Nevin Manimala

Sci Rep. 2021 Jul 12;11(1):14282. doi: 10.1038/s41598-021-93344-z.

ABSTRACT

Block cipher has been a standout amongst the most reliable option by which data security is accomplished. Block cipher strength against various attacks relies on substitution boxes. In literature, extensively algebraic structures, and chaotic systems-based techniques are available to design the cryptographic substitution boxes. Although, algebraic and chaotic systems-based approaches have favorable characteristics for the design of substitution boxes, but on the other side researchers have also pointed weaknesses in these approaches. First-time multilevel information fusion is introduced to construct the substitution boxes, having four layers; Multi Sources, Multi Features, Nonlinear Multi Features Whitening and Substitution Boxes Construction. Our proposed design does not hold the weakness of algebraic structures and chaotic systems because our novel s-box construction relies on the strength of true random numbers. In our proposed method true random numbers are generated from the inevitable random noise of medical imaging. The proposed design passes all the substitution box security evaluation criteria including Nonlinearity, Bit Independence Criterion (BIC), Strict Avalanche Criterion (SAC), Differential Approximation Probability (DP), Linear Approximation Probability (LP), and statistical tests, including resistance to Differential Attack, Correlation Analysis, 2D, 3D histogram analysis. The outcomes of the evaluation criteria validate that the proposed substitution boxes are effective for block ciphers; furthermore, the proposed substitution boxes attain better cryptographic strength as compared to very recent state-of-the-art techniques.

PMID:34253755 | DOI:10.1038/s41598-021-93344-z

Sci Rep. 2021 Jul 12;11(1):14304. doi: 10.1038/s41598-021-92692-0.

ABSTRACT

Colorectal cancer (CRC) is a common cause of cancer-related deaths worldwide. The CRC mRNA gene expression dataset containing 644 CRC tumor and 51 normal samples from the cancer genome atlas (TCGA) was pre-processed to identify the significant differentially expressed genes (DEGs). Feature selection techniques Least absolute shrinkage and selection operator (LASSO) and Relief were used along with class balancing for obtaining features (genes) of high importance. The classification of the CRC dataset was done by ML algorithms namely, random forest (RF), K-nearest neighbour (KNN), and artificial neural networks (ANN). The significant DEGs were 2933, having 1832 upregulated and 1101 downregulated genes. The CRC gene expression dataset had 23,186 features. LASSO had performed better than Relief for classifying tumor and normal samples through ML algorithms namely RF, KNN, and ANN with an accuracy of 100%, while Relief had given 79.5%, 85.05%, and 100% respectively. Common features between LASSO and DEGs were 38, from them only 5 common genes namely, VSTM2A, NR5A2, TMEM236, GDLN, and ETFDH had shown statistically significant survival analysis. Functional review and analysis of the selected genes helped in downsizing the 5 genes to 2, which are VSTM2A and TMEM236. Differential expression of TMEM236 was statistically significant and was markedly reduced in the dataset which solicits appreciation for assessment as a novel biomarker for CRC diagnosis.

PMID:34253750 | DOI:10.1038/s41598-021-92692-0

Sci Rep. 2021 Jul 12;11(1):14323. doi: 10.1038/s41598-021-93253-1.

ABSTRACT

Tracking studies of juveniles are rare compared to those of adults, and consequently little is known about the influence of intrinsic and extrinsic factors on activity during this critical life stage. We used hourly GPS data, collected from 66 Antarctic fur seal pups from birth until moulting, to investigate the explanatory power of multiple individual-based and environmental variables on activity levels. Pups were sampled from two nearby breeding colonies of contrasting density during two subsequent years, and a two-state hidden Markov model was used to identify modalities in their movement behaviour, specifically ‘active’ and ‘inactive’ states. We found that movement was typified by central place exploration, with active movement away from and subsequent return to a location of inactivity. The probability of such directed exploration was unaffected by several factors known to influence marine mammal movement including sex, body condition, and temperature. Compared to pups born at the high-density colony, pups at low-density were more active, increased their activity with age, and transitioned earlier into the tussock grass, which offers protection from predators and extreme weather. Our study illustrates the importance of extrinsic factors, such as colony of birth, to early-life activity patterns and highlights the adaptive potential of movement.

PMID:34253749 | DOI:10.1038/s41598-021-93253-1

Sci Rep. 2021 Jul 12;11(1):14332. doi: 10.1038/s41598-021-93122-x.

ABSTRACT

Community detection remains little explored in the analysis of biodiversity change. The challenges linked with global biodiversity change have also multiplied manifold in the past few decades. Moreover, most studies concerning biodiversity change lack the quantitative treatment central to species distribution modeling. Empirical analysis of species distribution and abundance is thus integral to the study of biodiversity loss and biodiversity alterations. Community detection is therefore expected to efficiently model the topological aspect of biodiversity change driven by land-use conversion and climate change; given that it has already proven superior for diverse problems in the domain of social network analysis and subgroup discovery in complex systems. Thus, quantum inspired community detection is proposed as a novel technique to predict biodiversity change considering tiger population in eighteen states of India; leading to benchmarking of two novel datasets. Elements of land-use conversion and climate change are explored to design these datasets viz.-Landscape based distribution and Number of tiger reserves based distribution respectively; for predicting regions expected to maximize Tiger population growth. Furthermore, validation of the proposed framework on the said datasets is performed using standard community detection metrics like-Modularity, Normalized Mutual Information (NMI), Adjusted Rand Index (ARI), Degree distribution, Degree centrality and Edge-betweenness centrality. Quantum inspired community detection has also been successful in demonstrating an association between biodiversity change, land-use conversion and climate change; validated statistically by Pearson’s correlation coefficient and p value test. Finally, modularity distribution based on parameter tuning establishes the superiority of the second dataset based on the number of Tiger reserves-in predicting regions maximizing Tiger population growth fostering species distribution and abundance; apart from scripting a stronger correlation of biodiversity change with land-use conversion.

PMID:34253748 | DOI:10.1038/s41598-021-93122-x

Sci Rep. 2021 Jul 12;11(1):14285. doi: 10.1038/s41598-021-92811-x.

ABSTRACT

Pancreatic duct stenting is a well-established method for reducing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. However, there is no consensus on the optimal type of plastic stent. This study aimed to evaluate the feasibility and safety of a new 4-Fr plastic stent for pancreatic duct stenting. Forty-nine consecutive patients who placed the 4-Fr stent into the pancreatic duct (4Fr group) were compared with 187 consecutive patients who placed a conventional 5-Fr stent (control group). The primary outcome was technical success. Complications rate, including post-ERCP pancreatitis (PEP) were the secondary outcomes. Propensity score matching was introduced to reduce selection bias. The technical success rate was 100% in the 4Fr group and 97.9% in the control group (p = 0.315). Post-ERCP amylase level was significantly lower in the 4-Fr group than the control group before propensity score matching (p = 0.006), though without statistical significance after propensity score matching (p = 0.298). The rate of PEP in the 4Fr group (6.1%) was lower than the control group (15.5%), though without statistical significance before (p = 0.088) and after (p = 1.00) propensity score matching. Pancreatic duct stenting using a novel 4-Fr plastic stent would be at least similar or more feasible and safe compared to the conventional plastic stent.

PMID:34253746 | DOI:10.1038/s41598-021-92811-x

BMJ Qual Saf. 2021 Jul 12:bmjqs-2020-012729. doi: 10.1136/bmjqs-2020-012729. Online ahead of print.

ABSTRACT

BACKGROUND: Internationally, patient and public involvement (PPI) is core policy for health service quality improvement (QI). However, authentic QI partnerships are not commonplace. A lack of patient and staff capability to deliver successful partnerships may be a barrier to meaningful QI collaboration.

OBJECTIVES: The research questions for this scoping review were: What is known regarding the capabilities required for healthcare staff and patients to effectively partner in QI at the service level?; and What is known regarding the best practice learning and development strategies required to build and support those capabilities?

METHODS: A six-stage scoping review was completed. Five electronic databases were searched for publications from January 2010 to February 2020. The database searches incorporated relevant terms for the following concepts: capabilities for PPI in healthcare QI; and best practice learning and development strategies to support those capabilities. Data were analysed using descriptive statistics and qualitative content analysis.

RESULTS: Forty-nine papers were included. Very little peer-reviewed literature focused explicitly on capabilities for QI partnerships and thus implicit paper content was analysed. A Capability framework for successful partnerships in healthcare quality improvement was developed. It includes knowledge, skills and attitudes across three capability domains: Personal Attributes; Relationships and Communication; and Philosophies, Models and Practices, and incorporates 10 capabilities. Sharing power and leadership was discussed in many papers as fundamental and was positioned across all of the domains. Most papers discussed staff and patients’ co-learning (n=28, 57.14%). Workshops or shorter structured training sessions (n=36, 73.47%), and face-to-face learning (n=34, 69.38%) were frequently reported.

CONCLUSION: The framework developed here could guide individualised development or learning plans for patient partners and staff, or could assist organisations to review learning topics and approaches such as training content, mentoring guidelines or community of practice agendas. Future directions include refining and evaluating the framework. Development approaches such as self-reflection, communities of practice, and remote learning need to be expanded and evaluated.

PMID:34253682 | DOI:10.1136/bmjqs-2020-012729

BMJ Open. 2021 Jul 12;11(7):e050519. doi: 10.1136/bmjopen-2021-050519.

ABSTRACT

OBJECTIVE: To systematically review evidence on effectiveness of contact tracing apps (CTAs) for SARS-CoV-2 on epidemiological and clinical outcomes.

DESIGN: Rapid systematic review.

DATA SOURCES: EMBASE (OVID), MEDLINE (PubMed), BioRxiv and MedRxiv were searched up to 28 October 2020.

STUDY SELECTION: Studies, both empirical and model-based, assessing effect of CTAs for SARS-CoV-2 on reproduction number (R), total number of infections, hospitalisation rate, mortality rate, and other epidemiologically and clinically relevant outcomes, were eligible for inclusion.

DATA EXTRACTION: Empirical and model-based studies were critically appraised using separate checklists. Data on type of study (ie, empirical or model-based), sample size, (simulated) time horizon, study population, CTA type (and associated interventions), comparator and outcomes assessed, were extracted. The most important findings were extracted and narratively summarised. Specifically for model-based studies, characteristics and values of important model parameters were collected.

RESULTS: 2140 studies were identified, of which 17 studies (2 empirical, 15 model-based studies) were eligible and included in this review. Both empirical studies were observational (non-randomised) studies and at high risk of bias, most importantly due to risk of confounding. Risk of bias of model-based studies was considered low for 12 out of 15 studies. Most studies demonstrated beneficial effects of CTAs on R, total number of infections and mortality rate. No studies assessed effect on hospitalisation. Effect size was dependent on model parameters values used, but in general, a beneficial effect was observed at CTA adoption rates of 20% or higher.

CONCLUSIONS: CTAs have the potential to be effective in reducing SARS-CoV-2 related epidemiological and clinical outcomes, though effect size depends on other model parameters (eg, proportion of asymptomatic individuals, or testing delays), and interventions after CTA notification. Methodologically sound comparative empirical studies on effectiveness of CTAs are required to confirm findings from model-based studies.

PMID:34253676 | DOI:10.1136/bmjopen-2021-050519

BMJ Open. 2021 Jul 12;11(7):e046227. doi: 10.1136/bmjopen-2020-046227.

ABSTRACT

INTRODUCTION: Telemedicine gained strength in primary healthcare (PHC) during the COVID-19 pandemic. Thus, there is a need to know its scope, technologies used and impacts on people’s health. This study will map telemedicine use in PHC around the world and its impacts on quality of care in the context of the COVID-19 pandemic.

METHODS: This is a scoping review protocol developed according to Arksey and O’Malley and Levac et al, based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The records will be mapped in the following multidisciplinary health sciences databases: Virtual Health Library, PubMed, Scopus, Web of Science, CINAHL and Embase. Searches will also be conducted on Google Scholar, preprint repositories and specific COVID-19 databases (grey literature). Quantitative data will be analysed using descriptive statistics, while thematic analysis will be performed for qualitative data. Preliminary findings will be presented to stakeholders to identify missing studies and develop effective dissemination strategies.

ETHICS AND DISSEMINATION: Results will be disseminated through publication in an open access scientific journal, scientific events, and academic and community newspapers. Ethical approval was obtained due to stakeholder consultation, but will not involve the direct participation of patients. Link to the protocol record in the Open Science Framework (OSF) (osf.io/q94en).

PMID:34253666 | DOI:10.1136/bmjopen-2020-046227

BMJ Mil Health. 2021 Jul 12:bmjmilitary-2021-001845. doi: 10.1136/bmjmilitary-2021-001845. Online ahead of print.

ABSTRACT

INTRODUCTION: Medication-assisted treatment (MAT) is a combination of behavioural therapy and medications to assist with recovery and has been administered to individuals with alcohol and opioid withdrawal symptoms. Military veterans seeking MAT could have barriers preventing them from receiving the care they desire. The present study sought to compare outcomes in individuals who received MAT or those who participated in self-help groups for opioid or alcohol use disorder. In addition, the present study sought to compare outcomes between veterans and non-military-connected individuals.

METHODS: We used the 2015-2017 United States Treatment Episode Data Set Discharges data from the Substance Abuse and Mental Health Services Administration. The data set included 138 594 unique discharges. A multinomial logistic regression model was used to examine differences in substance use outcomes for veterans/non-veterans in MAT and a self-help group.

RESULTS: Fewer veterans (2.58%) than non-veterans (4.28%) reported usage of MAT. Fewer veterans (38.94%) than non-veterans (40.17%) reported signing up for a self-help group. Finally, those who participated in MAT and a self-help group had a better outcome (66.64%)-defined as no substance use at discharge-than those who only received MAT (43.02%) and those who did not participate in MAT or self-help groups (34.84%).

CONCLUSIONS: Recommendations for future research on MAT and implementation for the veteran population would benefit the literature base.

PMID:34253642 | DOI:10.1136/bmjmilitary-2021-001845

J Immunother Cancer. 2021 Jul;9(7):e002101. doi: 10.1136/jitc-2020-002101.

ABSTRACT

BACKGROUND: A major current challenge is to exploit tertiary lymphoid structures (TLSs) to promote the lymphocyte infiltration, activation and differentiation by tumor antigens to increase antitumor immune responses. The mechanisms that underlie the role of TLS formation in the adaptive immune responses against nasopharyngeal carcinoma (NPC) remain largely unknown.

METHODS: Cell populations and the corresponding markers were identified by single-cell RNA sequencing and fluorescence-activated cell sorting analysis. In vitro differentiation experiments were used to simulate the generation, regulation and function of the Th-CXCL13 cell subset in the tumor microenvironment of NPC. These were followed by histological evaluation of the colocalization of tumor-associated B cells (TABs) and Th-CXCL13 cells within TLSs, and statistical analysis of the relationship between the cells in TLSs and overall survival.

RESULTS: A PD-1⁺CXCR5^–CD4⁺ Th-CXCL13 cell subset was identified in NPC. This subset was a major source of CXCL13, representing the majority of the CD4⁺ T cells at levels comparable with Th1 and Tfh cells present in the TLSs. Monocytes activated by toll-like receptor 4 agonists served as the antigen-presenting cells that most efficiently triggered the expansion of Th-CXCL13 cells. Transforming growth factor beta 1 (TGF-β1) stimulation and activation of Sox4 were critical for the induction and polarization of Th-CXCL13 cells in this process. The potential functional contributions of TABs recruited by Th-CXCL13 cells which induced plasma cell differentiation and immunoglobulin production via interleukin-21 and CD84 interactions in the TLSs demonstrated improved survival.

CONCLUSIONS: Induction of Th-CXCL13 cells links innate inflammation to immune privilege in tumor-associated TLSs and might predict better survival.

PMID:34253636 | DOI:10.1136/jitc-2020-002101