Hemiparkinsonism caused by a lateral sphenoid wing meningioma, with tractography analysis: illustrative case.

BACKGROUND: The etiologies of parkinsonism are diverse. A possible and rare cause of hemiparkinsonism is mechanical compression of the basal ganglia and its connecting white matter tracts. The authors present a case of hemiparkinsonism caused by a lateral sphenoid wing meningioma, discuss the underlying pathophysiology based on tractography, and systematically review the existing literature. OBSERVATIONS: A 59-year-old female was referred for a left-sided tremor of the hand, accompanied by a cogwheel rigidity of the left arm. Symptomatology appeared 1 year earlier and worsened in the previous 6 months, finally also showing involvement of the left leg. Magnetic resonance imaging (MRI) showed a space-occupying suspected meningioma originating from the right lateral sphenoid wing and compressing the ipsilateral striatum. Tractography studies contributed to elucidate the underlying pathophysiology. Resection of the meningioma could be performed without complications. At the 4-month follow-up, the patient's hemiparkinsonism had completely recovered. LESSONS: An intracranial space-occupying lesion may be a rare cause of hemiparkinsonism. In new-onset parkinsonism, especially if a secondary form is suspected, brain MRI should be performed promptly to avoid misdiagnosis and treatment. Tractography studies help understand the underlying pathophysiology. After surgical decompression of the affected structures, symptoms can recover completely.

Changes in patient characteristics, glucose lowering treatment, glycemic control and complications in type 2 diabetes in general practices (Disease Analyzer, Germany: 2008-2016).

OBJECTIVES: The objectives were to examine long-term changes in type 2 diabetes patient characteristics, diabetes treatment, control and complications in general practices. METHODS: All type 2 diabetes patients were identified in a representative general practice database (Disease Analyser, Germany) in three periods (01/2008-12/2008: n = 90.866, 818 practices, mean age (SD): 67.6 (12.1) years, 51% males; 01/2012-12/2012: n = 179.923, 1.158 practices, 68.3 (12.6) years, 51% males; 10/2015-09/2016: n = 201.667, 1.184 practices, 68.2 (12.9) years, 52% males). Chi-square and Wilcoxon rank-sum tests were used for testing differences (2008 vs. 2015/16). RESULTS: The mean number of type 2 patients per practice increased (2008: 111; 2015/16: 170). The proportion of retirees declined (74% vs. 61%) and patients in the working population increased (18% vs. 28%) (all p < 0.001). There were no relevant changes in mean HbA1c (7.1% vs. 7.2%), fasting blood glucose (141 mg/dl vs. 144 mg/dl) and BMI (31 kg/m2 vs. 32 kg/m2), whereas total cholesterol (204 mg/dl vs. 196 mg/dl) and triglycerides (159 mg/dl vs. 153 mg/dl) slightly declined (all p < 0.001). Prescription use of metformin, dipeptidyl peptidase-4 (DPP-4) and sodium dependent glucose transporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists enlarged (dual or triple combinations) while sulfonylurea use decreased. Prevalence of polyneuropathy (6.2% vs. 8.6%), nephropathy (1.9% vs. 3.2%) and depression (7.6% vs. 10.0%) rised (all p < 0.001). CONCLUSIONS: General practitioners play a key role in diabetes care, increasingly treating type 2 diabetes patients in the working population. There was no change in glycemic control over the study period (2008-2016). The use of glucose-lowering drug combinations increased and microvascular complications were more often recorded.

Increased depression symptom score in newly diagnosed type 2 diabetes patients.

The aim was to investigate the association between diabetes duration and depressive symptoms in type 2 diabetes. The DIAREG registry used data of a nationwide general medicine practice database (Disease Analyzer, Germany) augmented by prospective data from patient reported outcomes (PRO) including Center of Epidemiological Studies Depression Scale (CES-D: <16 vs. ≥16) and the SF-36. Multiple logistic regression models were used to investigate the association of diabetes duration with PROs. Overall, 1807 type 2 diabetes patients were registered in 108 practices. From 270 (15%) patients complete PRO could be collected, which were similar with respect to age, sex, body mass index, HbA1c, diabetes duration and treatment to patients with incomplete data (p≥0.05). Patients with a longer diabetes duration (reference: <2 years) displayed a significantly increased odds of having no indication of depression (CES-D <16: 66%) (Odds Ratio, 95%CI: 2-<5 years: 5.9, 1.2-29.6; 5-<10 years: 6.2, 1.3-28.7; ≥10 years: 5.6, 1.2-23.1), after adjusting for age, sex, BMI, diabetes complications, antidepressants and glucose-lowering treatment. Patients with <2 years diabetes duration also exhibited a significantly decreased mean mental component score (SF-36: <2 years: 50, 2-<5 years: 69). In type 2 diabetes with a short duration an increased depressive symptom score was observed.

High quality terahertz glass wave plates.

In this paper we present four λ/2-wave plates made out of fused silica glass for operation in the terahertz frequency range. The design of the wave plates is based on form birefringence. They were fabricated by selective laser-induced etching resulting in a series of glass bars separated by air grooves. Wave plates operating at single, two and several frequencies were designed, fabricated and characterized.

Changes in Glycemic Control and Body Weight After Initiation of Dapagliflozin or Basal Insulin Supported Oral Therapy in Type 2 Diabetes: A Primary Care Database Study.

BACKGROUND: The aim was to compare changes in HbA1c and body weight after initiation of dapagliflozin or basal insulin supported oral therapy (BOT) in type 2 diabetes patients in primary care practices. METHODS: Patients from 983 primary care practices who started dapagliflozin or BOT between December 2012 and July 2015 (index date, ID) were retrospectively analyzed (Disease Analyzer; Germany). Changes in HbA1c (%) and body weight (kg) were evaluated 90-270 days after ID. Propensity score (PS) matching (1:1) was used to adjust for differences in baseline clinical characteristics (180-0 days before ID: age, sex, health insurance, diabetologist care, glucose lowering therapy, HbA1c, body mass index) and duration (days) between start of therapies and last HbA1c or weight documentation after ID. RESULTS: After PS matching, 766 dapagliflozin (mean ± SD; age: 63 ± 10 years; HbA1c: 8.9 ± 1.2%) and 766 BOT (age: 63 ± 10 years; HbA1c: 8.7 ± 1.1%) patients were included. HbA1c decreased by mean (SD) of 1.0% (1.3) in dapagliflozin and by 1.0% (1.4) in BOT patients after 90-270 days (HbA1c reduction; dapagliflozin vs BOT: -0.01%; P = .79). In 440 dapagliflozin users with available data, body weight (97.4 ± 19.9 kg) decreased by 3.1 (5.8) kg after 90-270 days, whereas no significant weight change was observed in 440 matched BOT patients (97.5 ± 19.9 kg) (weight reduction; dapagliflozin vs BOT: -3.0 kg; P < .05). CONCLUSIONS: Initiation of dapagliflozin therapy reduced HbA1c similar to basal insulin with the additional benefit of weight reduction in type 2 diabetes patients treated in general practices.

Development of a multi-channel time-to-space terahertz spectrometer.

We present a compact sensor head for a multi-channel terahertz (THz) spectroscopy system. A THz pulse generated by a photoconductive antenna is split into spatially separated sub-pulses, which have different transit times. The time-dependent order of the sub-pulses can be translated into a spatial resolution. By using only one pair of antennas the developed sensor head provides up to 20 individual measurement zones with full amplitude and phase information. The sensor head can be integrated into two boxes with a small footprint so that the system is well suited for industrial applications.

Terahertz transceiver concept.

We present a photoconductive terahertz transceiver based on a modulation of the optical pulses used for generation and detection at different rates. External modulation of the THz pulses is not required as opposed to previously reported approaches. Devices from fiber-optic technology are used, providing flexibility and stability to the system. Imaging and thickness measurement experiments are carried out to demonstrate the performance of the transceiver.

Licensing the future: report on BioMed Central's public consultation on open data in peer-reviewed journals.

We report the outcomes of BioMed Central's public consultation on implementing open data-compliant licensing in peer-reviewed open access journals. Respondents (42) to the 2012 consultation were six to one in favor (29 in support; 5 against; 8 abstentions) of changing our authors' default open access copyright license agreement, to introduce the Creative Commons CC0 public domain waiver for data published in BioMed Central's journals. We summarize the different questions we received in response to the consultation and our responses to them - matters such as citation, plagiarism, patient privacy, and commercial use were raised. In light of the support for open data in our journals we outline our plans to implement, in September 2013, a combined Creative Commons Attribution license for published articles (papers) and Creative Commons CC0 waiver for published data.

Spectrum to space transformed fast terahertz imaging.

We present an imaging technique in which the broadband frequency information of terahertz (THz) pulses is transformed into spatial resolution. Efficient blazed diffractive gratings spread the individual frequency components over a wide and defined spatial range and f-theta optics are employed to focus the individual components onto a one-dimensional image-line. Measuring the time domain waveform of the THz waves allows therefore for a direct reconstruction of spatial sample characteristics as the spatial domain information is encoded in the terahertz spectrum. We will demonstrate terahertz imaging on selected samples with an improvement in acquisition speed up to two orders of magnitude.

Optically controlled terahertz beam steering and imaging.

We propose a spatial modulator for terahertz waves based on light induced electron plasma in photo-active semiconductors. A two-dimensional array of computer controlled light is used to create free carries in bulk silicon, which results in a spatial modulation of the transmission at terahertz frequencies. This method not only exhibits a remarkable modulation depth over a broad frequency range but also allows for an optically controlled beam steering of terahertz waves by inducing virtual grating structures. In addition, we analyze the possibility of all-optically controlled terahertz imaging.

Onwards and upwards: European Journal of Medical Research continues as an open access publication.

The well-established European Journal of Medical Research has joined BioMed Central's portfolio of journals in January 2012, converting to the open access publishing model. Since its launch in 1995 the journal has been a print-only publication; from now on, it continues as an open access, online-only journal. The conversion to open access opens up the potential for the journal to become a leading, globally visible title in the field of general medicine over the coming years.

Terahertz Brewster lenses.

Typical lenses suffer from Fresnel reflections at their surfaces, reducing the transmitted power and leading to interference phenomena. While antireflection coatings can efficiently suppress these reflections for a small frequency window, broadband antireflection coatings remain challenging. In this paper, we report on the simulation and experimental investigation of Brewster lenses in the THz-range. These lenses can be operated under the Brewster angle, ensuring reflection-free transmission of p-polarized light in an extremely broad spectral range. Experimental proof of the excellent focusing capabilities of the Brewster lenses is given by frequency and spatially resolved focus plane measurements using a fiber-coupled THz-TDS system.

Synthesis and characterisation of nonclassical ruthenium hydride complexes containing chelating bidentate and tridentate phosphine ligands.

The synthesis and characterisation of nonclassical ruthenium hydride complexes containing bidentate PP and tridentate PCP and PNP pincer-type ligands are described. The mononuclear and dinuclear ruthenium complexes presented have been synthesised in moderate to high yields by the direct hydrogenation route (one-pot synthesis) or in a two-step procedure. In both cases [Ru(cod)(metallyl)(2)] served as a readily available precursor. The influences of the coordination geometry and the ligand framework on the structure, binding, and chemical properties of the M--H(2) fragments were studied by X-ray crystal structure analysis, spectroscopic methods, and reactivity towards N(2), D(2), and deuterated solvents.

Signal transduction of somatostatin in human B lymphoblasts.

Somatostatin (SST) and somatostatin receptors (SSTR) are widely distributed in lymphoid tissues. Here, we report on the stimulatory effects of SST in Epstein-Barr virus-immortalized B lymphoblasts. By RT-PCR, we demonstrated the exclusive expression of the somatostatin receptor isoform 2A (SSTR2A) in B lymphoblasts. Addition of SST rapidly increased the cytosolic free calcium concentration [Ca(2+)](i) maximally by about 200 nM, with an EC(50) of 1.3 nM, and stimulated the formation of inositol phosphates. Furthermore, SST increased binding of guanosine 5'-O-(3-thiotriphosphate) by 50% above basal. These effects were partly inhibited by pertussis toxin (PTX), which indicates the involvement of PTX-sensitive G proteins. We provide further evidence that Galpha(16,) a PTX-insensitive G protein confined to lymphohematopoietic cells, is involved in the otherwise unusual coupling of SSTR2A to phospholipase C activation. In addition, SST activated extracellular regulated kinases and induced a 3.5-fold stimulation of DNA synthesis and a 4.4-fold stimulation of B lymphoblast proliferation, which was accompanied by an enhanced immunoglobulin formation. Thus SST exerts a growth factor-like activity on human B lymphoblasts.