A review on value-addition to plastic waste towards achieving a circular economy

Plastic and mixed plastic waste (PW) has received increased worldwide attention owing to its huge rate of production, high persistency in the environment, and unsustainable waste management practices. Therefore, sustainable PW management and upcycling approaches are imperative to achieve the objectives of the United Nations Sustainable Development Goals. Numerous recent studies have shown the application and feasibility of various PW conversion techniques to produce materials with better economic value. Within this framework, the current review provides an in-depth analysis of cutting-edge thermochemical technologies such as pyrolysis, gasification, carbonization, and photocatalysis that can be used to value plastic and mixed PW in order to produce energy and industrial chemicals. Additionally, a thorough examination of the environmental impacts of contemporary PW upcycling techniques and their commercial feasibility through life cycle assessment (LCA) and techno-economical assessment are provided in this review. Finally, this review emphasizes the opportunities and challenges accompanying with existing PW upcycling techniques and deliver recommendations for future research works.

Sleep loss disrupts decision-making ability and neuronal cytomorphology in zebrafish and the effects are mediated by noradrenaline acting on α1-adrenoceptor

Sleep is an instinct behavior, and its significance and functions are still an enigma. It is expressed throughout one's life and its loss affects psycho-somatic and physiological processes. We had proposed that it might maintain a fundamental property of the neurons and the brain. In that context, it was shown that sleep, rapid eye movement sleep (REMS) in particular, by regulating noradrenaline (NA), maintains the brain excitability. It was also reported that sleep-loss affected memory, reaction time and decision-making ability among others. However, as there was lack of clarity on the cause-and-effect relationship as to how the sleep-loss could affect these basic behaviors, their association was questioned and it was difficult to propose a cure or at least ways and means to ameliorate the symptoms. Also, we wanted to conduct the studies in a simpler model system so that conducting future molecular studies might be easier. Hence, using zebrafish as a model we evaluated if sleep-loss affected the basic decision-making ability, a cognitive process and if the effect was induced by NA. Indeed, our findings confirmed that upon sleep-deprivation, the cognitive decision-making ability of the prey zebrafish was compromised to protect itself by running away from the reach of the exposed predator Tiger Oscar (TO) fish. Also, we observed that upon sleep-loss the axonal arborization of the prey zebrafish brain was reduced. Interestingly, the effects were prevented by prazosin (PRZ), an α1-adrenoceptor (AR) antagonist and when the zebrafish recovered from the lost sleep.

DermSynth3D: Synthesis of in-the-wild annotated dermatology images

In recent years, deep learning (DL) has shown great potential in the field of dermatological image analysis. However, existing datasets in this domain have significant limitations, including a small number of image samples, limited disease conditions, insufficient annotations, and non-standardized image acquisitions. To address these shortcomings, we propose a novel framework called DermSynth3D. DermSynth3D blends skin disease patterns onto 3D textured meshes of human subjects using a differentiable renderer and generates 2D images from various camera viewpoints under chosen lighting conditions in diverse background scenes. Our method adheres to top-down rules that constrain the blending and rendering process to create 2D images with skin conditions that mimic in-the-wild acquisitions, ensuring more meaningful results. The framework generates photo-realistic 2D dermatological images and the corresponding dense annotations for semantic segmentation of the skin, skin conditions, body parts, bounding boxes around lesions, depth maps, and other 3D scene parameters, such as camera position and lighting conditions. DermSynth3D allows for the creation of custom datasets for various dermatology tasks. We demonstrate the effectiveness of data generated using DermSynth3D by training DL models on synthetic data and evaluating them on various dermatology tasks using real 2D dermatological images. We make our code publicly available at https://github.com/sfu-mial/DermSynth3D.

Multi-sample ζ-mixup: richer, more realistic synthetic samples from a p-series interpolant

Modern deep learning training procedures rely on model regularization techniques such as data augmentation methods, which generate training samples that increase the diversity of data and richness of label information. A popular recent method, mixup, uses convex combinations of pairs of original samples to generate new samples. However, as we show in our experiments, mixup  can produce undesirable synthetic samples, where the data is sampled off the manifold and can contain incorrect labels. We propose ζ -mixup, a generalization of mixup  with provably and demonstrably desirable properties that allows convex combinations of T ≥ 2 samples, leading to more realistic and diverse outputs that incorporate information from T original samples by using a p-series interpolant. We show that, compared to mixup, ζ -mixup  better preserves the intrinsic dimensionality of the original datasets, which is a desirable property for training generalizable models. Furthermore, we show that our implementation of ζ -mixup  is faster than mixup, and extensive evaluation on controlled synthetic and 26 diverse real-world natural and medical image classification datasets shows that ζ -mixup  outperforms mixup, CutMix, and traditional data augmentation techniques. The code will be released at https://github.com/kakumarabhishek/zeta-mixup.

Separation of platelets by size in a microfluidic device based on controlled incremental filtration

The significant biological and functional differences between small and large platelets suggested by recent studies could have profound implications for transfusion medicine. However, investigating the relationship between platelet size and function is challenging because separating platelets by size without affecting their properties is difficult. A standard approach is centrifugation, but it inevitably leads to premature activation and aggregation of separated platelets. This paper describes the development and validation of a microfluidic device based on controlled incremental filtration (CIF) for separating platelets by size without the cell damage and usability limitations associated with centrifugation. Platelet samples derived from whole blood were used to evaluate the dependence of the CIF device separation performance on design parameters and flow rate, and to compare the properties of PLT fractions generated by the CIF device with those produced using a centrifugation protocol in a split-sample study. This was accomplished by quantifying the platelet size distribution, mean platelet volume (MPV), platelet-large cell ratio (P-LCR) and platelet activation before and after processing for all input and output samples. The 'large platelet' fractions produced by the CIF device and the centrifugation protocol were essentially equivalent (no significant difference in MPV and P-LCR). Platelets in the 'small platelet' fraction produced by the CIF device were significantly smaller than those produced by centrifugation (lower MPV and P-LCR). This was because the CIF 'small platelet' fraction was contaminated by much fewer large platelets (∼2-times lower recovery of >12 fL platelets) and retained the smallest platelets that were discarded by the centrifugation protocol. There was no significant difference in platelet activation between the two methods. However, centrifugation required a substantial amount of additional anticoagulant to prevent platelet aggregation during pelleting. Unlike centrifugation, the CIF device offered continuous, flow-through, single-step processing that did not cause platelet aggregation. Such a capability has the potential to accelerate the basic studies of the relationship between platelet size and function, and ultimately improve transfusion practice, particularly in the pediatric setting, where the need for low-volume, high-quality platelet transfusions is most urgent.

Efficient pneumonia detection using Vision Transformers on chest X-rays

Pneumonia is a widespread and acute respiratory infection that impacts people of all ages. Early detection and treatment of pneumonia are essential for avoiding complications and enhancing clinical results. We can reduce mortality, improve healthcare efficiency, and contribute to the global battle against a disease that has plagued humanity for centuries by devising and deploying effective detection methods. Detecting pneumonia is not only a medical necessity but also a humanitarian imperative and a technological frontier. Chest X-rays are a frequently used imaging modality for diagnosing pneumonia. This paper examines in detail a cutting-edge method for detecting pneumonia implemented on the Vision Transformer (ViT) architecture on a public dataset of chest X-rays available on Kaggle. To acquire global context and spatial relationships from chest X-ray images, the proposed framework deploys the ViT model, which integrates self-attention mechanisms and transformer architecture. According to our experimentation with the proposed Vision Transformer-based framework, it achieves a higher accuracy of 97.61%, sensitivity of 95%, and specificity of 98% in detecting pneumonia from chest X-rays. The ViT model is preferable for capturing global context, comprehending spatial relationships, and processing images that have different resolutions. The framework establishes its efficacy as a robust pneumonia detection solution by surpassing convolutional neural network (CNN) based architectures.

Rapid, label-free enrichment of lymphocytes in a closed system using a flow-through microfluidic device

The majority of adoptive cellular therapies are produced from peripheral mononuclear cells obtained via leukapheresis and further enriched for the cells of interest (e.g., T cells). Here, we present a first-of-its-kind closed system, which effectively removes ~85% of monocytes and ~88% of platelets, while recovering ~88% of concentrated T cells in a separate output stream, as the leukapheresis sample flows through a microfluidic device at 5 mL/min. The system is driven by a common peristaltic pump, enabled by a novel pressure wave dampener, and operates in a closed bag-to-bag configuration, without requiring any specialized, dedicated equipment. When compared to standard density gradient centrifugation on paired samples, the new system demonstrated a 1.5-fold increase in T cell recovery and a 2-fold reduction in inter-sample variability for this separation outcome. The T cell-to-monocyte ratio of the leukapheresis sample was increased to 20:1, whereas with density gradient processing it decreased to 2:1. As a result of superior purity and/or gentler processing, T cells enriched by the system showed a 2.7-times higher fold expansion during subsequent culture, and an overall 3.5-times higher cumulative yield. This centrifugation-free and label-free closed system for enriching lymphocytes could significantly simplify and standardize the manufacturing of life-saving cellular therapies.

Recent advances in microfluidic cell separation to enable centrifugation-free, low extracorporeal volume leukapheresis in pediatric patients

Leukapheresis is a common extracorporeal procedure for leukodepletion and cellular collection. During the procedure, a patient's blood is passed through an apheresis machine to separate white blood cells (WBCs) from red blood cells (RBCs) and platelets (PLTs), which are then returned to the patient. Although it is well-tolerated by adults and older children, leukapheresis poses a significant risk to neonates and low-weight infants because the extracorporeal volume (ECV) of a typical leukapheresis circuit represents a particularly large fraction of their total blood volume. The reliance of existing apheresis technology on centrifugation for separating blood cells limits the degree to which the circuit ECV could be miniaturized. The rapidly advancing field of microfluidic cell separation holds excellent promise for devices with competitive separation performance and void volumes that are orders of magnitude smaller than their centrifugation-based counterparts. This review discusses recent advancements in the field, focusing on passive separation methods that could potentially be adapted to perform leukapheresis. We first outline the performance requirements that any separation method must meet to replace centrifugation-based methods successfully. We then provide an overview of the passive separation methods that can remove WBCs from whole blood, focusing on the technological advancements made in the last decade. We describe and compare standard performance metrics, including blood dilution requirements, WBC separation efficiency, RBC and PLT loss, and processing throughput, and discuss the potential of each separation method for future use as a high-throughput microfluidic leukapheresis platform. Finally, we outline the primary common challenges that must still be overcome for these novel microfluidic technologies to enable centrifugation-free, low-ECV leukapheresis in the pediatric setting.

The Comparison of Dexmedetomidine to Dexamethasone as Adjuvants to Bupivacaine in Ultrasound-Guided Infraclavicular Brachial Plexus Block in Upper Limb Surgeries

Background The clinical utility of adjuvants with local anesthesia produces an excellent nerve block with prolonged duration and faster onset. Brachial plexus block is widely used nowadays in patients undergoing upper limb surgery There are several approaches to achieve brachial plexus block such as interscalene, supraclavicular, infraclavicular, and axillary. The objective of this study is to compare the effectiveness of dexamethasone to dexmedetomidine as adjuvants to bupivacaine in patients undergoing ultrasound-guided infraclavicular brachial plexus (USG-ICBP) block. Methods A randomized, prospective, double-blind study was undertaken on the patients posted for upper limb surgeries under ultrasound-guided infraclavicular brachial plexus block. Sixty patients with the American Society of Anesthesiologists (ASA) classes I and II were randomly allocated into two groups. Group A received 25 mL of 0.5% bupivacaine and 1.5 mL (6 mg) of dexamethasone, and group B received 25 mL of 0.5% bupivacaine and 0.75 mL (75 mcg) of dexmedetomidine along with 0.75 mL of 0.9% normal saline (NS). Student's t test or Mann-Whitney test and chi-square test were used for statistical analysis. Results The onset of sensory block was significantly faster in the patients in group B as compared to the patients in group A. In terms of the duration of the block, sensory and motor blocks were maintained for a significantly longer duration in the group A patients as compared to those in group B. Moreover, the duration of postoperative analgesia was significantly longer-lasting in the group A patients. In terms of adverse effects, procedure-related complications such as the failure of the block and inadequate block were comparable across the groups. However, drug-related adverse effects were significantly more common in group B. Conclusion As compared to 75 mcg of dexmedetomidine, the addition of 6 mg of dexamethasone as adjuvant to 25 mL of 0.5% bupivacaine resulted in significantly longer-lasting sensory and motor blocks, postoperative analgesia, and a delayed time for first rescue analgesia without increasing undue adverse effects. Dexmedetomidine use is associated with more sedation as compared to dexamethasone.

A survey on deep learning for skin lesion segmentation

Skin cancer is a major public health problem that could benefit from computer-aided diagnosis to reduce the burden of this common disease. Skin lesion segmentation from images is an important step toward achieving this goal. However, the presence of natural and artificial artifacts (e.g., hair and air bubbles), intrinsic factors (e.g., lesion shape and contrast), and variations in image acquisition conditions make skin lesion segmentation a challenging task. Recently, various researchers have explored the applicability of deep learning models to skin lesion segmentation. In this survey, we cross-examine 177 research papers that deal with deep learning-based segmentation of skin lesions. We analyze these works along several dimensions, including input data (datasets, preprocessing, and synthetic data generation), model design (architecture, modules, and losses), and evaluation aspects (data annotation requirements and segmentation performance). We discuss these dimensions both from the viewpoint of select seminal works, and from a systematic viewpoint, examining how those choices have influenced current trends, and how their limitations should be addressed. To facilitate comparisons, we summarize all examined works in a comprehensive table as well as an interactive table available online³.

Manufacturing regulatory T cells for adoptive cell therapy in immune diseases: A critical appraisal

Regulatory T cells (Tregs) are a unique subset of lymphocytes that play a vital role in regulating the immune system by suppressing unwanted immune responses and thus preventing autoimmune diseases and inappropriate inflammatory reactions. In preclinical and clinical trials, these cells have demonstrated the ability to prevent and treat graft vs. host disease, alleviate autoimmune symptoms, and promote transplant tolerance. In this review, we provide a background on Treg cells with a focus on important Treg cell markers and Treg subsets, and outline the methodology currently used for manufacturing adoptive regulatory T cell therapies (TRACT). Finally, we discuss the approaches and outcomes of several clinical trials in which Tregs have been adoptively transferred to patients.

Recent advancements in antimony (Sb) removal from water and wastewater by carbon-based materials: a systematic review

Antimony (Sb) has been classified as a high-priority contaminant in the environment. Sb contamination resulting from the use of antimony-containing compounds in industry necessitates the development of efficient methods to remove it from water and wastewater. Adsorption is a highly efficient and reliable method for pollutants removal owing to its availability, recyclability, and low cost. Recently, carbonaceous materials and their applications for the removal of Sb from the aqueous matrices have received special attention worldwide. Herein, this review systematically summarizes the occurrence and exposure of Sb in the environment and on human health, respectively. Different carbon-based adsorbents have been classified for the adsorptive removal of Sb and their adsorption characteristics have been delineated. Recent development in the adsorption performance of the adsorbent materials for improving the Sb removal from the aqueous medium has been outlined. Further, to develop an understanding of the effect of different parameters like pH, competitive ions, and dissolved ions for Sb adsorption and subsequent removal have been discussed. A retrospective analysis of literature was conducted to present the adsorption behavior and underlying mechanisms involved in the removal of Sb using various adsorbents. Moreover, this study has identified emerging research gaps and emphasized the need for developing modified/engineered carbonaceous adsorbents to enhance Sb adsorption from various aqueous matrices.

Disaster management ontology- an ontological approach to disaster management automation

The geographical location of any region, as well as large-scale environmental changes caused by a variety of factors, invite a wide range of disasters. Floods, droughts, earthquakes, cyclones, landslides, tornadoes, and cloudbursts are all common natural disasters that destroy property and kill people. On average, 0.1% of the total deaths globally in the past decade have been due to natural disasters. The National Disaster Management Authority (NDMA), a branch of the Ministry of Home Affairs, plays an important role in disaster management in India by taking responsibility for risk mitigation, response, and recovery from all natural and man-made disasters. This article presents an ontology-based disaster management framework based on the NDMA's responsibility matrix. This ontological base framework is named as Disaster Management Ontology (DMO). It aids in task distribution among necessary authorities at various stages of a disaster, as well as a knowledge-driven decision support system for financial assistance to victims. In the proposed DMO, ontology has been used to integrate knowledge as well as a working platform for reasoners, and the Decision Support System (DSS) ruleset is written in Semantic Web Rule Language (SWRL), which is based on the First Order Logic (FOL) concept. In addition, OntoGraph, a class view of taxonomy, is used to make taxonomy more interactive for users.

Red blood cell rosetting enables size-based separation of specific lymphocyte subsets from blood in a microfluidic device

The isolation of a specific lymphocyte subset from blood is the required first step in the manufacturing of many novel cellular immunotherapies. Microfluidic size-based separation methods are poised to significantly simplify this process because they require neither centrifugation nor magnetic or fluorescent labeling to operate. Lymphocytes can be separated from red blood cells (RBCs) and platelets as well as monocytes and granulocytes because their size differs from each of these cell types. However, further separation of a specific lymphocyte subset from other unwanted lymphocytes using size-based methods is impossible because all lymphocytes have approximately the same size and can only be distinguished by surface markers. This paper describes a new approach that made it possible for a size-based separation method to isolate a desired subset of lymphocytes by making unwanted lymphocytes as well as other blood cells artificially larger. The separation was enabled by selectively binding multiple RBCs to each unwanted cell to create 'rosettes' with an effective size significantly larger than the diameter of a typical lymphocyte. The desired lymphocytes remained unaffected by rosetting and were separated from the rosettes by passing the mixture through a microfluidic size-based separation device based on controlled incremental filtration (CIF). This new rosette-enabled size-based (RESIZE) separation approach demonstrated recovery of 80-90% for all lymphocyte subsets tested (CD3⁺, CD4⁺, CD56⁺) which was ∼2.5-fold higher than that for the standard immunodensity method (RBC rosetting followed by density gradient centrifugation). The purity of separation was >90% for CD3⁺ cells but declined with increasing cell rarity. Unlike the immunodensity approach, RESIZE required neither centrifugation nor cell washing after the separation and was ∼2.5-fold faster when processing the same sample volume. The results of this study suggest that integration of the RESIZE approach for high-yield isolation of lymphocyte subsets from blood could significantly streamline the manufacturing workflow and thus have a potentially transformative impact on the cost and availability of novel cellular immunotherapies.

A Prospective Study Comparing Stapler and Open Surgical Technique of Hemorrhoidectomy

Introduction Hemorrhoids are basically anal cushions which turn out to be pathological giving rise to bleeding, pain and protrusion outside the anal canal. The chief complaint of patients with hemorrhoids is bleeding from the rectum which is usually painless and associated with episodes of defecation. The study was done to assess postoperative pain, time duration of the procedure, complications in the postoperative period, return to normal work, and recurrence between the stapler and open hemorrhoidectomy for grade III and IV hemorrhoids. Material and methods The present prospective study was conducted among 60 patients in the General Surgery department at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar over the duration of two years presenting with grade III and IV degree hemorrhoids. Thirty patients each were divided into open hemorrhoidectomy and stapled hemorrhoidectomy groups. The study evaluated variables like operative time, stay at the hospital and postoperative complications and compared them between the two techniques. Follow-up of patients was done at regular intervals. Evaluation of postoperative pain was done using visual analogue scale (VAS) with ranges from 0 to 10. We evaluated the data using the chi-square test with a p-value <0.05 as significant. Results Of 60 patients, 47 (78.3%) were males and 13 (21.7%) were females with a male: female ratio being 3.6:1. The operating time and hospital stay were much less in the stapler hemorrhoidectomy group as compared to the open procedure group. Also, postoperative pain (visual analogue scale) was less in the stapler hemorrhoidectomy group with 36.7% of patients presenting with pain at one week, 23.3% at one month and 3.3% at three months in the open hemorrhoidectomy group whereas 13.3% presenting as pain in one week, 10% presenting at one month and none presenting at three months in the stapler hemorrhoidectomy group. There was recurrence seen in 10% of cases at three months in the open hemorrhoidectomy group as compared to the stapler hemorrhoidectomy group where no recurrence was found at three months follow-up. Conclusion Hemorrhoid offers a variety of surgical modalities of treatment. We have come to the conclusion that stapled hemorrhoidectomy has less complications and good patient compliance. It can be an effective option in the treatment of third and fourth-grade hemorrhoids. With proper training and expertise, stapler hemorrhoidectomy is a better and reliable technique for hemorrhoid surgery.

Scoliosis in osteogenesis imperfecta: results of posterior spinal fusion in 39 patients

PURPOSE

To evaluate the outcomes of scoliosis corrective surgery in Osteogenesis Imperfecta (OI) patients with primarily pedicles screw fixation in terms of correcting and maintaining the correction of the spinal deformity, and to assess for several peri-operative parameters and complications associated with this surgical treatment.

METHODS

Retrospective case series of 39 consecutive patients with OI treated surgically for scoliosis. The surgeries were performed between 2002 and 2020 by three different surgeons. All patients' medical peri-operative and post-operative charts were evaluated. Radiological assessment was performed by evaluation of the pre-operative, immediate post-operative and last follow-up plain radiographs.

RESULTS

There were 20 females and 19 males included in this review with a mean age of 14 years (range, 6-20 years) at the time of surgery. The median follow-up time was 7.9 years. The mean pre-operative cobb angle (CA) of the major curve was 76.5 degrees (SD ± 18.9), decreasing to 42.6 (SD ± 17.4) in the long-term post-operative follow-up (P < 0.001). A total of 21 adverse events in 16 patients were noted. Only 4 patients required subsequent invasive surgical treatment or prolonged hospital stay. All other patients were treated conservatively with no lasting complication.

CONCLUSION

Scoliosis surgical correction in OI patients seems to yield acceptable results, with maintained coronal plane surgical correction in the long-term follow-up. Even though a high peri-operative complications rate is observed in this series, there were no long-term sequelae or lasting complications.

LEVEL OF EVIDENCE

Level IV, Case series.

Occurrence and transport of SARS-CoV-2 in wastewater streams and its detection and remediation by chemical-biological methods

This paper explains the transmission of SARS-CoV and influences of several environmental factors in the transmission process. The article highlighted several methods of collection, sampling and monitoring/estimation as well as surveillance tool for detecting SARS-CoV in wastewater streams. In this context, WBE (Wastewater based epidemiology) is found to be the most effective surveillance tool. Several methods of genomic sequencing are discussed in the paper, which are applied in WBE, like qPCR-based wastewater testing, metagenomics-based analysis, next generation sequencing etc. Additionally, several types of biosensors (colorimetric biosensor, mobile phone-based biosensors, and nanomaterials-based biosensors) showed promising results in sensing SARS-CoV in wastewater. Further, this review paper outlined the gaps in assessing the factors responsible for transmission and challenges in detection and monitoring along with the remediation and disinfection methods of this virus in wastewater. Various methods of disinfection of SARS-CoV-2 in wastewater are discussed (primary, secondary, and tertiary phases) and it is found that a suite of disinfection methods can be used for complete disinfection/removal of the virus. Application of ultraviolet light, ozone and chlorine-based disinfectants are also discussed in the context of treatment methods. This study calls for continuous efforts to gather more information about the virus through continuous monitoring and analyses and to address the existing gaps and identification of the most effective tool/ strategy to prevent SARS-CoV-2 transmission. Wastewater surveillance can be very useful in effective surveillance of future pandemics and epidemics caused by viruses, especially after development of new technologies in detecting and disinfecting viral pathogens more effectively.

A Metasynthesis and Meta-analysis of the Impact and Diagnostic Safety of COVID-19 Symptom Agnostic Rapid Testing in Low- and Middle-Income Countries: Protocol for a Systematic Review

BACKGROUND

Amid all public health measures to contain COVID-19, the most challenging has been how to break the transmission chain. This has been even more challenging in low- and middle-income countries (LMICs). A public health emergency warrants a public health perspective, which comes down to prevention. Rapid mass testing has been advocated throughout the pandemic as a way to promptly deal with asymptomatic infections, but its usefulness in LMICs is yet to be fully understood.

OBJECTIVE

The study objectives of this paper are to (1) investigate the impact of the different rapid mass testing options for SARS-CoV-2 that have been delivered at point of care in LMICs and (2) evaluate the diagnostic safety (accuracy) of rapid mass testing for SARS-CoV-2 in LMICs.

METHODS

This review will systematically search records in PubMed, EBSCOhost, Cochrane library, Global Index Medicus COVID-19 Register, and Scopus. Records will be managed using Mendeley reference manager and SWIFT-Review. Risk of bias for randomized controlled trials will be assessed using the RoB 2 assessment tool, while nonrandomized interventions will be assessed using the tool developed by the Evidence Project. A narrative approach will be used to synthesize data under the first objective, and either a meta-analysis or synthesis without meta-analysis for the second objective. Tables, figures, and textual descriptions will be used to present findings. The overall body of evidence for the first objective will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach, and for the second objective using GRADE.

RESULTS

The screening of records has been finalized. We hope to finalize the synthesis by the end of February 2023 and to prepare the manuscript for publication by April 2023. The study will be reported in accordance with standard guidelines for the reporting of systematic reviews. Review results will be disseminated through conferences and their peer-reviewed publication in a relevant journal.

CONCLUSIONS

This review highlights the role of a preventive approach in infection control using rapid mass testing. It also flags the overriding need to involve users and providers in the evaluation of such tests in the settings for which they are intended. This will be the first review to the best of our knowledge to generate both qualitative and quantitative evidence regarding rapid mass testing specific to LMICs.

TRIAL REGISTRATION

PROSPERO CRD42022283776; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=283776.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/41132.

Dermatological impact of hand hygiene practices during COVID-19: A cross-sectional web-based survey among doctors in a tertiary care hospital in Eastern India

BACKGROUND

The COVID-19 pandemic continues to persist throughout the world with intermittent exacerbation. The changing trend of hand hygiene practices during this pandemic has led to new onset or aggravation of pre-existing hand eczema, especially among doctors. There is a paucity of studies regarding skin changes seen with changing hand hygiene practices in the Indian subcontinent.

OBJECTIVES

To estimate the frequency of various cutaneous manifestations and associated factors with hand hygiene practices in doctors during COVID-19 via a web-based online questionnaire survey.

METHODS

It was a cross-sectional web-based survey conducted at a tertiary care teaching institute from July 2021 to September 2021. Those doctors (faculty, residents, and interns) of the hospital completing the questionnaire with electronic informed consent were included in the study.

RESULTS

A total of 143 doctors completed the survey. The most common symptoms were dryness in 60 (42%) and itching in 25 (17.5%) doctors. The most common skin changes were scaling in 30 (21%) and redness in 16 (11.2%) doctors. There was a significant association between skin changes and frequency of hand washing and hand sanitizer use (p value < 0.05).

CONCLUSION

The prevalence of hand changes and symptoms was 77% in doctors in our study. The most commonly seen hand changes were scaling followed by redness and symptoms observed were dryness and itching.

Biochar application for greenhouse gas mitigation, contaminants immobilization and soil fertility enhancement: A state-of-the-art review

Rising global temperature, pollution load, and energy crises are serious problems, recently facing the world. Scientists around the world are ambitious to find eco-friendly and cost-effective routes for resolving these problems. Biochar has emerged as an agent for environmental remediation and has proven to be the effective sorbent to inorganic and organic pollutants in water and soil. Endowed with unique attributes such as porous structure, larger specific surface area (SSA), abundant surface functional groups, better cation exchange capacity (CEC), strong adsorption capacity, high environmental stability, embedded minerals, and micronutrients, biochar is presented as a promising material for environmental management, reduction in greenhouse gases (GHGs) emissions, soil management, and soil fertility enhancement. Therefore, the current review covers the influence of key factors (pyrolysis temperature, retention time, gas flow rate, and reactor design) on the production yield and property of biochar. Furthermore, this review emphasizes the diverse application of biochar such as waste management, construction material, adsorptive removal of petroleum and oil from aqueous media, immobilization of contaminants, carbon sequestration, and their role in climate change mitigation, soil conditioner, along with opportunities and challenges. Finally, this review discusses the evaluation of biochar standardization by different international agencies and their economic perspective.

Specific Human Capital and Skills in Indian Manufacturing: Observed Wage and Tenure Relationships from a Worker Survey

Successive Indian governments have attempted to increase the growth in employment alongside encouraging skill enhancement. Against this background, we empirically explore issues surrounding the investment in specific capital by workers. In particular, we try to discern the presence of specific human capital investment by investigating whether there is a link between tenure and wages and find that there is indeed such a link evident in India. This allows us to infer that it is valuable to have long-term relations between employers and their workers and therefore labour market institutions that support long-term employer-employee relationship need to be encouraged.

Comparative Assessment of Clinical and Quality of Life Outcomes in Mandibular Angle Fractures Treated with Standard and Three-Dimensional Mini-Plates

Aims and Objectives

To undertake a multidimensional comparative assessment of the standard and three dimensional (3D) mini-plates in managing isolated mandibular angle fractures (MAFs).

Patients and Methods

Thirty-six subjects were divided equally into two groups. Group A underwent fixation with a standard 2 mm miniplate, while group B with 2 mm 3D mini-plates. Evaluations were done preoperatively (T0), postoperatively at one week (T1), one month (T2) and three months (T3). Maximal inter-incisal mouth opening (MIO) and mean bite force (MBF) at the central incisors, right and left molars were calculated. Postoperative complications and Quality of life (QoL) outcomes were evaluated using the short form Oral Health Impact Profile (OHIP-14).

Results

Mean operative time was almost similar for both groups. Although mean MIO improved significantly from T1 to T3 in both groups, intergroup comparison of MIO was not significant. The MBF values were significantly higher in group B on the right and left molars at T2 and T3. Although significant improvement in OHIP-14 scores was seen from T2 to T3 in both the groups, intergroup comparison of OHIP was not significant.

Conclusion

3D plates demonstrated similar clinical and QoL outcomes compared to the standard mini-plates.

A Machine-Learning-Blockchain-Based Authentication Using Smart Contracts for an IoHT System

Nowadays, finding genetic components and determining the likelihood that treatment would be helpful for patients are the key issues in the medical field. Medical data storage in a centralized system is complex. Data storage, on the other hand, has recently been distributed electronically in a cloud-based system, allowing access to the data at any time through a cloud server or blockchain-based ledger system. The blockchain is essential to managing safe and decentralized transactions in cryptography systems such as bitcoin and Ethereum. The blockchain stores information in different blocks, each of which has a set capacity. Data processing and storage are more effective and better for data management when blockchain and machine learning are integrated. Therefore, we have proposed a machine-learning-blockchain-based smart-contract system that improves security, reduces consumption, and can be trusted for real-time medical applications. The accuracy and computation performance of the IoHT system are safely improved by our system.

Optimization of Selective Laser Melting Parameter for Invar Material by Using JAYA Algorithm: Comparison with TLBO, GA and JAYA

In this study, the hardness and surface roughness of selective laser-melted parts have been evaluated by considering a wide variety of input parameters. The Invar-36 has been considered a workpiece material that is mainly used in the aerospace industry for making parts as well as widely used in bimetallic thermostats. It is the mechanical properties and metallurgical properties of parts that drive the final product's quality in today's competitive marketplace. The study aims to examine how laser power, scanning speed, and orientation influence fabricated specimens. Using ANOVA, the established models were tested and the parameters were evaluated for their significance in predicting response. In the next step, the fuzzy-based JAYA algorithm has been implemented to determine which parameter is optimal in the proposed study. In addition, the optimal parametric combination obtained by the JAYA algorithm was compared with the optimal parametric combination obtained by TLBO and genetic algorithm (GA) to establish the effectiveness of the JAYA algorithm. Based on the results, an orientation of 90°, 136 KW of laser power, and 650 mm/s scanning speed were found to be the best combination of process parameters for generating the desired hardness and roughness for the Invar-36 material.

Effect of Metal-Cored Filler Wire on Surface Morphology and Micro-Hardness of Regulated Metal Deposition Welded ASTM A387-Gr.11-Cl.2 Steel Plates

Environmental and human-friendly welding is the need of the hour. In this context, this study explores the application of the regulated metal deposition (RMD) technique for ASTM A387-Gr.11-Cl.2 steel plates. To examine the effect of metal-cored filler wire (MCFW), MEGAFIL 237 M was employed during regulated metal deposition (RMD) welding of 6 mm thick ASTM A387-Gr.11-Cl.2 steel plates. The welding was carried out at an optimized current (A) of 100 A, voltage (V) of 13 V, and gas flow rate (GFR) of 21 L/min. Thereafter, the as-welded plates were examined for morphological changes using optical microscopy. Additionally, the micro-hardness of the as-welded plates was measured to make corroboration with the obtained surface morphologies. In addition to this, the as-welded plates were subjected to heat treatment followed by surface morphology and micro-hardness examination. A comparison was made between the as-welded and heat-treated plates for their obtained surface morphologies and microhardness values. During this, it was observed that the weld zone of as-welded plates has a dendritic surface morphology which is very common in fusion-based welding. Similarly, the weld zone of heat-treated plates has a finer and erratic arrangement of martensite. Moreover, the obtained surface morphologies in the weld zone of as-welded and heat-treated plates have been justified by their respective hardness values of 1588.6 HV and 227.3 HV.

A voyage from 3D to 4D printing in nanomedicine and healthcare: part I

The transition from 3D to 4D printing has revolutionized various domains of healthcare, pharmaceuticals, design and architecture, and coating processes. The evolution from 3D printing to 4D printing (4DP) has added a fourth dimension as a time-dependent response. This review discusses the significance, demands, various types of smart materials/biomaterials, as well as bioinks and printers used in 4DP technology. This review also provides insights into the limitations of the bioprinting process and bioinks used in various bioprinting technologies and the challenges that come with these limitations. A brief discussion on the future potential of the fundamentals and capabilities of 4D printing is also discussed.

A voyage from 3D to 4D printing in nanomedicine and healthcare: part II

Recent advancements in biomedical tissue engineering are gaining wide interest. Implementing biology of living cells and organisms using technological solutions such as incorporating 4D printing and bioprinting for tissue regeneration/tissue repair, organ regeneration, early diagnosis of deadly diseases (particularly cancer, cardiac disorders and tuberculosis) has successfully opened a new generation of biomedical research. The present review primarily addresses the clinical application of 4D printing and bioprinting techniques for applications such as early detection of diseases and drug delivery. Notably, this review continues the discussion from part I regarding published informative data, in vitro and in vivo findings, commercial biosensors for early disease diagnosis, drug delivery and current challenges in 4D printing/bioprinting.

Differential translational regulation of host exosomal proteins play key role in immunomodulation in antimony resistance in Visceral Leishmaniasis: A proteomic profiling study

In host-pathogen interactions, exosomal secretions are crucial for cell to cell communication and have an established role in immunomodulation. Protozoans, including Leishmania, modulates their host vesicular secretions for better survival; although the role of exosomal secretions in unresponsive against sodium antimony gluconate (SAG) has never been documented. In this study, the exosomal proteome of RAW macrophages infected with either SAG responsive (SAG^S) or SAG unresponsive (SAG^R) L. donovani parasites has been compared with uninfected RAW macrophages. Proteins isolated from exosomes were labelled with iTRAQ reagents; followed by subsequent LC-TOF/-MS analysis. In total, 394 proteins (p < 0.05) were identified which were shared common among all sets. Highly differentially expressed proteins were sorted by log2 value -1 and +1 as down regulated and up regulated respectively which yielded 58 proteins in SAG^R and 41 proteins during SAG^S infection. Out of the 58 proteins identified during SAG^R infection, 17 proteins were of immune modulatory function. Network visualization model and pathway analysis revealed the interactions among these proteins via different immunological pathways with reported involvement of some proteins in SAG resistance and host immune modulation. Hence, the differential abundance of immune pathway related proteins in exosomes of infected host during SAG^R infection supports the immune modulatory strategy adopted by SAG resistant parasites for enhanced survival .

Sub-mucosal dexamethasone for post-operative pain and oedema control in lower third molar surgery

Background:

Surgical excision of the problematic mandibular third molars causes substantial tissue damage and an inflammatory response. Discomfort and edema are common postoperative signs and symptoms caused by the latter. To find out whether dexamethasone may help with the edema and pain that come along with the surgical removal of impacted mandibular third molars, researchers have performed clinical studies.

Methods:

Twenty individuals with bilaterally affected mandibular third molars who were scheduled for extraction participated in a prospective trial. At two separate sessions, teeth were raised and cut after buccal ostectomy. Since the surgical operation on the left foot, both patients were administered a mixture of 4 mg dexamethasone submucosal injection and antibiotics for 3 days. On the 1^st, 3^rd, and 7^th postoperative days, edema and pain were assessed.

Results:

At the 1^st, 3^rd, and 7^th postoperative days, there was a clinically meaningful decrease in the level of edema and discomfort in both arms.

Conclusions:

The current report offers empirical proof that administering a 4 mg dexamethasone submucosal injection during surgery greatly reduced post-surgical edema and discomfort.

Advanced deep learning algorithms for infectious disease modeling using clinical data- A Case Study on CoVID-19

BACKGROUND

Infectious disease happens when an individual is defiled by a micro-organism/virus from another person or an animal. It is troublesome that causes hurt at both individual and huge scope scales.

CASE PRESENTATION

The ongoing episode of COVID-19 ailment brought about by the new coronavirus first distinguished in Wuhan China, and its quick spread far and wide, revived the consideration of the world towards the impacts of such plagues on individual's regular daily existence. We attempt to exploit this effectiveness of Advanced deep learning algorithms to predict the Growth of Infectious disease based on time series data and classification based on (symptoms) text data and X-ray image data.

CONCLUSION

Goal is identifying the nature of the phenomenon represented by the sequence of observations and forecasting.

Mevalonate kinase of Leishmania donovani protects parasite against oxidative stress by modulating ergosterol biosynthesis

Leishmaniasis comprises of a wide variety of diseases, caused by protozoan parasite belonging to the genus Leishmania. Leishmania parasites undergo different types of stress during their lifetime and have developed strategies to overcome this damage. Identifying the mechanistic approach used by the parasite in dealing with the stress is of immense importance for unfolding the survival strategy adopted by the parasite. Mevalonate kinase (MVK) is an important regulatory factor in the mevalonate pathway in both bacteria and eukaryotes. In this study, we explored the role of Leishmania donovani mevalonate kinase (LdMVK) in parasite survival under stress condition. Hydrogen peroxide (H₂O₂) and menadione, the two known oxidants were used to carry out the experiments. The MVK expression was found to be up regulated ∼2.1 fold and ∼2.3 fold under oxidative stress condition and under the effect of anti-Leishmania drug, AmBisome respectively. The cell viability declined under the effect of MVK inhibitor viz: vanadyl sulfate (VS). The level of intracellular ROS was also found to be increased under the effect of MVK inhibitor. To confirm the findings, LdMVK over expression (LdMVK OE) and LdMVK knockdown (LdMVK KD) parasites were generated. The level of ergosterol, an important component of plasma membrane in L. donovani, was observed and found to be reduced by nearly 60 % in LdMVK KD parasite and increased by nearly 30 % in LdMVK OE parasites as compared to wild type. However, the ergosterol content was found to be elevated under oxidative stress. Furthermore, LdMVK was also found to be associated with maintaining the plasma membrane integrity and also in preventing the peroxidation of cellular lipids when exposed to oxidative stress. The above data clearly suggests that MVK has a vital role in protecting the parasite from oxidative stress. These findings may also explore the contribution of LdMVK in drug unresponsiveness which may help in future rational drug designing for leishmaniasis.

Oxidant activated soluble adenylate cyclase of Leishmania donovani regulates the cAMP-PKA signaling axis for its intra-macrophage survival during infection

Adenosine 3',5'-cyclic monophosphate (cAMP) is a stress sensor molecule that transduces the cellular signal when Leishmania donovani moves from insect vector to mammalian host. At this stage, the parasite membrane-bound receptor adenylate cyclase predominantly produces cAMP to cope with the oxidative assault imposed by host macrophages. However, the role of soluble adenylate cyclase of L. donovani (LdHemAC) has not been investigated fully. In the present investigation, we monitored an alternative pool of cAMP, maintained by LdHemAC. The elevated cAMP effectively transmits signals by binding to Protein Kinase A (PKA) present in the cytosol and regulates antioxidant gene expression and phosphorylates several unknown PKA substrate proteins. Menadione-catalyzed production of reactive oxygen species (ROS) mimics host oxidative condition in vitro in parasites where cAMP production and PKA activity were found increased by ~1.54 ± 0.35, and ~1.78 ± 0.47-fold, respectively while expression of LdHemAC gene elevated by ~2.18 ± 0.17-fold. The LdHemAC sense these oxidants and became activated to cyclize ATP to enhance the cAMP basal level that regulates antioxidant gene expression to rescue parasites from oxidative stress. In knockdown parasites (LdHemAC-KD), the downregulated antioxidant genes expression, namely, Sod (2.30 ± 0.46), Pxn (2.73 ± 0.15), Tdr (2.7 ± 0.12), and Gss (1.57 ± 0.15) results in decreased parasite viability while in overexpressed parasites (LdHemAC-OE), the expression was upregulated by ~5.7 ± 0.35, ~2.57 ± 0.56, ~4.7 ± 0.36, and ~2.4 ± 0.83, respectively, which possibly overcomes ROS accumulation and enhances viability. Furthermore, LdHemAC-OE higher PKA activity regulates phosphorylation of substrate proteins (~56 kDs in membrane fraction and ~25 kDs in the soluble fraction). It reduced significantly when treated with inhibitors like DDA, Rp-cAMP, and H-89 and increased by ~2.1 ± 0.28-fold, respectively under oxidative conditions. The LdHemAC-KD was found less infective to RAW 264.7 macrophages and more prone to oxidative damage as compared to LdHemAC-OE and control parasites. Together, this study demonstrates mechanistic links among LdHemAC, cAMP, and PKA in parasite survival and invasion under host oxidative condition.

Leishmania donovani Secretory Mevalonate Kinase Regulates Host Immune Response and Facilitates Phagocytosis

Leishmania secretes over 151 proteins during in vitro cultivation. Cellular functions of one such novel protein: mevalonate kinase is discussed here; signifying its importance in Leishmania infection.

Visceral Leishmaniasis is a persistent infection, caused by Leishmania donovani in Indian subcontinent. This persistence is partly due to phagocytosis and evasion of host immune response. The underlying mechanism involves secretory proteins of Leishmania parasite; however, related studies are meagre. We have identified a novel secretory Leishmania donovani glycoprotein, Mevalonate kinase (MVK), and shown its importance in parasite internalization and immuno-modulation. In our studies, MVK was found to be secreted maximum after 1 h temperature stress at 37°C. Its secretion was increased by 6.5-fold in phagolysosome-like condition (pH ~5.5, 37°C) than at pH ~7.4 and 25°C. Treatment with MVK modulated host immune system by inducing interleukin-10 and interleukin-4 secretion, suppressing host’s ability to kill the parasite. Peripheral blood mononuclear cell (PBMC)-derived macrophages infected with mevalonate kinase-overexpressing parasites showed an increase in intracellular parasite burden in comparison to infection with vector control parasites. Mechanism behind the increase in phagocytosis and immunosuppression was found to be phosphorylation of mitogen-activated protein (MAP) kinase pathway protein, Extracellular signal-regulated kinases-1/2, and actin scaffold protein, cortactin. Thus, we conclude that Leishmania donovani Mevalonate kinase aids in parasite engulfment and subvert the immune system by interfering with signal transduction pathways in host cells, which causes suppression of the protective response and facilitates their persistence in the host. Our work elucidates the involvement of Leishmania in the process of phagocytosis which is thought to be dependent largely on macrophages and contributes towards better understanding of host pathogen interactions.

Predicting the clinical management of skin lesions using deep learning

Automated machine learning approaches to skin lesion diagnosis from images are approaching dermatologist-level performance. However, current machine learning approaches that suggest management decisions rely on predicting the underlying skin condition to infer a management decision without considering the variability of management decisions that may exist within a single condition. We present the first work to explore image-based prediction of clinical management decisions directly without explicitly predicting the diagnosis. In particular, we use clinical and dermoscopic images of skin lesions along with patient metadata from the Interactive Atlas of Dermoscopy dataset (1011 cases; 20 disease labels; 3 management decisions) and demonstrate that predicting management labels directly is more accurate than predicting the diagnosis and then inferring the management decision ([Formula: see text] and [Formula: see text] improvement in overall accuracy and AUROC respectively), statistically significant at [Formula: see text]. Directly predicting management decisions also considerably reduces the over-excision rate as compared to management decisions inferred from diagnosis predictions (24.56% fewer cases wrongly predicted to be excised). Furthermore, we show that training a model to also simultaneously predict the seven-point criteria and the diagnosis of skin lesions yields an even higher accuracy (improvements of [Formula: see text] and [Formula: see text] in overall accuracy and AUROC respectively) of management predictions. Finally, we demonstrate our model's generalizability by evaluating on the publicly available MClass-D dataset and show that our model agrees with the clinical management recommendations of 157 dermatologists as much as they agree amongst each other.

Molecular Elucidation and Therapeutic Targeting for combating COVID19: Current Scenario and Future Prospective

A corona virus disease 2019 (COVID-19) is a contagious disease which is caused by a novel corona virus. Human corona virus (HCoV) recognized as one of the most rapidly evolving viruses owing to its high genomic nucleotide substitution rates and recombination. Among the severe acute respiratory syndrome (SARS) and Middle-East respiratory syndrome (MERS), COVID-19 has spread more rapidly and increased the level of globalization and adaptation of the virus in every environmental condition due to their high rate of molecular diversity. The whole article highlights the general characteristics of corona virus, their molecular diversity, and molecular protein targeting against COVID-19 with their newer approaches. Through this review, an attempt has made to critically evaluate the recent advances and future aspects helpful to the treatment of COVID-19 based on the present understanding of SARS-CoV-2 infections, which may help offer new insights and potential therapeutic targets for the treatment of the COVID-19.

Pooled testing for COVID-19 diagnosis by real-time RT-PCR: A multi-site comparative evaluation of 5- & 10-sample pooling

BACKGROUND & OBJECTIVES

Public health and diagnostic laboratories are facing huge sample loads for COVID-19 diagnosis by real-time reverse transcription-polymerase chain reaction (RT-PCR). High sensitivity of optimized real-time RT-PCR assays makes pooled testing a potentially efficient strategy for resource utilization when positivity rates for particular regions or groups of individuals are low. We report here a comparative analysis of pooled testing for 5- and 10-sample pools by real-time RT-PCR across 10 COVID-19 testing laboratories in India.

METHODS

Ten virus research and diagnostic laboratories (VRDLs) testing for COVID-19 by real-time RT-PCR participated in this evaluation. At each laboratory, 100 nasopharyngeal swab samples including 10 positive samples were used to create 5- and 10-sample pools with one positive sample in each pool. RNA extraction and real-time RT-PCR for SARS-CoV-2-specific E gene target were performed for individual positive samples as well as pooled samples. Concordance between individual sample testing and testing in the 5- or 10-sample pools was calculated, and the variation across sites and by sample cycle threshold (Ct) values was analyzed.

RESULTS

A total of 110 each of 5- and 10-sample pools were evaluated. Concordance between the 5-sample pool and individual sample testing was 100 per cent in the Ct value ≤30 cycles and 95.5 per cent for Ctvalues ≤33 cycles. Overall concordance between the 5-sample pooled and individual sample testing was 88 per cent while that between 10-sample pool and individual sample testing was 66 per cent. Although the concordance rates for both the 5- and 10-sample pooled testing varied across laboratories, yet for samples with Ct values ≤33 cycles, the concordance was ≥90 per cent across all laboratories for the 5-sample pools.

INTERPRETATION & CONCLUSIONS

Results from this multi-site assessment suggest that pooling five samples for SARS-CoV-2 detection by real-time RT-PCR may be an acceptable strategy without much loss of sensitivity even for low viral loads, while with 10-sample pools, there may be considerably higher numbers of false negatives. However, testing laboratories should perform validations with the specific RNA extraction and RT-PCR kits in use at their centres before initiating pooled testing.

Differential Regulation of miRNA Profiles of Human Cells Experimentally Infected by Leishmania donovani Isolated From Indian Visceral Leishmaniasis and Post-Kala-Azar Dermal Leishmaniasis

MicroRNAs are small ribonucleic acid that act as an important regulator of gene expression at the molecular level. However, there is no comparative data on the regulation of microRNAs (miRNAs) in visceral leishmaniasis (VL) and post-kala-azar dermal leishmaniasis (PKDL). In this current study, we compared the expression miRNA profile in host cells (GTHP), with VL strain (GVL) and PKDL strain-infected host cell (GPKDL). Normalized read count comparison between different conditions revealed that the miRNAs are indeed differentially expressed. In GPKDL with respect to GVL and GTHP, a total of 798 and 879 miRNAs were identified, out of which 349 and 518 are known miRNAs, respectively. Comparative analysis of changes in miRNA expression suggested that the involvement of differentially expressed miRNAs in various biological processes like PI3K pathway activation, cell cycle regulation, immunomodulation, apoptosis inhibition, different cytokine production, T-cell phenotypic transitions calcium regulation, and so on. A pathway enrichment study using in silico predicted gene targets of differentially expressed miRNAs showed evidence of potentially universal immune signaling pathway effects. Whereas cytokine-cytokine receptor interaction, phagocytosis, and transforming growth factor beta (TGF-β) signaling pathways were more highly enriched using targets of miRNAs upregulated in GPKDL. These findings could contribute to a better understanding of PKDL pathogenesis. Furthermore, the identified miRNAs could also be used as biomarkers in diagnosis, prognosis, and therapeutics of PKDL infection control.

Data Integration in the Brazilian Public Health System for Tuberculosis: Use of the Semantic Web to Establish Interoperability

Background

Interoperability of health information systems is a challenge due to the heterogeneity of existing systems at both the technological and semantic levels of their data. The lack of existing data about interoperability disrupts intra-unit and inter-unit medical operations as well as creates challenges in conducting studies on existing data. The goal is to exchange data while providing the same meaning for data from different sources.

Objective

To find ways to solve this challenge, this research paper proposes an interoperability solution for the tuberculosis treatment and follow-up scenario in Brazil using Semantic Web technology supported by an ontology.

Methods

The entities of the ontology were allocated under the definitions of Basic Formal Ontology. Brazilian tuberculosis applications were tagged with entities from the resulting ontology.

Results

An interoperability layer was developed to retrieve data with the same meaning and in a structured way enabling semantic and functional interoperability.

Conclusions

Health professionals could use the data gathered from several data sources to enhance the effectiveness of their actions and decisions, as shown in a practical use case to integrate tuberculosis data in the State of São Paulo.

Artificial intelligence in glioma imaging: challenges and advances

Primary brain tumors including gliomas continue to pose significant management challenges to clinicians. While the presentation, the pathology, and the clinical course of these lesions are variable, the initial investigations are usually similar. Patients who are suspected to have a brain tumor will be assessed with computed tomography (CT) and magnetic resonance imaging (MRI). The imaging findings are used by neurosurgeons to determine the feasibility of surgical resection and plan such an undertaking. Imaging studies are also an indispensable tool in tracking tumor progression or its response to treatment. As these imaging studies are non-invasive, relatively cheap and accessible to patients, there have been many efforts over the past two decades to increase the amount of clinically-relevant information that can be extracted from brain imaging. Most recently, artificial intelligence (AI) techniques have been employed to segment and characterize brain tumors, as well as to detect progression or treatment-response. However, the clinical utility of such endeavours remains limited due to challenges in data collection and annotation, model training, and the reliability of AI-generated information. We provide a review of recent advances in addressing the above challenges. First, to overcome the challenge of data paucity, different image imputation and synthesis techniques along with annotation collection efforts are summarized. Next, various training strategies are presented to meet multiple desiderata, such as model performance, generalization ability, data privacy protection, and learning with sparse annotations. Finally, standardized performance evaluation and model interpretability methods have been reviewed. We believe that these technical approaches will facilitate the development of a fully-functional AI tool in the clinical care of patients with gliomas.

Leishmania donovani infection induce differential miRNA expression in CD4+ T cells

Visceral leishmaniasis is characterized by mixed production of Th1/2 cytokines and the disease is established by an enhanced level of Th2 cytokine. CD4+ T cells are main cell type which produces Th1/2 cytokine in the host upon Leishmania infection. However, the regulatory mechanism for Th1/2 production is not well understood. In this study, we co-cultured mice CD4+ T cells with Leishmania donovani infected and uninfected macrophage for the identification of dysregulated miRNAs in CD4+ T cells by next-generation sequencing. Here, we identified 604 and 613 known miRNAs in CD4+ T cells in control and infected samples respectively and a total of only 503 miRNAs were common in both groups. The expression analysis revealed that 112 miRNAs were up and 96 were down-regulated in infected groups, compared to uninfected control. Nineteen up-regulated and 17 down-regulated miRNAs were statistically significant (p < 0.05), which were validated by qPCR. Further, using insilco approach, we identified the gene targets of significant miRNAs on the basis of CD4+ T cell biology. Eleven up-regulated miRNAs and 9 down-regulated miRNAs were associated with the cellular immune responses and Th1/2 dichotomy upon Leishmania donovani infection. The up-regulated miRNAs targeted transcription factors that promote differentiation of CD4+ T cells towards Th1 phenotype. While down-regulated miRNAs targeted the transcription factors that facilitate differentiation of CD4+ T cells towards Th2 populations. The GO and pathway enrichment analysis also showed that the identified miRNAs target the pathway and genes related to CD4+ T cell biology which plays important role in Leishmania donovani infection.