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Mass vaccination has proven useful in the control of COVID-19, though vaccine rollout has met major challenges. The learning curve of this process has been valuable. This qualitative study aimed to assess the plan, the process and the progress of the COVID-19 vaccination rollout in Lagos, Nigeria. This study was conducted at vaccination centers in eight of the 20 Local Government Areas in Lagos State from May to July 2021 among healthcare administrators, health workers and vaccine recipients. Data were collected by conducting three key informant interviews, 24 in-depth interviews and eight focus group discussions to explore the vaccination experiences of participants and the challenges facing the vaccination plan and process. The interviews and discussions were recorded, transcribed verbatim and analyzed using the thematic approach. The four-phased plan for the vaccine rollout was clear to all the key informants because the vaccination process was preceded by training. The process was strengthened by the electronic registration system, though riddled by the frequently unstable electronic and internet data capturing. This was mitigated by a stopgap manual registration and recording of client details. Challenges in the logistics of maintaining supplies of the disposable materials required for the vaccination process were overcome by the creativity of the health professionals. Vaccine hesitancy, fueled by misinformation, myths and misconceptions about the vaccine and its side effects, played a huge role in the community response. The reported vaccine side effects were mild; fever, headaches, pain at the injection site, excessive eating and sleepiness. Though the COVID-19 vaccination process appeared to have largely made progress, the future of vaccination in Nigeria is predicated upon a bottom-up approach to programmatic planning, health education and local vaccine production. Collaborations such as public-private partnerships have the potential of boosting vaccine provision for Nigeria’s large population to ensure equitable access to vaccines.

Background: Waterpipe smoking (WPS) has been reported to have a wide range of damaging health effects on pulmonary and cardiovascular systems. Studies suggest that waterpipe tobacco smoking is associated with reduced harm perceptions, mental health problems and the use of psychoactive substances. We investigate the patterns of use and the association of WPS with anxiety, poly-tobacco and alcohol use in Lagos, Nigeria. Materials and Methods: A cross-sectional study design was used to assess the data from 818 adolescents and adults in Lagos State, Nigeria. An online questionnaire obtained demographic information, waterpipe, e-cigarette, alcohol and other tobacco product use from respondents. Anxiety was assessed using the validated Generalised Anxiety Disorder 7-point scale. Bivariate and multivariate logistic regression analysis was used to identify the factors associated with waterpipe ever-use. P < 0.05 was considered statistically significant. Results: The mean (standard deviation) age of respondents was 23.43 (±3.96), over half were female (55.2%) and a majority had a college diploma or more (88.59%). Among study participants, 18.58% reported waterpipe ever-use. Among ever waterpipe users, 17.33% reported current use (past 30-days), with a majority having smoked waterpipe in a bar or pub. Alcohol use (P < 0.001), e-cigarette ever-use (P: 0.010) and poly-tobacco ever-use (P: 0.030) were significantly associated with higher odds of waterpipe use in the multivariate regression model. Further, there was a lower likelihood of waterpipe ever-use in the bivariate regression model among respondents with mild and moderate to severe anxiety levels than those with normal anxiety levels (P: 0.030); however, this association was no longer significant in the adjusted model. Conclusions: Our findings suggest a relatively high prevalence of WPS in Lagos, Nigeria. Concurrent alcohol consumption, e-cigarette and poly-tobacco use are associated with WPS, and most waterpipe smokers have normal anxiety levels. The Nigerian Government should consider surveillance measures for WPS and a more comprehensive smoke-free policy.

Background: Volunteering within the health-care sector is crucial during pandemics. This study aimed to assess the attitudes and perceptions of clinical medical and dental students in Lagos, Nigeria, about volunteering during the coronavirus disease 2019 (COVID-19) pandemic. Materials and Methods: A descriptive cross-sectional study was conducted amongst medical and dental students undergoing clinical postings at the two public universities in Lagos, Nigeria, using total population sampling. Data were collected using a web-based questionnaire and analysed using Statistical Package for the Social Sciences. Chi-square test and logistic regression analysis were used to test for association at the level of significance of 5%. Results: The mean age of the respondents was 23.3 years ± 2.6 standard deviation and 62.5% were females. The majority (82.9%) of the respondents agreed to volunteer if provided with adequate personal protective equipment (PPE) and if adequately trained to do so (79.3%). Although perceived as dangerous, the majority (91.2%) of the respondents considered volunteering during the COVID-19 pandemic as a form of educational experience. Compared to the final-year students, penultimate year students were more likely to volunteer in the event of a health manpower shortage. The final-year students were more likely to volunteer if government made the request. Female students were more likely than male students to volunteer even if they were not compensated but would require parental approval. Conclusion: Medical and dental students perceived their involvement during the COVID-19 pandemic as a form of educational experience but would require adequate training and PPE. There is a need to train and provide adequate PPE for them to function as volunteers.

PURPOSE: This study aims to investigate whether there is a significant difference between typical and atypical parenchymal patterns in the development of fibrosis, which is the most crucial factor affecting morbidity in pulmonary sarcoidosis. METHODS: In our hospital, 145 cases with Siltzbach Types 2 and 3 sarcoidoses diagnosed by clinical, radiological, and histopathologic were retrospectively investigated. Perilymphatic nodules, accompanying mosaic attenuation, and interlobular septal thickening and central peribronchovascular bunch-like thickening on high-resolution computed tomography were assessed as typical. Solid nodules, galaxy finding, consolidation, ground-glass opacity, isolated mosaic attenuation, and interlobular septal thickening, and pleural fluid were accepted as atypical findings. Findings indicating fibrosis were fine and rough reticular opacity, traction bronchiectasis, volume loss, and cystic changes. For the analysis of variables, SPSS 25.0 program was used. RESULTS: Ten (16%) of the 61 cases with typical findings and 16 (19%) of the 84 with atypical findings developed fibrosis (P = 0.827). The mean age of cases with fibrosis was higher. With the cut-off of 50 years, sensitivity was 61.5%, and specificity was 68.9%. The highest fibrosis rate was in cases with ground glass pattern (n = 7/17), whereas higher reversibility rates were in those with miliary pattern (n = 9/12) and galaxy sign (n = 5/6). CONCLUSION: The incidence of fibrosis is higher in the atypical group with no significant difference. The incidence of fibrosis differs in each atypical pattern, being highest in ground-glass opacity and lowest in the miliary pattern.

More than 1400 microbes are known to cause disease in man and are therefore classified as pathogenic microbes. Only 12% of microbes on earth are responsible for the emerging and re-emerging diseases. All infectious agents have adapted routes for exiting from their reservoirs of infection because that is the only way there can be a perpetuation of their species. Factors aiding the seeming resilience of microbes include microbial evolution and adaptation, human susceptibility, climate and weather, changing ecosystem, human demography and behaviour amongst others. Therefore, man must recognize that the war against microbes is likely going to be there permanently. If we are careless however, the microbes may make life uncomfortable for man and change how we live drastically. A strengthened health intelligence system will support an early warning system that gives clear pictures of what is on the ground and what is evolving. This will also monitor the environment including the water supply system, the sewage, the soil, and the air for evidence of microbes that may be pathogenic to man. We must also mount a robust anthropological surveillance to monitor human behavior as it may affect disease transmission and must search for and deploy effective antimicrobial agents. Overall, we must develop the human capacity that will efficiently deliver our selected strategies to detect, prevent, and mitigate the impact of microbes on human health.

The concept of inequalities in time scales has attracted the attention of mathematicians for a quarter century. And these studies have inspired the solution of many problems in the branches of physics, biology, mechanics and economics etc. In this article, new principles of non-linear integral inequalities are presented in time scales via diamond-α dynamic integral and the nabla integral.

The aim of this study is to investigate the therapeutic effects of Chloroquine (CLQ) against Adriamycin (ADR) induced hepatotoxicity. ADR is a chemotherapeutic agent used in the treatment of many cancer types, but it causes hepatotoxicity. CLQ is used as an anti-inflammatory drug in the treatment of malaria, rheumatoid arthritis, and pneumonia caused by Covid-19. Rats were divided into four groups: Control group, ADR group (2 mg/kg Adriamycin, one in three days for 30 days, i.p.), CLQ group (50 mg/kg Chloroquine, per day for 30 days, i.p.), ADR+CLQ (2 mg/kg Adriamycin, one in three days for 30 days, i.p. and 50 mg/ kg Chloroquine, per day for 30 days, i.p.). Animals were sacrificed, and liver tissues were extracted for further examinations. Histopathological changes in liver tissues were scored and IL-17 immunostaining was performed to determine the expression levels among experimental groups. Bodyweights in the ADR group decreased significantly compared to the Control group and CLQ group. Furthermore, bodyweight in ADR+CLQ group was significantly higher compared to ADR group. The histopathological score was significantly higher in ADR group when compared to Control and CLQ group while CLQ administrations reduced the damage induced by ADR in the ADR+CLQ group. IL-17 immunoreactivity was considerably increased in the ADR group. On the other hand, IL-17 expressions of ADR+CLQ were substantially less compared to ADR group. We suggest that CLQ can be used as a therapeutic agent to reduce the detrimental effects of ADR, thanks to its anti-inflammatory properties.

INTRODUCTION[|]This study is an analysis of the subfoveal choroidal thickness (SFCT) and ganglion cell complex (GCC) in children who have type 1 diabetes mellitus (T1D) without diabetic retinopathy.[¤]METHODS[|]In all, 36 right eyes of 36 patients with T1D and 36 right eyes of sex- and age-matched healthy subjects were included in this prospective study. SFCT and GCC measurements were obtained using spectral domain optical coherence tomography (SD-OCT). Correlations between SCFT, GCC and duration of T1D, glycated hemoglobin, and age were also investigated.[¤]RESULTS[|]The mean SFCT was 342.1+-42.3 µm in the T1D group and 354+-70.8 µm in the control group (p>0.05). There was no significant difference between the groups in the GCC superior and inferior retina values. The average GCC was thinner in the T1D group (T1D group: 88.11+-14.93 µm, control group: 103.39+-15.65 µm; p=0.005). The mean central retinal thickness (CRT) was decreased in the T1D group (T1D group: 248.1+-16.5 µm, control group: 262.1+-18.3 µm; p=0.021).[¤]DISCUSSION AND CONCLUSION[|]The mean SFCT was not significantly different in diabetic children compared with healthy eyes. The CRT and average GCC thickness were lower in children with T1D. SD-OCT can reveal neurodegenerative changes that may occur before vascular changes in diabetic children.[¤]

Abstract Background Endometriosis is an estrogen-dependent inflammatory disease that often causes infertility and chronic pelvic pain. Although endometriosis is known as a benign disease, it has demonstrated characteristics of malignant neoplasms, including neoangiogenesis, tissue invasion, and cell implantation to distant organs. Octamer-binding protein 4 (Oct-4) is a molecular marker for stem cells that plays an essential role in maintaining pluripotency and self–renewal processes in various types of benign and malignant tissues. CD44 is a multifunctional cell surface adhesion molecule that acts as an integral cell membrane protein and plays a role in cell–cell and cell–matrix interactions. E-cadherin is an epithelial cell–cell adhesion molecule that plays important role in the modulation of cell polarization, cell migration, and cancer metastasis. The aim of this study was to investigate the expression patterns of Oct-4, CD44, and E-cadherin in eutopic and ectopic endometrial tissues from women with endometrioma compared to control endometrial tissues from women without endometrioma. Methods In the present study, Oct-4, CD44, and E-cadherin expressions were evaluated in eutopic and ectopic endometrial tissue samples from women with endometrioma (n = 32) and compared with those of control endometrial tissue samples from women without endometrioma (n = 30). Results Immunohistochemical expression of Oct-4 was significantly higher in the ectopic endometrial tissue samples of women with endometrioma than in the control endometrial tissue samples (p = 0.0002). Conversely, CD44 and E-cadherin expressions were significantly lower in the ectopic endometrial tissue samples of women with endometrioma than in the control endometrial tissue samples (p = 0.0137 and p = 0.0060, respectively). Correlation analysis demonstrated significant correlations between Oct-4 expression and endometrioma cyst diameter (p = 0.0162), rASRM stage (p = 0.0343), and total rASRM score (p = 0.0223). Moreover, CD44 expression was negatively correlated with the presence of peritoneal endometriotic lesions (p = 0.0304) while E-cadherin expression was negatively correlated with the presence of deep infiltrating endometriosis (p = 0.0445). Conclusions Increased expression of Oct-4 and decreased expression of adhesion molecules in endometriotic tissues may contribute to the development and progression of endometriosis.

Software development projects require a critical and costly testing phase to investigate efficiency of the resultant product. As the size and complexity of project increases, manual prediction of software defects becomes a time consuming and costly task. An alternative to manual defect prediction is the use of automated predictors to focus on faulty modules and let the software engineer to examine the defective part with more detail. In this aspect, improved fault predictors will always find a software quality application project to be applied on. There are many base predictors tested-designed for this purpose. However, base predictors might be combined with an ensemble strategy to further improve to increase their performance, particularly fault-detection abilities. The aim of this study is to demonstrate fault-prediction performance of ten ensemble predictors compared to baseline predictors empirically. In our experiments, we used 15 software projects from PROMISE repository and we evaluated the fault-detection performance of algorithms in terms of F-measure (FM) and Area under the Receiver Operating Characteristics (ROC) Curve (AUC). The results of experiments demonstrated that ensemble predictors might improve fault detection performance to some extent.

Sporadic Creutzfeldt-Jakob disease (sCJD) is a rapidly progressive dementia. No clinical blood tests are available for diagnosis. The authors identified three miRNAs in whole-blood that are downregulated in sCJD patients, and discriminate sCJD from Alzheimer’s disease patients and healthy controls.

Abstract Background Adenocarcinoma of the pancreatic body and tail is associated with a dismal prognosis. As patients frequently present themselves with locally advanced tumors, extended surgery including multivisceral resection is often necessary in order to achieve tumor-free resection margins. The aim of this study was to identify prognostic factors for postoperative morbidity and mortality and to evaluate the influence of multivisceral resections on patient outcome. Methods This is a retrospective analysis of 94 patients undergoing resection of adenocarcinoma located in the pancreatic body and/or tail between April 1995 and December 2016 at our institution. Uni- and multivariable Cox regression analysis was conducted to identify independent prognostic factors for postoperative survival. Results Multivisceral resections, including partial resections of the liver, the large and small intestines, the stomach, the left kidney and adrenal gland, and major vessels, were carried out in 47 patients (50.0%). The median postoperative follow-up time was 12.90 (0.16–220.92) months. Median Kaplan-Meier survival after resection was 12.78 months with 1-, 3-, and 5-year survival rates of 53.2%, 15.8%, and 9.0%. Multivariable Cox regression identified coeliac trunk resection (p = 0.027), portal vein resection (p = 0.010), intraoperative blood transfusions (p = 0.005), and lymph node ratio in percentage (p = 0.001) as independent risk factors for survival. Although postoperative complications requiring surgical revision were observed more frequently after multivisceral resections (14.9 versus 2.1%; p = 0.029), postoperative survival was not significantly inferior when compared to patients undergoing standard distal or subtotal pancreatectomy (12.35 versus 13.87 months; p = 0.377). Conclusions Our data indicates that multivisceral resection in cases of locally advanced pancreatic carcinoma of the body and/or tail is justified, as it is not associated with increased mortality and can even facilitate long-term survival, albeit with an increase in postoperative morbidity. Simultaneous resections of major vessels, however, should be considered carefully, as they are associated with inferior survival.

Abstract Backround HPV causes specific cell-mediated immunity in the cervix. Mononuclear cells such as helper T cells (CD4+), cytotoxic T cells (CD8+), and dendritic cells play a critical role in the initiation of the HPV-specific immune response and destruction of virus-infected cervical epithelial cells. The programmed cell death ligand 1 (PD-L1) gene encodes an immune inhibitory receptor ligand and overexpression of PD-L1 inhibits T-cell activation and cytokine production. The aim of this study was to investigate the expression of PD-L1 in cervical tissue and its correlation with clinicopathological findings. Methods In this cross-sectional study, a total of 94 women who were referred for colposcopy due to abnormal Papanicolaou (PAP) test results and/or HPV positivity were evaluated. The presence of HR-HPV–DNA was analyzed using type- and gene-specific primers along with commercial real-time polymerase chain reaction. The cervical examination was done with a colposcope. Cervical biopsies were obtained from the areas that were evaluated as abnormal during the colposcopy. Histopathological result of cervical biopsies were defined as no intraepithelial neoplasia (CIN 0), mild CIN (CIN I), and moderate-to-high CIN (CIN II-III). All women were classified into four groups based on their HR-HPV positivity and cervical biopsy results: Group I (controls; n = 29), HR-HPV (−) CIN 0; Group II (n = 21), HR-HPV (+) CIN 0; Group III (n = 20), HR-HPV (+) CIN I; and Group IV (n = 24), HR-HPV (+) CIN II-III. A semi-quantitative scoring system was used to evaluate the degree of Ki-67, p16, and PD-L1 immunoreactivity in the cervical tissue samples. Results We found that PD-L1 expression in both mononuclear cells and in cervical epithelial cells gradually increases from the HR-HPV (−), CIN 0 group to the HR-HPV (+), CIN II-III group (p = 0.0003 and p = 0.0394, respectively) and mononuclear PD-L1 expression was correlated with HPV type, initial Pap test results, HPV persistence, and CIN persistence or recurrence (p = 0.0180, p = 0.0109, p = 0.0042, and p = 0.0189, respectively). Moreover, mononuclear PD-L1 expression was also correlated with Ki-67 and p16 immunoreactivity (p = 0.0432 and p = 0.0166, respectively). Epithelial PD-L1 expression was only correlated with HPV type and the presence of HPV persistence (p = 0.0122 and p = 0.0292, respectively). Conclusion During the initial evaluation of the cervical histology results, the assessment of PD-L1 expression—especially in mononuclear cells in cervical tissue samples—may provide more information on the progression of HR-HPV infection and its persistence.

Using questionnaires and serologic testing, we evaluated bat and lyssavirus exposure among persons in an area of Nigeria that celebrates a bat festival. Bats from festival caves underwent serologic testing for phylogroup II lyssaviruses (Lagos bat virus, Shimoni bat virus, Mokola virus). The enrolled households consisted of 2,112 persons, among whom 213 (10%) were reported to have ever had bat contact (having touched a bat, having been bitten by a bat, or having been scratched by a bat) and 52 (2%) to have ever been bitten by a bat. Of 203 participants with bat contact, 3 (1%) had received rabies vaccination. No participant had neutralizing antibodies to phylogroup II lyssaviruses, but >50% of bats had neutralizing antibodies to these lyssaviruses. Even though we found no evidence of phylogroup II lyssavirus exposure among humans, persons interacting with bats in the area could benefit from practicing bat-related health precautions.

Introduction: Many studies have been done on proteomics, genomics, epigenetic, immunogenetics in many body fluids. Among these, circulating cell-free DNA (ccfDNA) entered the literature in 1948, but it has not been studied for many years due to technological deficiencies. Following recent advances, geno-metastasis has been mentioned and new research is needed in this area. ccfDNA is known to be an important biomolecule in this regard. Objective: The presence of cell-free DNA in the circulatory system may offer a tremendous opportunity to provide novel biomarkers for thyroid diseases. This experimental study was conducted to determine the amount of ccfDNA in different thyroid diseases, then to evaluate whether the ccfDNA concentration varied between the disease groups and control group. Methods: In total, we included 121 individuals in the present study. We collected blood samples and then determined the ccfDNA concentration in plasma of collected blood samples from three groups: thyroiditis (n = 33), benign (n = 37), and malignant (n = 30) and from a control group (n = 21). Results: The median values of the ccfDNA groups were found as 1610, 1665, 1685 and 576 ng/mL for the thyroiditis, benign, malign, and control groups, respectively. Findings showed that the ccfDNA of the three groups was significantly higher than the control (p

Continuous seed propagation in Turkey has given rise to a great number of seedling walnut trees which represents valuable walnut genetic resources. The number of native walnut trees is estimated to be over 5 million in Turkey and they possess large phenotypic variability in yield, nut and kernel characteristics, late bud breaking, late flowering, winter hardiness and tolerance to diseases. Progress in walnut breeding requires the exploitation of genetic variation among cultivars and landraces. In this study, we used 32 local diverse walnut genotypes obtained from seeds and 2 standard cultivars (‘Sebin’ and ‘Bilecik’). This study implemented 21 previously used simple sequence repeats (SSR) markers to determine genetic diversity. The analysis revealed 135 alleles with an average of 6.43 alleles per locus. Genetic similarity ranged from 0.23 (for samples KW22 and KW29) to 0.87 (for samples KW27 and KW28). The highest number of alleles per locus was obtained from WGA276 locus (11 alleles), followed by WGA054 (9 alleles), WGA202 and WGA321 (8 alleles) while the lowest number was detected in WGA027. According to the morphological and molecular data, the genotypes differed from each other and the cvs. Sebin and Bilecik. The majority of the genotypes had higher fruit weight and some of the genotypes had higher kernel ratio than cvs. Sebin and Bilecik implying the importance of registering genotypes as cultivars. This research provides information on the genetic relationship of walnut genotypes and cultivars and emphasises the importance of protection and utilisation of seed-propagated walnut genetic resources.

Tree, leaf, pod and seed morphology, as well as pod biochemistry of 36 wild-grown carob genotypes sampled from rural areas in Marmaris district located at western Turkey, were investigated. Leaf and pod dimensions, pod and seed weight, seed ratio, pod and seed colour and shape and surface traits were investigated. Soluble solid content (SSC), titratable acidity, vitamin C and protein and dietary fibre contents were also detected. Results showed significant differences for all quantitative traits, although differences are more pronounced for some pod (weight, width, length and thickness) and seed characteristics (weight, dimensions and ratio). Pod and seed colour, shape and surface qualitative threats were found to be quite variable among genotypes. The majority of genotypes had an open tree growth habit. Leaf length and width were found to be between 8.04 cm (M19) and 11.60 cm (M12) and 8.40 cm (M2) and 12.04 cm (M12) among genotypes. Pod weight ranged from 8.3 g (M35) to 29.5 g (M3) in the wild genotypes. The average pod dimensions (width, length and thickness) were between 14.27 and 23.38 mm, 12.54 and 21.67 cm and 4.80 and 8.37 mm, respectively. The SSC ranged from 49.36 to 69.36% in the pods of wild carob genotypes. The results of this study indicate a good genetic resource potential of Turkish wild carob populations for future breeding programmes.

Unbalanced bidding, also known as skewed bidding, is the process of increasing and/or decreasing the prices of various bid items without altering the total offered bid price. Bids can be unbalanced either mathematically (front-end loading) or materially (quantity error exploitation). Owners should be very careful when evaluating the tenders as awarding a contract to an unbalanced bid may result in severe cost overruns because the prices of those items do not reflect their true costs and markup allocations. Unbalanced bidding is still a contentious issue in the construction industry. While some researchers consider it as a legal bidding strategy in such a fierce competitive business environment, others view it as an unethical practice and claim that unbalanced bids should be disqualified. Studies regarding unbalanced bidding can be categorized into two groups: (1) the ones focusing on detecting or preventing this practice to help owners; and 2) the ones focusing on optimizing unbalanced bidding to help contractors. This study aims to develop a model, which consists of eight grading systems, to assist owners in detecting materially unbalanced bids. The proposed model is the improved version of the previous model, which was composed of five grading systems. In order to demonstrate how this grading-based model can be used by owners, an illustrative example is presented. It was found that owners can easily and successfully detect unbalanced bids via the proposed model.

BackgroundN6-methyladenosine (m6A) is one of the most abundant post-transcriptional modifications on mRNA influencing mRNA metabolism. There is emerging evidence for its implication in metabolic disease. No comprehensive analyses on gene expression of m6A regulators in human adipose tissue, especially in paired adipose tissue depots, and its correlation with clinical variables were reported so far. We hypothesized that inter-depot specific gene expression of m6A regulators may differentially correlate with clinical variables related to obesity and fat distribution.MethodsWe extracted intra-individually paired gene expression data (omental visceral adipose tissue (OVAT) N=48; subcutaneous adipose tissue (SAT) N=56) of m6A regulators from an existing microarray dataset. We also measured gene expression in another sample set of paired OVAT and SAT (N=46) using RT-qPCR. Finally, we extracted existing gene expression data from peripheral mononuclear blood cells (PBMCs) and single nucleotide polymorphisms (SNPs) in METTL3 and YTHDF3 from genome wide data from the Sorbs population (N=1049). The data were analysed for differential gene expression between OVAT and SAT; and for association with obesity and clinical variables. We further tested for association of SNP markers with gene expression and clinical traits.ResultsIn adipose tissue we observed that several m6A regulators (WTAP, VIRMA, YTHDC1 and ALKBH5) correlate with obesity and clinical variables. Moreover, we found adipose tissue depot specific gene expression for METTL3, WTAP, VIRMA, FTO and YTHDC1. In PBMCs, we identified ALKBH5 and YTHDF3 correlated with obesity. Genetic markers in METTL3 associate with BMI whilst SNPs in YTHDF3 are associated with its gene expression.ConclusionsOur data show that expression of m6A regulators correlates with obesity, is adipose tissue depot-specific and related to clinical traits. Genetic variation in m6A regulators adds an additional layer of variability to the functional consequences.

Introduction: Prior research has highlighted the psychosocial impact of infectious diseases on individuals and the community at large. However, little is known about the psychosocial implications of COVID-19. This study set out to determine the rate as well as correlates of anxiety and depressive symptoms among persons managed as in-patients for COVID-19 in Lagos, Nigeria. Materials and methods: We conducted an online survey between April to June ending 2020 using a consecutive sampling technique of persons positive for COVID-19 and who were managed as in-patients across five (5) treatment centres in Lagos, Nigeria. The survey collected information on demographic as well as clinical data including suicidality. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Results: There were one hundred and sixty participants in total. The mean age of respondents was 36.4 (±9.7) years with a higher proportion (56.9%) being males. With regards to diagnosis, 28.1% and 27.5% of the respondents were categorised as probable cases of depression and anxiety respectively, while 3.8% respondents reported suicidal ideation. Majority of the respondents (61.9%) reported the fear of infecting their loved ones. The variables that showed association with psychiatric morbidity were a past history of an emotional concern, employment status, guilt about infecting others and boredom. Conclusion: This study revealed a high burden of psychological/psychiatric morbidity among persons treated for COVID-19, particularly persons who have had prior emotional concerns. The findings from this study reiterate the need to pay attention to the mental health of people during disease outbreaks and to incorporate psychosocial interventions as part of the management package.

The teaching of ethics in teacher education programs is crucial for fostering the moral and ethical development of prospective teachers and shaping them into ethical role models for future students. This study, employing qualitative case study research, gathered data from undergraduates in teacher education programs to explore the best approaches for ethics education. It found that combining digital and case-based pedagogical methods, fostering an open-minded attitude among lecturers, and implementing a blend of Socratic and active learning techniques leads to the most favorable outcomes. Additionally, continuous formative assessment throughout the academic year is essential. To cultivate a teaching workforce with strong ethical and moral values, undergraduate courses in ethics and morality should be thought-provoking, integrating real-life cases with a mix of digital and tangible resources. The ethics course lecturer should not only serve as a role model and exhibit a caring disposition but also use effective teaching methodologies. The paper details key themes and categories for successful ethics instruction and offers specific recommendations.

INTRODUCTION[|]This study aims to compare the efficacy of intravitreal injection of aflibercept (IVA), ranibizumab (IVR) and dexamethasone implant (DEX IMP) for the treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO).[¤]METHODS[|]In this retrospective and comparative study, 57 eyes of 57 patients with ME after BRVO were studied. Patients were diveded into three groups according to treatment regimen as follows: 2 mg IVA (group 1, n=18), 0,5 mg IVR (group 2, n=20) and 0,7 mg Dex imp (group 3, n=19). Group 1 and group 2 were treated with three monthly anti-VEGF treatment followed by pro re nata (PRN) regimen, and group 3 was treated with 0,7 mg dexamethasone dose followed by another injection based on patients' data. Best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP) measurements were noted at baseline, 1, 2, 3 and 6 months.[¤]RESULTS[|]All groups were similar concerning age, gender, duration of symptoms, initial CMT and BCVA (p>0.05). Mean number of injections were 3,85+-0.74 in group 1, 3,85+-0,87 in group 2 and 1,75+-0,44 in group 3. All the groups decreased CMT and increased BCVA for six months. There was not a statistically significant difference between groups. Concerning side effects, one person in group 1 and 2, four people in group 3 increased IOP, but all of them controlled IOP with anti-glaucomatous drugs. One patient in group 1, two in group 2, four in group three patients had cataract progression.[¤]DISCUSSION AND CONCLUSION[|]All three drugs have similar results in patients with ME secondary to BRVO at a six-month follow-up. Compared to anti-VEGF drugs, dex imp has side effects as increased IOP and cataract progression, but it has higher BCVA at all months in the treatment of ME after BRVO.[¤]

Drying is widely used to prevent microbial spoilage by evaporating the determined amount of liquid in the food sample. In order to reduce energy consumption and increase food flavor quality, modeling the drying process is crucial. In the literature, different approaches are used for investigation of drying characteristic. Among these approaches, the porous media approach have complex phenomena. Molecular diffusion for gases (water vapor and air), capillary diffusion for liquid (water), and convection mechanisms (Darcy flow) were used in drying model in porous media. In this study, firstly, the effect of shrinkage on drying of porous media was investigated. Non-linear partial differential equations for air and food material in the drying problem were solved numerically for non-steady state condition. The shrinkage effect in the drying process was studied by using the ALE (Arbitrary Lagrangian Eulerian) method. In this study, air velocities of 0.5, 0.8 and 1 m s-1, air temperatures of 40, 50 and 60 °C and the geometric forms of rectangular, cylindrical and square were selected for hot air drying process. The fastest drying was obtained at square shape food at the air temperature of 60 °C and the air velocity of 0.5 m s-1. The analysis result showed that the air velocity and temperature have effect on the drying.

Abstract Background Teenage childbearing among adolescents aged 15 to 19 is a common sexual and reproductive health (SRH) issue among young people, particularly in developing countries. It is associated with higher maternal and neonatal complications. Almost half (47%) of the population in Ethiopia are young people under 15 years old. Therefore, a clear understanding of the trend and determinants of teenage childbearing is essential to design proper intervention programs. Methods Secondary analysis of the 2000 to 2016 Ethiopia Demographic and Health Survey (DHS) data were conducted. A total of 3710 (DHS 2000), 3266 (DHS 2005), 4009 (DHS 2011) and 3381 (DHS 2016) adolescents (aged 15 to 19 years old) were included from the four surveys. The main outcome variable of this study was teenage childbearing, and independent variables were categorized into individual- and community-level factors. The 2016 DHS was used to identify the factors associated with teenage childbearing. Multi-level logistic regression analysis technique was used to identify the factors associated with teenage childbearing. The analysis was adjusted for different individual- and community- level factors affecting teenage childbearing. Data analysis was conducted using STATA software. Results The prevalence of adolescents who started childbearing reduced from 16.3% in 2000 DHS to 12.5% in 2016 DHS, p-value =

Objectives: The aim of this study was to investigate associations between baseline characteristics and CD4 cell count response on first-line antiretroviral therapy and risk of virological failure (VF) with or without drug resistance. Methods: We conducted an analysis of UK Collaborative HIV Cohort data linked to the UK HIV Drug Resistance Database. Inclusion criteria were viral sequence showing no resistance prior to initiation of first-line efavirenz + tenofovir disoproxil fumarate + emtricitabine and virological suppression within 6 months. Outcomes of VF (≥200 copies/mL) with or without drug resistance were assessed using a competing risks approach fitted jointly with a model for CD4 cell count recovery. Hazard ratios for each VF outcome were estimated for baseline CD4 cell count and viral load and characteristics of CD4 cell count response using latent variables on a standard normal scale. Results: A total of 3640 people were included with 338 VF events; corresponding viral sequences were available in 134 with ≥1 resistance mutation in 36. VF with resistance was associated with lower baseline CD4 (0.30, 0.09–0.62), lower CD4 recovery (0.04, 0.00–0.17) and higher CD4 variability (4.40, 1.22–12.68). A different pattern of associations was observed for VF without resistance, but the strength of these results was less consistent across sensitivity analyses. Cumulative incidence of VF with resistance was estimated to be >2% at 3 years for baseline CD4 ≥350 cells/μL. Conclusion: Lower baseline CD4 cell count and suboptimal CD4 recovery are associated with VF with drug resistance. People with low CD4 cell count before ART or with suboptimal CD4 recovery on treatment should be a priority for regimens with high genetic barrier to resistance.

A considerable number of research has been carried out on the generalized Lebesgue spaces Lp(x) and boundedness of different integral operators therein. In this study, a new approach for weighted increasing near the origin and decreasing near infinity exponent function that provides a boundedness of the Hardy’s operator in variable exponent space is given.

Introduction and Objectives: The objectives of this study were to investigate the underlying mechanism of PPARα, LXRα, ChREBP, and SREBP-1c at the level of gene and protein expression with high-energy diets in liver and skeletal muscle. Materials and methods: Metabolic changes with consumption of high fat (Hfat), high sucrose (Hsuc) and high fructose (Hfru) diets were assessed. Levels of mRNA and protein of PPARα, LXRα, ChREBP, and SREBP-1c were investigated. Body weight changes, histological structure of liver and plasma levels of some parameters were also examined. Results: In Hfru group, body weights were higher than other groups (P

Abstract Background Post cholecystectomy syndrome is characterized as recurrence of symptoms as experienced before cholecystectomy. In rare cases, a remnant cystic duct is causing these symptoms and occasionally surgical resection is performed. During surgery, visualization of the biliary ducts could be difficult due to inflammation and dense adhesions. Case presentation In this article, we presented a 36-year old woman with post-cholecystectomy syndrome in which we evaluated the feasibility of near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) for visualization of the remnant cystic and common bile duct during robot-assisted surgery. Intraoperative visualization of the remnant biliary duct and other important structures was feasible, and resection of the remnant cystic duct was successfully performed under fluorescence guidance, without any complications. Conclusions NIR fluorescence imaging of the biliary ducts using ICG does not prolong the operating time, and could potentially decrease the operation time in difficult procedures, because of easy and fast detection of the biliary tract. Furthermore, it is a non-hazardous and non-invasive technique, as it does not require use of radiation and cannot cause bile duct injury. This case illustrated that ICG NIR fluorescence imaging during difficult robot-assisted surgical procedures of the bile ducts is effective and therefore highly recommended.

INTRODUCTION[|]To evaluate the potential effects of 1000-cSt silicone oil (SO), which is used for pars plana vitrectomy (PPV) surgery on subfoveal choroidal thickness.[¤]METHODS[|]In this retrospective study, 20 eyes of 20 patients who had undergone PPV and SO injection surgery for macula-off rhegmatogenous retinal detachment were included. Complete ophthalmologic examinations were performed before the surgery, one month, three months after PPV and two months after silicone oil removal. After one month following PPV and SO injection and two months following silicone oil removal, subfoveal choroidal thickness was evaluated using EDI (enhanced depth imaging) mode of spectral-domain optical coherence tomography.[¤]RESULTS[|]Subfoveal choroidal thickness measurements decreased statistically significantly at two months after silicone oil removal compared to the first month of PPV and SO injection. The mean subfoveal choroidal thickness was 284.2+-54.2 µm at one month after PPV and SO injection, while it was 258.8+-52.8 µm at two months after SO removal (p

Endüstride ve otomasyonda doğrusal hareket vazgeçilemez bir ihtiyaçtır. Söz konusu hareket dairesel çıktı üreten makinalara kayış, kasnak ve dişliler eklenerek temin edilmektedir. Ancak bu tür çözümler verim düşmesine ve maliyetlerin artmasına neden olmaktadır. Diğer taraftan lineer motorlar elektrik enerjisini doğrusal harekete direkt çeviren elektrik makinalarıdır. Lineer motorların endüstri ve otomasyon sistemlerinde fazla tercih edilmemesinin nedenleri ise düşük kuvvet/akım oranları ve uzunluk sınırlamalarıdır. Son yıllarda geliştirilen çift yanlı DC lineer motorda hem kuvvet/akım oranı artırılmış hem de uzunluk sınırlamasının önüne geçilmiştir. Bu çalışmada, çift yanlı DC lineer motorun öncelikle Ansys-Maxwell de detaylı nümerik analizleri yapılmıştır. Ayrıca ilgili motorun lineer olan tasarım topolojisi çember şekline dönüştürülerek, dairesel hareket üreten yeni bir elektrik motoru tasarlanmıştır. Geliştirilen ve çembersel motor olarak adlandırılan yeni motorun manyetik analizleri yapılmıştır. Elektrikli araçların tekerlekleri içerisine yerleştirilebilecek boyutta tasarlanan motorun moment/akım oranı analizleri yapılmıştır. Elde edilen sonuçlardan, tasarımı yapılan motorun teker içi kullanıma uygun olduğu, benzer amaçlı motorlara kıyasla tasarımı basit ve maliyeti düşük olduğu görülmüştür.

To conduct a retrospective evaluation of the efficacy and safety of intravitreal aflibercept treatment in diabetic macular edema. Patients treated with intravitreal aflibercept for diabetic macular edema participated in this study. Three injections were administered to the previously untreated 76 eyes of 50 patients for 3 consecutive months with one-month interval. The results were evaluated retrospectively by analyzing the patients medical records. The patients values of best corrected visual acuity inverted according to Snellen chart, and their central macular thickness and intraocular pressure were compared before and after treatment. The average age of the patients was 57.2 ± 10.1. Of the cases, 77.6% were phakic, and 22.4% were pseudophakic. The increases in best corrected visual acuity in the first month after each injection and at the end of the third month were statistically significant (p < 0.001). The mean central macular thickness was 405.63 ± 106.93 μm before treatment and 288.83 ± 62.49 μm after the third injection. This reduction in the mean central macular thickness was statistically significant (p < 0.05). During and after the three-month follow-up of the injection application process, the most common observed ocular side effect was subconjunctival hemorrhage (34.2%). During or after the applications, no systemic side effects, such as sudden death, thromboembolic events, or myocardial infarction, were seen. Functionally and anatomically, intravitreal aflibercept injection therapy in diabetic macular edema is an effective treatment option because it improves visual acuity and decreases central macular thickness. [Med-Science 2019; 8(2.000): 412-7]

Objective: The aim of this study was to compare additive diagnostic values of magnetic resonance (MR) arthrography with volumetric interpolated breath-hold examination (VIBE) sequence and multidetector computed tomography (MDCT) arthrography for diagnosis and grading of talar osteochondral lesions. Methods: MDCT arthrography and MR arthrography with three dimensional VIBE sequence were performed in 27 patients. Findings of MR arthrography and MDCT arthrography images were compared with arthroscopic findings. Sensitivity, specificity, and accuracy rates were calculated for both MR arthrography and MDCT arthrography imaging findings. Results: For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MR arthrography were 95%, 73%, 90%, respectively; For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography were 96%, 79%, 81%. For grade IV osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography and MR arthrography were 100%. For grade II lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 80%, 76%, 77%, respectively; for grade III lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 78%, 68%, 75%. For grade II osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 91%, 81%, 86%; for grade III osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 90%, 83%, 89%; For grade II and III osteochondral lesions, MDCT arthrography had higher sensitivity, specificity and accuracy rates than MR arthrography. MDCT arthrography had higher diagnostic performance than MR arthrography for detection of grade II and III lesions (p = 0.041 and p = 0.038, respectively). Conclusion: MDCT arthrography appears to be more reliable than MR arthrography with three dimensional VIBE sequence for accurate detection and grading of osteochondral lesions. Level of evidence: Level III, Diagnostic Study. Keywords: Osteochondral lesion, Computed tomography, Arthrography, Ankle, Magnetic resonance imaging

Thorsten Gietzen,1,2,* Ibrahim El-Battrawy,1,2,* Siegfried Lang,1,2 Xiao-Bo Zhou,1,2 Michael Behnes,1 Uzair Ansari,1 Martin Borggrefe,1,2 Ibrahim Akin1,2 1First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany; 2German Center for Cardiovascular Research (DZHK), Partner Site, Heidelberg-Mannheim, Mannheim, Germany *These authors contributed equally to this work Background: Recent studies have highlighted that Takotsubo syndrome (TTS), mimicking acute coronary syndrome (ACS), is associated with poor clinical outcome. TTS is associated with different repolarization disorders including ST-segment elevation. ST elevation myocardial infarction (STEMI) in ACS is associated with declined prognosis. However, the clinical and prognostic impact of ST-segment elevation on TTS remains lacking. Aim: The aim of this study was to determine the short- and long-term prognostic impact of ST-segment elevation on TTS patients as compared with STEMI patients. Patients and methods: Our institutional database constituted a consecutive cohort of 138 TTS patients and 138 ACS patients matched for age and sex. TTS patients (n=41) with ST-segment elevation were compared with ACS patients with ST-segment elevation (n=64). Results: Chest pain was significantly more documented in STEMI patients as compared with TTS patients (48.8% vs 78.1%; P

BackgroundData on the comorbidities that result in negative outcomes for people with COVID-19 are currently scarce for African populations. This study identifies comorbidities that predict death among a large sample of COVID-19 patients from Nigeria.MethodsThis was a retrospective analysis of medical records for 2184 laboratory confirmed cases of COVID-19 in Lagos, southwest Nigeria. Extracted data included age, sex, severity of condition at presentation and self-reported comorbidities. The outcomes of interest were death or discharge from facility.ResultsMost of the cases were male (65.8%) and the median age was 43 years (IQR: 33-55). Four hundred and ninety-two patients (22.5%) had at least one comorbidity and the most common amongst them were hypertension (74.2%) and diabetes (30.3%). The mortality rate was 3.3% and a significantly higher proportion of patients with comorbidities died compared to those with none. The comorbidities that predicted death were hypertension (OR: 2.21, 95%CI: 1.22-4.01), diabetes (OR: 3.69, 95% CI: 1.99-6.85), renal disease (OR: 12.53, 95%CI: 1.97-79.56), cancer (OR: 14.12, 95% CI: 2.03-98.19) and HIV (OR: 1.77-84.15].ConclusionComorbidities are prevalent and the associated risk of death is high among COVID-19 patients in Lagos, Nigeria. Public enlightenment, early identification and targeted care for COVID-19 cases with comorbidities are recommended as the pandemic evolves.