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Introduction: The emergence of biological threats that can potentially affect millions emphasizes the need to develop a policy framework in the Philippines that can mount an adequate and well-coord...

Background Voice features have been suggested as objective markers of bipolar disorder (BD). Aims To investigate whether voice features from naturalistic phone calls could discriminate between (1) BD, unaffected first-degree relatives (UR) and healthy control individuals (HC); (2) affective states within BD. Methods Voice features were collected daily during naturalistic phone calls for up to 972 days. A total of 121 patients with BD, 21 UR and 38 HC were included. A total of 107.033 voice data entries were collected [BD (n = 78.733), UR (n = 8004), and HC (n = 20.296)]. Daily, patients evaluated symptoms using a smartphone-based system. Affective states were defined according to these evaluations. Data were analyzed using random forest machine learning algorithms. Results Compared to HC, BD was classified with a sensitivity of 0.79 (SD 0.11)/AUC = 0.76 (SD 0.11) and UR with a sensitivity of 0.53 (SD 0.21)/AUC of 0.72 (SD 0.12). Within BD, compared to euthymia, mania was classified with a specificity of 0.75 (SD 0.16)/AUC = 0.66 (SD 0.11). Compared to euthymia, depression was classified with a specificity of 0.70 (SD 0.16)/AUC = 0.66 (SD 0.12). In all models the user dependent models outperformed the user independent models. Models combining increased mood, increased activity and insomnia compared to periods without performed best with a specificity of 0.78 (SD 0.16)/AUC = 0.67 (SD 0.11). Conclusions Voice features from naturalistic phone calls may represent a supplementary objective marker discriminating BD from HC and a state marker within BD.

Background: Coronary artery disease is a major cause of morbidity and mortality worldwide. A major health concern in the developing countries is opioid addiction, which has controversial cardiovascular side effects. We aimed to investigate whether Myocardial Infarction (MI) and its risk factors are associated with morphine dependency in the Iranian population. Methods: Electronic databases, including PubMed, Medline, Scopus, SID, Element, and Magiran were searched to find published articles including the keywords morphine, coronary artery disease, hypertension, hyperlipidemia, and diabetes mellitus. Results: Twelve studies involving 25,800 people were included in this systematic review and metaanalysis. Morphine dependency was significantly associated with MI with an adjusted odds ratio (AOR) of 2.28 (95%CI=1.26-4.11). It neither has significant associations with hypertension (AOR=0.952; 95%CI=0.696-1.301) nor diabetes (AOR=0.895; 95%CI=0.644-1.246). Morphine dependency also had no significant association with hyperlipidemia with a Crude Odds Ratio (COR) of 0.906 (95%CI=0.786-1.045). Conclusion: Morphine dependency was significantly related to MI, but its risk factors were not significantly associated with morphine dependency. The increasing prevalence of opioid abuse in developing countries may be a reason for the growing incidence of MI in younger ages and individuals with no risk factors. Besides, physicians should consider the presence of impurities in morphine-based opioids and their possible effects on health.

Concerns about the growing trend of population and limited resources resulted in valuing sustainability and enhancing production. Discussion about new developments, environment, and productions cannot be complete without the sustainability model. Emergy analysis is one of the main tools to measure the sustainability of ecosystems by analyzing inputs, services, and energies with a nature-oriented approach. Accordingly, the present study strived for assessing ecological sustainability from emergy, greenhouse gas (GHG) emissions, and economic viewpoints in rice and wheat production in the province of Mazandaran, Iran. It was concluded that fuel contributes more to GHG emissions with shares equal to 53.89% and 50.6% in the production of rice and wheat, respectively. The average total GHG emissions in rice and wheat production in the region were also 1493.8 kgCO2eq/ha and 837.3 kgCO2eq/ha, respectively. Besides, the average total energy supporting rice and wheat production was estimated at 5.36E + 16 and 5.95E + 16 seJ/ha, respectively. The average modified environmental loading index for wheat and rice was 9.75 and 32.9, respectively. These values were larger than the results reported in the relevant studies, which reflect that there is heavy pressure on the environment due to such agricultural practices. The average environmental sustainability index was also 0.11 and 0.05 for rice and wheat, respectively. The smaller environmental sustainability index as compared to similar studies reflected the lower sustainability of these systems. Economic analyses revealed that the average total net returns of rice and wheat production were 16,980.51 and 1151.34 US$/ha, respectively. Therefore, rice production is more sustainable than wheat production. It is recommended to produce rice and wheat with more caution in this region, especially concerning chemical-based fertilizers and fuel consumption.

Shamsul Azhar Shah,1 Nazarudin Safian,1 Saharuddin Ahmad,2 Siti Rohani Nurumal,1 Zulkefley Mohammad,1 Juliana Mansor,1 Wan Abdul Hannan Wan Ibadullah,1 Yugo Shobugawa,3 Megumi Rosenberg4 1Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia; 2Department of Family Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia; 3Department of Active Aging, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 4Centre for Health Development, World Health Organization, Kobe, JapanCorrespondence: Shamsul Azhar ShahDepartment of Community Health, Faculty of Medicine, National University of Malaysia, Cheras, Kuala Lumpur, 56000, MalaysiaTel +60 3-9145 8787Fax +60 3-91456670Email drsham@ppukm.ukm.edu.myPurpose: Older people often have chronic diseases which require a continuity of care over the long term. Countries undergoing population aging need to ensure that older people are receiving the care they need. This study assesses the prevalence of, reasons for, and factors associated with unmet healthcare needs among older people individuals in Malaysia.Patients and Methods: This cross-sectional study used data collected during 2018– 2020 from 1204 older adults aged 60 and older selected from Selangor state, Malaysia. A comprehensive face-to-face interview based on the Bahasa Malaysia version of the Japan Gerontological Evaluation Study (JAGES-BM) questionnaire was administered to gain information on unmet healthcare needs, socioeconomic factors, health-related factors, and measures of function (activities of daily living, depression, visual impairment, hearing impairment, memory impairment, and walking impairment). Multivariate logistic regression was used to analyze factors associated with their unmet healthcare needs.Results: Overall, the percentage of older people respondents with unmet healthcare needs is 6.6%. The most reported reasons for forgoing or delaying healthcare were lack of knowledge about healthcare and financial barriers to care. The inability to travel alone (adjusted odds ratio [aOR] 2.51), being overweight (aOR 1.88), and having self-reported depression (aOR 2.23) were each associated with a higher likelihood of having unmet healthcare needs in their daily life.Conclusion: The prevalence of unmet healthcare needs among older people in this part of Malaysia is lower than that reported in some other countries. However, it is possible to further reduce unmet healthcare needs by improving people’s knowledge and attitudes about appropriate healthcare utilization, strengthening financial protection measures and providing support to people at high risk of having unmet healthcare needs.Keywords: healthcare needs, old age, Malaysia

This study aims to find out online shop marketing communications @cutrizkyhijab1 on instagram and to find out the advantages and disadvantages of online shop@cutrizkyhijab1on marketing through Instagram media. The theory used in this study is the theory of social media, Instagram, marketing communication, and the Marketing Mix. The subjects of this research are Owners and 10 permanent consumers cutrizkyhijab1 listen research time from April to August. The method used in this research is the Qualitative Method with In-depth Interview (in-depth interview). Technical analysis used is descriptive qualitative analysis. The results of this study indicate that the marketing communication strategy carried out through Instagram media is used by online shop owner @cutrizkyhijab1through promotions on the Instagram application. Of the various supporting features on Instagram, the features that are most often used are the Instagram photo upload feature and Story Highlights. The advantages of online shop@cutrizkyhijab1Compared to other online shops, it lies in conveying messages to consumers by using the features available on Instagram, prices and up to date products for each product variation. Disadvantages of online shop@cutrizkyhijab1 in the form of competition between other online shops, thus making the owner @cutrizkyhijab1 must be diligent to post photos or videos so that their products can be seen by consumers.

Background Hepatic iron content (HIC) is an important parameter for the management of iron overload. Non-invasive HIC assessment is often performed using biopsy-calibrated two-dimensional breath-hold Cartesian gradient echo (2D BH GRE) R2 * -MRI. However, breath-holding is not possible in most pediatric patients or those with respiratory problems, and three-dimensional free-breathing radial GRE (3D FB rGRE) has emerged as a viable alternative. Purpose To evaluate the performance of a 3D FB rGRE and validate its R2 * and fat fraction (FF) quantification with 3D breath-hold Cartesian GRE (3D BH cGRE) and biopsy-calibrated 2D BH GRE across a wide range of HICs. Study type Retrospective. Subjects Twenty-nine patients with hepatic iron overload (22 females, median age: 15 [5-25] years). Field strength/sequence Three-dimensional radial and 2D and 3D Cartesian multi-echo GRE at 1.5 T. Assessment R2 * and FF maps were computed for 3D GREs using a multi-spectral fat model and 2D GRE R2 * maps were calculated using a mono-exponential model. Mean R2 * and FF values were calculated via whole-liver contouring and T2 * -thresholding by three operators. Statistical tests Inter- and intra-observer reproducibility was assessed using Bland-Altman and intraclass correlation coefficient (ICC). Linear regression and Bland-Altman analysis were performed to compare R2 * and FF values among the three acquisitions. One-way repeated-measures ANOVA and Wilcoxon signed-rank tests, respectively, were used to test for significant differences between R2 * and FF values obtained with different acquisitions. Statistical significance was assumed at P Results The mean biases and ICC for inter- and intra-observer reproducibility were close to 0% and >0.99, respectively for both R2 * and FF. The 3D FB rGRE R2 * and FF values were not significantly different (P > 0.44) and highly correlated (R2 ≥ 0.98) with breath-hold Cartesian GREs, with mean biases ≤ ±2.5% and slopes 0.90-1.12. In non-breath-holding patients, Cartesian GREs showed motion artifacts, whereas 3D FB rGRE exhibited only minimal streaking artifacts. Data conclusion Free-breathing 3D radial GRE is a viable alternative in non-breath-hold patients for accurate HIC estimation. Level of evidence 3 TECHNICAL EFFICACY: Stage 2.

This article explores the concept of function assignment in first language (L1) and second language (L2) speech production, compares automation of function assignment in L1 and L2 speech production, pursues factors hampering automation of function assignment in L2 speech production, and discusses how to improve automation of function assignment in L2 speech production. Grammatical encoding, of which function assignment is one of the subordinate processes, is also one of the processes in L2 speech production. While function assignment in L1 speech production is mostly automatic, it demands much attentional resources and is executed under conscious supervision in L2 speech production. L2 learners’ incomplete knowledge of the target language and their limited working memory resources hamper automation of function assignment in L2 speech production. Furthermore, as per generative models of learning, to improve automation of function assignment, teachers can either adopt strategies or improve instructional designs targeting this subprocess. Together, this conceptual paper gives a comprehensive overview of automation of function assignment, explores its impact on second language acquisition (SLA), and reveals that it is feasible to facilitate automation of function assignment in L2 speech production by improving instructional designs, especially the presentation methods of sentence elements.

Purpose Integrating spirituality into the patient care within a healthcare team, increases the ability to provide “holistic care” for cancer patients. The spiritual care experiences of different involved persons can be a guide for future planning. Therefore, this study aimed to explore the spiritual care experiences of hospitalized cancer patients, their family caregivers and healthcare team members in oncology settings. Methods This is a descriptive qualitative study which was conducted with 21 participants, who were selected by purposive sampling. Semi-structured interviews were used to collect the data. The data were analyzed with conventional content analysis method. Results Two themes of "systematic care" and "caring with paradoxical results" were extracted from the spiritual care experiences of our participants. Conclusions Spiritual care as professional, comprehensive, collaborative and artistic care should be provided in a multidisciplinary healthcare team for cancer patients. Otherwise, patients may experience deprivation of spiritual services and consequently, spiritual distress.

The COVID-19 pandemic has had implications in the central nervous system. COVID-19 infection is characterized by coagulation activation and endothelial dysfunction, causing the endocrine system's ischemic and hemorrhagic vascular syndromes. We aimed to provide an overview of the global literature on the impact of COVID-19 on pituitary function and structure. A narrative, nonsystematic review of the literature retrieved from a significant medical online database (PubMed) between February 1, 2020 and June 30, 2021. The relevant literature was narrated in a concise thematic account. Most specific recommendations for managing endocrine disorders during COVID-19 rely on the same principles of epidemiological safety measures, delaying nonemergency admissions and transforming the routine follow-up to telemedicine clinics. Ongoing medications should be continued. Special attention is required to both primary and secondary adrenal disorders. Corticosteroids are a mainstay of treatment in COVID-19 infection. Therefore, it is essential to consider all aspects of high doses, including adverse metabolic reactions, especially in people with diabetes and prediabetes. Surgery is postponed for nonemergency situations, restricting most planned surgeries, and if required in an emergency, plans should include an additional risk. Sick-day rules should be adhered to strictly. Regular contact with endocrinology teams can be maintained through teleconsultations and virtual clinics. In conclusion, special attention is needed to the interaction between COVID-19 infection and pituitary conditions in a bidirectional manner. The direct impact of COVID-19 on pituitary structure and function is possible and should be recognized timely and treated effectively. Furthermore, appropriate organizational adjustments are needed to maintain a coordinated response within the conventional multidisciplinary management to optimize the care of patients with pituitary conditions among the ongoing COVID-19 pandemic.

The Long-term contraceptive method, abbreviated as MKJP, is a method of contraception that is known to be effective because it can provide protection from the risk of pregnancy for a period of up to ten years consisting of the Female Operation Method (FOM), the Male Operation Method (MOP), and the intrauterine device (IUD). and implants or what is known as implant KB is a contraceptive device under the skin with a validity period of three years. The method used to achieve the target of this activity is by way of approach, counseling, and free counseling services. Thus the community will get services through a series of activities that support the improvement of the quality of public health and education, of course. The final output of this activity is that women of childbearing age in the Talang Jambe village of Palembang are able to understand long-term contraceptive methods. And of course, after counseling and counseling services for women of childbearing age and becoming active family planning acceptors with long-term contraceptive methods.

In this work, a non-conventional distillation sequence with thermal coupling (Petlyuk Column) was presented as a technique to perform the separation of the NGL consist of ethane, propane, butane or other higher alkanes. The improvements were investigated through the energy analysis and remixing effect. From the result obtained, it was found that the Petlyuk arrangement consumes less amount of energy and able to reduce the remixing effects as compared to the conventional column sequencing. The Petlyuk arrangement saved about 44.49% and 12.83% in terms of cooling and heating duty, respectively. The overall annual energy saving shown by this arrangement is 39.22%. This arrangement proved to be able to prevent the remixing effect occurrence that contributes to thermal and separation inefficiency. The desired separation efficiency also obtained by this arrangement as all the product specifications are met. The ability in avoiding remixing effect by the Petlyuk column permits a significant reduction in CO2 emission with an average of 29.43 % of each equipment involved. Hence, it can be concluded that the Petlyuk arrangement model is a better alternative to be implemented in the NGL fractionation train.

Background: Proliferation of adipose tissue increases leptin secretion and decreases adiponectin concentration. Exercise is an intervention to control and reverse this process. Therefore, the present study aimed to determine the effect of 8-week high-intensity interval training on leptin, adiponectin, and the ratio of leptin to adiponectin in overweight adolescent boys. Materials and Methods: The present quasi-experimental study was conducted on overweight adolescent boys (13-18 years old, mean body mass index 27.05±1.4 kg/m2). A total of 30 participants volunteered who were divided into three groups of 10 people including short-term (9 sessions of 30-second training with 150-second rest), long-term (4 sessions of 150-second training with 240-second rest), and control group. The training groups performed high-intensity running sprints 3 times per week for 8 weeks. Data were analyzed using two-way repeated-measures ANOVA (3 groups×2 measurement times) and Bonferroni test. Results: Performed high-intensity interval training failed to affect leptin, weight, and body mass index but increased adiponectin and decreased the ratio of leptin to adiponectin (P = 0.042) and fat percentage. No difference was observed between the two types of interval training in changing the level of leptin, adiponectin, fat percentage, and body mass index. Conclusion: High-intensity interval training increases metabolic benefits in overweight adolescents by increasing adiponectin and subsequently decreasing the leptin/adiponectin ratio. Low exercise, no calorie restriction, and other factors affecting puberty may influence the research results.

Therapeutic outcomes in oncology may be aided by precision diagnostics that offer early detection, localization and the opportunity to monitor response to therapy. Here, we report a multimodal nanosensor engineered to target tumours through acidosis, respond to proteases in the microenvironment to release urinary reporters and (optionally) carry positron emission tomography probes to enable localization of primary and metastatic cancers in mouse models of colorectal cancer. We present a paradigm wherein this multimodal sensor can be employed longitudinally to assess burden of disease non-invasively, including tumour progression and response to chemotherapy. Specifically, we showed that acidosis-mediated tumour insertion enhanced on-target release of matrix metalloproteinase-responsive reporters in urine. Subsequent on-demand loading of the radiotracer 64Cu allowed pH-dependent tumour visualization, enabling enriched microenvironmental characterization when compared with the conventional metabolic tracer 18F-fluorodeoxyglucose. Through tailored target specificities, this modular platform has the capacity to be engineered as a pan-cancer test that may guide treatment decisions for numerous tumour types.

Aggregatibacter actinomycetemcomitans is a significant pathogen in periodontal disease, contributing to aggressive and chronic inflammatory conditions of the periodontal area. This pathogen is shown to contribute to the tenacious biofilm formation in the oral cavity and results in persistent induction of pro-inflammatory response leads to progressive periodontitis. Besides the immune-modulatory capabilities, quorum sensing (QS) activity is believed to influence the virulence activities, leading to a progressive inflammatory response by the host. QS modulates the expression of genes involved in the processes related to survival and biofilm formation activities by answering the localized bacterial population's fluctuation. Understanding the QS activity of this pathogen and its impact on disease might be useful as an alternative approach to counteract the infection. Therefore, this review paper is focusing on the evaluation of the QS activities of A. actinomycetemcomitans and how this activity influences the progression of periodontal disease. Based on the previous findings, we found that there are possibilities the QS activity interrupted by enzymes or molecules that blocking the QS signals produced by other species of bacteria. However, due to minimal QS studies that have been done specifically on A. actinomycetemcomitans, the mechanism is not conclusive. Therefore, this might initiate an essential option for alternative treatment against periodontal pathogen infection and oral health care.

Background Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are common among individuals with human immune deficiency virus (HIV) infection worldwide. In this study, we did a systematic review and meta-analysis of the published literature to estimate the global and regional prevalence of HCV, HBV and HIV coinfections among HIV-positive prisoners. Methods We searched PubMed via MEDLINE, Embase, the Cochrane Library, SCOPUS, and Web of science (ISI) to identify studies that reported the prevalence of HBV and HCV among prisoners living with HIV. We used an eight-item checklist for critically appraisal studies of prevalence/incidence of a health problem to assess the quality of publications in the included 48 cross-sectional and 4 cohort studies. We used random-effect models and meta-regression for the meta-analysis of the results of the included studies. Results The number of the included studies were 50 for HCV-HIV, and 23 for HBV-HIV co-infections. The pooled prevalence rates of the coinfections were 12% [95% confidence interval (CI) 9.0–16.0] for HBV-HIV and 62% (95% CI 53.0–71.0) for HCV-HIV. Among HIV-positive prisoners who reported drug injection, the prevalence of HBV increased to 15% (95% CI 5.0–23.0), and the HCV prevalence increased to 78% (95% CI 51.0–100). The prevalence of HBV-HIV coinfection among prisoners ranged from 3% in the East Mediterranean region to 27% in the American region. Also, the prevalence of HCV-HIV coinfections among prisoners ranged from 6% in Europe to 98% in the East Mediterranean regions. Conclusions Our findings suggested that the high prevalence of HBV and HCV co-infection among HIV-positive prisoners, particularly among those with a history of drug injection, varies significantly across the globe. The results of Meta-regression analysis showed a sliding increase in the prevalence of the studied co-infections among prisoners over the past decades, rising a call for better screening and treatment programs targeting this high-risk population. To prevent the above coinfections among prisoners, aimed public health services (e.g. harm reduction via access to clean needles), human rights, equity, and ethics are to be seriously delivered or practiced in prisons. Protocol registration number: CRD42018115707 (in the PROSPERO international). Graphic abstract

The pandemic of COVID-19 has become one of the greatest threats to human health, causing severe disruptions in the global supply chain, and compromising health care delivery worldwide. Although government authorities sought to contain the spread of SARS-CoV-2, by restricting travel and in-person activities, failure to deploy time-sensitive strategies in ramping-up of critical resource production exacerbated the outbreak. Here, we developed a mathematical model to analyze the effects of the interaction between supply chain disruption and infectious disease dynamics using coupled production and disease networks built on global data. Analysis of the supply chain model suggests that time-sensitive containment strategies could be created to balance objectives in pandemic control and economic losses, leading to a spatiotemporal separation of infection peaks that alleviates the societal impact of the disease. A lean resource allocation strategy can reduce the impact of supply chain shortages from 11.91 to 1.11% in North America. Our model highlights the importance of cross-sectoral coordination and region-wise collaboration to optimally contain a pandemic and provides a framework that could advance the containment and model-based decision making for future pandemics.

Introduction: The objective of this study was to compare the level of complements C3 and C4 in serum, and stimulated saliva between oral lichen planus (OLP) and healthy individuals. Methods: A case-control study was performed on 31 healthy and 31 who suffer the erosive type of OLP. Serum and saliva level of C3 and C4 were measured by immunoturbidimetry method. Results: C3 and C4 were expressed at a lower level in serum and saliva of OLP patients compared to control groups. Serum C3 and C4 levels did not correlate with their saliva levels. The receiver operating characteristic analysis showed significantly diagnostic abilities for serum and saliva C3 and C4 to discrimination of OLP patients from controls (cutoff [mg/dl] for C3 were 83 in serum and 3.45 in saliva and for C4 were 9.5 in serum and 0.9 in saliva). Conclusion: Serum and salivary levels of total C3 and C4 were lower in patients with OLP than in healthy controls. Therefore, they may able to discriminate OLP from healthy.

Generally, bacteria co-exist setting up communities associated to solid superficies, this is to which we refer as biofilms that serve as a survival strategy. This type of formation cause serious sanitary problems for both humans and animals. Nowadays, chemical or natural compounds able to block this formation are looked for. In this project, we have evaluation of antimicrobial effects of Rosemary and Withania somnifera extract prepared by ultrasound waveform on Escherichia coli biofilm isolated from urinary tract infection. Rosemary and Withania somnifera extracts were obtained by using rotary devices. E. coli was collected from the patients being cured in Zabol hospitals. The least hindering and killing concentration of the samples were calculated by lowering their densityin sinks. The growth and biofilm formation of strains were determined by microtiterplate method. Data were analyzed statistically by determination of significant difference using analysis of variance (ANOVA) test. All tests were analyzed at the significance level P less than 0.05. The results revealed that the concentrations of 5 and 10 mg/mL are the most restrain in the biofilm formation of the isolated plates. Rosemary and Withania somnifera extracts have considerable antimicrobial and ant biofilm effect on the samples of the E. coli resistant to antibiotics.

The increasing numbers of financially distressed firms in the Malaysian market demonstrate the importance of predicting financial distress among firms in Malaysia. Using firm financial ratios, this study focuses on predicting financial distress using the hazard model and logistic regression (logit model) based on the Malaysian market. This study used listed firms on the Malaysian stock market from 2000 to 2018 to create two sets of data comprising the main sample and holdout sample in order to compare the predictability between hazard and logit models. The results clearly show that the hazard model is better compared to the logit model in predicting financial distress for the Malaysian market since more variables were found to be significant in addition to the model being more consistent in terms of accuracy.

Neurodegeneration with brain iron accumulation (NBIA) is a term used for a group of hereditary neurological disorders with abnormal accumulation of iron in basal ganglia. It is clinically and genetically heterogeneous with symptoms such as dystonia, dysarthria, Parkinsonism, intellectual disability, and spasticity. The age at onset and rate of progression are variable among individuals. Current therapies are exclusively symptomatic and unable to hinder the disease progression. Approximately 16 genes have been identified and affiliated to such condition with different functions such as iron metabolism (only two genes: Ferritin Light Chain (FTL) Ceruloplasmin (CP)), lipid metabolism, lysosomal functions, and autophagy process, but some functions have remained unknown so far. Subgroups of NBIA are categorized based on the mutant genes. Although in the last 10 years, the development of whole-exome sequencing (WES) technology has promoted the identification of disease-causing genes, there seem to be some unknown genes and our knowledge about the molecular aspects and pathogenesis of NBIA is not complete yet. There is currently no comprehensive study about the NBIA in Iran; however, one of the latest discovered NBIA genes, GTP-binding protein 2 (GTPBP2), has been identified in an Iranian family, and there are some patients who have genetically remained unknown.

Background. Tuberculosis (TB) is a serious health threat to people living with human immunodeficiency virus (HIV). This study aimed to identify the characteristics, unsuccessful TB treatment rate, and determinants of unsuccessful TB treatment outcome among patients with TB-HIV coinfection in Kuala Lumpur. Methods. This was a cross-sectional study. The data of all patients with TB-HIV in the federal territory of Kuala Lumpur from 2013 to 2017 were collected and reviewed. The data were retrieved from the national database (TB Information System) at the Kuala Lumpur Health Department from 1 March 2018 to 31 May 2018. Results. Out of 235 randomly selected patients with TB-HIV, TB treatment outcome was successful in 57.9% (cured and completed treatment) and unsuccessful in 42.1% (died, failed, or lost to follow-up). Patients who did not receive DOTS (directly observed treatment, short course) (adjusted odds ratio: 21.71; 95% confidence interval: 5.36–87.94) and those who received shorter treatment duration of 6 months. It is crucial to strengthen and widen the coverage of DOTS, especially among high-risk groups, in healthcare settings. Strict follow-up by healthcare providers is needed for patients with TB-HIV to gain treatment adherence and for better rates of successful TB treatment.

Optimization of village potential in the order of pioneering Paranggupito tourism village, Wonogiri Regency. Along with the development of tourist villages, the Central Java Provincial Government responded to this condition with the existence of the Central Java Provincial Regulation No. 2 of 2019 concerning the empowerment of tourist villages in Central Java Province One of the districts in Central Java located at the southern tip of which is currently working to build a tourist village in Wonogiri Regency. Currently, Wonogiri Regency has 6 tourist villages that have already obtained SK as tourism villages from the Wonogiri Regency Youth and Sports and Tourism Office in 2020, one of which is the Paranggupito tourism village. This research will focus on pioneering tourism villages by maximizing the existing potential. The purpose of this research is to multiply the potential and tourist attractions, mapping the potential of tourism villages, and develop the concept of a tourism village with the activities offered by the strategy of packaging tourism villages into tour package products. In this study, descriptive qualitative research methods are used by describing and mapping the potential of tourism villages, as well as compiling village tour packages. In addition, non-physical development will also be carried out including the development of human resources, both technical and managerial skills for tourism village managers, building cooperation networks, and compiling marketing media to be used. In pioneering Paranggupito tourism village, it is made in 2 concepts that are oriented towards the tourist market to be targeted, concept 1 which emphasizes more on educational and adventure tourism with the target market being young people who like an adventure.

Background The projection studies are imperative to satisfy demands for health care systems and proper response to the public health problems such as inflammatory bowel disease (IBD). Methods To accomplish this, we established an illness-death model based on available data to project the future prevalence of IBD in Asia, Iran in particular, separately from 2017 to 2035. We applied two deterministic and stochastic approaches. Results In 2035, as compared to 2020, we expected a 2.5-fold rise in prevalence for Iran with 69 thousand cases, a 2.3-fold increment for North Africa and the Middle East with 220 thousand cases, quadrupling of the prevalence for India with 2.2 million cases, a 1.5-fold increase for East Asia region with 4.5 million cases, and a 1.6-fold elevation in prevalence for high‐income Asia‐Pacific and Southeast Asia regions with 183 and 199 thousand cases respectively. Conclusions Our results showed an emerging epidemic for the prevalence of IBD in Asia regions and/or countries. Hence, we suggest the need for immediate action to control this increasing trend in Asia and Iran. However, we were virtually unable to use information about age groups, gender, and other factors influencing the evolution of IBD in our model due to lack of access to reliable data.

Objectives: The purpose of the present study was to investigate whether LEP19 G>A and LEPR 668 A>G polymorphisms, would influence the effect of an 8-week combined aerobic and resistance training. Methods: Thirty obese boys (BMIz>+2) aged 11-13 (12.66±0.47) were recruited from three middle schools in Quchan. The changes in body composition parameters and metabolic factors in response to 8-weeks combined aerobic and resistance training program were analyzed regarding LEP and LEPR polymorphism. DNA was extracted from cheek cells donated by the 30 participants and genotyping was carried out using PCR. Results: Our results suggest that carriers of rs2167270G allele and rs1137101A allele were characterized by a greater reduction in body mass and WHR (P< 0.05). Also, a significant decrease was observed in leptin levels in carriers of rs2167270G allele after the training program (P=0.031). Moreover, the LEP and LEPR polymorphisms were associated with changes in lipid profile in response to training. Conclusion: In response to 8 weeks of regular physical activity, obese boys with G (rs2167270) and A (rs1137101) alleles had the best likelihood of losing weight which was associated with a decrease in body mass, fat mass (%), WHR and leptin concentrations.

The embedment of induction loop underground for traffic volume monitoring caused damaging effects to the road and reduced road surface aesthetics. A wireless magnetometer implanted underground in a small uniform area was developed to detect three-axis magnetic flux changes due to the perturbation of vehicle passing over the sensor. In this project, a wireless magnetometer sensor system operating at a radio frequency of 2.4 GHz for detecting and transmitting Z-field data has been developed to investigate the patterns of magnetic field associated with the car directions and speed. This is the first report in revealing the responses of the sensor to different car speed and sensing directions. Field tests were conducted by car passes over in a direction in-line or countering the X and Y axes of the magnetometer. The results showed that the strong magnetic field density as low as -100 to -230 μT could be generated when a car passed over the sensor in a direction countering X and Y axes. The speed detection limit of the sensor is < 60 kmph. The X, Y and Z flux patterns obtained is important in designing an algorithm for accurate detection and counting of vehicles.

This study sought to explore the leadership of principals as educational administrators based on their natural attributes. The excellence in the actions of principals as educational administrators will serve as the determining factor for the success of a school across nine fields listed in the Malaysian School Principals Competency Standards. This success is mainly driven by the natural attributes of principals’ leadership in influencing the processes and behaviour of teachers in the delivery of education. This study also explores leadership issues and problems that are still of current interest. Principals’ competency levels in executing leadership still show that teachers are constrained by numerous flaws particularly in the teaching and learning in schools. Such conditions are often mirrored in schools with poor leadership display by Principals who are bent on putting off planned educational programmes. This qualitative study was done as a single case study. Qualitative data obtained via interviews with 10 informants in school formed the research case. The interviews were semi-structured and were analysed manually using category classification. The interviews explained the natural attributes reflected via Principals’ leadership orientation to answer the issues in this study. The findings of this study shall serve as additional elements in the process of selecting and placing Principals, as well as be developed as a guide for educational administrators desiring effective and quality leadership orientation for managing and administrating schools in Sabah. This study is of importance as it contributes additional knowledge in the fields of education and human resource for the benefit of other researchers.

Objectives: The outbreak of Coronavirus Disease 2019 (COVID-19) has influenced all age groups; however, the risk of mortality increases with age. Several factors impact the development of this disease. This study aimed to determine the relationship between some risk factors in the development of COVID-19 among community dwellers of ≥50 years of age.This cross-sectional study was performed at Shahroud University of Medical Sciences from April 1, 2019, to June 20, 2020. Methods & Materials: This cross-sectional study was conducted on individuals aged ≥50 years, including middle-aged and aging suspected of COVID-19 referring to registration centers in Shahroud University of Medical Sciences from Feb. 20th to Jun. 20th, 2020. The basis for diagnosing COVID-19 in suspected cases was a positive Reverse Transcription Polymerase Chain Reaction (RT-PCR) test based on a nasopharyngeal swab or Computed Tomography (CT) scan. The data used included demographic information, a history of smoking, and comorbidities. Data analysis was performed in SPSS by descriptive statistics, Chi-squared test, Independent Samples t-test, and logistic regression model. Results: In the first 4 months of the COVID-19 outbreak, 3945 suspicious cases were referred to Shahroud healthcare centers. After removing the missing cases, of the 3119 registered cases, 1348 participants were aged ≥50 years. Of all eligible participants, 602 cases were diagnosed with COVID-19, and 303 were males. The obtained data suggested that the Mean±SD age of the study subjects was 66.62±11.33 years. Diabetes (P=0.014) and other comorbidities, such as asthma, acute respiratory, hepatic and kidney diseases, and cancer in borderline significantly increased the incidence of COVID-19 by 38% and 32%, respectively. An increase of one unit in Body Mass Index (BMI) (P=0.002) enhanced the odds of infection by 4%. Conclusion: Based on the multivariate logistic regression results, high BMI and diabetes were significant risk factors in the development of COVID-19 among aged subjects. This conclusion emphasizes the importance of BMI and diabetes in the assessment of patients in middle-aged and aging groups.

Aims There is a rapid increase in the number of people infected with COVID-19 throughout the world. The present study aimed to determine people’s knowledge, attitudes, and practices (KAP) regarding COVID-19 in an Iranian sample. Instruments & Methods This was a population-based cross-sectional study conducted on people over 18 years of age in Saveh city, of Iran, in 2020. A multiple-stage sampling method was used. Participants (N=471) completed an anonymous and self-report questionnaire assessing socio-demographic variables and KAP. Data were analyzed using ANOVA and independent t-tests by SPSS 21. The significance level was considered to be ≤0.05. Findings Of participants, 74.5% did not have accurate knowledge of how the coronavirus is spread. In terms of attitudes, more than 63.2% considered COVID-19 to be a dangerous disease. About 59.6% of participants reported regular use of a mask in the past week. As compared to men, women reported attitudes and practices more aligned with recommended safety standards. Higher education level was significantly related to the mean KAP score (p

Myelitis, including longitudinally extensive transverse myelitis (LTEM), is reported in more than forty patients after coronavirus disease 2019 (COVID-19). Among COVID-19 vaccines, only Oxford-AstraZeneca COVID-19 vaccine (AZD1222) has been associated with few cases of myelitis (1 LTEM). We report the first case of myelitis/LTEM after BBIBP-CorV/Sinopharm vaccine, interestingly presented as a hemicord syndrome. A 71-year-old male presented with left-side diplegia, right-side hemihyposthesis with facial sparing and impaired position sensation in left foot after vaccination with BBIBP-CorV. MRI revealed a longitudinal signal in left cervical hemicord. This is the first reported myelitis and LTEM with COVID-19 vaccines other than AZD1222.

Hypothesis Measuring the length of the basilar membrane (BM) in the cochlear hook region will result in improved accuracy of cochlear duct length (CDL) measurements. Background Cochlear implant pitch mapping is generally performed in a patient independent approach, which has been shown to result in place-pitch mismatches. In order to customize cochlear implant pitch maps, accurate CDL measurements must be obtained. CDL measurements generally begin at the center of the round window (RW) and ignore the basal-most portion of the BM in the hook region. Measuring the size and morphology of the BM in the hook region can improve CDL measurements and our understanding of cochlear tonotopy. Methods Ten cadaveric human cochleae underwent synchrotron radiation phase-contrast imaging. The length of the BM through the hook region and CDL were measured. Two different CDL measurements were obtained for each sample, with starting points at the center of the RW (CDLRW) and the basal-most tip of the BM (CDLHR). Regression analysis was performed to relate CDLRW to CDLHR. A three-dimensional polynomial model was determined to describe the average BM hook region morphology. Results The mean CDLRW value was 33.03 ± 1.62 mm, and the mean CDLHR value was 34.68 ± 1.72 mm. The following relationship was determined between CDLRW and CDLHR: CDLHR = 1.06(CDLRW)-0.26 (R2 = 0.99). Conclusion The length and morphology of the hook region was determined. Current measurements underestimate CDL in the hook region and can be corrected using the results herein.

Chromium (Cr) is a trace element and plays a significant role in fish nutrition and physiology. An experiment was designed to know the effects of Cr addition in the diets to growth and feed utilization in striped catfish (Pangasianodon hypophthalmus). Four diets with Cr (0, 2, 4, and 8 mg kg-1) were fed to striped catfish in aquaria with triplicate groups for 60 days. Survival, growth parameters (weight gain, WG; %WG; specific growth rate, SGR), and feed utilization (feed intake, FI; feed efficiency, FE; protein efficiency ratio, PER; feed conversion ratio, FCR) were calculated at the end of the feeding trial. Several hemato-biochemical parameters, such as hemoglobin (Hb), red blood cell (RBC), white blood cell (WBC) and glucose level, and frequency of micronucleus (MN) formation in erythrocytes, were analyzed. The growth parameters (WG, %WG, and SGR) and feed utilization (FE and PER) increased significantly in the fish fed with 2 and 4 mg kg-1 Cr supplemented diets. On the other hand, the growth parameters suppressed in the fish fed with 8 mg kg-1 Cr-based diet. The polynomial regression analysis based on WG showed that 2.82 mg kg-1 Cr supplementation in the diet is optimum for the tested fish species. The values of Hb (g/dL), RBC (×106/mm3) and blood glucose (mg/dL) significantly decreased in the fish fed with the highest (8 mg kg-1) Cr-based feed. Conversely, MN frequency was significantly increased in the fish fed with 8 mg kg-1 Cr-based diet. Overall, 2.82 mg Cr kg-1 can be added to the diets of striped catfish for its better growth with maximum utilization of feed.

Background: The newly emerged coronavirus disease 2019 (COVID-19) seems to involve different organs, including the cardiovascular system. We systematically reviewed COVID-19 cardiac complications and calculated their pooled incidences. Secondarily, we compared the cardiac troponin I (cTnI) level between the surviving and expired patients. Methods: A systematic search was conducted for manuscripts published from December 1, 2019 to April 16, 2020. Cardiovascular complications, along with the levels of cTnI, creatine kinase (CK), and creatine kinase MB (CK-MB) in hospitalized PCR-confirmed COVID-19 patients were extracted. The pooled incidences of the extracted data were calculated, and the unadjusted cTnI level was compared between the surviving and expired patients. Results: Out of 1094 obtained records, 22 studies on a total of 4,157 patients were included. The pooled incidence rate of arrhythmia was 10.11%. Furthermore, myocardial injury had a pooled incidence of 17.85%, and finally, the pooled incidence for heart failure was 22.34%. The pooled incidence rates of cTnI, CK-MB, and CK elevations were also reported at 15.16%, 10.92%, and 12.99%, respectively. Moreover, the pooled level of unadjusted cTnI was significantly higher in expired cases compared with the surviving (mean difference = 31.818, 95% CI = 17.923-45.713, P value Conclusion: COVID-19 can affect different parts of the heart; however, the myocardium is more involved.

The fourth most common form of cancer among women is cervical cancer with 569,847new cases and 311,365 reported deaths worldwide in 2018. Cervical cancer is classified as the third leading cause of cancer among women in Malaysia, with approximately 1,682 new cervical cases and about 944 deaths occurred in 2018. Cervical cancer can be detected early by cervical cancer screening. Papanicolaou test, also known as Pap smear test is conducted to detect cancer or precancer in the cervix. The disadvantage of this conventional method is that the sample of microscopic images will risk blurring effects, noise, shadow, lighting and artefact problems. The diagnostic microscopic observation performed by a microbiologist is normally time-consuming and may produce inaccurate results even by experienced hands. Thus, correct diagnosis information is essential to assist physicians to analyze the condition of the patients. In this study, an automatedsegmentation system is proposed to be used as it is more accurate and faster compared to the conventional technique. Using the proposed method in this paper, the image was enhanced by applying a median filter and Partial Contrast Stretching. A segmentation method based on mathematical morphology was performed to segment the nucleus in the Pap smear images. Image Quality Assessment (IQA) which measures the accuracy, sensitivity and specificity were used to prove the effectiveness of the proposed method. The results of the numerical simulation indicate that the proposed method shows a higher percentage of accuracy and specificity with 93.66% and 95.54% respectively compared to Otsu, Niblack and Wolf methods. As a conclusion, the percentage of sensitivity is slightly lower, with 89.20% compared to Otsu and Wolf methods. The results presented here may facilitate improvements in the detection performance in comparison to the existing methods.

IoT or Internet of Things can improve the possibility of interaction between various smart components in real time. In the infrastructure of IoT, wireless sensors can be used in order to reduce communication costs. Despite having positive effects, using wireless nodes add some challenges to the system. Limited resources, such as energy, CPU power and memory, are the main concerns in this technology. Energy consumption is the most challenging one. Designing an optimized routing pattern through heuristic algorithms is a common way to tackle this problem. Therefore, in the proposed algorithm, a WOA-based method has been proposed to expand the life span of the system. Also, a novel fitness function is defined for reducing the energy consumption of the network, load balancing and node coverage. Clustering is done unequally; it means that cluster heads (CHs) nearer to the base station (BS) have more energy for data relay. In this paper, for reducing the number of messages, a clustering stage is added at the beginning of each metaround. The number of rounds in a metaround is variable. The status of each node is analyzed by BS before each round. Low energy level causes a new metaround. Moreover, the CH–BS interaction is implemented through multi-hop pattern. Results suggest that there is an enhancement instability, energy-saving, throughput and lifespan.

INTRODUCTION Osteoporosis is a preventable progressive metabolic disease. Girls have an increased risk of occurrence of osteoporosis in their old age. The BASNEF model can be employed to change behaviors related to health. The BASNEF model was employed to determine the predictors of osteoporosis preventive behaviors among adolescent girls. MATERIAL AND METHODS This cross-sectional study was carried out on 209 adolescent girls selected from high schools in the Quchan County in 2016 using path analysis by stratified sampling. The data was collected through a demographic questionnaire and a 52-item researcher-made questionnaire, based on the BASNEF model constructs. The data was analyzed using Shapiro-Wilk test, bootstrapping, and path analysis. RESULTS The average age of the students was 16.10 ±0.59. The results of path analysis showed that Model 1 matched the BASNEF model relationships completely; however, it could not predict osteoporosis preventive behaviors. The constructs of Model 2 (modified) was able to predict 50% of variances in osteoporosis preventive behaviors. There were positive and direct relationships between the following pairs of constructs: knowledge and attitudes (B = 0.23, p

Partial discharge (PD) signal classification analysis on cross-linked polyethylene (XLPE) cables is complex, requiring a comprehensive understanding of the characteristics of PD patterns. In the realm of high-voltage electrical insulation, PD pattern characteristics, such as PD charge and inception voltage, are essential as assessment criteria in diagnostics systems using PD classifiers. This paper provides a review of the various PD patterns and classifiers used by previous researchers, specifically for XLPE cables. In addition, the differences of the studies on various sensor developments based on PD detection in the past 27 years are also discussed. The repeatability, recognition accuracy, recognition speed, and effect of feature sizes on each PD classification method are reviewed and explained. This review indicates that the pattern recognition for PD signal using artificial neural network (ANN) exhibits better performance than the other methods in terms of accuracy and repeatability, and the reduction of feature size does not affect the accuracy of ANN.