Optimization of Alkali Treatment for Production of Fermentable Sugars and Phenolic Compounds from Potato Peel Waste Using Topographical Characterization and FTIR Spectroscopy.

Potato peel waste (PPW) was utilized as a bio-template for the production of valuable compounds such as reducing sugars (RS), total sugar (TS) and total phenolic compounds (TPC). Two methods of alkali treatments, i.e., chemical (NaOH) and thermochemical (NaOH assisted with autoclaving) processes, were employed for the deconstruction of PPW. Response surface methodology (RSM) was used to study the effects of alkali concentration (0.6-1.0 w/v), substrate concentration (5-15 g) and time (4-8 h) on the extraction of RS, TS and TP from PPW. The application of alkali plus steam treatment in Box-Behnken design (BBD) with three levels yielded the optimum releases of RS, TS and TP as 7.163, 28.971 and 4.064 mg/mL, respectively, corresponding to 10% substrate loading, in 0.6% NaOH for 8 h. However, the alkali treatment reported optimum extractions of RS, TS and TP as 4.061, 17.432 and 2.993 mg/mL, respectively. The thermochemical pretreatment was proven a beneficial process as it led to higher productions of TP. FTIR and SEM were used to analyze the deterioration levels of the substrate. The present work was used to explore the sustainable management of PPW, which is a highly neglected substrate bioresource but is excessively dumped in open environment, raising environmental concerns. The cost-effective methods for the breakdown of PPW starch into fermentable sugars might be utilized to extract valuable compounds.

Fabrication and Characterization of Ag-Graphene Nanocomposites and Investigation of Their Cytotoxic, Antifungal and Photocatalytic Potential.

In the present study, we aimed to synthesize (Ag)1-x(GNPs)x nanocomposites in variable ratios (25% GNPs-Ag, 50% GNPs-Ag, and 75% GNPs-Ag) via an ex situ approach to investigate the incremental effects of GNPs (graphene nanoparticles) on AgNPs (silver nanoparticles). The prepared nanocomposites were successfully characterized using different microscopic and spectroscopic techniques, including X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, ultraviolet spectroscopy, and Raman spectroscopic analysis. For the evaluation of morphological aspects, shape, and percentage elemental composition, SEM and EDX analyses were employed. The bioactivities of the synthesized nanocomposites were briefly investigated. The antifungal activity of (Ag)1-x(GNPs)x nanocomposites was reported to be 25% for AgNPs and 66.25% using 50% GNPs-Ag against Alternaria alternata. The synthesized nanocomposites were further evaluated for cytotoxic potential against U87 cancer cell lines with improved results (for pure AgNPs IC50: ~150 µg/mL, for 50% GNPs-Ag IC50: ~12.5 µg/mL). The photocatalytic properties of the nanocomposites were determined against the toxic dye Congo red, and the percentage degradation was recorded as 38.35% for AgNPs and 98.7% for 50% GNPs-Ag. Hence, from the results, it is concluded that silver nanoparticles with carbon derivatives (graphene) have strong anticancer and antifungal properties. Dye degradation strongly confirmed the photocatalytic potential of Ag-graphene nanocomposites in the removal of toxicity present in organic water pollutants.

Synthesis and Characterization of Silver and Graphene Nanocomposites and Their Antimicrobial and Photocatalytic Potentials.

Microbial pathogens and bulk amounts of industrial toxic wastes in water are an alarming situation to humans and a continuous threat to aquatic life. In this study, multifunctional silver and graphene nanocomposites (Ag)1-x(GNPs)x [25% (x = 0.25), 50% (x = 0.50) and 75% (x = 0.75) of GNPs] were synthesized via ex situ approach. Further, the synthesized nanocomposites were explored for their physicochemical characteristics, such as vibrational modes (Raman spectroscopic analysis), optical properties (UV visible spectroscopic analysis), antibacterial and photocatalytic applications. We investigated the antimicrobial activity of silver and graphene nanocomposites (Ag-GNPs), and the results showed that Ag-GNPs nanocomposites exhibit remarkably improved antimicrobial activity (28.78% (E. coli), 31.34% (S. aureus) and 30.31% (P. aeruginosa) growth inhibition, which might be due to increase in surface area of silver nanoparticles (AgNPs)). Furthermore, we investigated the photocatalytic activity of silver (AgNPs) and graphene (GNPs) nanocomposites in varying ratios. Interestingly, the Ag-GNPs nanocomposites show improved photocatalytic activity (78.55% degradation) as compared to AgNPs (54.35%), which can be an effective candidate for removing the toxicity of dyes. Hence, it is emphatically concluded that Ag-GNPs hold very active behavior towards the decolorization of dyes and could be a potential candidate for the treatment of wastewater and possible pathogenic control over microbes. In the future, we also recommend different other in vitro biological and environmental applications of silver and graphene nanocomposites.

Multi-Sensor Fusion for Underwater Vehicle Localization by Augmentation of RBF Neural Network and Error-State Kalman Filter.

The Kalman filter variants extended Kalman filter (EKF) and error-state Kalman filter (ESKF) are widely used in underwater multi-sensor fusion applications for localization and navigation. Since these filters are designed by employing first-order Taylor series approximation in the error covariance matrix, they result in a decrease in estimation accuracy under high nonlinearity. In order to address this problem, we proposed a novel multi-sensor fusion algorithm for underwater vehicle localization that improves state estimation by augmentation of the radial basis function (RBF) neural network with ESKF. In the proposed algorithm, the RBF neural network is utilized to compensate the lack of ESKF performance by improving the innovation error term. The weights and centers of the RBF neural network are designed by minimizing the estimation mean square error (MSE) using the steepest descent optimization approach. To test the performance, the proposed RBF-augmented ESKF multi-sensor fusion was compared with the conventional ESKF under three different realistic scenarios using Monte Carlo simulations. We found that our proposed method provides better navigation and localization results despite high nonlinearity, modeling uncertainty, and external disturbances.

New perspectives and future directions in the treatment of heart failure.

The management of heart failure has changed significantly over the last 30 years, leading to improvements in the quality of life and outcomes, at least for patients with a substantially reduced left ventricular ejection fraction (HFrEF). This has been made possible by the identification of various pathways leading to the development and progression of heart failure, which have been successfully targeted with effective therapies. Meanwhile, many other potential targets of treatment have been identified, and the list is constantly expanding. In this review, we summarise planned and ongoing trials exploring the potential benefit, or harm, of old and new pharmacological interventions that might offer further improvements in treatment for those with HFrEF and extend success to the treatment of patients with heart failure with preserved left ventricular ejection fraction (HFpEF) and other heart failure phenotypes.

Insilico study of genes involved in Congenital Hypothyroidism.

OBJECTIVE: To study the orthologs of the five genes of congenital hypothyroidism NIS, PAX8, DUOX2, FOXE1, NKX2-1 that are involved in the development of the thyroid gland. METHODS: The study was conducted at INMOL Cancer Hospital, Lahore in September 2017 and comprised of finding gene orthologs, phylogenetic tree and domains of NIS, PAX8, DUOX2, FOXE1, NKX2-1 which were studied using different bioinformatics tools, including FASTA, BLAST, ENSEMBL, UniProt, MultiAlin, to find out the important domains involved in the mutations of these genes. RESULTS: Genes showed consensus sequence / motifs involved in congenital hypothyroidism. Phylogenetic results showed that these genes shared some common motifs. Phylogenetic trees revealed sub-clusters with high protein homology. CONCLUSIONS: Genes involved in congenital hypothyroidism were found to have a consensus sequence motifs.

HEP-Net opinion on the management of ascites and its complications in the setting of decompensated cirrhosis in the resource constrained environment of Pakistan.

Approximately one half of patients develop ascites within 10 years of diagnosis of compensated cirrhosis. It is a poor prognostic indicator, with only 50% surviving beyond two years. Mortality worsens significantly to 20% to 50% at one year if the ascites becomes refractory to medical therapy. Pakistan has one of the highest prevalence of viral hepatitis in the world and patients with ascites secondary to liver cirrhosis make a major percentage of both inpatient and outpatient burden. Studies indicate that over 80% of patients admitted with ascites have liver cirrhosis as the cause. This expert opinion suggests proper assessment of patients with ascites in the presence of underlying cirrhosis. This expert opinion includes appropriate diagnosis and management of uncomplicated ascites, refractory ascites and complicated ascites (including spontaneous bacterial peritonitis (SBP) ascites, hepatorenal syndrome (HRS) and hyponatremia. The purpose behind this expert opinion is to help consultants, postgraduate trainees, medical officers and primary care physicians optimally manage their patients with cirrhosis and ascites in a resource constrained setting as is often encountered in a developing country like Pakistan.

Role of differential proteomics in studying pharmacological mechanisms of traditional Chinese medicines.

Traditional Chinese Medicines (TCMs) have been used for more than 3,000 years. However, most TCMs are used based on previous experience, and their exact mechanisms are still unclear. Proteomics, as a major component of systems biology, is an appropriate tool that could bring breakthroughs in the study of pharmacological mechanisms of TCMs. Researchers made substantial progress by using the proteomics approach to investigate the mechanism of TCMs. In this review, we summarize the current applications of proteomics in the mechanistic study of TCMs. Proteomics technologies and strategies that might be used in the future to enhance the study of TCMs are also discussed.

Life satisfaction in Norwegian medical doctors: a 15-year longitudinal study of work-related predictors.

BACKGROUND: Despite many recent studies on burn-out and dissatisfaction among American medical doctors, less is known about doctors in the Scandinavian public health service. The aims of this study were to analyse long-term work-related predictors of life satisfaction among established doctors in Norway and to identify predictors in a subgroup of doctors who reported a decline in life satisfaction. METHODS: Two nationwide cohorts of doctors (n = 1052), who graduated medical school 6 years apart, were surveyed at graduation from medical school (T1, 1993/94 and 1999), and 4 (T2), 10 (T3), and 15 (T4) years later. Work-related predictors of life satisfaction (three items) obtained at T2 to T4 were analysed. Individual and lifestyle confounders were controlled for using mixed-models repeated-measures analyses, and logistic regression analyses were applied to identify predictors of the decrease in life satisfaction. RESULTS: Ninety per cent (947/1052) responded at least once, and 42% (450/1052) responded at all four times. Work-related predictors of higher life satisfaction in the adjusted model were work-home stress (ß = - 0.20, 95% confidence interval [CI] = - 0.25 to - 0.16, p < 0.001), perceived job demands (ß = - 0.10, CI = - 0.15 to - 0.05, p < 0.001), and colleague support (ß = 0.05, CI = 0.04 to 0.07, p < 0.001). The new adjusted individual predictors that we identified included female gender, reality weakness trait, and problematic drinking behaviour. Neuroticism trait and low colleague support predicted a decrease in life satisfaction. CONCLUSIONS: Work-home stress, perceived job demands, and colleague support were the most important predictors of life satisfaction related to doctors' work. When personality traits were controlled for, female doctors were more satisfied with their life than male doctors. These findings suggest that improving work-related factors with targeted interventions, including a supportive work environment, may increase life satisfaction among doctors.

DNA sequenced based bacterial taxonomy should entail decisive phenotypic remarks: Towards a balanced approach.

Phenotypic characteristics while complimenting 16S rRNA gene sequencing in identifying bacteria become decisive in solving conflicts of equal % similarity of a given DNA sequence to more than one classified microorganisms. "Phenotypic light" may also indicate right direction when a new species' 16S rDNA sequence is under consideration. In fact 16S rRNA gene sequences give indication that either a novel species has been isolated or the test organism is identified. In each case additional tests are required for resolving different issues. Predictions of microbial phenotypes from metagenomic data depend heavily on our knowledge of expressed genes. Thus renaissance of microbial phenotypic characterization is likely to emerge at par with genotypic signatures. Interplay of these and other complimentary levels of analyses are likely to lead DNA barcoding for microorganisms as it has provided efficient methods for species-level identifications of animals and plants. In this review, an attempt has been made to realize the reader(s) importance of interplay of genotypic and phenotypic characteristics of bacteria for development of comprehensive and more stable classification schemes. It is expected that future valid classification schemes will be based on the phenetic relationships of microorganisms.

Contextual Factors and Mental Distress as Possible Predictors of Hazardous Drinking in Norwegian Medical Doctors: A 15-Year Longitudinal, Nationwide Study.

BACKGROUND: We have previously identified long-term individual predictors of hazardous drinking in doctors, but longitudinal studies on contextual factors (work and life stress) and mental distress being independently linked to hazardous drinking over the first 15 years of a medical career are lacking. METHODS: Two nationwide cohorts of Norwegian doctors (n = 1,052) from all 4 Norwegian universities were surveyed in their final year of medical school (1993/1994 and 1999) (T1), and 4 (T2), 10 (T3), and 15 (T4) years later. Hazardous drinking was measured using a validated 9-item version of the Alcohol Use Disorder Identification Test. Work-related and other predictors were analysed using generalized estimating equations. RESULTS: Ninety percent (947/1,052) responded at least once, and 42% (450/1,052) responded at all 4 time points. Hazardous drinking was reported by 16% at T1, 14% at T2 and T3, and 15% at T4. Life events (p = 0.009) and mental distress (p = 0.002) were adjusted predictors of hazardous drinking, in addition to male gender, no religious activity, drinking to cope with tension, and low conscientiousness. CONCLUSIONS: Doctors' work-related stress was not linked to hazardous drinking, but life events, mental distress, and drinking to cope were. Prevention should target mental distress and drinking to cope with tension.

Effect of Prolonged Simulated Microgravity on Metabolic Proteins in Rat Hippocampus: Steps toward Safe Space Travel.

Mitochondria are not only the main source of energy in cells but also produce reactive oxygen species (ROS), which result in oxidative stress when in space. This oxidative stress is responsible for energy imbalances and cellular damage. In this study, a rat tail suspension model was used in individual experiments for 7 and 21 days to explore the effect of simulated microgravity (SM) on metabolic proteins in the hippocampus, a vital brain region involved in learning, memory, and navigation. A comparative (18)O-labeled quantitative proteomic strategy was used to observe the differential expression of metabolic proteins. Forty-two and sixty-seven mitochondrial metabolic proteins were differentially expressed after 21 and 7 days of SM, respectively. Mitochondrial Complex I, III, and IV, isocitrate dehydrogenase and malate dehydrogenase were down-regulated. Moreover, DJ-1 and peroxiredoxin 6, which defend against oxidative damage, were up-regulated in the hippocampus. Western blot analysis of proteins DJ-1 and COX 5A confirmed the mass spectrometry results. Despite these changes in mitochondrial protein expression, no obvious cell apoptosis was observed after 21 days of SM. The results of this study indicate that the oxidative stress induced by SM has profound effects on metabolic proteins.

Risk Factors Measured During Medical School for Later Hazardous Drinking: A 10-year, Longitudinal, Nationwide Study (NORDOC).

AIMS: To investigate the prevalence and temporal patterns of hazardous drinking and risk factors during medical school for future hazardous drinking among doctors. METHODS: Two cohorts of graduating medical students (N = 1052) from all four Norwegian universities (NORDOC) were surveyed in their final year of medical school training (1993/94 and 1999) (T1) and again 4 (T2) and 10 (T3) years later. Longitudinally, 53% (562/1052) of the sample responded at all three time points. Hazardous drinking was defined as drinking five or more drinks during one session at least 2-3 times per month. Predictors of hazardous drinking, identified by logistic regression models after controlling for cohort, included a parental history of alcohol problems, having children, no religious activity, use of alcohol to cope with tension and some personality traits. RESULTS: There was a significant decline in the prevalence of hazardous drinking from T1 (14%) to T2 (10%) but not from T2 to T3 (8%). Approximately 23% of hazardous drinkers at T1 remained hazardous drinkers at T3 (N = 18). At T2, significant adjusted predictors included male gender (OR = 2.0, P = 0.04), use of alcohol as a coping strategy (OR = 2.2, P = 0.03) and hazardous drinking at T1 (OR = 9.8, P < 0.001). The significant adjusted predictors at T3 included older age (OR = 1.1, P = 0.01), male gender (OR = 3.6, P = 0.002) and hazardous drinking at T1 (OR = 7.5, P < 0.001). CONCLUSIONS: Hazardous drinking and drinking to cope with tension during medical school were the most important predictors of later hazardous drinking and should be targets of preventive efforts in medical schools.

Data-Centric Routing for Intra Wireless Body Sensor Networks.

A significant proportion of the worldwide population is of the elderly people living with chronic diseases that result in high health-care cost. To provide continuous health monitoring with minimal health-care cost, Wireless Body Sensor Networks (WBSNs) has been recently emerged as a promising technology. Depending on nature of sensory data, WBSNs might require a high level of Quality of Service (QoS) both in terms of delay and reliability during data reporting phase. In this paper, we propose a data-centric routing for intra WBSNs that adapts the routing strategy in accordance with the nature of data, temperature rise issue of the implanted bio-medical sensors due to electromagnetic wave absorption, and high and dynamic path loss caused by postural movement of human body and in-body wireless communication. We consider the network models both with and without relay nodes in our simulations. Due to the multi-facet routing strategy, the proposed data-centric routing achieves better performance in terms of delay, reliability, temperature rise, and energy consumption when compared with other state-of-the-art.

A survey of routing protocols in wireless body sensor networks.

Wireless Body Sensor Networks (WBSNs) constitute a subset of Wireless Sensor Networks (WSNs) responsible for monitoring vital sign-related data of patients and accordingly route this data towards a sink. In routing sensed data towards sinks, WBSNs face some of the same routing challenges as general WSNs, but the unique requirements of WBSNs impose some more constraints that need to be addressed by the routing mechanisms. This paper identifies various issues and challenges in pursuit of effective routing in WBSNs. Furthermore, it provides a detailed literature review of the various existing routing protocols used in the WBSN domain by discussing their strengths and weaknesses.

A comprehensive study of data collection schemes using mobile sinks in wireless sensor networks.

Recently sink mobility has been exploited in numerous schemes to prolong the lifetime of wireless sensor networks (WSNs). Contrary to traditional WSNs where sensory data from sensor field is ultimately sent to a static sink, mobile sink-based approaches alleviate energy-holes issues thereby facilitating balanced energy consumption among nodes. In mobility scenarios, nodes need to keep track of the latest location of mobile sinks for data delivery. However, frequent propagation of sink topological updates undermines the energy conservation goal and therefore should be controlled. Furthermore, controlled propagation of sinks' topological updates affects the performance of routing strategies thereby increasing data delivery latency and reducing packet delivery ratios. This paper presents a taxonomy of various data collection/dissemination schemes that exploit sink mobility. Based on how sink mobility is exploited in the sensor field, we classify existing schemes into three classes, namely path constrained, path unconstrained, and controlled sink mobility-based schemes. We also organize existing schemes based on their primary goals and provide a comparative study to aid readers in selecting the appropriate scheme in accordance with their particular intended applications and network dynamics. Finally, we conclude our discussion with the identification of some unresolved issues in pursuit of data delivery to a mobile sink.

Frequency and clinicopathological correlations of histopathological variants of idiopathic focal segmental glomerulosclerosis in nephrotic adolescents.

OBJECTIVE: To determine the frequency and clinicopathological correlations of focal segmental glomerulosclerosis variants in adolescents with idiopathic nephrotic syndrome. METHODS: All consecutive adolescents (12 to 18 years) who presented with idiopathic nephrotic syndrome in the period, January 2009 to December 2012, and in whom the histological diagnosis of focal segmental glomerulosclerosis was made on renal biopsies, were included in this prospective study. Their clinical, laboratory and histopathological features at the time of presentation or biopsy were noted from the case files and the biopsy reports. RESULTS: Among 50 adolescents, 34 (68%) were males and 16 (32%) females.The mean age was 15.14 +/- 2.3 years. The mean duration of disease was 6.3 +/- 11.2 months.The mean serum creatinine was 0.96 +/- 0.82 mg/dl. The mean 24-hour urinary protein excretion was 3.8 +/- 0.68 grams. Biopsy indications were steroid-resistant nephritic syndrome in 15 (30%), steroid-dependant nephritic syndrome in 19 (38%) and adolescent nephritic syndrome in 16 (32%) cases. Among the focal segmental glomerulosclerosis variants, 40 (80%) were "not otherwise specified", followed by the collapsing variant, which accounted for 8 (16%) cases. The tip and cellular variants, both were found in one (2%) case each. Among the histological features, global glomerulosclerosis was found in 23 (46%) cases, and segmental scarring/collapse in all (100%). A variable degree of tubular atrophy and interstitial fibrosis was noted in 44 (88%) cases. CONCLUSION: The results from this study indicate that the pattern of focal segmental glomerulosclerosis variants differs markedly in adolescents compared with younger children.

Toward explainable AI in radiology: Ensemble-CAM for effective thoracic disease localization in chest X-ray images using weak supervised learning.

Chest X-ray (CXR) imaging is widely employed by radiologists to diagnose thoracic diseases. Recently, many deep learning techniques have been proposed as computer-aided diagnostic (CAD) tools to assist radiologists in minimizing the risk of incorrect diagnosis. From an application perspective, these models have exhibited two major challenges: (1) They require large volumes of annotated data at the training stage and (2) They lack explainable factors to justify their outcomes at the prediction stage. In the present study, we developed a class activation mapping (CAM)-based ensemble model, called Ensemble-CAM, to address both of these challenges via weakly supervised learning by employing explainable AI (XAI) functions. Ensemble-CAM utilizes class labels to predict the location of disease in association with interpretable features. The proposed work leverages ensemble and transfer learning with class activation functions to achieve three objectives: (1) minimizing the dependency on strongly annotated data when locating thoracic diseases, (2) enhancing confidence in predicted outcomes by visualizing their interpretable features, and (3) optimizing cumulative performance via fusion functions. Ensemble-CAM was trained on three CXR image datasets and evaluated through qualitative and quantitative measures via heatmaps and Jaccard indices. The results reflect the enhanced performance and reliability in comparison to existing standalone and ensembled models.

Amylase and Cellulase Production from Newly Isolated Bacillus subtilis Using Acid Treated Potato Peel Waste.

Species belonging to the genus Bacillus produce many advantageous extracellular enzymes that have tremendous applications on a commercial scale for the textile, detergent, feed, food, and beverage industries. This study aimed to isolate potent thermo-tolerant amylolytic and cellulolytic bacterium from the local environment. Using the Box-Behnken design of response surface methodology, we further optimized the amylase and cellulase activity. The isolate was identified by 16S rRNA gene sequencing as Bacillus subtilis QY4. This study utilized potato peel waste (PPW) as the biomaterial, which is excessively being dumped in an open environment. Nutritional status of the dried PPW was determined by proximate analysis. All experimental runs were carried out in 250 mL Erlenmeyer flasks containing acid treated PPW as a substrate by the thermos-tolerant Bacillus subtilis QY4 incubated at 37 °C for 72 h of submerged fermentation. Results revealed that the dilute H2SO4 assisted autoclaved treatment favored more amylase production (0.601 IU/mL/min) compared to the acid treatment whereas high cellulase production (1.269 IU/mL/min) was observed in the dilute acid treatment and was found to be very effective compared to the acid assisted autoclaved treatment. The p-value, F-value, and coefficient of determination proved the significance of the model. These results suggest that PPW could be sustainably used to produce enzymes, which offer tremendous applications in various industrial arrays, particularly in biofuel production.

The Role of Pro-Inflammatory Chemokines CCL-1, 2, 4, and 5 in the Etiopathogenesis of Type 2 Diabetes Mellitus in Subjects from the Asir Region of Saudi Arabia: Correlation with Different Degrees of Obesity.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is becoming a major global health concern, especially in developing nations. The high prevalence of obesity and related diabetes cases are attributed to rapid economic progress, physical inactivity, the consumption of high-calorie foods, and changing lifestyles. OBJECTIVES: We investigated the roles of pro-inflammatory chemokines CCL1, 2, 4, and 5 in T2DM with varying levels of obesity in the Asir region of Saudi Arabia. MATERIALS AND METHODS: In total, 170 confirmed T2DM subjects and a normal control group were enrolled. Demographic data, serum levels of CCL-1, 2, 4, and 5, and biochemical indices were assessed in the subjects and control groups by standard procedures. RESULTS: T2DM subjects were divided into four groups: A (normal body weight), B (overweight), C (obese), and D (highly obese). We observed that male and female control subjects had similar mean serum concentrations of pro-inflammatory chemokines CCL-1, 2, 4, and 5. T2DM subjects in all the four groups showed significantly higher levels of all the four chemokines compared to the controls, regardless of gender. In T2DM subjects with obesity and severe obesity, the rise was most significant. There was a progressive rise in the concentrations of CCL-1, 2, and 4 in T2DM subjects with increasing BMI. Serum CCL5 levels increased significantly in all T2DM subject groups. The increase in CCL5 was more predominant in normal-weight people, compared to overweight and obese T2DM subjects. CONCLUSIONS: Male and female control subjects had similar serum levels of pro-inflammatory chemokines CCL-1, 2, 4, and 5. The progressive rise in blood concentrations of three pro-inflammatory chemokines CCL-1, 2, and 4 in T2DM subjects with increasing BMI supports the idea that dyslipidemia and obesity contribute to chronic inflammation and insulin resistance. Serum CCL5 levels increased significantly in all T2DM subject groups. The selective and more pronounced increase in CCL5 in the T2DM group with normal BMI, compared to subjects with varying degrees of obesity, was rather surprising. Further research is needed to determine if CCL5 underexpression in overweight and obese T2DM subjects is due to some unexplained counterbalancing processes.