Rationale, study design and methodology of the LANDMARC trial: a 3-year, pan-India, prospective, longitudinal study to assess management and real-world outcomes of diabetes mellitus.

AIM: India contributes towards a large part of the worldwide epidemic of diabetes and its associated complications. However, there are limited longitudinal studies available in India to understand the occurrence of diabetes complications over time. This pan-India longitudinal study was initiated to assess the real-world outcomes of diabetes across the country. METHODS: The LANDMARC study is the first prospective, multicentre, longitudinal, observational study investigating a large cohort of people with type 2 diabetes mellitus across India over a period of 3 years. The primary objective of this ongoing study is to determine the proportion of people developing macrovascular diabetes complications over the duration of the study (36 months ± 45 days) distributed over seven visits; the secondary objective is to evaluate microvascular diabetes complications, glycaemic control and time-to-treatment adaptation or intensification. Overall, 6300 participants (aged 25-60 years) diagnosed with type 2 diabetes for at least 2 years will be included from 450 centres across India. Data will be recorded for baseline demographics, comorbidities, glycaemic measurements, use of anti-hyperglycaemic medications and any cardiovascular or other diabetes-related events occurring during the observational study period. CONCLUSIONS: The LANDMARC study is expected to reveal the trends in complications associated with diabetes, treatment strategies used by physicians, and correlation among treatment, control and complications of diabetes within the Indian context. The findings of this study will help to identify the disease burden, emergence of early-onset complications and dose titration patterns, and eventually develop person-centred care and facilitate public health agencies to invest appropriate resources in the management of diabetes. (Trial Registration No: CTRI/2017/05/008452).

Dosimetric response of fabricated Ge-doped optical fibres in computed tomography RQT beam quality x-ray beams.

Novel germanium (Ge)-doped silica glass fibres tailor-made in Malaysia are fast gaining recognition as potential media for thermoluminescence (TL) dosimetry, with active research ongoing into exploitation of their various beneficial characteristics. Investigation is made herein of the capability of these media for use in diagnostic imaging dosimetry, specifically at the radiation dose levels typically obtained in conduct of Computed Tomography (CT). As a first step within such efforts, there is need to investigate the performance of the fibres using tightly defined spectra, use being made of a Philips constant potential industrial x-ray facility, Model MG165, located at the Malaysian Nuclear Agency Secondary Standards Dosimetry Lab (SSDL). Standard radiation beam qualities (termed RQT) have been established for CT, in accord with IEC 61267: 2003 and IAEA Technical Reports Series No. 457: 2007. A calibrated ionisation chamber has also been utilised, forming a component part of the SSDL equipment. The fabricated fibres used in this study are 2.3 mol% flat fibre (FF) of dimensions 643 × 356 µm2 and 2.3 mol% cylindrical fibre (CF) of 481 µm diameter, while the commercial fibre used is 4 mol% with core diameter of 50 µm. The dopant concentrations are nominal preform values. The fibres have been irradiated to doses of 20, 30 and 40 milligray (mGy) for each of the beam qualities RQT 8, RQT 9 and RQT 10. For x-rays generated at constant potential values from 100 to 150 kV, a discernible energy-dependent response is seen, comparisons being made with that of lithium fluoride (LiF) thermoluminescence dosimeters (TLD-100). TL yield versus dose has also been investigated for x-ray doses from 2 to 40 mGy, all exhibiting linearity. Compared to TLD-100, greater sensitivity is observed for the fibres.

[Bipolar versus monopolar transurethral resection of the prostate: a prospective randomized study]. / Résection transuréthrale de la prostate bipolaire versus monopolaire: étude prospective randomisée.

PURPOSE: To compare bipolar with standard monopolar transurethral resection of the prostate (TURP). MATERIAL AND METHODS: A prospectively randomized study was conducted between January 2010 and September 2011. Primary end points studied were efficacy (maximum flow rate [Qmax], International Prostate Symptom Score) and safety (adverse events, decline in postoperative serum sodium [Na+] and haemoglobin [Hb] levels). Secondary end points were operation time and duration of irrigation, catheterization, and hospitalization. RESULTS: Sixty consecutive patients were randomized and completed the study, with 29 patients in the monopolar TURP group and 31 in the TURIS group. At baseline, the two groups were comparable in age, prostate volume, mean prostate-specific antigen value, International Prostate Symptom Score, and they had at least 12 months of follow-up. Declines in the mean postoperative serum Na+ for bipolar and monopolar TURP groups were 1.2 and 8.7 mmol/L, respectively. However, there was no statistical difference in the decline in postoperative Hb between the two groups. The mean catheterization time was 26.6 and 52 hours in the bipolar and standard groups, respectively. This difference was statistically significant as was the difference in the time to hospital discharge. The IPSS and Qmax improvements were comparable between the two groups at 12 months of follow-up. CONCLUSION: No clinically relevant differences in short-term efficacy are existed between the two techniques, but bipolar TURP is preferable due to a more favorable safety profile and shorter catheterization duration.

Profile of NF-κBp(65/NFκBp50) among prostate specific antigen sera levels in prostatic pathologies.

AIM: The aim of this work was to characterise the immunoexpression of NF-κB (p50/p65) in human prostatic pathologies and to study its profiles of activation among sera prostate specific antigen antigen (PSA) according the three groups: 0-4ng/mL, 4-20ng/mL and >20ng/mL. PATIENTS AND METHODS: Twenty-four men with benign prostate hyperplasia (BPH); 19 men with prostate cancer (PC) and five men with normal prostates (NP). Immunohistochemical and western blot analysis was performed. Serum levels of PSA were assayed by immulite autoanalyser. RESULTS: In BPH and PC samples, immunoexpressions were observed for NF-κBp65 and NF-κBp50; while in NP samples, only were detected NF-κBp50. PC samples showed immunoreactions to NF-κBp65 and NF-κBp50 more intense (respectively 24.18±0.67 and 28.23±2.01) than that observed in BPH samples (respectively18.46±2.04 and 18.66±1.59) with special localisation in the nucleus. Different profiles of NF-κBp65 immunoexpressions were observed and BPH patients with sera PSA levels between 0-4ng/mL presented a significant weak percentage compared to BPH patients with sera PSA levels between 4-20ng/mL and >20ng/mL. No immunoreactions to NF-κBp65 were observed in PC patients with sera PSA levels between 4-20ng/mL. CONCLUSION: The sensibility of both NF-κB and PSA to inflammation allowed confirming the relationship between these two molecules and its involvement in prostatic diseases progression (inflammatory and neoplasic).

Measurement of pore volume, connectivity and clogging of pervious concrete reactive barrier used to treat acid mine drainage.

It has recently been shown that pervious concrete is a promising, effective technology as a permeable reactive barrier system for treatment of acid mine drainage (AMD). However, pore clogging also occurs simultaneously during AMD treatment. In the present study, mixtures of pervious concrete were made and used in a column experiment during which pore clogging occurred in the samples. Pore volume, connectivity and other parameters of pervious concrete were evaluated using five (5) different methods comprising the volumetric method (VM), linear-traverse method (LTM), image analysis (IA), falling head permeability test and X-ray microcomputed tomography. It was found that pervious concrete effectively removed from AMD, about 90 to 99% of various heavy metals including Al, Fe, Zn, Mn and Mg. Cr concentration significantly increased in the treated effluent, owing to leaching from cementitious materials used in mixtures. The VM and LTM gave statistically similar pore volume results, while IA's values were 20 to 30% higher than those of the conventional methods. The falling head permeability test and IA were found to be effective in quantifying pore clogging effects. Pervious concrete exhibited high pore connectivity of 95.0 to 99.7%, which underlies its efficacious hydraulic conductivity.

High-Quality Graphene Using Boudouard Reaction.

Following the game-changing high-pressure CO (HiPco) process that established the first facile route toward large-scale production of single-walled carbon nanotubes, CO synthesis of cm-sized graphene crystals of ultra-high purity grown during tens of minutes is proposed. The Boudouard reaction serves for the first time to produce individual monolayer structures on the surface of a metal catalyst, thereby providing a chemical vapor deposition technique free from molecular and atomic hydrogen as well as vacuum conditions. This approach facilitates inhibition of the graphene nucleation from the CO/CO2 mixture and maintains a high growth rate of graphene seeds reaching large-scale monocrystals. Unique features of the Boudouard reaction coupled with CO-driven catalyst engineering ensure not only suppression of the second layer growth but also provide a simple and reliable technique for surface cleaning. Aside from being a novel carbon source, carbon monoxide ensures peculiar modification of catalyst and in general opens avenues for breakthrough graphene-catalyst composite production.

[Culicidae Larvae and Their Seasonal Dynamics in the Region of Fez-Meknes, Morocco]. / Les Larves de Culicidae et Leur Dynamique Saisonnière dans la Région de Fès-Meknès, Maroc.

Objective: As part of the prevention of vector-borne diseases in central Morocco, a study of the seasonal fluctuation of Culicidian biodiversity was conducted from November 2015 to November 2016 on four breeding sites located in the city of Fez in central Morocco (Jnan El Alami, Lgaâda dam, Awinat Elhajaj, Douwar Lhandiya Source). The study aimed to improve the knowledge of seasonal dynamics and activity period of Culicidian mosquitoes, in order to target the period of control. Methods: Larvae were collected by dipping method at a 15-day interval at least once a month. Statistical analyses were performed using version 3.6.1 of the statistical processing software. Results: During this study, nine species were found with high monthly and seasonal variations in numbers of each species and from site to site. Predominant species are vectors of disease: Culex pipiens, Cx. perexiguus, Cx. theileri, known vectors of West Nile virus, followed by Anopheles maculipennis s. l. and An. sergentii that are the main vectors of malaria in Morocco. Cx. pipiens and Cx. perexiguus reached the highest density in September, while Cx. theileri was found in large numbers in February and can therefore emerge in late winter and mid-spring. The lowest number of An. sergentii was collected in November, but increased in September, October and December. An. maculipennis s. l. occurred in June, with recurrences in March and July. Culiseta longiareolata was found in spring and summer and in abundance in June. However, Uranotaenia unguiculata was only present in September and October. Both An. cinereus and Cx. hortensis were present in November and February. Conclusion: The results obtained will be an important tool for management and monitoring Culicidae proliferation and can be used to improve the efficiency of control management.

Surface Modification and Subsequent Fermi Density Enhancement of Bi(111).

Defects introduced to the surface of Bi(111) break the translational symmetry and modify the surface states locally. We present a theoretical and experimental study of the 2D defects on the surface of Bi(111) and the states that they induce. Bi crystals cleaved in ultrahigh vacuum (UHV) at low temperature (110 K) and the resulting ion-etched surface are investigated by low-energy electron diffraction (LEED), X-ray photoelectron spectroscopy, ultraviolet photoelectron spectroscopy (UPS), and scanning tunneling microscopy (STM) as well as spectroscopy (STS) techniques in combination with density functional theory (DFT) calculations. STS measurements of cleaved Bi(111) reveal that a commonly observed bilayer step edge has a lower density of states (DOS) around the Fermi level as compared to the atomic-flat terrace. Following ion bombardment, the Bi(111) surface reveals anomalous behavior at both 110 and 300 K: Surface periodicity is observed by LEED, and a significant increase in the number of bilayer step edges and energetically unfavorable monolayer steps is observed by STM. It is suggested that the newly exposed monolayer steps and the type A bilayer step edges result in an increase to the surface Fermi density as evidenced by UPS measurements and the Kohn-Sham DOS. These states appear to be thermodynamically stable under UHV conditions.

Quantitative Inventory of Mosquito Larvae (Diptera: Culicidae) and Physicochemical Analysis of Aquatic Habitats in the Region of Fez, Morocco.

Mosquitoes occupy a major health problem, as a potential vector for the transmission of many pathogens, the most important of which in Morocco are Plasmodium parasites and West Nile fever virus. Acquiring knowledge about the biotypology of these mosquitoes is an essential step in any control strategy. Thus, the objective of this study is to draw up an inventory of the culicidian fauna in the Fez region (North-central part of Morocco) and to determine the physicochemical parameters influencing the production of mosquito larvae of aquatic habitats in this area. Mosquito larvae of the extant biotopes were sampled every two months between November 2015 and December 2016, by means of the "dipping" method. The physicochemical parameters of the various larval biotopes were collected six times during the year of follow-up. Mosquito species were identified using morphological criteria. The results were analyzed using ecological indices and the generalized linear model (Poisson model) on R software. The identification of the 1,122 mosquito larvae collected from the various studied breeding areas revealed the presence of 11 species belonging to two subfamilies (Culicinae and Anophelinae) and five genera (Anopheles, Culex, Culiseta, Aedes, and Uranotaenia). Anopheles were observed in small numbers in permanent, stagnant, and shallow habitats. The larvae of An. maculipennis s. l. (major vector of malaria in Morocco) were collected. Culex larvae, especially Cx. pipiens (the main vector of WNV in Morocco), were collected in the majority of the larval habitats and on the different types of environments. Two other species of Culex, which plays a significant role in the transmission of WNV, were also collected, particularly, Cx. perexiguus and Cx. theileri. The results found, via this first study of its kind at the regional level, also made it possible to update the list of Culicidae species reported in the Fez region. Four new species have been recorded: Aedes flavescens, Uranotaenia unguiculata, Culiseta longiareolata, and Culex perexiguus. The results of this study will contribute to the provision of information for entomological surveillance and to better plan and guide vector control activities at local and national levels.

Les moustiques constituent un problème majeur de santé, en tant que vecteur potentiel de la transmission de nombreux agents pathogènes dont les plus importants au Maroc sont le Plasmodium et le virus de la fièvre du West Nile. Acquérir des connaissances sur la biotypologie de ces moustiques est une étape essentielle dans toute stratégie de lutte. Ainsi, l'objectif de ce travail est de dresser l'inventaire de la faune culicidienne dans la région de Fès (Centre Nord du Maroc) et de déterminer les paramètres physicochimiques influençant la production en larves de moustiques des habitats aquatiques dans cette zone. L'échantillonnage des larves a été réalisé tous les deux mois dans les différents biotopes existants, entre novembre 2015 et décembre 2016, à l'aide de la méthode de dipping. Les paramètres physicochimiques des différents biotopes larvaires ont été relevés six fois durant l'année du suivi. L'identification des caractères morphologiques des larves a été déterminée. Les résultats ont été analysés moyennant des indices écologiques et le modèle linéaire généralisé (GLM), suite à un modèle de Poisson sur le logiciel R. L'identification des 1 122 larves de culicidés récoltées au niveau des différents gîtes prospectés a révélé la présence de 11 espèces appartenant à deux sous-familles (Culicinae et Anophelinae) et cinq genres (Anopheles, Culex, Culiseta, Aedes et Uranotaenia). Les anophèles ont été observés en faible nombre dans des habitats permanents, à eaux stagnantes, et peu profondes. Les larves d'An. maculipennis s. l. (vecteur majeur du paludisme au Maroc) ont été récoltées. Les larves de Culex, en particulier de Cx. pipiens (principal vecteur du WNV au Maroc), ont été collectées dans la majorité des gîtes prospectés et dans les différents types de milieux. Deux autres espèces de Culex, dont le rôle dans la transmission du WNV est reconnu, ont été également collectées au cours de cette étude ; il s'agit de Cx. perexiguus et Cx. theileri. Les résultats trouvés via cette étude, première du genre au niveau de la région, ont permis également de mettre à jour la liste des espèces culicidiennes signalées au niveau de la région de Fès par l'ajout de quatre espèces : Aedes flavescens, Uranotaenia unguiculata Culiseta longiareolata et Culex perexiguus. Les résultats de cette étude contribueront à l'apport d'informations pour la surveillance entomologique et pour mieux planifier et orienter les activités de la lutte antivectorielle au niveau local et national.

Fabricated germanium-doped fibres for computed tomography dosimetry.

For a range of doses familiarly incurred in computed tomography (CT), study is made of the performance of Germanium (Ge)-doped fibre dosimeters formed into cylindrical and flat shapes. Indigenously fabricated 2.3 mol% and 6 mol% Ge-dopant concentration preforms have been used to produce flat- and cylindrical-fibres (FF and CF) of various size and diameters; an additional 4 mol% Ge-doped commercial fibre with a core diameter of 50 µm has also been used. The key characteristics examined include the linearity index f(d), dose sensitivity and minimum detectable dose (MDD), the performance of the fibres being compared against that of lithium-fluoride based TLD-100 thermoluminescence (TL) dosimeters. For doses in the range 2-40 milligray (mGy), delivered at constant potential of 120 kilovoltage (kV), both the fabricated and commercial fibres demonstrate supralinear behaviours at doses < 2 mGy, while a value of close to f(D) = 1 (linear) has been obtained for all dosimeters for doses > 4 mGy. In terms of dose sensitivity, all of the fibres show superior TL sensitivity when compared against TLD-100, the 2.3 mol% and 6 mol% Ge-doped FF demonstrating the greatest TL sensitivity at 84 and 87 times that of TLD-100. The TL yields for the novel Ge-doped silica glass render them appealing for use within the present medical imaging dose range, offering linearity at high sensitivity down to less than 2 mGy.

Autoantibodies to the extracellular domain of the calcium sensing receptor in patients with acquired hypoparathyroidism.

Acquired hypoparathyroidism (AH) has been considered to result from an autoimmune process but the self-antigens have not been identified. We studied 25 patients with AH, of which 17 had type I autoimmune polyglandular syndrome and 8 had AH associated with autoimmune hypothyroidism. Five of 25 (20%) AH sera reacted to a membrane-associated antigen of 120-140 kD in human parathyroid gland extracts using immunoblot analysis. This is the exact size of the calcium sensing receptor (Ca-SR). The AH sera were then tested by immunoblot using a membrane fraction of HEK-293 cells transfected with Ca-SR cDNA. Eight of 25 (32%) AH sera reacted to a 120-140-kD protein, which closely matched that recognized by the anti-Ca-SR IgG raised in rabbits. The Ca-SR cDNA was translated in vitro into two parts in order to identify the antigenic epitopes. By using this technique, 14 of 25 (56%) AH sera were positive to the extracellular domain of the Ca-SR, whereas none of the AH patients sera reacted to the intracellular domain. The reactivity of the positive sera was completely removed after pre-absorption with the Ca-SR containing membranes. Sera from 50 patients with various other autoimmune diseases as well as 22 normal controls were also tested, and none of them was positive. In conclusion, the Ca-SR has been identified as an autoantigen in AH.

Ni-based heterogeneous catalyst from a designed molecular precursor for the efficient electrochemical water oxidation.

Bimetallic Ni-Mo alkoxide was synthesized and exploited as the single-source precursor for the solution-processed deposition of the mixed-oxide layers on different conducting surfaces. Upon potential cycling in 1 M NaOH, these composites convert, in situ, into highly porous NiOx/NiOOH catalysts characterized by the high electrocatalytic activity for water oxidation under both basic (pH 13.6) and near neutral (pH 9.2) conditions.

Correction: Ni-based heterogeneous catalyst from a designed molecular precursor for the efficient electrochemical water oxidation.

Correction for 'Ni-based heterogeneous catalyst from a designed molecular precursor for the efficient electrochemical water oxidation' by Denis A. Kuznetsov et al., Chem. Commun., 2016, 52, 9255-9258.

Human obese gene: molecular screening in Japanese and Asian Indian NIDDM patients associated with obesity.

The mouse obese (ob) gene has recently been isolated through the positional cloning technique and has been proved to result in the obese and NIDDM phenotype in mice when mutated (Nature 372:425-432, 1994). More recently, it has been demonstrated, by experiments with recombinant ob protein, that ob gene product can cause mice, including ob/ob mice, diet-induced obesity mice, and normal mice, to lower their food intake and body weight (Science 269:540-549, 1995). To investigate the genetic and/or environmental influences underlying the development of NIDDM associated with obesity, we isolated and partially sequenced the human obese (OB) gene. The human OB gene isolated in this study encoded 167 amino acids and its open reading frame was revealed to be divided into two parts with an intermediate intron of approximately 2.4 kb. Using the single-strand conformation polymorphism (SSCP) technique, we screened Japanese and Asian Indian subjects for mutations in the protein coding regions of the OB gene. A total of 75 NIDDM patients with obesity (54 Japanese and 21 Asian Indians), 40 NIDDM patients without obesity (34 Japanese and 6 Asian Indians), and 34 Japanese patients with simple obesity showed no abnormal SSCP patterns in either component of the coding sequences. These results suggested that mutations in the coding regions of the OB gene are not likely to be commonly identifiable and that there would likely be a kind of obesity-associated NIDDM not caused by mutations of the OB gene.

[Follicular thyroid carcinoma: metastasis to unusual skin locations]. / Carcinome vésiculaire de la thyroïde avec métastases cutanées de localisations inhabituelles.

INTRODUCTION: Cutaneous metastasis of thyroid cancer is rare. When it occurs, it usually affects the scalp and neck. We report here a case where follicular thyroid carcinoma metastasized to unusual skin locations. CASE: An 82-year-old woman was followed after a total thyroidectomy for follicular thyroid carcinoma. Assessment after 2 years showed the presence of a small cervical residue, pulmonary metastases, and a high thyroglobulin level. Two sets of internal radiation therapy with iodine 131 (100 mCi each) followed. Response to treatment was poor, and cutaneous and subcutaneous nodules appeared on the abdomen, back, and front left thigh. Biopsy of these lesions showed that they were malignant, and testing with anti-thyroglobulin antibodies confirmed the diagnosis of cutaneous metastasis of follicular thyroid carcinoma. DISCUSSION: Although the rare cutaneous metastases of follicular thyroid carcinoma usually occur on the scalp, firm nodular cutaneous lesions that are painless and resist standard treatment in patients with a history of thyroid cancer should suggest the possibility of metastasis.

Surgery for testicular cancer: indication, results and technical aspects.

The standard therapeutique approach to patients with advanced germ cell tumors of the testis is a combination of systemic chemotherapy with surgical removal of the residual disease. The indication of surgery, residual tumor resection (RTR) or retroperitoneal lymph node dissection (RPLND), has changed during the last 10 years. Sugery is not longer recommended after chemotherapy of pure seminoma and surveillance of the residual tumor is the favored option. RPLND is a critical component of the treatment armentarium in low-stage nonseminomatous germ cell. RPLND is an accurate staging tool prviding important information to dtermine the need for chemotherapy. When performed properly, RPLND eliminates the retroperitoneum as a site for relapse, wich in turn provides emotional and psychological relief to the patient, and simplifies the follow-up protocol. In advanced nonseminomatous tumours, surgery after chemotherapy is recommended in most of the cases since large studies have shown that a considerable proportion of patients with complete radiological remission after chemotherapy harbor vital carcinoma or teratoma. Prediction models of necrosis after chemotherapy in order to avoid RTR are generally accepted since the accuracy of most models is too low. RTR is indicated in patients with elevated markers after two different chemotherapy regimens (including salvage chemotherapy) either to resect teratoma or cystic residual disease or to remove chemorefractory disease. Laparoscopic approache is a viable staging tool; however, oncologic control of the retroperitoneum has not been reliably determined.

A comparison of insulin lispro Mix25 and human insulin 30/70 in the treatment of type 2 diabetes during Ramadan.

OBJECTIVE: To compare insulin lispro Mix25 and human insulin 30/70 with regard to their effect on morning and evening postprandial glucose (PPG) control, and on average daily blood-glucose (BG), in patients with Type 2 diabetes who wish to fast during Ramadan. METHOD: Insulin lispro Mix25 and human insulin 30/70 were compared in an open-label, multicenter, randomised, crossover study involving 151 patients. Each treatment period had a duration of 14 days during which the patients self-monitored their BG before and 2 h after the main meals on any 3 days within the last 5 days of each treatment period. RESULTS: The 2 h PPG excursion following the main evening meal after sunset was significantly lower with insulin lispro Mix25 (3.4+/-2.9 mmol/l) compared with human insulin 30/70 (4.0+/-3.2 mmol/l, P=0.007). The evening pre-meal fasting BG values were also lower with insulin lispro Mix25 (7.1+/-2.2 mmol/l) versus human insulin 30/70 (7.5+/-2.6 mmol/l, P=0.034). The average daily BG concentration was 9.5+/-2.4 mmol/l during treatment with insulin lispro Mix25 versus 10.1+/-2.5 mmol/l with human insulin 30/70 given in identical doses (P=0.004). CONCLUSION: When compared with human insulin 30/70, treatment of insulin-requiring Type 2 patients with insulin lispro Mix25 during Ramadan resulted in better average daily glycaemia, and better BG control before and after the evening meal. Insulin lispro Mix25 should be considered as a therapeutic option during Ramadan.