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Sparseness is often witnessed in big data emanating from a variety of sources, including IoT, pervasive computing, and behavioral data. Frequent itemset mining is the first and foremost step of association rule mining, which is a distinguished unsupervised machine learning problem. However, techniques for frequent itemset mining are least explored for sparse real-world data, showing somewhat comparable performance. On the contrary, the methods are adequately validated for dense data and stand apart from each other in terms of performance. Hence, there arises an immense need for evaluating these techniques as well as proposing new ones for large sparse real-world datasets. In this study, a novel method: Mining Frequent Itemsets by Iterative TRimmed Transaction lattICE (TRICE) is proposed. TRICE iteratively generates combinations of varying-sized trimmed subsets of I, where I denote the set of distinct items in a database. Extensive experiments are conducted to assess TRICE against HARPP, FP-Growth, optimized SaM, and optimized RElim algorithms. The experimental results show that TRICE outperforms all these algorithms both in terms of running time and memory consumption. TRICE maintains a substantial performance gap for all sparse real-world datasets on all minimum support thresholds. Moreover, assessment of memory use of optimized SaM and RElim algorithms has been performed for the first time.

Cloud computing emerged as one of the leading computational paradigms due to elastic resource provisioning and pay-as-you-go model. Large data centers are used by the service providers to host the various services. These data centers consume enormous energy, which leads to increase in operating costs and carbon footprints. Therefore, green cloud computing is a necessity, which not only reduces energy consumption, but also affects the environment positively. In order to reduce the energy consumption, workload consolidation approach is used that consolidates the tasks in minimum possible servers. However, workload consolidation may lead to service level agreement (SLA) violations due to non-availability of resources on the server. Therefore, workload consolidation techniques should consider the aforementioned problem. In this paper, we present two consolidation based energy-efficient techniques that reduce energy consumption along with resultant SLA violations. In addition to that, we also enhanced the existing Enhanced-Conscious Task Consolidation (ECTC) and Maximum Utilization (MaxUtil) techniques that attempt to reduce energy consumption and SLA violations. Experimental results show that the proposed techniques perform better than the selected heuristic based techniques in terms of energy, SLA, and migrations.

Introduction: Arteriovenous (AV) access maturity and patency is critical for patients on hemodialysis. Maintaining a functioning AV access for these patients is of paramount importance. Salvage of failing AV accesses has been traditionally done mainly with angiographic techniques requiring significant amounts of contrast agent and radiation exposure. Ultrasound-guided angioplasty has been described, but its utility needs to be further studied. Methods: Group 1: 42 patients undergoing ultrasound-assisted angioplasty (UAA) for AV access salvage were assessed prospectively for 9 months (October 2016 to June 2017). Group 2: Retrospective data of 47 patients who underwent angioplasty for failing AV access without ultrasound assistance, over 9 months was collected (January to September 2016). This group was matched with Group 1 in terms of age, sex, type of AV access, and cause of AV access dysfunction. Results: There was a statistically significant decrease in the average number of angiographic runs (2.5 vs. 7.9) and fluoroscopy time in minutes (3.8 vs. 13.1) recorded during UAA (P < 0.01). The average quantity of contrast agent used in milliliters (17.6 vs. 49.8) was also significantly less when ultrasound assistance was used (P < 0.01). Conclusion: UAA for failing AV access reduces the radiation exposure and the amount of contrast agent used in these patients who require multiple of these sessions and need dialysis to get the contrast agent out of their circulation. This technique is feasible and reliable; hence should be used more frequently and effectively. Our model of UAA for AV access salvage allows all cases including complex cases to be performed with the added advantage of reduced radiation exposure and contrast agent; serving as a boon to these already distressed patients. Immediate complication management and adjunctive open procedures also become possible because of the hybrid operating room setup with fluoroscopy facility.

To date, information on the management of specific neurosurgical tumors, such as glioma, in Pakistan remains scattered and scarce. Our review synthesizes the predicaments of glioma management routinely presented to the neurosurgery, medical oncology, radiation oncology, and radiology departments in Pakistan. Expert opinions were integrated from each of the relevant fields in the form of personal citations. The data presented in our review were collected from various PubMed and non-PubMed indexed articles, coupled with various health reports from the Government of Pakistan along with the World Health Organization. Through these data, it was postulated that the utilization of innovative and instrumental technologies is a constant struggle for neurosurgeons in Pakistan, considering the cost-effectiveness. Hence, this results in significant limitations for surgeons to provide the best outcome for their patients. As most Pakistanis (74%) pay out of pocket, measuring cost-effectiveness is extremely crucial. It was found that significant differences in intra-operative and postoperative care existed among various centers. Public sector institutions fared much worse. The role of diagnostics in glioma surgery is severely limited across centers in Pakistan and as such, research and training need to be addressed promptly. In order to achieve success in glioma management, the data in our article demonstrate various facets of health care that need to be addressed simultaneously and swiftly. Surgical access needs to be improved; only then, optimal management of glioma can be accomplished in Pakistan.

Abstract Background Cardiac surgical procedures are associated with postoperative neurological complications such as cognitive decline and delirium, which can complicate recovery and impair quality of life. Perioperative depression and anxiety may be associated with increased mortality after cardiac surgeries. Surgical prehabilitation is an emerging concept that includes preoperative interventions to potentially reduce postoperative complications. While most current prehabilitation interventions focus on optimizing physical health, mind–body interventions are an area of growing interest. Preoperative mind–body interventions such as Isha Kriya meditation, may hold significant potential to improve postsurgical outcomes. Methods This is a prospective, randomized controlled feasibility trial. A total of 40 adult patients undergoing cardiac surgery will be randomized to one of three study groups. Participants randomized to either of the two intervention groups will receive meditative intervention: (1) commencing two weeks before surgery; or (2) commencing only from the day after surgery. Meditative intervention will last for four weeks after the surgery in these groups. Participants in the third control group will receive the current standard of care with no meditative intervention. All participants will undergo assessments using neurocognitive, sleep, depression, anxiety, and pain questionnaires at various time points in the perioperative period. Blood samples will be collected at baseline, preoperatively, and postoperatively to assess for inflammatory biomarkers. The primary aim of this trial is to assess the feasibility of implementing a perioperative meditative intervention program. Other objectives include studying the effect of meditation on postoperative pain, sleep, psychological wellbeing, cognitive function, and delirium. These will be used to calculate effect size to design future studies. Discussion This study serves as the first step towards understanding the feasibility of implementing a mind–body intervention as a prehabilitative intervention to improve postoperative surgical outcomes after cardiac surgery. Trial registration Clinicaltrials.gov, NCT03198039. Registered on 23 June 2017.

Surveillance and detection of polioviruses (PV) remain crucial to monitoring eradication progress. Intratypic differentiation (ITD) using the real-time RT-PCR kit is key to the surveillance workflow, where viruses are screened after cell culture isolation before a subset are verified by sequencing. The ITD kit is a series of real-time RT-PCR assays that screens cytopathic effect (CPE)-positive cell cultures using the standard WHO method for virus isolation. Because ITD screening is a critical procedure in the poliovirus identification workflow, validation of performance of real-time PCR platforms is a core requirement for the detection of poliovirus using the ITD kit. In addition, the continual update and improvement of the ITD assays to simplify interpretation in all platforms is necessary to ensure that all real-time machines are capable of detecting positive real-time signals. Four platforms (ABI7500 real-time systems, Bio-Rad CFX96, Stratagene MX3000P, and the Qiagen Rotor-Gene Q) were validated with the ITD kit and a redesigned poliovirus probe. The poliovirus probe in the real-time RT-PCR pan-poliovirus (PanPV) assay was re-designed with a double-quencher (Zen™) to reduce background fluorescence and potential false negatives. The updated PanPV probe was evaluated with a panel consisting of 184 polioviruses and non-polio enteroviruses. To further validate the updated PanPV probe, the new assay was pilot tested in five Global Polio Laboratory Network (GPLN) laboratories (Madagascar, India, Philippines, Pakistan, and Democratic Republic of Congo). The updated PanPV probe performance was shown to reduce background fluorescence and decrease the number of false positives compared to the standard PanPV probe.

The article discusses a study on the storage stability of serum fatty acids at low temperature below -20°C for two to five years. Topics mentioned include the effectiveness of butylated hydroxytoluene oxidant in preventing the degradation of fatty acid in red blood cells, the use of electron capture negative ion gas chromatography-mass spectrometry to detect fatty acids, and the analysis of variance of serum pool and storage condition.

Nine organic substrates viz., rice grains, sorghum grains, wheat grains, millet grains, wheat straw, rice husk, cow dung, sawdust, and poultry manure were used for mass multiplication of Trichoderma harzianum. Of these, sorghum grains followed by millet grains were the best substrates. The poultry manure appeared to be the most unsuitable substrate, whereas rice grains, wheat grains, wheat straw, and rice husk performed moderately well. Sucrose was the best carbon source and supported the highest colony growth of T. harzianum on Czapek's Agar plates. Similarly, ammonium nitrate at 3,000 ppm appeared to be the most suitable nitrogen source and produced the highest colony growth as well as abundant conidia. A combined use of sucrose at 30,000 ppm as carbon source, and ammonium nitrate at 3,000 ppm as nitrogen source significantly enhanced the mycelial growth and conidial production by T. harzianum in wheat straw, rice husk, and millet grains, whereas, in sorghum grains and rice grains, the addition of carbon and nitrogen sources showed negative effect on sporulation of T. harzianum. Studies on shelf life of the inocula multiplied on various substrates showed that the populations of T. harzianum on all the substrates achieved the peak at 60-75 days incubation period and declined gradually thereafter. However, even after 330 days, the populations were greater than the population at 0-day. At 345-360 days interval, population was found to be less than the initial population at 0-day. [ABSTRACT FROM AUTHOR]

It is renowned fact that the study of nonlinear partial differential equations (NPDEs) play a vital rule in cosmic phenomena, atomic and matter physics, that is why researchers have a keen interest to study and find their solutions. Sharma–Tasso–Olever equation is such type of an important equation. In this article, we consider the fractional-order Sharma–Tasso–Olever equation with non-singular Atangana–Baleanu derivative and utilize three remarkable analytical methods, namely, the homotopy perturbation method (HPM), the homotopy perturbation method with Laplace transform (HPLM), and the Adomian decomposition method (ADM), for obtaining the rational solutions. To get a better understanding of this new derivative operator with these methods, the achieved results are compared with the existing results in the literature of Caputo derivative. The numerical results reveal the efficiency, reliability, significant features, and simple in computation with high accuracy by using Atangana–Baleanu derivative with these three approaches. These three methods can be used to find the analytical solutions of many other fractional order problems with Atangana–Baleanu derivative in science and engineering.

In the theory of differential equations, the study of existence and the uniqueness of the solutions are important. In the last few decades, many researchers have had a keen interest in finding the existence–uniqueness solution of constant fractional differential equations, but literature focusing on variable order is limited. In this article, we consider a Caputo type variable order fractional differential equation. First, we present the existence–uniqueness of a solution of the considered problem. Secondly, By borrowing the idea from the theory of ordinary differential equations, we extend the continuation theorem for the variable order fractional differential equation. Further, we prove the global existence results. Finally, we present different types of Ulam–Hyers stability results, which have never been studied before for the Caputo type variable order fractional differential equation.

The purpose of this study is to develop smart cementitious material by incorporating multi-walled carbon nanotubes (MWCNTs). Two different types of carbon nanotubes (CNT) were dispersed using probe ultrasonicator; (i) Pristine CNT (P-CNT), and (ii) Functionalized CNT through annealing (A-CNT). Percolation threshold and optimum content of CNTs were determined by measuring electrical resistivity, porosity, compressive and flexural strengths at various contents of CNTs (0, 0.5 %, 0.75 %, and 1 % with respect to mass of cement). Self-sensing study was also carried out on smart material by relating the electrical properties with cyclic compressive loading. For this purpose, the electrical response was recorded with Wheatstone Bridge (WSB) circuit. The effect of curing and saturation degree of specimens on the resistivity pattern was also discussed. The results of electrical resistivity and mechanical properties showed that the content of CNTs should be at least 0.75 % to develop smart cementitious materials with a significant sensitivity and without detrimental effect on the mechanical properties. Moreover, smart material incorporating pristine CNT provides better sensitivity of self-sensing response as compared to the annealed CNT. Self-sensing test results also showed that with the increase in the content of CNT, sensitivity and repeatability of the sensing response were improved.

Abstract Background Delirium is associated with a significantly increased risk of postoperative morbidity and mortality. Furthermore, delirium has been associated with an increased risk of prolonged cognitive deficits and accelerated long-term cognitive decline. To date, experimental interventions for delirium have mainly focused on alternative pharmacologic and behavioral strategies in the postoperative period. Few studies have examined whether proactive strategies started before surgery can prevent delirium or reduce its sequelae. Neurocognitive training programs such as Lumosity have been shown to be effective in increasing cognitive performance in both elderly healthy volunteers and patients suffering from a myriad of acute and chronic medical conditions. When initiated in the preoperative period, such training programs may serve as interesting and novel patient-led interventions for the prevention of delirium and postoperative cognitive decline (POCD). We hypothesize that perioperative neurocognitive training is feasible in the older cardiac surgical population and are testing this hypothesis using a randomized controlled design. Methods The Prevention of Early Postoperative Decline (PEaPoD) study is a randomized, controlled trial with a target enrollment of 45 elderly cardiac surgical patients. Subjects will be randomized in a 1:1 ratio to undergo either at least 10 days of preoperative neurocognitive training, continued for 4 weeks postoperatively, or usual care control. The primary outcome, feasibility, will be assessed by study recruitment and adherence to protocol. Secondary outcomes will include potential differences in the incidence of postoperative in-hospital delirium and POCD up to 6 months, as determined by the Confusion Assessment Method and the Montreal Cognitive Assessment. Discussion PEaPoD will be the first trial investigating the use of perioperative cognitive training to potentially reduce delirium and POCD in the cardiac surgical population. Information gleaned from this feasibility study will prove valuable in designing future efficacy studies aimed at determining whether this low-risk, patient-led intervention can reduce serious postoperative morbidity. Trial registration ClinicalTrials.gov, NCT02908464. Registered on 21 September 2016.

Background: Measles virus infection remains a significant cause of childhood mortality and morbidity despite continued global efforts and the availability of a safe and effective vaccine. Molecular analysis of indigenous measles viruses could provide critical information on outbreak linkages and transmission pathways that can aid the implementation of appropriate control programs in Pakistan. Methods: Blood samples and throat swabs were collected from subjects suspected with measles in Islamabad, Pakistan from 2013 to 2015. Serum samples were tested for the presence of measles immunoglobulin M (IgM) antibodies using enzyme-linked immunosorbent assay (ELISA) while throat swabs were used for the isolation (Vero/SLAM cell line) and subsequent characterization and phylogenetic analysis of measles strains. Results: Of 373 blood samples, 66% tested positive for measles IgM. Male subjects were more often infected (58%) than female (42%) with the highest frequency of positive cases (63%) in the 0–5-years age group. Among the positive cases, only 13% had received one or two doses of the measles vaccine, while 87% were unvaccinated. Of 80 throat swabs, 29 (36%) showed a measles virus-specific cytopathic effect (CPE) and were characterized as genotype B3 through partial sequencing of the nucleoprotein (N) gene. Phylogenetic analysis revealed the Pakistani B3 strains to be closely related to strains from neighboring countries (Iran and Afghanistan) as well as with B3 viruses from the USA, Germany, and the UK. Conclusions: The study results showed that despite the availability of an effective vaccine, the burden of measles infections is very high in Pakistan due to poor routine immunization coverage even in major cities, including the capital city of Islamabad. It is imperative that national health authorities take urgent strategic steps to improve routine immunization and implement adequate molecular identification methods to tackle future measles outbreaks. Keywords: Measles virus, Epidemiology, Outbreak

Abstract Background Postoperative delirium is common in elderly cardiac surgery patients. It is multifactorial and is influenced by the patient’s baseline status and the nature of the medical and surgical interventions that the patient receives. Some of these factors are potentially modifiable, including postoperative sedation and analgesia protocols. This study has been designed to evaluate the effectiveness of postoperative intravenous acetaminophen in conjunction with either dexmedetomidine or propofol in decreasing the incidence of delirium. Methods This is a prospective, randomized, placebo-controlled, double-blinded, factorial trial that includes patients who are at least 60 years old and who are undergoing cardiac surgeries involving cardiopulmonary bypass, including coronary artery bypass graft (CABG) and combined CABG/valve surgeries. Patients are randomly assigned to receive one of four postoperative analgesic-sedation regimens: (1) acetaminophen and dexmedetomidine, (2) acetaminophen and propofol, (3) dexmedetomidine and placebo, or (4) propofol and placebo. The primary outcome, incidence of delirium, will be assessed with the Confusion Assessment Method (CAM or CAM-ICU). The secondary outcome, postoperative cognitive decline, will be assessed with the Montreal Cognitive Assessment. Additional secondary outcomes, including duration of delirium, postoperative analgesic requirement, length of stay, and incidence of adverse events, will also be reported. Data will be analyzed in 120 randomly assigned patients who received at least one dose of the study medication(s) on a modified intention-to-treat basis. Discussion This study has been approved by the institutional review board at Beth Israel Deaconess Medical Center, and the trial is currently recruiting. This study will systematically examine the implications of modification in postoperative sedative/analgesic protocols after cardiac surgery, specifically for short- and long-term cognitive outcomes. Any positive outcomes from this study could direct simple yet effective practice changes aimed to reduce morbidity. Trial registration ClinicalTrials.gov Identifier: NCT02546765, registered January 13, 2015.

Three Paecilomyces species viz., Paecilomyces variotii, P. lilacinus and P. fumosoroseus were examined at various intensity levels to manage root-knot nematode Meloidogyne incognita. Unlike P. fumosoroseus, increasing concentrations of P. variotii and P. lilacinus culture filtrates considerably inhibited egg-hatching and sustained juvenile transience. Increase in shoot and root weights were observed after applying biocontrol agents in vitro and in vivo on mungbean (Vigna radiata). Significant reductions in number of galls per root system as compared to the control treatment were observed when isolates of P. variotii and P. lilacinus were used. A variation in the efficacy of local isolates of P. variotii was also evident. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate complementary and alternative medicine (CAM) use among Malaysian diabetic patients. Subjects for this case—control study were randomly selected from the pool of patients who were attending diabetes clinics, at the Hospital Tuanku Jaa’far, Seremban, Malaysia. Perceived effect of CAM use, reasons for starting CAM, and sociodemographic factors were collected from patients (n=230). Blood glucose levels were also recorded. Almost half of the study population (49.6%, 114/230) were using CAM together with conventional treatment for diabetes. Thirteen different types of CAM were utilised by the 114 CAM users and herbal medicine (64.9%) was found to be the most commonly used CAM modality. The majority of patients reported quality and safety of CAM (63.2%) and an additional treatment for diabetes (53.5%) as two main reasons for using CAM. About 44% of patients reported that their condition had improved by using CAM (R2=0.512, p=0.004), which was evident by their lowered fasting blood glucose (p=0.045, 7.171 versus 8.767). About 18% perceived their health condition as poor compared to 56% who perceived it as good after commencing CAM use. [ABSTRACT FROM PUBLISHER]

Instant messaging applications (apps) have played a vital role in online interaction, especially under COVID-19 lockdown protocols. Apps with security provisions are able to provide confidentiality through end-to-end encryption. Ill-intentioned individuals and groups use these security services to their advantage by using the apps for criminal, illicit, or fraudulent activities. During an investigation, the provision of end-to-end encryption in apps increases the complexity for digital forensics investigators. This study aims to provide a network forensic strategy to identify the potential artifacts from the encrypted network traffic of the prominent social messenger app Signal (on Android version 9). The analysis of the installed app was conducted over fully encrypted network traffic. By adopting the proposed strategy, the forensic investigator can easily detect encrypted traffic activities such as chatting, media messages, audio, and video calls by looking at the payload patterns. Furthermore, a detailed analysis of the trace files can help to create a list of chat servers and IP addresses of involved parties in the events. As a result, the proposed strategy significantly facilitates extraction of the app’s behavior from encrypted network traffic which can then be used as supportive evidence for forensic investigation.

Abstract Background Postoperative cognitive dysfunction (POCD) is a common complication of cardiac surgery. Studies have identified potentially injurious roles for cardiopulmonary bypass (CPB) and subsequent reperfusion injury. Cognitive dysfunction has also been linked to the deleterious effects of hyperoxia following ischemia-reperfusion injuries in several disease states, but there has been surprisingly little study into the role of hyperoxia in reperfusion injury after CPB. The potential for tightly regulated intraoperative normoxia to ameliorate the neurocognitive decline following cardiac surgery has not been investigated in a prospective manner. We hypothesize that the use of a protocolized management strategy aimed towards maintenance of an intraoperative normoxic level of oxygen, as opposed to hyperoxia, will reduce the incidence of POCD in older patients undergoing cardiac surgery. Methods/Design One hundred patients aged 65 years and older undergoing non-emergency coronary artery bypass grafting surgery on cardiopulmonary bypass will be enrolled in this prospective, randomized, controlled trial. Subjects will be randomized to receive a fraction of inspired oxygen of either 35% or 100% while under general anesthesia throughout the intraoperative period. The primary outcome measure will be the incidence of POCD in the acute postoperative phase and up to 6 months. The assessment of neurocognition will be undertaken by trained personnel, blinded to study group, with the telephone Montreal Cognitive Assessment (t-MoCA) tool. Secondary outcome measures will include assessment of delirium using the Confusion Assessment Method (CAM and CAM-ICU), as well as time to extubation, days of mechanical ventilation, length of ICU and hospital stay and mortality at 6 months. With the aim of later identifying mechanistic aspects of the effect of oxygen tension, blood, urine, and atrial tissue specimens will be taken at various time points during the perioperative period and later analyzed. Discussion This trial will be one of the first randomized controlled studies to prospectively assess the relationship between intraoperative oxygen levels and postoperative neurocognition in cardiac surgery. It addresses a promising biological avenue of intervention in this vulnerable aging population. Trial registration ClinicalTrials.gov Identifier: NCT02591589 , registered February 13, 2015.

Joveinan marbles and skarns are located 5 km NE of Ghohrood and 140 km NW ofIsfahan in the *central part of Urumieh- Dokhtar magmatic arc. Intrusion of Ghohroodgranitoid into the Cretaceous carbonate rocks caused the contact metamorphism andformation of skarn mineral paragenesis wollastonite, clinopyroxene, garnet, actinolite,epidote, chlorite, calcite, quartz, magnetite and sulfides (iron and copper). Mineralogicalstudies and paragenetic mineral relations confirm that the Joveinan skarn is polygeneticin origin and evolved in two major stages, metamorphism and metasomatism(progressive and retrogressive). In metamorphism stage that occurred immediately afterthe granitoid magma emplacement within carbonate rocks, Joveinan marbles were formed. Metasomatic stage occurred with generation of anhydrous calc-silicatesminerals such as wollastonite, diopsidic-hedenbergitic pyroxene and ugrandite garnets.The main stage of retrograde metasomatic, alteration of primary calc-silicate minerals ofskarn (pyroxene-garnet), caused the formation of epidote, actinolite and chlorite. Theassociation of wollastonite, magnetite and andradite represents that skarn crystallized inover 550 ° C temperature range and low partial pressure of CO2. Joveinan skarn is acalcic skarn that has been formed at shallow depth by oxidative hydrothermal fluids andevolved in different stages.

Data and information security is considered to be an important and challenging task for any field of life. But it becomes more critical especially when it deals with the medical field due to life and health hazards. The ratio of internal security threats to external threats always remains high. A huge number of efforts and technical expertise are required in the case of attacking the system from the external environment. But it requires fewer efforts if a system is attacked internally by the stakeholders of the system. This article presents an access control model that secures the medical data of patients against internal cybersecurity threats. It allows only the legitimate users, that is, authorized patients and doctors to communicate despite the fact of physical boundaries. The proposed model implements authorization in combination with permissions and roles instead of roles only for medical staff. It removes the discrepancies in the existing access control models. The proposed model ensures communication among doctors and patients in a secure, private, and efficient manner. The model is demonstrated by using mathematical modeling along with implementation examples. The proposed model outperformed in comparison with state-of-the-art access control models.

Cellular protective mechanisms exist to ensure survival of the cells and are a fundamental feature of all cells that is necessary for adapting to changes in the environment. Indeed, evolution has ensured that each cell is equipped with multiple overlapping families of genes that safeguard against pathogens, injury, stress, and dysfunctional metabolic processes. Two of the better-known enzymatic systems, conserved through all species, include the heme oxygenases (HO-1/HO-2), and the ectonucleotidases (CD39/73). Each of these systems generates critical bioactive products that regulate the cellular response to a stressor. Absence of these molecules results in the cell being extremely predisposed to collapse and, in most cases, results in the death of the cell. Recent reports have begun to link these two metabolic pathways, and what were once exclusively stand-alone are now being found to be intimately interrelated and do so through their innate ability to generate bioactive products including adenosine, carbon monoxide, and bilirubin. These simple small molecules elicit profound cellular physiologic responses that impact a number of innate immune responses, and participate in the regulation of inflammation and tissue repair. Collectively these enzymes are linked not only because of the mitochondria being the source of their substrates, but perhaps more importantly, because of the impact of their products on specific cellular responses. This review will provide a synopsis of the current state of the field regarding how these systems are linked and how they are now being leveraged as therapeutic modalities in the clinic.

Background Diabetes mellitus type II (DMT-2) is a widely spread metabolic disorder both in developed and developing countries. The role of oxidative stress is well established in DMT-2 pathogenesis. The synthetic drugs for DMT-2 are associated with serious side complications. Antioxidant and α-glucosidase inhibitory actions of phytochemicals from various plant species are considered as an alternative to synthetic drugs for DMT-2 management. The present study aimed to evaluate the antioxidant activity, α-glucosidase inhibitory potential and phytochemical profiling of Hyophorbe lagenicaulis. Methods The total phenolic and flavonoid contents, in vitro antioxidant activity (α, α-diphenyl-β-picrylhydrazyl (DPPH) free radical scavenging and phosphomolybdenum method) and α-glucosidase inhibition of ultrasonicated hydroethanolic H. lagenicaulis leaf extracts were determined spectrophotometrically. The results of DPPH assay and α-glucosidase inhibition were reported in terms of IC50 value. The phytochemical profiling was accomplished by UHPLC-Q-TOF/MS/MS technique. Results and Discussion Findings leaped 60% ethanolic extract as rich fraction regarding total phenolic and flavonoid contents. The 60% ethanolic fraction was a promising source of natural antioxidants and α-glucosidase inhibitory agents as indicated by anti-radical and enzyme inibitory activities. Kaempferol, rutin, hesperetin 5-O-glucoside, kaempferol-coumaroyl-glucoside, luteolin 3-glucoside, Isorhamnetin-3-O-rutinoside, trimethoxyflavone derivatives and citric acid were identified by UHPLC-Q-TOF-MS/MS. These compounds were believed to be responsible for the strong antioxidant and enzyme inhibitory activity of plant extracts. The extensive metabolite profiling of H. lagenicaulis was carried out the first time as never reported previously. The H. lagenicaulis might be an appropriate choice to manage diabetes mellitus in an alternate way. The findings may be further exploited extensively for toxicity evaluation to proceed with functional food development having antidiabetic attributes.

In this article, we consider a fractional differential equation (FDE) with Caputo derivative and study the existence and continuation of its solution. Firstly, we prove a theorem on the existence of local solutions. Then we extend the continuation theorems for ODEs to those FDEs. Also several global existence results for FDE are obtained.

We grew a set of indium and molybdenum co-doped lithium niobate crystals with various indium doping concentrations and investigated their photorefractive properties at different wavelengths (442, 488 and 532 nm). It was found that the diffraction efficiency of 1.0 mol% indium and 0.5 mol% molybdenum co-doped lithium niobate crystal could reach 61.57% at 488 nm. Moreover for 3.0 mol% indium and 0.5 mol% molybdenum co-doped lithium niobate crystal, the response time was greatly shortened to 0.61, 0.76, and 0.74 s at 442, 488, and 532 nm, respectively, while the photorefractive sensitivity reached as high as 7.35 cm/J at 442 nm. These results indicate that co-doping of indium is an efficient way to further enhance the photorefractive properties of molybdenum-doped lithium niobate crystal.

BackgroundThe polio environmental surveillance (ES) system has been an incredible tool for advancing polio eradication efforts because of its ability to highlight the spatial and temporal extent of poliovirus circulation. While ES often outperforms, or is more sensitive than AFP surveillance, the sensitivity of the ES system has not been well characterized. Fundamental uncertainty of ES site sensitivity makes it difficult to interpret results from ES, particularly negative results.Methods and findingsTo study ES sensitivity, we used data from Afghanistan and Pakistan to examine the probability that each ES site detected the Sabin 1, 2, or 3 components of the oral polio vaccine (OPV) as a function of virus prevalence within the same district (estimated from AFP data). Accounting for virus prevalence is essential for estimating site sensitivity because Sabin detection rates should vary with prevalence-high immediately after supplemental immunization activities (SIAs), but low in subsequent months. We found that most ES sites in Pakistan and Afghanistan are highly sensitive for detecting poliovirus relative to AFP surveillance in the same districts. For example, even when Sabin poliovirus is at low prevalence of ~0.5-3% in AFP surveillance, most ES sites have ~34-50% probability of detecting Sabin. However, there was considerable variation in ES site sensitivity and we flagged several sites for re-evaluation based on low sensitivity rankings and low wild polio virus detection rates. In these areas, adding new sites or modifying collection methods in current sites could improve sensitivity of environmental surveillance.ConclusionsRelating ES detections to virus prevalence significantly improved our ability to evaluate site sensitivity compared to evaluations based solely on ES detection rates. To extend our approach to new sites and regions, we provide a preliminary framework for relating ES and AFP detection rates, and descriptions of how detection rates might relate to SIAs and natural seasonality.

Symptomatic aortic stenosis remains a surgical disease, with aortic valve replacement resulting in symptom reduction and improvement in survival. For patients who are deemed a higher surgical risk, Transcatheter aortic-valve replacement (TAVR) is a viable, less invasive and increasingly common alternative. The study compares early outcomes in patients treated within one year of the commencement of TAVR program in a community hospital against outcomes of TAVR patients from nationwide reported data (Society of Thoracic Surgeons/ American College of Cardiology TVT registry). Preoperative characteristics and standardized procedural outcomes of all patients who underwent TAVR in Cape Cod Hospital between June 2015 and May 2016 (n = 62, CCH group) were compared using standardized data format to those of TAVR patients operated during the same time period in other centers within the United States participating in the STS/ACC TVT Registry (n = 24,497, USA group). Most preoperative patient characteristics were similar between groups. However, CCH patients were older (age≥80 years: 77.4% versus 64.3%, p = 0.032) and more likely to be non-elective cases (37.1% versus 9.7%, p