AIM: To determine whether magnetic resonance imaging (MRI) can be used to categorize small bowel Crohn's disease (SB CD) into groups that correlate with response to medical therapy and surgical pathology.METHODS: ...AIM: To determine whether magnetic resonance imaging (MRI) can be used to categorize small bowel Crohn's disease (SB CD) into groups that correlate with response to medical therapy and surgical pathology.METHODS: Data was collected from all patients with MRI evidence of SB CD without significant colonic disease over a 32-mo period. Two radiologists, blinded to clinical findings, evaluated each MRI and grouped them based on bowel wall thickness and wall enhancement. These categories were: (1) "fibrosis", (2) "mild segmental hyper-enhancement and mild wall thickening", (3) "mild segmental hyper-enhancement and marked wall thickening", (4) "marked segmental transmural hyper-enhancement". Patient response to additional medical therapy post-MRI was prospectively determined at 8-wk. Non-responders underwent endoscopy and were offered therapeutic endoscopy or surgery. Surgical pathology was assessed against the MRI category. RESULTS: Fifty-five patients were included. Females and category "2" patients were more likely, and patients with luminal narrowing and hold-up less likely, to respond to medical therapy (P < 0.05). Seventeen patients underwent surgery. The surgical pathologicalfindings of fibrosis and the severity of inflammation correlated with the MRI category in all cases.CONCLUSION: Our fi ndings suggest that SB CD can be grouped by the MRI f indings and that these groups are associated with patients more likely to respond to continued medical therapy. The MRI categories also correlated with the presence and level of intestinal inflammation and fibrosis on surgical pathology, and may be of prognostic use in the management of CD patients.展开更多
AIM： TO determine if a nasojejunal tube （NJT） is required for optimal examination of enteroclysis and if patients can be examined only in the supine position. METHODS： Data were collected from all patients undergo...AIM： TO determine if a nasojejunal tube （NJT） is required for optimal examination of enteroclysis and if patients can be examined only in the supine position. METHODS： Data were collected from all patients undergoing small bowel （SB） magnetic resonance imaging （MRI） examination over a 32-mo period. Patients either underwent a magnetic resonance （MR） follow-through （MRFT） or a MR enteroclysis （MRE） in the supine position. The quality of proximal and distal SB distension as well as the presence of motion artefact and image quality were assessed by 2 radiologists. RESULTS： One hundred and fourteen MR studies were undertaken （MRFT-49, MRE-65） in 108 patients in the supine position only. Image artefact was more frequent in MRE than in MRFT （29.2% vs 18.4%）, but was not statistically significant （P = 0.30）. Adequate distension of the distal SB was obtained in 97.8% of MRFT examinations and in 95.4% of MRE examinations, respectively. Proximal SB distension was, however, less frequently optimal in MRFT than in MRE （P = 0.0036）, particularly in patients over the age of 50 years （P = 0.0099）. Image quality was good in all examinations. CONCLUSION： All patients could be successfully iraaged in the supine position. MRE and MRFT are equivalent for distal SB distension and artefact effects. Proximal SB distension is frequently less optimal in MRFT than in MRE. MRE is, therefore, the preferred MR examination method of the SB.展开更多
当进入过敏季节我们可能并不太会拿出手帕或者打喷嚏来预防过敏。日前，一项刊登在国际杂志The American Journal of Clinical Nutrition上的研究报告中。来自佛罗里达大学的研究人员通过研究发现。一种益生菌组合或许能够帮助减轻花粉...当进入过敏季节我们可能并不太会拿出手帕或者打喷嚏来预防过敏。日前，一项刊登在国际杂志The American Journal of Clinical Nutrition上的研究报告中。来自佛罗里达大学的研究人员通过研究发现。一种益生菌组合或许能够帮助减轻花粉症的症状。展开更多
AIM To quantify the impact of split-dose regimen on endoscopists' compliance with guideline recommendations for timing of repeat colonoscopy in patients with normal colonoscopy or 1-2 small polyps(< 10 mm).METH...AIM To quantify the impact of split-dose regimen on endoscopists' compliance with guideline recommendations for timing of repeat colonoscopy in patients with normal colonoscopy or 1-2 small polyps(< 10 mm).METHODS A retrospective chart review of all endoscopy reports was undertaken in average-risk individuals > 50 years old with a normal screening colonoscopy and 1-2 small polyps. Data were abstracted from two time periods, pre and post-split-dose bowel preparation institution. Main outcome measurements were recommendation for timing of repeat colonoscopy and bowel preparation quality. Bivariate analysis by χ~2 tests and Student's t-tests were performed to assess differences between the two cohorts. Multivariable logistic regression was used with guideline consistent recommendations as the dependent variables and an indicator for 2011 cohort as the primary predictor. RESULTS Four thousand two hundred and twenty-five patients were included in the study; 47.0%(1987) prior to the institution of split dose bowel preparation, and 53.0%(2238) after the institution of split dose bowel preparation. Overall, 82.2%(n = 3472) of the colonoscopies were compliant with guideline recommendations, with a small but significantly increased compliance rate in year 2011(83.7%) compared to year 2009(80.4%, P = 0.005), corresponding to an unadjusted odds ratio of 1.25(95%CI: 1.07-1.47; P = 0.005). Colonoscopies with either "Adequate" or "Excellent" had increased from 30.6% in year 2009 to 39.6% in year 2011(P < 0.001). However, there was no significant difference in poor/inadequate category of bowel preparation as there was a mild increase from 4.6% in year 2009 to 5.1% in year 2011(P = 0.50). CONCLUSION Split-dose bowel regimen increases endoscopists' compliance to guidelines in average-risk patients with normal colonoscopy or 1-2 small polyps.展开更多
AIM： To investigate the endoscopic ampullectomy practices of expert biliary endoscopists. METHODS： An anonymous expert biliary endoscopists practices. survey was mailed to 79 to assess ampullectomy RESULTS： Forty s...AIM： To investigate the endoscopic ampullectomy practices of expert biliary endoscopists. METHODS： An anonymous expert biliary endoscopists practices. survey was mailed to 79 to assess ampullectomy RESULTS： Forty six （58%） biliary endoscopists returned the questionnaire. Of these, 63% were in academia and in practice for an average of 16.4 years （± 8.6）. Endoscopists performed an average of 1.1 （± 0.8） ampullectomies per month. Prior to ampullectomy, endoscopic ultrasound was ＂always＂ utilized by 67% of respondents vs ＂sometimes＂ in 31% of respondents. Empiric biliary sphincterotomy was not utilized uniformly, only 26% ＂always＂ and 37% ＂sometimes＂ performed it prior to resection. Fifty three percent reported ＂never＂ performing empiric pancreatic sphincterotomy prior to ampullectomy. Practitioners with high endoscopic retrograde cholangiopancreatography volumes were the most likely to perform a pancreatic sphincterotomy （OR = 10.9; P = 0.09）. Participants overwhelmingly favored ＂always＂ placing a prophylactic pancreatic stent, with 86% placing it after ampullectomy rather than prior to resection （23%）. Argon plasma coagulation was the favored adjunct modality （83%） for removal of residual adenomatous tissue. Practitioners uniformly （100%） preferred follow-up examination to be within 6 mo postmpullectomy.CONCLUSION： Among biliary experts, there is less variation in ampultectomy practices than is reflected in the literature.展开更多
AIM To assess the effects of probiotic Medilac-S^(®)as adjunctive therapy for the induction of remission of ulcerative colitis(UC)in a Chinese population through a systematic review and meta-analysis.METHODS A sy...AIM To assess the effects of probiotic Medilac-S^(®)as adjunctive therapy for the induction of remission of ulcerative colitis(UC)in a Chinese population through a systematic review and meta-analysis.METHODS A systematic literature search was conducted to find randomized,controlled trials in a Chinese population with at least two study arms-a control arm which receives a conventional,oral aminosalicylate drug,and a treatment arm,which administers the same conventional drug in conjunction with the probiotic Medilac-S^(®)per os.Both English and Chinese databases were searched,including Pub Med,EMBASE,Google Scholar,Chinese National Knowledge Infrastructure,Wanfang Data,and VIP Search,and study data was extracted onto standardized abstraction sheets.Meta-analyses were conducted for primary and secondary outcomes of interest using a fixed or random effects model.The primary outcome was the induction of clinical remission and the secondary outcomes included changes in Sutherland index,endoscopic and histological scores,proportion of reported clinical symptoms and adverse events(AEs).For outcomes with sufficient data,the type of conventional drug therapy was also assessed to determine if the effects of combination therapy with Medilac-S^(®)was influenced by drug type.All tests were conducted using a typeⅠerror rate of 0.05 and all confidence intervals(CI)were based on a 95%confidence level.Review protocol was uploaded to PROSPERO(CRD42018085658 upon completion).RESULTS Fifty-three clinical trials with a total of 3984 participants were identified and included in the review.Medilac-S^(®)adjunctive therapy significantly improved induction of clinical remission(RR=1.21;95%CI:1.18-1.24;P<0.0001)with the estimated likelihood of effective treatment,on average,21%higher for those consuming the probiotic.Sutherland index scores showed the control mean was on average 3.10(CI:2.41-3.78;P=0.0428)units greater than the treatment mean,thereby demonstrating significant improvement in participants taking the probiotic.Similarly,a significant difference was seen between the overall reduction of endoscopic and histological scores of control and treatment arm participants,with score decreases in the control groups 0.71(CI:0.3537-1.0742)and 1.1(CI:0.9189-1.2300)units smaller than treatment group score decreases.The proportion of participants reporting clinical symptoms,(abdominal pain,tenesmus,blood and mucous in stool,and diarrhea)was significantly reduced after combination therapy with Medilac-S~(P<0.0001)and estimated to be on average 44%(RR=0.44,CI:0.32-0.59),53%(RR=0.53,CI:0.38-74),40%(RR=0.40,CI:0.28-0.58)and 47%(RR=0.47 CI:0.36-0.42)respectively,of the proportion of individuals reporting the aforementioned symptoms after conventional therapy alone.The risk of AEs was also significantly reduced with adjunctive Medilac-S~therapy.The proportion of individuals in the treatment groups reporting AEs was an estimated 72%of the proportion of individuals in the control groups reporting AEs(RR=0.72,CI:0.55-0.94,P=0.0175).Upon comparing effect means for different drug types in conjunction with Medilac-S^(®),evidence of significant variability(P<0.0001)was observed,and sulfasalazine was found to be the most effective drug in both primary and secondary outcomes.CONCLUSION Evidence suggests Medilac-S~adjunctive therapy should be considered standard care for UC in a Chinese population because it aids in the induction of clinical remission,improves symptoms of the gastrointestinal tract and reduces risk of AEs.展开更多
To characterize colorectal cancer (CRC) in octogenarians as compared with younger patients.METHODSA single-center, retrospective cohort study which included patients diagnosed with CRC at the age of 80 years or older ...To characterize colorectal cancer (CRC) in octogenarians as compared with younger patients.METHODSA single-center, retrospective cohort study which included patients diagnosed with CRC at the age of 80 years or older between 2008-2013. A control group included consecutive patients younger than 80 years diagnosed with CRC during the same period. Clinicopathological characteristics, treatment and outcome were compared between the groups. Fisher’s exact test was used for dichotomous variables and χ<sup>2</sup> was used for variables with more than two categories. Overall survival was assessed by Kaplan-Meier survival analysis, with the log-rank test. Cancer specific survival (CSS) and disease-free survival were assessed by the Cox proportional hazards model, with the Fine and Gray correction for non-cancer death as a competing risk.RESULTSThe study included 350 patients, 175 patients in each group. Median follow-up was 40.2 mo (range 1.8-97.5). Several significant differences were noted. Octogenarians had a higher proportion of Ashkenazi ethnicity (64.8% vs 47.9%, P < 0.001), a higher rate of personal history of other malignancies (22.4% vs 13.7%, P = 0.035) and lower rates of family history of any cancer (36.6% vs 64.6%, P < 0.001) and family history of CRC (14.4% vs 27.3%, P = 0.006). CRC diagnosis by screening was less frequent in octogenarians (5.7% vs 20%, P < 0.001) and presentation with performance status (PS) of 0-1 was less common in octogenarians (71% vs 93.9%, P < 0.001). Octogenarians were more likely to have tumors located in the right colon (45.7% vs 34.3%, P = 0.029) and had a lower prevalence of well differentiated histology (10.4% vs 19.3%, P = 0.025). They received less treatment and treatment was less aggressive, both in patients with metastatic and non-metastatic disease, regardless of PS. Their 5-year CSS was worse (63.4% vs 77.6%, P = 0.009), both for metastatic (21% vs 43%, P = 0.03) and for non-metastatic disease (76% vs 88%, P = 0.028).CONCLUSIONOctogenarians presented with several distinct characteristics and had worse outcome. Further research is warranted to better define this growing population.展开更多
Guignardia citricarpa, the plant pathogenic fungus that causes citrus black spot, was recently introduced into the United States. The development of this disease in the presence of multiple applications of copper per ...Guignardia citricarpa, the plant pathogenic fungus that causes citrus black spot, was recently introduced into the United States. The development of this disease in the presence of multiple applications of copper per year to manage citrus canker warrants an investigation into the effects of copper on growth of isolates of G. citricarpa from citrus in Florida. Guignardia citricarpa and G. mangiferae isolates, confirmed by internal transcribed spacer (ITS) sequencing of ribosomal DNA and DNA homology, were inoculated on non-amended media and media amended with 50 and 500 μg·ml-1 copper sulfate. Radial colony growth was assessed over a 26 to 59 day period. Copper reduced the growth of G. citricarpa isolates in media amended with 500 μg·ml-1 copper but had variable effects on radial growth in media amended with 50 μg·ml-1 copper. There was little effect of copper on the in vitro growth of G. mangiferae isolates. Field application of copper with and without an adjuvant for the control of citrus black spot was undertaken in a commercial grove in Florida in 2011. Spray applications were made on a 23.3 ± 4.7 day interval and fruit accessed between December 2011 and March 2012 for black spot symptoms. Copper failed to reduce the proportion of fruit exhibiting symptoms compared to that of the controls.展开更多
Phosphorus (P) risk indices are commonly used in the USA to estimate the field-scale risk of agricultural P runoff. Because the Ohio P Risk Index is increasingly being used to judge farmer performance, it is important...Phosphorus (P) risk indices are commonly used in the USA to estimate the field-scale risk of agricultural P runoff. Because the Ohio P Risk Index is increasingly being used to judge farmer performance, it is important to evaluate weighting/scoring of all P Index parameters to ensure Ohio farmers are credited for practices that reduce P runoff risk and not unduly penalized for things not demonstrably related to runoff risk. A sensitivity analysis provides information as to how sensitive the P Index score is to changes in inputs. The objectives were to determine 1) which inputs are most highly associated with P Index scores and 2) the relative impact of each input variable on resultant P Index scores. The current approach uses simulations across 6134 Ohio point locations and five crop management scenarios (CMSs), representing increasing soil disturbance. The CMSs range from all no-till, which is being promoted in Ohio, rotational tillage, which is a common practice in Ohio to full tillage to represent an extreme practice. Results showed that P Index scores were best explained by soil test P (31.9%) followed by connectivity to water (29.7%), soil erosion (13.4%), fertilizer application amount (11.3%), runoff class (9.5%), fertilizer application method (2.2%), and finally filter strip (2.0%). Ohio P Index simulations across CMSs one through five showed that >40% scored <15 points (low) while <1.5% scored >45 points (very high). Given Ohio water quality problems, the Ohio P Index needs to be stricter. The current approach is useful for Ohio P Index evaluations and revision decisions by spatially illustrating the impact of potential changes regionally and state-wide.展开更多
Background: The SpineNav3DTM technology was recently incorporated in the Accuro device for the automatic detection of spinal bone landmarks. The goal of our study was to validate the ability of the Accuro ultrasound s...Background: The SpineNav3DTM technology was recently incorporated in the Accuro device for the automatic detection of spinal bone landmarks. The goal of our study was to validate the ability of the Accuro ultrasound scanner to detect the distance from skin to epidural space by comparing it to the golden standard (the standard ultrasound). The secondary end-point was the inter-rater agreement between an expert anesthesiologist and a novice trainee in determining the epidural space depth with the Accuro device. Methods: 96 consecutive healthy volunteer parturients at term had their lumbar area scanned for the measurements of the depth of the epidural space (recorded in cm) by two anesthesiologists. The expert investigator made the measurements with both the standard ultrasound and the Accuro devices, and the trainee made the measurements with the Accuro device only. Results: There were no differences in the mean depth of the epidural space as measured by the expert or the novice investigator with both the devices (standard ultrasound and Accuro) in both positions (sitting and lateral) at any intervertebral level with a difference less than 0.25 cm. Conclusion: We have demonstrated that this handheld ultrasound system with 3D spine navigation technology can automatically identify the key neuraxial landmarks within ultrasound images of the lumbar spine acquired in the transverse plane and measure the epidural depth with the same accuracy as the standard ultrasounds. We have also demonstrated that the measurements may be rapidly and adequately obtained by a novice who had never previously used ultrasounds.展开更多
BACKGROUND Transoral outlet reduction(TORe)is a minimally invasive endoscopic revision of Roux-en-Y gastric bypass(RYGB)for weight recurrence;however,little has been published on its clinical implementation in the com...BACKGROUND Transoral outlet reduction(TORe)is a minimally invasive endoscopic revision of Roux-en-Y gastric bypass(RYGB)for weight recurrence;however,little has been published on its clinical implementation in the community setting.AIM To characterize the safety and efficacy of TORe in the community setting for adults with weight recurrence after RYGB.METHODS This is a retrospective cohort study of argon plasma coagulation and purse-string suturing for gastric outlet reduction in consecutive adults with weight recurrence after RYGB at a single community center from September 2020 to September 2022.Patients were provided longitudinal nutritional support via virtual visits.The primary outcome was total body weight loss(TBWL)at twelve months from TORe.Secondary outcomes included TBWL at three months and six months;excess weight loss(EWL)at three,six,and twelve months;twelve-month TBWL by obesity class;predictors of twelve-month TBWL;rates of post-TORe stenosis;and serious adverse events(SAE).Outcomes were reported with descriptive statistics.RESULTS Two hundred eighty-four adults(91.9%female,age 51.3 years,body mass index 39.3 kg/m^(2))underwent TORe an average of 13.3 years after RYGB.Median pre-and post-TORe outlet diameter was 35 mm and 8 mm,respectively.TBWL was 11.7%±4.6%at three months,14.3%±6.3%at six months,and 17.3%±7.9%at twelve months.EWL was 38.4%±28.2%at three months,46.5%±35.4%at six months,and 53.5%±39.2%at twelve months.The number of follow-up visits attended was the strongest predictor of TBWL at twelve months(R^(2)=0.0139,P=0.0005).Outlet stenosis occurred in 11 patients(3.9%)and was successfully managed with endoscopic dilation.There was one instance of post-procedural nausea requiring overnight observation(SAE rate 0.4%).CONCLUSION When performed by an experienced endoscopist and combined with longitudinal nutritional support,purse-string TORe is safe and effective in the community setting for adults with weight recurrence after RYGB.展开更多
Purpose: Diabetic peripheral neuropathy (DPN) is prevalent among the population with type 2 diabetes, and treatment approaches are limited. The combination of L-methylfolate-methylcobalamin-pyridoxal-5-phospate (LMF-M...Purpose: Diabetic peripheral neuropathy (DPN) is prevalent among the population with type 2 diabetes, and treatment approaches are limited. The combination of L-methylfolate-methylcobalamin-pyridoxal-5-phospate (LMF-MC-PP, Metanx?) is a prescription medical food that has demonstrated significant improvements in sensory perception and quality of life as well as reduced neuropathic pain in patients with DPN. The present study examined the effects of LMF-MC-PP on sensory perception and epidermal nerve fiber density (ENFD) among patients with confirmed DPN. Methods: Patients with type 2 diabetes and diagnosed with diabetic peripheral polyneuropathy, based on loss of vibratory perception, warm-cold discrimination or monofilament sensation, underwent bilateral lower extremity ENFD assessments via skin punch biopsy and were started on LMF-MC-PP. ENFD and monofilament testing were repeated at 6 months. Findings: Of 123 patients evaluated, all had monofilament testing at baseline and 6 months and 122 had assessments at both time points. A significant (p < 0.05) improvement in ENFD from baseline to 6 months was observed. A significant (p = 0.0001) improvement in monofilament testing also was observed. Overall, more patients had intact sensation after 6 months, with 60 (48.8%) of 123 patients having positive monofilament test at baseline as compared to 95 (77.2%) positive after 6 months. An analysis of the association between improvements in ENFD and monofilament testing found that the two tended to occur together, and this was significant (p < 0.05) for the right limb. Implications: Clinically important and statistically significant improvements in ENFD and monofilament sensation were associated with LMF-MC-PP in patients with DPN. When compared to the decrease in ENFD expected among DPN patients, the improvements are even more clinically significant. These findings should be validated in a larger, placebo-controlled study.展开更多
Many studies have shown that chlorophyll meter readings （CMRs） can be used to diagnose deficiencies of nitrogen （N） during the growth of corn （Zea mays L.） in small-plot trials, but there is need to address addi...Many studies have shown that chlorophyll meter readings （CMRs） can be used to diagnose deficiencies of nitrogen （N） during the growth of corn （Zea mays L.） in small-plot trials, but there is need to address additional problems encountered when diagnoses are made in fields of the size managed in production agriculture. A noteworthy difference between smallplot trials and production agriculture is the extent to which the effects of N are confounded with the effects of other factors such as tillage, landscape, soil organic matter and moisture content. We illustrate how some of these factors can cause differences in the physiological age of plants and introduce errors in the diagnoses of N deficiencies. We suggest methods （measuring the height to the youngest leaf collar and assigning leaf numbers by using the first leaf with pubescence and the ear leaf as references to identify growth stages） for minimizing these errors. The simplified method of growth stage identification can be used to select appropriate plants and leaves for making diagnoses in fields and to distinguish the effects of N from the effects of other factors that influence plant growth.展开更多
Objective Long-term seroprotection via the hepatitis A vaccine is essential for the prevention of disease from the hepatitis A virus(HAV).Due to documented difficulties during decade-long follow-ups after receiving va...Objective Long-term seroprotection via the hepatitis A vaccine is essential for the prevention of disease from the hepatitis A virus(HAV).Due to documented difficulties during decade-long follow-ups after receiving vaccines,statistical-modeling approaches have been applied to predict the duration of immune protection.Methods Based on five-year follow-up data from a randomized positive-controlled trial among Chinese children(1–8 years old)following a 0,6 months vaccination schedule,a power-law model accounting for the kinetics of B-cell turnover,as well as a modified power-law model considering a memory-B-cell subpopulation,were fitted to predict the long-term immune responses induced by HAV vaccination(Healive or Havrix).Anti-HAV levels of each individual and seroconversion rates up to 30 years after vaccination were predicted.Results A total of 375 participants who completed the two-dose vaccination were included in the analysis.Both models predicted that,over a life-long period,participants vaccinated with Healive would have close but slightly higher antibody titers than those of participants vaccinated with Havrix.Additionally,consistent with previous studies,more than 90%of participants were predicted to maintain seroconversion for at least 30 years.Moreover,the modified power-law model predicted that the antibody titers would reach a plateau level after nearly 15 years post-vaccination.Conclusions Based on the results of our modeling,Healive may adequately induce long-term immune responses following a 0,6 months vaccination schedule in children via induction of memory B cells to provide stable and durable immune protection.展开更多
Dairy cows rely on a complex ruminal microbiota to digest their host-indigestible feed. Our ability to characterize this microbiota has advanced significantly due to developments in next-generation sequencing. However...Dairy cows rely on a complex ruminal microbiota to digest their host-indigestible feed. Our ability to characterize this microbiota has advanced significantly due to developments in next-generation sequencing. However, efforts to sample the rumen, which typical y involves removing digesta directly from the rumen via a cannula, intubation, or rumenocentesis, is costly and labor intensive. As a result, the majority of studies characterizing the rumen microbiota are conducted on samples col ected at a single time point. Currently, it is unknown whether there is significant day-to-day variation in the rumen microbiota, a factor that could strongly influence conclusion drawn from studies that sample at a single time point. To address this, we examined day-to-day changes in the ruminal microbiota of lactating dairy cows using next-generation sequencing to determine if single-day sampling is representative of sampling across 3 consecutive days. We sequenced single-day solid and liquid fractions of ruminal digesta col ected over 3 consecutive days from 12 cannulated dairy cows during the early, middle, and late stages of a single lactation cycle using the V4 region of the bacterial 16 S r RNA gene. We then generated 97% similarity operational taxonomic units(OTUs) from these sequences and showed that any of the individual samples from a given 3-day sampling period is equivalent to the mean OTUs determined from the combined 3-d data set. This finding was consistent for both solid and liquid fractions of the rumen,and we thus conclude that there is limited day-to-day variability in the rumen microbiota.展开更多
Habitual fish consumption is associated with numerous health benefits;however, in Australia fish intake remains low. The aim of this study was to compare the effect of specific or general fish consumption recommendati...Habitual fish consumption is associated with numerous health benefits;however, in Australia fish intake remains low. The aim of this study was to compare the effect of specific or general fish consumption recommendations on fish intake behavior over the duration of a 12-month clinical trial. Participants were randomized into a control group (general dietary advice), and two intervention groups (received dietetic advice to consume 180 g fish/wk), with one intervention group receiving LC omega-3 PUFA supplements. Dietary data was available for n = 117 at baseline, n = 85 at 3 months and n = 63 at 12 months. Total, fatty and lean fish intake (g/day) was calculated, and the change in fish intake between and within groups over the duration of the study was measured. Total fish consumption did not differ significantly between groups or within groups, however fatty fish intake was significantly greater in the intervention groups at three months (p = 0.004). The proportion of study participants complying with fish intake recommendations was also highest at the three month time point for both intervention groups. Overall, compliance to fish intake recommendations was highest at the three month time point and appeared to be influenced by dietetic intervention. Provision of fish may increase compliance in future studies, however if research is to be translated to practice, behavioral approaches are required to increase fish intake in the long term.展开更多
The substitution box,often known as an S-box,is a nonlinear component that is a part of several block ciphers.Its purpose is to protect cryptographic algorithms from a variety of cryptanalytic assaults.A Multi-Criteri...The substitution box,often known as an S-box,is a nonlinear component that is a part of several block ciphers.Its purpose is to protect cryptographic algorithms from a variety of cryptanalytic assaults.A Multi-Criteria Decision Making(MCDM)problem has a complex selection procedure because of having many options and criteria to choose from.Because of this,statistical methods are necessary to assess the performance score of each S-box and decide which option is the best one available based on this score.Using the Pythagorean Fuzzy-based Technique for Order of Preference by Similarity to Ideal Solution(TOPSIS)method,the major objective of this investigation is to select the optimal S-box to be implemented from a pool of twelve key choices.With the help of the Pythagorean fuzzy set(PFS),the purpose of this article is to evaluate whether this nonlinear component is suitable for use in a variety of encryption applications.In this article,we have considered various characteristics of S-boxes,including nonlinearity,algebraic degree,strict avalanche criterion(SAC),absolute indicator,bit independent criterion(BIC),sum of square indicator,algebraic immunity,transparency order,robustness to differential cryptanalysis,composite algebraic immunity,signal to noise ratio-differential power attack(SNR-DPA),and confusion coefficient variance on some standard S-boxes that are Advanced Encryption Following this,the findings of the investigation are changed into Pythagorean fuzzy numbers in the shape of a matrix.This matrix is then subjected to an analysis using the TOPSIS method,which is dependent on the Pythagorean fuzzy set,to rank the most suitable S-box for use in encryption applications.展开更多
It is well known that viral load of the hepatitis C virus (HCV) is related to the efficacy of interferon therapy. The complex biological parameters that impact on viral load are essentially unknown. The current knowle...It is well known that viral load of the hepatitis C virus (HCV) is related to the efficacy of interferon therapy. The complex biological parameters that impact on viral load are essentially unknown. The current knowledge of the hepatitis C virus does not provide a mathematical model for viral load dynamics within untreated patients. We car-ried out an empirical modelling to investigate whether different fluctuation patterns exist and how these patterns (if exist) are related to host-specific factors. Data was prospectively col-lected from 147 untreated patients chronically infected with hepatitis C, each contributing be-tween 2 to 10 years of measurements. We pro-pose to use a three parameter logistic model to describe the overall pattern of viral load fluctua-tion based on an exploratory analysis of the data. To incorporate the correlation feature of longitu-dinal data and patient to patient variation, we introduced random effects components into the model. On the basis of this nonlinear mixed ef-fects modelling, we investigated effects of host-specific factors on viral load fluctuation by in-corporating covariates into the model. The pro-posed model provided a good fit for describing fluctuations of viral load measured with varying frequency over different time intervals. The aver-age viral load growth time was significantly dif-ferent between infection sources. There was a large patient to patient variation in viral load as-ymptote.展开更多
Nowadays most communications are done by utilizing digital transmission mechanisms.The security of this digital information transmitted through different communication systems is quite important.The secrecy of digital...Nowadays most communications are done by utilizing digital transmission mechanisms.The security of this digital information transmitted through different communication systems is quite important.The secrecy of digital data is one of the burning topics of the digitally developed world.There exist many traditional algorithms in the literature to provide methods for robust communication.The most important and recent modern block cipher named the advanced encryption standard(AES)is one of the extensively utilized encryption schemes with binary based.AES is a succession of four fundamental steps:round key,sub-byte,shift row,and mix column.In this work,we will provide an innovative methodology for extending the AES in a Galois fieldwith any characteristic p.All four steps in the fundamental process with binary characteristics will be adjusted because of the new enhancement.By applying double affine transformations,we have enhanced the number of options in our suggested substitution boxes.The reconstruction of the nonlinear confusion component and encryption structure provides robustness in the generalized AES.The increase in the keyspace due to the Galois field generalization implies that we have improved additional confusion abilities and broadened the current notions.The implementation of the proposed structure of AES for image,audio,and video encryption will provide high security for secure communication.展开更多
文摘AIM: To determine whether magnetic resonance imaging (MRI) can be used to categorize small bowel Crohn's disease (SB CD) into groups that correlate with response to medical therapy and surgical pathology.METHODS: Data was collected from all patients with MRI evidence of SB CD without significant colonic disease over a 32-mo period. Two radiologists, blinded to clinical findings, evaluated each MRI and grouped them based on bowel wall thickness and wall enhancement. These categories were: (1) "fibrosis", (2) "mild segmental hyper-enhancement and mild wall thickening", (3) "mild segmental hyper-enhancement and marked wall thickening", (4) "marked segmental transmural hyper-enhancement". Patient response to additional medical therapy post-MRI was prospectively determined at 8-wk. Non-responders underwent endoscopy and were offered therapeutic endoscopy or surgery. Surgical pathology was assessed against the MRI category. RESULTS: Fifty-five patients were included. Females and category "2" patients were more likely, and patients with luminal narrowing and hold-up less likely, to respond to medical therapy (P < 0.05). Seventeen patients underwent surgery. The surgical pathologicalfindings of fibrosis and the severity of inflammation correlated with the MRI category in all cases.CONCLUSION: Our fi ndings suggest that SB CD can be grouped by the MRI f indings and that these groups are associated with patients more likely to respond to continued medical therapy. The MRI categories also correlated with the presence and level of intestinal inflammation and fibrosis on surgical pathology, and may be of prognostic use in the management of CD patients.
文摘AIM： TO determine if a nasojejunal tube （NJT） is required for optimal examination of enteroclysis and if patients can be examined only in the supine position. METHODS： Data were collected from all patients undergoing small bowel （SB） magnetic resonance imaging （MRI） examination over a 32-mo period. Patients either underwent a magnetic resonance （MR） follow-through （MRFT） or a MR enteroclysis （MRE） in the supine position. The quality of proximal and distal SB distension as well as the presence of motion artefact and image quality were assessed by 2 radiologists. RESULTS： One hundred and fourteen MR studies were undertaken （MRFT-49, MRE-65） in 108 patients in the supine position only. Image artefact was more frequent in MRE than in MRFT （29.2% vs 18.4%）, but was not statistically significant （P = 0.30）. Adequate distension of the distal SB was obtained in 97.8% of MRFT examinations and in 95.4% of MRE examinations, respectively. Proximal SB distension was, however, less frequently optimal in MRFT than in MRE （P = 0.0036）, particularly in patients over the age of 50 years （P = 0.0099）. Image quality was good in all examinations. CONCLUSION： All patients could be successfully iraaged in the supine position. MRE and MRFT are equivalent for distal SB distension and artefact effects. Proximal SB distension is frequently less optimal in MRFT than in MRE. MRE is, therefore, the preferred MR examination method of the SB.
基金Supported by the Michigan Institute for Clinical and Health Research MICHR T2 Translational Science Award Program Application(MICHR T2),No.UL1RR024986 to Menees SB
文摘AIM To quantify the impact of split-dose regimen on endoscopists' compliance with guideline recommendations for timing of repeat colonoscopy in patients with normal colonoscopy or 1-2 small polyps(< 10 mm).METHODS A retrospective chart review of all endoscopy reports was undertaken in average-risk individuals > 50 years old with a normal screening colonoscopy and 1-2 small polyps. Data were abstracted from two time periods, pre and post-split-dose bowel preparation institution. Main outcome measurements were recommendation for timing of repeat colonoscopy and bowel preparation quality. Bivariate analysis by χ~2 tests and Student's t-tests were performed to assess differences between the two cohorts. Multivariable logistic regression was used with guideline consistent recommendations as the dependent variables and an indicator for 2011 cohort as the primary predictor. RESULTS Four thousand two hundred and twenty-five patients were included in the study; 47.0%(1987) prior to the institution of split dose bowel preparation, and 53.0%(2238) after the institution of split dose bowel preparation. Overall, 82.2%(n = 3472) of the colonoscopies were compliant with guideline recommendations, with a small but significantly increased compliance rate in year 2011(83.7%) compared to year 2009(80.4%, P = 0.005), corresponding to an unadjusted odds ratio of 1.25(95%CI: 1.07-1.47; P = 0.005). Colonoscopies with either "Adequate" or "Excellent" had increased from 30.6% in year 2009 to 39.6% in year 2011(P < 0.001). However, there was no significant difference in poor/inadequate category of bowel preparation as there was a mild increase from 4.6% in year 2009 to 5.1% in year 2011(P = 0.50). CONCLUSION Split-dose bowel regimen increases endoscopists' compliance to guidelines in average-risk patients with normal colonoscopy or 1-2 small polyps.
文摘AIM： To investigate the endoscopic ampullectomy practices of expert biliary endoscopists. METHODS： An anonymous expert biliary endoscopists practices. survey was mailed to 79 to assess ampullectomy RESULTS： Forty six （58%） biliary endoscopists returned the questionnaire. Of these, 63% were in academia and in practice for an average of 16.4 years （± 8.6）. Endoscopists performed an average of 1.1 （± 0.8） ampullectomies per month. Prior to ampullectomy, endoscopic ultrasound was ＂always＂ utilized by 67% of respondents vs ＂sometimes＂ in 31% of respondents. Empiric biliary sphincterotomy was not utilized uniformly, only 26% ＂always＂ and 37% ＂sometimes＂ performed it prior to resection. Fifty three percent reported ＂never＂ performing empiric pancreatic sphincterotomy prior to ampullectomy. Practitioners with high endoscopic retrograde cholangiopancreatography volumes were the most likely to perform a pancreatic sphincterotomy （OR = 10.9; P = 0.09）. Participants overwhelmingly favored ＂always＂ placing a prophylactic pancreatic stent, with 86% placing it after ampullectomy rather than prior to resection （23%）. Argon plasma coagulation was the favored adjunct modality （83%） for removal of residual adenomatous tissue. Practitioners uniformly （100%） preferred follow-up examination to be within 6 mo postmpullectomy.CONCLUSION： Among biliary experts, there is less variation in ampultectomy practices than is reflected in the literature.
文摘AIM To assess the effects of probiotic Medilac-S^(®)as adjunctive therapy for the induction of remission of ulcerative colitis(UC)in a Chinese population through a systematic review and meta-analysis.METHODS A systematic literature search was conducted to find randomized,controlled trials in a Chinese population with at least two study arms-a control arm which receives a conventional,oral aminosalicylate drug,and a treatment arm,which administers the same conventional drug in conjunction with the probiotic Medilac-S^(®)per os.Both English and Chinese databases were searched,including Pub Med,EMBASE,Google Scholar,Chinese National Knowledge Infrastructure,Wanfang Data,and VIP Search,and study data was extracted onto standardized abstraction sheets.Meta-analyses were conducted for primary and secondary outcomes of interest using a fixed or random effects model.The primary outcome was the induction of clinical remission and the secondary outcomes included changes in Sutherland index,endoscopic and histological scores,proportion of reported clinical symptoms and adverse events(AEs).For outcomes with sufficient data,the type of conventional drug therapy was also assessed to determine if the effects of combination therapy with Medilac-S^(®)was influenced by drug type.All tests were conducted using a typeⅠerror rate of 0.05 and all confidence intervals(CI)were based on a 95%confidence level.Review protocol was uploaded to PROSPERO(CRD42018085658 upon completion).RESULTS Fifty-three clinical trials with a total of 3984 participants were identified and included in the review.Medilac-S^(®)adjunctive therapy significantly improved induction of clinical remission(RR=1.21;95%CI:1.18-1.24;P<0.0001)with the estimated likelihood of effective treatment,on average,21%higher for those consuming the probiotic.Sutherland index scores showed the control mean was on average 3.10(CI:2.41-3.78;P=0.0428)units greater than the treatment mean,thereby demonstrating significant improvement in participants taking the probiotic.Similarly,a significant difference was seen between the overall reduction of endoscopic and histological scores of control and treatment arm participants,with score decreases in the control groups 0.71(CI:0.3537-1.0742)and 1.1(CI:0.9189-1.2300)units smaller than treatment group score decreases.The proportion of participants reporting clinical symptoms,(abdominal pain,tenesmus,blood and mucous in stool,and diarrhea)was significantly reduced after combination therapy with Medilac-S~(P<0.0001)and estimated to be on average 44%(RR=0.44,CI:0.32-0.59),53%(RR=0.53,CI:0.38-74),40%(RR=0.40,CI:0.28-0.58)and 47%(RR=0.47 CI:0.36-0.42)respectively,of the proportion of individuals reporting the aforementioned symptoms after conventional therapy alone.The risk of AEs was also significantly reduced with adjunctive Medilac-S~therapy.The proportion of individuals in the treatment groups reporting AEs was an estimated 72%of the proportion of individuals in the control groups reporting AEs(RR=0.72,CI:0.55-0.94,P=0.0175).Upon comparing effect means for different drug types in conjunction with Medilac-S^(®),evidence of significant variability(P<0.0001)was observed,and sulfasalazine was found to be the most effective drug in both primary and secondary outcomes.CONCLUSION Evidence suggests Medilac-S~adjunctive therapy should be considered standard care for UC in a Chinese population because it aids in the induction of clinical remission,improves symptoms of the gastrointestinal tract and reduces risk of AEs.
文摘To characterize colorectal cancer (CRC) in octogenarians as compared with younger patients.METHODSA single-center, retrospective cohort study which included patients diagnosed with CRC at the age of 80 years or older between 2008-2013. A control group included consecutive patients younger than 80 years diagnosed with CRC during the same period. Clinicopathological characteristics, treatment and outcome were compared between the groups. Fisher’s exact test was used for dichotomous variables and χ<sup>2</sup> was used for variables with more than two categories. Overall survival was assessed by Kaplan-Meier survival analysis, with the log-rank test. Cancer specific survival (CSS) and disease-free survival were assessed by the Cox proportional hazards model, with the Fine and Gray correction for non-cancer death as a competing risk.RESULTSThe study included 350 patients, 175 patients in each group. Median follow-up was 40.2 mo (range 1.8-97.5). Several significant differences were noted. Octogenarians had a higher proportion of Ashkenazi ethnicity (64.8% vs 47.9%, P < 0.001), a higher rate of personal history of other malignancies (22.4% vs 13.7%, P = 0.035) and lower rates of family history of any cancer (36.6% vs 64.6%, P < 0.001) and family history of CRC (14.4% vs 27.3%, P = 0.006). CRC diagnosis by screening was less frequent in octogenarians (5.7% vs 20%, P < 0.001) and presentation with performance status (PS) of 0-1 was less common in octogenarians (71% vs 93.9%, P < 0.001). Octogenarians were more likely to have tumors located in the right colon (45.7% vs 34.3%, P = 0.029) and had a lower prevalence of well differentiated histology (10.4% vs 19.3%, P = 0.025). They received less treatment and treatment was less aggressive, both in patients with metastatic and non-metastatic disease, regardless of PS. Their 5-year CSS was worse (63.4% vs 77.6%, P = 0.009), both for metastatic (21% vs 43%, P = 0.03) and for non-metastatic disease (76% vs 88%, P = 0.028).CONCLUSIONOctogenarians presented with several distinct characteristics and had worse outcome. Further research is warranted to better define this growing population.
文摘Guignardia citricarpa, the plant pathogenic fungus that causes citrus black spot, was recently introduced into the United States. The development of this disease in the presence of multiple applications of copper per year to manage citrus canker warrants an investigation into the effects of copper on growth of isolates of G. citricarpa from citrus in Florida. Guignardia citricarpa and G. mangiferae isolates, confirmed by internal transcribed spacer (ITS) sequencing of ribosomal DNA and DNA homology, were inoculated on non-amended media and media amended with 50 and 500 μg·ml-1 copper sulfate. Radial colony growth was assessed over a 26 to 59 day period. Copper reduced the growth of G. citricarpa isolates in media amended with 500 μg·ml-1 copper but had variable effects on radial growth in media amended with 50 μg·ml-1 copper. There was little effect of copper on the in vitro growth of G. mangiferae isolates. Field application of copper with and without an adjuvant for the control of citrus black spot was undertaken in a commercial grove in Florida in 2011. Spray applications were made on a 23.3 ± 4.7 day interval and fruit accessed between December 2011 and March 2012 for black spot symptoms. Copper failed to reduce the proportion of fruit exhibiting symptoms compared to that of the controls.
文摘Phosphorus (P) risk indices are commonly used in the USA to estimate the field-scale risk of agricultural P runoff. Because the Ohio P Risk Index is increasingly being used to judge farmer performance, it is important to evaluate weighting/scoring of all P Index parameters to ensure Ohio farmers are credited for practices that reduce P runoff risk and not unduly penalized for things not demonstrably related to runoff risk. A sensitivity analysis provides information as to how sensitive the P Index score is to changes in inputs. The objectives were to determine 1) which inputs are most highly associated with P Index scores and 2) the relative impact of each input variable on resultant P Index scores. The current approach uses simulations across 6134 Ohio point locations and five crop management scenarios (CMSs), representing increasing soil disturbance. The CMSs range from all no-till, which is being promoted in Ohio, rotational tillage, which is a common practice in Ohio to full tillage to represent an extreme practice. Results showed that P Index scores were best explained by soil test P (31.9%) followed by connectivity to water (29.7%), soil erosion (13.4%), fertilizer application amount (11.3%), runoff class (9.5%), fertilizer application method (2.2%), and finally filter strip (2.0%). Ohio P Index simulations across CMSs one through five showed that >40% scored <15 points (low) while <1.5% scored >45 points (very high). Given Ohio water quality problems, the Ohio P Index needs to be stricter. The current approach is useful for Ohio P Index evaluations and revision decisions by spatially illustrating the impact of potential changes regionally and state-wide.
文摘Background: The SpineNav3DTM technology was recently incorporated in the Accuro device for the automatic detection of spinal bone landmarks. The goal of our study was to validate the ability of the Accuro ultrasound scanner to detect the distance from skin to epidural space by comparing it to the golden standard (the standard ultrasound). The secondary end-point was the inter-rater agreement between an expert anesthesiologist and a novice trainee in determining the epidural space depth with the Accuro device. Methods: 96 consecutive healthy volunteer parturients at term had their lumbar area scanned for the measurements of the depth of the epidural space (recorded in cm) by two anesthesiologists. The expert investigator made the measurements with both the standard ultrasound and the Accuro devices, and the trainee made the measurements with the Accuro device only. Results: There were no differences in the mean depth of the epidural space as measured by the expert or the novice investigator with both the devices (standard ultrasound and Accuro) in both positions (sitting and lateral) at any intervertebral level with a difference less than 0.25 cm. Conclusion: We have demonstrated that this handheld ultrasound system with 3D spine navigation technology can automatically identify the key neuraxial landmarks within ultrasound images of the lumbar spine acquired in the transverse plane and measure the epidural depth with the same accuracy as the standard ultrasounds. We have also demonstrated that the measurements may be rapidly and adequately obtained by a novice who had never previously used ultrasounds.
文摘BACKGROUND Transoral outlet reduction(TORe)is a minimally invasive endoscopic revision of Roux-en-Y gastric bypass(RYGB)for weight recurrence;however,little has been published on its clinical implementation in the community setting.AIM To characterize the safety and efficacy of TORe in the community setting for adults with weight recurrence after RYGB.METHODS This is a retrospective cohort study of argon plasma coagulation and purse-string suturing for gastric outlet reduction in consecutive adults with weight recurrence after RYGB at a single community center from September 2020 to September 2022.Patients were provided longitudinal nutritional support via virtual visits.The primary outcome was total body weight loss(TBWL)at twelve months from TORe.Secondary outcomes included TBWL at three months and six months;excess weight loss(EWL)at three,six,and twelve months;twelve-month TBWL by obesity class;predictors of twelve-month TBWL;rates of post-TORe stenosis;and serious adverse events(SAE).Outcomes were reported with descriptive statistics.RESULTS Two hundred eighty-four adults(91.9%female,age 51.3 years,body mass index 39.3 kg/m^(2))underwent TORe an average of 13.3 years after RYGB.Median pre-and post-TORe outlet diameter was 35 mm and 8 mm,respectively.TBWL was 11.7%±4.6%at three months,14.3%±6.3%at six months,and 17.3%±7.9%at twelve months.EWL was 38.4%±28.2%at three months,46.5%±35.4%at six months,and 53.5%±39.2%at twelve months.The number of follow-up visits attended was the strongest predictor of TBWL at twelve months(R^(2)=0.0139,P=0.0005).Outlet stenosis occurred in 11 patients(3.9%)and was successfully managed with endoscopic dilation.There was one instance of post-procedural nausea requiring overnight observation(SAE rate 0.4%).CONCLUSION When performed by an experienced endoscopist and combined with longitudinal nutritional support,purse-string TORe is safe and effective in the community setting for adults with weight recurrence after RYGB.
文摘Purpose: Diabetic peripheral neuropathy (DPN) is prevalent among the population with type 2 diabetes, and treatment approaches are limited. The combination of L-methylfolate-methylcobalamin-pyridoxal-5-phospate (LMF-MC-PP, Metanx?) is a prescription medical food that has demonstrated significant improvements in sensory perception and quality of life as well as reduced neuropathic pain in patients with DPN. The present study examined the effects of LMF-MC-PP on sensory perception and epidermal nerve fiber density (ENFD) among patients with confirmed DPN. Methods: Patients with type 2 diabetes and diagnosed with diabetic peripheral polyneuropathy, based on loss of vibratory perception, warm-cold discrimination or monofilament sensation, underwent bilateral lower extremity ENFD assessments via skin punch biopsy and were started on LMF-MC-PP. ENFD and monofilament testing were repeated at 6 months. Findings: Of 123 patients evaluated, all had monofilament testing at baseline and 6 months and 122 had assessments at both time points. A significant (p < 0.05) improvement in ENFD from baseline to 6 months was observed. A significant (p = 0.0001) improvement in monofilament testing also was observed. Overall, more patients had intact sensation after 6 months, with 60 (48.8%) of 123 patients having positive monofilament test at baseline as compared to 95 (77.2%) positive after 6 months. An analysis of the association between improvements in ENFD and monofilament testing found that the two tended to occur together, and this was significant (p < 0.05) for the right limb. Implications: Clinically important and statistically significant improvements in ENFD and monofilament sensation were associated with LMF-MC-PP in patients with DPN. When compared to the decrease in ENFD expected among DPN patients, the improvements are even more clinically significant. These findings should be validated in a larger, placebo-controlled study.
基金the Iowa Soybean Association, USA through the ISA On-Farm NetworkTM and Watershed Programming.
文摘Many studies have shown that chlorophyll meter readings （CMRs） can be used to diagnose deficiencies of nitrogen （N） during the growth of corn （Zea mays L.） in small-plot trials, but there is need to address additional problems encountered when diagnoses are made in fields of the size managed in production agriculture. A noteworthy difference between smallplot trials and production agriculture is the extent to which the effects of N are confounded with the effects of other factors such as tillage, landscape, soil organic matter and moisture content. We illustrate how some of these factors can cause differences in the physiological age of plants and introduce errors in the diagnoses of N deficiencies. We suggest methods （measuring the height to the youngest leaf collar and assigning leaf numbers by using the first leaf with pubescence and the ear leaf as references to identify growth stages） for minimizing these errors. The simplified method of growth stage identification can be used to select appropriate plants and leaves for making diagnoses in fields and to distinguish the effects of N from the effects of other factors that influence plant growth.
基金sub-project of National Major Scientific and Technological Special Project of China for‘Significant New Drugs Development’[2015ZX09501008-004]。
文摘Objective Long-term seroprotection via the hepatitis A vaccine is essential for the prevention of disease from the hepatitis A virus(HAV).Due to documented difficulties during decade-long follow-ups after receiving vaccines,statistical-modeling approaches have been applied to predict the duration of immune protection.Methods Based on five-year follow-up data from a randomized positive-controlled trial among Chinese children(1–8 years old)following a 0,6 months vaccination schedule,a power-law model accounting for the kinetics of B-cell turnover,as well as a modified power-law model considering a memory-B-cell subpopulation,were fitted to predict the long-term immune responses induced by HAV vaccination(Healive or Havrix).Anti-HAV levels of each individual and seroconversion rates up to 30 years after vaccination were predicted.Results A total of 375 participants who completed the two-dose vaccination were included in the analysis.Both models predicted that,over a life-long period,participants vaccinated with Healive would have close but slightly higher antibody titers than those of participants vaccinated with Havrix.Additionally,consistent with previous studies,more than 90%of participants were predicted to maintain seroconversion for at least 30 years.Moreover,the modified power-law model predicted that the antibody titers would reach a plateau level after nearly 15 years post-vaccination.Conclusions Based on the results of our modeling,Healive may adequately induce long-term immune responses following a 0,6 months vaccination schedule in children via induction of memory B cells to provide stable and durable immune protection.
基金supported by Agriculture and Food Research Initiative Competitive Grant nos.2013–67015-21348 and 2015–67015-23246 from the USDA National Institute of Food and Agriculture
文摘Dairy cows rely on a complex ruminal microbiota to digest their host-indigestible feed. Our ability to characterize this microbiota has advanced significantly due to developments in next-generation sequencing. However, efforts to sample the rumen, which typical y involves removing digesta directly from the rumen via a cannula, intubation, or rumenocentesis, is costly and labor intensive. As a result, the majority of studies characterizing the rumen microbiota are conducted on samples col ected at a single time point. Currently, it is unknown whether there is significant day-to-day variation in the rumen microbiota, a factor that could strongly influence conclusion drawn from studies that sample at a single time point. To address this, we examined day-to-day changes in the ruminal microbiota of lactating dairy cows using next-generation sequencing to determine if single-day sampling is representative of sampling across 3 consecutive days. We sequenced single-day solid and liquid fractions of ruminal digesta col ected over 3 consecutive days from 12 cannulated dairy cows during the early, middle, and late stages of a single lactation cycle using the V4 region of the bacterial 16 S r RNA gene. We then generated 97% similarity operational taxonomic units(OTUs) from these sequences and showed that any of the individual samples from a given 3-day sampling period is equivalent to the mean OTUs determined from the combined 3-d data set. This finding was consistent for both solid and liquid fractions of the rumen,and we thus conclude that there is limited day-to-day variability in the rumen microbiota.
文摘Habitual fish consumption is associated with numerous health benefits;however, in Australia fish intake remains low. The aim of this study was to compare the effect of specific or general fish consumption recommendations on fish intake behavior over the duration of a 12-month clinical trial. Participants were randomized into a control group (general dietary advice), and two intervention groups (received dietetic advice to consume 180 g fish/wk), with one intervention group receiving LC omega-3 PUFA supplements. Dietary data was available for n = 117 at baseline, n = 85 at 3 months and n = 63 at 12 months. Total, fatty and lean fish intake (g/day) was calculated, and the change in fish intake between and within groups over the duration of the study was measured. Total fish consumption did not differ significantly between groups or within groups, however fatty fish intake was significantly greater in the intervention groups at three months (p = 0.004). The proportion of study participants complying with fish intake recommendations was also highest at the three month time point for both intervention groups. Overall, compliance to fish intake recommendations was highest at the three month time point and appeared to be influenced by dietetic intervention. Provision of fish may increase compliance in future studies, however if research is to be translated to practice, behavioral approaches are required to increase fish intake in the long term.
基金This research was funded by Princess Nourah bint Abdulrahman University Researchers Supporting Project Number(PNURSP2022R87),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘The substitution box,often known as an S-box,is a nonlinear component that is a part of several block ciphers.Its purpose is to protect cryptographic algorithms from a variety of cryptanalytic assaults.A Multi-Criteria Decision Making(MCDM)problem has a complex selection procedure because of having many options and criteria to choose from.Because of this,statistical methods are necessary to assess the performance score of each S-box and decide which option is the best one available based on this score.Using the Pythagorean Fuzzy-based Technique for Order of Preference by Similarity to Ideal Solution(TOPSIS)method,the major objective of this investigation is to select the optimal S-box to be implemented from a pool of twelve key choices.With the help of the Pythagorean fuzzy set(PFS),the purpose of this article is to evaluate whether this nonlinear component is suitable for use in a variety of encryption applications.In this article,we have considered various characteristics of S-boxes,including nonlinearity,algebraic degree,strict avalanche criterion(SAC),absolute indicator,bit independent criterion(BIC),sum of square indicator,algebraic immunity,transparency order,robustness to differential cryptanalysis,composite algebraic immunity,signal to noise ratio-differential power attack(SNR-DPA),and confusion coefficient variance on some standard S-boxes that are Advanced Encryption Following this,the findings of the investigation are changed into Pythagorean fuzzy numbers in the shape of a matrix.This matrix is then subjected to an analysis using the TOPSIS method,which is dependent on the Pythagorean fuzzy set,to rank the most suitable S-box for use in encryption applications.
文摘It is well known that viral load of the hepatitis C virus (HCV) is related to the efficacy of interferon therapy. The complex biological parameters that impact on viral load are essentially unknown. The current knowledge of the hepatitis C virus does not provide a mathematical model for viral load dynamics within untreated patients. We car-ried out an empirical modelling to investigate whether different fluctuation patterns exist and how these patterns (if exist) are related to host-specific factors. Data was prospectively col-lected from 147 untreated patients chronically infected with hepatitis C, each contributing be-tween 2 to 10 years of measurements. We pro-pose to use a three parameter logistic model to describe the overall pattern of viral load fluctua-tion based on an exploratory analysis of the data. To incorporate the correlation feature of longitu-dinal data and patient to patient variation, we introduced random effects components into the model. On the basis of this nonlinear mixed ef-fects modelling, we investigated effects of host-specific factors on viral load fluctuation by in-corporating covariates into the model. The pro-posed model provided a good fit for describing fluctuations of viral load measured with varying frequency over different time intervals. The aver-age viral load growth time was significantly dif-ferent between infection sources. There was a large patient to patient variation in viral load as-ymptote.
基金This research was funded by Princess Nourah bint Abdulrahman University Researchers Supporting Project Number(PNURSP2022R87)Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘Nowadays most communications are done by utilizing digital transmission mechanisms.The security of this digital information transmitted through different communication systems is quite important.The secrecy of digital data is one of the burning topics of the digitally developed world.There exist many traditional algorithms in the literature to provide methods for robust communication.The most important and recent modern block cipher named the advanced encryption standard(AES)is one of the extensively utilized encryption schemes with binary based.AES is a succession of four fundamental steps:round key,sub-byte,shift row,and mix column.In this work,we will provide an innovative methodology for extending the AES in a Galois fieldwith any characteristic p.All four steps in the fundamental process with binary characteristics will be adjusted because of the new enhancement.By applying double affine transformations,we have enhanced the number of options in our suggested substitution boxes.The reconstruction of the nonlinear confusion component and encryption structure provides robustness in the generalized AES.The increase in the keyspace due to the Galois field generalization implies that we have improved additional confusion abilities and broadened the current notions.The implementation of the proposed structure of AES for image,audio,and video encryption will provide high security for secure communication.
