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Chloroquine-primaquine (CQ-PQ) continues to be the frontline therapy for radical cure of Plasmodium vivax malaria. Emergence of CQ-resistant (CQR) P. vivax parasites requires a shift to artemisinin combination therapies (ACTs), which imposes a significant financial, logistical, and safety burden. Monitoring the therapeutic efficacy of CQ is thus important. Here, we evaluated the therapeutic efficacy of CQ-PQ for P. vivax malaria in northeast Myanmar. We recruited 587 patients with P. vivax monoinfection attending local malaria clinics during 2012 to 2013. These patients received three daily doses of CQ at a total dose of 24 mg of base/kg of body weight and an 8-day PQ treatment (0.375 mg/kg/day) commencing at the same time as the first CQ dose. Of the 401 patients who finished the 28-day follow-up, the cumulative incidence of recurrent parasitemia was 5.20% (95% confidence interval [CI], 3.04% to 7.36%). Among 361 (61%) patients finishing a 42-day follow-up, the cumulative incidence of recurrent blood-stage infection reached 7.98% (95% CI, 5.20% to 10.76%). The cumulative risk of gametocyte carriage at days 28 and 42 was 2.21% (95% CI, 0.78% to 3.64%) and 3.93% (95% CI, 1.94% to 5.92%), respectively. Interestingly, for all 15 patients with recurrent gametocytemia, this was associated with concurrent asexual stages. Genotyping of recurrent parasites at the merozoite surface protein 3α gene locus from 12 patients with recurrent parasitemia within 28 days revealed that 10 of these were the same genotype as at day 0, suggesting recrudescence or relapse. Similar studies in 70 patients in the same area in 2007 showed no recurrent parasitemias within 28 days. The sensitivity to chloroquine of P. vivax in northeastern Myanmar may be deteriorating.

Microwave photonic synthetic aperture radar (MWP-SAR) offers a larger signal bandwidth than conventional SAR, and its theoretical resolution can be improved to centimeter level. To achieve same order of magnitude resolution in the azimuth direction, long synthetic aperture is always required, which results in extremely high requirements for the accuracy of imaging procedure. Compared with the conventional SAR imaging algorithms, two major problems should be considered: 1) the scattering characteristics of target might vary from the frequency of signal and the angle of incidence, which seriously affects the coherence of received echo and 2) the imaging of the MWP-SAR system is more sensitive to motion errors and therefore requires higher accuracy of motion compensation processing. To solve the above issues, a high-precision imaging method for MWP-SAR is proposed. First, based on the attribute scattering center (ASC) model, this article analyzes the target scattering characteristics with different frequencies and incident angles. Then, according to the influence of scattering phase on MWP-SAR imaging, an optimal subaperture division algorithm is proposed to guarantee the coherence of each subaperture data and better imaging results. Furthermore, to compensate for the effects of high-order motion errors, this article proposes a motion error estimation algorithm based on subimage registration, where the full-aperture high-order motion errors can be divided into multiple linear components, and the flight trajectory of platform can be accurately reconstructed. Finally, a full-aperture time-domain high-precision imaging method is presented, and the effectiveness of the proposed formation is verified by both simulation and actual airborne MWP-SAR data processing. [ABSTRACT FROM AUTHOR]

Bistatic synthetic aperture radar (BiSAR) has received more and more attention because of its forward-looking imaging capability and configuration flexibility. For BiSAR moving target imaging (MTIm), its noncooperative motion leads to unknown range cell migration (RCM) and additional phase modulation. Consequently, MTIm in BiSAR faces two main challenges: 1) the unknown RCM correction and Doppler parameter estimation are tightly coupled and 2) the Doppler parameters of the extended moving target’s different scattering points are different, i.e., the Doppler parameters are spatially variant. To cope with these problems, an optimal polar format refocusing method for bistatic SAR MTIm is proposed. First, the main part of tight coupling and spatial variation effects caused by the BiSAR platforms is eliminated, while the moving target is 2-D defocused and shifted. Then, we analyze the characteristics of 2-D defocused and shifted of the moving target in BiSAR and give the analytical expressions. Basis this, a new bistatic polar format transformation is introduced, in which the degree of freedom of defocusing result is reduced from 2-D to only 1-D. After that, the parameter estimation and refocusing issues are transformed into a constrained optimization problem (COP), and differential evolution (DE) is applied to solve the COP and obtain the refocusing results. Finally, considering the spatial variation of the extended moving target, compensation processing is performed to relocate each scattering point. Numerical simulations verify the effectiveness of the proposed method. [ABSTRACT FROM AUTHOR]

Heart rate variability (HRV) falls in humans with sepsis, but the mechanism is not well understood. We utilized a mouse model of endotoxemia to test the hypothesis that cytokines play a role in abnormal HRV during sepsis. Adult male C57BL/6 mice underwent surgical implantation of probes to continuously monitor electrocardiogram and temperature or blood pressure via radiotelemetry. Administration of high-dose LPS (Escherichia coli LPS, 10 mg/kg, n = 10) caused a biphasic response characterized by an early decrease in temperature and heart rate at 1 h in some mice, followed by a prolonged period of depressed HRV in all mice. Further studies showed that LPS doses as low as 0.01 mg/kg evoked a significant decrease in HRV. With high-dose LPS, the initial drops in temperature and HR were temporally correlated with peak expression of TNF[alpha] 1 h post-LPS, whereas maximal depression in HRV coincided with peak levels of multiple other cytokines 3-9 h post-LPS. Neither hypotension nor hypothermia explained the HRV response. Pretreatment with dexamethasone prior to LPS significantly blunted expression of 7 of the 10 cytokines studied and shortened the duration of depressed HRV by about half. Interestingly, dexamethasone treatment alone caused a dramatic increase in both low- and highfrequency HRV. Administration of recombinant TNF[alpha] caused a biphasic response in HR and HRV similar to that caused by LPS. Understanding the role of cytokines in abnormal HRV during sepsis could lead to improved strategies for detecting life-threatening nosocomial infections in intensive care unit patients. sepsis; lipopolysaccharide; dexamethasone; tumor necrosis factor alpha doi: 10.1152/ajpregu.00132.2009

Objective. To explore the effect of acupoint application of Chinese medicine on children's height and bone age. Methods. Altogether, 120 children with a short stature treated in our hospital from September 2017 to September 2018 were divided into the control group (CG, n = 60) and the observation group (OG, n = 60) according to the random number table method. The children in CG were given healthy diet and exercise plans and supplemented with daily vitamin intake. The OG was treated with acupoint application of Chinese medicine on the basis of the CG. The clinical efficacy of the CG and the OG of children after treatment was observed. The height increment, growth rate, and bone age of children were compared before and after treatment. The levels of IGF-1 and 25-(OH)D in the serum of children before and after treatment were tested. According to the clinical curative effect after treatment, the children were divided into good curative effect group (markedly effective + effective) and poor curative effect group (ineffective). Logistics regression analysis was applied to analyze the risk factors. Results. Compared with the CG, the curative effect on the OG was evidently improved (P < 0.05). In addition, the height increment, the growth speed, and the bone age of the OG increased evidently (P < 0.05). Compared with the CG, the expression of IGF-1 and 25-(OH)D of the OG elevated (P < 0.05). Serum IGF-1 and 25-(OH)D concentrations were positively correlated with growth rate and bone age (P < 0.05). Risk factors analysis showed that disease course, IGF-1, 25-(OH)D expression, and heredity were the risk factors affecting the curative effect on children. Conclusion. Acupoint application of Chinese medicine has effect on the height and bone age of children with short stature, which is worthy of clinical promotion. In addition, early treatment should be carried out to improve the clinical efficacy of children. [ABSTRACT FROM AUTHOR]

Aims: High‐expressed miR‐330‐3p in gestational diabetes mellitus (GDM) patients was reported. However, the role and mechanism of miR‐330‐3p in GDM are rarely reported. In this research, we aim to investigate the effects of miR‐330‐3p on GDM. Methods: MiR‐330‐3p expression in the GDM patients' blood was determined by q‐PCR. Blood glucose of blood samples was detected using blood glucose detection kits. Glucokinase (GCK) was confirmed to be a target gene of miR‐330‐3p by bioinformatics and luciferase analysis. Correlations between miR‐330‐3p with GCK and blood glucose were analyzed by Pearson correlation analysis. After INS‐1 cells were treated with glucose and transfected with mimic, inhibitor or siGCK, GCK expression was detected by western blot, and q‐PCR, enzyme‐linked immunosorbent assays, cell counting kit‐8 and Annexin‐V/propidium iodide were conducted to examine the expression of insulin, cell viability and apoptosis. Results: MiR‐330‐3p was high‐expressed in GDM patients' blood, while GCK was low‐expressed. The miR‐330‐3p expression level positively correlated with blood glucoseand and it was highly expressed in glucose‐treated INS‐1 cells (11 and 22 mmol/L), while miR‐330‐3p expression negatively correlated with GCK expression. GCK expression was inhibited by miR‐330‐3p mimic and enhanced by the miR‐330‐3p inhibitor. MiR‐330‐3p mimic inhibited INS‐1 cells' insulin expression, cell viability and induced apoptosis. Yet miR‐330‐3p inhibitor and siGCK exhibited opposite effects which miR‐330‐3p mimic and GCK played on INS‐1 cells. In addition, siGCK reversed the effect of miR‐330‐3p inhibitor on INS‐1 cells. Conclusion: Our findings proved that miR‐330‐3p targeting GCK lead to the dysfunction of INS‐1 cells in GDM, and could become a therapeutic target for GDM treatment. [ABSTRACT FROM AUTHOR]

A hydroponic experiment was carried out utilizing four barley genotypes with differing salt tolerances to investigate the influence of salinity (NaCl) and cadmium (Cd) on the activities of antioxidant enzymes, sodium (Na) and Cd concentrations, and accumulation in plants. The activities of the two antioxidant enzymes, superoxide dismutase (SOD) and peroxidase (POD), were significantly increased when plants were exposed to both Na and Cd stresses for all genotypes, relative to the control. The increased enzymatic activity was more predominant with a prolonged time of stress exposure. The combined stress (NaCl+Cd) led to a further increase in POD activity, but had little effect on SOD activity. Two salt-tolerant genotypes, ‘Gebeina’ and ‘Zhou 1,’ showed a more rapid increase of POD and SOD activities than the two salt-sensitive genotypes, ‘Newgoutei’ and ‘Quzhou’ in response to the combined stress treatment. Additions of NaCl to the Cd-containing medium caused a significant reduction in both Cd concentration and accumulation. The extent of the reduction in Cd concentration was also dependent on genotypes. The salt-tolerant genotypes had lower Na concentrations than sensitive genotypes, and the effect of Cd stress on Na concentration and accumulation varied with genotypes. It may be concluded that a significant interaction exists between Na and Cd in their influence on antioxidant enzyme activity and the accumulation of each element in the plant. [ABSTRACT FROM AUTHOR]

Background: With the advent of artificial intelligence (AI) in healthcare, digital platforms like ChatGPT offer innovative alternatives to traditional medical consultations. This study seeks to understand the comparative outcomes of AI-assisted ChatGPT consultations and conventional face-to-face interactions among infertility patients., Methods: A cross-sectional study was conducted involving 120 infertility patients, split evenly between those consulting via ChatGPT and traditional face-to-face methods. The primary outcomes assessed were patient satisfaction, understanding, and consultation duration. Secondary outcomes included demographic information, clinical history, and subsequent actions post-consultation., Results: While both consultation methods had a median age of 34 years, patients using ChatGPT reported significantly higher satisfaction levels (median 4 out of 5) compared to face-to-face consultations (median 3 out of 5; p < 0.001). The ChatGPT group also experienced shorter consultation durations, with a median difference of 12.5 minutes (p < 0.001). However, understanding, demographic distributions, and subsequent actions post-consultation were comparable between the two groups., Conclusions: AI-assisted ChatGPT consultations offer a promising alternative to traditional face-to-face consultations in assisted reproductive medicine. While patient satisfaction was higher and consultation durations were shorter with ChatGPT, further studies are required to understand the long-term implications and clinical outcomes associated with AI-driven medical consultations. Key Messages What is already known on this topic:  Artificial intelligence (AI) applications, such as ChatGPT, have shown potential in various healthcare settings, including primary care and mental health support. Infertility is a significant global health issue that requires extensive consultations, often facing challenges such as long waiting times and varied patient satisfaction. Previous studies suggest that AI can offer personalized care and immediate feedback, but its efficacy compared with traditional consultations in reproductive medicine was not well-studied. What this study adds:  This study demonstrates that AI-assisted ChatGPT consultations result in significantly higher patient satisfaction and shorter consultation durations compared with traditional face-to-face consultations among infertility patients. Both consultation methods were comparable in terms of patient understanding, demographic distributions, and subsequent actions postconsultation. How this study might affect research, practice, or policy:  The findings suggest that AI-driven consultations could serve as an effective and efficient alternative to traditional methods, potentially reducing consultation times and improving patient satisfaction in reproductive medicine. Further research could explore the long-term impacts and broader applications of AI in clinical settings, influencing future healthcare practices and policies toward integrating AI technologies., (© The Author(s) 2024. Published by Oxford University Press on behalf of Fellowship of Postgraduate Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Artemisinin-based combination therapies (ACTs) are currently used as the first-line therapy for uncomplicated Plasmodium falciparum malaria. However, the recent emergence and/or spread of artemisinin resistance in parts of Greater Mekong Subregion (GMS) of southeast Asia requires close monitoring of the therapeutic efficacy of ACTs. This study was conducted from March 2012 to December 2013 in four clinics and seven villages along the China-Myanmar border. A total of 109 patients with uncomplicated falciparum malaria were treated with dihydroartemisinin-piperaquine (DP) and followed up on days 1, 2, 3, 7, 14, 21, 28, and 42 after treatment. A total of 71 patients (22 children and 49 adults) completed the 42-day follow-up. DP remained highly efficacious for treatment of uncomplicated falciparum malaria with an overall 42-day cure rate of 100%. The day 3 parasite-positive rate was 7.04% (5/71). Within 14 days of treatment, a total of 13 (18.31%) patients had detectable gametocytes and a large proportion of these were persistent from the first three days of treatment. The presence of gametocytes in patients through 14 days after DP treatment suggests that the incorporation of a single dose of primaquine for clearing gametocytemia should be considered for blocking parasite transmission., (© The American Society of Tropical Medicine and Hygiene.)

Low-dose metronomic (LDM) chemotherapy represents a new strategy to treat solid tumors by stronger antiangiogenic activity and less side-effects, especially in combination with other antiangiogenic agents. The aim of the study is to investigate the antiangiogenic effect of docetaxel alone and combined with (-)-epigallocatechin-3-gallate (EGCG) in preclinical settings of gastric cancer. BGC-823 human gastric cancer xenograft model was used, and tumor growth, side-effects of mice were closely monitored. Expression of vascular endothelial growth factor and CD31 were observed by immunohistochemistry, and microvessel density of the tumor tissues was assessed by CD31 immunohistochemical analysis. Our results indicated that LDM docetaxel inhibited angiogenesis and growth of gastric cancer with less toxicity, and the effects were further enhanced by the concurrent administration of EGCG. Our study, for the first time, rationally demonstrated that LDM docetaxel treatment used alone or combined with EGCG is effective and safe in preclinical settings of gastric cancer. Our data suggest that LDM docetaxel used alone or combined with EGCG may be an innovative and promising therapeutic strategy in the experimental treatment of human gastric cancer.

Low-dose metronomic chemotherapy represents a new strategy to treat solid tumors by exhibiting stronger anti-angiogenic activity and less side effects, especially in combination with other anti-angiogenic agents. Capecitabine is a novel fluoropyrimidine carbamate, which has a broader spectrum of antitumor activity than other fluoropyrimidines, such as 5-FU, DFUR or UFT; it has proved effective over a wide dose range. The aim of this study was to investigate the anti-angiogenic effect of capecitabine alone and combined with the angiogenic inhibitor (-)-epigallocatechin-3-gallate (EGCG) on gastric cancer. A BGC-823 human gastric cancer xenograft model was used, and tumor growth, side effects and the number of days of survival of mice were closely monitored and recorded. Quantitative real-time PCR was used to determine vascular endothelial growth factor (VEGF) mRNA levels. The expression of VEGF and CD31 was determined by immunohistochemistry. Our results indicated that metronomic capecitabine inhibited angiogenesis, growth of gastric cancer and improved survival with less toxicity, and the effects were further enhanced by the concurrent administration of EGCG. Clinical trials and further pre-clinical studies, will hopefully provide answers to the use of continuous low-dose anti-angiogenic therapies for the treatment of human gastric cancer.

Objectives: To test the hypothesis that nearest-neighbor analysis adds to logistic regression in the early diagnosis of late-onset neonatal sepsis., Design: The authors tested methods to make the early diagnosis of neonatal sepsis using continuous physiological monitoring of heart rate characteristics and intermittent measurements of laboratory values. First, the hypothesis that nearest-neighbor analysis makes reasonable predictions about neonatal sepsis with performance comparable to an existing logistic regression model was tested. The most parsimonious model was systematically developed by excluding the least efficacious clinical data. Second, the authors tested the hypothesis that a combined nearest-neighbor and logistic regression model gives an outcome prediction that is more plausible than either model alone. Training and test data sets of heart rate characteristics and laboratory test results over a 4-y period were used to create and test predictive models., Measurements: Nearest-neighbor, regression, and combination models were evaluated for discrimination using receiver-operating characteristic areas and for fit using the Wald statistic., Results: Both nearest-neighbor and regression models using heart rate characteristics and available laboratory test results were significantly associated with imminent sepsis, and each kind of model added independent information to the other. The best predictive strategy employed both kinds of models., Conclusion: The authors propose nearest-neighbor analysis in addition to regression in the early diagnosis of subacute, potentially catastrophic illnesses such as neonatal sepsis, and they recommend it as an approach to the general problem of predicting a clinical event from a multivariable data set.