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60 articles

Does Digital Terrorism Really Exist?

May 2020 DOI 10.14302/issn.2692-5915.jafs-20-3405
Donald L. BureshCorresponding author

This paper attempts to answer the question of whether digital terrorism, also known as cyberterrorism, exists. The paper defines terrorism both in the conventional and digital sense. It then gives a short history of conventional terrorism, dating back two thousand years and ending with the terrorist activities in several third-world nations. The essay then discusses digital terrorism, highlighting the Estonian, Georgian, and Ukrainian cyber-attacks. The work concludes that digital terrorism does indeed exist, but that the future is uncertain in the sense that future cyber-attacks will probably not resemble past attacks as the technology advances.

General Doctor's Consultation Work Begins before Entering the Patient and does not End when Patient Comes Out

May 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3335
Luis Turabian JoseCorresponding author Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia, Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain

The consultation is the activity of meeting and communication between an individual and the doctor for the knowledge and solution of a health problem. In today's busy world of general medicine, constant demands for the general practitioner (GP) arise: she or he should not only make a diagnosis not only should make a differential diagnosis during consultation, but must also establish a good relationship, explore patient ideas, concerns and expectations and negotiate a management plan, taking into account limited resources, the quality framework and results, having Information technology skills, plus, the need to promote health during any consultation. Normally the GP has only 10 minutes to achieve all that, as well as to manage your own emotions, agendas and uncertainty. In this way, novice doctors may find it difficult to move in this situation of complexity, and they can also observe a gap in the literature that really guides them in practice. Rigorous preparation is the key to success for many endeavours. Some tips to perform an efficient and safe consultation work in general medicine are suggested: 1) Focus on the next patient; 2) Preparing the consultation before entering the patient, memorizing the patient's previous history; 3) Establishing a connection with the patient; 4) Remembering the elements that must be in each consultation (the current reason, update other previous processes, chronic diseases and continued attention, "case finding", health promotion); 5) Striking a balance between empathy and assertiveness; 6) Putting in writing and contextualized the clinical record; and 7) Making reflection-safety questions, learning questions, and preparation questions for the next visit. Rigorous preparation is the key to success for the general practitioner in every consultation. Think about these topics of the consultation before doing it, and after it, prepare the next consultation of that patient. All these things are force multipliers.

From Smoking to Vaping: What does Judaism have to Say?

Jan 2020 DOI 10.14302/issn.2641-4538.jphi-20-3163
Turner AkivaCorresponding author Chair and Professor, Department of Health Science, Nova Southeastern University, USA

The author reviews rabbinic decisions about smoking from a historical perspective along with the positions of the medical community. The author then brings the current, though limited, rabbinic considerations about vaping given the current state of science, as well as possible discussions for the future, as more becomes known about the safety and health risks associated with vaping.

Chalkley Counting in Oral Tongue Squamous Cell Carcinoma:Does It have A Prognostic Value?

Mar 2019 DOI 10.14302/issn.2576-6694.jbbs-19-2625
T Tan SweeCorresponding author Gillies McIndoe Research Institute, Wellington, New Zealand

Chalkley counting has been regarded as a relatively reliable method of quantifying tumor angiogenesis. In this study we investigated the reliability of Chalkley counting in quantifying tumor angiogenesis in oral tongue squamous cell carcinoma (OTSCC) using CD34; and tumor vasculogenesis using angiotensin converting enzyme, angiotensin II receptor 1 and angiotensin II receptor 2, in 32 OTSCC samples. Chalkley counting was performed by two independent observers. The averages of three ‘hot spot’ counts were compared with known prognostic factors. All four markers showed no correlation with any of the prognostic factors. When comparing the results from the two independent observers, the only marker shown to have a significant moderate correlation was CD34. The other three markers showed no significant correlation. The lack of statistical significance between the independent observers, and known prognostic factors with the four markers used, shows that Chalkley counting is not a reliable prognostic tool in OTSCC.

Agronomy Research Open Access

Does Soil Testing for Fertiliser Recommendation Fall Short of a Soil Health Card?

Jan 2019 DOI 10.14302/issn.2639-3166.jar-18-2496
Raj GuptaCorresponding author

Nutrient depletion and imbalanced use of fertiliser nutrients, inappropriate tillage and rain- water management practices often result in land degradation. Declining soil health contributes to climate change through loss in soil productivity, biodiversity, soil carbon, and moisture and ecosystem services. In order to address declining soil health, government of India has launched a soil health card (SHC) scheme aimed at need base use of chemical fertilisers. The paper points out the short-comings in the SHC scheme. Balanced and need base use of chemical fertilizers can be helpful in environmental protection and restoring soil health. The paper identifies potential agronomic practices and production management systems that can reduce our dependence on synthetic nutrients. Integration of soil fertility management domains with computer based QUEFT crop model has the potential of making fertiliser recommendations more domain and crop specific and less cumbersome. For soil health assessment chemical indicators must be integrated with physical and biological properties of the soils which can be predicted through reflectance spectroscopy. For assessing soil health related issues across different agro-ecoregions, there is however an urgent need for building-up more robust soil reflectance libraries.  

EEG Responses to Shamanic Drumming. Does the Suggestion of Trance State Moderate the Strength of Frequency Components?

Jan 2018 DOI 10.14302/issn.2574-4518.jsdr-17-1794
Konopacki MateuszCorresponding author Umea University, Sweden.

One of the techniques used to induce trance state in shamanic ceremonies is monotonous drumming. According to previous EEG research, certain patterns of drumming cause an increase in power of alpha and theta frequencies of the listener. Present study aimed to determine, if suggestion to experience trance state could increase the relative alpha and theta amplitude and the intensity of experienced state. A group of twenty-four subjects participated in the study. Suggestion to experience trance state decreased alpha frequency power during the drumming condition. No other significant effects of suggestion or drumming were found.

Liver Stiffness by ARFI does not Correlate with Decompensation and Portal Hypertension in Patients with Cirrhosis

Jun 2017 DOI 10.14302/issn.2574-4526.jddd-17-1557
Kidd Leong HoieCorresponding author Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, Melbourne, Australia

Background and Aims: Establishing the degree of fibrosis is important in determining the prognosis of patients with chronic liver disease. Acoustic Radiation Force Impulse Imaging (ARFI) has been validated as a reliable method to estimate liver fibrosis. It remains unclear if ARFI readings may be a useful way to stage patients with established cirrhosis and predict the development of complications. The aim of this study was to determine if ARFI liver stiffness measurements correlate with the severity of liver disease in patients with cirrhosis, and predict the development of complications and decompensation. Methods: All patients attending our institution who had a prior clinical diagnosis of cirrhosis and an ARFI liver stiffness measurement (LSM) over 26 months were included. Area under the receiver operating characteristic (AUROC) curves were calculated for ARFI detection of any complication, any varices, medium or large varices, moderate or severe ascites, encephalopathy, Child Pugh Grade B or C and MELD ≥15. Results: ARFI LSM did not correlate with complications: any complication (AUROC 0.672), any varices (0.631), medium or large varices (0.610), moderate or severe ascites (0.681), Child Pugh B/C (0.691) or MELD ≥15 (0.711). Hepatic encephalopathy did correlate with higher LSM (0.854), but only in a small number of cases. Conclusion: ARFI in patients with cirrhosis does not correlate with the presence of portal hypertension or decompensated liver disease.

Ophthalmic Science Open Access

Transiently Raised IOP Equivalent to That Experienced During Ocular Surgery Causes Moderate Inflammation but does not Affect Retinal Function or Result in Retinal Ganglion Cell Loss in An Animal Model

May 2017 DOI 10.14302/issn.2470-0436.jos-17-1453
Zhang JieCorresponding author Department of Ophthalmology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland 1142, New Zealand.

Purpose: High intraocular pressure (IOP) is known to result in retinal ganglion cell (RGC) loss, both with chronically raised intraocular pressure (such as with glaucoma) and with acute raises in pressure (due to injury or acute angle closure). Because IOP is often raised during ocular surgery, the purpose of this study was to evaluate the effect of transient moderate IOP on retinal function, RGC survival and the expression of Connexin 43 (Cx43) and glial fibrillary acidic protein (GFAP), ubiquitously expressed central nervous system (CNS) proteins that are known to be elevated during the retinal inflammatory response to injury. Materials and Methods: Wistar rats were exposed to transient IOP at 40 mmHg for 5 or 30 minutes, and 60 mmHg for 5 minutes (via cannulation of the anterior chamber with a saline reservoir raised to a height corresponding to the desired IOP), mimicking potential IOP rises during surgery such as DSAEK and some laser procedures (LASIK and femtosecond laser cataract surgery). Separate groups of animals had IOP maintained at 10 mmHg for 5 or 30 minutes as cannulation controls, or 120 mmHg for 60 minutes as positive controls. Changes in the optic nerve and retina were assessed immunohistochemically for GFAP and Cx43 expression. Retinal function was assessed using electroretinography (ERG) recorded at baseline and 14 days after the IOP rise and compared with RGC counts. Results: Results showed that there was a differential GFAP labelling pattern observed in the anterior optic nerve in the 40 mmHg 30 minute and 60 mmHg 5 minute groups 4 hours after manipulation. Gap junction protein Cx43 was minimally up-regulated in the retina in the short-term. There was, however, minimal long-term effect on retinal function and no RGC loss. Conclusions: n conclusion, elevations of IOP that are short in duration such as those occurring during surgical procedures, do not cause significant changes long-term in retinal function or RGC survival. Key Messages: Cx43 and GFAP are known to be elevated during the retinal inflammatory response to injury. No previous study has explored the effect of moderate and relatively short increases in IOP on the initial inflammatory response. We observed a mild glial inflammatory response in the anterior optic nerve, but only a minimal up-regulation of Cx43. However, transient and moderate IOP rises did not induce long term disruption to RGC function or number as measured by electrophysiology and RGC counts, respectively. This is applicable to clinical practice, as it means the IOP elevations that occur during some surgical procedures are unlikely to be causing long term damage in retinal function or RGC survival.

Does a Controlled Diet Improve Cellulite?

Jul 2016 DOI 10.14302/issn.2379-7835.ijn-16-986
S Yarak,Corresponding author Universidade Federal de São Paulo, Dermatology Department. 

Abstract: Several researchers have suggested that a targeted diet for reducing theadipose tissue may interfere with the severity of cellulite. Others emphasize that the diet composition seems to play a more relevant role than the calorie profile for weight loss and cellulite control. Objective: The aim of this study was to evaluate the influence of a controlled diet on body composition and cellulite improvement in adult women. Methods: Thirty two healthy women, aged from 25 to 40 were included. They receivedan orientation for a controlled diet to be followed for 3 months. Assessments were performed at the baseline and the end of the study which included four parameters: 1) Photonumeric cellulite severity scale; 2) Anthropometric measuremets 3) Skin elasticity (Cutometer®) and 4) Collagen density or echogenicity and length of the dermis-hypodermis interface line (ultrasonography - DermaScan®). The data was compared with the Paired T-test, Wilcoxon and Pearson's correlation for statistical analyses. Results: Only 14 completed the study. Although the scores of photonumeric scalereduced, there was no difference in the grade of cellulite severity. There were significant reductions in body measurement. The skin elasticity showed no significant change. On the other hand, the dermal density or echogenicity showed a significant increase in the right and left sides (p = 0.05 and p = 0.005, respectively); however, no difference was observed in the lenght of dermis-hypodermis line. Conclusion: the controlled diet was effective for the reduction of weight and body composition, but despite the increase in dermal collagen density, no clinical effect on cellulite could be detected.

Early Glycine Supplementation Re-Establishes Adrenal Catecholamine Secretion in Hypothalamic Obesity Model in Rats but does not Affect Visceral Adiposity.

Jun 2015 DOI 10.14302/issn.2572-5424.jgm-14-604
Eliza Andreazzi AnaCorresponding author Laboratory of Physiology, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora/MG - Brazil

Obesity is a worldwide epidemic that features a multifactorial syndrome characterized by a chronic positive energetic unbalance. Neonatal administration of monosodium L-glutamate (MSG) causes lesion on the arcuate nucleus of hypothalamus that led to development of obesity in the adult life in rodents characterized by a notorious accumulation of catecholamine in the adrenal medulla. The amino acid glycine induces catecholamine secretion of adrenal medulla. Thus, the objective of our work was to evaluate the possible effects of glycine administration in the MSG-obesity model in rats and investigate its impact on adrenal catecholamine medulla homeostasis. Male Wistar rats received MSG solution (4mg/g body weight) subcutaneously in the cervical area for 5 days after delivery, controls received saline solution. Animals were also divided in two groups, in which one received tap water added with glycine (0.1g/Kg) after weaning on 21st day until 90 days of life.Biometrical variables, visceral fat pads weight, total content and basal secretion of adrenal cathecolamine were evaluated. Glycine increased Lee index of all tested groups and had no effect on visceral adiposity. However, glycine treatment completely reestablished catecholamine total content and basal secretion of MSG-obese group. In conclusion, although glycine treatment apparently completely reestablishes catecholamine secretion homeostasis it is not sufficient to significant directly reduce visceral adiposity in MSG obesity model in rats.

Temporalis Fascia Lateral or Medial Side Up In Underlay Tympanoplasty Type – I Does It Makes A Difference?

May 2015 DOI 10.14302/issn.2379-8572.joa-14-545
Asrar Ahmed LatifiCorresponding author Department of ENT, Buraidah Central Hospital, Buraidah,AlQassim-KSA

Objectives: The study was aimed to find out which of the two techniques, medial or lateral side of the temporalis fascia graft was better in underlay method for correcting the perforations of the tympanic membrane keeping all other factors constant. Methods: We designed a prospective randomized study from Jan 2010 to Jan 2013 at Buraidah Central Hospital, Al Qassim, Saudi Arabia. Eighty patients having dry central; moderate, large and subtotal perforations of the tympanic membrane were subjected for tympanoplasty type –I by underlay technique. In 41 patients the temporalis fascia graft was placed with medial (rough) side up (Technique-I) and 39 patients the graft was placed with the lateral (smooth) side up (Technique-II). Results: The graft take up rate was 95.1% in technique-I and 87.2% in technique -II. Failure rate was 4.9% in technique – I and 12.8% in technique – II. Conclusion: Technique – I was judge to be giving better result because: 1.Rough surface of the medial side of the graft after moistening enhances wetting, increases the critical surface tension and broadens the contact surface. 2.The friction due to rough surface resists displacement forces between the graft and remains of the tympanic membrane. 3.Rough surface of the medial side of the temporalis fascia increases the adhesion power and increases the overlap between the two surfaces. To the best of our knowledge this is the only such prospective study for this method.

Etodolac, A Preferential COX-2 Inhibitor, does not Inhibit Platelet Aggregation in a Randomized Placebo-Controlled Trial

Jan 2013 DOI 10.14302/issn.2328-0182.japst-12-99
C Korte WolfgangCorresponding author Center for Laboratory Medicine, St. Gallen;

To date, platelet aggregation studies have not been formally evaluated in persons receiving Etodolac, a preferential cyclooxygenase-2 (COX-2) inhibitor. Our purpose was to investigate the influence of Etodolac in therapeutic (analgesic) doses (300 mg every 12h) on platelet aggregation as compared to placebo in healthy volunteers. Platelet aggregation, the primary efficacy variable in this trial, was performed according to the Born method with platelet rich plasma; it was evaluated as maximal platelet aggregation induced by 3 substances (adenosine diphosphate (ADP), epinephrine, collagen); each of these substances was used at 3 different concentrations. No significant difference in platelet aggregation as assessed by Born aggregometry was seen in volunteers treated with etodolac or placebo. Etodolac - applied in regular analgesic doses to volunteers - does not show an inhibitory effect on platelet aggregation and therefore seems an attractive analgesic substance for the perioperative setting.

The Dose Modulates the Body’s Physiology: Literature Review

Dec 2025
Tariku Belay YilkalCorresponding author

The body interacts with endogenous and exogenous molecules through various receptor networks at the cellular and organismal levels by which the different physiological processes of the organ systems get activated. Life could no longer exist without the body’s interaction with these signaling molecules. The number of molecules interacted with a receptor type within the body determines the efficiency of biological processes that would determine the biochemistry and anatomy behind the basic body functions. The dose plays a complex role in multiple physiological processes by modulating the natural processes of the different biological systems. It is always connected to the physiological and anatomical aspects of the biological sciences in which it manifests the biological sensitivity that would determine the efficiency of biological responses of the body systems. There are always physiologic and non-physiologic doses for every compound administered into the biological systems. The does that facilitated the body to manifest that biological sensitivity which has maintained the physiological processes of the body systems was noted as physiologic dose, whereas the dose that has suppressed the biological sensitivity of the body that became inefficient in maintaining the physiological processes of the different biological systems was termed non-physiologic dose. It is important to adjust the dose or dosage based on physical and biological factors such as the efficiency of the different organ systems, body weight, and the timing of the dose triggering a biological response to maintain the natural processes of the body systems. This means that integrated biological data is required in order to be able to identify the physiologic and non physiologic doses for biological or pharmacological use.

Agronomy Research Open Access

Reproductive Ability of Currant–Gooseberry Hybrids After Cryopreservation of Pollen in Liquid Nitrogen

Dec 2025 DOI 10.14302/issn.2639-3166.jar-24-5295
G. Verzhuk V.Corresponding author

The present study of the reproductive ability of currant and gooseberry hybrids after long-term cryopreservation of pollen in liquid nitrogen is of enormous importance for organizing the conservation of the diversity of this crop. Four distant interspecific hybrids of currant and gooseberry served as objects of the study. The pollen fertilizing ability was studied by pollination of allotetraploid Jošta with pollen of tetraploid hybrids stored for a year at ultra-low temperatures (–196°C) and freshly collected pollen (control pollination). Berry set in 2022, when pollinated with cryopreserved pollen, averaged 56.4% and was higher than in the control pollination (38.2%). In 2023, the number of berries set on average for all cross combinations in the experiment was also quite high (59.6%), but lower than in the pollination control (81.4%), which can be explained by unfavorable weather conditions during pollen collection in the year of establishment (2022). The obtained data specify that pollen of the allotetraploids does not lose its high fertilizing ability during its long-term cryopreservation. Berry setting, average berry weight and seed production are quite high and comparable to pollination with freshly collected pollen (control pollination variant). Seed germination and values of morphometric parameters of seedlings obtained from pollination with cryopreserved and freshly collected pollen in most cases have close values. Cryopreservation of pollen of currant-gooseberry hybrids for a year and more allows to preserve pollen for successful pollination and berry formation and is a reliable way to preserve germplasm.

Caregiver-Child Co-Rumination and Treatment Outcomes in a Randomized Clinical Trial of Rumination-Focused Cognitive-Behavioral Therapy

Nov 2025 DOI 10.14302/issn.2476-1710.jdt-25-5775
A. Kaufman ErinCorresponding author

A number of developmental factors increase risk for adolescent rumination. This particular kind of repetitive negative thinking pattern often begins in the context of familial stressors and parental modeling. Though rumination can be effectively targeted with rumination-focused cognitive behavioral therapy (RF-CBT), it is unknown whether caregiver-child co-rumination (1) affects caregiver views of their child’s psychopathology, (2) or interferes with youth rumination- focused treatment. The present study uses data from a randomized clinical trial of RF-CBT to examine whether caregiver-child co-rumination, or caregivers’ own rumination patterns, are associated with bias in parental perception of their adolescent’s depression symptoms. We also examine if co-rumination scores at baseline moderate rumination scores for youth at treatment termination, and whether treatment effects dampen or decay more significantly post-treatment among youth with higher caregiver-child co-rumination. Youth (N = 76) were randomized to either 10-14 sessions of RF-CBT (n = 38) or treatment as usual (TAU; n = 38) and completed interviews and surveys at pre-treatment baseline, post-treatment, and 3-, 6-, 9-, and 12-month follow up. Results indicate that neither caregiver rumination nor co-rumination scores bias caregivers’ views of their child’s depression symptoms. In terms of reduction in child’s rumination scores, estimated treatment effects were larger for patients with higher baseline co- rumination scores, and there was no statistically significant difference in treatment effect decay over time in high versus low co-rumination groups. Results indicate co-rumination overall does not dampen the effect of RF-CBT, and those experiencing the highest levels of co-rumination may benefit most from treatment.  

Review on Frequency Neurofeedback on Autism Spectrum Disorder: Overview, Efficacy and Research Direction

Nov 2025
Ryan AlexanderCorresponding author

Frequency neurofeedback (FNF) is a biofeedback method that targets frequencies between 1 and 50 Hz. The efficacy of FNF with autism has been labeled ‘probably efficacious’ in literature reviews in the last decade, despite new research pointing towards a higher standard. The aim of this review was to analyze key features of these studies, with a goal of determining the efficacy standard of FNF on autism and establishing a research direction. Electronic databases and literature reviews were used to collect a total of ten randomized and/or matched controlled trials. FNF reaches a Level 4 efficacy standard, with an impact on a broad range of factors including core autistic traits, social communication, emotional regulation, cognitive flexibility, executive function, behaviors of concern, attention, metabolic or thermal activity, and EEG e.g. decreased absolute power, mu rhythm, coherence and hyperconnectivity. Current evidence generalizes to male children, up to 18 years, with a low-average or higher intellectual functioning, with autism as the only diagnosis. A meta-analysis suggests a large superior effect when compared to wait list controls. Current research does not meet the higher efficacy standards outlined by Arns et al. (2020). Small samples plague most studies, and the maintenance of improvements post-training are yet to be assessed adequately. Eight recommendations are made.

The Impact of Public Financing, Economic Growth, and Corruption on Immunization Performance: Evidence from 37 Sub-Saharan African Countries

Oct 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5729
Collins Adeyanju GbadeboCorresponding author

Background In sub-Saharan Africa, where many countries continue to experience high burdens of vaccine-preventable diseases, increasing immunization access have been a priority for the governments and international organizations such as Gavi, the Vaccine Alliance. Over 40 Gavi-supported African countries have been impacted, with 364 million children reached and over US$5.7 billion disbursed, averting over 8.9 million child deaths. Despite this progress, the African region has struggled with immunization coverage due to various factors. Nevertheless, some African countries are transitioning out of Gavi support due to economic growth. However, many require strong political will to increase their expenditure on immunization. This study therefore aims to understand the factors influencing immunization performance and its relationship to public expenditure. Methods Data on 37 Gavi-eligible sub-Saharan African countries between 2006 and 2019 was obtained from the World Bank’s World Development Indicators, the WHO and UNICEF Joint Reporting Form and the Transparency International’s Corruption Perception Index. Descriptive immunization and health expenditure were analyzed using a panel regression of variables. DPT3 was used as an indicator of immunization uptake. The indicator for public expenditure on immunization per child was based on government spending on immunization divided by the number of children in the birth cohort. Results The average gross national income increased from US$639 to US$1,192 per capita, while government spending on immunization increased from US$1.7 to about US$4.5 per child. The findings show that there is a correlation between improved immunization financing, increased gross national income, reduced corruption, and improved immunization coverage. However, performance declines beyond a certain threshold when gross national income per capita increases. In addition, an English-speaking country effect was observed. Conclusions While improved immunization financing increases immunization coverage and constitutes an advocacy talking point, there is a need to understand why an increase in gross national income per capita does not translate into an improved immunization coverage. Key highlights Increasing national spending on immunization drives up the uptake of childhood vaccines. There is a threshold beyond which immunization coverage falls despite increased GNI. Controlling corruption increases immunization coverage tendency. French- and English-speaking countries’ immunization coverage differs. Immunization and health system financing have separate outcomes.

The Role of Cerebral Hypercarbia in the Induction of the Near-Death Experience

Dec 2024
A Shaw NigelCorresponding author

The near-death experience (NDE) is an altered state of consciousness which arises when a person is critically ill or injured and possibly clinically dead. It should not be conflated with other mental events such as the deathbed vision or the fear or anticipation of death. Many believe that the NDE represents a genuine paranormal phenomenon providing a glimpse of an otherworldly existence and proof of an afterlife. Those who are skeptical of such a survivalist or supernatural interpretation have long pointed out that the core components of the NDE can be readily simulated with a variety of states, conditions and agents. In this conception, the NDE is reduced to no more or less than an extraordinarily complex hallucination. Since its rediscovery in the 1970s, multiple, often ingenious, attempts have been made to account for the NDE in such naturalistic or neuroscientific terms. None has so far proven completely satisfactory. One of the oldest, least considered but still promising is the CO2 theory which argues that a hypercarbic brain is a necessary precursor for the induction of a NDE. Supportive evidence that CO2 does play a pivotal role in the generation of the NDE can be gathered from diverse sources. These include: 1. measurement of blood gases; 2. Meduna’s now abandoned CO2 therapy; 3. analysis of the very limited number of pathophysiological conditions underlying the NDE; 4. recent discoveries of the role of 5-HT neurons in the central respiratory system. A model is proposed in which CO2 molecules are considered to be functionally equivalent to those of the classical hallucinogens (LSD, mescaline, psilocybin, dimethyltryptamine). These agents can mimic the phenomenology of the NDE with remarkable fidelity. What is still missing from any such explanation is the long-sought transduction mechanism which converts physical events into mental ones. This is a generic problem which confronts all attempts to explain the neurogenesis of mystical, psychedelic or visionary activity.

Exercises Pursued by Older Adults with Osteoarthritis and Their Structural Impacts are Hard to Uncover; a Scoping Review of Selected 1970-2024 Studies

Sep 2024 DOI 10.14302/issn.2474-7785.jarh-24-5282
Marks RayCorresponding author

Persons with osteoarthritis often have signs of reduced muscle strength. Some studies suggest that this strength could be improved with exercise. However, does this form of therapy improve the disease status as assessed by improvements in cartilage viability, a hallmark of the disease? This brief describes the possible usage of exercises in general, plus those known to improve strength and function, and reduce pain and whether structural impacts that favor or impede disease regression have been observed in this context among the older osteoarthritis adult population. Since exercise may also do harm, rather than good in osteoarthritis management if excessive, contra indicated, or suboptimal, what is the consensus in this regard in 2024?

Effect of adding different levels of soaked pigeon pea seeds (Cajanus cajan L) on the Growth and Feed Utilization Efficiency of Nile tilapia (Oreochromis niloticus) fingerlings.

Dec 2023 DOI 10.14302/issn.2691-6622.ijar-23-4637
M. Yagoub HassanCorresponding author

This study was conducted to evaluate the effect of socked pigeon pea seed meal on Growth and Food Utilization Efficiency of Nile tilapia (Oreochromis niloticus) fingerlings. 120 fish the weight and length average (3.4±0.04g and 3.2±0.00cm) were randomly distributed in 12 plastic Tanks (Aquarium) 36L according to the complete randomization, allocated to a represent four treatments (T0, T1, T2, and T3) of Nile tilapia (Oreochromis niloticus) fingerlings. four feeds were prepared in pellet form which consisted of 0%, 25%, 50% and 75% pigeon pea seed meal as replacement of fish meal. All diets contents 30% protein. Nile tilapia (Oreochromis niloticus) fingerlings were fed at the rate of 5% of their body weight. The result showed significant variation (P < 0.05) in final body weight, weight gain (WG), daily weight growth (DWG), Specific Growth Rate (SGR), and Food Conversion Ratio (FCR) among treatments. But, high SGR in T0 (control) and the best FCR were obtained at T 0% pigeon pea seed meal. Over all, best growth performance was observed in fish fed diet T1 (25%). The best performing fish’s final weight, DWG, SGR and FCR were 9.46±0.33g, 0.13±0.01g/day, 2.93±0.73% /day and 1.49±0.30 respectively. On the other hand, there was high significant variation (P < 0.05) in survival rate were obtained at T2 (50%). this study recommend that a diet containing 25% Pigeon pea seed meal for juvenile Nile tilapia is optimum in terms of growth performance and profitability, and does not impact water quality and plankton abundance in plastic Tanks (Aquarium) culture system.

Assessment of Environmentally Responsible Health-Oriented Behaviors in Students

Nov 2023 DOI 10.14302/issn.2693-1176.ijgh-21-3909
safari YahyaCorresponding author

Background & Objective Changing people’s attitude toward the environment is an important approach to the prevention of environmental damages. The present study aimed to evaluate environmentally responsible health-oriented behaviors in students. Materials and Methods This research was performed on 360 medical students (180 males and 180 females) who were selected via stratified random sampling. Data were collected using a responsible environmental behaviors questionnaire. Data analysis was performed in SPSS version 21 using linear regression analysis and Pearson’s correlation-coefficient. Results The scores of the environmental attitude, environmental knowledge, and environmental behaviors of the participants were estimated at 52.63±5.74, 74.43±5.99, and 103.37±11.51, respectively. An insignificant correlation was observed between the environmental knowledge and environmental behaviors of the students (r=0.07; P=0.20). However, the correlation-coefficient between the environmental attitude and environmental behaviors of the students was positive and significant (r=-0.54; P<0.001). A negative, significant correlation was also denoted between the environmental knowledge and environmental attitude of the students (r=-0.39; P<0.001). Conclusion Despite relatively poor environmental awareness and attitude, the majority of the students had proper environmental behaviors. Therefore, it seems that having an environmentally responsible behavior does not rely on environmental attitude and knowledge. In fact, behaviors influenced by social conditions and structure encourage and facilitate environmental behaviors.

Monk Fruit is a Safe, Natural, Non-Caloric Sweetener in Individuals with Type 2 Diabetes

Aug 2023 DOI 10.14302/issn.2379-7835.ijn-23-4688
Fernando Javier Lavalle-GonzalezCorresponding author

Non-nutritive sweeteners are used as adjuncts in treating patients with diabetes to reduce carbohydrate intake. Monk fruit is an FDA-approved1 natural NNS2-. There is no information regarding the use of monk fruit in individuals with T2DM3. The primary objective was to compare the glycemic response to sucrose and monk fruit in individuals with and without T2DM. Twenty-six individuals with T2DM and 29 without DM4 underwent two oral glucose tolerance tests5 after a 250-ml sucrose- or monk fruit-sweetened beverage. Glucose levels were measured at 0, 30, 60, 90, and 120 minutes. An appetite scale was used before and after the procedure. Insulin levels were measured in ten randomly selected individuals from the control group. The glucose levels at 30 and 120 min were significantly lower in both groups in the monk fruit-OGTT. There was a peak response in the T2DM group at 90 min (median, IQR, 247 mg/dL, 203-293) with the sucrose OGTT, while no peak response was seen in the monk fruit OGTT. There were no differences between sweeteners in terms of appetite evaluation. The postprandial effect on insulin levels was flat with the monk fruit-sweetened beverage. In contrast, there was a significantly higher spike with the sucrose-sweetened beverage. In conclusion, monk fruit does not increase glucose levels in individuals with T2DM; thus, it could be a safe alternative as a substitute food sweetener.

A review of ultrasound for the diagnosis of acute appendicitis in adults

Feb 2023 DOI 10.14302/issn.2641-5526.jmid-23-4450
Pather VijayCorresponding author

Acute appendicitis is one of the most common surgical emergencies globally, with a lifetime incidence of 8.6% in men and 6.7% in women. While acute appendicitis should be managed promptly to reduce the morbidity associated with perforated appendicitis, morbidity from negative appendicectomy is similar to morbidity from uncomplicated appendicitis. Computer tomography is widely used to aid in the diagnosis of acute appendicitis, however, is costly, often has a slow turn around time, and is associated with exposure to ionising radiation. In contrast, ultrasound is cheap, widely available, requires minimal patient preparation, and does not require exposure to ionising radiation. Ultrasonography is becoming increasingly used for adult patients in emergency settings. The literature has estimated the sensitivity of ultrasound for acute appendicitis in adult patients as between 39-96.4%. The sensitivity and specificity of ultrasound for the diagnosis of acute appendicitis is significantly increased when the appendix is visualised. In cases of a non visualised appendix, indirect ultrasound signs can improve the sensitivity to 93.9% and specificity to 85.7%. The variation in sensitivity and specificity for ultrasound in the diagnosis of acute appendicitis in adults may be due to multiple factors. Ultrasonographer experience, a retrocaecal appendix and obesity have all been described. Given the availability, cost and potential to reduce the rate of negative appendicectomy, ultrasound should be considered as the first line imaging modality for adult patients presenting with suspected AA.

Osteoarthritis Literacy and Equity Issues: A Post COVID-19 Analysis and Update

Nov 2022 DOI 10.14302/issn.2474-7785.jarh-22-4354
Marks RayCorresponding author Department of Health and Behavior Studies, Columbia University, Teachers College New York, USA.

Background Osteoarthritis, the most common joint disease and one affecting a large number of older adults is not always amenable to the use of passive interventions such as surgery or pharmacologic interventions, but even then, to maximize any desirable intervention approaches, a trustworthy and supportive partnership with the sufferer is strongly indicated. Complicating this process are emerging equity and persistent health literacy issues, as well as post COVID-19 service associated ramifications and persistent disease risks. Aim This mini review was designed to examine what current data reveal as regards the presentation of osteoarthritis and its pathology among the older adult as of the current post COVID-19 pandemic period in 2022, and how health literacy and equity issues are likely implicated in some degree with the disease presentation and its outcomes and will be likely to continue, unless remediated. Methods Peer reviewed published articles on this topic were sought from multiple data bases using the key words- osteoarthritis, health equity, health literacy, prevention, and intervention. Results As in prior years, osteoarthritis continues to induce considerable physical disability and consistently impedes the attainment of a high life quality for many older adults. Although not studied to any degree, attention to health equity and literacy issues appear to pose additional osteoarthritis intervention challenges, especially among the long COVID affected older adults and those with low income and educational levels. Conclusions Many behaviourally oriented and necessary osteoarthritis management approaches and interventions may fail to reduce the functional disability and pain experienced by older people with any form of osteoarthritis to any meaningful degree if a) the provider does not tailor their recommendations in light of possible prevailing health literacy, economic, and educational challenges; b) the patient does not understand how their health behaviours impact joint disease as well as COVID-19 risk status, and are not empowered to undertake these.

Computational Systemic Biology for Toxicity Studies: A Mini Review of Previously Published Articles

Jun 2022 DOI 10.14302/issn.2328-0182.japst-22-4193
Tariku Belay YilkalCorresponding author School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda

The strategy for safe drug discovery and development has limited clinical success as compared to wasted time and resources annually. This is due to the fact that the results of multiphase preclinical trials are less likely to make an accurate early prediction on the safety of test compounds to progress into the clinic as a valuable therapeutic agent. A lot of time and resources has been wasted in the multistage processes of drug discovery and development that does not work at the end of the procedure every year. During pre-marketing stage, for instance, the number of unsuccessful clinical trials are greater than the successful one because of safety issues. A toxicity study at different stages of preclinical and clinical trials is a routine procedure to investigate the undesirable side effects of test compounds being manifested on the natural processes of living things. It deals with the effect and mechanism of toxicity of test compounds that triggers different biological responses on different organ systems. The biological responses that would be manifested as a result of interaction between the receptors and active molecules of a test compound could be desirable pharmacological effect or undesirable side effect or both responses are manifested simultaneously depending on the selectivity or specificity of the molecule of a test compound for its receptor subtype which makes safe drug discovery and development very challenging. The response efficiency of the body (the net outcome of the body’s biological reaction against the side effect) would determine the potency of a test compound to manifest undesirable pharmacologic effect. In other words, the amount of a drug required to cause a biological harm or injury depends on the magnitude of the body’s biological reaction in which the immune response plays a great pharmacological role by neutralizing and harmonizing xenobiotics with the biological molecules. The dose of a test compound at 100 mg/kg body weight, for instance, could be lethal to some of the study animals while it is still non-lethal to some other study animals depending on the response efficiency of the body. The immune system is well connected to each and every biological systems of the body which allows it to detect undesirable side effects being manifested through immunoglobulins signalling and activation mechanisms. This complex communication network helps to localize the diverse side effects of a test compound being manifested on different organ systems into the immune system which makes a toxicity study relatively simple to monitor. The cellular immune system becomes active following the molecule-receptor interaction and start producing antibodies which is also known as immunoglobulins to protect bodily harm and destruction. Under normal biological circumstances, the amount of immunoglobulins produced by the cellular immune system following exposure to a test compound is proportional to the number of harmful molecules interacted with its receptor subtype. Thus, with the reference to the changes in the immune response against the administered dose, it would be able to deal with the diverse undesirable side effects of a test compound being manifested on treated study animals using computational systemic biology.

Variant Trifurcation of the Ulnar Nerve in Guyon’s Canal of the Human Wrist: Case report

Dec 2021 DOI 10.14302/issn.2577-2279.ijha-21-4005
Musa Fadlelmula KhalidCorresponding author Jazan University -Faculty of Medicine-Anatomy Department

During routine dissection of the right hand of a 52-year-old Asian descent male cadaver in the Department of Anatomy at Jazan University-Faculty of Medicine, we observed an anatomical variation of the ulnar nerve (UN). There was a trifurcation of the nerve in the ulnar tunnel proximal to the pisiform bone. An awareness of such variation may be of great clinical importance despite the presence of trifurcation of the ulnar nerve, which does not usually cause symptoms but becomes important in the evaluation of entrapment neuropathy and during surgical and orthopedic interventions

Human Psychology Open Access

Would John Stuart Mill Support or Reject Net Neutrality?

Jul 2021 DOI 10.14302/issn.2644-1101.jhp-21-3889
Donald L. BureshCorresponding author

In this article, the philosophy of John Stuart Mill is applied to the notion of net neutrality. It is argued that Mill would support net neutrality, provided it does not come in conflict with the principles of capitalism. The essay posits that Mill would contend that net neutrality would be supported if it promoted the greatest good for the greatest number of people. On the other hand, Mill would be against net neutrality if it harmed others, particularly those individuals without market power. The article observed that Mill believed that the purpose of government is to ensure the welfare of the people. In general, the paper concludes that Mill would probably have supported net neutrality.

A Comprehensive Research Study Literature Review of EPIC© in Terms of Enabling Healthcare Agility: A Report Card

Feb 2021 DOI 10.14302/issn.2641-5526.jmid-21-3739
Ralph J. JohnsonCorresponding author

Background As healthcare markets have become more dynamic and turbulent, healthcare organizations have evolved by becoming increasingly “Smart-Agile” in their business practices. Smart-Agility definition-ally ensures success due to its inherent ability to rapidly detect and react appropriately to varied and evolving unclear, complex, and seemingly tumultuous situations and produce high-quality, low-cost goods and services with high customer satisfaction. Thus, there is a vital need for Smart-Agile healthcare IT systems for collection, analyses, and reporting of substantial quantities of healthcare data to inform patient treatment and organizational decisions. EPIC® and its meaningful-use components appear increasingly popular, capturing a majority portion of the healthcare Electronic Healthcare Records (EHR) IT market (>~30%).Yet, there are few, if any, studies reporting on EPIC in terms of Smart-Agility. Aim The intent of this article is to report a systematic review of scientific literature regarding EPIC’s healthcare IT systems meaningful-use features cross-compared with Smart-Agility aspects to produce a positive vs. negative report card—and whether its features are critical vs. non-critical in terms of Smart-Agility. Method Findings reported herein derive from a grounded, iterative review of open-source, peer-reviewed scientific literature following PRISMA. Findings Report card results were mixed. EPIC clearly succeeds and excels (better than average) on Smart-Agile healthcare IT system core aspects that are the most central, critical and valuable in terms of informing healthcare organizations’ decisions and their patients’ care (6 out of 7; B+, -A), specifically: Standardized Data Collection / Connectivity, Real-Time Data Warehousing/Outcome Measures, Enhanced Patient Safety, Patient Tracking and Follow-up (Continuity of Care), Patient Involvement, and Potential Use in Medical Education. The only critical core criterion it failed on was End-User Satisfaction, and some of that appears to dissipate with new users’ software familiarity. Conclusion EPIC provides a solid and relatively inexpensive foundation with great potential for enabling Smart Agility in healthcare organizations with its high-quality collection and management of vast amounts of inter-connected raw data, auto-analysis, and fast report generation. But it does so with hidden costs and inefficiencies. Avenues of further inquiry are suggested.

Delayed Laparoscopic Repair of Bladder Injury with Vesico Cutaneous Fistula in Fracture Pelvis

Jan 2021
Ramalingam ManickamCorresponding author Urology Clinic, Coimbatore

Small extra-peritoneal bladder injury is commonly treated conservatively as it heals spontaneously. However if there is an impinging bony spicule in the rent, the bladder wound does not heal and it is preferable to repair the rent primarily. We present a case of non healing extra-peritoneal bladder injury initially managed conservatively in a trauma center with supra-pubic catheter (SPC). Cystogram was done after 7 weeks showed persistent leakage of contrast. Hence patient was managed by laparoscopic repair of persistent extra-peritoneal bladder rent.

Use of Microfluidic Assays to Develop Reliable and Economic Nucleic Acid Application Technologies, Employing MicroRNAs for the Diagnostic Screening of Colon Cancer in Human Stool in Low-Resource Settings

Oct 2020 DOI 10.14302/issn.2379-7835.ijn-20-3418
E. Ahmed FaridCorresponding author GEM Tox Labs, Institute for Research in Biotechnology, 2905 South Memorial Drive, Greenville, NC 27834, USA

Isolation methods that employ readily-available inexpensive supplies on the open market, which are reliable, as well as economical, such as nucleic acid amplification techniques (NAAT) based on microfluidic technology in low-resource research settings (LRRS) that meets the ASSURED guidelines are essential to develop a noninvasive diagnostic colon cancer screen in stool using micro(mi)RNA molecules. A combination of a microfluidic-based MiRNA stool test with a reliable rolling circle amplification/detection method applied to the quantification of miRNA molecules, result in an affordable sensitive and specific isothermal method for the noninvasive quantitative detection of miRNAs in LRRS. Scientists and engineers have become interested in miRNAs, and they have intensified their efforts to apply emerging simple detection tools to the important bioanalytical challenge of quantifying these small 18-26 nt long molecules. Some of the proposed approaches incorporate novel material, such as simple centrifuges and methods based on microfluidic technology, while others utilize the interesting biological properties of these molecules, such as forming branched RCA structures, allowing for the detection of these biomarker molecules at an attomolar "aM" concentration level, using low cost extraction and isothermal amplification methods in LRRS. We have been interested in studying colorectal cancer (CRC) because it is the 3rd most common malignancy worldwide, and stool can be obtained noninvasively from the patients. We have focused in this research on colon cancer (CC) because it is more common in the USA than rectal cancer (RC). The innovation of our approach lies in the exploratory use of an affordable, quantitative miRNA profiling in noninvasive stool samples in LRRS, whose extracted fragile total RNA is stabilized shortly after excretion from stool by commercially available kits, so it does not ever fragment, followed by quantitative standardized analytical tests that are neither labor intensive, nor require expensive instrumentation, in order to develop apanel of novel miRNA genes for the noninvasive diagnostic screening of early left and right sporadic colon cancers, more economically, and with higher sensitivity and specificity than any other colon cancer screening test currently available on the market. To show the clinical sensitivity and specificity of the proposed quantitative miRNA test using simple methodologies in LRRS,the miRNA results are to be correlated with FOBT, colonoscopy, and pathology data. Standardization establishes test’s performance criteria (sample selection, optimal sample running conditions, preservation and storage), in order to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in low-resource laboratory settings worldwide.

Osteoarthritis and Falls: Is there a Link?

Aug 2020 DOI 10.14302/issn.2474-7785.jarh-20-3496
Marks RayCorresponding author Department of Health and Behavior Studies, Teachers College, Columbia University, NY 10027, United States

Osteoarthritis, a widespread joint disease, commonly results in considerable pain and functional disability, especially among older adults. At the same time, falls and fall injuries, also common among the older population, may not only contribute to the onset of osteoarthritis, but once established, to falls that lead to fractures and disability in their own right. But what does the research show specifically? Objective This report aimed to examine what is known about the interrelationship between falls and osteoarthritis and the implications that can be drawn from this information. Methods Using the PUBMED data base, studies describing an association between osteoarthritis and falls were sought. Those fulfilling the eligibility criteria were reviewed and summarized in narrative form. Results Consistent support for an osteoarthritis-falls associated linkage is limited and not as robust as one would predict. Whether the observed associations between these health determinants are a cause of osteoarthritis, a consequence or both, or simply spurious findings is hard to decipher. Conclusion More numerous and carefully designed research to examine this issue is warranted and may be extremely helpful in preventing, as well as ameliorating a high degree of excess disability and associated fiscal costs due to both falls as well as osteoarthritis among the elderly.

Model Based Research Open Access

Artificial Neural Network Model for Rainfall Data Analysis During 2004-2017 in Tamil Nadu, India – Prevailing Pattern Evaluation on Climate Change

Jun 2020 DOI 10.14302/issn.2643-2811.jmbr-20-3402
Stanley Raj A.Corresponding author Department of Physics, Loyola College, Chennai, Tamilnadu- 600034, India.

This research paper focuses on rainfall variations in Tamil Nadu, India using Wavelet, Linear regression and Artificial Neural Networks model from 2004 to 2017. As the rainfall is the key factor in understanding climate change, the seasonal datasets from 2004-2017 of Tamil Nadu state has been taken for study. The salient feature of this study is the application of Neural Networks and wavelet analysis. It reveals that the rainfall variations are ambiguous that it does not maintain a constant pattern. Wavelet coefficients of multiresolution spectrogram reveals that the intensity of rainfall in each year. Linear regression model divulge the pattern of rainfall followed in every season and the results show that except winter season all other season suffers deficient rainfall. The deficiency of rainfall may be due to different parameters like ElNino or LaNina pattern or global warming. Results showed that all seasons except winter does not maintain consistency in the rainfall variability. Winter season provides the positive slope values of 4.7 and 0.6 for January and February respectively. Moreover Artificial Neural Networks training provides prominent results of Regression value 0.98 which is comparably high with other seasons taken for study.

Use of Microfluidic Assays to Develop Reliable and Economic Nucleic Acid Application Technologies, Employing MicroRNAs for the Diagnostic Screening of Colon Cancer in Human Stool in Low-Resource Settings

Jun 2020 DOI 10.14302/issn.2379-7835.ijn-19-3123
E. Ahmed FaridCorresponding author GEM Tox Labs, Institute for Research in Biotechnology, 2905 South Memorial Drive, Greenville, NC 27834, USA

Isolation methods that employ readily-available inexpensive supplies on the open market, which are reliable, as well as economical, such as nucleic acid amplification techniques (NAAT) based on microfluidic technology in low-resource research settings (LRRS) that meets the ASSURED guidelines are essential to develop a noninvasive diagnostic colon cancer screen in stool using micro(mi)RNA molecules. A combination of a microfluidic-based MiRNA stool test with a reliable rolling circle amplification/detection method applied to the quantification of miRNA molecules, result in an affordable sensitive and specific isothermal method for the noninvasive quantitative detection of miRNAs in LRRS. Scientists and engineers have become interested in miRNAs, and they have intensified their efforts to apply emerging simple detection tools to the important bioanalytical challenge of quantifying these small 18-26 nt long molecules. Some of the proposed approaches incorporate novel material, such as simple centrifuges and methods based on microfluidic technology, while others utilize the interesting biological properties of these molecules, such as forming branched RCA structures, allowing for the detection of these biomarker molecules at an attomolar "aM" concentration level, using low cost extraction and isothermal amplification methods in LRRS. We have been interested in studying colorectal cancer (CRC) because it is the 3rd most common malignancy worldwide, and stool can be obtained noninvasively from the patients. We have focused in this research on colon cancer (CC) because it is more common in the USA than rectal cancer (RC). The innovation of our approach lies in the exploratory use of an affordable, quantitative miRNA profiling in noninvasive stool samples in LRRS, whose extracted fragile total RNA is stabilized shortly after excretion from stool by commercially available kits, so it does not ever fragment, followed by quantitative standardized analytical tests that are neither labor intensive, nor require expensive instrumentation, in order to develop apanel of novel miRNA genes for the noninvasive diagnostic screening of early left and right sporadic colon cancers, more economically, and with higher sensitivity and specificity than any other colon cancer screening test currently available on the market. To show the clinical sensitivity and specificity of the proposed quantitative miRNA test using simple methodologies in LRRS,the miRNA results are to be correlated with FOBT, colonoscopy, and pathology data. Standardization establishes test’s performance criteria (sample selection, optimal sample running conditions, preservation and storage), in order to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in low-resource laboratory settings worldwide.  

Global Health Involvement in Thyroid Cancer Incidence Increase

May 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3353
Mango LucioCorresponding author Head for Higher Education in Healthcare, University of International Studies (UNINT) – Rome, Italy

In recent decades was observed a gradual increase in the detection of thyroid nodules in the adult population. Given the increase in prevalence of nodules, a similar trend to the growth in the incidence of thyroid cancers was found. The reasons for this increased incidence for thyroid cancer are controversial. Increased incidence is caused by an improvement in diagnostic techniques or does not result from an overdiagnosis, but represents a real increase in the incidence of thyroid cancer? Whatever the reality, the fact of an increased incidence of thyroid cancer for certain involves problems to global health which in any case must be evaluated and corrected.  

Energy Conservation Open Access

The Fermi-Pasta-Ulam Quantum Recurrence in The Dynamics of an Elementary Physical Vacuum Cell and The Problem of its Polarization

Feb 2020 DOI 10.14302/issn.2642-3146.jec-20-3179
A. A Berezin.Corresponding author Independent researcher, Moscow, Russia

A model of a Quantum recurrence in the dynamics of an elementary physical vacuum cell within the framework of four coupled Shrodinger equations has been suggested. The model of an elementary vacuum cell shows that a Quantum recurrence which represents the dynamics of virtual transformations in the cell, qualitatively differs from that of Poincare and the Fermi-Pasta-Ulam. Whereas these recurrences develop in time or space, the Quantum recurrence develops in a sequence of Fourier images represented by non exponentially separating functions. The sequence experiences random energy additions but no exponential separation occurs. The Quantum recurrence can be defined as the most frequent array of Fourier images that appear in a certain quantum system during a period of its observation. Different scenarios of the Fourier images sequences interpreted as bosons (electron and positron) and fermions (photons) apearing in the solutions of the model demonstrate that during some periods of its observation they become indistinguishable. The quantum dynamics of every physical vacuum cell depends on the dynamics of many other vacuum cells interacting with it, thus the quasi periodicity (during the period of observation) of the Fourier images recurrence can have infinite periods of time and space and the amplitudes of the Fourier images can vary many orders in their magnitudes. Such recurrence times does not correspond even roughly to the Poincare recurrence time of an isolated macroscopic system. It reminds the behavior of spatially coupled standard mappings with different parameters. The amount of energy in the physical vacuum is infinite but extracting a part of it and converting, it into a time-space form requires a process of periodical transfer of the reversible microscopic system dynamics into that of a macroscopic system. This process can be realized through a resonant interaction between the classical and quantum recurrences developing in these two systems. However, a technical realization of this problem is problematic.

Evolutionary Science Open Access

Structuredness as a Measure of the Complexity of the Structure and the Role of Post-Dissipative Structures and Ratchet Processes in Evolution

Jan 2020 DOI 10.14302/issn.2689-4602.jes-19-3155
Mikhailovsky GeorgeCorresponding author Global Mind Share, 878 W Ocean View Ave., Norfolk, VA, 23503, USA 

As shown earlier, the algorithmic complexity, like Shannon information and Boltzmann entropy, tends to increase in accordance with the general law of complification. However, the algorithmic complexity of most material systems does not reach its maximum, i.e. chaotic state, due to the various laws of nature that create certain structures. The complexity of such structures is very different from the algorithmic complexity, and we intuitively feel that its maximal value should be somewhere between order and chaos. I propose a formula for calculation such structural complexity, which can be called - structuredness. The structuredness of any material system is determined by structures of three main types: stable, dissipative, and post-dissipative. The latter are defined as stable structures created by dissipative ones, directly or indirectly. Post-dissipative structures, as well as stable, can exist for an unlimited time, but at the micro level only, without energy influx. The appearance of such structures leads to the “ratchet” process, which determines the structure genesis in non-living and, especially, in living systems. This process allows systems with post-dissipative structures to develop in the direction of maximum structuring due to the gradual accumulation of these structures, even when such structuring contradicts the general law of complification. 

Investigation of Edge-Selectively Nitrogen-Doped Metal Free Graphene for Oxygen Reduction Reaction

Jan 2020 DOI 10.14302/issn.2689-2855.jan-19-2744
Kejian DengCorresponding author Key Laboratory of Catalysis and Materials Sciences of the State Ethnic Affairs Commission & Ministry of Education, South-Central University for Nationalities, Wuhan, 430074, Hubei, China

In order to distinguish the roles of four types of nitrogen species in oxygen reduction reaction, the ketoamine condensation reactions between the ketone group of graphene oxide and amidogen of aniline and o-phenylenediamine were employed to generate –C=N- bond at the edge of graphene nanoplatelets, and then nitrogen-doped graphene nanoplatelets with pyrrolic N, pyridinic N and pyridinic N+-O- rather than graphitic nitrogen were obtained by post thermal treatments. The resulting catalysts were characterized by X-ray diffraction analysis, X-ray photoelectron spectroscopy and electrochemical measurements. It is found that edge-selectively nitrogen-doped graphene nanopaltelets with nitrogen content of up to 4.28 atom% have been prepared. Nitrogen doping helps to improve activity of oxygen reduction reaction slightly, suggesting nitrogen doping at the edge of graphene does not contribute a lot to the enhancement of activity.

Nephrology Advances Open Access

Evaluation of the Relationship Between Advanced Oxidation end Products and Inflammatory Markers in Maintenance Hemodialysis Patients

Dec 2019 DOI 10.14302/issn.2574-4488.jna-19-3112
Aydin ZekiCorresponding author Darica Farabi Training and Research Hospital, Department of Nephrology, Kocaeli, Turkey

Introduction Increased oxidative stress and blunted anti-oxidant mechanisms are important problems in hemodialysis (HD) patients. Reactive oxygen species (ROS) act directly on proteins, leading to the formation of oxidized amino acids. Advanced oxidation protein products (AOPP) are among these substances. Many oxidant substances increase the level of AOPP. Iron is an element with strong oxidant capacity, especially when used intravenously. It is thought that iron treatment further increases the oxidative stress in HD patients. We aimed to investigate the relationship between AOPP and inflammatory status in HD patients. Materials and Methods Patients who were on maintenance HD program without additional co-morbidities and no history of use of intravenous iron within the last two weeks were recruited in the study. The blood samples taken just before the dialysis session were analyzed for AOPP, serum iron, total iron binding capacity (TIBC), ferritin, C-reactive protein (CRP), ß2-microglobulin, fibrinogen, interleukin (IL)-1, IL-6 and tumor necrosis factor-α levels besides routine biochemical measurements and complete blood count. Results The number of patients included in the study was 102 (n: 53 female, %52.0) and the mean age was 47.6±13.9 years. The mean transferrin saturation was 25.4%. AOPP levels, iron use in patients was higher compared to patients who do not use (respectively 2.58±0.19 mmol/l and 2.50 ±0.16mmol/l, p = 0.046). We did not detect statistically significant correlation of AOPP levels with iron parameters and other inflammatory markers. Conclusion The present study showed that intravenous iron therapy does not increase oxidative stress. Although serum AOPP level was higher in patients on intravenous iron treatment, it was not correlated with iron indices and inflammatory markers. So, intravenous iron may exert its oxidant effect free from serum iron indices.

Using Prostatic Fluid Levels of Zinc to Bromine Concentration Ratio in Non-Invasive and Highly Accurate Screening for Prostate Cancer

Dec 2019 DOI 10.14302/issn.2372-6601.jhor-19-3094
Zaichick VladimirCorresponding author Radionuclide Diagnostics Department, Medical Radiological Research Centre, Obninsk, 249036, Russia.

Prostate specific antigen (PSA) does not provide the high reliability and precision that is required for an accurate screening for prostate cancer (PCa). The aim of our study was to search for a simple, rapid, direct, preferably non-invasive, and highly accurate biomarker and procedure for the screening for PCa. For this purpose the levels of bromine (Br) and zinc (Zn) were prospectively evaluated in expressed prostatic fluid (EPF). Also Zn/Br concentration ratio was calculated for EPF samples, obtained from 38 apparently healthy males and from 33, 51, and 24 patients with chronic prostatitis (CP), benign prostatic hyperplasia (BPH) and PCa, respectively. Measurements were performed using an application of energy dispersive X-ray fluorescent (EDXRF) microanalysis developed by us. It was found that in the EPF of cancerous prostates the levels of Zn and Zn/Br were significantly lower in comparison with those in the EPF of normal, inflamed, and hyperplastic prostates. It was shown that “Sensitivity”, “Specificity” and “Accuracy” of PCa identification using the Zn and Zn/Br levels in the EPF samples were all significantly higher than those resulting from of PSA tests in blood serum. It was concluded that the Zn and Zn/Br levels in EPF, obtained by EDXRF, is a fast, reliable, and non-invasive diagnostic tool that can be successfully used by local, non-urologist physicians at the point-of-care to provide a highly effective PCa screening and as an additional confirmatory test before a prostate gland biopsy.

Evolutionary Science Open Access

Conservation, Creation, and Evolution: Revising the Darwinian Project

Sep 2019 DOI 10.14302/issn.2689-4602.jes-19-2990
Shkliarevsky GennadyCorresponding author Bard College

There is hardly anything more central to our universe than conservation. Many scientific fields and disciplines view the law of conservation as one of the most fundamental universal laws. The Darwinian model pivots the process of evolution on variability, reproduction, and natural selection. Conservation plays a marginal role in this model and is not really universal, as the model allows exceptions to conservation, i.e. non-conservation, to play an equally important role in evolution. This anomalous role of conservation in the Darwinian model raises questions: What is the reason for this anomaly? Is conservation really universal, as we tend to believe or is it not, as the Darwinian model suggests? This contribution proposes a new model of evolution that focuses on levels of organization, rather than of species, organisms, or populations. It argues that conservation is central to evolution. Not only does this new model restores the universal status of conservation but it also makes possible to resolve some outstanding problems and controversies that continue to plague the Darwinian model. The article tries to advance the broad Darwinian project that seeks to explain the process of evolution as a product of the spontaneous processes in nature.

“Prevention of Death Anxiety by Familiarity with the Concept of Death”

Jul 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2947
Asadzandi MinooCorresponding author Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

Objectives Death is the only definitive phenomenon in life, and everyone is sure that it will happen in the future. Based on the philosophical perspective, the concept of death differs in different cultures. The purpose of this study was “explaining the difference between the concept of death from the perspective of theology and empirical science”. Methods In this qualitative evolutionary study, a targeted review was conducted to answer the question “what is the difference between the concept of death from the perspective of theology and empirical science?” Articles published between 1990 and 2018 were extracted from the PubMed, science direct, google scholar, SID, and Cochrane databases. At the same time, Islamic religious evidence (Quran and Hadiths) was investigated for understanding the concept of the death in Islam. The “Shia Seminary” research methodology was used to avoid interpretations of the Quran verses and to ensure the authenticity of the Hadiths. Findings Empirical sciences consider death as a biological phenomenon, which results from irreversible damage to cerebral hemispheres and brain stem (brain death) that causes grief process, fear, anxiety, and sadness. From the perspective of Islam, death is an existential phenomenon, the transfer of the soul from one world to another. Death is the complete reception of the soul from the body by the angels and the beginning of another life, in the "world of grief. Conclusion Given that in Islam, death does not mean destruction. It is imperative that the spiritual counselors teach the patient and the family about the life after death and the blessings of paradise. In pastoral care at the end of life, reducing patients’ anxiety and fear of death, with hope in God's mercy is necessary.

Contextual Action Theory in Nursing

May 2019 DOI 10.14302/issn.3070-5835.jcpn-19-2741
Ladislav ValachCorresponding author Lindenstrasse 26, 3047 Bremgarten, Switzerland

After pointing out the wide scope of issues in nursing and summarizing some of the attempts in nursing to deal with this problem of wide scope we propose a conceptual consideration to address this issue anew. We suggest that the contextual action theory is well equipped to provide an economical and concise way of integrating various approaches and disciplines as well as different tasks a nursing conceptualization has to address, particularly in dealing with the issue of practice. We describe what action is, how it could be seen as a system and how it could be useful in nursing practice. Specifically, we detail the application of the contextual action theory in devising nursing procedures, in providing theories and research methods in nursing research and in evaluation processes in nursing. In addressing some limitations of the suggested approach, we stress that it is not a theory of everything and that it does not deliver ready-made instruments for obtaining quantitative data.

The Australian Royal Commission into the Aged Care Industry 2019

Jan 2019 DOI 10.14302/issn.2474-7785.jarh-19-2608
W. Harvey PeterCorresponding author Conjoint Clinical Professor, Deakin University, School of Medicine, Faculty of Health

In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.

Knowledge, Attitude and Practice of Healthcare Workers Towards Availability of Antiretroviral Pre-Exposure Prohylaxis in Nigeria

Dec 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2333
Joseph Afe AbayomiCorresponding author Community Medicine Department, Equitable Health Access Initiative, Lagos, Nigeria

Introduction: The introduction of preexposure prophylaxis (PrEP) against incident HIV infection has changed the epidemiology of disease as continuous treatment with tenofovir and emtricitabine among high risk groups can reduce the relative risk for incident HIV infection by over 90%.However,despite the approved use of TDF+FTC, as a fixed dose combination of emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg, for oral PrEP since 2012 , it does not appear to have become widely accepted and in use among healthcare workers especially those in low income countries. Researches are therefore needed to consider the awareness and practice of health workers towards the availability of PrEP services in this part of the world. Healthcare workers are expected to be promoters of the use of PrEP services. Method: A cross sectional questionnaire-based study conducted in southern Nigerian over a 6 months period. Data were collected from 250 healthcare workers using interviewer-administered questionnaires. The data analysis was done using statistical package for the social sciences (SPSS) for windows version 20.0 software (SPSS Inc; Chicago, IL, USA). Frequency counts were generated for all variables and statistical test of significance was performed with chi-square test. Significance was fixed at P < 0.05 and highly significance if P < 0.01. Results: A high proportion of the respondents(>60%) were highly educated healthcare workers(majorly Nurses and medical doctors) and about half (55%) having at least 10yrs working experience in the health sector with most especially on the HIV program(>90%), majority (94%) of the health workers were aware about ARV pre-exposure prophylaxis but very few ( 6% )could give the standard definition for PrEP as the use of ARV drugs by HIV negative persons to prevent the acquisition of HIV.Most(67%) of them gave wrong definition for PrEP and worse still about one fifth (20%) had no idea what PrEP was all about. Most (70%) could not correctly identify all the ARV drugs in a standard PrEP regimen while about 35% had no idea at all of the approved ARVs used for PrEP. Though PrEP services was not available at any of the facilities where the respondents were working ,the approved drugs(TDF+FTC) for PrEP were available at about 40% of the health facilities(public and private) and 15% community pharmacies in the vicinity of the respondents . Only 60% of the respondents were willing to access PrEP service for themselves if indicated while 35% would not use such services even if it is indicated for reasons which include concern about adverse effects and safety.Awareness of PrEP was significantly associated with the ability of the healthcare workers to identify the correct ARV regimen, ARV dosages and also correct indication for PrEP. Awareness was also associated with the knowledge of the correct proven efficacy for PrEP(>95%) and high likelihood of seeing a patient placed on PrEP and willingness to use PrEP based on personal indication Conclusion: The level of awareness of PrEP among healthcare workers was very high at about 90% yet many(60%) could not give correct standard definitions of PrEP, PrEP ARV regimen, dosages and level of efficacy of PrEP. Also none of the respondent had PrEP services available either at their center or any known referral centers. This is unacceptable in a country with second highest HIV burden in the world and has adopted PrEP in her national HIV guideline with ongoing PrEP demonstration studies. The few healthcare workers who were able to mentioned this information were more likely to have seen a patient placed on PrEP and were more willing to use PrEP based on personal indication. Recommendations: There is need to deepen the and knowledge of PrEP among healthcare workers especially those in poor resource settings by engaging them through update courses outreach, educational resources, campaigns/seminars and workshops and various job aids. All healthcare service providers should be very comfortable to carry out HIV risk assessment of their clients and provide PrEP to those indicated directly or indirectly through referral

Organ Transplantation Open Access

Should All Living Kidney Donors Receive Donor Health Insurance? - Ethical Guidance for Evaluating Policies and Actions that Provide Financial Benefits to Living Organ Donors

Dec 2018 DOI 10.14302/issn.2576-9359.jot-18-2388
M. Flechner StuartCorresponding author Glickman Urologic and Kidney Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio 44195

This review article provides ethical guidance for determining which kinds of financial benefits provided to living organ donors are ethically appropriate. It does so by way of ethical analysis of a policy case study: the National Kidney Registry (NKR) has implemented a donor insurance program to all its living donors. Is such a policy ethically supportable, or is it an unethical practice? The article proceeds as follows. First, a framework for grounding the ethical commitments of transplant programs is defended. It is argued that this framework can be accepted by all who work in transplant medicine, regardless of differences in ethical theory preference or background. Second, from this framework two ethical principles are formulated. (1) Living donors should, as far as possible, not be worse off for donating. (2) Disincentives towards donation should be removed as much as possible. Third, issues with unethical incentives are explored: undue inducement, commodification of the body, potential decreased organ donation rates, and potential exploitation of vulnerable populations. Lastly, these ethical considerations are applied to the policy change at the NKR, showing that the NKR policy change appears to be ethically supportable. Financial benefits provided to donors are ethically sound if they are in keeping with principles (1) and (2), and do not cause undue inducement, commodification, decreased organ donation, or exploitation. It is ethically appropriate for transplant programs to institute as well as study such programs with the goal of serving the welfare and interests of patients, donors, and the general public.

The Anemone, The Porcupine: Hairy Cell Leukaemia

Nov 2018 DOI 10.14302/issn.2689-5773.jcdp-18-2435
Bajaj AnubhaCorresponding author Consultant Histopathologist

Theobjective of reviewing Hairy Cell Leukaemia may be achieved by emphasising the condition as a category of chronic lymphocytic leukaemia with hair like protrusions of the cytoplasm situated on the aberrant B cell surface. An infrequent disorder, hairy cell leukaemia contributes an estimated 2% of lymphoid malignancies with a male predominance ( M:F ::4-5:1). A majority (90%) of instances depict a mutant immunoglobulin heavy chain variable region (IGHV). The haematopoietic stem cells (HSCs) elucidate a B raf proto-oncogene( BRAF V600E gene- 7q34). An enlarged spleen may be discerned along with pancytopenia as a presenting symptom. The morphology of specific hairy cell leukaemia may be on account of an in vitro interaction of primary hairy cells with BRAF genes and MEK inhibitors, which incite a prominent MEK - ERK dephosphorylation, thereby curtailing transcriptional outpourings of the RAS- RAF- MEK-ERK pathway. Bone marrow aspiration or bone marrow trephine biopsy may be inadequate for diagnosis in 30%-50% individuals on account of extensive fibrosis and the bone marrow sections depict a characteristic interstitial infiltration of leukaemia cells.. Reticulin stains exhibit broad, dense reticulum fibres surrounding the individual or aggregates of leukaemia cells with fibrotic extensions into the abutting bone marrow. The immune reactivity of classic hairy cell leukaemia is concurrent CD19+ CD20+,CD 11c+, CD25+, CD103+ and CD123+. Immune staining for CD20+, annexin 1 and VE1 (a BRAF V600E stain) validates the diagnosis and analyses the extent of malignant bone marrow infiltration. Application of inhibitors of BRAF V600E gene is efficacious in patients resistant to standard therapy. An enlarged spleen beyond 3 centimetres of the left costal margin, a white blood cell count greater than 10000 cells/µL , circulating hairy cells in the peripheral blood greater than 5000 cells/µL and a β 2 micro-globulin level exceeding twice the normal range of 3 µg/ml delineate an inferior outcome with resistance to purine analogues (PNAs). CD38+ elucidation ensures a worse prognosis as does the lack of an IGHV mutation with a reduced overall survival,. A lack of BRAF genetic mutation in 10% -20% of hairy cell leukaemia comprises of inferior prognosis.

Physiology of Distinct Modes of Muscular Contraction

Oct 2018 DOI 10.14302/issn.2578-8590.ipj-18-2441
Habibzadeh NasimCorresponding author PhD in Sport Science, Department of Sport Science, Teesside University, UK

Physiological changes in musculature allow widespread movements in human body. Correspondingly, varying in muscle prototypes characterise direct different training paradigms in therapeutics practice or can governs athletic performances. Mode of muscle contraction type are isometric, concentric or eccentric. Great examples of concentric exercise are walking- up-hill, stair ascent and lifting a dumbbell in bicep curl or pushing a bar up. Examples of eccentric muscle actions are walking - down-hill, satire decent and, isokinetic arm and leg extensions. During isometric muscle contraction the length of muscle does not change while muscle exert force .This type of movement can be seen while a person performs a maximal voluntary contractions (MVCs).Eccentric exercises increasing the concentric and isometric contraction as well. Performing the eccentric muscle contraction in daily life enhance quality of life and lifespan due to increasing muscle strength with low cost of energy consuming and thus it can apply in variety of domains. A simple walking task such as downhill - walking (i.e. 30 min) can provide the aforementioned conditions.

Application of Nanotechnology for the Preservation of Red Blood Cells

Sep 2018 DOI 10.14302/issn.2689-2855.jan-18-2342
Belousov AndreyCorresponding author Laboratory of Applied Nanotechnology of Belousov.

This study was devoted to the learning of the use of nanotechnology to correct the functional activity of red blood cells (RBCs) at the storage stages at a positive temperature. It was established that saline NaCl, which had previously been processed by magnetite nanoparticles (ICNB) had a marked membrane-stabilizing effect, inhibits hemolysis and increasing the sedimentation stability of preserved RBCs. The complex analysis of the obtained data allowed to determine the primary mechanisms effect of the saline NaCl, which had previously been processed by ICNB on the preserved RBCs. The proposed method of additive modernization of preserved RBCs was adapted to the production process. The optimization results were obtained in creating a simple and practical method of additive modernization of preservation solutions that does not violate the compliance requirements, improves the quality, efficiency and safety transfusion of RBCs.

Health Care Providers Perception and Practice of HIV Disclosure to Sero-Positive Children and Adolescents in a Tertiary Health Facility in Abuja, Nigeria

Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2202
AA OkechukwuCorresponding author Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada.

Background: Ideally, disclosure of HIV status to infected children and adolescents should involve both health care workers and parents/caregivers. Most studies on disclosure in children have focus mainly on parents/caregivers with little information on health care workers. We conduct this study to evaluate the practice, perception of the healthcare workers in our health facility on disclosure to infected children and adolescents. It is envisaged that such information will help in the design of better strategies on disclosure in our environment. Methods: A cross sectional hospital based study was conducted among health care workers at the special treatment clinic, and heart to heart unit of the University of Abuja Teaching Hospital, Gwagwalada from January to March 2017 for the above objective. A structured questionnaire was used to collect information on disclosure among the healthcare workers, which include among others: their bio-data, knowledge, perception, and practice on disclosure in the two service areas of the hospital. Results: Of the 80 health care workers interviewed, 60(75.0%) were females, 11(13.8%) were doctors, 9(11.3%) nurses, 17(21.3%) monitoring/evaluation/record clerks, and 16(20.0%) were either voluntary counseling and testing counselors or adherence counselors. Their mean age and duration in service in the two areas were 39.70±7.10 and 7.93±4.99 years respectively. Over half 48(60.0%) of the health care workers were unaware of the hospital having guideline on disclosure, 64(80.0%) have not been trained, and 68(85.0%) does not know any key information on disclosure. While all 80(100%) felt that disclosure was a good practice for better adherence, only 16(20.0%) had actually disclosed, with 6(37.5%) not seeking any formal permission from parent/caregivers before disclosing. Ages 8-16 years was recommended by 60(75%) as the appropriate age to disclose, however 28(35.0%) recommended age 14-16 years. Over half of the respondents 58(72.5%) admitted that disclosure should be a shared responsibility between themselves and the caregivers, most however perceive their role as only preparing the parents/caregivers for disclosure, and providing ongoing counseling to both the parents/caregivers and the children and adolescents. Lack of training on disclosure, and none availability of guideline in the health institution were major setback on the ability of the healthcare providers to fully participate in disclosure process. Conclusion: While healthcare providers support the idea of disclosing at mid and late adolescent, their perceived role was that of support and provision of ongoing counseling. Lack of training and none availability of disclosure guideline affects their perceived role. There is need to train and retrain healthcare workers on disclosure guideline, and making such guideline available in the health facilities.

Assessment of Pupils’ Knowledge and Practices Towards Prevention and Control of Tungiasis Infestation in Ugenya Sub County, Kenya

Jun 2018
Mwai JCorresponding author Kenya Medical Research Institute.

Background: Tungiasis is a parasitic tropical disease caused by female Tungapenetranswhich has remained an important public health problem and it affects resource-poor communities causing different health disabilities hence the need for behavior change. Main objective of the study was to determine factors influencing prevention and control of tungiasis infestation among school age children in Ugenya Sub County, Kenya. Methods: A descriptive cross sectional design and utilizing quantitative data collection method. Simple random sampling technique was applied to select the participants. Quantitative data was collected through a pretested structured questionnaire. The data was keyed-into excel and analyzed using SPSS version 23. Results: Study findings indicate that majority of the pupils infested with tungiasis were in classes 5 – 6 at 191(49%). Male participants were 200 (51%), while 185(49%) were female. Gender of pupils (χ2=4.383a, df=1, P<0.005) and household head occupation (χ2=44.729, df = 28, P<0.005) had a statistical significance with tungiasis infestation. Further significance was noted between participants who had ever heard of jiggers (χ2=6.361, df=1, P<0.005), Knowledge on important causes of jiggers (χ2=36.482, df = 9, P<0.005), mode of disease transmission (χ2=17.215, df = 5, P<0.005), signs and symptoms (χ2=4.088, df = 1, P<0.005), seriousness of jiggers in the area (χ2=13.175, df = 1, P<0.005) as well as pupil’s wearing of shoes (χ2=3.934, df = 1, P<0.005) and tungiasis infestation. Conclusions: Study concludes that tungiasis is still a big problem in rural settings and knowledge on tungiasis infestation does not translate to prevention and control in the areas. More emphasis should be given to improving practices touching on personal hygiene and health education to increase awareness both at school and in the households.

Biomaterials Open Access

Nanotechnology Meets Immunotherapy: CAR-T Cells Technology and Beyond

Mar 2018
Rizzello LorisCorresponding author Department of Chemistry, University College London (UCL), 20 Gordon Street, WC1H 0AJ - London (UK)

The crusade against cancer has a new army: immunotherapy. The rational design is very simple, but brilliant at the same time. Extract the patients T-cells, reprogram them in vitro for the expression of highly specific receptors against cancer, perfuse them back to the patient. As a result, T-cells are now instructed to selectively kill circulating tumor cells, while avoiding potential side effects. This ‘Fairy Tale’ however does not lack of drawbacks and limitations. First, malignant progression can be accompanied by profound immune suppression, which counteracts the immune system-mediated tumor elimination. Second, the immune cells modification does not match high standards in terms of safety for humans. Here, nanotech can fill these gaps, and help immunotherapy to be safer and more effective.

Immunization Open Access

RETRACTED: Efficacy of BCG Vaccine and Role of Non Specific Sensitivity Due to Atypical Mycobacteria

Jan 2018 DOI 10.14302/issn.2577-137X.ji-17-1800
R Patil RajanCorresponding author School of Public Health, SRM University.

This article has been retracted on December 28, 2018. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2577-137X.ji-25-5837) This paper attempts to summarizes possible reasons for BCG trial failure in India. It also lists out some of the important controversies and questions raised with regards to BCG trial in the context of Non Specific sensitivity. It emphasizes on the fact, that Tuberculin test does not accurately reflect individual’s responded immunologically to mycobacterium, it only indicates nature of immune response that has been elicited in an infected individual. The dynamics of tuberculin reaction needs to be understood through immunological considerations. Categorization of Tuberculin test results factoring in immunological considerations,will have great implication on the interpretation of tuberculin test and therefore on the estimation of annual risk of infection of tuberculosis.

A Cost Analysis of Systematic Vitamin D Supplementation in the Elderly Versus Supplementation Based on Assessed Requirements

Sep 2017 DOI 10.14302/issn.2474-7785.jarh-17-1724
Wanby PärCorresponding author Section of Endocrinology, Department of Internal Medicine, Kalmar County Hospital, Kalmar, Sweden

Hypovitaminosis D is common among older people and treatment with vitamin D is associated with reduced risk of falls and fractures. This paper provides a cost analysis of assessing the vitamin D status of and providing the pharmaceuticals for elderly citizens in Kalmar County, Sweden (population approximately 230,000). Four hypothetical interventions were analyzed: (a) systematic vitamin D/calcium supplementation to all elderly (≥75 years), (b) assessment of vitamin D status in elderly and supplementation to those with insufficient levels, (c) systematic vitamin D/calcium supplementation to all nursing-home residents, and (d) assessment of vitamin D status in nursing-home residents and supplementation to those with insufficient levels. The calculations were based on an estimated reduction in overall costs due to the assessed number of hip fractures after vitamin D/calcium supplementation. The annual net economic benefit of vitamin D/calcium supplementation was estimated at (a) €304,000, (b) €860,000, (c) €755,000, and (d) €740,000. The provision of systematic vitamin D supplementation to nursing-home residents would provide a substantial net economic benefit to society and assessment of the vitamin D status before starting supplementation does not seem to be necessary. Although assessment of all elderly citizens would be more comprehensive, the true proportion with insufficient vitamin D levels in the general population is uncertain and to reaching consensus on the most advantageous daily vitamin D intake, vitamin D blood levels are necessary. Also, systematic supplementation to all elderly would result in other outcomes that could be worth the cost, but that remains to be evaluated.

Suboccipital Decompression for Occipital Neuralgia

Aug 2017 DOI 10.14302/issn.2694-1201.jsn-17-1527
Trescot AndreaCorresponding author Pain and Headache Center, 12836 Old Glenn Hwy, Eagle River, AK 99654

Cervicogenic headaches are a significant cause of head and neck pain, and occipital neuralgia is a common component of these cervicogenic headaches. Occipital injections are commonly performed at the occipital ridge, but this site does not address more proximal entrapments of the nerve in the suboccipital region. Because of the potentially dangerous structures in this region, clinicians have tended to avoid the suboccipital region, despite the pathologies seen in this region. This article discusses the pathology of the region, the alternative techniques, and the novel interventional approach developed for this region, specifically the “Stealth” approach of occipital decompression.

Ophthalmic Science Open Access

The Influence of Race, Age, and Pupil Size on the Measurement of a Photorefraction Device

Apr 2017 DOI 10.14302/issn.2470-0436.jos-17-988
Chen Ying-LingCorresponding author University of Tennessee Space Institute, 411 B. H. Goethert Parkway, Tullahoma.

Photorefraction (PR) methods have beenwidely used for pediatric vision screening since the 1980’s. While PR is easy to implement, the accuracy of refractive error measurements in humans has been unsatisfactory, largely due to the variations of intraocular scattering, the retinal reflectance, and pupil size. The objective of our studies was to clinically evaluate the accuracy of refraction measurements of an improved PR-based device, the Dynamic Ocular Evaluation System (DOES), and to investigate whether the accuracy is affected by the patient’s age, race, and pupil size, which are relevant to individual intraocular scattering and retinal reflectance. We performed DOES measurements in 99 volunteers (198 eyes) under two environmental light conditions and using four fixation targets. These results were compared to the standard clinical refraction testing performed the same day. The correlation and standard deviation were determined by Bland-Altman analysis. The influence of intraocular scattering, retinal reflectance, and pupil size was evaluated by comparing results from different age groups, races, and lighting conditions. In the region between -4 diopter (D) and +4D, the device showed a binocular refraction measurement accuracy of 0.45 D, 0.3 D, and 0.18 D root-mean-square (RMS) error (n=1337) for spherical equivalent and cross cylinders Jo and J45, respectively. Inaccuracy increased at high refraction (>4D). Age, race, and pupil size did not appear to significantly affect DOES PR measurement. This suggests that enhancements in the PR system and analysis may satisfactorily correct intersubject variability that currently limits the clinical use of PR devices and measurements.

Ageing-Demographic Time-Bomb or Social Construct: Outline of the Potential Horizons and Opportunities

Nov 2016 DOI 10.14302/issn.2474-7785.jarh-16-1274
James Power JohnCorresponding author Dr John J. Power The School of Nursing and Midwifery, Queen’s University Belfast

Ageing whilst an inevitable process in the human being, does not have to be marked by progressive decline and social withdrawal. `Ageism’ can generate a number of negative and at times destructive perspectives, labelling the elderly and possibly encouraging them to reflect the attitudes and behaviour of the label. This discussion paper addresses concerns about the `demographic time-bomb’ in some advanced economies from a sociological and policy perspective; exploring briefly functional, critical and social action theory. The paper concludes by suggesting that social perspective significantly translate to social behaviour and interaction with and by the elderly. Many of the ageist preconceptions are not necessarily supported by research, and that advancing age should be marked by empowerment, participation, choice and more effective social integration or reintegration. Importantly, the ageing process and perspectives on ageing need to be addressed, both politically and structurally within societies.

Effect of Coenzyme Q 10 Supplementation on Statin-Induced Myalgia, A Randomized Double-Blind, Placebo-Controlled Study

Apr 2016 DOI 10.14302/issn.2474-3585.jpmc-15-704
Rott DavidCorresponding author Cardiac Rehabilitation Institute, Leviev Heart Center, The Chaim Sheba Medical Center, Tel Hashomer Israel

Objective: Statins are highly effective medications for reducing low-density lipoprotein cholesterol concentrations and cardiovascular events. Their most common side effects are a variety of myopathic complaints, possibly due to reduced circulating Coenzyme Q10 (CoQ10) levels. We sought to determine whether CoQ10 supplementation decreases the rate of myalgia in patients with statin-related myalgia. Methods: Patients treated with a statin for clinical indications who reported statin induced myalgia were eligible. Patients were randomized to treatment with CoQ10 120 mg/day (17 patients) or placebo (20 patients) in a double-blind manner. Treatment was continued for 12 weeks. All patients were instructed to continue taking their prescribed statin as usual. Myalgia score was assessed before intervention and then weekly, for 12 weeks of therapy, using a visual analogue scale (VAS). Results: Over 12 weeks of treatment, myalgia score gradually decreased in both the treatment group and placebo group to the same extent (from 6.2 to 3.3 in the treatment group and from 5.9 to 3.1 in the placebo group), without significant differences between the groups. No significant change was noted between the two groups in the number of patients tolerated statin therapy. Conclusions: CoQ10 does not appear to decrease the rate of myalgia when compared to placebo in patients with statin-related myalgia.

Different Effects of Ethanol and Activation of TRPM8 ION Channel on Metabolic Response to Cold

Mar 2016 DOI 10.14302/issn.2572-5424.jgm-16-1353
V. Kozyreva TamaraCorresponding author Novosibirsk State University, Novosibirsk, Pirogov str. 2, Novosibirsk, 630090, Russia.

The possible interrelation of ethanol and the membrane protein molecules such as TRP ion channels in the whole living organism has not been studied. In the present research we study the influence of ethanol (50%) and agonist of TRPM8 ion channel L-menthol (1% in 50% ethanol) application to abdominal skin on the thermoregulatory response to cooling in rats. We used two types of cooling with the different rates of skin temperature decrease - 0.1 °C/sec for rapid and 0.005°C/s for slow cooling. It was shown, that the effects of ethanol and activation of the cold-sensitive TRPM8 ion channel are mainly directed at different components of thermoregulatory metabolic response to cold. Menthol, as an agonist of the TRPM8 ion channel, besides the constrictor vascular response stimulates predominantly the emergency first phase of metabolic response which appears only at rapid cooling without any effect on the second phase of metabolic response to cooling. Ethanol inhibits the most powerful second phase of metabolic response to cold which is manifested at decreased deep body temperature and is associated with the development of not only non-shivering but also shivering thermogenesis. Effect of ethanol is accompanied by the acceleration of the deep body temperature fall. Ethanol does not prevent the effect of menthol on thermoregulatory blood vessel and emergency phase of metabolic response, and the activation of the cold-sensitive TRPM8 ion channel by menthol has no obvious influence on the effects of ethanol – inhibition being the most powerful thermogenic component of the metabolic response to cold.

Antioxidant Activity Open Access

The Total Antioxidant Capacity of Foods: A Reappraisal. Application to Commercial Orange Juices

Dec 2015 DOI 10.14302/issn.2471-2140.jaa-15-715
Kevers ClaireCorresponding author Plant Molecular Biology and Biotechnology and CEDEVIT B22, University of Liège Chemin de la Vallée, 4, Sart Tilman, 4000 Liège Belgium

Since a few years, more and more attention has been specifically given to dietary antioxidants as agents promoting health and preventing the incidence of diseases. As part of these efforts, analytical methods and assays have been developed to measure the antioxidant content in food substances. In this paper, the antioxidant capacity of 17 orange juices is determined by various assays (DPPH, ORAC, heamolysis, xanthine/xanthine oxidase) as the content in ascorbic acid and total phenolics. The results evidence all the complexity to evaluate the in vitro antioxidant capacity of foods. In very general terms, in spite of the wide utilization in these tests (FRAP, TAC, ORAC TRAP and others), their significance remains obscure. The discrepancy of the results and the absence of good correlation between the assays clearly highlight all the importance of understanding the strengths and weakness of assays evaluating antioxidant potential of a food at the risk of giving erroneous information to the consumer. It is clear that the use of "total antioxidant capacity" assays for the in vitro assessment of antioxidant quality of food does not be employed by food industrials as a marketing argument or for the assessment of the "wholesomeness" of a food.

Identification of Novel Biomarker for Human Uterine Leiomyosarcoma

Jun 2014 DOI 10.14302/issn.2372-6601.jhor-13-379
Hayashi TakumaCorresponding author Dept. of Immunology and Infectious Disease, Shinshu University, School of Medicine, Matsumoto, Nagano 390-8621, Japan

Sarcomas are neoplastic malignancies that typically arise in tissues of mesenchymal origin. The identification of novel molecular mechanisms leading to sarcoma formation and the establishment of new therapies has been hampered by several critical factors. Human uterine leiomyosarcoma (Ut-LMS) develops more frequently in the muscle tissue layer of the uterine body than in the uterine cervix. Although the development of gynecologic tumors is often correlated with the secretion of female hormones; that of human Ut-LMS does not and its risk factors remain unknown. Importantly, a diagnostic biomarker that can distinguish malignant Ut-LMS from benign tumor uterine leiomyoma (LMA) has yet to be established. Therefore the risk factor(s) associated with human Ut-LMS to establish a diagnosis and novel therapeutic method. Proteasome b-ring subunit LMP2/b1i-deficient mice spontaneously develop Ut-LMS, with a disease prevalence of ~40% by 14 months of age. We shown that LMP2/b1i expression was absent in human Ut-LMS, but present in other human uterine mesenchymal tumors including uterine LMA. Therefore, defective-LMP2/b1i expression may be one of the risk factors for human Ut-LMS. LMP2/b1i is a potential diagnostic biomarker for human Ut-LMS, and may be a targeted-molecule for a new therapeutic approach.

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