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Showing papers by "Cairo University published in 2018"


Journal ArticleDOI
Gregory A. Roth1, Gregory A. Roth2, Degu Abate3, Kalkidan Hassen Abate4  +1025 moreInstitutions (333)
TL;DR: Non-communicable diseases comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2).

5,211 citations


Journal ArticleDOI
Jeffrey D. Stanaway1, Ashkan Afshin1, Emmanuela Gakidou1, Stephen S Lim1  +1050 moreInstitutions (346)
TL;DR: This study estimated levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs) by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017 and explored the relationship between development and risk exposure.

2,910 citations


Journal ArticleDOI
TL;DR: Over the past generation, the global burden of Parkinson's disease has more than doubled as a result of increasing numbers of older people, with potential contributions from longer disease duration and environmental factors.
Abstract: Summary Background Neurological disorders are now the leading source of disability globally, and ageing is increasing the burden of neurodegenerative disorders, including Parkinson's disease. We aimed to determine the global burden of Parkinson's disease between 1990 and 2016 to identify trends and to enable appropriate public health, medical, and scientific responses. Methods Through a systematic analysis of epidemiological studies, we estimated global, regional, and country-specific prevalence and years of life lived with disability for Parkinson's disease from 1990 to 2016. We estimated the proportion of mild, moderate, and severe Parkinson's disease on the basis of studies that used the Hoehn and Yahr scale and assigned disability weights to each level. We jointly modelled prevalence and excess mortality risk in a natural history model to derive estimates of deaths due to Parkinson's disease. Death counts were multiplied by values from the Global Burden of Disease study's standard life expectancy to compute years of life lost. Disability-adjusted life-years (DALYs) were computed as the sum of years lived with disability and years of life lost. We also analysed results based on the Socio-demographic Index, a compound measure of income per capita, education, and fertility. Findings In 2016, 6·1 million (95% uncertainty interval [UI] 5·0–7·3) individuals had Parkinson's disease globally, compared with 2·5 million (2·0–3·0) in 1990. This increase was not solely due to increasing numbers of older people, because age-standardised prevalence rates increased by 21·7% (95% UI 18·1–25·3) over the same period (compared with an increase of 74·3%, 95% UI 69·2–79·6, for crude prevalence rates). Parkinson's disease caused 3·2 million (95% UI 2·6–4·0) DALYs and 211 296 deaths (95% UI 167 771–265 160) in 2016. The male-to-female ratios of age-standardised prevalence rates were similar in 2016 (1·40, 95% UI 1·36–1·43) and 1990 (1·37, 1·34–1·40). From 1990 to 2016, age-standardised prevalence, DALY rates, and death rates increased for all global burden of disease regions except for southern Latin America, eastern Europe, and Oceania. In addition, age-standardised DALY rates generally increased across the Socio-demographic Index. Interpretation Over the past generation, the global burden of Parkinson's disease has more than doubled as a result of increasing numbers of older people, with potential contributions from longer disease duration and environmental factors. Demographic and potentially other factors are poised to increase the future burden of Parkinson's disease substantially. Funding Bill & Melinda Gates Foundation.

1,388 citations


Journal ArticleDOI
TL;DR: Despite a low-risk profile and few postoperative complications, patients in Africa were twice as likely to die after surgery when compared with the global average for postoperative deaths, and Initiatives to increase access to surgical treatments in Africa should be coupled with improved surveillance for deteriorating physiology in patients who develop postoperative complication.

353 citations


Journal ArticleDOI
TL;DR: A novel hybrid solution based on SSA and chaos theory is proposed and it is shown that logistic chaotic map is the optimal map of the used ten, which can significantly boost the performance of original SSA.
Abstract: Salp Swarm Algorithm (SSA) is one of the most recently proposed algorithms driven by the simulation behavior of salps. However, similar to most of the meta-heuristic algorithms, it suffered from stagnation in local optima and low convergence rate. Recently, chaos theory has been successfully applied to solve these problems. In this paper, a novel hybrid solution based on SSA and chaos theory is proposed. The proposed Chaotic Salp Swarm Algorithm (CSSA) is applied on 14 unimodal and multimodal benchmark optimization problems and 20 benchmark datasets. Ten different chaotic maps are employed to enhance the convergence rate and resulting precision. Simulation results showed that the proposed CSSA is a promising algorithm. Also, the results reveal the capability of CSSA in finding an optimal feature subset, which maximizes the classification accuracy, while minimizing the number of selected features. Moreover, the results showed that logistic chaotic map is the optimal map of the used ten, which can significantly boost the performance of original SSA.

319 citations


Journal ArticleDOI
TL;DR: Graphical abstract Sites of hydrolysis for each phospholipase (PLA1, PLA2, PLC and PLD) are presented.

313 citations


Journal ArticleDOI
Rafael Lozano1, Nancy Fullman, Degu Abate2, Solomon M Abay  +1313 moreInstitutions (252)
TL;DR: A global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends and a estimates of health-related SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous.

312 citations


Journal ArticleDOI
TL;DR: This manuscript will review the general structure, regulation and function of HSP90 family and their potential role in pathophysiology.
Abstract: The mammalian HSP90 family of proteins is a cluster of highly conserved molecules that are involved in myriad cellular processes Their distribution in various cellular compartments underlines their essential roles in cellular homeostasis HSP90 and its co-chaperones orchestrate crucial physiological processes such as cell survival, cell cycle control, hormone signaling, and apoptosis Conversely, HSP90, and its secreted forms, contribute to the development and progress of serious pathologies, including cancer and neurodegenerative diseases Therefore, targeting HSP90 is an attractive strategy for the treatment of neoplasms and other diseases This manuscript will review the general structure, regulation and function of HSP90 family and their potential role in pathophysiology

309 citations


Journal ArticleDOI
TL;DR: This work estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods and used the cohort-component method of population projection, with inputs of fertility, mortality, population, and migration data.

287 citations


Journal ArticleDOI
TL;DR: A facile method to convert biomolecule-based carbon nanodots (CNDs) into high-surface-area 3D-graphene networks with excellent electrochemical properties and excellent morphological properties is presented.
Abstract: A facile method to convert biomolecule-based carbon nanodots (CNDs) into high-surface-area 3D-graphene networks with excellent electrochemical properties is presented. Initially, CNDs are synthesized by microwave-assisted thermolysis of citric acid and urea according to previously published protocols. Next, the CNDs are annealed up to 400 °C in a tube furnace in an oxygen-free environment. Finally, films of the thermolyzed CNDs are converted into open porous 3D turbostratic graphene (3D-ts-graphene) networks by irradiation with an infrared laser. Based upon characterizations using scanning electron microscopy, transmission electron microscopy, X-ray photoelectron spectroscopy, X-ray diffraction, Fourier-transform infrared spectroscopy, and Raman spectroscopy, a feasible reaction mechanism for both the thermolysis of the CNDs and the subsequent laser conversion into 3D-ts-graphene is presented. The 3D-ts-graphene networks show excellent morphological properties, such as a hierarchical porous structure and a high surface area, as well as promising electrochemical properties. For example, nearly ideal capacitive behavior with a volumetric capacitance of 27.5 mF L-1 is achieved at a current density of 560 A L-1 , which corresponds to an energy density of 24.1 mWh L-1 at a power density of 711 W L-1 . Remarkable is the extremely fast charge-discharge cycling rate with a time constant of 3.44 ms.

287 citations


Journal ArticleDOI
Ahmed Tealab1
TL;DR: Although there are many studies that presented the application of neural network models, but few of them proposed new neural networks models for forecasting that considered theoretical support and a systematic procedure in the construction of model, this leads to the importance of formulating new models of neural networks.

Journal ArticleDOI
Gregory A. Roth1, Gregory A. Roth2, Catherine O. Johnson1, Kalkidan Hassen Abate3, Foad Abd-Allah4, Muktar Beshir Ahmed3, Khurshid Alam5, Tahiya Alam1, Nelson Alvis-Guzman6, Hossein Ansari, Johan Ärnlöv7, Tesfay Mehari Atey8, Ashish Awasthi9, Tadesse Awoke10, Aleksandra Barac11, Till Bärnighausen12, Neeraj Bedi13, Derrick A Bennett14, Isabela M. Benseñor15, Sibhatu Biadgilign, Carlos A Castañeda-Orjuela, Ferrán Catalá-López16, Kairat Davletov17, Samath D Dharmaratne18, Eric L. Ding12, Manisha Dubey19, Emerito Jose A. Faraon20, Talha Farid21, Maryam S. Farvid12, Valery L. Feigin22, João C. Fernandes23, Joseph Frostad1, Alemseged Aregay Gebru8, Johanna M. Geleijnse24, Philimon Gona25, Max Griswold1, Gessessew Bugssa Hailu8, Graeme J. Hankey5, Hamid Yimam Hassen26, Rasmus Havmoeller7, Simon I. Hay1, Susan R. Heckbert1, Caleb Mackay Salpeter Irvine1, Spencer L. James1, Dube Jara27, Amir Kasaeian28, Abdur Rahman Khan21, Sahil Khera29, Abdullah T Khoja30, Jagdish Khubchandani31, Daniel Kim32, Dhaval Kolte33, Dharmesh Kumar Lal9, Anders Larsson34, Shai Linn35, Paulo A. Lotufo15, Hassan Magdy Abd El Razek36, Mohsen Mazidi37, Toni Meier38, Walter Mendoza39, George A. Mensah40, Atte Meretoja41, Haftay Berhane Mezgebe8, Erkin M. Mirrakhimov42, Shafiu Mohammed43, Andrew E. Moran44, Grant Nguyen1, Minh Nguyen1, Kanyin Liane Ong1, Mayowa O. Owolabi45, Martin A Pletcher1, Farshad Pourmalek46, Caroline A. Purcell1, Mostafa Qorbani, Mahfuzar Rahman47, Rajesh Kumar Rai, Usha Ram19, Marissa B Reitsma1, Andre M. N. Renzaho48, Maria Jesus Rios-Blancas, Saeid Safiri49, Joshua A. Salomon12, Benn Sartorius50, Sadaf G. Sepanlou28, Masood Ali Shaikh, Diego Augusto Santos Silva51, Saverio Stranges52, Rafael Tabarés-Seisdedos16, Niguse Tadele Atnafu53, Jarnail Singh Thakur54, Roman Topor-Madry55, Thomas Truelsen56, E. Murat Tuzcu57, Stefanos Tyrovolas58, Kingsley N. Ukwaja, Tommi Vasankari, Vasiliy Victorovich Vlassov59, Stein Emil Vollset60, Tolassa Wakayo3, Robert G. Weintraub61, Charles D.A. Wolfe62, Abdulhalik Workicho3, Gelin Xu63, Simon Yadgir1, Yuichiro Yano64, Paul S. F. Yip65, Naohiro Yonemoto66, Mustafa Z. Younis67, Chuanhua Yu68, Zoubida Zaidi, Maysaa El Sayed Zaki36, Ben Zipkin1, Ashkan Afshin1, Emmanuela Gakidou1, Stephen S Lim1, Ali H. Mokdad1, Mohsen Naghavi1, Theo Vos1, Christopher J L Murray1 
Institute for Health Metrics and Evaluation1, University of Washington2, Jimma University3, Cairo University4, University of Western Australia5, University of Cartagena6, Karolinska Institutet7, Mekelle University8, Public Health Foundation of India9, University of Gondar10, University of Belgrade11, Harvard University12, Jazan University13, University of Oxford14, University of São Paulo15, University of Valencia16, Kazakh National Medical University17, University of Peradeniya18, International Institute for Population Sciences19, University of the Philippines Manila20, University of Louisville21, Auckland University of Technology22, Catholic University of Portugal23, Wageningen University and Research Centre24, University of Massachusetts Boston25, Mizan–Tepi University26, Debre markos University27, Tehran University of Medical Sciences28, New York Medical College29, Islamic University30, Ball State University31, Northeastern University32, Brown University33, Uppsala University34, University of Haifa35, Mansoura University36, Chinese Academy of Sciences37, Martin Luther University of Halle-Wittenberg38, United Nations Population Fund39, National Institutes of Health40, University of Melbourne41, Kyrgyz State Medical Academy42, Ahmadu Bello University43, Columbia University44, University of Ibadan45, University of British Columbia46, BRAC47, University of Sydney48, University of Maragheh49, University of KwaZulu-Natal50, Universidade Federal de Santa Catarina51, University of Western Ontario52, Addis Ababa University53, Post Graduate Institute of Medical Education and Research54, Jagiellonian University Medical College55, University of Copenhagen56, Cleveland Clinic57, Hospital Sant Joan de Déu Barcelona58, National Research University – Higher School of Economics59, Norwegian Institute of Public Health60, Royal Children's Hospital61, King's College London62, Nanjing University63, University of Mississippi Medical Center64, University of Hong Kong65, Kyoto University66, Jackson State University67, Wuhan University68
TL;DR: Large disparities in total burden of CVD persist between US states despite marked improvements in CVD burden, and increases in risk-deleted CVD DALY rates between 2006 and 2016 in 16 states suggest additional unmeasured risks beyond these traditional factors.
Abstract: Importance Cardiovascular disease (CVD) is the leading cause of death in the United States, but regional variation within the United States is large. Comparable and consistent state-level measures of total CVD burden and risk factors have not been produced previously. Objective To quantify and describe levels and trends of lost health due to CVD within the United States from 1990 to 2016 as well as risk factors driving these changes. Design, Setting, and Participants Using the Global Burden of Disease methodology, cardiovascular disease mortality, nonfatal health outcomes, and associated risk factors were analyzed by age group, sex, and year from 1990 to 2016 for all residents in the United States using standardized approaches for data processing and statistical modeling. Burden of disease was estimated for 10 groupings of CVD, and comparative risk analysis was performed. Data were analyzed from August 2016 to July 2017. Exposures Residing in the United States. Main Outcomes and Measures Cardiovascular disease disability-adjusted life-years (DALYs). Results Between 1990 and 2016, age-standardized CVD DALYs for all states decreased. Several states had large rises in their relative rank ordering for total CVD DALYs among states, including Arkansas, Oklahoma, Alabama, Kentucky, Missouri, Indiana, Kansas, Alaska, and Iowa. The rate of decline varied widely across states, and CVD burden increased for a small number of states in the most recent years. Cardiovascular disease DALYs remained twice as large among men compared with women. Ischemic heart disease was the leading cause of CVD DALYs in all states, but the second most common varied by state. Trends were driven by 12 groups of risk factors, with the largest attributable CVD burden due to dietary risk exposures followed by high systolic blood pressure, high body mass index, high total cholesterol level, high fasting plasma glucose level, tobacco smoking, and low levels of physical activity. Increases in risk-deleted CVD DALY rates between 2006 and 2016 in 16 states suggest additional unmeasured risks beyond these traditional factors. Conclusions and Relevance Large disparities in total burden of CVD persist between US states despite marked improvements in CVD burden. Differences in CVD burden are largely attributable to modifiable risk exposures.

Journal ArticleDOI
TL;DR: The present review is focused on the recent trends on the extraction of different bioactive chemical constituents depending on the nature of sample matrices and their chemical classes including anthocyanins, flavonoids, polyphenols, alkaloids, oils, etc.
Abstract: Plant extracts have been long used by the traditional healers for providing health benefits and are nowadays suitable ingredient for the production of formulated health products and nutraceuticals. Traditional methods of extraction such as maceration, percolation, digestion, and preparation of decoctions and infusions are now been replaced by advanced extraction methods for increased extraction efficiency and selectivity of bioactive compounds to meet up the increasing market demand. Advanced techniques use different ways for extraction such as microwaves, ultrasound waves, supercritical fluids, enzymes, pressurized liquids, electric field, etc. These innovative extraction techniques, afford final extracts selectively rich in compounds of interest without formation of artifacts, and are often simple, fast, environment friendly and fully automated compared to existing extraction method. The present review is focused on the recent trends on the extraction of different bioactive chemical constituents depending on the nature of sample matrices and their chemical classes including anthocyanins, flavonoids, polyphenols, alkaloids, oils, etc. In addition, we review the strategies for designing extraction, selection of most suitable extraction methods, and trends of extraction methods for botanicals. Recent progress on the research based on these advanced methods of extractions and their industrial importance are also discussed in detail.

Journal ArticleDOI
Gregory A. Roth1, Degu Abate2, Kalkidan Hassen Abate3, Solomon M Abay, Cristiana Abbafati4, Nooshin Abbasi5, Nooshin Abbasi6, Hedayat Abbastabar5, Foad Abd-Allah7, Jemal Abdela, Ahmed Abdelalim7, Ibrahim Abdollahpour5, Ibrahim Abdollahpour8, Rizwan Suliankatchi Abdulkader9, Haftom Temesgen Abebe10, Molla Abebe, Zegeye Abebe, Ayenew Negesse Abejie11, Semaw Ferede Abera12, Olifan Zewdie Abil13, Haftom Niguse Abraha, Aklilu Roba Abrham, Laith J. Abu-Raddad14, Mmk Accrombessi, Dilaram Acharya15, Dilaram Acharya16, AA Adamu17, AA Adamu18, Oladimeji Adebayo19, Rufus A. Adedoyin20, Adekanmbi21, OO Adetokunboh17, OO Adetokunboh18, Beyene Meressa Adhena, Mina G. Adib, Amha Admasie, Ashkan Afshin1, Gina Agarwal22, Kareha M Agesa1, Anurag Agrawal23, Anurag Agrawal24, Sutapa Agrawal25, Alireza Ahmadi, Mehdi Ahmadi, Muktar Beshir Ahmed3, Sayem Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Mte Aichour26, Mohammad Esmaeil Akbari5, Rufus Akinyemi19, Nadia Akseer27, Ziyad Al-Aly28, Ziyad Al-Aly29, A Al-Eyadhy30, RM Al-Raddadi31, RM Al-Raddadi32, F Alahdab33, Khurshid Alam, Tahiya Alam, Animut Alebel, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Jordi Alonso, Khalid A Altirkawi, Nelson Alvis-Guzman, Azmeraw T. Amare, Leopold Ndemnge Aminde, Erfan Amini, Walid Ammar, Yaw Ampem Amoako, Nahla Anber, Catalina Liliana Andrei, Sofia Androudi, Animut, Mina Anjomshoa, Hossein Ansari, Mustafa Geleto Ansha, Cat Antonio, Palwasha Anwari, Olatunde Aremu, Johan Ärnlöv, Amit Arora, Monika Arora, A Artaman, Krishna K. Aryal, Hamid Asayesh, Ephrem Tsegay Asfaw, Zerihun Ataro, Suleman Atique, Atre, Marcel Ausloos, Efga Avokpaho, Ashish Awasthi, B. P. Ayala Quintanilla, Yohanes Ayele, Rakesh Ayer, Peter Azzopardi, Arefeh Babazadeh, Umar Bacha, Hamid Badali, Alaa Badawi 
TL;DR: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017 is presented.

Journal ArticleDOI
TL;DR: This document advocates for a multidisciplinary team of experts to guide institutional use of this therapy and the care of patients receiving it, and highlights key aspects of care delivery in this rapidly growing technology.
Abstract: Extracorporeal membrane oxygenation (ECMO) has been used increasingly for both respiratory and cardiac failure in adult patients. Indications for ECMO use in cardiac failure include severe refractory cardiogenic shock, refractory ventricular arrhythmia, active cardiopulmonary resuscitation for cardiac arrest, and acute or decompensated right heart failure. Evidence is emerging to guide the use of this therapy for some of these indications, but there remains a need for additional evidence to guide best practices. As a result, the use of ECMO may vary widely across centers. The purpose of this document is to highlight key aspects of care delivery, with the goal of codifying the current use of this rapidly growing technology. A major challenge in this field is the need to emergently deploy ECMO for cardiac failure, often with limited time to assess the appropriateness of patients for the intervention. For this reason, we advocate for a multidisciplinary team of experts to guide institutional use of this therapy and the care of patients receiving it. Rigorous patient selection and careful attention to potential complications are key factors in optimizing patient outcomes. Seamless patient transport and clearly defined pathways for transition of care to centers capable of providing heart replacement therapies (e.g., durable ventricular assist device or heart transplantation) are essential to providing the highest level of care for those patients stabilized by ECMO but unable to be weaned from the device. Ultimately, concentration of the most complex care at high-volume centers with advanced cardiac capabilities may be a way to significantly improve the care of this patient population.

Journal ArticleDOI
TL;DR: Recommendations from a subsequent Delphi consensus to broaden the generalizability of recommendations includes intravenous CD20 inhibitors as a first line therapy option for moderate to severe pemphigus.
Abstract: Background Several European countries recently developed international diagnostic and management guidelines for pemphigus, which have been instrumental in the standardization of pemphigus management. Objective We now present results from a subsequent Delphi consensus to broaden the generalizability of the recommendations. Methods A preliminary survey, based on the European Dermatology Forum and the European Academy of Dermatology and Venereology guidelines, was sent to a panel of international experts to determine the level of consensus. The results were discussed at the International Bullous Diseases Consensus Group in March 2016 during the annual American Academy of Dermatology conference. Following the meeting, a second survey was sent to more experts to achieve greater international consensus. Results The 39 experts participated in the first round of the Delphi survey, and 54 experts from 21 countries completed the second round. The number of statements in the survey was reduced from 175 topics in Delphi I to 24 topics in Delphi II on the basis of Delphi results and meeting discussion. Limitations Each recommendation represents the majority opinion and therefore may not reflect all possible treatment options available. Conclusions We present here the recommendations resulting from this Delphi process. This international consensus includes intravenous CD20 inhibitors as a first-line therapy option for moderate-to-severe pemphigus.

Journal ArticleDOI
Joseph R. Zunt1, Nicholas J Kassebaum2, Natacha Blake, Linda Glennie  +182 moreInstitutions (35)
TL;DR: Meningitis burden remains high and progress lags substantially behind that of other vaccine-preventable diseases, and particular attention should be given to developing vaccines with broader coverage against the causes of meningitis.
Abstract: Summary Background Acute meningitis has a high case-fatality rate and survivors can have severe lifelong disability. We aimed to provide a comprehensive assessment of the levels and trends of global meningitis burden that could help to guide introduction, continuation, and ongoing development of vaccines and treatment programmes. Methods The Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2016 study estimated meningitis burden due to one of four types of cause: pneumococcal, meningococcal, Haemophilus influenzae type b, and a residual category of other causes. Cause-specific mortality estimates were generated via cause of death ensemble modelling of vital registration and verbal autopsy data that were subject to standardised data processing algorithms. Deaths were multiplied by the GBD standard life expectancy at age of death to estimate years of life lost, the mortality component of disability-adjusted life-years (DALYs). A systematic analysis of relevant publications and hospital and claims data was used to estimate meningitis incidence via a Bayesian meta-regression tool. Meningitis deaths and cases were split between causes with meta-regressions of aetiological proportions of mortality and incidence, respectively. Probabilities of long-term impairment by cause of meningitis were applied to survivors and used to estimate years of life lived with disability (YLDs). We assessed the relationship between burden metrics and Socio-demographic Index (SDI), a composite measure of development based on fertility, income, and education. Findings Global meningitis deaths decreased by 21·0% from 1990 to 2016, from 403 012 (95% uncertainty interval [UI] 319 426–458 514) to 318 400 (265 218–408 705). Incident cases globally increased from 2·50 million (95% UI 2·19–2·91) in 1990 to 2·82 million (2·46–3·31) in 2016. Meningitis mortality and incidence were closely related to SDI. The highest mortality rates and incidence rates were found in the peri-Sahelian countries that comprise the African meningitis belt, with six of the ten countries with the largest number of cases and deaths being located within this region. Haemophilus influenzae type b was the most common cause of incident meningitis in 1990, at 780 070 cases (95% UI 613 585–978 219) globally, but decreased the most (–49·1%) to become the least common cause in 2016, with 397 297 cases (291 076–533 662). Meningococcus was the leading cause of meningitis mortality in 1990 (192 833 deaths [95% UI 153 358–221 503] globally), whereas other meningitis was the leading cause for both deaths (136 423 [112 682–178 022]) and incident cases (1·25 million [1·06–1·49]) in 2016. Pneumococcus caused the largest number of YLDs (634 458 [444 787–839 749]) in 2016, owing to its more severe long-term effects on survivors. Globally in 2016, 1·48 million (1·04—1·96) YLDs were due to meningitis compared with 21·87 million (18·20—28·28) DALYs, indicating that the contribution of mortality to meningitis burden is far greater than the contribution of disabling outcomes. Interpretation Meningitis burden remains high and progress lags substantially behind that of other vaccine-preventable diseases. Particular attention should be given to developing vaccines with broader coverage against the causes of meningitis, making these vaccines affordable in the most affected countries, improving vaccine uptake, improving access to low-cost diagnostics and therapeutics, and improving support for disabled survivors. Substantial uncertainty remains around pathogenic causes and risk factors for meningitis. Ongoing, active cause-specific surveillance of meningitis is crucial to continue and to improve monitoring of meningitis burdens and trends throughout the world. Funding Bill & Melinda Gates Foundation.

Journal ArticleDOI
TL;DR: The increased antioxidant enzyme activities contributed to the observed reduction in hydrogen peroxide and malondialdehyde contents, while enhanced levels of proline and other metabolites contributed to osmoprotection, collectively resulting in significant plant growth improvement under salinity.
Abstract: Soil salinity is established as one of the major environmental problems, decreasing crop productivity worldwide, thereby threatening sustainable agriculture. In the present study, we evaluated the effects of titanium dioxide nanoparticles (nTiO2) for ameliorating soil salinity in broad bean, an important leguminous crop. As nTiO2 is known to have pro-oxidant and antioxidant properties, the effects of three different nTiO2 concentrations (0·01%, 0·02% and 0·03%) were compared with respect to plant growth and stress responses. The 0·01% nTiO2 application significantly increased shoot length, leaf area and root dry weight of plants under normal conditions. These growth-promoting effects were simultaneous with increased levels of chlorophyll b, soluble sugars and proline and enhanced activities of antioxidant enzymes. Under saline soil conditions, although proline level and enzymatic antioxidant activities were increased, plant growth significantly reduced. The 0·01% nTiO2 supplementation significantly increased the activities of enzymatic antioxidants and levels of soluble sugars, amino acids and proline in salt-affected plants versus plants subjected to salinity alone. Thus, the increased antioxidant enzyme activities contributed to the observed reduction in hydrogen peroxide and malondialdehyde contents, while enhanced levels of proline and other metabolites contributed to osmoprotection, collectively resulting in significant plant growth improvement under salinity. Furthermore, nTiO2-mediated positive effects were concentration dependent with 0·01% nTiO2 being the most effective, whereas 0·02% showed an intermediate response and 0·03% was almost ineffective under both control and saline soil conditions. Our findings provide a foundation for nTiO2 application in improving growth of plants cultivated on naturally contaminated saline soils. Copyright © 2017 John Wiley & Sons, Ltd.

Journal ArticleDOI
TL;DR: In this paper, the distribution of malocclusion traits worldwide in mixed and permanent dentitions was determined by an electronic search using PubMed, Embase and Google Scholar search engine, up to December 2016.
Abstract: Objective: Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of malocclusion traits worldwide in mixed and permanent dentitions. Methods: An electronic search was conducted using PubMed, Embase and Google Scholar search engines, to retrieve data on malocclusion prevalence for both mixed and permanent dentitions, up to December 2016. Results: Out of 2,977 retrieved studies, 53 were included. In permanent dentition, the global distributions of Class I, Class II, and Class III malocclusion were 74.7% [31 - 97%], 19.56% [2 - 63%] and 5.93% [1 - 20%], respectively. In mixed dentition, the distributions of these malocclusions were 73% [40 - 96%], 23% [2 - 58%] and 4% [0.7 - 13%]. Regarding vertical malocclusions, the observed deep overbite and open bite were 21.98% and 4.93%, respectively. Posterior crossbite affected 9.39% of the sample. Africans showed the highest prevalence of Class I and open bite in permanent dentition (89% and 8%, respectively), and in mixed dentition (93% and 10%, respectively), while Caucasians showed the highest prevalence of Class II in permanent dentition (23%) and mixed dentition (26%). Class III malocclusion in mixed dentition was highly prevalent among Mongoloids. Conclusion: Worldwide, in mixed and permanent dentitions, Angle Class I malocclusion is more prevalent than Class II, specifically among Africans; the least prevalent was Class III, although higher among Mongoloids in mixed dentition. In vertical dimension, open bite was highest among Mongoloids in mixed dentition. Posterior crossbite was more prevalent in permanent dentition in Europe.

Journal ArticleDOI
TL;DR: In this paper, a communication assisted dual-setting relay protection scheme for micro-grids with grid connected and islanded capability is proposed, where the relay settings are optimally determined to minimize the overall relay operating time for primary and backup operation.
Abstract: This paper proposes a communication assisted dual setting relay protection scheme for micro-grids with grid connected and islanded capability. Previous work on dual setting relays has been applied to grid connected distributed generation systems only, but one major shortcoming is the failure of the backup scheme to operate in a coordinated manner. The proposed scheme relies on the use of dual setting directional overcurrent relays that are capable of operating in both forward and reverse directions, with different settings, and with a low bandwidth communication to maintain proper protection coordination. The problem is formulated as a non-linear constrained programming problem where the relay settings are optimally determined to minimize the overall relay operating time for primary and backup operation. The scheme is tested on a modified version of the IEEE 30 bus test system equipped with distributed generation and with capability of operating in an islanded mode. The proposed scheme is compared against the conventional scheme and the results show that it is capable of overcoming the problem of infeasibility, experienced by the conventional method, without the need of installing fault current limiters. Furthermore, it achieves remarkable reduction in both the primary and backup relay operating times, which was reflected in a reduction in the total relay operating time.

Journal ArticleDOI
Albert M. Sirunyan1, Armen Tumasyan1, Wolfgang Adam, Federico Ambrogi  +2291 moreInstitutions (195)
TL;DR: In this paper, a search for the direct electroweak production of charginos and neutralinos in signatures with either two or more leptons (electrons or muons) of the same electric charge, or with three or more hadronically decaying tau-leptons.
Abstract: Results are presented from a search for the direct electroweak production of charginos and neutralinos in signatures with either two or more leptons (electrons or muons) of the same electric charge, or with three or more leptons, which can include up to two hadronically decaying tau leptons. The results are based on a sample of proton-proton collision data collected at $ \sqrt{s}=13 $ TeV, recorded with the CMS detector at the LHC, corresponding to an integrated luminosity of 35.9 fb$^{−1}$. The observed event yields are consistent with the expectations based on the standard model. The results are interpreted in simplified models of supersymmetry describing various scenarios for the production and decay of charginos and neutralinos. Depending on the model parameters chosen, mass values between 180 GeV and 1150 GeV are excluded at 95% CL. These results significantly extend the parameter space probed for these particles in searches at the LHC. In addition, results are presented in a form suitable for alternative theoretical interpretations.

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TL;DR: A modified cuckoo search algorithm that imitates the obligate brood parasitic behavior of some cuckoos species in combination with the Lévy flight behavior and can significantly improve the classification performance is presented.
Abstract: In this paper, a modified cuckoo search algorithm with rough sets is presented to deal with high dimensionality data through feature selection. The modified cuckoo search algorithm imitates the obligate brood parasitic behavior of some cuckoo species in combination with the Levy flight behavior of some birds. The modified cuckoo search uses the rough sets theory to build the fitness function that takes the number of features in reduct set and the classification quality into account. The proposed algorithm is tested and validated benchmark on several benchmark datasets drawn from the UCI repository and using different evaluation criteria as well as a further analysis is carried out by means of the Analysis of Variance test. In addition, the proposed algorithm is experimentally compared with the existing algorithms on discrete datasets. Finally, two learning algorithms, namely K-nearest neighbors and support vector machines are used to evaluate the performance of the proposed approach. The results show that the proposed algorithm can significantly improve the classification performance.

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Albert M. Sirunyan1, Armen Tumasyan1, Wolfgang Adam, Federico Ambrogi  +2340 moreInstitutions (198)
TL;DR: A measurement of the inelastic proton-proton cross section with the CMS detector at a center-of-mass energy of $ \sqrt{s}=13 $ TeV is presented in this paper.
Abstract: A measurement of the inelastic proton-proton cross section with the CMS detector at a center-of-mass energy of $ \sqrt{s}=13 $ TeV is presented. The analysis is based on events with energy deposits in the forward calorimeters, which cover pseudorapidities of −6.6 4.1 GeV and/or M$_{Y}$ > 13 GeV, where M$_{X}$ and M$_{Y}$ are the masses of the diffractive dissociation systems at negative and positive pseudorapidities, respectively. The results are compared with those from other experiments as well as to predictions from high-energy hadron-hadron interaction models.

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TL;DR: The results of this, largest to date, support the use of ECMO as a rescue therapy in patients with severe MERS-CoV, which was associated with lower mortality in MERS patients with refractory hypoxemia.
Abstract: Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS‐CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy in severely hypoxemic patients who failed conventional strategies. We collected data retrospectively on MERS-CoV patients with refractory respiratory failure from April 2014 to December 2015 in 5 intensive care units (ICUs) in Saudi Arabia. Patients were classified into two groups: ECMO versus conventional therapy. Our primary outcome was in-hospital mortality; secondary outcomes included ICU and hospital length of stay. Thirty-five patients were included; 17 received ECMO and 18 received conventional therapy. Both groups had similar baseline characteristics. The ECMO group had lower in-hospital mortality (65 vs. 100%, P = 0.02), longer ICU stay (median 25 vs. 8 days, respectively, P < 0.01), and similar hospital stay (median 41 vs. 31 days, P = 0.421). In addition, patients in the ECMO group had better PaO2/FiO2 at days 7 and 14 of admission to the ICU (124 vs. 63, and 138 vs. 36, P < 0.05), and less use of norepinephrine at days 1 and 14 (29 vs. 80%; and 36 vs. 93%, P < 0.05). ECMO use, as a rescue therapy, was associated with lower mortality in MERS patients with refractory hypoxemia. The results of this, largest to date, support the use of ECMO as a rescue therapy in patients with severe MERS-CoV.

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TL;DR: In this paper, a search for additional neutral Higgs bosons in the τ τ final state in proton-proton collisions at the LHC was performed in the context of the minimal supersymmetric extension of the standard model (MSSM), using the data collected with the CMS detector in 2016 at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9 fb−1.
Abstract: A search is presented for additional neutral Higgs bosons in the τ τ final state in proton-proton collisions at the LHC. The search is performed in the context of the minimal supersymmetric extension of the standard model (MSSM), using the data collected with the CMS detector in 2016 at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9 fb−1. To enhance the sensitivity to neutral MSSM Higgs bosons, the search includes production of the Higgs boson in association with b quarks. No significant deviation above the expected background is observed. Model-independent limits at 95% confidence level (CL) are set on the product of the branching fraction for the decay into τ leptons and the cross section for the production via gluon fusion or in association with b quarks. These limits range from 18 pb at 90 GeV to 3.5 fb at 3.2 TeV for gluon fusion and from 15 pb (at 90 GeV) to 2.5 fb (at 3.2 TeV) for production in association with b quarks, assuming a narrow width resonance. In the m h hod + scenario these limits translate into a 95% CL exclusion of tan β > 6 for neutral Higgs boson masses below 250 GeV, where tan β is the ratio of the vacuum expectation values of the neutral components of the two Higgs doublets. The 95% CL exclusion contour reaches 1.6 TeV for tan β = 60.

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TL;DR: The experimental result reveals that the proposed nature-inspired algorithm finds an optimal subset of features, maximizing the accuracy and minimizing a number of features selected and is more stable.

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TL;DR: There is no difference between IFN treatment and supportive treatment for MERS patients in terms of mortality, however, ribavirin and IFN combination might have efficacious effects with timely administration and monitoring of adverse events.
Abstract: Middle East respiratory syndrome (MERS) is a respiratory disease caused by MERS coronavirus. Because of lack of vaccination, various studies investigated the therapeutic efficacy of antiviral drugs and supportive remedies. A systematic literature search from 10 databases was conducted and screened for relevant articles. Studies reporting information about the treatment of MERS coronavirus infection were extracted and analyzed. Despite receiving treatment with ribavirin plus IFN, the case fatality rate was as high as 71% in the IFN-treatment group and exactly the same in patients who received supportive treatment only. Having chronic renal disease, diabetes mellitus and hypertension increased the risk of mortality (P < .05), and chronic renal disease is the best parameter to predict the mortality. The mean of survival days from onset of illness to death was 46.6 (95% CI, 30.5-62.6) for the IFN group compared with 18.8 (95% CI, 10.3-27.4) for the supportive-only group (P = .001). Delay in starting treatment, older age group, and preexisting comorbidities are associated with worse outcomes. In conclusion, there is no difference between IFN treatment and supportive treatment for MERS patients in terms of mortality. However, ribavirin and IFN combination might have efficacious effects with timely administration and monitoring of adverse events. Large-scale prospective randomized studies are required to assess the role of antiviral drugs for the treatment of this high mortality infection.

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TL;DR: A variant of gray wolf optimization (GWO) that uses reinforcement learning principles combined with neural networks to enhance the performance is proposed and its performance is assessed on solving feature selection problems and on finding optimal weights for neural networks algorithm.
Abstract: In this paper, a variant of gray wolf optimization (GWO) that uses reinforcement learning principles combined with neural networks to enhance the performance is proposed. The aim is to overcome, by reinforced learning, the common challenge of setting the right parameters for the algorithm. In GWO, a single parameter is used to control the exploration/exploitation rate, which influences the performance of the algorithm. Rather than using a global way to change this parameter for all the agents, we use reinforcement learning to set it on an individual basis. The adaptation of the exploration rate for each agent depends on the agent’s own experience and the current terrain of the search space. In order to achieve this, experience repository is built based on the neural network to map a set of agents’ states to a set of corresponding actions that specifically influence the exploration rate. The experience repository is updated by all the search agents to reflect experience and to enhance the future actions continuously. The resulted algorithm is called experienced GWO (EGWO) and its performance is assessed on solving feature selection problems and on finding optimal weights for neural networks algorithm. We use a set of performance indicators to evaluate the efficiency of the method. Results over various data sets demonstrate an advance of the EGWO over the original GWO and over other metaheuristics, such as genetic algorithms and particle swarm optimization.

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22 Nov 2018-Cells
TL;DR: Autophagy induction by exosomes could attenuate DN in a rat model of streptozotocin-induced diabetes mellitus and markedly improved renal function and showed histological restoration of renal tissues.
Abstract: Background: Diabetic nephropathy (DN) is a serious complication of diabetes mellitus and a common cause of end-stage renal disease. Autophagy has a defensive role against kidney damage caused by hyperglycemia. Mesenchymal stem cell (MSC)-derived exosomes are currently considered as a new promising therapy for chronic renal injury. However, the renal-protective mechanism of exosomes on DN is not completely understood. We examined the potential role of MSC-derived exosomes for enhancement of autophagy activity and their effect on DN. In our study, we used five groups of rats: control; DN; DN treated with exosomes; DN treated with 3-methyladenine (3-MA) and chloroquine (inhibitors of autophagy); and DN treated with 3-methyladenine (3-MA), chloroquine, and exosome groups. We assessed renal function, morphology, and fibrosis. Moreover, ratios of the autophagy markers mechanistic target of rapamycin (mTOR), Beclin-1, light chain-3 (LC3-II), and LC3-II/LC3-I were detected. Additionally, electron microscopy was used for detection of autophagosomes. Results: Exosomes markedly improved renal function and showed histological restoration of renal tissues, with significant increase of LC3 and Beclin-1, and significant decrease of mTOR and fibrotic marker expression in renal tissue. All previous effects were partially abolished by the autophagy inhibitors chloroquine and 3-MA. Conclusion: We conclude that autophagy induction by exosomes could attenuate DN in a rat model of streptozotocin-induced diabetes mellitus.

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TL;DR: In this article, a unified method to the conformable time fractional non linear Schr o ¾ dinger equation with perturbation terms is presented, where the predicted solutions in finite series forms of various functions satisfying some particular ODEs are substituted into the reduced form of the governing equation.