Aim: To characterize vaso-occlusive crises (VOCs) and describe healthcare costs among commerciallyinsured, Medicaid-insured, and Medicare-insured patients with sickle cell disease (SCD).
Aim: An experimental study was conducted on 192-day-old broiler chicks for evaluating the effect of 10% neem leaf extract (NLE) supplementationon biochemical parameters in chickens experimentally infected with Escherichia coli O78 at 10 7 CFU/0.5 ml at 7 days of age. Materials and Methods:The 192-day-old broiler chicks were procured. These chicks were divided into two groups (A and B) containing 96 birds each on the 1 st day. Diet of all the chicks of Group A was supplemented with 10%NLE in water, whereas chicks of Group B were given feed and water devoid of NLE supplementation throughout the experiment. After rearing for 1 week, chicks of both the groups (A and B) were again divided into two subgroups (Group A into A1 and A2 and Group B into B1 and B2) of 54 and 42 birds, respectively. At the age of 7 days all the chicks of groups A1 and B1 were injected with E. coli O78 at 10 7 CFU/0.5 ml intraperitoneally. Blood samples were collected from six chicks from each group at day 0, 2, 4, 7, 14, 21, 28 days post-infection and serum was separated for biochemical studies.Results: There was a significant increase in serum alanine transaminase (ALT), aspartate transaminase (AST), lactate dehydrogenase (LDH) activities, globulin concentration and a decrease in total protein (TP), albumin concentrations, and alkaline phosphatase (ALP) activity in both the infected groups. However, the changes in biochemical values, i.e., ALT, AST, LDH, ALP, TP, albumin, and globulin wereof lower magnitude in NLE supplemented group suggesting hepatoprotective and cardioprotective effect of NLE. Conclusions: Fromthe present study, it is reasonable to conclude that significant increase in the value of ALT, AST, LDH, globulin, and significant decrease in the value of ALP, TP, and albumin was of lower magnitude in supplemented infected group (A1) as compared to non-supplemented infected group (B1) suggesting hepatoprotective and cardioprotective effect of NLE.
Aim:The present study was conducted to evaluate the effects of neem leaf extract (NLE) supplementation on immunological response and pathology of different lymphoid organs in experimentally Escherichia coli challenged broiler chickens.Materials and Methods:For this study, we procured 192-day-old broiler chicks from local hatchery and divided them into Groups A and Group B containing 96 birds each on the first day. Chicks of Group A were supplemented with 10% NLE in water, whereas chicks of Group B were not supplemented with NLE throughout the experiment. At 7th day of age, chicks of Group A were divided into A1 and A2 and Group B into B1 and B2 with 54 and 42 chicks, respectively, and chicks of Groups A1 and B1 were injected with E. coli O78 at 107 colony-forming units/0.5 ml intraperitoneally. Six chicks from each group were sacrificed at 0, 2, 4, 7, 14, 21, and 28 days post infection; blood was collected and thorough post-mortem examination was conducted. Tissue pieces of spleen and bursa of Fabricius were collected in 10% buffered formalin for histopathological examination. Serum was separated for immunological studies.Result:E. coli specific antibody titer was significantly higher in Group A1 in comparison to Group B1. Delayed-type hypersensitivity response against 2,4 dinirochlorobenzene (DNCB) antigen was significantly higher in Group A1 as compared to Group B1. Pathological studies revealed that E. coli infection caused depletion of lymphocytes in bursa of Fabricius and spleen. Severity of lesions in Group A1 was significantly lower in comparison to Group B1.Conclusion:10% NLE supplementation enhanced the humoral as well as cellular immune responses attributed to its immunomodulatory property in experimentally E. coli infected broiler chicken.
Stress in the crop not only decreases the production but can also have devastating consequences for farmers whose life depends upon the healthy crops. In recent time (January 2018) a such abiotic stress event (hoar frost) was experienced at ICAR research complex experimental filed, Ri-Bhoi district of Meghalaya on standing Maize crop. Therefore, remote sensing (Multispectral UAV-Unmanned Aerial Vehicle) technology were used to detect the effect of frost on in-filed Maize crop. Two set of multispectral data (before frost and after frost) with four advanced machine learning techniques viz. Random Forest (RF), Random Committee (RC), Support Vector Machine (SVM) and Artificial Neural Network were employed for detection of stress free crop and stressed crop due to frost. Results revealed that all the four methods of classification could able to identify / detect stress-free vs. stressed crops at satisfactory level. However, among the classifiers RF achieved relatively higher overall accuracy (OA=86.47%) with Kappa Indexanalysis (KIA=0.80) and found very cost effective in context of computational cost (time complexity = 0.08 Seconds) to train the model. In addition, we have also recorded the area of each classes and found that after frost stress-free area (36.01% of all over filed) is decreased by 11% in comparison of before frost (25.036% of all over filed). Based on the results we can suggest that the RF ensemble classification method can be used for further other crop classification in order to estimate the yield, detect the condition, monitoring the health etc.
Background: Episodes of acute pain caused by vaso-occlusive crises (VOCs) are a frequent and debilitating complication associated with sickle cell disease (SCD) and represent the most common cause for emergency room (ER) visits and inpatient (IP) stays. VOCs are due to a complex pathophysiology including multicellular adhesion. The purpose of this study was to characterize VOCs and assess the costs of SCD for patients with commercial insurance using an Excel-based model. Methods: Patients with SCD aged ≥16 years were identified in the IBM Truven MarketScan commercial databases (01/01/2000-06/30/2018). The index date was randomly selected among potential calendar dates to have ≥12 months of continuous health plan enrollment before (pre-index period) and after (follow-up period) that date. Patients with Medicare Supplemental coverage or stem cell transplant (SCT) were excluded. Data were analyzed at the state level for 23 key states with the highest concentration of patients with SCD and at the national level to be incorporated into an Excel-based model. The key variables in the model were age, gender, state of residence, and SCD clinical characteristics measured during the 12-month pre-index period. The following model inputs were assessed during the subsequent 12-month follow-up period: number, type, and setting (i.e., IP, ER, or outpatient [OP]) of VOC episodes; and total all-cause and SCD-related healthcare costs. Costs were reported in 2018 USD from a payer's perspective. We defined a VOC episode requiring medical services in claims data as follows: medical service claims with a VOC-related diagnosis occurring within 3 days of each other, IP re-admission within 14 days of a previous IP stay (both with VOC-related diagnoses), or any follow-up medical services with VOC-related diagnoses in the 7 days following an initial VOC diagnosis. A complicated VOC type was defined as a VOC episode with a diagnosis of priapism, splenic sequestration, acute hepatic sequestration, or acute chest syndrome. Variables were stratified by annual number of VOCs (i.e., 0, 1, ≥2 VOCs) and medical service setting (i.e., IP, ER, or OP). Results: A total of 16,092 commercially-insured patients with SCD from all US states were included in this study: mean age was 36.7 years, and 61.4% were females. In total, 27.7% had Hb-SS, 23.4% Hb-SC, 25.8% Hb-thalassemia, and 23.1% had an unspecified SCD type. The five states that contributed the highest number of patients with SCD were New York (n=1,711; 10.6%), Texas (n=1,593; 9.9%), Florida (n=1,397; 8.7%), Georgia (n=1,382; 8.6%), and California (n=966; 6.0%). In a given year, 64.7% of patients did not have any VOC episodes, 14.0% had only 1 VOC, and 21.2% had ≥2 VOCs (10.1% had ≥4 VOCs). Among patients with ≥1 VOC, the mean number of VOC episode was 3.3 (7.3% were complicated VOCs); among those with ≥2 VOCs, this figure was 4.8 (6.9% were complicated VOCs). The model showed that VOC episodes were distributed as follows: 37.4% in an IP setting, 26.4% in an ER, and 36.2% in an OP setting (Figure 1). The mean duration of a VOC episode was 11.7 days in an IP setting, 2.3 days in an ER setting, and 1.9 days in an OP setting (Figure 2). Total annual all-cause healthcare costs for patients with 0, 1, and ≥2 VOCs were $15,747, $27,194, and $64,555, respectively (Figure 3). Total annual SCD-related healthcare costs for patients with 0, 1, and ≥2 VOCs were $8,885, $21,323, and $60,624, respectively, representing 56.4%, 78.4%, and 93.9% of total annual all-cause healthcare costs, respectively (Figure 3). Conclusions: Among commercially-insured patients with SCD in the US, over one-third of patients experienced VOCs. The model showed that the contribution of SCD-related costs to annual total healthcare costs increases with the number of VOCs per year. Disclosures Joseph: Amgen: Equity Ownership; Novartis: Employment, Equity Ownership; Pfizer: Equity Ownership; Cigna: Equity Ownership. Latremouille-Viau:Novartis: Other: I am an employee of Analysis Group, Inc., which provided paid consulting services to Novartis for the conduct of this study. Sharma:NOVARTIS HEALTHCARE PVT. LTD.: Employment. Gagnon-Sanschagrin:Novartis: Other: I am an employee of Analysis Group, Inc., which provided paid consulting services to Novartis for the conduct of this study. Bhor:Novartis: Employment, Equity Ownership. Khare:HEALTHCARE PVT. LTD.: Employment. Singh:NOVARTIS HEALTHCARE PVT. LTD.: Employment. Serra:Novartis: Other: I am an employee of Analysis Group, Inc., which provided paid consulting services to Novartis for the conduct of this study. Davidson:Novartis: Other: I am an employee of Analysis Group, Inc., which provided paid consulting services to Novartis for the conduct of this study. Guerin:Novartis: Other: I am an employee of Analysis Group, Inc., which provided paid consulting services to Novartis for the conduct of this study. Shah:GBT: Research Funding; Alexion: Speakers Bureau; Novartis: Consultancy, Research Funding, Speakers Bureau.
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