Association of apolipoproteins and lipoprotein(a) with metabolic syndrome: a systematic review and meta-analysis.

BACKGROUND & AIMS: Apolipoproteins and lipoprotein(a) are associated with various cardiometabolic diseases, including insulin resistance, diabetes mellitus, hypertension, dyslipidemia, among others. This systematic review and meta-analysis was conducted to evaluate the association of these markers with metabolic syndrome (MetS). METHODS: We ran a systematic search through PubMed, Scopus, Embase, Ovid/Medline, and Web of Science on March 15, 2023. No language or date restrictions were applied. The only synthesised effect measure reported was the odds ratio (OR) with its corresponding 95% confidence interval (95% CI). We utilised the random-effects model for the quantitative synthesis. RESULTS: We analysed 50 studies (n = 150 519) with different definitions for MetS. Increased ApoB values were associated with MetS (OR = 2.8; 95% CI: 2.44-3.22; p < 0.01, I2 = 99%). Decreased ApoA1 values were associated with MetS (OR = 0.42; 95% CI: 0.38-0.47; p < 0.01, I2 = 99%). Increased values of the ApoB/ApoA1 ratio were associated with MetS (OR = 4.97; 95% CI: 3.83-6.44; p < 0.01, I2 = 97%). Decreased values of Lp(a) were associated with MetS (OR = 0.89; 95% CI: 0.82-0.96; p < 0.01; I2 = 92%). CONCLUSIONS: Increased values of ApoB and ApoB/ApoA1 ratio are associated with MetS, while decreased values of ApoA1 and Lp(a) are associated with MetS. These findings suggest that these lipid markers may serve as potential indicators for identifying subjects at risk of developing MetS. However, further research is required to elucidate the underlying mechanisms of these associations.

Use of Inotropics by Peripheral Vascular Line in the First Hour of Treatment of Pediatric Septic Shock: Experience at an Emergency Department.

OBJECTIVE: Mortality in pediatric septic shock remains unacceptably high. Delays in vasopressor administration have been associated with an increased risk of mortality. Current treatment guidelines suggest the use of a peripheral vascular line (PVL) for inotropic administration in fluid-refractory septic shock when a central vascular line is not already in place. The aim of this study was to report local adverse effects associated with inotropic drug administration through a PVL at a pediatric emergency department setting in the first hour of treatment of septic shock. METHODS: A prospective, descriptive, observational cohort study of patients with septic shock requiring PVL inotropic administration was conducted at the pediatric emergency department of a tertiary care pediatric hospital. For the infusion and postplacement care of the PVL for vasoactive drugs, an institutional nursing protocol was used. RESULTS: We included 49 patients; 51% had an underlying disease. Eighty-four percent of the children included had a clinical "cold shock." The most frequently used vasoactive drug was epinephrine (72%). One patient presented with local complications. CONCLUSIONS: At our center, infusion of vasoactive drugs through a PVL was shown to be safe and allowed for adherence to the current guidelines for pediatric septic shock.

Trapezoidal-Type Inequalities for Strongly Convex and Quasi-Convex Functions via Post-Quantum Calculus.

In this paper, we establish new (p,q)κ1-integral and (p,q)κ2-integral identities. By employing these new identities, we establish new (p,q)κ1 and (p,q)κ2- trapezoidal integral-type inequalities through strongly convex and quasi-convex functions. Finally, some examples are given to illustrate the investigated results.

Some New Hermite-Hadamard and Related Inequalities for Convex Functions via (p,q)-Integral.

In this investigation, for convex functions, some new (p,q)-Hermite-Hadamard-type inequalities using the notions of (p,q)π2 derivative and (p,q)π2 integral are obtained. Furthermore, for (p,q)π2-differentiable convex functions, some new (p,q) estimates for midpoint and trapezoidal-type inequalities using the notions of (p,q)π2 integral are offered. It is also shown that the newly proved results for p=1 and q→1- can be converted into some existing results. Finally, we discuss how the special means can be used to address newly discovered inequalities.

New Parameterized Inequalities for η-Quasiconvex Functions via (p, q)-Calculus.

In this work, first, we consider novel parameterized identities for the left and right part of the (p,q)-analogue of Hermite-Hadamard inequality. Second, using these new parameterized identities, we give new parameterized (p,q)-trapezoid and parameterized (p,q)-midpoint type integral inequalities via η-quasiconvex function. By changing values of parameter µ∈[0,1], some new special cases from the main results are obtained and some known results are recaptured as well. Finally, at the end, an application to special means is given as well. This new research has the potential to establish new boundaries in comparative literature and some well-known implications. From an application perspective, the proposed research on the η-quasiconvex function has interesting results that illustrate the applicability and superiority of the results obtained.

Generalized myoclonic epilepsy with photosensitivity in juvenile dogs caused by a defective DIRAS family GTPase 1.

The clinical and electroencephalographic features of a canine generalized myoclonic epilepsy with photosensitivity and onset in young Rhodesian Ridgeback dogs (6 wk to 18 mo) are described. A fully penetrant recessive 4-bp deletion was identified in the DIRAS family GTPase 1 (DIRAS1) gene with an altered expression pattern of DIRAS1 protein in the affected brain. This neuronal DIRAS1 gene with a proposed role in cholinergic transmission provides not only a candidate for human myoclonic epilepsy but also insights into the disease etiology, while establishing a spontaneous model for future intervention studies and functional characterization.

EEG before and after total corpus callosotomy for pharmacoresistant infantile spasms: Fast oscillations and slow-wave connectivity in hypsarrhythmia.

OBJECTIVE: We analyzed the features of fast oscillations (FOs) and connectivity in hypsarrhythmia to identify biomarkers for predicting seizure outcomes after total corpus callosotomy (TCC) in children with pharmacoresistant infantile spasms (IS). We hypothesize that the power of FOs and connectivity of slow waves in hypsarrhythmia would indicate the prognosis of IS. METHOD: We retrospectively identified 42 children with pharmacoresistant IS who underwent TCC from 2009 to 2014 at Nagasaki Medical Center. We collected preoperative hypsarrhythmia for 200 seconds from each child. Children were categorized into three groups with interictal epileptic discharges on EEG at 6 months after TCC: group A, no epileptic discharge; group B, lateralized epileptic discharges; and group C; bilateral epileptic discharges. We analyzed spectral power and phase synchronization in preoperative hypsarrhythmia among the three groups. RESULTS: We found 10 children in group A, 10 children in group B, and 22 children in group C. All group A and 1 in group B achieved seizure freedom after TCC. Six (67%) of 9 group B children who underwent further surgeries achieved seizure freedom. Ten (45%) of group C children had seizure reduction >50% after TCC, and 13 (87%) of 15 children who underwent further surgeries had residual seizures. The clinical profiles of the three groups did not differ significantly. The power of FOs (≥45 Hz) in hypsarrhythmia was significantly stronger in group C at the midline and temporal regions than in groups B and A (P = .014). The connectivity of theta (4-9 Hz) and FOs (29-70 Hz) tended to increase in group C, compared with the increased connectivity of 1-2 Hz in group A (P = .08). SIGNIFICANCE: The increased power and connectivity of FOs in hypsarrhythmia may correlate with pharmacoresistant and surgically resistant seizures in IS. The existence and connectivity of FOs are associated with unilateral/bilateral cortical epileptogenicity in hypsarrhythmia. Prominent slow waves and connectivity without FOs might correlate with seizure freedom after TCC. Modulation of the callosal system with subcortical/cortical epileptic discharges might play a role in generating hypsarrhythmia and IS.

Infantile spasms in down syndrome: Rescue by knockdown of the GIRK2 channel.

OBJECTIVE: The Ts65Dn (Ts) mouse model of Down syndrome (DS) is exquisitely sensitive to an infantile spasms phenotype induced by γ-aminobutyric acidB receptor (GABAB R) agonists. The Ts mouse contains the core genomic triplication of the DS critical region, which includes 3 copies of the Kcnj6 gene that encodes the GABAB R-coupled G protein-coupled inward rectifying potassium channel subunit 2 (GIRK2) channel. We test the hypothesis that GIRK2 is necessary for the GABAB R agonist-induced infantile spasms phenotype in Ts. METHODS: We assessed the result of either genetic or pharmacological knockdown of the GIRK2 channel in Ts brain upon the GABAB R agonist-induced infantile spasms phenotype in the Ts mouse model of DS. As well, we examined GABAB R currents in hippocampal neurons prepared from GIRK2-trisomic Ts control mice and GIRK2-disomic Ts mice in which Kcnj6 had been genetically knocked down from 3 to 2 copies. RESULTS: The reduction of the copy number of Kcnj6 in Ts mice rescued the GABAB R agonist-induced infantile spasms phenotype. There was an increase in GABAB R-mediated GIRK2 currents in GIRK2-trisomic Ts mouse hippocampal neurons, which were normalized in the GIRK2-disomic Ts mice. Similarly, pharmacological knockdown of the GIRK2 channel in Ts brain using the GIRK antagonist tertiapin-Q also rescued the GABAB R agonist-induced infantile spasms phenotype in Ts mutants. INTERPRETATION: The GABAB R-coupled GIRK2 channel is necessary for the GABAB R agonist-induced infantile spasms phenotype in the Ts mouse and may represent a novel therapeutic target for the treatment of infantile spasms in DS. Ann Neurol 2016;80:511-521.

The GIRK2 subunit is involved in IS-like seizures induced by GABA(B) receptor agonists.

OBJECTIVE: Infantile spasms (or IS) is a catastrophic childhood epilepsy that is particularly prevalent in children with Down syndrome. Previously, we have shown that the Ts65Dn (Ts) mouse model of Down syndrome is a useful substrate upon which to develop an animal model of infantile spasms. Specifically, the Ts mouse is exquisitely sensitive to the electroencephalography (EEG) and behavioral effects of γ-aminobutyric acid (GABA) B receptor (GABA(B)R) agonists with a resultant phenotype that bears behavioral, EEG, and pharmacologic semblance to infantile spasms in humans. The G protein-coupled inward rectifying potassium channel subunit 2 (GIRK2) gene, KCNJ6, is overexpressed in Ts mice, and the GABA(B)R-mediated GIRK2 current is significantly increased in these mutant animals as well. Therefore, we formulated the hypothesis that the GIRK2 channel plays a significant role in the behavioral (measured by acute extensor spasms quantification) and EEG (measured by the electrodecremental response duration) phenotype induced in the Ts mice by GABA(B)R agonists. METHODS: GIRK2(-/-), (+/-), and (+/+) mice were treated with γ-butyrolactone (GBL), a pro-drug of the GABA(B)R agonist γ-hydroxybutyric acid, and the specific GABA(B)R agonist baclofen (BAC) under continuous EEG monitoring. These drugs induce epileptiform bursts, extensor spasms, and an electrodecremental response (EDR) in Ts mice at low doses, and in wild-type mice at high doses. A dose-response curve was ascertained with two treatment groups: GBL (100, 200, and 400 mg/kg) and BAC (4, 8, 12, and 16 mg/kg). We determined the baseline, the presence and duration of electrodecremental epochs (EDEs), and quantified acute epileptic extensor spasms. RESULTS: Analysis of EEG and behavior of GIRK2(-/-), (+/-), and (+/+) mice after treatment with GABA(B)R agonists and antagonists, indicate that GIRK2(-/-) mice are highly resistant to GABA(B)R agonist-induced EEG and behavioral changes. SIGNIFICANCE: These data increase the possibility that GIRK2 channel function plays a major role in the genesis of infantile spasms.

Mania-like behavior induced by genetic dysfunction of the neuron-specific Na+,K+-ATPase α3 sodium pump.

Bipolar disorder is a debilitating psychopathology with unknown etiology. Accumulating evidence suggests the possible involvement of Na(+),K(+)-ATPase dysfunction in the pathophysiology of bipolar disorder. Here we show that Myshkin mice carrying an inactivating mutation in the neuron-specific Na(+),K(+)-ATPase α3 subunit display a behavioral profile remarkably similar to bipolar patients in the manic state. Myshkin mice show increased Ca(2+) signaling in cultured cortical neurons and phospho-activation of extracellular signal regulated kinase (ERK) and Akt in the hippocampus. The mood-stabilizing drugs lithium and valproic acid, specific ERK inhibitor SL327, rostafuroxin, and transgenic expression of a functional Na(+),K(+)-ATPase α3 protein rescue the mania-like phenotype of Myshkin mice. These findings establish Myshkin mice as a unique model of mania, reveal an important role for Na(+),K(+)-ATPase α3 in the control of mania-like behavior, and identify Na(+),K(+)-ATPase α3, its physiological regulators and downstream signal transduction pathways as putative targets for the design of new antimanic therapies.

PTG depletion removes Lafora bodies and rescues the fatal epilepsy of Lafora disease.

Lafora disease is the most common teenage-onset neurodegenerative disease, the main teenage-onset form of progressive myoclonus epilepsy (PME), and one of the severest epilepsies. Pathologically, a starch-like compound, polyglucosan, accumulates in neuronal cell bodies and overtakes neuronal small processes, mainly dendrites. Polyglucosan formation is catalyzed by glycogen synthase, which is activated through dephosphorylation by glycogen-associated protein phosphatase-1 (PP1). Here we remove PTG, one of the proteins that target PP1 to glycogen, from mice with Lafora disease. This results in near-complete disappearance of polyglucosans and in resolution of neurodegeneration and myoclonic epilepsy. This work discloses an entryway to treating this fatal epilepsy and potentially other glycogen storage diseases.

A study of time-fractional model for atmospheric internal waves with Caputo-Fabrizio derivative.

The internal atmospheric waves are gravity waves and occur in the inner part of the fluid system. In this study, a time-fractional model for internal atmospheric waves is investigated with the Caputo-Fabrizio time-fractional differential operator. The analytical solution of the considered model is retrieved by the Elzaki Adomian decomposition method. The variation in the solution is examined for increasing order of the fractional parameter α through numerical and graphical simulations. The accuracy of the obtained results is established by comparing the obtained solution of considered fractional model with the results available in the literature.

An exploration of the (3+1)-dimensional negative order KdV-CBS model: Wave solutions, Bäcklund transformation, and complexiton dynamics.

This research paper focuses on the study of the (3+1)-dimensional negative order KdV-Calogero-Bogoyavlenskii-Schiff (KdV-CBS) equation, an important nonlinear partial differential equation in oceanography. The primary objective is to explore various solution techniques and analyze their graphical representations. Initially, two wave, three wave, and multi-wave solutions of the negative order KdV CBS equation are derived using its bilinear form. This analysis shed light on the behavior and characteristics of the equation's wave solutions. Furthermore, a bilinear Bäcklund transform is employed by utilizing the Hirota bilinear form. This transformation yields exponential and rational function solutions, contributing to a more comprehensive understanding of the equation. The resulting solutions are accompanied by graphical representations, providing visual insights into their structures. Moreover, the extended transformed rational function method is applied to obtain complexiton solutions. This approach, executed through the bilinear form, facilitated the discovery of additional solutions with intriguing properties. The graphical representations, spanning 2D, 3D, and contour plots, serve as valuable visual aids for understanding the complex dynamics and behaviors exhibited by the equation's solutions.

Topology degree results on a G-ABC implicit fractional differential equation under three-point boundary conditions.

This research manuscript aims to study a novel implicit differential equation in the non-singular fractional derivatives sense, namely Atangana-Baleanu-Caputo ([Formula: see text]) of arbitrary orders belonging to the interval (2, 3] with respect to another positive and increasing function. The major results of the existence and uniqueness are investigated by utilizing the Banach and topology degree theorems. The stability of the Ulam-Hyers ([Formula: see text]) type is analyzed by employing the topics of nonlinear analysis. Finally, two examples are constructed and enhanced with some special cases as well as illustrative graphics for checking the influence of major outcomes.

On new common fixed point theorems via bipolar fuzzy [Formula: see text]-metric space with their applications.

This research work is devoted to investigating new common fixed point theorems on bipolar fuzzy [Formula: see text]-metric space. Our main findings generalize some of the existence outcomes in the literature. Furthermore, we illustrate our findings by providing some applications for fractional differential and integral equations.

Analysis of perturbed Boussinesq equation via novel integrating schemes.

To analyze and study the behaviour of the shallow water waves, the perturbed Boussinesq equation has acquired fundamental importance. The principal objective of this paper is to manifest the exact traveling wave solution of the perturbed Boussinesq equation by two well known techniques named as, two variables [Formula: see text] expansion method and generalized projective Riccati equations method. A diverse array of soliton solutions, encompassing periodic, bright solitons, singular solitons and bright singular solitons are obtained by the applications of proposed techniques. The constraint conditions for newly constructed solutions are also specified. To enhance comprehension, the numerical illustrations of constructed solutions have been represented using surface plots, 2D plots and density plots. The results delineated in this paper transcend existing analysis, offering a novel, well-structured, and modern perspective. The solutions obtained not only enrich understanding of shallow water wave models but also exhibit efficacy in providing detailed descriptions of their dynamics.

Extraction of new solitary wave solutions in a generalized nonlinear Schrödinger equation comprising weak nonlocality.

This article delves into examining exact soliton solutions within the context of the generalized nonlinear Schrödinger equation. It covers higher-order dispersion with higher order nonlinearity and a parameter associated with weak nonlocality. To tackle this equation, two reputable methods are harnessed: the sine-Gordon expansion method and the [Formula: see text]-expansion method. These methods are employed alongside suitable traveling wave transformation to yield novel, efficient single-wave soliton solutions for the governing model. To deepen our grasp of the equation's physical significance, we utilize Wolfram Mathematica 12, a computational tool, to produce both 3D and 2D visual depictions. These graphical representations shed light on diverse facets of the equation's dynamics, offering invaluable insights. Through the manipulation of parameter values, we achieve an array of solutions, encompassing kink-type, dark soliton, and solitary wave solutions. Our computational analysis affirms the effectiveness and versatility of our methods in tackling a wide spectrum of nonlinear challenges within the domains of mathematical science and engineering.

Fungal infections in patients after recovering from COVID-19: a systematic review.

Background and aims: The presence of fungal infections has been described in patients after recovering from COVID-19. This study aims to conduct a systematic review of studies that reported fungal infections (Mucor spp., Pneumocystis jirovecii, or Aspergillus spp.) in adults after recovering from COVID-19. Methods: We performed a systematic review through PubMed, Web of Science, OVID-Medline, Embase, and Scopus. The study selection process was performed independently and by at least two authors. We performed a risk of bias assessment using the Newcastle-Ottawa Scale for cohort and case-control studies, and the Joanna Briggs Institute's Checklists for Case Series and Case Reports. Results: The systematic search found 33 studies meeting all inclusion criteria. There was a total population of 774 participants, ranging from 21 to 87 years. From them, 746 developed a fungal infection. In 19 studies, Mucor spp. was reported as the main mycosis. In 10 studies, P. jirovecii was reported as the main mycosis. In seven studies, Aspergillus spp. was reported as the main mycosis. Regarding the quality assessment, 12 studies were classified as low risk of bias and the remaining studies as high risk of bias. Conclusion: Patients' clinical presentation and prognosis after recovering from COVID-19 with fungal infection differ from those reported patients with acute COVID-19 infection and those without COVID-19 infection.

Association of vitamin B12, folate, and homocysteine with COVID-19 severity and mortality: A systematic review and meta-analysis.

Objective: We aimed to review the available evidence on the association between vitamin B12, folate, and homocysteine levels with worse outcomes among COVID-19 patients. Methods: The search was carried out in ten databases simultaneously run on 10 May 2023, without language restrictions. We included cross-sectional, case-control, and cohort studies. The random-effects meta-analysis was performed using the Sidik-Jonkman method and corrected 95% confidence intervals using the truncated Knapp-Hartung standard errors. Standardized mean difference and 95% CI was used as the measure effect size. Results: Thirteen articles were included in this review (n = 2134). Patients with COVID-19 who did not survive had the highest serum vitamin B12 values (SMD: 1.05; 95% CI: 0.31-1.78; p = 0.01, I2 = 91.22%). In contrast, low serum folate values were associated with patients with severe COVID-19 (SMD: -0.77; 95% CI: -1.35 to -0.19; p = 0.02, I2 = 59.09%). The remaining tested differences did not yield significant results. Conclusion: Elevated serum levels of vitamin B12 were associated with higher mortality in patients with COVID-19. Severe cases of COVID-19 were associated with low serum folate levels. Future studies should incorporate a larger sample size.

Highly pathogenic avian influenza A(H5N1) in animals: A systematic review and meta-analysis.

Introduction: Avian influenza A H5N1 is a significant global public health threat. Although relevant, systematic reviews about its prevalence in animals are lacking. Methods: We performed a systematic literature review in bibliographic databases to assess the prevalence of H5N1 in animals. A meta-analysis with a random-effects model was performed to calculate the pooled prevalence and 95 % confidence intervals (95%CI). In addition, measures of heterogeneity (Cochran's Q statistic and I2 test) were reported. Results: The literature search yielded 1359 articles, of which 33 studies were fully valid for analysis, including 96,909 animals. The pooled prevalence for H5N1 in birds (n = 90,045, 24 studies) was 5.0 % (95%CI: 4.0-6.0 %; I2 = 99.21); in pigs (n = 3,178, 4 studies) was 1.0 % (95%CI: 0.0-1.0 %); in cats (n = 2,911, 4 studies) was 0.0 % (95%CI: 0.0-1.0 %); and in dogs (n = 479, 3 studies) was 0.0 % (95%CI: 0.0-2.0 %). Conclusions: While the occurrence of H5N1 in animals might be comparatively limited compared to other influenza viruses, its impact on public health can be substantial when it transmits to humans. This virus can potentially induce severe illness and has been linked to previous outbreaks. Therefore, it is essential to closely monitor and comprehend the factors influencing the prevalence of H5N1 in both avian and human populations to develop effective disease control and prevention strategies.