Immune-Cell-Mediated Cancer Treatment: Advantages, Drawbacks And Future Direction

Cancer ranks as the most lethal and prevalent non-communicable disease in clinical settings. Therapeutic options for cancer comprise chemotherapy, radiotherapy, surgery, and combined treatment. Cancer remission and relapse cases are widespread despite having various advanced medications and sophisticated dissection techniques. A new approach involving immune-cell-mediated cancer therapy has been adopted extensively for cancer treatments by utilizing immune cells. Immunotherapy has gained much attention to prevent and treat various types of cancer. Immunotherapy treatments operate in multiple contexts. Several immunotherapy therapeutic interventions assist the immune function in halting or reducing the advancement of cancer cells. Many also facilitate the immune cells in destroying cancerous cells or safeguarding against cancer from disseminating to certain other regions of the human body. Among other methods, genetic manipulation of immune cells offers hope for innovative anticancer treatment. T lymphocytes and natural killer cells have become the most extensively documented immune cells for immunotherapy. Chimeric antigen receptor T-cell therapy exhibits the most promising blood cancer treatment. However, adoptive NK cell transfer therapy displays potential anticancer treatment options, although more research is needed to be carried out. In addition, cytokine-induced immunomodulation is also plausible for cancer immunotherapy. This review will highlight the most comprehensive information, observations, and consequences associated with different cancer immunotherapy initiatives

The State of Interventional Radiology in Myanmar: A National Report

Purpose: Radiology global outreach programs have increased in recent years but progressed more slowly than other specialties. Establishing radiology services is increasingly recognized as a priority in resource-limited settings. Myanmar has a tremendous disease burden that is treatable with interventional radiology (IR) techniques, and aims to grow and effectively integrate this service into its public healthcare sector. Through collaborations between Asia Pacific Society of Cardiovascular and Interventional Radiology (APSCVIR) and Myanmar Radiological Society (MRS), the field of IR has grown exponentially over recent years. This study aims to provide a Myanmar national IR report on the current trends and future challenges. Methods and materials: Descriptive variables across five domains (facility and equipment, workforce, supplies, infrastructure, and casemix) from the four public sector hospitals with IR capability were obtained between 2016-2019. The four hospitals were Yangon General Hospital (YGH), Yangon Specialty Hospital (YSH), Mandalay General Hospital (MGH), and Defense Services General Hospital (DSGH). Data were analyzed to demonstrate progress in IR and the differing casemix. Results: There are currently four IR-capable hospitals and nine interventional radiologists across Myanmar’s public healthcare sector. IR case volumes tripled from 514 cases in 2016 to more than 1,500 cases in 2019. The three most common procedures performed were trans-arterial chemoembolization (TACE, 63%), bronchial arterial embolization (BAE, 7.7%), and drainages (7.7%). Significant challenges to the growth and adoption of IR services span the domains of infrastructure, equipment and supplies, workforce, and IR awareness, among other clinical specialties. Conclusion: Myanmar’s healthcare priorities, coupled with international radiological outreach programs, have led to rapid growth of IR. The exponential growth in case volumes is promising for Myanmar and other developing countries. But to widen the scope of practice and integrate the service within local clinical workflows, a holistic effort that addresses multiple domains is needed in the future

High rate of virological failure and low rate of switching to second-line treatment among adolescents and adults living with HIV on first-line ART in Myanmar, 2005-2015.

BACKGROUND: The number of people living with HIV on antiretroviral treatment (ART) in Myanmar has been increasing rapidly in recent years. This study aimed to estimate rates of virological failure on first-line ART and switching to second-line ART due to treatment failure at the Integrated HIV Care program (IHC). METHODS: Routinely collected data of all adolescent and adult patients living with HIV who were initiated on first-line ART at IHC between 2005 and 2015 were retrospectively analyzed. The cumulative hazard of virological failure on first-line ART and switching to second-line ART were estimated. Crude and adjusted hazard ratios were calculated using the Cox regression model to identify risk factors associated with the two outcomes. RESULTS: Of 23,248 adults and adolescents, 7,888 (34%) were tested for HIV viral load. The incidence rate of virological failure among those tested was 3.2 per 100 person-years follow-up and the rate of switching to second-line ART among all patients was 1.4 per 100 person-years follow-up. Factors associated with virological failure included: being adolescent; being lost to follow-up at least once; having WHO stage 3 and 4 at ART initiation; and having taken first-line ART elsewhere before coming to IHC. Of the 1032 patients who met virological failure criteria, 762 (74%) switched to second-line ART. CONCLUSIONS: We found high rates of virological failure among one third of patients in the cohort who were tested for viral load. Of those failing virologically on first-line ART, about one quarter were not switched to second-line ART. Routine viral load monitoring, especially for those identified as having a higher risk of treatment failure, should be considered in this setting to detect all patients failing on first-line ART. Strategies also need to be put in place to prevent treatment failure and to treat more of those patients who are actually failing

Evaluation on dry forage yields and nutritional characteristics of introduced herbaceous legumes in Myanmar

The study was carried out to evaluate the forage yields, nutritive values and in vitro fermentation parameters of herbaceous legumes. Five varieties of introduced herbaceous legumes; Stylosanthes guianensis cv. Ubon stylo, Macrotyloma axillare cv. Archer, Centrosema brasilianum cv. Ooloo, Stylosanthes guianensis cv. Stylo 184 and Macroptilum bracteatum cv. Cadarga were evaluated at the research farm, University of Veterinary Science, Yezin, Myanmar. No fertilizer and no irrigation were applied for cultivation to test drought resistance. Dry forage yield, nutritive values and gas production at four harvesting times were measured with 4×5 factorial arrangement (5 legumes and 4 harvesting time) in randomized complete block design. There was no interaction between legumes and harvesting time on forage yield, nutritive values and fermentation parameters but they were affected by the main effects of legume types and harvesting time. Among the legume forages, the highest dry forage yields were found in Ooloo, Ubon stylo, and Stylo 184, and followed by the DM yield of Archer and Cadarga. The DM yield of the second harvest was significantly higher (p<0.05) than those of the first, third and fourth harvest which were not significantly different from each other. As a chemical composition, the DM content of Archer was lower (p<0.05) than those of other varieties. Among the legumes forages, the lower CP content was found in Cadarga. The higher NDF was observed in Ooloo. Ooloo, Ubon stylo and Cadarga showed higher ADF in comparison with the other two varieties. Among the harvesting time, the lowest DM content was found at the first harvest. The highest CP content was found at third harvest. The NDF content was not significantly different. The lowest ADF content was found in fourth harvest. According to the dry forage yield, Ubon stylo and Ooloo had the highest dry forage yield and in term of nutritive values, Stylo 184 and Archer had higher nutritive values. As the main effect of forages, Stylo 184 and Archer had higher gas production in comparison with the other varieties. As the main effect of harvesting time, the fourth harvest had the highest gas production in comparison with other harvesting time. It could be better for cultivation by application of fertilizer and irrigation to get more forage yield and quality. &nbsp

Long-term outcomes of second-line antiretroviral treatment in an adult and adolescent cohort in Myanmar.

BACKGROUND: Myanmar has a high burden of Human Immunodeficiency Virus (HIV) and second-line antiretroviral treatment (ART) has been available since 2008 in the public health sector. However, there have been no published data about the outcomes of such patients until now. OBJECTIVE: To assess the treatment and programmatic outcomes and factors associated with unfavorable outcomes (treatment failure, death and loss to follow-up from care) among people living with HIV (aged ≥ 10 years) receiving protease inhibitor-based second-line ART under the Integrated HIV Care Program in Myanmar between October 2008 and June 2015. DESIGN: Retrospective cohort study using routinely collected program data. RESULTS: Of 824 adults and adolescents on second-line ART, 52 patients received viral load testing and 19 patients were diagnosed with virological failure. However, their treatment was not modified. At the end of a total follow-up duration of 7 years, 88 (11%) patients died, 35 (4%) were lost to follow-up, 21 (2%) were transferred out to other health facilities and 680 (83%) were still under care. The incidence rate of unfavorable outcomes was 7.9 patients per 100 person years follow-up. Patients with a history of injecting drug use, with a history of lost to follow-up, with a higher baseline viral load and who had received didanosine and abacavir had a higher risk of unfavorable outcomes. Patients with higher baseline C4 counts, those having taken first-line ART at a private clinic, receiving ART at decentralized sites and taking zidovudine and lamivudine had a lower risk of unfavorable outcomes. CONCLUSIONS: Long-term outcomes of patients on second-line ART were relatively good in this cohort. Virological failure was relatively low, possibly because of lack of viral load testing. No patient who failed on second-line ART was switched to third-line treatment. The National HIV/AIDS Program should consider making routine viral load monitoring and third-line ART drugs available after a careful cost-benefit analysis

National scale-up of tuberculosis-human immunodeficiency virus collaborative activities in Myanmar from 2005 to 2016 and tuberculosis treatment outcomes for patients with human immunodeficiency virus-positive tuberculosis in the Mandalay Region in 2015.

Background: HIV-associated TB is a serious public health problem in Myanmar. Study objectives were to describe national scale-up of collaborative activities to reduce the double burden of TB and HIV from 2005 to 2016 and to describe TB treatment outcomes of individuals registered with HIV-associated TB in 2015 in the Mandalay Region. Methods: Secondary analysis of national aggregate data and, for treatment outcomes, a cohort study of patients with HIV-associated TB in the Mandalay Region. Results: The number of townships implementing collaborative activities increased from 7 to 330 by 2016. The number of registered TB patients increased from 1577 to 139 625 in 2016, with the number of individuals tested for HIV increasing from 432 to 114 180 (82%) in 2016: 10 971 (10%) were diagnosed as HIV positive. Uptake of co-trimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) nationally in 2016 was 77% and 52%, respectively. In the Mandalay Region, treatment success was 77% and mortality was 18% in 815 HIV-associated TB patients. Risk factors for unfavourable outcomes and death were older age (≥45 years) and not taking CPT and/or ART. Conclusion: Myanmar is making good progress with reducing the HIV burden in TB patients, but better implementation is needed to reach 100% HIV testing and 100% CPT and ART uptake in TB-HIV co-infected patients

Clinical importance of the Mandalay spitting cobra (Naja mandalayensis) in Upper Myanmar – Bites, envenoming and ophthalmia

This is an accepted manuscript of an article published by Elsevier in Toxicon on 03/06/2020, available online: https://doi.org/10.1016/j.toxicon.2020.05.023 The accepted version of the publication may differ from the final published version.© 2020 Elsevier Ltd Examination of 18 cobras brought to three hospitals in the Mandalay Region by patients bitten or spat at by them distinguished 3 monocled cobras (Naja kaouthia) and 15 Mandalay spitting cobras (N. mandalayensis), based on their morphological characteristics. We confirm and extend the known distributions and habitats of both N. mandalayensis and N. kaouthia in Upper Myanmar. Clinical symptoms of local and systemic envenoming by N. mandalayensis are described for the first time. These included local swelling, blistering and necrosis and life-threatening systemic neurotoxicity. More information is needed about the clinical phenotype and management of bites by N. mandalayensis, the commoner of the two cobras in Upper Myanmar. Since the current cobra antivenom manufactured in Myanmar has lower pre-clinical efficacy against N. mandalayensis than N. kaouthia, there is a need for more specific antivenom therapy.Published versio

Confirmation of Skywalker Hoolock Gibbon (Hoolock tianxing) in Myanmar extends known geographic range of an endangered primate

Characterizing genetically distinct populations of primates is important for protecting biodiversity and effectively allocating conservation resources. Skywalker gibbons (Hoolock tianxing) were first described in 2017, with the only confirmed population consisting of 150 individuals in Mt. Gaoligong, Yunnan Province, China. Based on river geography, the distribution of the skywalker gibbon has been hypothesized to extend into Myanmar between the N’Mai Kha and Ayeyarwaddy Rivers to the west, and the Salween River (named the Thanlwin River in Myanmar and Nujiang River in China) to the east. We conducted acoustic point-count sampling surveys, collected noninvasive samples for molecular mitochondrial cytochrome b gene identification, and took photographs for morphological identification at six sites in Kachin State and three sites in Shan State to determine the presence of skywalker gibbons in predicted suitable forest areas in Myanmar. We also conducted 50 semistructured interviews with members of communities surrounding gibbon range forests to understand potential threats. In Kachin State, we audio-recorded 23 gibbon groups with group densities ranging between 0.57 and 3.6 group/km2. In Shan State, we audio-recorded 21 gibbon groups with group densities ranging between 0.134 and 1.0 group/km2. Based on genetic data obtained from skin and saliva samples, the gibbons were identified as skywalker gibbons (99.54–100% identity). Although these findings increase the species’ known population size and confirmed distribution, skywalker gibbons in Myanmar are threatened by local habitat loss, degradation, and fragmentation. Most of the skywalker gibbon population in Myanmar exists outside protected areas. Therefore, the IUCN Red List status of the skywalker gibbon should remain as Endangered

Printed circuit board design for reduction of common-mode radiation

Recently, radiated electromagnetic interference (EMI) has become a major design issue for high speed circuit designers, and it is likely to become even more severe in the future. With increasing operational speeds of circuits, electronic products may not pass the EMI regulatory standards such as FCC, CISPR, etc. Therefore, it is critical to design an electronic system with Electromagnetic Compatibility (EMC) consideration.Master of Scienc

Defensive Analysis on Web-Application Input Validation for Advanced Persistent Threat (APT) Attack `

Nowadays, any kinds of cyber-attacks arefirstly attacked to web site and the site containsinformation about business, government andother organizations. So, the role of web pagesecurity is becoming the essential part of cybersecurity. Most of the web pages are suffered fromattacks such as Advanced Persistent Threat(APT). An APT is an extended campaigntargeted at a specific organization to achieve aclear objective. Most of the web pages havemuch vulnerability due to insecure source codes.In this paper, it will be defined web pagevulnerabilities on PHP source code. It will becollected the attacks from the scenarios. Theresult can be concluded the attack vectors via thesource code. Each level of source code can begenerated by the attributes of source code. Theseattributes can be measured in order to securesource codes and can be evaluated by measuringthe vulnerabilities metrics