Joint association of TyG index and high sensitivity C-reactive protein with cardiovascular disease: a national cohort study.

BACKGROUND: Both the triglyceride-glucose (TyG) index, as a surrogate marker of insulin resistance, and systemic inflammation are predictors of cardiovascular diseases; however, little is known about the coexposures and relative contributions of TyG index and inflammation to cardiovascular diseases. Using the nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS), we conducted longitudinal analyses to evaluate the joint and mutual associations of the TyG index and high-sensitivity C-reactive protein (hsCRP) with cardiovascular events in middle-aged and older Chinese population. METHODS: This study comprised 8 658 participants aged at least 45 years from the CHARLS 2011 who are free of cardiovascular diseases at baseline. The TyG index was calculated as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Cardiovascular events were defined as the presence of physician-diagnosed heart disease and/or stroke followed until 2018.We performed adjusted Cox proportional hazards regression and mediation analyses. RESULTS: The mean age of the participants was 58.6 ± 9.0 years, and 3988 (46.1%) were females. During a maximum follow-up of 7.0 years, 2606 (30.1%) people developed cardiovascular diseases, including 2012 (23.2%) cases of heart diseases and 848 (9.8%) cases of stroke. Compared with people with a lower TyG index (< 8.6 [median level]) and hsCRP < 1 mg/L, those concurrently with a higher TyG and hsCRP had the highest risk of overall cardiovascular disease (adjusted hazard ratio [aHR], 1.300; 95% CI 1.155-1.462), coronary heart disease (aHR, 1.294; 95% CI 1.130-1.481) and stroke (aHR, 1.333; 95% CI 1.093-1.628), which were predominant among those aged 70 years or below. High hsCRP significantly mediated 13.4% of the association between the TyG index and cardiovascular disease, while TyG simultaneously mediated 7.9% of the association between hsCRP and cardiovascular risk. CONCLUSIONS: The findings highlight the coexposure effects and mutual mediation between the TyG index and hsCRP on cardiovascular diseases. Joint assessments of the TyG index and hsCRP should be underlined for the residual risk stratification and primary prevention of cardiovascular diseases, especially for middle-aged adults.

Laser-induced breakdown spectroscopy (LIBS) of animal fat (lard): Efficient sample preparation for onsite analysis and influence of sample temperature on the signal intensity and plasma parameters.

We report an efficient sample preparation method (freezing) for onsite fat and meat analysis via a specially designed thermoelectric cooling and temperature-controlling system. This investigation also focused on the effect of phase change on the sensitivity and reproducibility of LIBS emission signals and plasma parameters. The plasma emissions of animal fats (lard) were recorded when the sample was frozen (-2 °C), fluid (15 °C), and in a liquid state (37 °C) with a thermoelectric cooling system. At each temperature, the plasma emissions were acquired at laser pulse energy from 50 to 300 mJ and detector gate delay (DGD) from 0.5 to 5 µs. With increasing sample temperature, the DGD, where the optical emission intensity reached a maximum, decreased. At a laser pulse energy of 200 mJ and a sample temperature of -2 °C, the emission signals increased fourfold, the signal-to-noise ratio (SNR) improved tenfold, and the self-absorption in the emission lines decreased significantly. The repeatability of the emission signals and plasma parameters of frozen and liquid fat samples was determined using the relative standard deviation (RSD) of Se I (473.08 nm) and K I (766.48 nm) emission lines. The RSDs of the emission signals improved from 40 to 18 % and 37 to 16 %, whereas the shot-to-shot RSDs of the electron temperature and electron number density get improved from 11 to 6 % and 12 to 6.8 %, respectively.

Sensitivity of Globisporangium ultimum to the fungicide metalaxyl is enhanced by the infection with a toti-like mycovirus.

In recent years, numerous oomycete mycoviruses have been discovered; however, very few studies have focused on their effects on the host oomycete phenotype. In this study, we investigated the impact of toti-like Pythium ultimum RNA virus 2 (PuRV2) infection on the phytopathogenic soil-borne oomycete Globisporangium ultimum, which serves as a model species for Globisporangium and Pythium, specifically the UOP226 isolate in Japan. We generated a PuRV2-free isogenic line through hyphal tip isolation using high-temperature culture and subsequently compared the phenotypic characteristics and gene expression profiles of UOP226 and the PuRV2-free isogenic line. Our findings revealed that the metalaxyl sensitivity of UOP226 was greater than that of the PuRV2-free isogenic line, whereas the mycelial growth rate and colony morphology remained unchanged in the absence of the fungicide. Furthermore, transcriptome analyses using RNA-seq revealed significant downregulation of ABC-type transporter genes, which are involved in fungicide sensitivity, in UOP226. Our results suggest that PuRV2 infection influences the ecology of G. ultimum in agricultural ecosystems where metalaxyl is applied.

Divergent responses of ascorbate and glutathione pools in ozone-sensitive and ozone-tolerant wheat cultivars under elevated ozone and carbon dioxide interaction.

Crop plants face complex tropospheric ozone (O3) stress, emphasizing the need for a food security-focused management strategy. While research extensively explores O3's harmful effects, this study delves into the combined impacts of O3 and CO2. This study investigates the contrasting responses of O3-sensitive (PBW-550) and O3-resistant (HUW-55) wheat cultivars, towards elevated ozone (eO3) and elevated carbon dioxide (eCO2), both individually and in combination. The output of the present study confirms the positive effect of eCO2 on wheat cultivars exposed to eO3 stress, with more prominent effects on O3-sensitive cultivar PBW-550, as compared to the O3-resistant HUW-55. The differential response of the two wheat cultivars can be attributed to the mechanistic variations in the enzyme activities of the Halliwell-Asada pathway (AsA-GSH cycle) and the ascorbate and glutathione pool. The results indicate that eCO2 was unable to uplift the regeneration of the glutathione pool in HUW-55, however, PBW-550 responded well, under similar eO3 conditions. The study's findings, highlighting mechanistic variations in antioxidants, show a more positive yield response in PBW-550 compared to HUW-55 under ECO treatment. This insight can inform agricultural strategies, emphasizing the use of O3-sensitive cultivars for sustained productivity in future conditions with high O3 and CO2 concentrations.

Antidiabetic Potential of Tea and Its Active Compounds: From Molecular Mechanism to Clinical Evidence.

Diabetes mellitus (DM) is a chronic endocrine disorder that poses a long-term risk to human health accompanied by serious complications. Common antidiabetic drugs are usually accompanied by side effects such as hepatotoxicity and nephrotoxicity. There is an urgent need for natural dietary alternatives for diabetic treatment. Tea (Camellia sinensis) consumption has been widely investigated to lower the risk of diabetes and its complications through restoring glucose metabolism homeostasis, safeguarding pancreatic ß-cells, ameliorating insulin resistance, ameliorating oxidative stresses, inhibiting inflammatory response, and regulating intestinal microbiota. It is indispensable to develop effective strategies to improve the absorption of tea active compounds and exert combinational effects with other natural compounds to broaden its hypoglycemic potential. The advances in clinical trials and population-based investigations are also discussed. This review primarily delves into the antidiabetic potential and underlying mechanisms of tea active compounds, providing a theoretical basis for the practical application of tea and its active compounds against diabetes.

An identity-irrelevant discrimination task reveals familiarity-advantage in face perception and no self-advantage in voice perception.

Whether or not self-face and self-voice are processed more accurately than others' remains inconclusive. Most previous studies asked participants to judge the presented stimulus as their own or as others', and compared response accuracy to discuss self-advantage. However, it is possible that participants responded correctly in the "other" trials not by identifying "other" but rather by rejecting "self." The present study employed an identity-irrelevant discrimination task, in which participants detected the odd stimulus among the three sequentially presented stimuli. We measured the discrimination thresholds for the self, friend, and stranger conditions. In Experiment 1 (face), the discrimination thresholds for self and friends' faces were lower than those for strangers' faces. This suggests that self-face may not be perceived as special or unique, and facial representation may become more accurate due to increased familiarity through repetitive exposure. Whereas, in Experiment 2 (voice), the discrimination thresholds did not differ between the three conditions, suggesting that the sensitivity to changes is the same regardless of identity. Overall, we found no evidence for self-advantage in identification accuracy, as we observed a familiarity-advantage rather than self-advantage in face processing and a null difference in voice processing.

Predictive validity of the Developmental Coordination Disorder Questionnaire as a screening tool to identify motor skill problems: A systematic review and meta-analysis.

BACKGROUND: The Developmental Coordination Disorder Questionnaire (DCDQ) has been used to screen children who probably have developmental coordination disorder (DCD). AIMS: We systematically reviewed studies on the predictive validity of the DCDQ and performed a meta-analysis on its diagnostic accuracy. METHODS AND PROCEDURES: Literature was searched through four electronic databases: MEDLINE, Embase, CINAHL, and PsycArticles. A total of 27 studies was selected based on the inclusion criteria. The sensitivity and specificity of the DCDQ were assessed using summary receiver operating characteristic (sROC) curves. Subgroup analyses were conducted according to the DCDQ type, reference standard, and participant type. OUTCOMES AND RESULTS: Overall, the DCDQ has a sensitivity of 0.70 and a specificity of 0.77, showing moderate diagnostic accuracy (area under the curve, 0.80). Subgroup analysis showed that the revised version of the DCDQ had higher diagnostic accuracy than the original version. When the reference standard was the Diagnostic and Statistical Manual of Mental Disorders, the sensitivity and specificity of the DCDQ were 0.87 and 0.83, respectively. The diagnostic accuracy was higher in clinical samples compared to the general population. CONCLUSIONS AND IMPLICATIONS: This study demonstrated that the DCDQ has adequate diagnostic accuracy, suggesting it can help screen children with motor skill deficits.

Is the time of anthesis in rice (Oryza sativa) influenced by photoperiod?

Photoperiod sensitivity in rice cultivars is defined when the cultivar begins anthesis on a relatively invariant date, varying by < 7 days, regardless of the date of sowing or germination. While the date of flowering in photoperiod sensitive (PPS) rice cultivars is characteristically determined by the day length, especially during the short-day season (September-December), the response of the flower opening time (FOT) to photoperiod remains hitherto unexplored. This paper examines whether day length restrains year-to-year variation in FOT in PPS cultivars. We examined 105 PPS and 173 photoperiod insensitive (PPI) cultivars grown in different years and estimated their year-to-year FOT difference (or FOTD) and the year-to-year difference of sunrise to anthesis duration (or SADD). Wilcoxon signed rank test and bootstrap test were then performed to test whether these descriptors significantly differed between PPS and PPI groups of cultivars. The means of FOTD and SADD were detected to be significantly less in the PPS group than in the PPI group of cultivars, indicating significantly lesser variability of FOT in PPS than in PPI cultivars. This is the first report of a strong restraining influence of photoperiod on FOT variability in PPS cultivars.

3D Printed MXene-Based Wire Strain Sensors with Enhanced Sensitivity and Anisotropy.

Stretchable strain sensors play a crucial role in intelligent wearable systems, serving as the interface between humans and environment by translating mechanical strains into electrical signals. Traditional fiber strain sensors with intrinsic uniform axial strain distribution face challenges in achieving high sensitivity and anisotropy. Moreover, existing micro/nano-structure designs often compromise stretchability and durability. To address these challenges, a novel approach of using 3D printing to fabricate MXene-based flexible sensors with tunable micro and macrostructures.  Poly(tetrafluoroethylene) (PTFE) as a pore-inducing agent is added into 3D printable inks to achieve controllable microstructural modifications. In addition to microstructure tuning, 3D printing is employed for macrostructural design modifications, guided by finite element modeling (FEM) simulations. As a result, the 3D printed sensors exhibit heightened sensitivity and anisotropy, making them suitable for tracking static and dynamic displacement changes. The proposed approach presents an efficient and economically viable solution for standardized large-scale production of advanced wire strain sensors.

Decoding food reactions: a detailed exploration of food allergies vs. intolerances and sensitivities.

The food matrix is a complex system encompassing all constituent elements in food production. It influences the digestibility of these elements through direct interactions and affects the digestive environment. Furthermore, the gastrointestinal system possesses precise mechanisms that efficiently process dietary components into essential nutrients, effectively preventing the onset of abnormal immune responses or dysfunctional host reactions in most instances. However, the incidence of adverse food reactions is constantly increasing, and evidence indicates that this process is environmental. Adverse reactions can be categorized as toxic or nontoxic. Toxic reactions are dose-dependent and can result from natural compounds, processing-induced substances, or contaminants. Nontoxic reactions like food intolerance and hypersensitivity depend on individual susceptibility and evoke specific pathological and physiological responses. This review aims to elucidate the mechanisms underlying the occurrence of immune- (food allergies and sensitivities) and non-immune-mediated (food intolerance) reactions, emphasizing the fundamental distinctions between these two categories. Enhanced comprehension and distinction of these mechanisms will significantly contribute to advancing preventive and therapeutic approaches and establishing guidelines for food labeling concerning immune-mediated reactions.

MXene-Based Soft Humidity-Driven Actuator with High Sensitivity and Fast Response.

Soft actuators possessing notable mechanical deformations, high sensitivity, and fast response speed play a crucial role in various applications, such as artificial muscles, soft robots, and intelligent devices. In this study, a smart humidity-driven actuator was successfully fabricated by utilizing MXene/cellulose nanofiber (CNF)/LiCl (MCL) through vacuum-assisted filtration with fast response speed and high sensitivity. Utilizing the excellent humidity responsiveness of MXene/CNF and the robust hygroscopicity of LiCl, the synergistic effect of these materials enhances the hygroscopic properties and response speed of the actuator. The MCL actuator demonstrates excellent actuation performance, fast deformation, and reliable cyclic stability. To illustrate the extensive potential of the soft actuator, a range of applications, from bionic devices to soft grippers and crawling actuators, are showcased. Remarkably, the crawling actuator demonstrates sustained crawling motion without necessitating a humidity switch, relying on the humidity gradient from water droplets, and exhibits spontaneous directional motions within a certain range, which makes it a promising prospect in the field of soft robotics.

Visual Acuity and Retinal Thickness and Sensitivity after Intravitreal Ranibizumab Injection for Macular Edema in Branch Retinal Vein Occlusion.

Background/Objectives: To investigate changes in visual acuity and retinal sensitivity and thickness after intravitreal ranibizumab injection (IRI) for macular edema in branch retinal vein occlusion (BRVO) patients. Methods: This study evaluated 34 patients with treatment-naïve BRVO and at least 6 months' follow-up after pro re nata IRI. Best-corrected visual acuity (BCVA) was determined as the logarithm of the minimum angle of resolution (logMAR). In nine retinal regions, retinal sensitivity was calculated by MP-3 microperimetry; and in nine macular subfields, retinal thickness was measured by optical coherence tomography (OCT); evaluations were performed before IRI and then monthly for 6 months. Results: IRI significantly improved visual acuity and retinal sensitivity and thickness. In patients with good improvement in BCVA (change in logMAR > 0.2), IRI significantly improved retinal sensitivity in eight of nine regions, i.e., in all except the outer non-occluded region, and in patients with poor improvement in BCVA (change in logMAR < 0.2), in six of nine regions, i.e., not in the inner, outer non-occluded, and outer temporal regions. We found significant differences in the trend profile in the foveal, outer occluded, and inner nasal regions between patients with good and poor improvement in BCVA. Conclusions: The findings suggest that IRI improves visual acuity and retinal sensitivity and thickness and that retinal effects may vary between patients with good and poor visual improvement.

Sensitivity and Specificity of Selected Biomarkers and Their Combinations in the Diagnosis of Ovarian Cancer.

One of the greatest challenges in modern gynecological oncology is ovarian cancer. Despite the numerous studies currently being conducted, it is still sometimes detected at late clinical stages, where the prognosis is unfavorable. One significant contributing factor is the absence of sensitive and specific parameters that could aid in early diagnosis. An ideal screening test, in view of the low incidence of ovarian cancer, should have a sensitivity of greater than 75% and a specificity of at least 99.6%. To enhance sensitivity and specificity, diagnostic panels are being created by combining individual markers. The drive to develop better screening tests for ovarian cancer focuses on modern diagnostic methods based on molecular testing, which in turn aims to find increasingly effective biomarkers. Currently, researchers' efforts are focused on the search for a complementary parameter to those most commonly used that would satisfactorily enhance the sensitivity and specificity of assays. Several biomarkers, including microRNA molecules, autoantibodies, cDNA, adipocytokines, and galectins, are currently being investigated by researchers. This article reviews recent studies comparing the sensitivity and specificity of selected parameters used alone and in combination to increase detection of ovarian cancer at an early stage.

Global stability analysis and modelling onchocerciasis transmission dynamics with control measures.

Background: Onchocerciasis infection is one of the neglected tropical diseases targeted for eradication by 2030. The disease is usually transmitted to humans through the bites of black flies. These black flies mostly breed near well-oxygenated fast-running water bodies. The disease is common in mostly remote agricultural villages near rivers and streams. Objective: In this study, a deterministic model describing the infection dynamics of human onchocerciasis disease with control measures is presented. Methods: We derived the model's reproductive number and used a stability theorem of a Metzler matrix to show that disease-free equilibrium is both locally and globally asymptotically stable whenever the reproductive number is less than one. Parameter contribution was conducted using sensitivity analysis. The model endemic equation is shown to be a cubic polynomial in the presence of infected immigrants and a quadratic form in their absence. Results: When the inflow of infected immigrants is null, the model endemic equation may admit a unique equilibrium if the reproductive number is greater than one, or admits multiple endemic equilibria if the reproductive number is less than unity. We carried out a sensitivity analysis to identify the significant parameters that contribute to onchocerciasis spread. Conclusion: Onchocerciasis disease can be eradicated if the importation of infected immigrants is properly monitored. The integration of the One Health concept in the public health system is key in tackling the emergence and spread of diseases.

Comprehensive pan-cancer analysis: essential role of ABCB family genes in cancer.

Background: The adenosine triphosphate-binding-cassette (ABC) transporter orchestrates the transmembrane transport of diverse substrates with the aid of ATP as an energy source. ABC transporter constitutes a widespread superfamily of transporters prominently present on the cellular membrane of organisms. Advancements in understanding have unveiled additional roles beyond mere intracellular or extracellular transport functions for the ABC protein family, encompassing involvement in DNA repair, protein translation, and gene expression regulation. Yet its role in tumors is still unknown. Methods: This study drew support from multiple databases, including Gene Expression Omnibus (GEO), European Genome-phenome Archive (EGA), The Cancer Genome Atlas (TCGA), and employed multidimensional bioinformatics analyses, incorporating online databases and the R-project. Through a comprehensive analysis, we seek to discern transcriptional-level disparities among genes and their consequential impacts on prognosis, tumor microenvironment (TME), stemness score, immune subtypes, clinical characteristics, and drug sensitivity across human cancers. Results: ABC transporter subfamily B (ABCB) family genes exhibited heightened expression across diverse tumors, demonstrating a significant correlation with overall prognosis in pan-cancer contexts. Notably, gene expression levels manifested substantial associations with TME, stemness score, immune subtypes, clinical characteristics, and drug sensitivity in specific cancers, including kidney renal papillary cell carcinoma (KIRP), liver hepatocellular carcinoma (LIHC), and pancreatic adenocarcinoma (PAAD). Within this subset, transporter associated with antigen processing 1 (TAP1), TAP2, and ABCB6 emerged as noteworthy oncogenes. Conclusions: The outcomes of this study contribute to a comprehensive understanding of the implications of ABCB family genes in tumor progression, offering insights into potential therapeutic targets for cancer. Notably, the identification of ABCB6 as a significant oncogene suggests promising avenues for targeted therapies in KIRP, LIHC, and PAAD.

Diagnostic Efficacy Study Comparing Tzanakis Scoring System With Alvarado Scoring System in Effective Diagnosis of Acute Appendicitis.

Objective Among the common causes of abdominal emergencies, acute appendicitis ranks at the top, particularly in the young population. While negative appendectomy is not uncommon, the risk of appendicular perforation is substantial if the diagnosis is missed or delayed. This study evaluated the diagnostic efficacy of the Tzanakis scoring system for acute appendicitis, comparing it with the Alvarado scoring system, considering the histopathological finding as the gold standard. Materials and methods This prospective observational study, conducted in the General Surgery department in a tertiary care hospital in India, included clinically diagnosed acute appendicitis cases posted for open or laparoscopic appendicectomy. Results The mean age for the 60 participants included in the study was 30.97±13.44, and the median was 24.5 yrs. The sensitivity of ultrasonography (USG) in diagnosing histopathological positive acute appendicitis was 89%, and the specificity was 50%. The sensitivity, specificity, positive, and negative predictive values of the Tzanakis score were 87%, 50%, 96%, and 22%, respectively, and those of the Alvarado score were 54%, 75%, 96%, and 10%, respectively. Conclusion The receiver operator characteristic (ROC) curve for the Alvarado and Tzanakis scores showed that the area under the curve (AUC) was greater for the Tzanakis scoring system (0.670) than for the Alvarado scoring system (0.598). Differences between the AUCs were not statistically significant. Although the Tzanakis scoring system is more sensitive than the Alvarado scoring system in diagnosing acute appendicitis, studies with larger samples are needed to show the superiority of this scoring system over the Alvarado scoring system.

Estimation of glucose absorption, insulin sensitivity, and glucose effectiveness from the oral glucose tolerance test.

CONTEXT: Glucose tolerance during an oral glucose tolerance test (OGTT) is affected by variations in glucose effectiveness (GE) and glucose absorption and thus affects minimal model calculations of insulin sensitivity (SI). The widely used OGTT SI by Dalla Man et al. does not account for variances in GE and glucose absorption. OBJECTIVE: To develop a novel model that concurrently assesses SI, GE, and glucose absorption. DESIGN: Cross-sectional. SETTING: Academic Medical Center. PARTICIPANTS: Eighteen subjects without abnormalities on OGTT (controls) and 88 subjects with diabetes. INTERVENTION: All subjects underwent 75-gram 120-minute 6-timepoint OGTT. MAIN OUTCOMES: SI from the Dalla Man model was validated with the novel model Si using Bland Altman limits of agreement methodology. Comparisons of SI, GE, and gastrointestinal glucose half-life (GIGt1/2); a surrogate measure for glucose absorption were made between subjects with diabetes and controls. RESULTS: In controls and diabetes, the novel model SI was higher than the current OGTT model. SI from both controls (ƿ=0.90, p < 0.001) and diabetes (ƿ=0.77, p < 0.001) has high agreement between models. GE was higher in diabetes (median:0.021 1/min, IQR [interquartile range]: 0.020-0.022) compared to controls (median:0.016 1/min, IQR: 0.015-0.017), p = 0.02. GIGt1/2 was shorter in diabetes (median: 48.404 min, IQR: 54.424-39.426) than in controls (median: 55.086 min, IQR: 61.368-48.502) without statistical difference. CONCLUSIONS: Our novel model SI has a good correlation with SI from the widely used Dalla Man's model while concurrently calculating GE and GIGt1/2. Thus, besides estimating SI, our novel model can quantify differences in insulin-independent glucose disposal mechanisms important for diabetes pathophysiology.

Noninvasive cardiac-specific biomarkers for the diagnosis and prevention of vascular stenosis in cardiovascular disorder.

Background: The most frequent lesion in the blood vessels feeding the myocardium is vascular stenosis, a condition that develops slowly but can prove to be deadly in a long run. Non-invasive biomarkers could play a significant role in timely diagnosis, detection and management for vascular stenosis events associated with cardiovascular disorders. Aims: The study aimed to investigate high sensitivity troponin I (hs-TnI), cardiac troponin I (c-TnI) and high sensitivity C-reactive protein (hs-CRP) that may be used solely or in combination in detecting the extent of vascular stenosis in CVD patients. Methodology: 274 patients with dyspnea/orthopnea complaints visiting the cardiologists were enrolled in this study. Angiographic study was conducted on the enrolled patients to examine the extent of stenosis in the five prominent vessels (LDA, LCX, PDA/PLV, RCA, and OM) connected to the myocardium. Samples from all the cases suspected to be having coronary artery stenosis were collected, and subjected to biochemical evaluation of certain cardiac inflammatory biomarkers (c-TnI, hsTn-I and hs-CRP) to check their sensitivity with the level of vascular stenosis. The extent of mild and culprit stenosis was detected during angiographic examination and the same was reported in the form significant (≥50% stenosis in the vessels) and non-significant (<50% stenosis in the vessels) Carotid Stenosis. Ethical Clearance for the study was provided by Dr. Ram Manohar Lohia Institute of Medical Sciences Institutional Ethical Committee. Informed consent was obtained from all the participants enrolled in the study. Results: We observed that 85% of the total population enrolled in this study was suffering from hypertension followed by 62.40% detected with sporadic episodes of chest pain. Most of the subjects (42% of the total population) had stenosis in their LAD followed by 38% who had stenosis in their RCA. Almost 23% patients were reported to have stenosis in their LCX followed by OM (18% patients), PDA/PLV (13%) and only 10% patients had blockage problem in their diagonal. 24% of the subjects were found to have stenosis in a single vessel and hence were categorized in the Single Vessel Disease (SVD) group while 76% were having stenosis in two or more than two arteries (Multiple Vessel Disease). hs-TnI level was found to be correlated with the levels of stenosis and was higher in the MVD group as compared to the SVD group. Conclusion: hs-TnI could be used as a novel marker as it shows prominence in detecting the level of stenosis quite earlier as compared to c-TnI which gets detected only after a long duration in the CVD patients admitted for angiography. hs- CRP gets readily detected as inflammation marker in these patients and hence could be used in combination with hs-TnI to detect the risk of developing coronary artery disease.

Psychophysical, electrofunctional, and morphological evaluation in naïve neovascular AMD patients treated with intravitreal anti-VEGF.

Objectives: The aim of this study was to investigate the retinal morpho-functional characteristics of patients with neovascular wet age-related macular degeneration (nAMD) treated with intravitreal injection (IV) of aflibercept (AFL). Methods: The study was conducted on 35 patients previously diagnosed with type 1 nAMD who received a fixed-dosing regimen of aflibercept injections over 12 months. The goal was to assess trends in visual abilities over time by measuring visual acuity (VA), contrast sensitivity (CS), visual evoked potentials (VEPs), and spectral domain-optical coherence tomography (SD-OCT). The same psychophysical, electro-functional, and morphological tests administered at baseline (T0) were repeated 4 to 8 weeks after the last aflibercept injection (Tn), resulting in a total of six examinations. Results: At Tn, all subjects exhibited improved VA for both far and near distances compared to values detected at T0. Similarly, VEP amplitude and latency values at Tn showed a greater P100 improvement than those observed at T0. Additionally, the CS examination at Tn demonstrated improvement, particularly at high spatial stimulation frequencies. The Tn SD-OCT results highlighted a reduction in macular thickness compared to T0 values. Conclusions: This exploratory research indicates that intravitreal injections of AFL, following a fixed-dosing regimen, represent a valuable therapeutic approach for enhancing visual performance. This conclusion is supported by comprehensive statistical analysis of psychophysical, electro-functional, and morphological examinations within the same group of patients with nAMD, as demonstrated for the first time.

The microbiological profile of necrotising fasciitis at a secondary level hospital in Gauteng.

Background: Necrotising fasciitis (NF) is a fulminant soft tissue infection that requires timely diagnosis, urgent surgical debridement, and appropriate antimicrobial therapy. The choice of empiric antimicrobial therapy depends on the microorganisms cultured and the antimicrobial resistance profile of the institution. Necrotising fasciitis has not been studied in our setting. Objectives: The aim of the study was to audit the microbiological profile of NF and antimicrobial susceptibility profile. Method: This was a retrospective study in a secondary level hospital from the period of 2014-2020. The patients' demographic data, clinical features, location of infection, comorbidities, laboratory and microbiological profiles were analysed. Results: There were 53 patients during 2014-2020 with median age of 45.5 (38.5-56.0) years. The majority of the patients were males (35 [66.04%]), had no comorbidities (25 [47.17%]), and the lower limb was the most common anatomic site (17 [32.08%]). Type II (monomicrobial) NF was the predominant type (31 [58.49%]). Staphylococcus aureus was the most prevalent Gram-positive bacteria (18 [38%]) and Escherichia coli, the main species isolated in the Gram-negative bacteria (14 [36%]) with susceptibility to cloxacillin (94%) and amoxicillin and/or clavulanic acid (92%), respectively. Conclusion: Staphylococcus aureus and Escherichia coli were the most common bacteria with low rate of antimicrobial resistance. Amoxicillin and/or clavulanic acid and an adjunctive clindamycin are appropriate antimicrobial therapy for empiric treatment for NF in our setting. Contribution: Amoxicillin and/or clavulanic acid and an adjunctive clindamycin can be used as an empiric treatment for NF.