Evaluation of Serum CA 19-9 as a Diagnostic Marker for Pancreatic Malignancy.

In biliary-pancreatic malignancy, the serum CA 19-9 is considered as a tumor marker. Its high level may indicate the presence of a malignant disorder, but it can also be raised in benign conditions and also in malignancies from other organs. The value may be normal even in malignant condition. This comparative study was conducted in the Department of Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from 1st June 2016 to 31st May 2017 to determine the sensitivity and specificity of CA 19-9 as a tumor marker in pancreatic malignancy in our perspective and to establish a cut-off value of CA 19-9 which might prove as a definitive indication of pancreatic malignancy. We found that when the cut off value of CA 19-9 is 38 U/ml (according to ROC curve), the sensitivity, specificity, PPV and NPV were 77.8%, 77.8%, 77.8%, 77.8% respectively. And if the serum CA 19-9 threshold was raised to 100 and 120 to diagnose pancreatic cancer, sensitivity became 72.2% and 66.7% and NPV 76.2% and 73.9% respectively. However, the specificity increased to 88.9% and 94.4% and the PPV increased to 86.7% and 92.3% respectively.

Cryptocurrency and stock market: bibliometric and content analysis.

This study conducted a systematic review regarding the association between cryptocurrency and the stock market. This study used bibliometric and content analysis covering 151 articles from 2008 to November 2021. Using VOSviewer software, we explored the influential aspects of the literature, such as the prominent institutions, authors, countries, and journals. Additionally, we performed co-authorship, bibliographic coupling, and co-occurrence of keywords to understand the network. Furthermore, in the content analysis, we discussed key findings of four major research streams that we identified. Finally, we present seven research questions that can be explored in the future. The findings have a number of implications for the present state of the literature on cryptocurrency and the stock market, including study gaps and potential future research initiatives.

A comparison of traditional diarrhoea measurement methods with microbiological and biochemical indicators: A cross-sectional observational study in the Cox's Bazar displaced persons camp.

BACKGROUND: Water, Sanitation, and Hygiene (WASH) systems aim to reduce the spread of enteric pathogens, particularly amongst children under five years old. The most common primary outcome of WASH trials is carer-reported diarrhoea. We evaluate different diarrhoea survey instruments as proxy markers of enteric pathogen presence in stool. METHODS: We recruited 800 community-based participants from the Cox's Bazar Displaced Person's Camp in Bangladesh, split evenly between the rainy (July/August 2020) and dry (November/December 2020) periods. Participants were randomized evenly into either a standard survey asking carers if their child under five years old has had diarrhoea in the past fortnight, or a pictorial survey asking carers to pick from a pictorial chart which stools their child under five years old has had in the past fortnight. We collected stools from a random sub-sample of 120. Stools were examined visually, and tested for proteins associated with enteric infection and 16 enteric pathogens. We calculated sensitivities and specificities for each survey type, visual examination, and proteins with respect to enteric pathogen presence. FINDINGS: The sensitivity of the standard survey for enteric pathogen presence was 0.49[95%CI:0.32,0.66] and the specificity was 0.65[0.41,0.85]. Similar sensitivities and specificities were observed for pictorial survey, visual inspection, and proteins. INTERPRETATION: While diarrhoea is an important sign in clinical practice it appears that it is a poor proxy for enteric pathogen presence in stool in epidemiological surveys. When enteric infection is of interest, this should be measured directly. FUNDING: The project was funded by the National Institutes for Health Research Global Health Research Unit on Improving Health in Slums (16/136/87) and by the University of Warwick.

High prevalence of plasmid-mediated quinolone resistance (PMQR) among E. coli from aquatic environments in Bangladesh.

Fluro(quinolones) is an important class of antibiotic used widely in both human and veterinary medicine. Resistance to fluro(quinolones) can be acquired by either chromosomal point mutations or plasmid-mediated quinolone resistance (PMQR). There is a lack of studies on the prevalence of PMQR in organisms from environmental sources in Bangladesh. In this study, we investigated the occurrence of PMQR genes in E. coli from various water sources and analysed associations between multi-drug resistance (MDR) and resistance to extended spectrum ß-lactam antibiotics. We analysed 300 E. coli isolates from wastewaters of urban live-bird markets (n = 74) and rural households (n = 80), rural ponds (n = 71) and river water samples (n = 75) during 2017-2018. We isolated E. coli by filtering 100 ml of water samples through a 0.2µm cellulose membrane and incubating on mTEC agar media followed by identification of isolated colonies using biochemical tests. We selected one isolate per sample for detection of PMQR genes by multiplex PCR and tested for antibiotic susceptibility by disc diffusion. Clonal relatedness of PMQR-positive isolates was evaluated by enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR). About 66% (n = 199) of E. coli isolates harbored PMQR-genes, predominantly qnrS (82%, n = 164) followed by aac(6')-lb-cr (9%, n = 17), oqxAB (7%, n = 13), qnrB (6%, n = 11) and qepA (4%, n = 8). Around 68% (n = 135) of PMQR-positive isolates were MDR and 92% (n = 183) were extended spectrum ß-lactamase (ESBL)-producing of which the proportion of positive samples was 87% (n = 159) for blaCTX-M-1' 34% (n = 62) for blaTEM, 9% (n = 16) for blaOXA-1, blaOXA-47 and blaCMY-2, and 2% (n = 4) for blaSHV. Further, 16% (n = 32) of PMQR-positive isolates were resistant to carbapenems of which 20 isolates carried blaNDM-1. Class 1 integron (int1) was found in 36% (n = 72) of PMQR-positive E. coli isolates. PMQR genes were significantly associated with ESBL phenotypes (p≤0.001). The presence of several PMQR genes were positively associated with ESBL and carbapenemase encoding genes such as qnrS with blaCTXM-1 (p<0.001), qnrB with blaTEM (p<0.001) and blaOXA-1 (p = 0.005), oqxAB and aac(6')-lb-cr with blaSHV and blaOXA-1 (p<0.001), qnrB with blaNDM-1 (p<0.001), aac(6')-lb-cr with blaOXA-47 (p<0.001) and blaNDM-1 (p = 0.002). Further, int1 was found to correlate with qnrB (p<0.001) and qepA (p = 0.011). ERIC-PCR profiles allowed identification of 84 of 199 isolates with 85% matching profiles which were further grouped into 33 clusters. Only 5 clusters had isolates (n = 11) with identical ERIC-PCR profiles suggesting that PMQR-positive E. coli isolates are genetically heterogeneous. Overall, PMQR-positive MDR E. coli were widely distributed in aquatic environments of Bangladesh indicating poor wastewater treatment and highlighting the risk of transmission to humans and animals.

A Comparative Study of Thermal Aging Effect on the Properties of Silicone-Based and Silicone-Free Thermal Gap Filler Materials.

Thermal conductive gap filler materials are used as thermal interface materials (TIMs) in electronic devices due their numerous advantages, such as higher thermal conductivity, ease of use, and conformity. Silicone is a class of synthetic materials based on a polymeric siloxane backbone which is widely used in thermal gap filler materials. In electronic packages, silicone-based thermal gap filler materials are widely used in industries, whereas silicone-free thermal gap filler materials are emerging as new alternatives for numerous electronics applications. Certainly, characterization of these TIMs is of immense importance since it plays a critical role in heat dissipation and long-term reliability of the electronic packages. Insubstantial studies on the effects of various chemical compounds on the properties of silicone-based and silicone-free TIMs has led to this study, which focuses on the effect of thermal aging on the mechanical, thermal, and dielectric properties of silicone-based and silicone-free TIMs and the chemical compounds that cause the changes in properties of these materials. Characterization techniques such as dynamic mechanical analysis (DMA), thermomechanical analysis (TMA), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), and broadband dielectric spectroscopy (BbDS) are used to study the mechanical, thermal, and dielectric characteristics of these TIMs, which will guide towards a better understanding of the applicability and reliability of these TIMs. The experiments demonstrate that upon thermal aging at 125 °C, the silicone-free TIM becomes hard, while silicone-based TIM remains viscoelastic, which indicates its wide applicability to higher temperature applications for a long time. Though silicone-based TIM displays better mechanical and thermal properties at elevated temperatures, dielectric properties indicate low conductivity for silicone-free TIM, which makes it a better candidate for silicone-sensitive applications where higher electric insulation is desired.

Improvement in reporting skills of radiology residents with a structured reporting curriculum.

RATIONALE AND OBJECTIVES: Radiology residents must acquire dictation and reporting skills to meet Accreditation Council for Graduate Medical Examination requirements and provide optimal patient care. Historically, these skills have been taught informally and vary between institutions and among radiologists. A structured curriculum improves resident report quality when using a quantitative grading scheme. This study describes the implementation of such a curriculum and evaluates its utility in tracking resident progress. MATERIALS AND METHODS: We implemented a three-stage reporting curriculum in our diagnostic radiology residency program in 2009. Stages 1 and 2 involve instruction and formative feedback composed of suggestions for improvement in a 360° format from faculty, peers, and others within the resident's sphere of influence. The third stage involves individual, biannual, written feedback with scored reports specifically assessing four categories: succinctness, spelling/grammar, clarity, and responsible referral. Biannual scores were collected from 2009 to 2013, sorted by year of residency training (R1 to R4), and average training level scores were statistically compared. RESULTS: Review of 1500 reports over a 4-year period yielded a total of 153 scores: 54, 36, 29, and 34 from R1, R2, R3, and R4 residents, respectively. The mean (standard deviation) scores for R1, R2, R3, and R4 residents were 10.20 (1.06), 10.25 (0.81), 10.5 (0.74), and 10.75 (0.69), respectively. Post hoc analysis identified significant differences between R1 and R4 residents (P = .012) and R2 and R4 residents (P = .009). CONCLUSIONS: Residents' reporting scores showed significant improvement over the course of their residency training. This indicates that there may be a benefit in using an organized reporting curriculum to track resident progress in producing reports that may improve patient care.