Database Files Research Articles

A pharmacovigilance study of terbinafine indication and liver enzyme elevation

To the Editor: Terbinafine is a commonly administered oral and topical antifungal medication. Terbinafine oral treatment regimens are based on the site of infection; nail infections often require a 6 to 12-week treatment schedule, but non-nail (ie, skin or hair) infections can usually be treated for 2 to 6 weeks. While it is commonly regarded that terbinafine-induced liver injury occurs within 30 days,1Maxfield L, Preuss CV, Bermudez R. Terbinafine. [Updated 2021 Aug 31]. In: StatPearls [Internet]. StatPearls Publishing; 2022 January. Accessed July 14, 2022. https://www.ncbi.nlm.nih.gov/books/NBK545218/Google Scholar we hypothesize that indications necessitating longer treatment durations are more likely associated with liver injury/liver enzyme elevation (LEE) events. To analyze this question, we computed a reporting odds ratios (ROR) using drug-event reports extracted from both the FDA Adverse Drug Event Reporting System (FAERS) and Canada Vigilance Adverse Reaction Online (CVARO) databases. It is important to highlight that one of the limitations of these commonly used databases is that the data entered by physicians or pharmaceutical companies is not corroborated or confirmed independently. Raw database files were downloaded from: https://fis.fda.gov/extensions/FPD-QDE-FAERS/FPD-QDE-FAERS.html (USA) and https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/adverse-reaction-database/canada-vigilance-online-database-data-extract.html. The FAERS database included reports logged between January 1, 2014, and December 31, 2020. The CVARO database included all publicly available reports from 1965 to September 2021 inclusively. To capture all terbinafine-associated drug reports, we searched both databases using “%terbinafine%” and “%lamisil%” (% represents a wildcard modifier) terms. Additionally, we made sure to exclude topical terbinafine preparations from the search results. Adverse events are encoded in both databases using MedDRA’s list of accepted terminologies. There was a total of 21,034 and 3913 oral terbinafine-associated adverse drug reaction reports in both the FAERS and CVARO databases, respectively. Notably, 247 (FAERS) and 125 (CVARO) of these reports were related to LEE events. Unfortunately, the degree of LEE (eg, 2-fold vs. 100-fold) or its clinical significance is not detailed in the databases. Furthermore, details on other possible interacting medications that patients might be taking are not available from these sources. Following data extraction, the ROR, a classically accepted method of signal generation for common adverse drug reactions in pharmacovigilance studies, was computed.2Rothman K.J. Lanes S. Sacks S.T. The reporting odds ratio and its advantages over the proportional reporting ratio.Pharmacoepidemiol Drug Saf. 2004; 13: 519-523https://doi.org/10.1002/pds.1001Google Scholar, 3Sakaeda T. Tamon A. Kadoyama K. Okuno Y. Data mining of the public version of the FDA adverse event reporting system.Int J Med Sci. 2013; 10: 796-803https://doi.org/10.7150/ijms.6048Google Scholar Table I demonstrates the RORs for terbinafine and LEE events and is further stratified by indication. Isoniazid, a well-known hepatotoxic agent, was used as a comparator to better contextualize the magnitude of terbinafine-LEE associated RORs.Table IROR for terbinafine-LEE reports according to indicationVariables assessedFAERS ROR (CI)CVARO ROR (CI)Terbinafine-LEE ReportsNon-Onychomycosis1.71 (1.07-2.72)1.51 (0.37-6.09)Terbinafine-LEE ReportsNail Infections4.58 (3.84-5.46)4.51 (2.64-7.68)Isoniazid-LEE Reports5.35 (5.06-5.67)5.51 (5.00-6.07)RORs are listed for terbinafine and onychomycosis and non-onychomycosis indications. In brackets are each ROR’s confidence intervals. FDA adverse event reporting system and Canada Vigilance Adverse Reaction Online RORs are listed in their respective columns.CVARO, Canada Vigilance Adverse Reaction Online; FAERS, FDA Adverse Drug Event Reporting System; LEE, liver enzyme elevation; ROR, reporting odds ratio. Open table in a new tab RORs are listed for terbinafine and onychomycosis and non-onychomycosis indications. In brackets are each ROR’s confidence intervals. FDA adverse event reporting system and Canada Vigilance Adverse Reaction Online RORs are listed in their respective columns. CVARO, Canada Vigilance Adverse Reaction Online; FAERS, FDA Adverse Drug Event Reporting System; LEE, liver enzyme elevation; ROR, reporting odds ratio. Terbinafine-LEE RORs were more than 2-fold higher for onychomycosis versus non-onychomycosis (ie, skin and nail) infections in both FAERS and CVARO databases (Table I, Supplementary Table I, available via Mendeley at https://doi.org/10.17632/n8pkb4tzyz.1). Additionally, onychomycosis-indicated LEE RORs more closely approximated isoniazid-LEE RORs compared with non-onychomycosis-LEE RORs in both databases, possibly suggesting a greater likelihood of LEE and liver injury with longer terbinafine use. Our analysis suggests a possible relationship between liver injury and longer usage of terbinafine, which is comparable to that of isoniazid, where older patients undergo monthly blood tests to evaluate for this idiosyncratic event.4Gray E.L. Goldberg H.F. Baseline abnormal liver function tests are more important than age in the development of isoniazid-induced hepatoxicity for patients receiving preventive therapy for latent tuberculosis infection.Intern Med J. 2016; 46: 281-287https://doi.org/10.1111/imj.12979Google Scholar As a result, we emphasize the importance of further investigating this potentially duration-sensitive adverse drug reaction, assessing its clinical significance and impact on patients to better direct clinicians in the safe prescribing of terbinafine in populations at higher risk of liver-related injuries and complications. None disclosed.

Challenges in the management of breast cancer in Kinshasa, the Democratic Republic of the Congo.

e12503 Background: Breast cancer mortality has decreased by almost 40% since the 1980s in high-income countries. However, this trend is not paralleled in low-income countries, where poor outcomes are consistently reported, thus making it a significant public health consideration. Moreover, the lack of cancer registries in these countries makes it difficult to assess the true burden of disease. The aim of the present study was to provide data on breast cancer management and the faced challenges in the Democratic Republic of the Congo. Methods: Retrospective cohort study of women admitted for breast cancer care from January 2010 to December 2020 at 3 institutions (Cliniques Universitaires de Kinshasa, Centre Hospitalier Nganda, Hôpital Saint-Joseph) in Kinshasa, DRC. Patient demographics, diagnostic procedures and treatments received were collected from the patients’ files database. The study was approved by each institution’s ethics committee. Results: A total of 349 patients were included in the cohort. The median age at diagnosis was 46 years (IQR 40-56 years). Only 12 women were nulliparous and approximately 50% (119/234 with available data) were post-menopausal. 60.2% presented with clinically involved axillary lymph nodes while in 88.2% of cases breast cancer was diagnosed at advanced stages (TNM III-IV). Distant metastases were present at diagnosis in 91 patients (26.1%) with the most common site being the lungs. Invasive ductal carcinoma was the most commontype (128/178 whose biopsy results were available, 91.4%) with a grade 2 morphology in 54.3% of cases. Immunohistochemistry was performed in only 10.3% of patients (n=36) with the findings showing HR+/HER2−ve: 6.0%; HR+/HER2+: 2.6%; HR−/HER2−: 1.7%. Surgery was performed in 53 patients (15.2%), among whom 40, 11 and 2 underwent modified radical mastectomy, simple mastectomy and breast-conserving surgery, respectively. The median time to surgery after diagnosis was 30 days (IQR: 13.25-64.75). Chemotherapy was administered to 81 (23.2%) patients; 50% of cases this consisted of an anthracycline-based regimen but only 19 patients completed 6 cycles. Among this cohort 57 (16,3%) patients received endocrine therapy with Tamoxifen being the most prescribed drug (44/57 patients). No patient received radiotherapy as there was no capacity. The median follow-up was 13 days (IQR: 0-45.5) limiting assessment of oncological outcomes. Conclusions: Patients with breast cancer in Kinshasa tend to present with advanced stage disease. Lack of organized screening, limited treatment resources and lack of robust follow-up pose significant challenges in breast cancer management and may be associated with adverse oncological outcomes. Multiple efforts are warranted to enhance early diagnosis, improve access to histopathologic evaluation to guide treatment as well as access to systemic therapies to allow implementation of evidence-based best practices.

P-227 Overexpression of survivin-1, TAG-72 and HERC5 in patients diagnosed with hepatocellular carcinoma in the Black Sea Coast geographical area

Epidemiological data regarding hepatocellular carcinoma (HCC) report unsatisfactory morbimortality rates despite the global efforts to decrease the incidence and prolong patient survival. Current guidelines lack diagnostic biomarkers to better characterize patients with HCC. We aimed to validate the overexpression of Survivin-1, tumor-associated glyocoprotein 72 (Tag-72), and HECT and RLD domain containing E3 ubiquitin protein ligase 5 (HERC5) as tissue biomarkers for HCC characterization in patients from our geographical area and to standardize a local biomarker panel to be introduced in the current management guideline. Thirty liver specimens of HCC and a similar number of liver tissue specimens of benign liver tumors were selected from the Gastroenterology file database and Pathology Clinic registries from St. Apostle Andrew Emergency Clinical Hospital, Constanta and Fundeni Institute, Bucharest and compared in terms of Survivin-1, Tag-72, and HERC5 overexpression. The morphological features of the tumors were noted based on the WHO Histological Classification for digestive tumors. Demographic data of all patients providing the liver specimens, as well as liver diseases background like chronic viral infections, other co-morbidities and laboratory parameters recorded at the time of hospital admission were noted. For the IHC assessment, the representative samples were chosen, and 4-μm sections of formalin-fixed, paraffin-embedded tissue blocks were obtained for each case enrolled. Epitope retrieval was conducted prior to incubation of tissue sections with a panel of three primary antibodies (ready-to-use) from Novus Biological: survivin-1 (NB100-911 clone), Tag-72 (CC49 clone), and HERC5 (NBP-91985 clone). The immunostaining protocol for each antibody used was provided by the manufacturer. As chromogen, we used 3,3'diaminobenzidine (DAB), and brown staining was obtained. The final step was represented by counterstaining all slides with Mayer's Hematoxylin. Comparisons of the studied biomarker overexpression from HCC tissue samples with a matched non-HCC group of normal liver tissue specimens were made.Student t-test, Mann-Whitney U-test and Chi-square test were used to find differences between the two studied groups and to compare the categorical variables. The discriminative power of Survivin -1, Tag-72, and HERC5 overexpression was assessed using ROC curves. The multivariate linear regression analysis revealed that Survivin-1, Tag-72, and HERC5 were significantly overexpressed upon IHC analysis in HCC samples in patients older than 50 years (P=0.003, P=0.006, P=0.004), male gender (P=0.031, P=0.004, P=0.020), patients with increased AFP over 180 ng/dl (P=0.012, P=0.004, P=0.029), with low serum albumin < 3 mg/dl (P=0.031, P=0.021, P=0.003, respectively), with imaging features of portal thrombosis (P=0.004, P=0.020, P=0.004, respectively), ascites (P=0.002, P=0.004, P=0.019, respectively) and in BCLC B and C classes patients (P=0.045, P=0.036, P=0.045, and P=0.033, P=0.001, P=0.027, respectively). The diagnostic performance of Survivin-1, Tag-72 and HER-C5 tissue biomarkers for HCC characterization was superior to that of AFP, considered the gold standard biomarker used in clinical guidelines (Survivin-1: Z statistic=2.911, P=0.0039; Tag-72: Z statistic=2.789, P=0.0049, respectively; HERC5: Z statistic=2.844, P=0.0043) and AFP assay alone (Z statistic=5.022, P < 0.0001). Our study results validate the overexpression of Survivin-1, Tag-72, and HERC5 as tissue biomarkers for HCC characterization in patients from our geographical region and could be standardized in the current HCC management guideline.

Coordination mechanisms for COVID-19 in the WHO Regional office for Africa

AimThis study describes the coordination mechanisms that have been used for management of the COVID 19 pandemic in the WHO AFRO region; relate the patterns of the disease (length of time between onset of coordination and first case; length of the wave of the disease and peak attack rate) to coordination mechanisms established at the national level, and document best practices and lessons learned.MethodWe did a retrospective policy tracing of the COVID-19 coordination mechanisms from March 2020 (when first cases of COVID-19 in the AFRO region were reported) to the end of the third wave in September 2021. Data sources were from document and Literature review of COVID-19 response strategies, plans, regulations, press releases, government websites, grey and peer-reviewed literature. The data was extracted to Excel file database and coded then analysed using Stata (version 15). Analysis was done through descriptive statistical analysis (using measures of central tendencies (mean, SD, and median) and measures of central dispersion (range)), multiple linear regression, and thematic analysis of qualitative data.ResultsThere are three distinct layered coordination mechanisms (strategic, operational, and tactical) that were either implemented singularly or in tandem with another coordination mechanism. 87.23% (n = 41) of the countries initiated strategic coordination, and 59.57% (n = 28) initiated some form of operational coordination. Some of countries (n = 26,55.32%) provided operational coordination using functional Public Health Emergency Operation Centres (PHEOCs) which were activated for the response. 31.91% (n = 15) of the countries initiated some form of tactical coordination which involved the decentralisation of the operations at the local/grassroot level/district/ county levels. Decentralisation strategies played a key role in coordination, as was the innovative strategies by the countries; some coordination mechanisms built on already existing coordination systems and the heads of states were effective in the success of the coordination process. Financing posed challenge to majority of the countries in initiating coordination.ConclusionCoordinating an emergency is a multidimensional process that includes having decision-makers and institutional agents define and prioritise policies and norms that contain the spread of the disease, regulate activities and behaviour and citizens, and respond to personnel who coordinate prevention.

14-Day Outcome of Treatment Protocol Given to Patients with COVID-19 Admitted in FIC/HDU Karachi

Aims: To observe outcomes in patients admitted to the High Dependency Unit (HDU) at the Field Isolation Centre Karachi after 14 days of COVID-19 treatment protocol.&#x0D; Patients and meth­ods: This cross-sectional study was conducted at HDU/FIC Karachi at Expo Centre. The duration of the study was from 1st December 2020 to 10th March 2021. All patients diagnosed as cases of COVID-19, of both genders with age ranging from 18 to 91 years were included.&#x0D; Methodology: All patients were treated according to the protocols set as under:&#x0D; Anti-viral drug Remdesivir was given in all patients aged less than 75 years, with moderate to severe disease (based on clinical classification released by National Health Commission of China). Dexamethasone 6mg IV once daily was initiated in all oxygen dependent patients and increased to twice daily if Ferritin levels were greater than 1000ug/L. As a supportive treatment, patients with moderate or severe disease were given Injection Enoxaparin in prophylactic dose and in therapeutic dose for patients with elevated D-Dimer levels. Along with this, superadded bacterial infections were covered with broad-spectrum antibiotics and adjusted as per culture and sensitivity. Patients were also given Famotidine (H-2 receptor blocker), and anti-hyperlipidemic drug Fenofibrate based on initial supportive literature. But in patients with known liver diseases or with deranged ALT levels ≥ 5 times upper limits of normal, Fenofibrate and Remdesivir were discontinued.&#x0D; All data regarding the medications given, oxygen demand, disease severity and co-morbid conditions and the outcome on 14th day of admission was collected through the online HMIS database and patient files, on pre-approved Performa. Patients’ confidentiality was ensured.&#x0D; Results: A total of 183 patients were included in the study. There were 66.7% male and 33.3% female patients with a mean age 59.01±14.83 years. Majority (72.1%) of patients were of more than 50 years of age. Among 183 patients, 2.2% were smokers, 51.9% were hypertensive and 41% were diabetic while 5.5% had ischemic heart disease, and 3.8% were found with asthma. We found 84.7% with shortness of breath, 67.8% of patients with fever, 57.9% with cough, 17.5% with myalgia, 14.8% with fatigue, 4.9% with diarrhea, 2.7% with nausea and 1.6% with vomiting. In our study, 35% of patients expired. Out of 183 patients, 147 patients needed oxygen at the time of admission, which was reduced to 45 patients after 2 weeks, while 26 patients need NIV at admission, reduced to 21 patients on NIV after 2 weeks. We found significant mean difference of age (p=0.000) while significant association of outcome was found with Remdesivir given (p=0.039), cough (p=0.025), intubation after 2 weeks (p=0.006), Oxygen need at admission (p=0.000), Oxygen need after 2 weeks (p=0.000), NIV Need at admission (p=0.000) and NIV Need after 2 weeks (p=0.000).&#x0D; Conclusion: This study revealed various characteristics (age, supplemental oxygen requirement and comorbid conditions) of COVID-19 patients to be associated with poor outcome at 14th day of admission. Remdesivir was found to decrease mortality, especially in patients with moderate to severe disease.

A Prediction Model of Recidivism of Specific Populations Based on Big Data

This research is aimed at establishing and improving the relevant information database of “released prisoners,” integrating the behavior data of specific populations, constructing the early-warning model of recidivism, evaluating the database file information by using prediction analysis technology, and making a prediction alarm to the people who are most likely to commit the crime again on the basis of big data analysis so as to ultimately achieve the goal of reducing the recidivism rate. The research used the data exchange technology of the heterogeneous database to complete data collection and database establishment, used the feature engineering technology to analyze the big data of specific populations, obtained the multidimensional behavior trajectory data, and carried out sorting and statistics. On this basis, the linear regression algorithm was applied to make the prediction and evaluation, and the visual results were presented to assist in researching and judging the possibility of recidivism of specific personnel. Through programming realization and simulation experiments, the research obtained the tendency prediction of the people to commit crimes again by statistical analysis from multidimensional data with a long time span. In the next step, the real test will be carried out to help the public security work in China and contribute to the maintenance of national and social stability.

ABUSE RELATED POSTS REPORTER USING WEB CRAWLER IN PYTHON

This research paper shows one of the application areas where Web Scraping can be used to solve some social issues. According to [4], Web Scraping automates this process and helps you display all the data at the same place with ease and in a small amount of time. Main objective of Web Scraping is to extract information from one or many websites and process it into simple structures such as spreadsheets, database or CSV file. In our website, we have made use of this technology to solve a important social issue. Many cases of abuse have been increased with the use of Internet. Our website allows the authorized communities to search for such abuse related posts from different websites, while staying on a single webpage. The user will just have to enter the keyword, for e.g. – women abuse, and he will get the posts from several number of websites on a single webpage. The method explained in this paper is applied to a popular social platform – ‘Twitter’ as a use case. It can be applied to a number of websites. This will help the authorities to save time in searching for such crimes and give more time to solve these issues. KEYWORDS : Web Scraping, Django, HTML, CSS, Python, Selenium.

Is Bariatric Procedure Type Associated With Morbidity in Transplant Patients?

Roux-en-Y Gastric Bypass (RYGB) has been associated with increased weight loss but more complications when compared with sleeve gastrectomy (SG). However, a direct comparison between RYGB and SG has never been performed in patients with a history of solid organ transplantation. The aim of this study was to determine the association between procedure type and surgical outcomes. Patients with a history of solid organ transplantation were identified in the Metabolic and Bariatric Surgery Accreditation Quality Improvement Project Participant Use File database from 2017 to 2018. Procedure type (SG versus RYGB) was used to stratify patients. Propensity score matching and multivariable logistic regressions were used, and outcomes were compared. Of 678 cases identified, 80% (n=542) underwent an SG and 20% (n=136) had an RYGB. Patients differed significantly (P<0.05) by multiple demographic variables. Multivariable regression revealed RYGB to be associated with higher overall morbidity (odds ratio [OR] 1.98; P=0.012), morbidity related to surgery (OR 2.47; P=0.002), unplanned readmissions (OR 2.48; P=0.002), and readmissions related to surgery (OR 2.32; P=0.016). After propensity score matching, RYGB, compared with SG, was also associated with higher morbidity (14% versus 7.4%; P=0.077) and readmissions (13% versus 6.6%; P=0.099) related to surgery, although this did not reach statistical significance. In patients with a history of solid organ transplant, RYGB was associated with increased morbidity and readmissions compared with SG.

A Unified Forensic Model Applicable to the Database Forensics Field

The Database Forensics Investigation (DBFI) field is focused on capturing and investigating database incidents. DBFI is a subdomain of the digital forensics domain, which deals with database files and dictionaries to identify, acquire, preserve, examine, analyze, reconstruct, present, and document database incidents. Several frameworks and models have been offered for the DBFI field in the literature. However, these specific models and frameworks have redundant investigation processes and activities. Therefore, this study has two aims: (i) conducting a compressive survey to discover the challenges and issues of the DBFI field and (ii) developing a Unified forensic model for the database forensics field. To this end, the design science research (DSR) method was used in this study. The results showed that the DBFI field suffers from many issues such as the lack of standardization, multidimensional nature, heterogeneity, and ambiguity, making it complex for those working in this domain. In addition, a model was proposed in this paper, called the Unified Forensic Model (UFM), which consists of five main stages: initialization stage, acquiring stage, investigation stage, restoring and recovering stage, and evaluation stage. Each stage has several processes and activities. The applicability of UFM was evaluated from two perspectives: completeness and implementation perspectives. UFM is a novel model covering all existing DBFI models and comprises two new stages: the recovering and restoring stage and the evaluation stage. The proposed UFM is so flexible that any forensic investigator could employ it easily when investigating database incidents.

An Evaluation of Pediatric Gastrocutaneous Fistula Closure Through the Punch Excision of Epithelized Tract Procedure.

Persistent gastrocutaneous fistulae frequently complicate gastrostomy tube placement. A minimally invasive technique for tract closure employing balloon catheter retraction and punch excision of the epithelized tract (PEET) was recently reported. We hypothesized the PEET technique of closure would lead to decreased complications without an increased incidence of recurrence. We conducted a single-center retrospective cohort study evaluating children who underwent gastrocutaneous fistula (GCF) closure 1/1/2018-12/31/2021, comparing patients who underwent the PEET procedure to those repaired with layered closure. Procedure duration and outcomes were additionally compared to the 2018-2019 National Surgical Quality Improvement Program (NSQIP) Participant Use File (PUF) database. Sixty-two children underwent operative GCF closure, including 25 with PEET and 37 traditional layered closure. Procedural time was significantly decreased employing PEET (14 vs 26minutes, P < .0001), less than half the national median by the NSQIP PUF database of 292 GCF closures (14 vs 34.5minutes, P < .0001). Those repaired with the PEET method experienced no episodes of recurrence, surgical site infection, readmission, reoperation, or mortality within 30days of the procedure. Conversely, in traditional closure, there was a 24.3% complication rate, including 7 surgical site infections, 1 readmission, and 2 unplanned reoperations. National procedural complication rate by NSQIP PUF was 5.5%, with a 4.8% rate of surgical site infection, .3% reoperation incidence, and .3% mortality. Our study suggests GCF closure employing the PEET procedure is a safe, more efficient method of tract closure than the traditional layered closure technique.

Selective Power-Loss-Protection Method for Write Buffer in ZNS SSDs

Most SSDs (solid-state drives) use an internal DRAM (Dynamic Random Access Memory) to improve the I/O performance and extend SSD lifespan by absorbing write requests. However, this volatile memory does not guarantee the persistence of buffered data in the event of sudden power-off. Therefore, highly reliable enterprise SSDs employ power-loss-protection (PLP) logic to ensure the durability of buffered data using the back-up power of capacitors. The SSD must provide enough capacitors for the PLP in proportion to the size of the volatile buffer. Meanwhile, emerging ZNS (Zoned Namespace) SSDs are attracting attention because they can support many I/O streams that are useful in multi-tenant systems. Although ZNS SSDs do not use an internal mapping table unlike conventional block-interface SSDs, a large write buffer is required to provide many I/O streams. The reason is that each I/O stream needs its own write buffer for write buffering where the host can allocate separate zones to different I/O streams. Moreover, the larger capacity and more I/O streams the ZNS SSD supports, the larger write buffer is required. However, the size of the write buffer depends on the amount of capacitance, which is limited not only by the SSD internal space, but also by the cost. Therefore, in this paper, we present a set of techniques that significantly reduce the amount of capacitance required in ZNS SSDs, while ensuring the durability of buffered data during sudden power-off. First, we note that modern file systems or databases have their own solutions for data recovery, such as WAL (Write-ahead Log) and journal. Therefore, we propose a selective power-loss-protection method that ensures durability only for the WAL or journal required for data recovery, not for the entire buffered data. Second, to minimize the time taken by the PLP, we propose a balanced flush method that temporarily writes buffered data to multiple zones to maximize parallelism and preserves the data in its original location when power is restored. The proposed methods are implemented and evaluated by modifying FEMU (QEMU-based Flash Emulator) and RocksDB. According to experimental results, the proposed selective-PLP reduces the amount of capacitance by 50 to 90% while retaining the reliability of ZNS SSDs. In addition, the balanced flush method reduces the PLP latency by up to 96%.

Digital Forensic Analysis of Wallapop Application on Android Operating System

The use of second hand shopping applications is increasing day by day. Applications can be used for product search, product sale / purchase, product search / search, specific filtering for the searched product, product selection by category, saving searched products, product listing and messaging with people. There may be situations that may create legal problems between users in shopping applications. Defamation, fraud, fraudulent products, sale of prohibited substances are carried to judicial authorities. Wallapop app is a second hand sales app with more than 10 million downloads on google play store. Application were examined by XRY, Praben, Oxygen, Axiom, Ufed and Autopsy Forensic examination programs and no characteristic information about the application could be obtained. In the study, manual forensic analysis of Wallapop application on mobile devices with Android operating system was performed and an examination method was proposed. In the study, manual forensic analysis of Wallapop application on mobile devices with Android operating system is performed and a methodology about the artifacts produced by Wallapop application, their analysis and the relations with each other is presented. The contents of the database files, location information, session information and other data that may be considered as evidence are shown.

Copy Number Variation Analysis of Euploid Pregnancy Loss.

Objectives: Copy number variant (CNV) is believed to be the potential genetic cause of pregnancy loss. However, CNVs less than 3 Mb in euploid products of conceptions (POCs) remain largely unexplored. The aim of this study was to investigate the features of CNVs less than 3 Mb in POCs and their potential clinical significance in pregnancy loss/fetal death. Methods: CNV data were extracted from a cohort in our institution and 19 peer-reviewed publications, and only those CNVs less than 3 Mb detected in euploid pregnancy loss/fetal death were included. We conducted a CNV map to analyze the distribution of CNVs in chromosomes using R packages karyoploteR_1.10.5. Gene names and annotated gene types covered by those CNVs were mined from the human Release 19 reference genome file and GENECODE database. We assessed the expression patterns and the consequences of murine knock-out of those genes using TiGER and Mouse Genome Informatics (MGI) databases. Functional enrichment and pathway analysis for genes in CNVs were performed using clusterProfiler V3.12.0. Result: Breakpoints of 564 CNVs less than 3 Mb were obtained from 442 euploid POCs, with 349 gains and 185 losses. The CNV map showed that CNVs were distributed in all chromosomes, with the highest frequency detected in chromosome 22 and the lowest frequency in chromosome Y, and CNVs showed a higher density in the pericentromeric and sub-telomeric regions. A total of 5,414 genes mined from the CNV regions (CNVRs), Gene Ontology (GO), and pathway analysis showed that the genes were significantly enriched in multiple terms, especially in sensory perception, membrane region, and tight junction. A total of 995 protein-coding genes have been reported to present mammalian phenotypes in MGI, and 276 of them lead to embryonic lethality or abnormal embryo/placenta in knock-out mouse models. CNV located at 19p13.3 was the most common CNV of all POCs. Conclusion: CNVs less than 3 Mb in euploid POCs distribute unevenly in all chromosomes, and a higher density was seen in the pericentromeric and sub-telomeric regions. The genes in those CNVRs are significantly enriched in biological processes and pathways that are important to embryonic/fetal development. CNV in 19p13.3 and the variations of ARID3A and FSTL3 might contribute to pregnancy loss.

Intelligent Intersection Vehicle and Pedestrian Detection Based on Convolutional Neural Network

The preprocessed images are input to a pretrained neural network to obtain the corresponding feature mapping, and the corresponding region of interest is set for each point in the feature mapping to obtain multiple candidate feature regions; subsequently, these candidate feature regions are fed into a region proposal network and a deep residual network for binary classification and BB regression, and some of the candidate feature regions are filtered out, and the remaining feature regions are subjected to ROIAIign operation; finally, classification, BB regression, and mask generation are performed on these feature regions, and full convolutional nerve network operation is performed in each feature region and output. To further identify the specific model of the vehicle, this paper proposes a multifeature model recognition method that fuses the improved model with the optimized Mask R-CNN algorithm. A vehicle local feature dataset including vehicle badges, lights, air intake grille, and whole vehicle outline is established to simplify the network structure of model. Meanwhile, its detection frame generation process and the adjustment rules of overlapping frame confidence in nonmaximum suppression are improved for coarse vehicle localization. Then, the generated vehicle detection frames after localization are output to the Mask R-CNN algorithm after further optimizing the RPN structure. The localized vehicle detection frames are then output to the Mask R-CNN algorithm after further optimization of the RPN structure for local feature recognition, and good recognition results are achieved. Finally, this paper establishes a distributed server-based vehicle recognition system, which mainly includes database module, file module, feature extraction and matching module, message queue module, WEB module, and vehicle detection module. Due to the limitations of traditional region generation methods, this paper provides a brief analysis of the region generation network in the Faster R-CNN algorithm and details the loss calculation principle of the output layer.

Achieving Privacy-Preserving DSSE for Intelligent IoT Healthcare System

As the product of combining Internet of Things (IoT), cloud computing, and traditional healthcare, Intelligent IoT Healthcare (IIoTH) brings us a lot of convenience, meanwhile security and privacy issues have attracted great attention. Dynamic searchable symmetric encryption (DSSE) technique can make the user search the dynamic healthcare information from IIoTH system under the condition that the privacy is protected. In this article, a novel privacy-preserving DSSE scheme for IIoTH system is proposed. It is the first DSSE scheme designed for personal health record (PHR) files database with forward security. We construct the secure index based on hash chain and realize trapdoor updates for resisting file injection attacks. In addition, we realize fine-grained search over encrypted PHR files database of attribute-value type. When the user executes search operations, he/she gets only a matched attribute value instead of the whole file. As a result, the communication cost is reduced and the disclosure of patient's privacy is minimized. The proposed scheme also achieves attribute access control, which allows users have different access authorities to attribute values. The specific security analysis and experiments show the security and the efficiency of the proposed scheme.

Mechanistic modeling of hybrid low salinity polymer flooding: Role of geochemistry

Low salinity polymer (LSP) based enhanced oil recovery (EOR) technique is getting more attention due to its potential of improving both displacement and sweep efficiencies. Modeling LSP flooding is challenging due to the complicated physical processes and the sensitivity of polymers to brine salinity. In this study, a coupled numerical model has been implemented to allow investigating the polymer-brine-rock geochemical interactions associated with LSP flooding along with the flow dynamics. MATLAB Reservoir Simulation Toolbox (MRST) was coupled with the geochemical software IPhreeqc, which is the interface module of Phreeqc (i.e., pH-Redox-Equilibrium in C programming language). The effects of polymer were captured by considering Todd–Longstaff mixing model, inaccessible pore volume, permeability reduction, polymer adsorption as well as salinity and shear rate effects on polymer viscosity. Regarding geochemistry, the presence of polymer in the aqueous phase was considered by adding a new solution specie and related chemical reactions to Phreeqc database files. Thus, allowing for modeling the geochemical interactions related to the presence of polymer. Coupling the two simulators was successfully performed, verified, and validated through several case studies. The coupled MRST–IPhreeqc simulator allows for modeling a wide variety of geochemical reactions including aqueous, mineral precipitation/dissolution, and ion exchange reactions. Capturing these reactions allows for real time tracking of the aqueous phase salinity and its effect on polymer rheological properties. The coupled simulator was verified against Phreeqc for a realistic reactive transport scenario. Furthermore, the coupled simulator was validated through history matching a single-phase LSP coreflood from the literature. This paper provides an insight into the geochemical interactions between partially hydrolyzed polyacrylamide (HPAM) and aqueous solution chemistry (salinity and hardness), and their related effect on polymer viscosity. This work is also considered as a base for future two-phase polymer solution and oil interactions, and their related effect on oil recovery.

Alcohol exacerbated biochemical and biophysical alterations in liver mitochondrial membrane of diabetic male wistar rats – A possible amelioration by green tea

Alcohol exacerbated biochemical and biophysical alterations in liver mitochondrial membrane of diabetic male wistar rats – A possible amelioration by green tea

Association between Surgery, Anesthesia, and Obstetric Workforce and Emergent Surgical and Obstetric Mortality among United States Hospital Referral Regions.

To determine the association between SAO workforce and mortality from emergent surgical and obstetric conditions within US HR Rs. SAO workforce per capita has been identified as a core metric of surgical capacity by the Lancet Commission on Global Surgery, but its utility has not been assessed at the subnational level for a high-income country. The number of practicing surgeons, anesthesiologists, and obstetricians per capita was estimated for all HRRs using the US Health Resources & Services Administration Area Health Resource File Database. Deaths due to emergent general surgical and obstetric conditions were determined from the Center for Disease Control and Prevention WONDER database. We utilized B-spline quantile regression to model the relationship between SAO workforce and emergent surgical mortality at different quantiles of mortality and calculated the expected change in mortality associated with increases in SAO workforce. The median SAO workforce across all HRRs was 74.2 per 100,000 population (interquartile range 33.3-241.0). All HRRs met the Lancet Commission on Global Surgery lower target of 20 SAO per 100,000, and 97.7% met the upper target of 40 per 100,000. Nearly 2.8 million Americans lived in HRRs with fewer than 40 SAO per 100,000. Increases in SAO workforce were associated with decreases in surgical mortality in HRRs with high mortality, with minimal additional decreases in mortality above 60 to 80 SAO per 100,000. Increasing SAO workforce capacity may reduce emergent surgical and obstetric mortality in regions with high surgical mortality but diminishing returns may be seen above 60 to 80 SAO per 100,000. Trial Registration: N/A.

Impact Of “Defensive Medicine” On The Costs Of Diabetes And Associated Conditions

OBJECTIVES This study explores the association between the medicolegal environment and Medicare costs for Diabetes and associated conditions of interest to vascular surgeons. METHODS The 2018 Medicare Geographic Variation Public Use Files and Chronic Conditions Data Files were linked to National Practitioner Database files from the preceding 5 years, in addition to US Census data and AMA workforce statistics. State-level medicolegal environment was characterized by K-means clustering across a panel of metrics related to malpractice payment magnitude and prevalence. RESULTS Median (IQR) unadjusted Medicare per-capita expenditure on diabetic patients was $15,963 ($14,885 to $17,673), ranging from $13,762 (Iowa) to $21,865 (D.C.). Cluster analysis based on malpractice-related variables yields 5 distinct medicolegal environments. Per-capita spending on diabetes ranged from $15,799 in medicolegally favorable states to $18,838 in more adverse medicolegal environments. Malpractice claim prevalence was an independent predictor of states with the highest DM spending [Table1]. Diabetic patients in states with adverse medicolegal environments had more procedures, imaging tests, and readmissions (p<0.05). By multivariate analysis, amputation rates were associated with cost, co-morbidity prevalence, and race, but not medicolegal factors. CONCLUSION This study explores the association between the medicolegal environment and Medicare costs for Diabetes and associated conditions of interest to vascular surgeons. The 2018 Medicare Geographic Variation Public Use Files and Chronic Conditions Data Files were linked to National Practitioner Database files from the preceding 5 years, in addition to US Census data and AMA workforce statistics. State-level medicolegal environment was characterized by K-means clustering across a panel of metrics related to malpractice payment magnitude and prevalence. Median (IQR) unadjusted Medicare per-capita expenditure on diabetic patients was $15,963 ($14,885 to $17,673), ranging from $13,762 (Iowa) to $21,865 (D.C.). Cluster analysis based on malpractice-related variables yields 5 distinct medicolegal environments. Per-capita spending on diabetes ranged from $15,799 in medicolegally favorable states to $18,838 in more adverse medicolegal environments. Malpractice claim prevalence was an independent predictor of states with the highest DM spending [Table1]. Diabetic patients in states with adverse medicolegal environments had more procedures, imaging tests, and readmissions (p<0.05). By multivariate analysis, amputation rates were associated with cost, co-morbidity prevalence, and race, but not medicolegal factors.

Forensic analysis of instant messengers: Decrypt Signal, Wickr, and Threema

As organized criminals use instant messengers, it becomes increasingly important to obtain digital evidence from instant messengers. Recently, instant messengers apply end-to-end encryption, so all digital evidence can only be obtained from your mobile device. However, some instant messengers encrypt and store database and multimedia files, making forensic analysis of mobile devices difficult. In this paper, we present a methodology for analyzing the decryption algorithm of the messenger, and apply this methodology to Signal, Wickr, and Threema. We extracted data from both unrooted and rooted devices and performed static and dynamic analysis. As a result, we succeeded in decrypting all the encrypted database, multimedia, log, and preferences files of three messengers. We describe the decryption algorithms and disclose all decryption scripts.