Recent Time Research Articles

Organic Solar cells: Recent advances and Challenges

In recent time, Organic Solar Cells (OSCs) have made a great progress in pursuing high power conversion, reaching the application threshold. Researchers have advanced past basic concepts of charge carrier dynamics in organic semiconductors to create devices with an experimental power conversion efficiency of about 18%. This review highlights the progress of OSC efficiency and investigate the state-of-art of organic cells in various factors such as temperature, energy conversion efficiency, solar shedding, operation and monitoring that affect the solar panel efficiency. Literature has shown how organic solar cells are seen as the solar technology of the future where it is offering the lowest energy payback times, ecology sustainability, while its energy efficiency still dropping, and a high energy loss is observed.

Abstract A047: Discovery of potent and paralog selective PROTAC degraders of CBP or p300 proteins for the treatment of various cancers

Abstract E1A binding protein (p300) and its paralog CREB binding protein (CBP or CREBBP) are ubiquitously expressed histone acetyl transferases (HAT). They act by scaffolding or as co-activator and enhancer of different transcription factors like HIF1a, BRCA-1, p53, c-Myc, PD-L1, Estrogen receptor (ER) and Androgen receptor (AR). CBP and p300 are multidomain proteins that harbour different functional units imperative for chromatin remodelling and transcription like Bromodomain (BD), Histone acetyl transferase (HAT) domain, KIX domain etc. These two closely related epigenetic modulators are known to play oncogenic role in a variety of cancers. Conventional CBP/p300 inhibitors targeting either BD, HAT or KIX domain do not discriminate between CBP and p300 proteins due to high homology. Because of the indiscriminate inhibition of both proteins, HAT domain inhibitors showed tolerability issues preventing their clinical advancement. In contrast, bromodomain inhibitors are better tolerated because they only block coactivation function at the transcription level without impacting the scaffolding or global histone acetylation function. They show less than desirable efficacy in various cancer models within very well tolerated doses. The implication of selective inhibition of either of these proteins in various cancer has been reported in the literature due to differential dependency on either of the paralogs. A synthetic lethal relationship between these paralogs in cancer set up has also been well established recently. However, none of the reported inhibitors of the various domains described above could selectively target CBP or p300 alone due to high sequence homology. Paralog selectivity in recent time has been proved to be possible with degrader approach due to differentiated ternary complex formation. Structure-guided modeling and iterative medicinal chemistry approaches were applied to identify paralog selective and potent first in class degraders with diverse linker length and linker composition. Identified compounds showed pronounced paralog selective degradation of target proteins and cellular effects in a panel of cell lines with loss of function mutation for either of the paralog proteins but not in wild type cells. The paralog selective lead degraders are currently being further optimized to identify development candidates. Selective degraders of CBP and p300 are expected to enhance efficacy of SOC drugs or immune checkpoint blockers by governing the acetylation and transcription of oncogenic factors and co-stimulatory molecules involved in tumor progression. Citation Format: Chandrasekhar Abbineni, Saravanan Thiyagarajan, Krishna Chaitanya T, Achala Apte, Naveen Kumar R, Avinash Kumar, Dabbeeru Madhu Babu, Shwetha S, Aishwarya B Kamath, Monalisha Mandal, Rituparna Panigrahi, Sivapriya Marappan, Subhendu Mukherjee, Kavitha Nellore, Shekar Chelur, Murali Ramachandra, Susanta Samajdar. Discovery of potent and paralog selective PROTAC degraders of CBP or p300 proteins for the treatment of various cancers [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2023 Oct 11-15; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2023;22(12 Suppl):Abstract nr A047.

Updates in Characteristics and Survival Rates of Hepatocellular Carcinoma in a Nationwide Cohort of Real-World US Patients, 2003-2021.

Causes of hepatocellular carcinoma (HCC) may change as treatments become available for some liver diseases. We examined the distribution of HCC cause and survival of a nationwide cohort of insured patients. Optum's de-identified Clinformatics® Data Mart Database (CDM), 2003-2021. A total of 34707 patients with HCC were included: mean age: 68.3±11.6 years, 61% male, 62% Caucasian, 74% cirrhosis. Non-alcoholic fatty liver disease (NAFLD) was the most common etiology (38.9%), then hepatitis C virus (HCV) (25.3%), cryptogenic (18.0%), alcohol-associated liver disease (9.4%), other liver diseases (5.8%) and hepatitis B virus (HBV) at 2.6%. NAFLD patients were the oldest (mean age 71.1±11.2) and had the highest Charlson Comorbidity Index (CCI) (mean 10.5±3.9), while HCV were the youngest (mean age 64.2±9.2 years) and HBV had the lowest CCI (mean 7.2±4.4) (both P<0.0001). The overall 5-year survival was 18.8% (95% CI 18.2-19.3) but was lower in the recent 2014-2021 period vs 2003-2013 (18.1% vs 19.5%, P=0.003). The 2014-2021 cohort (inclusive of HCV treatment advances) was significantly older, with more females, fewer Caucasians, more African Americans, more Hispanics, fewer Asians, more cirrhosis, more NAFLD, and higher CCI (all P<0.001). On multivariable analysis, males (aHR: 1.13), Caucasians (aHR: 1.46), African Americans (aHR: 1.53) and Hispanics (aHR: 1.28) vs Asians, 2014-2021 (vs 2003-2013) cohort (aHR: 1.12), NAFLD (aHR: 1.14) or cryptogenic liver disease (aHR: 1.45) were associated with increased mortality (all P<0.001). HCC patients in more recent time 2014-2021 were more likely to be older, more likely to have nonviral etiology, and had worse survival compared to those from 2003 to 2013.

Trends and correlates of naloxone possession and use among people who inject drugs in Seattle, Washington

BackgroundNaloxone distribution has been implemented as an essential opioid overdose prevention measure for people who inject drugs (PWID), and many jurisdictions in the United States have implemented policy change to increase naloxone access. This project describes temporal trends in and correlates of naloxone possession and use among PWID in the Seattle area of Washington State. MethodsUsing a repeat cross-sectional design, we utilized two sets of serial cross-sectional surveys of PWID, which included biennial surveys of Seattle area syringe service program (SSP) clients and community-based National HIV Behavioral Surveillance surveys of PWID (NHBS-PWID) conducted from 2012-2019. Survey participant characteristics were descriptively compared between participants reporting naloxone possession to those not reporting naloxone possession. Multivariable Poisson regression was used to calculate prevalence ratios for naloxone possession comparing later to earlier survey years, adjusting for age, gender, race/ethnicity, primary drug, and experiencing and witnessing an overdose in the past 12 months. ResultsNaloxone possession and use increased in both survey populations. The prevalence of possessing naloxone was 2.8 times greater [2019 vs. 2013= 95% CI: 2.40-3.33] among SSP participants and 2.8 times greater [2018 vs. 2012=95% CI: 2.41-3.16] among NHBS-PWID participants for the most recent time period. The prevalence of naloxone use was 1.3 times greater [2019 vs. 2017= 95% CI: 1.13-1.58] and 2.1 times greater [2015 vs. 2012=95% CI:1.62-2.73] among SSP and NHBS-PWID participants, respectively, for the most recent time period. ConclusionNaloxone possession and use increased in PWID in the Seattle area from 2012-2019, and is, at least in part, likely the result of numerous policy and programmatic efforts to facilitate easier naloxone accessibility in the wake of dramatic increases in overdose mortality. Further research on disparities in naloxone possession are needed to ensure equitable access.

Temporal trends in age- and stage-specific incidence of colorectal adenocarcinomas in Germany

BackgroundA national colorectal cancer (CRC) screening programme was launched in 2002 in Germany. A comprehensive evaluation of the programme effectiveness using real-world data is still lacking. In addition, there are regional reports on increasing colorectal cancer incidence in younger populations. Therefore, we aimed to describe and compare the overall, age- and stage-specific incidence trends for colorectal, colon and rectal cancer.MethodsWe used data from seven population-based cancer registries in Germany. We report absolute and relative changes in incidence rates between the early screening phase (2003–2005) and the most recent time period available (2015–2017), as well as annual percent changes. We analysed incidences according to tumour site (colorectum, colon, and rectum) and to six age groups (young adults: 15–34, 35–39, 40–49, screening-entitled/older adults: 50–54, 55–69 and 70 + years old).ResultsIn our sample of 271,011 colorectal adenocarcinomas, about two-thirds were located in the colon and 95% of them occurred in the age group 50+ (50–54: 5%, 55–69: 32.8%, 70+: 57.2%). For the time period 2003–2005 the age-specific incidence rates of individuals in the age group 55–69 were about 76/100,00 for colon and 54/100,000 for rectal cancer (age group 70 + colon: 179/100,000; rectum: 84/100,000). The incidence rates in young adults were less than 13% of that of individuals in the age group 55–69 (< 5% of individuals aged 70+; <33% of individuals aged 50–54).Over time, incidence decreased in individuals at the age of 55+, for all subsites considered as well as for early and late stage cancers (with few exceptions), while incidence of young adult CRC (both early and late stage) increased steepest in the youngest age groups. For late stage rectal cancer, a shift was observed in all age groups from UICC stage IV to stage III being the most frequent stage.ConclusionsSix years after the introduction of the national colonoscopy screening program, late stage CRC incidence began to decline substantially in the screening-eligible age groups (55-69, 70+). It is likely that this decline and the increase in early stage CRC observed in younger age groups can be attributed to the program. Long lasting public awareness campaigns for CRC screening might have led to opportunistic screening in younger adults. Whether these benefits outweigh the possible harm of screening in younger age groups remains unclear.

Internet Search Trends for Common Hand Surgery Diagnoses.

The internet is a common resource for patients seeking health information. Trends in internet search interests for common hand surgery diagnoses and their seasonal variations have not been previously studied. The objectives of this study were (1) to describe the temporal trends in internet search interest for common hand surgery diagnoses in the recent five-year time period and (2) to assess seasonal variations in search term interest. An internet-based study of internet search term interest of 10 common hand surgery diagnoses was performed using Google Trends (Google, Inc., Mountain View, CA) from January 2017 to December 2021. The 10 diagnoses were "carpal tunnel syndrome," "trigger finger," "thumb arthritis," "ganglion cyst," "de Quervain's tenosynovitis," "lateral epicondylitis," "Dupuytren disease," "distal radius fracture," "finger fracture," and "scaphoid fracture." Analysis of variance (ANOVA) was used to assess for seasonal differences in search interest, and temporal trends were assessed using the two-tailed Mann-Kendall trend test. During the study period, there was an increasing trend for search interest for "carpal tunnel syndrome," "trigger finger," "thumb arthritis," "Dupuytren disease," and "finger fracture," both in the United States and worldwide. There was no significant temporal trend for "ganglion cyst," "de Quervain's tenosynovitis," "lateral epicondylitis," and "distal radius fracture." There were no significant temporal trend for "scaphoid fracture" in the United Statesand a decreasing trend worldwide. There was significant seasonal variation in search term interest for "finger fracture" in the United States, "finger fracture" worldwide, and "scaphoid fracture" in the United States, with popularity peaking in the fall. Despite growth in global internet usage, internet search interest has remained stagnant for many common hand surgery conditions, which may represent a shifting preference for patients to obtain health information from other resources. Internet search interest for traumatic hand conditions corresponds to seasonal variations in fracture epidemiology and peaks in the fall season.

A slowly cooled deep crust on asteroid 4 Vesta and the recent impact history of rubble pile vestoids recorded by diogenites

In this study, we investigate the 40Ar/39Ar systematics of nineteen diogenites thought to come from deep crustal levels of asteroid 4 Vesta. We applied both Electron Backscattered Diffraction (EBSD) and 40Ar/39Ar and methods to the unbrecciated diogenite LAP 031381. We obtained three plateau ages resulting in a combined weighted mean age of 4441 ± 15 Ma (P = 0.16). The EBSD analyses suggest that LAP 031381 displays minimal evidence of shock and, when combined with petrography observations, diffusion modelling and 40Ar/39Ar data, these results suggest that the crustal volume that initially contained this diogenite, reached a temperature of ca. 630 °C at ∼ 4.44 Ga. This corresponds to a linear cooling rate of ∼ 5 °C / Ma for a crystallization age of 4550 Ma. Independent thermal models suggest that these conditions were present at a depth of 60 to 65 km at 4.44 Ga.The other eighteen diogenites yielded 40Ar/39Ar results that indicate that they have been variously shocked by impact events and seven of them yielded plateau ages ranging from 2413 ± 189 Ma to 84 ± 162 Ma. We combined these results with 40Ar/39Ar ages from eucrites and howardites and propose that the HED (Howardite, Eucrite, Diogenite) meteorites recorded impact events at the surface of Vesta until ∼ 3.4 Ga when they were then ejected during a large collision. The eucrites, diogenites and howardites were then recombined into small rubble pile asteroids which probably make up a large part of the Vestoid family. After ejection, the K/Ar system in plagioclase crystals ceased in most cases to be fully reset by impact events as the temperature spikes reached during small impacts lack enough energy to trigger significant 40Ar* diffusion. On the other hand, ultra-transient and high-temperature – sensitive pyroxene crystals kept a more systematic record of small impacts until recent time. 38Arc cosmochron cosmogenic exposure ages on diogenites mostly range from 51 ± 7 Ma to 0 ± 1 Ma and when combined with other HED cosmochron ages, suggest that almost all the HED meteorites were continuously ejected from secondary rubble pile asteroids mostly between 50 Ma and present.

Pelagic sedimentation rates in the North Pacific using Thorium-230 depth profiling

Evaluating the stratigraphy of the North Pacific is the first step towards understanding the role of this region in climate variability in the past. This region has been notoriously difficult to work in due to the presumed low sedimentation rates (<0.1 cm/kyr), which would likely be inadequate to capture glacial-interglacial cycles of the Late Pleistocene (∼500,000 years). These low sedimentation rates have been estimated from magnetostratigraphy and biostratigraphy, but those techniques are only minimally constrained during this geologically recent time period. Here, we reconstruct average sedimentation rates for the last 500 kyr across the deep (>3000 m) North Pacific using 230Th depth profiling, which is based on the exponential radioactive decay of 230Th and is one of only a few chronological tools applicable to sediment within this relatively calcium carbonate deficient region. Sedimentation rates are indeed low (<0.25 cm/kyr) within the subtropical gyre, especially between 20 and 30°N, but sedimentation rates greater than 0.5 cm/kyr are observed between 30 and 40°N, particularly west of 200°E. Sedimentation rates are higher underneath the Asian dust plume, and no water depth dependence is observed below 4000 m. Sedimentation rates from 230Th depth profiling generally agree with other methods, but they may be more representative of the average sedimentation rates for the last 500 kyr compared to other proxies that operate on much shorter (e.g., radiocarbon) or much longer (e.g., magnetostratigraphy) timescales. Overall, the efficacy of 230Th chronology is a promising tool for further investigation into the history of the North Pacific in the past.

Heterogeneous preferences and market potentials for biofortified foods in sub-Saharan Africa: Evidence from Nigeria

In recent time, biofortified staple crops have been bred to correct for Vitamin A deficiency in sub-Saharan African countries. In this study, we used a cross sectional preference data from a survey of 750 food buyers in Nigeria to access heterogeneous preferences and market potentials for biofortified foods. We used Hybrid Latent Class (HLC) framework to jointly examine respondents’ choice component with their responses to attitudinal questions preventing potential endogeneity and measurement error. The result indicate that consumers are willing to pay an extra premium of ₦l50 for biofortified garri over the normal price of white or yellow garri for health gains, thus suggesting that there is a potential market for biofortified foods in Nigeria. Our results show that consumers who had higher preference for biofortified foods attached a greater preference for higher vitamin A content of the product. We also observed that respondents were faced with regional heterogeneity. We observed that respondents in the urban area were more willing to pay for biofortified food quality attributes. We observed that in order to increase the demand for biofortified foods in Nigeria, a key strategy is to ensure that consumers have access to the products. In addition, the public should be better informed on health implication of consuming foods fortified with vitamin A such as biofortified products.

Exploring the effect of photobiomodulation and gamma visual stimulation induced by 808 nm and visible LED in Alzheimer's disease mouse model

Although photobiomodulation (PBM) and gamma visual stimulatqion (GVS) have been overwhelmingly explored in the recent time as a possible light stimulation (LS) means of Alzheimer's disease (AD) therapy, their effects have not been assessed at once. In our research, the AD mouse model was stimulated using light with various parameters [continuous wave (PBM) or 40 Hz pulsed visible LED (GVS) or 40 Hz pulsed 808 nm LED (PBM and GVS treatment)]]. The brain slices collected from the LS treated AD model mice were evaluated using (i) fluorescence microscopy to image thioflavine-S labeled amy-loid-β (Aβ) plaques (the main hallmark of AD), or (ii) two-photon excited fluorescence (TPEF) imaging of unlabeled Aβ plaques, showing that the amount of Aβ plaques was reduced after LS treatment. The imaging results correlated well with the results of Morris water maze (MWM) test, which demonstrated that the spatial learning and memory abilities of LS treated mice were noticeably higher than those of untreated mice. The LS effect was also assessed by in vivo nonlinear optical imaging, revealing that the cerebral amyloid angiopathy decreased spe-cifically as a result of 40 Hz pulsed 808 nm irradiation, on the contrary, the angiopathy reversed after visible 40 Hz pulsed light treatment. The obtained results provide useful reference for further optimization of the LS (PBM or GVS) parameters to achieve efficient phototherapy of AD.

Socioeconomic status and pediatric cochlear implant usage during COVID-19

ObjectiveCOVID-19 (COVID) delayed access to speech and hearing services. The objective of this study was to identify interactions between socioeconomic status (SES) and cochlear implant (CI) usage during COVID. MethodsConsecutive pediatric patients (age 0–17) with CI and audiology visits between 2019 and 2022 at a tertiary care children's hospital were reviewed. Age, sex, race, insurance type, and proxy measures for SES using zip code were recorded. Hours spent with CI on and in different listening environments were compared between pre-COVID (1/1/2019–12/31/2019), COVID (4/1/2020–3/31/2021), and most recent (6/1/2021–5/31/2022) time periods. ResultsMost patients were male (32/59, 54 % ears of 48 patients) and White, non-Hispanic (45/59, 76 %). Median age at implant was 2.0 years (range:0.6–12.2). There were no significant differences in hours spent with CI on during COVID compared with pre-COVID. However, children spent more time listening to louder noises (70–79 dB and ≥80 dB) recently compared with during COVID (p = 0.01 and 0.006, respectively). During COVID, children living in areas with greater educational attainment showed smaller reductions in total hours with CI on (β = 0.1, p = 0.02) and hours listening to speech in noise (β = 0.03, p = 0.005) compared with pre-COVID. In the most recent time period, children of minority race (β = −3.94 p = 0.008) and those who were older at implant (β = −0.630, p = 0.02) were more likely to experience reductions in total hours with CI on compared with during COVID. ConclusionInterventions which mitigate barriers of implant use and promote rich listening home-environments for at risk populations should be implemented during challenging future social and environmental conditions.

Per- and polyfluoroalkyl substances (PFAS) in Canadian municipal wastewater and biosolids: Recent patterns and time trends 2009 to 2021

The concentrations of per- and polyfluoroalkyl substances (PFAS) were determined in raw influent, final effluent, and treated biosolids at Canadian wastewater treatment plants (WWTPs) to evaluate the fate of PFAS through liquid and solids trains of typical treatment process types used in Canada and to assess time trends of PFAS in wastewater between 2009 and 2021. Data for 42 PFAS in samples collected from 27 WWTP across Canada were used to assess current concentrations and 48 WWTPs were included in the time trends analysis. Although regulated and phased-out of production by industry since the early 2000s and late 2000s/early2010s, respectively, perfluorooctanesulfonate (PFOS), perfluorooctanoate (PFOA), and other long-chain PFAS continue to be widely detected in Canadian wastewater and biosolids. Short-chain PFAS that are not currently regulated in Canada were also widely detected. In general, elevated concentrations of several PFAS were observed at WWTPs that receive landfill leachate. Except for PFOS, concentrations of long-chain perfluoroalkyl carboxylates (PFCAs) and perfluoroalkane sulfonates (PFSAs) generally decreased over time in influent, effluent, and biosolids, which is attributable to industrial production phase-outs and regulations. Concentrations of PFOS did not decrease over time in wastewater media. This indicates that regulatory action and industrial phase-outs of PFOS are slow to be reflected in wastewater. Concentrations of short-chain PFCAs in wastewater influent and effluent consistently increased between 2009 and 2021, which reflect the use of short-chain PFAS as replacements for phased-out and regulated longer-chained PFAS. Short-chain PFAS were infrequently detected in biosolids. Continued periodic monitoring of PFAS in wastewater matrices in Canada and throughout the world is recommended to track the effectiveness of regulatory actions, particularly activities to address the broad class of PFAS.

Long-Term Mortality in Patients With Severe Hypercholesterolemia Phenotype From a Racial and Ethnically Diverse US Cohort.

Tools for mortality prediction in patients with the severe hypercholesterolemia phenotype (low-density lipoprotein cholesterol ≥190 mg/dL) are limited and restricted to specific racial and ethnic cohorts. We sought to evaluate the predictors of long-term mortality in a large racially and ethnically diverse US patient cohort with low-density lipoprotein cholesterol ≥190 mg/dL. We conducted a retrospective analysis of all patients with a low-density lipoprotein cholesterol ≥190 mg/dL seeking care at Montefiore from 2010 through 2020. Patients <18 years of age or with previous malignancy were excluded. The primary end point was all-cause mortality. Analyses were stratified by age, sex, and race and ethnicity. Patients were stratified by primary and secondary prevention. Cox regression analyses were used to adjust for demographic, clinical, and treatment variables. A total of 18 740 patients were included (37% non-Hispanic Black, 30% Hispanic, 12% non-Hispanic White, and 2% non-Hispanic Asian patients). The mean age was 53.9 years, and median follow-up was 5.2 years. Both high-density lipoprotein cholesterol and body mass index extremes were associated with higher mortality in univariate analyses. In adjusted models, higher low-density lipoprotein cholesterol and triglyceride levels were associated with an increased 9-year mortality risk (adjusted hazard ratio [HR], 1.08 [95% CI, 1.05-1.11] and 1.04 [95% CI, 1.02-1.06] per 20-mg/dL increase, respectively). Clinical factors associated with higher mortality included male sex (adjusted HR, 1.31 [95% CI, 1.08-1.58]), older age (adjusted HR, 1.19 per 5-year increase [95% CI, 1.15-1.23]), hypertension (adjusted HR, 2.01 [95% CI, 1.57-2.57]), chronic kidney disease (adjusted HR, 1.68 [95% CI, 1.36-2.09]), diabetes (adjusted HR, 1.79 [95% CI, 1.50-2.15]), heart failure (adjusted HR, 1.51 [95% CI, 1.16-1.95]), myocardial infarction (adjusted HR, 1.41 [95% CI, 1.05-1.90]), and body mass index <20 kg/m2 (adjusted HR, 3.36 [95% CI, 2.29-4.93]). A significant survival benefit was conferred by lipid-lowering therapy (adjusted HR, 0.57 [95% CI, 0.42-0.77]). In the primary prevention group, high-density lipoprotein cholesterol <40 mg/dL was independently associated with higher mortality (adjusted HR, 1.49 [95% CI, 1.06-2.09]). Temporal trend analyses showed a reduction in statin use over time (P<0.001). In the most recent time period (2019-2020), 56% of patients on primary prevention and 85% of those on secondary prevention were on statin therapy. In a large, diverse cohort of US patients with the severe hypercholesterolemia phenotype, we identified several patient characteristics associated with increased 9-year all-cause mortality and observed a decrease in statin use over time, in particular for primary prevention. Our results support efforts geared toward early recognition and consistent treatment for patients with severe hypercholesterolemia.

Microbiological Survey of Animate and Inanimate Surfaces in a Correctional Center, South-South, Nigeria

Correctional centers (formerly referred to as prisons, in Nigeria) are facilities where offenders of the law are kept after been convicted of a crime. Many factors have in recent time contributed to an increasing rate of morbidity and mortality in these facilities, including overcrowding, poor sanitary conditions, inadequate ventilation, extreme temperatures, inadequate means for maintaining personal hygiene, lack of access to clean drinking water, and nutritionally deficient food. This study therefore centered on the microbiological survey of animate and inanimate surfaces in a correctional center, South-South Nigeria. For this research, a total of 150 samples (100 from skin (upper arm) and 50 from wall surfaces) were collected from the inmate skins and inanimate surfaces, using sterile swab sticks and were immediately transported to the Department of Microbiology Laboratory, Rivers State University for analyses using standard microbiological procedures. Data obtained from the study showed the inmates within the age bracket 21-30 were the highest (44%) while the age bracket 71-80 represented the lowest (1%) number of inmates. The study showed that male inmates represented 75% of the prisoners studied while the female represented 25%. The result showed that 37% of the studied inmates had spent 2-4 years in the correctional center while the least period of exposure or stay in the facility was recorded for 13 years in the correctional center, which represented 1% of the inmates. The age bracket 21-30 recorded the highest number of microorganisms (39) and 71-80 showed the least (1). Different microbial species were recovered from the skin of the inmates and included Staphylococcus spp, Escherichia coli, Streptococcus spp, Klebsiella spp, Bacillus spp, and Aspergillus spp., with Staphylococcus spp showing the highest occurrence of 48%, while Klebsiella spp had the least occurrence (1%).The study indicated that the correctional center could pose serious environmental health concerns, requiring public health interventions. Adequate personal hygiene should be encouraged among the inmates. Regular sanitation as well as adequate healthcare and routine checkup should therefore be made available to the inmates.

Finding recently persistent flows in high-speed packet streams based on cuckoo filter

In high-speed networks, flow-level traffic measurement is an essential tool to understand how network bandwidth is consumed and support the detection of anomalous traffic. While many prior work focuses on tracking the frequent flows (a.k.a. heavy hitters), in this paper, we put more focus on tracking the persistent flows, which jointly consider the frequency, duration and regularity of the packet arrival events of a flow. Although this more generalized metric called persistence has been defined before, it is still unknown how to use limited memory on data plane to monitor the top-k persistent flows in a recent time interval. In this paper, we propose an algorithm named PFD-DW built upon cuckoo filter (an improved version of hash table with better memory efficiency), to monitor the top-k persistent flows under the time-decaying window. It can be regarded as a variant of cuckoo filter, which transforms each bucket into a bucket-level min-heap. Its advantage is that, when the table is full and a packet of a new flow arrives, it can select the least persistent flow along the cuckoo kicking path as the victim of flow replacement. We deliberately avoid the scanning of the entire table to keep the high time efficiency. Based on real-world network traffic traces, we evaluate the performance of our DAKP-CF, a degraded version of PFD-DW that only considers each flow’s packet arrival frequency. The results show that it outperforms the existing algorithms for the top-k frequent flow identification task. It provides nearly 98% identification accuracy with roughly 50% less memory cost. We also evaluate our PFD-DW algorithm for the more generalized task of identifying the recently persistent flows. It provides 93% identification rate of top-3000 persistent flows using only 576KB memory, while attaining 1.5% persistence estimation error. Its memory cost is reduced by 97% than another proposed solution PFD-SW under sliding time window. We have also developed a prototype of PFD-DW, based on the Fd.io VPP software switch accelerated by Intel DPDK.

A universal electronic consultation programme at the cardiology department after general practitioner referrals improves healthcare outcomes in patients with health failure

Abstract Background Electronic consultation (e-Consult) is an emerging health care innovation developed to address excess wait times for specialist care by enabling primary care physicians (PCPs) to obtain a specialist consultant’s expert opinion in a timely manner 1. A recent wait time report in England showed that in the first 7 months of 2017, 89.4% of patients waited up to 18 weeks to see a specialist. This result failed to meet their standard of 92% of patients waiting no more than 18 weeks for their consult 2. e-Consult services were shown to be effective in terms of providing faster access to specialist’s advice, with short response times (from 1 to 6 days) of the participating specialists and resulting in substantial avoidance of face-to-face referral visits 3. The recent ESC HF guideline made a "may be considered" recommendation for the use of home-based telemonitoring, according on a meta-analysis published in 2017 4,5. Nevertheless, never has been evaluated the impact on access to care and clinical outcomes of a clinician-to-clinician e-consult program as a first step for all the PCPs referrals to cardiologist in heart failure patients. Purpose We aimed to assess in patients with heart failure (HF) the clinical impact of the implementation of an outpatient care model that includes an initial e-consultation (from 2013 to 2021) and to compare it with a one-time in-person consultation model (from 2010 to 2012) for all the primary care physicians’ referrals to a cardiology department. Methods We selected 6,859 HF patients who visited the cardiology service at least once between 2010 and 2021: 4,851 were attended in e-consultation and 2,008 in one-time in-person consultations. Using an interrupted time series regression model, we analysed the impact of incorporating e-consultation into the health care model (started in 2013), and evaluated the elapsed time to cardiology care, cardiovascular (CV) and HF hospital admissions, and HF, CV and all-cause mortality. Results The interrupted time series regression model showed that the introduction of e-consultation substantially decreased waiting times to cardiology care (8.6 [8.7] vs 55.4 [79.9] days, p&amp;lt;0.001). and a reduction in the need for visits to the emergency department 1-year after e-consultation compared with the previous period (HR [IC95%]: 0.07 [0.05-0.08]). After e-consultation implantation, hospital admissions were reduced (RRi [IC95%]: 0,867 [0,875-0,838] for HF, 0,838 [0,825-0,856] for CV and 0,639 [0,635-0,651] all-cause), figure 1; and lower mortality (RRi [IC95%]: 0,981 [0,977-0,983] due to HF, 0,977 [0,970-0,980] for CV and 0,985 [0,984-0,985] for all-cause), figure 2. These results were maintained during the COVID-19 pandemic. Conclusion In HF patients, an outpatient care program that includes an e-consultation significantly reduced waiting times to cardiology care and was safe, with a lower rate of hospital admissions and mortality in the first year.Figure 1Figure 2

APPLICATIONS OF KNOWLEDGE DISCOVERY AND DATABASE (KDD) IN CLINICAL DECISION SUPPORT SYSTEM

Applications of Knowledge Discovery and Database (KDD) in Clinical Decision Support Systems) is a research work that aims to develop a medical system that has the ability to detect and suggest cure for an ailment with minimal effort. Healthcare system has been a major source of worry across the globe in recent time due to emergence of different types of diseases and epidemics. The number of health care personnel in various hospitals falls short of the number required most especially in terms of specialists. The medical system in Nigeria today suffers from lack of fast, accurate, reliable and intelligent software solutions that can help healthcare practitioners make decisions that would solve urgent, and in some cases, complex medical problems in real-time. Also, the cost of processing and analyzing large volumes of data in a medical environment is high most especially in terms of time consumption. So in this research design and implement clinical decision support system using knowledge discovery in database (KDD) was the major focus. The design required a computerized database for storing medical records as well as software for improved intelligence-based medical procedures that were going to be simpler to use, versatile, adaptable, savvy, and effortless at combining and evaluating medical data, allowing medical practitioners at all levels to make realistic, intelligent, and real-time decisions on critical health issues. The system was designed using the Object-Oriented Design and Analysis Methodology (OOADM).

Electrocoagulation Coupled Fenton Process for Treating Refinery Wastewater Using a Cylindrical Design of Ti and Al Electrodes

Due to the serious wizards that industrial waste causes to humans, animals, and plants, besides the fact that wastewater from refineries contains many harmful compounds and that this type of industry is prevalent in most countries, the issue of protecting the environment from industrial waste is importance at the recent time. The organic contaminants elimination from the wastewater connected with the Iraqi refinery at Qayyarah served as our case study. The chemical oxygen demand (COD) was the organic contaminants measure. A titanium electrode (cathode) and an aluminum electrode (anode) were combined with the electrocoagulation and Photo-Fenton-processes. Using a Mini Tab program, the Taguchi method Utilizing statistical techniques, successfully obtained the outcomes and final values. The most effective removal of COD was 90.148. With a standard deviation of 2.651, the best conditions for this experiment were as follows: The time required to achieve this removal efficiency was 50 minutes, 8 pH, 400 mg/L of hydrogen peroxide, 20 mg/L of ferrous sulfate, and a current density of 15 mA cm-2. Through ANOVA analysis of this process, it was found that the current density (C.D.) significantly influenced the removal efficiency, affecting it by 47.79%, followed by the electrolytic solution effect by 18.31%, and the hydrogen peroxide and ferrous sulfate concentrations effect by 12.55% and 2.36%, respectively. Also, a mathematical equation was found to describe the studied case. The reaction kinetics were also investigated, and the reaction rate constant (cm/s) was determined at ideal conditions, with km = 6.60546 x 10-5.

Low Socioeconomic Status Confers Poorer Real-World Overall Survival for Patients with Acute Myeloid Leukemia Treated in the Modern Era

Introduction: There has been considerable growth in the treatment armamentarium of acute myeloid leukemia (AML) in the last decade. However, there is a lack of recent real-world evidence examining trends in survival amidst this rapidly changing treatment landscape. Further, prior literature has demonstrated significant heterogeneity in outcomes across different demographic groups, with scant data to understand how newer therapies have impacted survival outcomes across demographic groups in a real-world setting. The objective of this study is to describe recent trends in overall survival (rwOS) among patients with AML and to examine associations between race, ethnicity, and socioeconomic status (SES) with rwOS over time. Methods: We conducted a retrospective cohort study with data from the nationwide Flatiron health (FH) electronic health record-derived de-identified database, which is comprised of predominantly community oncology-based sites. We included patients with ≥2 visits in the FH network with a confirmed diagnosis of AML between Jan 1, 2014 and Dec 31, 2022, with potential follow-up through May 31, 2023. Our exposures included year of diagnosis in 3-year periods (2014-2016, 2017-2019, 2020-2022), race, ethnicity, and area-level SES, as measured using the Yost Index at census block group level. Patient characteristics and treatment patterns were described overall and by time periods of AML diagnosis. The Kaplan-Meier method was used to estimate median rwOS and 95% confidence intervals (CIs) from the time of initial AML diagnosis; overall and stratified by time period of AML diagnosis. Cox proportional hazards models were used to estimate unadjusted and minimally-adjusted (for age and sex) hazard ratios (HR) and 95% CIs for associations between race, ethnicity, and SES (modeled separately) with rwOS overall and by year of AML diagnosis.. Results: A total of 10,062 patients were included in the analysis. The median (IQR) age at diagnosis was 70 years (58, 78) and 57% of patients were male. Three-fourths of the study population was White, and 70% of the cohort received care at the community oncology clinic. We identified more patients ≥75 years at diagnosis in 2020-2022 versus 2014-2016 (38% vs 31%) and an overall decrease in patients who underwent hematopoietic stem cell transplant (15% vs 21%). Although the overall proportion of patients receiving any first-line treatment was similar across time periods, fewer patients received induction chemotherapy-based regimens (29%) compared to less intensive therapies (e.g., venetoclax + hypomethylating agent; 34%) in later years. There were 6,132 deaths and an overall median rwOS was 14.2 months (95% CI 13.7-14.7). Age and sex-adjusted Cox models indicated no evidence of decreased risk of death for diagnoses in 2020-2022 (HR 0.98, 95% CI 0.92-1.05) or 2017-2019 (HR 0.95, 95% CI 0.90, 1.02) compared to diagnoses in 2014-2016. Adjusted Cox models showed no statistically significant associations between race or ethnicity with survival overall and across strata of AML diagnosis time periods. Consistent associations between the lowest SES and increased risk of overall mortality among patients with AML were observed across all time periods. Patients residing in areas in the lowest quintile of SES had increased risks of death across all three time periods (2014-2016: HR 1.18, 95% CI 1.00-1.38; 2017-2019: HR 1.28, 95% CI 1.09-1.50; 2020-2022: HR 1.21, 95% CI 1.02-1.43). Conclusion: Results of this real-world study indicate that persons with AML who are in the lowest SES group are associated with increased mortality risk, and this association persists across recent time periods. Race and ethnicity were not associated with survival in this study, although sample size was limited for some groups. Despite introduction of new therapeutic options and an increased utilization of less intensive therapies, we did not observe an increase in the overall proportion of patients with AML receiving first-line treatment. Additionally, we observed no improvement in survival outcomes across these time periods in a predominantly community-based setting. Our study adds to the growing evidence on the complex health inequities in AML and supports the persistent need for tolerable and accessible therapy to improve OS in AML. Future strategies and policies are urgently needed to offset the adverse effects of low SES to further improve outcomes for all patients with AML.

Trends in Survival Outcomes for Mantle Cell Lymphoma in the Era of Novel Therapies

Introduction Mantle Cell Lymphoma (MCL) is a rare malignancy, associated with aggressive features and poor outcomes. Previous treatment paradigms for MCL involved chemoimmunotherapy and stem cell transplant (SCT), though this has evolved in recent years with the introduction of novel treatments, including bruton's tyrosine kinase (BTK) inhibitors, chimeric antigen receptor T-cells (CAR-T) and immunomodulatory agents such as lenalidomide. Additionally, the incorporation of rituximab maintenance therapy following SCT has demonstrated improved progression-free (PFS) and overall survivals (OS) for MCL patients (pts). While the majority of these novel agents and treatments were FDA approved by demonstrating improved PFS, the benefits of these new treatments on OS trends for MCL pts are not well described. Therefore, to determine whether these advances have translated to OS improvement in the real-world setting, we performed a national analysis of OS trends through multiple treatment eras. Methods The National Cancer Database was used to identify pts diagnosed with MCL from 2004-2020. For pts receiving treatment, the use of front-line single or multiagent therapy, and upfront SCT was compared. Kaplan-Meier and Cox regression analysis was used to compare OS for all MCL pts. Survival was compared by year of diagnosis, with diagnosis in 2004-2013 considered to be managed in the era of chemoimmunotherapy, 2014 and later associated with the introduction of BTK inhibitors, and 2017 and later with the adoption of maintenance rituximab following SCT. Results A total of 31,284 pts with MCL were identified. The mean age at diagnosis was 67 years (yrs) [SD ±12], 93% of pts were White, and 70% had stage IV disease at diagnosis. Pts were increasingly more likely to have ≥2 comorbidities at MCL diagnosis (6.2% from 2004-2013, 8.6% from 2014-2016, and 10.8% from 2017-2020) and were increasingly managed at academic centers (40%, 44%, and 46%, respectively). Rates of pts managed with active surveillance significantly increased over time (4.7% from 2004-2013, 6.7% from 2014-2016, and 8.7% from 2017-2020). Regarding treatment, the rate of upfront multi-agent chemotherapy use decreased over time (67.7% from 2004-2013, 45.2% from 2014-2016, and 38.9% from 2017-2020), corresponding with an increase in single agent treatment (7.9%, 28.2%, and 32.4%, respectively). Notably, the rate of pts receiving SCT following front-line treatment remained similar in each time period (13.6%, 15.4%, and 14.1%, respectively). With a median follow-up of 3.5 yrs, the median OS for all pts with MCL from 2004-2020 was 5.9 yrs (95% CI 5.8-6.0 yrs). The median OS was significantly increased when comparing pts who were diagnosed between 2004-2013 (5.5 yrs) to those diagnosed 2014-2016 (6.8 yrs), and median was not reached for pts diagnosed 2017-2020 (all p&amp;lt;0.001). The median 1-, 3-, and 5-year OS significantly increased following the availability of novel agents after 2014 (2004-2013: 1-year 80%, 3-year 63%, 5-year 52% vs. 2014-2016: 1-year 82%, 3-year 67%, 5-year 58%, p&amp;lt;0.001). Whereas, pts diagnosed from 2017-2020 had similar OS trends as pts diagnosed from 2014-2016 with 1-year 82%, 3-year 66%, 5-year 51% OS, respectively. When adjusted for age and comorbidity burden, the most recent time periods were associated with decreased risk of death (2014-2016: HR 0.81 [95% CI 0.78-0.85], and 2017-2020: HR 0.82 [95% CI 0.78-0.86]) when compared to 2004-2013 (all p&amp;lt;0.001). Conclusions: To our knowledge, this is the largest retrospective review evaluating treatment trends and OS outcomes in pts with MCL in recent decades. These data show that OS has significantly improved for pts diagnosed in the most recent time periods. We hypothesize this is due to the introduction of novel agents such as BTK inhibitors, which is supported by the increased rate of single agent treatment over time, which may be related to BTK inhibitors supplanting chemoimmunotherapy in the front-line setting. We also found that no additional OS improvement was observed during the time period following the adoption of rituximab maintenance after transplant, which may be due to the limited number of pts receiving SCT through each time period. With more follow-up data, future studies may determine whether treatments such as CAR-T (FDA approved in 2020 with data not included in this cohort) have further improved OS outcomes for this incurable malignancy.