Extended C-band tunable multi-channel InP-based coherent receiver PICs.

Fully integrated monolithic, multi-channel InP-based coherent receiver PICs and transceiver modules with extended C-band tunability are described. These PICs operate at 33 and 44 Gbaud per channel under dual polarization (DP) 16-QAM modulation. Fourteen-channel monolithic InP receiver PICs show integration and data rate scaling capability to operate at 44 Gbaud under DP 16-QAM modulation for combined 4.9 Tb/s total capacity. Six channel simultaneous operation of a commercial transceiver module at 33 Gbaud is demonstrated for a variety of modulation formats including DP 16-QAM for >1.2Tbit/s aggregate data capacity.

Quality of life in multiple sclerosis: a Kuwaiti MSQOL-54 experience.

OBJECTIVES: We compared the quality of life (QOL) self-ratings of relapsing-remitting multiple sclerosis (RRMS) and progressive multiple sclerosis (PMS) patients with those of the general population; and assessed the association of demographic, clinical, and caregiver variables with patients' QOL. METHODS: Consecutive clinic attendees were assessed with MSQOL-54, Beck's Depression Inventory, and Expanded Disability Status Scale. Caregivers rated their impression of patients' QOL and attitudes to patients' illness. RESULTS: Of 170 patients (35.5% M, 64.5% F), 85.3% had RRMS and 14.7% PMS. RRMS had higher QOL domain scores (P < 0.001). Patients had lower QOL than controls (P < 0.001). Depression was the commonest significant covariate of QOL domains. After controlling for depression and disability, differences between the MS groups were less significant. Predictors of overall QOL were caregiver impression of patient's QOL, depression, and treatment side effects. CONCLUSION: Programs that address depression, disability, the impact of treatment side effects, caregiver attitudes and education should enhance QOL outcomes.

Activation of Nrf2 by ischemic preconditioning and sulforaphane in renal ischemia/reperfusion injury: a comparative experimental study.

Objectives of the study were to investigate impact of ischemic preconditioning (Ipre) and sulforaphane (SFN) and combination of them on nuclear factor 2 erythroid related factor 2 (Nrf2) gene and its dependent genes, heme oxygenase-1 (HO1) and NADPH-quinone oxidoreductase1 (NQO-1) and inflammatory cytokines TNF-alpha, IL1beta, and intercellular adhesion molecule-1 (ICAM1) and caspase-3 in renal ischemia/reperfusion (I/R) injury. Ninety male Sprague Dawely rats were classified into 5 groups (each consists of 18 rats): sham, control, Ipre, sulforaphane and Sulfo+Ipre. Each group was subdivided into 3 subgroups each containing 6 rats according to time of harvesting kidney and taking blood samples; 24 h, 48 h, and 7 days subgroups. Renal functions including serum creatinine, BUN were measured at basal conditions and by the end of experiment. Expression of Nrf2, HO-1, NQO-1, TNF-alpha, IL-1beta, and ICAM-1 was measured by real time PCR in kidney tissues by the end of experiment. Also, immunohistochemical localization of caspase-3 and chemical assay of malondialdehyde (MDA), GSH and SOD activity were measured in kidney tissues. Both Ipre and SFN improved kidney functions, enhanced the expression of Nrf2, HO-1, and NQO-1, attenuated the expression of inflammatory (TNF-alpha, IL-1, and ICAM-1) and apoptotic (caspase-3) markers. However, the effect of sulforaphane was more powerful than Ipre. Also, a combination of them caused more improvement in antioxidant genes expression and more attenuation in inflammatory genes but not caspase-3 than each one did separately. Sulforaphane showed more powerful effect in renoprotection against I/R injury than Ipre as well as there might be a synergism between them at the molecular but not at the function level.

Development and initial validation of an Arabic version of the Expanded Trail Making Test: implications for cross-cultural assessment.

The performances of Sudanese subjects, both normal and brain damaged, on an Arabic version of the Expanded Trail Making Test were compared to those of normal and brain-damaged subjects from the United States, who completed the standard English version of this test. Preliminary psychometric properties of the Arabic version of the Expanded Trail Making Test were defined. Significant intergroup differences in performance were observed. Interestingly, the performances of Sudanese normals were found to be similar to those of U.S. brain-damaged subjects. The results are discussed in terms of reducing neuropsychological diagnostic errors attributable to ethnocultural factors.

Features of isolated sleep paralysis among Nigerians.

BACKGROUND: There is paucity of studies on isolated sleep paralysis (ISP). OBJECTIVES: To explore the relationship of variables for ISP sufferers, and clarify factors predictive of ISP health behaviour (IHB--doing something to prevent further attacks). DESIGN: Cross-sectional study. SETTING: General population. MEASUREMENT: 24-item ISP questionnaire completed by respondents. SUBJECTS: One hundred and ten (38.2%m, aged 30.9 years). RESULTS: Mean ISP frequency in the lifetime, past year and past month, were respectively, 6.7, 2.02, and 0.5; average duration of episodes was four minutes, and 63.6% experienced it while awakening from sleep. Using ICSD criteria, 2.7% had severe experience (i.e. at least once per week), 18.2% moderately severe (once per month) and 75.5% mildly severe (less than once per month), with no significant demographic associations. 56.4% were afraid of the experience, 76.4% had little/no worries that something was seriously wrong with their bodies; 39.1% cited supernatural causes, 35.5% cited physiological/psychosocial causes; and 44.5% described a hallucinatory experience. 1.8% took medical measures, and 7.3% consulted a faith healer; 44.5% resorted to prayers and 41.8% did nothing to prevent further attacks. The primary determinant of IHB was being afraid of ISP. CONCLUSION: These findings have public mental health education, treatment and research implications.

Activation of nuclear factor erythroid 2-related factor 2 (Nrf2) and Nrf-2-dependent genes by ischaemic pre-conditioning and post-conditioning: new adaptive endogenous protective responses against renal ischaemia/reperfusion injury.

AIM: To investigate the impact of ischaemic pre-conditioning (Ipre) and post-conditioning (Ipost) on expression of nuclear factor erythroid 2-related factor 2 (Nrf2) gene and its dependent genes, haem oxygenase-1 (HO-1) and NADPH-quinone oxidoreductase-1 (NQO-1); inflammatory cytokines TNF-α, IL1ß and ICAM-1; and apoptotic markers such as caspase-3 in renal ischaemia/reperfusion (I/R) injury. METHODS: One hundred and fifty male Sprague Dawley rats were classified into five groups (each consisted of 30 rats): sham, control (I/R), Ipre + I/R, Ipre without I/R and Ipost + I/R. Serum creatinine and blood urea nitrogen (BUN) were measured at 2, 24 and 48 h after ischaemia. In kidney tissues, mRNA of Nrf2, HO-1, NQO-1, TNF-α, IL-1ß and ICAM-1 and immunohistochemical expression of Nrf2 and caspase-3 were assessed. RESULTS: Serum creatinine and BUN improved significantly in Pre + I/R group; however, they did not show any significant improvement in Post + I/R group. Also, Ipre-I/R group showed non-significant change in serum creatinine and BUN. The expression of Nrf2, HO-1 and NQO-1 is increased significantly in Pre + I/R and Pre - I/R groups, while the enhancement in Post + I/R group was non-significant. Moreover, the expression of proinflammatory cytokines (TNF-α, IL-1 and ICAM-1) and apoptotic (caspase-3) markers showed high significant attenuation in Pre + I/R group, but slight significant attenuation in Pre + I/R group. CONCLUSION: The renoprotective action of Ipre might include early activation and enhanced expression of Nrf2 gene and its dependent antioxidant genes, HO-1 and NOQ1, as endogenous adaptive renoprotective genes, as well as reduction in TNF-α, IL-1ß, ICAM-1 and caspase-3.

MTHFR functional genetic variation and methotrexate treatment response in rheumatoid arthritis: a meta-analysis.

AIM: To date, functional MTHFR SNPs have been tested for their impact on low-dose methotrexate (MTX) response in small rheumatoid arthritis (RA) cohorts. We sought to test their effect in the single largest cohort studied to date, and undertook a meta-analysis utilizing stringent study inclusion criteria. MATERIALS & METHODS: RA patients treated with MTX monotherapy from the Yorkshire Early Arthritis Register (YEAR) were genotyped using RFLP assays, and tested for association with treatment efficacy. Studies for meta-analysis were screened by a set of stringent inclusion criteria. RESULTS & CONCLUSION: rs1801131 and rs1801133 were not associated with response to MTX in the YEAR cohort, nor did they affect the probability of achieving a low disease activity state. A meta-analysis of comparable studies found no association with these SNPs. MTHFR SNPs rs1801131 and rs1801133 are unlikely to have a clinically meaningful effect on the first 6 months of MTX treatment in early RA.

Detection and significance of blood neutrophil CD64 expression as a diagnostic marker in bacterial meningitis in children.

Appropriate, rapid and reliable laboratory tests are essential for the diagnosis and therapy of acute bacterial meningitis especially in children. The purpose of this study was to evaluate the diagnostic value of flowcytometric detection of CD64 surface marker on blood neutrophils in diagnosis of acute bacterial meningitis. Our work included 132 (74 males and 58 females) patients with suspected meningitis, whose ages ranged from 2 months to 11 year. Patients were subjected to full clinical examination, complete blood count (CBC), cerebrospinal fluid (CSF) chemical and bacteriological analysis and detection of CD64 surface marker on blood neutrophils (CD64+ leucocytes). Based on the microbial culture results, patients were classified into bacterial meningitis group I (44) and non bacterial meningitis group II (88). The most prevalent isolates were Streptococcus pneumoniae (23) followed by H. influenzae (9) and N. meningitidis (6). Flowcytometry results indicated that the mean percentage of neutrophil CD64+ expression in bacterial meningitis (71.38 +/- 7.11) was significantly higher compared to culture negative meningitis (48.63 +/- 14.55) and controls (4.37 +/- 13.5). Flowcytometric assessment of neutrophil CD64 expression could serve as a reliable laboratory tool for detection of bacterial meningitis and may be a useful adjunct in differentiating bacterial and non bacterial meningitis.

A retrospective analysis of the first Yemeni experience on Artisan phakic intraocular lens for the treatment of moderate and high myopia.

OBJECTIVES: To evaluate the outcome and safety of the iris-fixated Artisan phakic intraocular lens (PIOL) for the correction of moderate and high myopia. MATERIALS AND METHODS: A retrospective non-controlled clinical study of the data of patients who underwent Artisan PIOLs between March 2006 and July 2008 was evaluated. Pre-operative examination included age, gender, refraction, uncorrected (UCVA) and best spectacle corrected (BSCVA) visual acuity, predictability and safety were analyzed. Post-operative time course ranged from 12 to 36 months. RESULTS: An Artisan myopia lens was implanted in 62 eyes of 39 patients. The mean pre-operative spherical equivalent (SE) was -13.17 ± 5.62 D. The pre-operative myopia ranged from -4.5 to -24 D. Mean patient age was 25.44 ± 5.22 years. At last follow-up visit, residual SE was within ±1.00 D in 36 eyes (58.1%) and ±2.00 D in 56 eyes (90.3%). In the last visit UCVA was equal to or better than pre-operative BSCVA in 57 (91.9%) of the eyes. One eye (1.6%) lost one Snellen line, three eyes (4.8%) lost two or more Snellen lines and one eye lost vision (1.6%). Post-operative complications included anterior chamber reaction in one eye, rise in intraocular pressure in two eyes and retinal detachment in one eye. CONCLUSION: When laser keratorefractive surgery is not an option, implantation of Artisan PIOL to correct moderate to high myopia results in a stable and good refractive result with few complications that must be kept in mind.

Subjective quality of life of community living Sudanese psychiatric patients: comparison with family caregivers' impressions and control group.

BACKGROUND: Researchers have paid scant attention to comparative studies of quality of life (QOL) issues among psychiatric diagnostic groups; the studies of patient-caregiver concordance ratings had small sample sizes; and the reports are rare from the African and Arab worlds. OBJECTIVES: to assess the subjective QOL of stable Sudanese outpatients, using the WHOQOL-Bref, compared with a general population sample; examine the caregiver-patient concordance; and assess the variables that impact on domains of QOL. METHOD: The responses of outpatients with schizophrenia (99), major affective disorders (120) and neuroses (81) (mean age 33.8) were compared with 211 controls and the impression of their family caregivers. RESULTS: Patients were dissatisfied with life circumstances; the schizophrenia group and those with co-morbidity had significantly lower QOL scores; while the control group had higher QOL scores. There was no significant impact on QOL domains, of socio-demographic factors, duration of illness and treatment side effects. The schizophrenia group had least concordance with caregivers, but eight items were judged to be satisfactorily concordant for all groups. CONCLUSIONS: Psychiatric patients in stable condition can make reliable judgments of QOL, with relatives providing additional information. Differences in QOL and concordance of ratings reflect disease severity.