Coinfection between SARS-CoV-2 and HIV with a low CD4+ T-cells count.

Coronavirus Disease 2019 (COVID-19) is an acute respiratory infectious disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection that started in Wuhan, China in December 2019 and has spread rapidly worldwide. It's critical to take extra precautions if a person has chronic illnesses (comorbidities), such as human immunodeficiency (HIV) infection. Concerns about people living with HIV (PLHIV) having a higher risk of serious COVID-19 disease may be based on the assumption that PLHIV are more likely to be immunocompromised. On the other hand, limited information is available in such people about the characteristics of co-infection between SARS-CoV-2 and Human Immunodeficiency Virus (HIV) who are at greater risk than the general population. Our findings, is of a 32 year old patient who came to Emergency Unit of Wangaya Hospital, Medical Faculty, Udayana University in Denpasar, Bali with complaint of fever, dry cough, and shortness of breath since prior 3 days and had also the past history prolonged fever, weight loss more than 10% 4 weeks. Diagnosis of COVID-19 was confirmed by nasopharyngeal swab sample was used for RT-PCR assay and PITC to confirm HIV infection. He had prolonged hospitalized and discharge after 18 days.

A review of the NG17 recommendations for the use of basal insulin in type 1 diabetes.

AIMS: To revisit the data analysis used to inform National Institute of Health and Care Excellence (NICE) NG17 guidance for initiating basal insulin in adults with type 1 diabetes mellitus (diabetes). METHODS: We replicated the data, methodology and analysis used by NICE diabetes in the NG17 network meta-analysis (NMA). We expanded this data cohort to a more contemporary data set (extended 2017 NMA) and restricted the studies included to improve the robustness of the data set (restricted 2017 NMA) and in a post hoc analysis, changed the index comparator from neutral protamine Hagedorn (NPH) insulin twice daily to insulin detemir twice daily. RESULTS: The absolute changes in HbA1c were similar to those reported in the NG17. However, all 95% credible intervals for change in HbA1c point estimates crossed the line of null effect, except for detemir twice daily (in the NICE and extended 2017 NMAs) and NPH four times daily. In the detemir twice-daily centred post hoc analysis, the 95% credible intervals for change in HbA1c crossed the line of null effect for all basal therapies, except NPH. CONCLUSIONS: In NG17, comparisons of basal insulins were based solely on efficacy of glycaemic control. Many of the trials used in this analysis were treat-to-target, which minimize differences in HbA1c . In the NMAs, statistical significance was severely undermined by the wide credible intervals. Despite these limitations, point estimates of HbA1c were used to rank the insulins and formed the basis of NG17 guidance. This study queries whether such analyses should be used to make specific clinical recommendations.

A multicentre, UK, retrospective, observational study to assess the effectiveness of insulin glargine 300 units/ml in treating people with Type 1 diabetes mellitus in routine clinical practice (SPARTA).

AIM: To conduct an open-label study to provide UK real-world evidence regarding the use of insulin glargine 300 units/ml (U300) in people with Type 1 diabetes mellitus. METHODS: People with Type 1 diabetes who had been prescribed U300 ≥6 months before data collection and had HbA1c levels recorded within 3 months prior to U300 (baseline) were included. The primary endpoint was change in HbA1c from baseline to month 6 after U300 initiation. Other endpoints included number of documented hypoglycaemic and diabetic ketoacidosis episodes, and change in daily basal insulin dose. RESULTS: A total of 298 people with Type 1 diabetes were included [mean age 42.1 years, mean HbA1c 79 mmol/mol (9.4%)]. After U300 initiation, the mean reduction in HbA1c from baseline to month 6 was -4 mmol/mol (-0.4%; P<0.001; n=188). The total daily basal insulin dose at 6 months was 1.3 units higher than at the time of U300 initiation (P<0.001; n=275) but was not significantly different from the prior basal insulin dose. There was no clinically significant difference in weight between baseline and month 6 [mean difference +0.7 kg, 95% CI -0.1, 1.5; P=0.084; n=115). During the 6 months before and after U300 initiation, severe hypoglycaemic episodes were documented for 6/298 and 4/298 participants. Diabetic ketoacidosis episodes requiring Accident and Emergency department visits or hospitalization were documented for 4/298 and 6/298 participants, before and after U300 initiation, respectively. CONCLUSIONS: In people with Type 1 diabetes, a change in basal insulin to U300 was associated with clinically and statistically significant HbA1c improvements, without significant changes in basal insulin dose and weight. Documented severe hypoglycaemia episodes and diabetic ketoacidosis requiring Accident and Emergency department visits or hospitalization were low and similar before and after U300 initiation.

The reliability and stability of visual working memory capacity.

Because of the central role of working memory capacity in cognition, many studies have used short measures of working memory capacity to examine its relationship to other domains. Here, we measured the reliability and stability of visual working memory capacity, measured using a single-probe change detection task. In Experiment 1, the participants (N = 135) completed a large number of trials of a change detection task (540 in total, 180 each of set sizes 4, 6, and 8). With large numbers of both trials and participants, reliability estimates were high (α > .9). We then used an iterative down-sampling procedure to create a look-up table for expected reliability in experiments with small sample sizes. In Experiment 2, the participants (N = 79) completed 31 sessions of single-probe change detection. The first 30 sessions took place over 30 consecutive days, and the last session took place 30 days later. This unprecedented number of sessions allowed us to examine the effects of practice on stability and internal reliability. Even after much practice, individual differences were stable over time (average between-session r = .76).

Integrating twisted wind profiles to Air Ventilation Assessment (AVA): The current status.

Twisted wind flows generated by the complex terrain of Hong Kong induce two types of complication to Air Ventilation Assessment (AVA), first, imposing a false boundary condition on the wind tunnel tests done for AVA and, second, creating an ambiguity in determining the approaching wind direction in calculating the probability of occurrence of winds. The latter issue is partially solved using correction methods in post-analysis of AVA but the accuracy of these methods is not yet accessed. This study employs two twisted wind profiles to test an urban area in a boundary layer wind tunnel to investigate the influence of twisted wind flows on the outcomes of AVA and to estimate the accuracy of three common correction methods: No-Shift, Threshold, and Proportional methods. The results reveal significant differences in wind speeds at the pedestrian level for twisted and conventional wind flows at locations with low building densities. The discrepancies in wind speeds are minimum at the locations where the density of buildings is high. The indicators calculated by the No-Shift method frequently deviate from those of the twisted wind flows, while the Threshold and Proportional methods routinely over-predict the indicators of AVA.

Evaluation of pedestrian wind comfort near 'lift-up' buildings with different aspect ratios and central core modifications.

Owing to the void space at lower heights, lift-up buildings have high building permeability at ground level and subsequently improve the air circulation in congested urban areas. Despite this advantage, the lift-up design has been sparsely adopted for buildings in urban areas partly because of the lack of understanding of the combined effects of building dimensions and lift-up design on the surrounding pedestrian level wind (PLW) field. Therefore, this study aims to investigate the influence of lift-up buildings with different aspect ratios (height/width) on the surrounding PLW field and pedestrian wind comfort level. Five lift-up buildings with aspect ratios 4:1 to 0.5:1 were tested in a boundary layer wind tunnel and results were compared with those of five buildings with similar dimensions but without lift-up design. The results reveal a strong dependence of the maximum wind speed in lift-up areas with building height, which results subsequently a small area of acceptable wind conditions near tall and slender lift-up buildings. Lift-up designs adopted for short and wide buildings produce larger areas of pedestrian wind comfort. The central cores modified with corner modifications are effective in increasing the pedestrian wind comfort in the lift-up area of tall and slender buildings.

Adopting 'lift-up' building design to improve the surrounding pedestrian-level wind environment.

Modern megacities are teeming with closely-spaced tall buildings, which limit air circulation at the pedestrian level. The resultant lack of air circulation creates poorly ventilated areas with accumulated air pollutants and thermal discomfort in the summer. To improve air circulation at the pedestrian level, buildings may be designed to have a 'lift-up' shape, in which the main structure is supported by a central core, columns or shear walls. However, a lack of knowledge on the influence of the 'lift-up' design on the surrounding wind environment limits the use of 'lift-up' buildings. This study aims to investigate the influence of 'lift-up' buildings and their dimensions on the pedestrian-level wind environments using wind tunnel tests. A parametric study was undertaken by using 9 'lift-up' building models with different core heights and widths. The results were compared with the surrounding wind environment of a control building with similar dimensions. The results reveal that the 'lift-up' core height is the most influential parameter and governs the area and magnitude of high and low wind speed zones around such buildings. Based on wind tunnel test results and a selected comfort criterion, appropriate core dimensions could be selected to have acceptable wind conditions near lift-up buildings.

Matrix metalloproteinase 9 -1562C/T polymorphism increased protein levels in patients with colorectal cancer in a sample from southeastern Brazil.

We examined whether the allelic and/or genotypic profile of locus -1562C/T of the matrix metalloproteinase (MMP-9) gene influences the protein expression levels of MMP-9 in patients with colorectal cancer (CRC) compared with controls. A total of 104 patients with CRC and 84 controls were evaluated. Peripheral blood was collected from both groups and DNA extraction was performed for -1562C/T genotyping; the plasma was used for MMP-9 quantification. The CT genotype was associated with increased MMP-9 expression (P = 0.0211). High levels of protein, independently of polymorphisms, were observed in the patient group (P < 0.0001) compared to controls. Mucinous tumors with signet ring cells were more frequent in females (P = 0.0177). Overall, patients older than 50 years showed a significant risk of developing CRC (P = 0.0001). MMP-9 plasma expression was increased in patients with CRC compared to controls, particularly in those with the heterozygous -1562CT genotype.

A fast and simple method for the polymerase chain reaction-based sexing of livestock embryos.

Embryo sexing is a powerful tool for livestock producers because it allows them to manage their breeding stocks more effectively. However, the cost of supplies and reagents, and the need for trained professionals to biopsy embryos by micromanipulation restrict the worldwide use of the technology to a limited number of specialized groups. The aim of this study was to couple a fast and inexpensive DNA extraction protocol with a practical biopsy approach to create a simple, quick, effective, and dependable embryo sexing procedure. From a total of 1847 sheep and cattle whole embryos or embryo biopsies, the sexing efficiency was 100% for embryo biopsies, 98% for sheep embryos, and 90.2% for cattle embryos. We used a primer pair that was common to both species and only 10% of the total extracted DNA. The whole protocol takes only 2 h to perform, which suggests that the proposed procedure can be readily applied to field conditions. Moreover, in addition to embryo sexing, the procedure can be used for further analyses, such as genotyping and molecular diagnosis in preimplantation embryos.

Synthetic brominated furanone F202 prevents biofilm formation by potentially human pathogenic Escherichia coli O103:H2 and Salmonella ser. Agona on abiotic surfaces.

AIMS: Investigate the use of a synthetic brominated furanone (F202) against the establishment of biofilm by Salmonella ser. Agona and E. coli O103:H2 under temperature conditions relevant for the food and feed industry as well as under temperature conditions optimum for growth. METHODS AND RESULTS: Effect of F202 on biofilm formation by Salmonella ser. Agona and E. coli O103:H2 was evaluated using a microtiter plate assay and confocal microscopy. Effect of F202 on bacterial motility was investigated using swimming and swarming assays. Influence on flagellar synthesis by F202 was examined by flagellar staining. Results showed that F202 inhibited biofilm formation without being bactericidal. F202 was found to affect both swimming and swarming motility without, however, affecting the expression of flagella. CONCLUSIONS: F202 showed its potential as a biofilm inhibitor of Salmonella ser. Agona and E. coli O103:H2 under temperature conditions relevant for the feed and food industry as well as temperatures optimum for growth. One potential mode of action of F202 was found to be by targeting flagellar function. SIGNIFICANCE AND IMPACT OF THE STUDY: The present study gives valuable new knowledge to the potential use of furanones as a tool in biofilm management in the food and feed industry.

Epidemiological Survey on Edentulousness in Elderly Nepalese Population.

BACKGROUND: A lot of epidemiological surveys have been conducted in dental caries and periodontal problems, but prosthetic sector is lacking such study. OBJECTIVE: The aim of this study was to assess the level of edentulousness, the cause of edentulousness, the denture wearing and denture needs of selected Nepalese population. It will also analyze how factors, such as habits, built, educational needs influence edentulousness. METHOD: Patients visiting the Dental Outpatient Department of Dhulikhel Hospital and various dental camps organized by the hospital were selected for study. The examination was conducted using basic diagnostic tools (Mouth mirror, straight probe and explorer). Statistical software SPSS 16.0 was used for data analysis, chi-square test was performed for each parameter. RESULT: The statistical analysis showed that age was statistically associated to edentulousness, but gender and built were not associated to edentulousness. Furthermore educational status and habit were statistically associated with edentulousness. CONCLUSION: Oral health awareness and education programs should be conducted at the community level for every individual. The role of oral hygiene practice, the negative effect of various oral habit, especially smoking and tobacco chewing habits, the need to replace missing teeth and care of artificial denture should be explained.

Rhipicephalus sanguineus (Acari: Ixodidae) female ticks exposed to castor oil (Ricinus communis): an ultrastructural overview.

Tick control has been accomplished through the use of synthetic acaricides, which has created resistant individuals, as well as contaminating the environment and nontarget organisms. Substances of plant origin, such as oils and extracts of eucalyptus and neem leaves, have been researched as an alternative to replace the synthetic acaricides. Ricinoleic acid esters from castor oil have recently been shown as a promising alternative in eliminating bacterial contamination during ethanol fermentation, by acting as an effective biocide. The same positive results have been observed when these esters are added to the food given to tick-infested rabbits. This study tested the effect of these substance on the reproductive system of Rhipicephalus sanguineus females, added to rabbit food, more specifically on oogenesis. For this, four groups were established: four control groups (CG1, CG2, CG3, and CG4) and four treatment groups (TG1, TG2, TG3, and TG4) with one rabbit in each (New Zealand White), used as hosts. After full 4 days feeding (semi-engorgement), the females were collected and had their ovaries extracted. In this study, it was observed that R. sanguineus females exposed to esters had their ovaries modified, which was demonstrated through transmission electron microscopy techniques. The addition of ricinoleic esters to the diet of tick-infested rabbits revealed how toxic such substances are for the cytoplasmic organelles of oocytes and pedicel cells. These compounds can change the morphophysiology of germ and somatic cells, consequently influencing their viability and, therefore, confirming that the ricinoleic acid esters from castor oil are a promising substance in the control of R. sanguineus.

Domestic carnivore's development: detection of Oct-4, a pluripotency marker, in pharyngeal arches.

Very few carnivore's embryology is reported mainly restricted to old literature without new technique analyses. Also, their development focuses on pharyngeal arches and stem cell sources and the high capacity for differentiation from those cells to generate embryonic tissue. We aimed to use immunohistochemistry to prove the potentiality of these stem cell niches. The results were to highlight the timetable for the development of dogs and cats, the proper formation of pharyngeal arches and the description of these cells on first and second arches since 17-25 days of pregnancy. After that, the differentiation process is reduced.

Renal impairment among patients with pelvic organ prolapse in a tertiary care center.

BACKGROUND: Pelvic organ prolapse is a multidimensional phenomenon. The manifestations of renal involvement following pelvic organ prolapse ranges from acute to chronic renal failure and may also lead to end stage renal failure. Prolonged duration and its severity in pelvic organ prolapse are responsible for renal impairment. OBJECTIVES: This study will find out the incidence of renal impairment among women with pelvic organ prolapse undergoing surgical management. It will also help to establish the association of renal impairment with degree and duration of pelvic organ prolapse. METHODS: This prospective study includes cases of pelvic organ prolapse who underwent surgical management from the year 2009-2012 in Dhulikhel hospital. Total 140 cases were assessed with age, duration and different symptoms. Clinical examination was done to find out the degree of prolapse and graded according to Baden Walker classification. Urine routine and microscopic examination, renal function test and abdominopelvic sonography were performed routinely. Renal impairment was assessed using hydronephrosis and creatinine clearance. Creatinine clearance was calculated using patient's weight and serum creatinine value by Cockcroft and Gault formula. RESULTS: Among 140 cases, 8 (5.7%) patients had procedentia, 106 (75.7%) had third degree, 22 (15.7%) had second degree, and four (2.8%) patients had first degree uterine prolapse. The mean duration of prolapse was found to be 11.47 years. Total 5 (3.57%) patients had hydronephrosis. Four had moderate and one had severe hydronephrosis. Total 49 (34.1%) patients had moderate to severe renal failure. Forty six (32%) in stage III moderate reduction in creatinine clearance, 2 (1.4%) with severe reduction and 1(0.7%) in end stage renal failure. CONCLUSION: Renal impairment is a common entity among women with pelvic organ prolapse. Both hydronephrosis and degree renal impairment correlates correspondingly with the duration and severity of prolapse.

Lack of association between Gly82Ser, 1704G/T and 2184A/G of RAGE gene polymorphisms and retinopathy susceptibility in Malaysian diabetic patients.

Diabetic retinopathy is the most common diabetic eye disease, occurring in about 60% of type 2 diabetic patients. Other than known clinical risk factors, the influence of genes has been suggested as part of the development of diabetic retinopathy. We investigated the association of Gly82Ser, 1704G/T and 2184A/G polymorphisms in the RAGE gene with retinopathy in type 2 diabetic patients in Malaysia. Ninety-eight unrelated retinopathy patients and 185 unrelated healthy controls from all over Malaysia were recruited in this study. The allele and genotype frequencies of the three gene polymorphisms were investigated using PCR-RFLP. The allele frequency of the three polymorphisms did not differ significantly between the control and the retinopathy group (P > 0.05). Analysis of the frequency of GA+AA, GT+TT and AG+GG in the retinopathy group did not reveal significant differences (P > 0.05) compared to the control group. We conclude that RAGE gene Gly82Ser, 1704G/T and 2184A/G polymorphisms are not associated with retinopathy development in the Malaysian population.

Q-Switched Neodymium-Doped Yttrium Aluminum Garnet laser therapy for pigmented skin lesions: efficacy and safety.

BACKGROUND: Nepalese population with Fitzpatrick skin types III-V has high prevalence of pigmentary disorders and it is a growing cosmetic concern. Q-Switched Neodymium- Doped Yttrium Aluminum Garnet (QS Nd-YAG) laser is an efficacious tool in the treatment of pigment disorders. OBJECTIVE: To highlight the efficacy and safety profile of various pigment disorders. METHODS: A prospective study done in Dhulikhel Hospital, Kathmandu University Hospital from January 2009 to January 2011. Patients undergoing laser for pigmented skin lesions were followed for response and safety profile. We included total 270 patients in the study with various disorders especially nevus, tattoos and melasma. Settings were repeated at 3-4 weeks interval and response was evaluated on clinical basis. Efficacy was then evaluated according to various parameters. RESULTS: For nevus, total 840 treatment sessions had been performed with an average of 6.88 sessions (range 3-11). Nd: YAG laser was very efficacious in removal of blue and black colored tattoos with an average of 7.9 and 9.5 sessions respectively. However, red mixed with blue and or green tattoos were relatively resistant to treatment and required average 10.33 treatment sessions. Melasma and freckles both responded to the therapy but recurrence rate was high. CONCLUSION: Our results indicate that QS Nd: YAG laser is an effective modality for pigment disorders among Nepalese population. Nevus and melasma respond well but recurrence rate of melasma is high. Blue tattoos respond well while mixed colored tattoos are quite resistant to Nd: YAG laser alone. Transient pain and temporary hyperpigmentation are common side effects.

Sensory analysis of lipstick.

Sensory analysis of lipstick product by trained panellists started with recruiting female panels who are lipstick users, in good health condition and willing to be a part of sensory members. This group of people was further scrutinized with duo-trio method using commercial lipstick samples that are commonly used among them. About 40% of the 15 panels recruited were unable to differentiate the lipstick samples they usually use better than chance. The balance of nine panels that were corrected at least with 65% across all trials in panels screening process was formed a working group to develop sensory languages as a means of describing product similarities and differences and a scoring system. Five sessions with each session took about 90 min were carried out using 10 types of lipsticks with different waxes mixture ratio in the formulation together with six commercial lipsticks that are the most common to the panels. First session was focus on listing out the panels' perception towards the characteristic of the lipstick samples after normal application on their lips. Second session was focus on the refining and categorizing the responses gathered from the first session and translated into sensory attributes with its definition. Third session was focus on the scoring system. Fourth and fifth sessions were repetition of the third session to ensure consistency. In a collective effort of the panels, sensory attributes developed for lipstick were Spreadability, Off flavour, Hardness, Smoothness, Moist, Not messy, Glossy and Greasy. Analysis of variance was able to provide ample evidence on gauging the panel performance. A proper panels selecting and training was able to produce a reliable and sensitive trained panel for evaluating the product based on the procedures being trained.

From immune response to cancer: a spot on the low molecular weight protein tyrosine phosphatase.

Reversible tyrosine phosphorylation is a key posttranslational regulatory modification of proteins in all eukaryotic cells in normal and pathological processes. Recently a pivotal janus-faced biological role of the low molecular weight protein tyrosine phosphatase (LMWPTP) has become clear. On the one hand this enzyme is important in facilitating appropriate immune responses towards infectious agents, on the other hand it mediates exaggerated inflammatory responses toward innocuous stimuli. The evidence that LMWPTP plays a role in oncological processes has added a promising novel angle. In this review we shall focus on the regulation of LMWPTP enzymatic activity of signaling pathways of different immunological cells, the relation between genetic polymorphism of LMWPTP and predisposition to some type of inflammatory disorders and the contribution of this enzyme to cancer cell onset, growth and migration. Therefore, the LMWPTP is an interesting target for pharmacological intervention, thus modifying both inappropriate cellular immune responses and cancer cell aggressiveness.

Activity and asymmetry index of masticatory muscles in women with and without dysfunction temporomandibular.

PURPOSE: [corrected] Compare the symmetry of the activity and masticatory muscles in individuals with TMD and asymptomatic. METHODS: The study included 50 women, while 31 had temporomandibular disorders (TMD) and 19 were asymptomatic (control group), aged between 19 and 40 years. The volunteers were subjected to clinical examination of the diagnostic criteria in research with TMD (RDC/TMD) with the aim of diagnosing volunteers with or without TMD, and evaluate the electromyographic activity of the right temporalis muscle (TR) and left (TL), right masseter (MR) and left (ML), in situations of rest, isometric contraction of the muscles of the jaw elevators. We obtained the rates of activity and asymmetry in each situation and for the collection and TMD control groups. RESULTS: For the index of activity for the rest there was significant difference (p = 0.0008) between the control group and the TMD group, with predominance of temporal muscle, was not observed difference between groups for the index of activity during the isometric contraction (p = 0.1069). For the index of asymmetry no difference between groups during rest, for the masseter muscles (p = 0.4182) and the temporal (p = 0.7614), and also during the isometry for both masseter muscles (p = 0.8691) and for time (p = 0.6643). CONCLUSIONS: The control group showed prevalence of TMD and temporal muscle during rest, which did not occur in the isometry, and no difference for the index of asymmetry between the groups for the masseter and temporal muscles.