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Abstract Background One of the main limitations of radiation therapy is the resistance of tumor cells. This study aimed at evaluating the relationship between the expression of epidermal growth factor receptor (EGFR) and echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) and tumor radiosensitivity in patients with non-small cell lung cancer. Methods Medical case files, pathological results for EGFR and EML4-ALK, and computerized tomography scans of patients with NSCLC treated with thoracic radiation therapy were analyzed. Results The sample size was 101 patients with mean age 58.43 ± 9.89 years. Statistically significant differences were observed in the mean reduction of long tumor diameter during the early treatment phase in EGFR-positive versus EGFR-negative patients (p value = 0.04) and in short tumor diameter during the late treatment phase in EGFR-positive versus EGFR-negative patients (p value = 0.04). Conclusion Patients with overexpression of EGFR mutations are more radiosensitive during the early treatment phase, and EML4-ALK mutations were less radiosensitive regardless of phases.

Abstract Background Secondary hypertension accounts for 5% of all cases of hypertension. Renal artery stenosis is one of the common causes of secondary hypertension. Atherosclerosis and fibromuscular dysplasia are the commonest types of stenosis associated with renal vascular hypertension, with the former accounting for 70–80% of all cases and the latter accounting for 10% of the incidence. The greatest incidence atherosclerosis is in men over the age of 40 years, mostly affecting the proximal part of the renal arteries, whereas fibromuscular dysplasia affects women ranging in age from 30 to 50 years. Currently, possible treatments are medical treatment using blood pressure-lowering drugs, balloon angioplasty with or without stent insertion, and surgery to reconstruct the artery. Case presentation We report a case of a 46-year-old Asian woman with stenosis of two branches of renal artery bifurcation treated by percutaneous balloon dilatation and stenting of both branches after referral to our department for a renal angiogram following 8 months of uncontrolled hypertension despite receiving medications. Initially, the patient presented with severe headache and fatigue. She was a known nonsmoker, was not diabetic, and had no history of diabetes in her family. She had no history of atherosclerosis. Apart from high blood pressure, the result of her physical examination was unremarkable. Laboratory investigations revealed normal serum cholesterol, lipid profile, and serum creatinine. She had been attending a hypertension clinic and receiving antihypertensive drugs for the past 8 months on a regular basis under close observation. Despite this treatment and care, her blood pressure remained high at 175/110 mmHg, which the attending doctor concluded to be uncontrolled blood pressure. Initial imaging indicated left renal artery stenosis, and the patient was referred to our department. Conclusions For patients with uncontrolled hypertension despite receiving medications, renal Doppler ultrasound should be included in the diagnostic workup for secondary hypertension. Once renal artery stenosis is suspected, renal angiography is highly recommended because the technique is able to accurately diagnose stenosis in the branch arteries, unlike computed tomographic angiography and magnetic resonance angiography. Percutaneous transluminal renal angioplasty is the treatment of choice for renal artery stenosis in patients with renovascular hypertension or renal dysfunction.

تعد حشرة عثة التين (Welker) Ephestia cautella احدى اهم الحشرات المخزنية التي تصيب يرقاتها التمور المخزونة لذا هدف البحث الى عزل بكتريا Bacillus thuringiensis من الترب المحلية وتشخيصها وغربلة العزلات ذات الكفاءة في المقاومة الاحيائية من يرقات حشرة عثة التين. عزلت 20 عزلة تعود الى جنس Bacillus من يرقات حشرة عثة التين المعاملة بعالق سبورات التربة وشخصت 8 عزلات بانها تعود لبكتريا B. thuringiensis. وقد تبين انها منتجة لانزيمات البروتيز واللايبيز والجيلاتينيز والهيمولايسين وتتميز بقابليتها على تكوين الاغشية الحيوية وان 7 من العزلات المحلية تقاوم المضاد الحيوي البنسلين واظهرت عزلة واحدة مقاومة المضاد الحيوي الكلورامفينكول واظهرت بقية العزلات حساسية تجاه الكلورامفينكول والتتراسايكلين والنالديكسيك اسيد والاينوكسين. بينت غربلة عزلات B. thuringiensis تفاوت في نسب قتل يرقات حشرة عث التين حيث اعطت العزلة المحلية B. thuringiensis KS3 نسبة قتل تصل الى 80 % من يرقات الحشرة مع اسودادها نتيجة فعالية السم البكتيري. وتبين ان التركيز القاتل النصفي هو 3.7 ملغم مل-1 مقارنة مع 4.6 ملغم مل-1 للعزلة التجارية كما اوضح نمط الترحيل الكهربائي بهلام متعدد الاكريل امايد بوجود SDS نمطا من البروتينات مشابه لنمط بروتينات العزلة التجارية.

Ankle foot orthosis (AFO) are commonly used to correct the instabilities and joint weakness of lower limb. In this research, AFO was developed by using pneumatic artificial muscle (PAM) to prevent plantarflexion to occur and also to correct the foot from the inversion syndrome. The research started with designing the AFO by using SolidWorks software based on anthropometry measurement data (n=5, age=12 years old). The mechanical simulation was conducted by using Autodesk Inventor software to obtain a safety factor before the fabrication process was conducted. The AFO was fabricated using 3D printer and the thermoplastic elastomer (TPE) rubber was selected as the material. PAM was tested by using test bed machine to generate the force and contraction by muscle. The result shows that the PAM was suitable for low speed as the displacement was greater. The AFO could be valuable for the gait rehabilitation.

Conservation scientists continue to debate the strengths and weaknesses of REDD+ as an instrument to slow greenhouse gas emissions in the developing world. We propose that general positions on this debate are less helpful than drawing lessons from specific investigations into the features of individual projects that make them successful or not. Here, focusing on a site-specific REDD+ intervention in Pemba, Zanzibar (Tanzania), we examine the circumstances under which REDD+ has a chance of success, teasing out specific features of both REDD+ interventions and the socio-economic and institutional contexts that render REDD+ a potentially valuable complement to community forestry. Additionally, we highlight some unanticipated positive outcomes associated with the design features of REDD+ projects. Our broader goal is to move away from ideologically-driven debate to empirically-based identification of general conditions where REDD+ could work, and to provide policy recommendations.

Abstract We analyze the connectedness between major cryptocurrencies and nonfungible tokens (NFTs) for different quantiles employing a time-varying parameter vector autoregression approach. We find that lower and upper quantile spillovers are higher than those at the median, meaning that connectedness augments at extremes. For normal, bearish, and bullish markets, Bitcoin Cash, Bitcoin, Ethereum, and Litecoin consistently remain net transmitters, while NFTs receive innovations. However, spillover topology at both extremes becomes simpler—from cryptocurrencies to NFTs. We find no markets useful for mitigating BTC risks, whereas BTC is capable of reducing the risk of other digital assets, which is a valuable insight for market players and investors.

Abstract Background Larval Source Management (LSM) is an important tool for malaria vector control and is recommended by WHO as a supplementary vector control measure. LSM has contributed in many successful attempts to eliminate the disease across the Globe. However, this approach is typically labour-intensive, largely due to the difficulties in locating and mapping potential malarial mosquito breeding sites. Previous studies have demonstrated the potential for drone imaging technology to map malaria vector breeding sites. However, key questions remain unanswered related to the use and cost of this technology within operational vector control. Methods Using Zanzibar (United Republic of Tanzania) as a demonstration site, a protocol was collaboratively designed that employs drones and smartphones for supporting operational LSM, termed the Spatial Intelligence System (SIS). SIS was evaluated over a four-month LSM programme by comparing key mapping accuracy indicators and relative costs (both mapping costs and intervention costs) against conventional ground-based methods. Additionally, malaria case incidence was compared between the SIS and conventional study areas, including an estimation of the incremental cost-effectiveness of switching from conventional to SIS larviciding. Results The results demonstrate that the SIS approach is significantly more accurate than a conventional approach for mapping potential breeding sites: mean % correct per site: SIS = 60% (95% CI 32–88%, p = 0.02), conventional = 18% (95% CI − 3–39%). Whilst SIS cost more in the start-up phase, overall annualized costs were similar to the conventional approach, with a simulated cost per person protected per year of $3.69 ($0.32 to $15.12) for conventional and $3.94 ($0.342 to $16.27) for SIS larviciding. The main economic benefits were reduced labour costs associated with SIS in the pre-intervention baseline mapping of habitats. There was no difference in malaria case incidence between the three arms. Cost effectiveness analysis showed that SIS is likely to provide similar health benefits at similar costs compared to the conventional arm. Conclusions The use of drones and smartphones provides an improved means of mapping breeding sites for use in operational LSM. Furthermore, deploying this technology does not appear to be more costly than a conventional ground-based approach and, as such, may represent an important tool for Malaria Control Programmes that plan to implement LSM.

Abstract This paper examines the high frequency multiscale relationships and nonlinear multiscale causality between Bitcoin, Ethereum, Monero, Dash, Ripple, and Litecoin. We apply nonlinear Granger causality and rolling window wavelet correlation (RWCC) to 15 min—data. Empirical RWCC results indicate mostly positive co-movements and long-term memory between the cryptocurrencies, especially between Bitcoin, Ethereum, and Monero. The nonlinear Granger causality tests reveal dual causation between most of the cryptocurrency pairs. We advance evidence to improve portfolio risk assessment, and hedging strategies.

Abstract Background Zanzibar provides a good case study for malaria elimination. The islands have experienced a dramatic reduction in malaria burden since the introduction of effective vector control interventions and case management. Malaria prevalence has now been maintained below 1% for the past decade and the islands can feasibly aim for elimination. Methods To better understand factors that may contribute to remaining low-level malaria transmission in Zanzibar, layered human behavioural and entomological research was conducted between December 2016 and December 2017 in 135 randomly selected households across six administrative wards. The study included: (1) household surveys, (2) structured household observations of nighttime activity and sleeping patterns, and (3) paired indoor and outdoor mosquito collections. Entomological and human behavioural data were integrated to provide weighted estimates of exposure to vector bites, accounting for proportions of people indoors or outdoors, and protected by insecticide-treated nets (ITNs) each hour of the night. Results Overall, 92% of female Anopheles mosquitoes were caught in the rainy season compared to 8% in the dry season and 72% were caught outdoors compared to 28% indoors. For individual ITN users, ITNs prevented an estimated two-thirds (66%) of exposure to vector bites and nearly three quarters (73%) of residual exposure was estimated to occur outdoors. Based on observed levels of ITN use in the study sites, the population-wide mean personal protection provided by ITNs was 42%. Discussion/conclusions This study identified gaps in malaria prevention in Zanzibar with results directly applicable for improving ongoing programme activities. While overall biting risk was low, the most notable finding was that current levels of ITN use are estimated to prevent less than half of exposure to malaria vector bites. Variation in ITN use across sites and seasons suggests that additional gains could be made through targeted social and behaviour change interventions. However, even for ITN users, gaps in protection remain, with a majority of exposure to vector bites occurring outdoors before going to sleep. Supplemental interventions targeting outdoor exposure to malaria vectors, and groups that may be at increased risk of exposure to malaria vectors, should be explored.

Abstract Objective To determine the diagnostic efficacy of 18F‐FDG PET/CT in distinguishing between pulmonary tuberculosis (PTB) and lung cancer in solitary pulmonary nodule (SPN) in a country with a high prevalence of PTB. Methods Patients with SPN who underwent 18F‐FDG PET/CT imaging were retrospectively included in the study. The final diagnosis was established by histopathology. A linear regression equation was fitted to a scatter plot of size and SUVmax of lung cancer and PTB. ROC was used to determine the optimal cutoff values and diagnostic accuracy of 18F‐FDG PET/CT in PTB and lung cancer. Results About 514 patients were included with the mean age of 57.5 ± 10.6 years. Four hundred and seventy‐five cases were diagnosed as lung cancer, and 39 cases were PTB by histopathology. 18F‐FDG PET/CT had sensitivity, specificity, and diagnostic accuracy of 96.0%, 48.7%, and 92.0%, respectively. Utilization of SUVmax ≥2.5 in SPN resulted in 2 and 11 false positives cases of lung cancer and PTB, respectively, whereas SUVmax