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Sickle Cell Anemia (SCA) is a disorder in Red Blood Cells (RBCs) of human blood. Children under five years and pregnant women are mostly affected by SCA. Early diagnosis of this ailment can save lives. In recent years, the computer aided diagnosis of SCA is preferred to resolve this issue. A novel and effective deep learning approach for identification of sickle cell anemia is proposed in this work. Around nine hundred microscopic images of human red blood cells are obtained from the public database ‘erythrocytes IDB’. All the images are resized uniformly. About 2048 deep features are extracted from the fully connected layer of pre-trained model InceptionV3. These features are further subjected to classification using optimization-based methods. An improved wrapper-based feature selection technique is implemented using Multi- Objective Binary Grey Wolf Optimization (MO-BGWO) approach with KNN and SVM for classification. The detection of sickle cell is also performed using typical InceptionV3 model by using SoftMax layer. It is observed that the performance of the proposed system seems to be high when compared to the classification using the original InceptionV3 model. The results are validated by various evaluation metrics such as accuracy, precision, sensitivity, specificity and F1-score. The SVM classifier yields high accuracy of about 96%. The optimal subset of deep features along with SVM enhances the system performance in the proposed work. Thus, the proposed approach is appropriate for pathologists to take early clinical decisions on detection of sickle cells.

Background Men who have sex with men (MSM) in low-to-middle-income countries bear a high burden of HIV and a significant proportion marry women to satisfy socio-cultural norms. It has previously been demonstrated that HIV prevalence is higher among married versus unmarried MSM, but limited data are available on HIV prevalence among their wives. Methods We recruited 149 married MSM couples where the husband disclosed his MSM behavior to his wife (disclosed MSM) and 150 married MSM who had not disclosed their MSM behavior to their wives (undisclosed MSM), in three Indian cities. All participants completed interviewer-administered surveys and underwent HIV testing. Multivariable logistic regression was used to assess correlates of HIV among wives of MSM. Descriptive statistics were used to compare characteristics of disclosed and undisclosed MSM. Results HIV prevalence in disclosed MSM, their wives, and undisclosed MSM was 46.9%, 27.9%, and 34.9%, respectively. In multivariable analysis, the strongest predictor of HIV prevalence among wives of MSM was husband’s HIV positive status (adjusted odds ratio: 13.4; 95% confidence interval: 5.44–33.2). Both disclosed and undisclosed MSM reported high levels of risk behavior including infrequent condom use. Most undisclosed MSM reported that they did not intend to disclose MSM behavior due to stigma. Conclusions We observed an extremely high HIV prevalence among women married to MSM despite low levels of individual risk behavior. Interventions are urgently needed in this vulnerable population particularly given the challenges related to disclosure of same sex behavior among their husbands.

Uyu’ atau lagu mendodoi anak merupakan salah satu jenis tradisi lisan rakyat bagi masyarakat etnik Lundayeh. Isi kandungan uyu’ penuh dengan unsur nasihat, lambang sosiobudaya, nilai kepahlawanan dan falsafah. Namun, uyu’ mula dilupakan khasnya dalam kalangan generasi muda. Oleh itu, kajian ini dilakukan untuk menghidupkan semula tradisi lisan dengan membuat penelitian kepada kandunganya. Untuk kajian ini, pengkaji akan memfokuskan kepada kosa kata arkaik golongan kata kerja dari uyu’ naso anak di Long Pasia. Pengkaji telah menggunakan pendekatan dengan kajian kualitatif melalui kaedah kajian lapangan dan temu bual bagi menghasilkan dokumentasi kosa kata arkaik golongan kata kerja dari uyu’ naso anak melalui kajian kepada tiga generasi (datuk nenek, ibu bapa dan kanak-kanak). Seterusnya, data akan dianalisis menggunakan skala keterancaman bahasa UNESCO (2009), edisi yang menetapkan tahap bahaya sedikit berbeza daripada edisi sebelumnya. Terminologi baharu ini adalah berdasarkan rangka kerja Vitality dan Endangerment Bahasa UNESCO yang menetapkan enam darjah daya hidup atau bahaya berdasarkan sembilan faktor. Dapatan kajian mendapati bahawa generasi kanak-kanak kehilangan kosa kata paling tinggi, apabila menyatakan 10 daripada 27 kosa kata kerja adalah arkaik. Hal ini menunjukkan bahawa kanak-kanak sudah tidak menuturkan bahasa warisan di rumah. Seharusnya, uyu’ etnik Lundayeh mesti dipergiatkan kerana mengandungi pelbagai unsur bahasa, selain melambangkan sosiobudaya, falsafah dan nilai masyarakat. Langkah mengaplikasikannya adalah salah satu usaha untuk memperkasa dan melestarikan kosa kata bahasa yang hampir pupus agar terus diwarisi generasi ke generasi. “Uyu” or song lullaby is a type of folk oral tradition in theLundayeh ethnic community. The content of “uyu” is full of elements of advice, socio-cultural symbols, heroic values, and philosophy. However, “uyu” is gradually being forgotten, especially among the younger generation. Therefore, this study was conducted to revive the “uyu’ oral tradition by examining its content. In this study, the researchers focused on the archaic vocabulary of the verbs from “uyu’ naso anak” in Long Pasia. The researchers adopted a qualitative research using field research methods and interviews to produce archaic vocabulary documentation of verbs from “uyu’ naso anak” through a study of three generations (grandparents, parents and children). Next, the data were analyzed using the UNESCO language risk scale (2009), the edition of which sets the level of danger slightly different than the previous edition. This new phrasing depends on the UNESCO Language Vitality and Endangerment framework that sets six degrees of vitality or danger based on nine factors. The findings of the study found that the children (younger generation) has lost the highest vocabulary, when stating 10 out of 27 vocabularies were archaic. Thus, this indicates that the children no longer speak the heritage language at home. The Lundayeh ethnic “uyu” must be promoted because it contains various elements of language other than community values. One of the efforts to strengthen and preserve the vocabulary of a language that is almost extinct is through application to ensure the language continues to be inherited from generation to generation.

Background Children and adolescents living with HIV (CALHIV) face unique challenges, including poorer treatment outcomes, risk for drug-resistance mutations (HIVDRMs), and limited drug formulations. We estimated viral suppression (VS) prevalence and evaluated predictors of VS and HIVDRMs in Kenya. Methods From 2018–2020, CALHIV 1–19 years on antiretroviral therapy (ART) >6 months were enrolled in this cross-sectional study. Participants underwent viral load (VL) testing; those with VL ≥1000 copies/mL had HIVDRM testing. Sociodemographic questionnaires and medical record abstraction were completed. VS prevalence (VL Results Nine hundred and sixty-nine participants were enrolled. VS prevalence was .80 (95% CI: .78–.83). Being on ART >24 months (adjusted PR [aPR]: 1.22; 95% CI: 1.06–1.41), an integrase strand transfer inhibitor–containing regimen (1.13; 1.02–1.26), and attending a level 3 health facility (1.23; 1.11–1.36) were associated with VS. Missing ≥3 doses of ART in the past month (aPR: .73; 95% CI: .58–.92), having a viremic mother with HIV (.72; .53–.98), and having 3–7 (.90; .83–.97), 8–13 (.89; .82–.97), or ≥14 (.84; .77–.92) compared with Conclusions HIV treatment programs should target interventions for pediatric patients at risk for treatment failure—namely, those with a caregiver with failed VS and those struggling with adherence.

The diagnostic and clinical overlap of early mild cognitive impairment (EMCI), mild cognitive impairment (MCI), late mild cognitive impairment (LMCI) and Alzheimer disease (AD) is a vital oncological issue in dementia disorder. This study is designed to examine Whole brain (WB), grey matter (GM) and Hippocampus (HC) morphological variation and identify the prominent biomarkers in MR brain images of demented subjects to understand the severity progression. Curve evolution based on shape constraint is carried out to segment the complex brain structure such as HC and GM. Pre-trained models are used to observe the severity variation in these regions. This work is evaluated on ADNI database. The outcome of the proposed work shows that curve evolution method could segment HC and GM regions with better correlation. Pre-trained models are able to show significant severity difference among WB, GM and HC regions for the considered classes. Further, prominent variation is observed between AD vs. EMCI, AD vs. MCI and AD vs. LMCI in the whole brain, GM and HC. It is concluded that AlexNet model for HC region result in better classification for AD vs. EMCI, AD vs. MCI and AD vs. LMCI with an accuracy of 93, 78.3 and 91% respectively.

The systolic and diastolic heart failure (HF) subjects are typically categorized based on clinical indices only. The relationship between different stages of systolic and diastolic heart failure and left ventricle (LV) myocardial tissue variations is presented in this work. The corr-entropy and optimized edge criterion has been incorporated into the level set (CEOELS) for effective segmentation of myocardium in cardiovascular magnetic resonance images to handle noise, intensity inhomogeneity and contour initialization. In order to learn shape and local variations in segmented myocardium, Krawtchouk moment features are computed for ten different moment orders. The relevant extracted features are obtained through Harris hawks optimization algorithm. The optimized features are fed to support vector machine (SVM) that uses fivefold cross-validation approach for classification. Experimental results show that CEOELS has provided better segmentation of LV blood cavity and myocardium with a similarity measure of 0.93 and 0.92, respectively. It is also observed that individual Krawtchouk moment orders greater than 30 have provided better HF prediction performance. Consequently, optimized Krawtchouk moment features produced an increased overall accuracy (80.8%) than individual feature sets. Significant improvement has also been achieved in distinction of hyperdynamic patients from normal and systolic dysfunction subjects that is less explored.

BackgroundThe World Health Organization early warning indicators (EWIs) permit surveillance of factors associated with the emergence of HIV drug resistance (HIVDR). We examined cross- and within-region performance on HIVDR EWIs for selected HIV care and treatment clinics (CTCs) in five regions of southern Tanzania.MethodsIn 2016, we retrospectively collected EWI data from 50 CTCs for the January to December 2013 period. EWIs included the following: on time ART pick-up, retention on ART, ARV stockouts, and pharmacy prescribing and dispensing practices. Data for pediatric and adult people living with HIV were abstracted from source files, and frequencies and proportions were calculated for each EWI overall, as well as stratified by region, facility, and age group.ResultsAcross and within all regions, on average, on-time pick-up of pills (63.0%), retention on ART (76.0%), and pharmacy stockouts (69.0%) were consistently poor for the pediatric population. Similarly, on-time pill pick up (66.0%), retention on ART (72.0%) and pharmacy stockouts (53.0%) for adults were also poor. By contrast, performance on pharmacy prescribing and dispensing practices were as desired for both pediatric and adult populations with few facility-level exceptions.ConclusionIn this study, regions and facilities in the southern highlands of Tanzania reported widespread presence of HIVDR risk factors, including sub-optimal timeliness of pill pickup, retention on ART, and drug stockouts. Routine EWI monitoring provides a check on quality of service delivery, as well as affordable, large-scale surveillance for HIVDR risk factors. EWI monitoring remains relevant particularly in the context of new ART drug roll-out such as dolutegravir, during the COVID-19 pandemic when resultant HIV service disruptions require careful monitoring, and for virologic suppression as countries move closer to epidemic control.

In this study, an attempt has been made to differentiate HEp-2 cellular shapes using Bag-of-keypoint features and optimization. For this, the images are considered from a publicly available database. To increase the cell structure visibility, the images are pre-processed using edge-sensitive local contrast enhancement. Further, the Speeded-up Robust Feature (SURF) keypoints are extracted and Bag-of-keypoints for each shape are generated. These features are subjected to Ant Colony Optimization (ACO) algorithm for feature selection. The optimal features obtained are then fed to Support Vector Machine (SVM) and k-Nearest Neighbour (kNN) classifiers. Results show that the ACO algorithm can identify the optimal features that characterize the cellular shapes. SVM and kNN are able to differentiate between the shapes with an average classification accuracy of 93.6% and 94.8% respectively. Since differential diagnosis of HEp-2 cellular shapes is significant in the disease-specific prognosis and treatment, this study seems to be clinically relevant.

Tissue engineering and regenerative medicine (TERM) holds great promise for addressing the growing need for innovative therapies to treat disease conditions. To achieve this, TERM relies on various strategies and techniques. The most prominent strategy is the development of a scaffold. Polyvinyl alcohol-chitosan (PVA-CS) scaffold emerged as a promising material in this field due to its biocompatibility, versatility, and ability to support cell growth and tissue regeneration. Preclinical studies showed that the PVA-CS scaffold can be fabricated and tailored to fit the specific needs of different tissues and organs. Additionally, PVA-CS can be combined with other materials and technologies to enhance its regenerative capabilities. Furthermore, PVA-CS represents a promising therapeutic solution for developing new and innovative TERM therapies. Therefore, in this review, we summarized the potential role and functions of PVA-CS in TERM applications.

Background Cardiovascular and metabolic regulation is governed by neurohumoral signalling in relevant organs such as kidney, liver, pancreas, duodenum, adipose tissue, and skeletal muscle. Combined targeting of relevant neural outflows may provide a unique therapeutic opportunity for cardiometabolic disease. Objectives We aimed to investigate the feasibility, safety, and performance of a novel device-based approach for multi-organ denervation in a swine model over 30 and 90 days of follow-up. Methods Five Yorkshire cross pigs underwent combined percutaneous denervation in the renal arteries and the common hepatic artery (CHA) with the iRF Denervation System. Control animals (n = 3) were also studied. Specific energy doses were administered in the renal arteries and CHA. Blood was collected at 30 and 90 days. All animals had a pre-terminal procedure angiography. Tissue samples were collected for norepinephrine (NEPI) bioanalysis. Histopathological evaluation of collateral structures and tissues near the treatment sites was performed to assess treatment safety. Results All animals entered and exited the study in good health. No stenosis or vessel abnormalities were present. No significant changes in serum chemistry occurred. NEPI concentrations were significantly reduced in the liver (− 88%, p = 0.005), kidneys (− 78%, p p = 0.018) and duodenum (− 95%, p = 0.028) following multi-organ denervation treatment compared to control animals. Histologic findings were consistent with favourable tissue responses at 90 days follow-up. Conclusions Significant and sustained denervation of the treated organs was achieved at 90 days without major safety events. Our findings demonstrate the feasibility of multi-organ denervation using a novel iRF Denervation System in a single procedure.

Nanotechnology is an embryonic field that grips countless impacts on the drug delivery system. Nanoparticles as haulers increase the capability of target-specific drug delivery to many folds hence are used in the treatment of dreadful diseases such as cancer, diabetes, etc. This boom has aimed at, to synthesize Copper oxide nanoparticles (CuO-NPs) using Acalypha Indica leaf extract and then incorporated with graphene oxide (GO) to form GO-CuO nanocomposites. Secondly, to sightsee the photocatalytic activity of CuO-NPs and GO-CuO nanocomposites towards the decolorization of methylene blue-dye and to test its activity against HCT-116 Human colon cancer cell lines. Synthesized nanocomposites were characterized using FTIR, UV–vis, X-ray powder diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDAX), X-ray Photoelectron Spectroscopy (XPS) and transmission electron microscopy (TEM) analysis. The photocatalytic studies revealed that synthesized nanocomposites have the efficiency to degrade methylene blue dye by 83.20% and cytotoxic activity was found to be 70% against HCT-116 Human colon cancer cell lines at 100 μg/ml. GO-CuO nanocomposites have appreciable activity towards cancer cell lines and photocatalytic activity when compared to nanoparticles as such.

This article examines “death” in a funeral chant set in the plantation estates of Malaysia, and written in English and Tamil, as a metaphor for the birth of the nation. It explores how the death of communal linguistic elements, both in orality and symbolic references, lead to the deconstruction of motherland identity markers which are then replaced by the reconstruction of diasporic identities that are observable through the use of standardized English. For this purpose, the Malaysian Indian life-writer, Muthammal Palanisamy’s English version of an oppari (Tamil for funeral chant), which was published in Malaysia (2002) will be read in relation to the Tamil version published in India (2007) through transliterated and translated texts of the chant. In so doing, the paper highlights the inherent gap between the two versions that can be usefully deployed to address whether English is an enabling tool through which ethnic Indians can express their identities in a postcolonial nation like Malaysia or is it perpetually contaminated by colonial history and values. On the other hand, the paper also draws attention to the question of whether the displacement of the vernacular language, i.e., Tamil, witnesses the inevitable cultural death of a diasporic community or does it display a form of inclusivity within the polyglot linguistic environment of the adopted land, Malaysia.

The World Health Organization early warning indicators (EWIs) permit surveillance of factors associated with the emergence of HIV drug resistance (HIVDR). We examined cross- and within-region performance on HIVDR EWIs for selected HIV care and treatment clinics (CTCs) in five regions of southern Tanzania. We retrospectively abstracted EWI data from 50 CTCs for the January to December 2013 period. EWIs included the following: on time ART pick-up, retention on ART, ARV stockouts, and pharmacy prescribing and dispensing practices. Data for pediatric and adult people living with HIV were abstracted from source files, and frequencies and proportions were calculated for each EWI overall, as well as stratified by region, facility, and age group. Across and within all regions, on average, on-time pick-up of pills (63.0%), retention on ART (76.0%), and pharmacy stockouts (69.0%) were consistently poor for the pediatric population. Similarly, on-time pill pick up (66.0%), retention on ART (72.0%) and pharmacy stockouts (53.0%) for adults were also poor. By contrast, performance on pharmacy prescribing and dispensing practices were as desired for both pediatric and adult populations with few facility-level exceptions. In this study, regions and facilities in the southern highlands of Tanzania reported widespread presence of HIVDR risk factors, including sub-optimal timeliness of pill pickup, retention on ART, and drug stockouts. There is an urgent need to implement the WHO EWIs monitoring to minimize the emergence of preventable HIV drug resistance and to maintain the effectiveness of first and second-line ART regimens. This is particularly critical in the context of new ART drug roll-out such as dolutegravir during the COVID-19 pandemic when resultant HIV service disruptions require careful monitoring, and for virologic suppression as countries move closer to epidemic control.

Background Persons living with HIV (PLWH) who are members of sero-discordant and sero-concordant relationships may experience psychological stressors or motivators that affect HIV care. We assessed the association between sero-discordance status, antiretroviral therapy (ART) uptake, and viral suppression in the African Cohort Study (AFRICOS). Methods AFRICOS enrolls PLWH and HIV-uninfected individuals at 12 sites in Uganda, Kenya, Tanzania, and Nigeria. At enrollment, we determined ART use through self-report. Viral suppression was defined as HIV RNA Results From January 2013 through March 2018, 223 index participants from sero-discordant dyads and 61 from sero-concordant dyads were enrolled. The majority of the indexes were aged 25–34 years (50.2%), female (53.4%), and married (96.5%). Sero-discordant indexes were more likely to disclose their status to partners compared with sero-concordant indexes (96.4% vs. 82.0%, p Conclusions PLWH in sero-discordant sexual partnerships demonstrated improved uptake of ART compared with those in sero-concordant partnerships. Interventions are needed to increase care engagement by individuals in sero-concordant relationships to improve HIV outcomes.

This article investigates the representation of nature in contemporary Malaysian life-writings in English by female writers of Malay, Chinese and Indian ethnic origins. Adibah Amin’s This End of th...

Prognosis of in a dementia disorder is a tedious task in preclinical stage. Ventricle pathology changes in dementia appear to be overlapped for neuro degeneration in brain. Identification of these overlaps among the groups severity helps to understand the pathogenesis of this disorder. In this work impact of changes in ventricle region on severity stages of dementia is observed using dual deep learning techniques (DDLT). Alzheimer's Disease Neuroimaging Initiative (ADNI) database that contains 1169 MR images are used in this study. Segmentation of ventricle region is carried out using multilevel threshold based Grey Wolf Optimization (GWO) technique. The feature vectors obtained from combined AlexNet and ResNet are analysed. The fused feature vectors are given to support vector machine (SVM) to observe the severity changes. Consequently, symmetry analysis of ventricle is carried out to perceive the distinctive changes in progression. The obtained results show that ventricle region is accurately delineated from other region with optimized thresholds. The segmented ventricle shows better correlation for all considered classes (> 0.9). It is observed that DDLT with multiclass SVM provides an improved accuracy of about 79.87% compared to individual transfer learning such as AlexNet (74%) and ResNet (76.53%). Further, symmetry analysis shows that left side ventricle with DDLT features shows an improved performance than right side for onset stages. Further, clinical correlation of left ventricle seems to be statically significant (p

Amiodarone, the most commonly used antiarrhythmic drug, can cause either hypothyroidism by inhibiting iodide transport into the thyroid gland or hyperthyroidism. We present a rare case of type 2 amiodarone-induced thyrotoxicosis with hypercalcemia. A 64-year-old man with systolic heart failure, hypertension, and hyperthyroidism presented with complaints of dyspnea on exertion, orthopnea, and vomiting for several days. Laboratory tests showed low thyroid stimulating hormone0.01 mIU/L, high free triiodothyronine (FT3) of 24.8 ng/dL, free thyroxine (FT4) of5.0 ng/dL, and hypercalcemia of 12.9 mg/dL. Hypercalcemia, a rare presentation of AIT, was treated with calcitonin and intravenous fluids. The patient was taken off methimazole and started on propylthiouracil for the persistent elevation of thyroid hormones, especially FT3, and to reduce the conversion of T4 to T3. The patient was not completely responding to treatment with propylthiouracil alone, so prednisone was added to the regimen on day 12, effectively returning the patient to the euthyroid state.

Recently, natural products are the powerful carbon source to synthesize carbon dots (CDs) with interesting physical and chemical properties. In this present work, we report a facile hydrothermal synthesis method for preparing fluorescent carbon dots using a biogenic precursor of rice bran without any surface passivation agent. The synthetic methodology was easy, simple, environmental friendly and convenient. Structural and optical properties of the RB-CDs have been studied by UV-visible, Fourier transform infrared spectroscopy (FTIR), Field emission scanning electron microscopy (FESEM), Fluorescence spectra and X-ray photoelectron spectroscopy (XPS) techniques. The prepared RB-CDs exhibited green emission upon irradiation with UV light and the calculated fluorescence quantum yield (QY) was found to be 7.4%. The morphological features of the synthesized RB-CDs were characterized by High-Resolution Transmission Electron Microscopy (HR-TEM), the average size of the RB-CDs was found to be 2.96 nm. The synthesized RB-CDs were beneficially applied as a catalyst for the catalytic degradation of methylene blue (MB) dye using NaBH4 as the reducing agent in the ambient conditions. The degradation of MB dye under light illumination was 89.20% in 30 min. Further, the obtained highly fluorescent RB-CDs were efficiently utilized as a fluorescent ink for luminescent pattern printing (patterning agent) in the anti-counterfeiting applications.

Diabetes is a growing problem affecting many people in the world. Diabetes leads to various complications like lower limb amputations, blindness, cardiovascular disease etc. Diabetes has many complexity that is reduced by individual monitoring and control of glucose level. Glucose level monitoring occur with recent development in Nanotechnology. Nanotechnology develops nanosensors which measure glucose level. Nanosensors fabricated by silicon dioxide in mass production reduces the cost of the nanosensors. Nanosensors made of silicon dioxide read the blood samples of a person without diabetes and a diabetic person with the help of SIGVIEW and analyzed using MATLAB. Statistical analysis is made with comparison of spectrogram, magnitude response, probability distribution, time domain and the autocorrelation of normal blood signals and diabetic signals. Comparison results in separation of a normal and diabetic person with an excellent performance of nanosensors in mass production.

Schizophrenia (SZ) is a brain disorder with high financial and social burden worldwide. The majority of morphometric analyses have focused on volumetric measurements derived from brain MR images. However, there is significant variation in the measurements due to heterogeneity of SZ. There is a need to study the links between MR image textures in Schizophrenic and normal images. In this work, the specific pattern changes in Schizophrenic MR images are better represented by texture features such as Hu moments, gray level co-occurrence matrix (GLCM), Zernike moments and structure tensor. The SZ subjects are differentiated from healthy subjects using binary particle swam optimization (BPSO) based fuzzy SVM (FSVM) classifier with mutual information quotient as an objective function for feature selection. Initially the MR brain images are skull-stripped using non- parametric region based active contour. The efficacy of the proposed work is analyzed with different objective functions and compared with BPSO based SVM classifier. This work is evaluated on National Alliance for Medical Image Computing (NAMIC) database. The results show that the proposed method is able to skull-strip the brain region with better similarity values compared to different tool based methods. BPSO-FSVM along with Hu moments, GLCM and structure tensor could classify the normal and SZ better with an accuracy of 90% compared to BPSO-SVM. The AUC is 0.9 for BPSO-FSVM. Thus BPSO optimized features highlights significant texture pattern change in Schizophrenia. Hence this frame work could be used to aid disease prognosis, treatment and study the neuropsychiatric disorder.

The 14-3-3 proteins are a family of ubiquitous and exclusively eukaryotic proteins with an astoundingly significant number of binding partners. Their binding alters the activity, stability, localization, and phosphorylation state of a target protein. The association of 14-3-3 proteins with the regulation of a wide range of general and specific signaling pathways suggests their crucial role in health and disease. Recent studies have linked 14-3-3 to several RNA and DNA viruses that may contribute to the pathogenesis and progression of infections. Therefore, comprehensive knowledge of host–virus interactions is vital for understanding the viral life cycle and developing effective therapeutic strategies. Moreover, pharmaceutical research is already moving towards targeting host proteins in the control of virus pathogenesis. As such, targeting the right host protein to interrupt host–virus interactions could be an effective therapeutic strategy. In this review, we generated a 14-3-3 protein interactions roadmap in viruses, using the freely available Virusmentha network, an online virus–virus or virus–host interaction tool. Furthermore, we summarize the role of the 14-3-3 family in RNA and DNA viruses. The participation of 14-3-3 in viral infections underlines its significance as a key regulator for the expression of host and viral proteins.

Obesity is a worldwide epidemic due to the availability of many unhealthy food options and limited physical exercise. Restriction of the daily food intake results in weight loss, which is also associated with better health outcomes including triglycerides, total cholesterol, low-density lipoprotein cholesterol, blood pressure, glucose, insulin, and C-reactive protein. Our aim is to briefly discuss the effects of intermittent fasting on weight and other biochemical markers mentioned previously. The study is designed as a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. To assess the effectiveness of intermittent fasting, related studies were reviewed between 2000 and 2018 and 815 studies were identified. Only four articles met the preset inclusion and exclusion criteria. All four studies have shown a significant decrease in fat mass with P-values

Female hypoactive sexual desire disorder (HSDD) is a multifactorial sexual dysfunction disorder characterized by a decrease in sexual desire and personal distress. HSDD occurs in naturally occurring postmenopausal women or secondary to oophorectomy. Multiple studies have assessed the use of transdermal testosterone (TDT) as a management option for patients with HSDD. Our aim is to assess published studies using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for the quality of evidence regarding testosterone use as a short- and long-term therapy for HSDD. We implemented this qualitative systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. We set a GRADE score of 4 (high evidence) as a cutoff point for the quality measure of published studies assessing the use of TDT in HSDD. The outcomes of interest were the efficacy of TDT on the total number of satisfying sexual activity, number of orgasms, sexual desire and distress level in patients with HSDD. These outcomes were evaluated through Sexual Activity Log (SAL), Profile of Female Sexual Function (PFSF), and Personal Distress Scale (PDS) evaluation tools. Five randomized controlled trials were identified to meet the inclusion criteria. The selected studies were of high evidence based on the GRADE score as two of the studies scored 4 points, the other two studies scored 5 points and one study scored 6 points. All of the high quality selected studies had similar outcomes suggesting high effectiveness for the use of 300 µg/d TDT with or without estrogen for the management of HSDD with minimal side effects. One study showed a trend for higher risk of breast cancer in long-term use (0.37%). The use of 300 µg/d of TDT in surgical and natural menopause is an effective plan to manage HSDD in the short- and long-term. Although side effects are minimal, further prospective research is needed to assess the more severe side effects such as breast cancer in the long-term use of TDT.

BACKGROUND An estimated 50% of adolescents and young adults (AYA) living with HIV are failing to adhere to prescribed antiretroviral treatment (ART). Digital games are effective in chronic disease management; however, research on gaming to improve ART adherence among AYA is limited. OBJECTIVE We assessed the feasibility and acceptability of videogaming to improve AYA ART adherence. METHODS Focus group discussions (FGDs) and surveys were administered to healthcare providers and AYA aged 13-24 years living with HIV at a pediatric HIV program in Washington, DC. During FGDs, AYA viewed demonstrations of three game prototypes linked to portable Wisepill medication dispensers. Content analysis strategies and thematic coding were used to identify adherence themes and gaming acceptance and feasibility. Likert scale and descriptive statistics were used to summarize response frequencies. RESULTS Providers (n=10) identified common adherence barriers and strategies, including use of gaming analogies to improve AYA ART adherence. Providers supported exploration of digital gaming as an adherence intervention. Six FGDs with 12 AYA identified disclosure of HIV status and irregular daily schedules as major barriers to ART and use of alarms and pillboxes as reminders. Most AYA were "very or somewhat likely" to use the demonstrated game prototypes to help with ART adherence and desired challenging, individually-tailored, user-friendly games with in-game incentives. Game prototypes were modified accordingly. CONCLUSIONS AYA and their providers supported the use of digital games for ART adherence support. Individualization and in-game incentives were preferable and informed the design of an interactive technology-based adherence intervention among AYA living with HIV.

Introduction: India has been identified as having the second largest number of births with sickle cell anemia (SCA) in the world after Africa, with estimated 44,400 new-borns affected per year. SCD was previously reported to have a milder course in children from India, with less severe disease among aboriginal tribal populations than in non-tribal populations. Recent reports indicate the occurrence of severe manifestations of SCD in both tribal and non-tribal populations in India. Stroke is one of the serious complications of SCD, but there are no data on transcranial Doppler (TCD) screening for evaluating children with SCD in India who may be at high risk for strokes. The objective of this study was to assess the feasibility of using TCD to measure time averaged maximum of the mean velocities (TAMMV) in the intracranial arteries in children attending a tertiary centre in central India. Methods: STUDY DESIGN: A cross sectional study was conducted in consecutively recruited stable children of either sex with homozygous SCA proven by electrophoresis and high performance liquid chromatography in the age group of 1-26 years. Patients who were febrile, acutely ill, hypoxic or asleep were not included in the study as these conditions can falsely elevate the intracranial blood flow velocities. Patients with hemoglobinopathies other than HbSS or S/b0 Thalassemia and those with a history of congenital neurological illness were excluded. DETERMINATION OF TCD VELOCITY: TCD was performed in a tertiary care center in Nagpur using either an imaging machine (Lasiq s8) in the department of radiology or a portable non-imaging TCD (Compumedics); for both a probe of frequency 2Mhz was used. Maximum values for TAMMV in the Middle (MCA) and Anterior (ACA) cerebral arteries were measured in all; for the non-imaging TCD values for posterior cerebral artery (PCA) and basilar artery were also obtained. The results of the first scan performed on these individuals were included in this study. Using values similar to the STOP trial, TAMMV of each of these vessels were categorized as follows: Normal = 200 cm/s; Low MEASUREMENT OF HAEMATOLOGICAL VALUES: Laboratory parameters such as Hemoglobin, white blood cell count (WBC), Mean corpuscular volume (MCV) and hemoglobin F (HbF) levels of the patients in the study were also included if the parameters were available on the day of TCD or within 90 days of TCD study. MEASUREMENT OF HEIGHT, WEIGHT AND BMI: The height and weight of each of the patients on the day of TCD or within a period of 60 days from the TCD were measured and the body mass index (BMI) was calculated. Results One hundred and twenty children and youth aged 1-26 (median 7) years, 67 male (56%), were recruited. Of the 120 patients, 106 (88.5%) belonged to the Scheduled Caste category, 3 (2.5%) to the Scheduled Tribe category and 11 (9.1%) to the Other Classes category. Three (2.5%) had had a clinical stroke and 8 (7%) had had seizures, one of whom also had a stroke. Twenty-seven (23%) children had TAMMV outside the normal range. Five had abnormal TAMMV in the MCA (n=4) and/or ACA (n=1), 8 had conditional TAMMV in the MCA (n=7) and/or ACA (n=1) while 14 patients had low (n=12) or unobtainable (n=2) TAMMV in the MCA. One child with stroke had low TAMMV and one had conditional TAMMV while the third had normal TAMMV. Of the 7 with isolated seizures, one had low TAMMV and one had conditional TAMMV while the remaining 5 were normal. BMI was 8.6-25.3 (median 14.1), height/weight was 3.4-10.3 (median 6.5), hemoglobin was 43-134 (median 81) g/L, oxygen saturation 87-100 (median 99)%, HbF was 1.9-60 (median 21) g/dL, MCV was 59.1-96.7 (median 83.2) fl, WBC was 2.3-35.9 (median 10.1)*109. Those with TAMMV outside the normal range were not different from those with normal TAMMV in terms of age, BMI, Height/weight, or recent hemoglobin, oxygen saturation, HbF, MCV, or WBC. Discussion This study demonstrates the feasibility and importance of TCD screening in Indian SCD population. TAMMV on TCD was outside the normal range in nearly a quarter of children with SCD, as has been reported in studies in other populations. The findings of this study may not be representative of stroke risk in tribal populations since they were underrepresented in this study. These data provide the rationale for implementing systematic screening with TCD to reduce the risk of stroke in children affected by SCD in India. Disclosures Darbari: Novartis: Membership on an entity's Board of Directors or advisory committees; Hilton Publishing: Membership on an entity's Board of Directors or advisory committees; Global Blood Therapeutics: Other: one day advisory board meeting .

In the present day, all industry processes are automatically controlled. The wireless control networks in industries continue to grow because of the attributes inherent to wireless communication, such as flexibility, straightforward installation, and low labour costs. The key objective of the proposed system is to supervise and to control the industrial automation wirelessly using SCADA system. Visual Basic is used to create Human Machine Interface (HMI) and it provides the instruction to microcontroller for controlling whole industrial plant. In this project the industry considered is the dairy industry. The dairy industry process is controlled through PC using wireless network like Zigbee technology. Through PC we can observe the dairy process; how the milk is stored and circulated and how the stored milk is used for cheese preparation. The processes at dangerous places can be controlled with good accuracy and enhanced safety using SCADA. It is observed from the results that the proposed system is working with the maximum satisfaction.

Human immunodeficiency virus (HIV) screening in health care settings including emergency departments (EDs) is recommended for adolescents in the United States. This study aimed to evaluate the acceptance of and the factors affecting the HIV screening in pediatric EDs.A prospective, cross-sectional study of rapid opt-out oral HIV screening among adolescents ≥13 years of age was conducted in two pediatric EDs during 2009-2011. Descriptive statistics and logistic regression models were used to identify factors associated with the acceptance of HIV screening.During 24 months, 8,519 adolescents were approached for HIV screening; 6,184 (72.6%) did not opt out, and of those 5,764 (93.2%) were tested for HIV. Most adolescents who accepted testing were black (80.5%), female (57.6%), aged 15-17 years (50.1%), and District of Columbia residents (67.7%), and were accompanied by a guardian (69.1%). Acceptance of HIV screening varied by age, race/ethnicity, and state of residence, with younger (15 years) (adjusted odds ratio [aOR], 1.67; 95% confidence interval [CI], 1.33-2.09), non-black adolescents (aOR, .88; 95% CI, .77-.99) and non-District of Columbia residents (aOR, .86; 95% CI, .77-.96) being more likely to opt out of testing. Lower odds of opt-out of HIV testing were seen among adolescents with a guardian present (aOR, .42; 95% CI, .34-.53). The reasons for opt-out varied significantly by age and the presence of a guardian.The patient's age and the presence of a guardian were significantly associated with adolescents' decision and reasons to opt out of HIV screening in pediatric EDs. Further studies are necessary to evaluate the interventions needed to increase routine ED HIV screening in adolescents.

The clinical application of human bone marrow derived multipotent mesenchymal stromal cells (MSC) requires expansion, cryopreservation, and transportation from the laboratory to the site of cell implantation. The cryopreservation and thawing process of MSCs may have important effects on the viability, growth characteristics and functionality of these cells both in vitro and in vivo. More importantly, MSCs after two rounds of cryopreservation have not been as well characterized as fresh MSCs from the transplantation perspective. The objective of this study was to determine if the effect of successive cryopreservation of pooled MSCs during the exponential growth phase could impair their morphology, phenotype, gene expression, and differentiation capabilities. MSCs cryopreserved at passage 3 (cell bank) were thawed and expanded up to passage 4 and cryopreserved for the second time. These cells (passive) were then thawed and cultured up to passage 6, and, at each passage MSCs were characterized. As control, pooled passage 3 cells (active) after one round of cryopreservation were taken all the way to passage 6 without cryopreservation. We determined the growth rate of MSCs for both culture conditions in terms of population doubling number (PDN) and population doubling time (PDT). Gene expression profiles for pluripotency markers and tissue specific markers corresponding to neuroectoderm, mesoderm and endoderm lineages were also analyzed for active and passive cultures of MSC. The results show that in both culture conditions, MSCs exhibited similar growth properties, phenotypes and gene expression patterns as well as similar differentiation potential to osteo-, chondro-, and adipo-lineages in vitro. To conclude, it appears that successive or multiple rounds of cryopreservation of MSCs did not alter the fundamental characteristics of these cells and may be used for clinical therapy.

Background aims. Dental pulp stromal cells (DPSC) are considered to be a promising source of stem cells in the fi eld of regenerative therapy. However, the usage of DPSC in transplantation requires large-scale expansion to cater for the need for clinical quantity without compromising current good manufacturing practice (cGMP). Existing protocols for cell culturing make use of fetal bovine serum (FBS) as a nutritional supplement. Unfortunately, FBS is an undesirable additive to cells because it carries the risk of transmitting viral and prion diseases. Therefore, the present study was undertaken to examine the effi cacy of human platelet lysate (HPL) as a substitute for FBS in a large-scale set-up. Methods . We expanded the DPSC in Dulbecco ’ s modifi ed Eagle ’ s medium – knock-out (DMEM-KO) with either 10% FBS or 10% HPL, and studied the characteristics of DPSC at pre- (T25 culture fl ask) and post- (5-STACK chamber) large-scale expansion in terms of their identity, quality, functionality, molecular signatures and cytogenetic stability. Results . In both pre- and postlarge-scale expansion, DPSC expanded in HPL showed extensive proliferation of cells ( c. 2-fold) compared with FBS; the purity, immune phenotype, colony-forming unit potential and differentiation were comparable. Furthermore, to understand the gene expression profi ling, the transcriptomes and cytogenetics of DPSC expanded under HPL and FBS were compared, revealing similar expression profi les. Conclusions . We present a highly economized expansion of DPSC in HPL, yielding double the amount of cells while retaining their basic characteristics during a shorter time period under cGMP conditions, making it suitable for therapeutic applications.