hypersensitivity caused by hypothalamic dysfunction. Until now, only 5 cases have been described in the literature as reverse Shapiro’s syndrome. We present a case of a 6-month-old girl who is now the sixth patient described in the literature. A 6-month-old female patient was admitted to the pediatrics unit for fever of unknown origin. Her fever occurred 2-3 times a day on average between 38°C and 39.5°C, and lasted for 1-2 hours. The fever was not diurnal, and antipyretics or staying in an air-conditioned room had no effect. She also had 2 convulsions during her hospital stay. Cranial magnetic resonance imaging (MRI) was requested owing to the patient’s convulsion history and retarded development. The cranial MRI showed diffuse hypoplasia of the corpus callosum in the midline sagittal T2-weighted image. T1-weighted imaging showed hypointensity due to delayed myelination of the genu of the corpus callosum (Figure 2, white arrow), which should normally appear hyperintense like the posterior limb of the internal capsule. Although dopamine agonists and serotonin agonists are recommended for the treatment, the rate of response to medical treatment is very low. Our patient did not benefit from cyproheptadine and methyl prednisolone.

Er-Yag Laser Root Preparation During Subepithelial Connective Tissue Graft Procedures.

Areas of gingival recession cause either an esthetic problem and or root sensitivity. Obtaining predictable root coverage has become an important part of periodontal therapy. A deep, long – standing recession promoted by ANUG was treated using subepithelial connective tissue graft technique combined with decontamination of root surface by using Er:YAG laser. Our clinical findigs suggest that this technique is a predictable procedure to treat gingival recession and promote root decontamination.

Quantification of Micrornas by Absolute Dpcr for the Diagnostic Screening of Colon Cancer

There is currently no validated micro(mi)RNA diagnostic stool test to screen for colon cancer (CC) on the market because of the complexity of fecal density, vulnerability of stool to daily changes, and the presence of three sources of miRNAs in stool (cell-free from fecal homogenates, exsosomal miRNAs from fecal exosomes, and fecal colonocytes). To address these complexities, we have first carried out a microarray miRNA experiment, using Affymetrix GeneChip miRNA 2.0 Arrays, on immunocaptured and enriched stool colonocytes of 15 subjects (three healthy controls and twelve colon cancer patients [three TNM stage 0-1 (e.g., polyps◻ ³ 1 cm, villous or tubvillous, or with high grade dysplasia), three stage 2, three stage 3, and three stage 4 in triplicates to select a smaller panel of 14 preferentially expressed mature miRNAs associated with colon cancer (12 Up-Regulated, miR-19a, miR-20a, miR-21, miR-31, miR-34a, miR-96, miR-106a, miR-133a, miR-135b, miR-206, miR-224 and miR-302; and 2 Down-Regulated, miR-143 and miR-145). In a subsequent validation study carried out on total small RNA extracted by immunocapture, followed by RT that employed TaqMan® miRNA Reverse Transcription (RT) Kit and a Custom TaqMan RT Primer Pool, absolute quantification of miRNAs, in copies/µl, was measured using a chip-based Absolute QuantStudio 3D Digital PCR analysis. To ensure that we have chosen human and not bacterial small total RNA, we have carried out coextraction protocols with E. coli K1 strain RS18, compare Agilent electrophoretic patterns, and also sequenced random samples throughout this research using mRNA/miRNA sequencing. Our initial quantitative dPCR miRNA data presented herein showe that the quantitative changes in the expression of a few mature miRNA genes in stool, which are associated with right and left colon cancer, would provide for a more convenient, sensitive and specific diagnostic screening markers thatare more useful than those test markers currently available on the market, such as the low-sensitivity (<15%) fecal occult blood test (FOBT); result in better compliance; and is more economical than the invasive and expensive colonoscopy exam in colon cancer, which can be cured if that cancer is detected at the early TNM stages, and that becomes incurable and deadly if not diagnosed before metastasis. Initial test performance characteristics of the miRNA approach showed that the test has a high numerical predictive value in colon cancer. Moreover, underpinning of the miRNA markers as a function of total RNA showed that the test can numerically differentiate between control subjects and colon cancer patients, particularly at the early stages of that curable cancer. We propose to extend our initial research results to a larger prospective and randomized five-years nested case-control study, to validate the expression of the above 14 miRNAs, in stool of 180 individuals in an epidemiologically designed study, using (30 controls and 150 colon cancer patients (thirty precancerous polyps (stage 0-1), forty five stage 2, and seventy-five colon cancer stages 3 or 4). chosen randomly by an epidemiological method from 900 control and CC subjects to allow for an adequate time to collect the required 900 stool samples, as well as allowing for statistically valid analysis, standardized test conditions, and to provide a mean for determining the true sensitivity and specificity of a miRNA-screening approach in noninvasive human stool. Power-analysis has indicated that a total of 180 individuals, which will take us 5 years to enroll in testing, is an appropriate number of subjects to standardize and validate our proposed miRNA screening test. We may find out at the end of the proposed validation study in stool that fewer miRNAs, or even one miRNA, may suffice to serve as an efficient and a quantitative marker for the non-invasive diagnostic screening of colon cancer in human stool. The above approach when combined with bioinformatics analysis, to correlate miRNA seed data with our previously published messenger (m)RNA target data in stool, allows for a thorough mechanistic understanding of how miRNA genes regulate mRNA expression, and would offer a better comprehensive diagnostic screening test for the non-invasive early detection stage (0-1) of colon cancer. In order to show the clinical sensitivity and specificity of the proposed miRNA test, the absolute miRNA PCR values, in copies/µl, will be correlated with FOBT, colonoscopy, and pathology data. Standardization will establish test’s performance characteristics (sample selection, optimal sample running conditions, preservation and storage) to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in the World. Ultimately, a smaller number of selected validated miRNAs (<10) showing increased and reduced expression could suffice to give quantitative miRNAs colon cancer expression values, useful for the early diagnostic screening of that curable cancer.

Metal Metalloproteinase 2 is Differentially Regulated by the Interplay between Glucose and Insulin

Pre-adipocytes are the precursors with the potential to make new fat cells during adipose tissue expansion. Nevertheless, the pre-adipocytes behaviors, and their possible roles in energy homeostasis have long been overlooked. Our previous study implicates that interleukin-4 (IL-4) plays a positive metabolic role by promoting insulin sensitivity and inhibiting lipid accumulation. Besides, abundant evidence shows the involvement of matrix metalloproteinase-2 (MMP-2) in the process of adipose tissue expansion. The present study aimed at examining the cross talk among glucose, insulin and IL-4 on regulating MMP-2 expression and activity in 3T3-L1 pre-adipocytes. Effects of insulin and/or IL-4 on MMP-2 expression and activity were examined in pre-adipocytes under euglycemic or hyperglycemic environment by RT-PCR and gelatin zymography, respectively. Our results revealed that glucose level is a pre-requisite for pre-adipocytes responding to insulin and/or IL-4 treatment. In high glucose-containing environment, short-term acute insulin treatment (AI) and long-term chronic insulin exposure (CI) showed opposite regulation to MMP-2 expression and activity. Interestingly, the dominant MMPs regulatory role of CI under euglycemic condition was attenuated in cells exposed to high glucose concentration. Our results suggest pre-adipocytes may participate in the process of increasing adiposity, diabetic onset and diabetic complications through ECM alterations resulted from the insulin- and/or glucose- mediated changes of MMP-2 activity. The present study uncovers novel observations regarding pre-adipocytes behaviors. 

The Development and Evaluation of A Multiplex Real-Time PCR Assay for the Detection of ESBL Genes in Urinary Tract Infections

Background Overuse of beta-lactam antibiotics has lead to selection for extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae, a major cause of antibiotic resistant urinary tract infections (UTIs). Standard detection methods are time-consuming, with disputed accuracy. This study describes a novel real-time PCR method to detect CTX-M, SHV, OXA and TEM. Methods 179 Enterobacteriaceae isolates from UTIs were collected from the Leicester Royal Infirmary, UK. A multiplex Plexor®-based real-time PCR assay detected ESBLs using their specific amplicon melting temperature, during each cycle, removing the need for a melt-curve analysis. Validation was achieved by end-point PCR and disk diffusion. Results The method was able to produce rapid and accurate results, achieving a sensitivity and specificity of 94.9% and 72% respectively, and the assay can differentiate between the different ESBL genes, with ease. Conclusions With further investigation, a Plexor®-based assay could form the basis of a high-throughput kit that health services could use to detect ESBLs or other antibiotic resistance genes.

Evaluation of Some Sugar Beet Genotypes Under Drought Stress Based on Selection Indices

This study was conducted to determine drought tolerant indices of some sugar beet genotypes under water stress and non-stress conditions. Nine sugar beet (Beta Vulgaris L.) genotypes were tested in a Split-plot experiment based on a randomized complete block design in three replications under three levels of water stress 100%, 75% and 50% from plant requirements at the experimental farm Faculty of Agriculture, Suez Canal University, Ismailia, Egypt during 2015/ 2016 and 2016 / 2017 seasons. Twelve drought tolerance indices were used in this study, stress sensitivity index (SSI), stress tolerance (TOL), mean productivity (MP), geometric mean (GMP), harmonic mean (HM),yield stability index (YSI), yield index (YI), stress tolerance index (STI), sensitivity drought index (SDI), relative drought index (RDI), drought response index (DI) and stress susceptibility percentage index (SSPI). GMP, MP and STI were more informative towards classification of better or superior genotypes with respect to tolerant and sensitive groups. The results showed that the genotypes with high STI, GMP and MP values were suitable for cultivation under drought stress and non-stress environments. Both Yp and Ys of root yield in the control-50% analysis had significantly positive correlated (P value<0.05) with MP, GMP, YI, HM and DI, This indicates that these indices were more effective in identifying high yielding genotypes under drought stress as well as non-stress conditions.Principal components analysis showed that the first two components in the control-50% analysis, genotype Bts 1237 and Temar were identified as the most stable high yielding genotypes in both environments

NIRS Footprint of Bio-Fertilizers from Hay Litter-Bags

The biofertilization of cropsusing microbial biota in the soil (MBS) is a modern practice that is used to sustain fertility. MBS agents can promote the yield and health of crops, by luxuriating in the shoot as well as in the root systems. Farmers devoted to systematic MBS fertilization are creating a “Symbiotic” (S) form of agriculture, which offers a greater advantage of resilience than Conventional (C) or organic farming. Since MBS is involved in organic matter degradation, hay-litter-bag probes can be used to reflect a global functionality of the active soil, in the short-medium term. It is here shown that the NIRS hay-litter-bag technique, intended not as mass decay but as a quality evolution of the hay probes, can be modelled as a valid footprint of S vs. C soils. A patented MBS was used in eight experiments in which litter-bags from an S treated thesis were compared with equivalent litter-bags from a non-inoculated C thesis. The chemical signature of the S vs. C in the litter-bag composition was a percentage decrease of sugars and fibres. A smart NIRS device was used to discriminate the origin of the S vs. C litter-bags and a sensitivity of 71% (P<0.0001) was obtained. External validations on 37 S farms showed that three NIRS models discriminated the true positive S spectra, with a sensitivity of 90% as single and 98% as compound probabilities The NIRS radiation of the hay-litter-bags confirmed the results of the S vs. C agriculture soil footprint. Moreover, the SCIO-NIR devices also made it possible to connect the S farms in a smart network.

Morpho-biochemical Identification and Antimicrobial Susceptibility Testing of Bacterial Isolates from Chicken Eggs in District Faisalabad

Microorganisms are the main cause of food-borne illness in humans that may occur by consuming unhygienic products from poultry and other sources. With the passage of time bacterial resistance to antibiotics is ever-increasing which necessitates development of new antibiotics. One of the most obvious reasons of antimicrobial resistance in human-beings is the consumption of contaminated food with microbes. The aim of present study is to isolate, identify and characterize the food-borne pathogens from chicken eggs. For this purpose, a total of 240 egg samples were collected from eight different towns of Faisalabad. Samples were collected from egg surface, yolk, albumin and egg tray. Isolation, identification and characterization of commonly occurring egg borne pathogens including E. coli, Salmonella spp., Bacillus subtilis, Staphylococcus aureus were carried out by different cultural, morphological and biochemical tests. Antibiotic resistance pattern of recovered bacterial pathogens was determined by disk diffusion method (Kirby-Bauer). Zone of inhibition was measured through vernier calliper. The results revealed a high prevalence of Salmonella entitidis with 40.83% following Staphylococcus aureus with 22.08%, Escherichia coli with 17.92% and Bacillus subtilis in a lower ratio with 2.5%. The antibiotic sensitivity test showed different resistance patterns of the isolated microbes. For this purpose, five different drugs were used that included cefotaxime, tetracycline, gentamicin, levofloxacin and penicillin. Bacillus subtilis was highly resistant to penicillin and cefotaxime. Whereas, E. coli showed resistance to three antibiotics that were tetracycline, cefotaxime and penicillin. The only drug to which Staphylococcus aureus showed resistance was cefotaxime. Salmonella was resistant to tetracycline and gentamicin. The study concluded that chicken egg is contaminated with a number of bacteria that could be pathogenic or not. So, there is need of proper attention to cope up with possible future egg-borne illnesses.

Research Progress of the Functional Nucleic Acid Techniques in GMO Detection

Functional nucleic acids are a kind of nucleic acid sequences with special functions, which can specifically bind with the target substances or catalyze the reactions. Many target, including mycotoxins, small RNA, heavy metal ions and DNA segment, can bind to particular selected oligonucleotides, and then realized the detection. The uses of functional nucleic acids to detect the genetically modified organism (GMO) have been pursued using different approaches. Meanwhile, the flanking sequence, which was the most specific target in the GMO detection, was also usually separated with the help of functional nucleic acid. During the detection, the functional nucleic acid provided superior sensitivity, specificity and success rate compared with the traditional methods. In this report, we described different functional nucleic acids used in the GMO detection, they were classified based on their structures, and some of them were developed in our lab. The principle, structural composition, advantage, and the comparisons of the functional nucleic acids were reported. Considering most of the functional nucleic acids are fluorescently-labeled, in order to reduce the cost, more and more functional nucleic acids without labeling are under research.

Compliance to Company Based Colorectal Cancer Screening in Germany using Fecal Immunochemical Test (FIT) - Results of Almost Half a Million FIT Tests

Background Despite the existence of the statutory early cancer detection program in Germany and the removal of financial barriers, which is frequently reported in the literature to be the main obstacle in screening, uptake of colorectal cancer screening remains quite low. The campaign for colorectal cancer screening in German companies reported in this article started in 2010. It was initiated because of the low compliance with opportunistic public colorectal cancer screening efforts. Its goal is to improve participation by offering an organized screening program using a simple test (FIT). Methods An offer for company employees is publicized through posters, company newsletters and the intranet. The difference between the positivity rates of those who returned the kits within 20 days and later than 20 days was assessed using the Z-test. The average time between a positive result and colonoscopy was estimated using the Poincaré plot method. The positive predictive values were calculated for carcinomas, advanced adenomas or any lesions. The sensitivity and specificity of immoCare-C published by Vogel et al. and Hundt et al. were used to derive the confidence intervals for the positive likelihood ratio (for carcinoma and any kind of adenoma). Results A total of 312,147 kits were returned and analyzed (return rate 70.2%). 5.6% gave a positive result. The PPV for cancer aged between 55 and 74 was 4.6% for men and women (95% CI: 2.38%-6.76% and 1.28%-7.99%, respectively), but 22% for men (95% CI: 17.93%-26.65%) and 8% for women (95%CI: 3.63%-12.26%) for advanced adenomas. The PPV for any lesion was higher for those with familial risk (49.3%) and 42.6% for those without familial risk (95% CI: 40.2%-45.0%), but with overlapping confidence intervals. Conclusions The reported sample is not representative. Although, offering CRC screening in companies may be an effective way of increasing uptake in the target population. Differences in the test performance between men and women need further evaluation.

Importance of Neutrophil/Lymphocyte Ratio in Squamous-Cell Carcinoma of the Larynx

Aim: The relation between inflammation and cancer has been known since the 19th century. However, investigations on the pathogenesis and pathophysiology of this relation have begun recently. It was demonstrated that increased neutrophil/lymphocyte ratio is a poor prognostic factor in some malignancies. The present study aimed to determine whether preoperative neutrophil/lymphocyte ratio has a prognostic value in larynx cancer. Method: Preoperative blood analyses of 139 patients, who underwent subtotal or total laryngectomy for larynx cancer between 2003 and 2013 at Marmara University School of Medicine, Department of ENT, were retrospectively evaluated. Neutrophil/lymphocyte ratio (NLR) was calculated dividing absolute neutrophil count by absolute lymphocyte count. Optimal cut-off value for NLR was determined by receiver operating characteristics (ROC) curve analysis. Statistical analyses were done using IBM SPSS statistic 22.0 (IBM SPSS, Turkey) and Med Calc 12.3.0 package programs. Results: The sensitivity of NLR in predicting advanced-stage (Stage 3 and 4) squamous-cell carcinoma of the larynx (LSSC), T4 LSSC and lymph node metastasis at different cut-off values were 66.2%, 83.9% and 73.8%, respectively and the specificity was 76.7%, 66.2% and 65.2%, respectively. Staging according to T classification revealed that NLR significantly increases with tumor stage (p<0.001). Statistically significant relation was determined between lymph node metastasis of tumor and neutrophil/lymphocyte ratio (p=0.003). Comparing overall survival (OS) and disease-free survival (DFS) between the cases with NLR <3.02 and the cases with NLR >3.02, it was demonstrated that OS and DFS are significantly lower in the cases with NLR<3.02 (p: 0.001 vs. p<0.05 for OS and p: 0.013 vs. p<0.05 for DFS) Conclusion: NLR increases with the stage of disease in LSSC. NLR is a simple, cheap, repeatable and valuable parameter that can be obtained from routine analyses, gives information about poor prognosis and survival, and is able to predict T4 LSSC, advanced-stage LSSC (stage 3-4) and lymph node metastasis.

Addressing the gastrointestinal health associated with schizophrenia: The argument for a new nutrition-based intervention

The purpose of this paper is to review the literature linking schizophrenia with chronic inflammation and gluten sensitivity. In addition, the paper discusses the need for dietary interventions that may improve multiple health outcomes for patients. Individuals with schizophrenia are at much greater risk for the development of additional autoimmune disorders. Second generation anti-psychotic medications are the most effective treatment for schizophrenia, but there are numerous potential side effects to the medications. More specifically, individuals with schizophrenia who are treated with SGAs are at increased risk for obesity, diabetes, as well as elevated lipids and blood pressure. An effective evidence-based dietary intervention has the potential to improve numerous outcomes for individuals with schizophrenia.

The Use of Predictive Markers for the Development of a Model to Predict Lowest Quartile Weight Loss following Roux-en-Y Gastric Bypass.

Introduction: The Roux-en-Y Gastric Bypass (RYGB) has been one of the most popular surgeries in the USA for years. While many models have been made to investigate the factors that affect weight loss, these factors are still highly debated. Objective: To create a model that predict performance of RYGB patients. Methods: 110 out of 344 patients who received a RYGB at a single institution between Jan 2010 and April 2014 were included in this study. Data was collected retrospectively. Patients were included if they had greater than 1 year follow up with at least three follow up points and could be modeled with r2>0.95. All patients were one year beyond surgery, while 40 were completely lost to follow up, 104 at 1 month, 138 at 3 months, 188 at 6 months, and 225 at one year. 9 patients were not included because they did not meet the criteria of the study. Patients were divided into quartiles based on percentage excess weight loss (%EWL) at one year. Multivariate analysis was performed to determine the significant factors that influence patients being in the first quartile of weight loss (17-60% %EWL). Results: Only males with a Body Mass Index (BMI) above 44 and females with a BMI above 64 were found to be predictive of patients being in the first quartile. Our model has Positive and Negative predictor values of 66% and 80% respectively with sensitivity and specificity of 29% and 95% respectively. Conclusions: An model to predict %EWL was created, only gender and pre-operative BMI were found to be significant factors. In general females have better outcomes with higher BMI’s than do males. This information should be discussed with patients when deciding a procedure. However, more studies are needed for validation of these results.

Comparing Uterine Electromyography & Tocodynamometer to Intrauterine Pressure Catheter for Monitoring Labor

Objective The tocodynamometer (TOCO) has poor sensitivity and specificity in monitoring uterine contractions, especially in obese patients. The intrauterine pressure catheter (IUPC) can be used to monitor adequacy of contractions, but only after amniotomy. Transabdominal uterine electromyography (EMG) and the TOCO were compared to the gold standard IUPC for monitoring uterine contractions. Methods Forty term pregnant women in labor with ruptured membranes were consented for this study. The root mean square (RMS) plot from EMG signals was compared to IUPC and TOCO recordings for 20 to 40 minutes. A comparison between the total contraction number, frequency, and the difference in contraction peak time was made using Student-t test or ANOVA (P<0.05 was significant). Results There was no significant difference in the contraction number and frequency when comparing the RMS, TOCO, and IUPC. The paper tracings had a greater standard deviation (8.57) than the digitally saved data (3.93). The mean peak time difference between TOCO and IUPC was 0.74 seconds (P=0.78; SD 5.2). For RMS vs. IUPC peaks, the mean peak difference between was 0.13 seconds (P=0.95; SD 3.93). Conclusions Uterine electrical activity measured with transabdominal uterine EMG may be used to monitor labor in patients as an alternative to the TOCO and the IUPC.

Metabolic Acidosis and Cardiovascular Disease in Patients on Peritoneal Dialysis

Backgroud: Metabolic acidosis, a common condition particularly in end stage renal disease patients, results in malnutrition and inflammation. In this study, we focused on the importance of metabolic acidosis on manifestations of cardiovascular disease in patients on peritoneal dialysis. Methods: We studied 20 patients on continuous ambulatory peritoneal dialysis (CAPD), 15 males and 5 females, on mean age 61.6 ±11.3 years old. Metabolic acidosis was determined by serum bicarbonate concentrations less than 22mmol/L, which were measured in gas machine. Dialysis adequacy was defined by total Kt/V/week for urea including peritoneal Kt/V for urea and residual GFR (ml/min/1.73m2). High sensitivity C-reactive protein (hsCRP) was measured using enzyme linked immunoabsorbed assay (ΕLISA). The concentrations of intact-parathormone (i-PTH) and beta2-microglobulin (beta2M) were measured by radioimmunoassays. Arterial stiffness was measured as carotid-femoral pulse wave velocity (c-f PWV) and augmentation index (AIx). We built a Cox regression analysis to predict coronary artery disease (CAD), congestive heart failure (CHF) and peripheral vascular disease (PVD). Results: Serum bicarbonate levels were inversely associated to beta2M, i-PTH and AIx (r=-0.451, p=0.04, r=-0.477, p=0.03 and r=-0.569, p=0.009 respectively). Cox- regression analysis revealed significant association of serum bicarbonate levels and PVD having as confounders traditional and specific for these patients risk factors. Conclusion: Metabolic acidosis may be an independent risk factor for arterial stiffening and peripheral vascular disease manifestation in patients on peritoneal dialysis.

The Effect of Medical Theraphy on Plasma Homocysteine Levels and Carotid Intima-Media Thickness in Parkinson's Disease

Objective: We aimed to investigate homocysteine levels and carotid intima-media thickness (CIMT) in Parkinson’s Disease (PD), to determine relationship of these parameters and as well as to determine whether CIMT in patients with PD was associated to age, disease duration, age of disease onset, stage, the Unified Parkinson Disease rating scale (UPDRS), the drugs used in therapy. Methods: The study population consisted of 55 PD patients (37 male) and 25 healty subjects. The severity of neurological impairment was assessed with UPDRS and the Hoehn-Yahr scale. CIMT and homocysteine levels were measured. Anti-parkinsonian treatments were recorded and the total daily dose of levodopa was calculated for each patient. Results:  Homocysteine levels were significantly higher in the patient group compared to the control group (p=0.002). A positive correlation was found between CIMT and homocysteine  (r=0.29 p=0.03), but   no a relationship between CIMT and UPDRS scores, disease duration, age of disease onset, and stage. Mean levodopa dosage did not predict CIMT 0.6 mm (AUC: 0.546, 95%CI 0.372-0.720, p=0.59). Homocysteine 14 µmol/l predicted CIMT 0.6 mm with 64% sensitivity and 69% specificity (AUC: 0.654, 95%CI 0.488-0.819, p=0.07). Dıscussion: This study revealed that homocysteine levels in levodopa + dopa decarboxylase enzyme inhibitor (DDEI) group were increased which was correlated with a mild increasement of CMIT. This might indicate to the importance of clinical and radiological follow up of PD patients who are under treatment of levodopa + DDEI. Conclusion: Our Findings May Suggest The Role Of CIMT As A Meaningful Clinical Marker For Follow-Up Of Patients With PD

Localization of Angina Related Artery by Admission ECG in Unstable Angina and NSTEMI Patients

Objective: To find out the diagnostic accuracy of admission ECG against coronary angiography (CAG) to predict the ARA in patients with USAP /NSTEMI. Background: In USAP even though multiple active plaques are documented, one critical lesion would be responsible for the index episode of angina. Contrary to STEMI there is no standard methodology to identify the Angina related artery (ARA) in USAP.Therefore we plan to determine whether  admission  ECG could  predict the ARA  in patients with USAP/NSTEMI. Patients and Methods: 250 eligible patients with USAP/NSTEMI undergoing coronary angiography were enrolled in the study. After locating the ARA , the patient’s admission ECG  was compared with CAG finding  to study  whether  it has  any  predictive  value  for identifying  ARA. Results: Sensitivity of the admission ECG for LAD as ARA was 73.6%, Specificity was 93.5%, PPV was 90%, NPV was 81.8%, +LR 10.4, Posterior probability 0.89,  -LR 0.29, Posttest odds 0.22. Similarly for RCA and LCx ,Sensitivity was 63.1%, Specificity was 93.7%, PPV was 90.5%, NPV was 72.7%, +LR 9, Posterior Probability 0.89, -LR 0.35, Posttest odds 0.33. For the LM and TVD, Sensitivity was 66.6%, Specificity was 98.5%, PPV was 91.4%, and NPV was 92.5%, +LR 33, Posterior Probability 0.89, -LR 0.33, Posttest odds 0.08. Conclusion: With high +LR, Admission ECG is moderately sensitive and highly specific for detecting culprit artery.

A Comparison Study of the Fitbit Activity Monitor and PSG for Assessing Sleep Patterns and Movement in Children

Background: Despite its expense, labor and intrusiveness, polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea (OSA). Recently, commercially available electronic activity monitors, such as Fitbit, have become widely accepted and can provide an estimate of sleep patterns for screening children with possible OSA. A previous study demonstrated Fitbit to be valid compared to PSG in adults. To date, these devices have not been extensively utilized for research in children with sleep disordered breathing (SDB). Objective: To evaluate the validity of the Fitbit activity monitor compared to PSG in children and adolescents with SDB. Methods: Data was collected from 14 children, ages 3 through 11, who were scheduled for a PSG during the study period. Fitbit was worn concurrently during the night of the PSG. Analyses were performed by comparing total sleep time, number of awakenings, sleep efficiency and wake after sleep onset (WASO) Fitbit parameters with the corresponding parameters measured by PSG using Spearman’s rho. Fitbit movement epochs were also compared to PSG epochs showing movement behavior. Results: Pilot data suggest that Fitbit demonstrates a high sensitivity for sleep, a low specificity for wake and a trend suggesting good association of movement measurements. Conclusion: Although Fitbit is not as accurate as PSG for determining wakefulness, it may be a useful screening device to assess gross sleep quality in children. Further studies are indicated to validate these findings.

Role of Echo-Planar Diffusion-Weighted Magnetic Resonance Imaging in Diagnosis of Cholesteatoma

Objective: We compared preoperative data of physical examination, CT and diffusion MRI findings of temporal bone with our intraoperative observations. We investigated the diagnostic efficiency of single-shot spin echo echoplanar diffusion MRI (SS SE EPI) on primary cholesteatoma. Methods: 33 patients with chronic otitis media who had been admitted to Otolaryngology Department of Haydarpasa Numune Training and Research Hospital between June 2010 and September 2011 were involved in this study. All patients did undergo otoscopic and audiometric examination. After imaging of temporal bone by CT and diffusion MRI, patients were operated and intraoperative observations were recorded. Patients with intraoperatively approved cholesteatoma were defined as group 1 and those without cholesteatoma were defined as group 2. Perioperative and preoperative findings of physical examination, CT and MRI of all patients were compared one by one. Results: Positive physical examination findings have been superior to MRI and CT, having a sensitivity of 96%, specifity of 87.5%, positive predictive value of 96% and negative predictive value of 87.5%. In terms of effectiveness of MRI in diagnosing intraoperative cholesteatoma, we had a sensitivity of 80%, specifity of 50%, positive predictive value of 83.3% and negative predictive value of 44.4%. These values are also lower than previously reported results. Conclusion: When we had preoperative suspection of cholesteatoma on physical examination and diffusion MRI, in addition with bone tissue erosion on CT, we found that physical examination is superior to MRI and CT in terms of capability of diagnosing the disease.

Age Variation in Bitter Taste Perception in Relation to the Tas2r38 Taste Receptor Phenotype

Objectives Taste sensitivity is an important determinant of food choice and differs between children and adults. This difference is probably due to several factors that constitute an individual’s phenotype. The aim of this study was to explore taste perception in relation to the TAS2R38 and CAVI (gustin) genotypes in age classes from infancy to adulthood in a Mediterranean population. Methods In this cross-sectional study we evaluated the TAS2R38 and gustin genotypes and administered a standardized PROP taste test in 705 individuals (435 adults, 270 children); the sample included 224 mother-child dyads. We also explored the acceptance and consumption of bitter and non-bitter vegetables. Results Sensitivity to bitterness was strongly related to the TAS2R38 haplotype, and we observed an intriguing relationship with age. In fact, children were more sensitive than adults with the same TAS2R38 haplotype also within mother-child dyads. The mother-child tasting differences decreased with age and became minimal when children reached adolescence. Variations in the gustin gene did not contribute significantly to the overall taste phenotype, but helped to differentiate among non-tasters. Conclusions The genetic profile of the bitter-taste receptor TAS2R38 explains most of the variance in bitter taste perception, but the related phenotype is also strongly influenced by age, also in mother-child dyads that share the same genotype. This finding is likely to have a significant impact on the complex feeding relationship between mother and child.

Isotretinoin-Induced Facial Hyperpigmentation: Idiosyncratic Reaction?

Isotretinoin is notorious for having a myriad of mucocutaneous side effects including cheilitis, xerodermia, facial erythema, pruritis, hair thinning, and brittle nails, among others. Although photosensitivity is considered to be one of the side effects of oral isotretinoin therapy, cutaneous hyperpigmentation has not, to the best of our knowledge, yet been reported as a side effect. This report presents a case of striking facial hyperpigmentation in a patient on oral isotretinoin.

Bioinformatics of Metabolomics in Diabetes Mellitus Type 2

Diabetes mellitus type 2 (DMT2) is a complex polygenic disorder. DMT2 is a result of insulin resistance and destruction of pancreatic β-cell or dysfunction. Therefore, glucose builds up in the bloodstream, leading to nerve damage, blindness, organ failures and sometimes death. Recently, some recently discovered genes play a key role in regulating the sensitivity to insulin. Scientists have long known that the disease often runs in families, and other genetic links. Human genetic discoveries will keep improving our knowledge about diabetes for many years to come. Varieties of prospective diabetic researches were developed to diagnose and control DMT2. Researchers spent thousands of millions of dollars to address DMT2. Pioneers of advanced biotechnology developed bioinformatics tools that changed the course of research about the role of metabolomics in DMT2. It will facilitate the identification of possible causes of DMT2 in genome studies. The present article aimed at reviewing the research studies per training to metabolomics and bioinformatics in genome studies in relation to DMT2.