Cell-mediated immunity in recent-onset type 1 diabetic children

Background: The ability to suppress an immune response makes regulatory T-cells (T-reg) an attractive candidate as a novel therapeutic agent for treating autoimmune diseases. The mechanisms involved in maintenance of peripheral tolerance include a specialized subset of regulatory-T-cells (Treg) within the T-cell population. The CD4+ CD25+ T-cells may be important in modulating the risk for autoimmunity. Auto-reactive cytotoxic T-cells recognize peptide epitopes displayed on the beta cells surface in the context of HLA class1 molecules. A population of CD8+ regulatory T-cells characterized by expression of CD25 and FOXP3 have been identified and induced in the human peripheral blood cells. The regulatory activity of these cells is on autologous, antigen-reactive CD4+ T-cells in a cell contactdependent manner. These findings provide an evidence for a new mechanism for induction of immune regulation in human. Objective: This study was aiming to assess the cellular immune parameters including the percentage of CD4+, CD8+, CD4+/CD8+ ratio,CD4+CD25+, CD8+ CD25+ lymphocytes, which may have its application in developing immune therapy based tools for halting disease progression. Methods: This study was conducted on 20 children of recent onset type 1 diabetes (disease duration 0.05) between the two groups. A significant inverse correlation was found between CD4+ CD25+ T-cells and HbA1c percentage among patients group (p < 0.05).Also a significant difference in the percentage of CD4+ CD25+ T-cells was found when patients with HbA1c8% (the latter group had significantly lower percentage of CD4+ CD8+ T-cells). Conclusion: Type 1diabetes is characterised at its onset by a lowered percentage of CD8+ and CD8+ CD25+ T-cells in peripheral blood, a normal percentage of CD4+ and CD4+ CD25+ T-cells. There may be an inverse correlation between percentage of CD4+ CD25+ T-cells at disease onset and HbA1c level after three months. These data support the hypothesis that a defect in function or deficiency in number of T- regulatory cells may affect the pathogenesis of type 1 diabetes.Keywords: Type 1 diabetes, cell-mediated immunity, childrenEgypt J Pediatr Allergy Immunol 2008; 6(2): 69-7

Thrombocytopenia in systemic lupus erythematosus patients and its association with antiphospholipid antibodies

Introduction: Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disease, characterized by immune-mediated inflammation in different organs. The course of the disease is characterized by relapses and remissions, and the degree of severity of the clinical manifestations is greatly affected by the number and nature of the various organ affection. The death rate in patients with SLE is still significant, and it may be due to lupus activity, when vital organs are affected, the complications of treatment especially infections or long-term complications, such as cardiovascular disorders. Objective: To detect the relation between thrombocytopenia in SLE patients and presence antiphospholipid antibodies.Patients and methods: This study was a cross-sectional study included 100 SLE patients who attended to Sohag University Hospitals. Patients included in this study were classified as SLE patients according to either the 2012 SLICC criteria or the new 2017 ACR/EULAR SLE classification criteria. All of the participants were subjected to the following: Full history, full clinical examination, routine investigations, ANA by immunofluorescence, and ANA profile for the most common 19 autoantibodies by immunoblot. All of the participants were subjected to detection of serum titers of all antiphospholipid antibodies (aPLs) including lupus anticoagulant (LA), anti-cardiolipin (aCL) and anti-beta2-glycoprotein I (ab2GPI).Results: In this study, we demonstrated that aPLs are strongly associated with increased risk of thrombocytopenia in SLE patients. We identified aPL profiles, especially LA and IgM isotypes, as biomarkers for the risk stratification of thrombocytopenia in SLE patients.Conclusions: We concluded that aPLs are strongly associated with increased risk of thrombocytopenia in SLE patients

Reconfigurable radiation pattern of planar antenna using metamaterial for 5G applications

In this research, a reconfigurable metamaterial (MM) structure was designed using a millimeter-wave (MMW) band with two configurations that exhibit di erent refractive indices. These two MM configurations are used to guide the antenna’s main beam in the desired direction in the 5th generation (5G) band of 28 GHz. The di erent refractive indices of the two MM configurations created phase change for the electromagnetic (EM) wave of the antenna, which deflected the main beam. A contiguous squares resonator (CSR) is proposed as an MM structure to operate at MMW band. The CSR is reconfigured using three switches to achieve two MM configurations with di erent refractive indices. The simulation results of the proposed antenna loaded by MM unit cells demonstrate that the radiation beam is deflected by angles of +30 an

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Numerical simulation of the aerodynamic performance of a novel micro-aerial vehicle mimicking a locust

This paper describes the design, micro-fabrication and testing of a novel Micro-Aerial Vehicle (MAV) that mimicking a real locust. Actual parameters of locust insect are used to create a micro-scale MAV that can replace the traditional types that mimicking dragonfly and birds. Based on the obtained results, the novel MAV crucial parameters are its weight and strength to take-off under normal locust performance parameters fashion. Computational Fluid Dynamics (CFD) simulations are carried out at angles of attack of 10°, 20° and 30° and flapping frequencies of 19 Hz, 24 Hz, 30 Hz, 35 Hz and 40 Hz to investigate the aerodynamic performance of this designed MAV and optimize its flapping frequency. The simulation results defined the frequency at which the MAV is capable of hovering and take-off. In addition, the simulation results showed that the MAV is able to utilize some lift enhancement mechanisms that are being actually used by insects. These results enhances the manufacturing process of future MAV’s, especially in the material selection and manufacturing method, and the transmission mechanism for flight.Peer Reviewe

Effect of water pipe tobacco smoking on plasma high sensitivity C reactive protein level and endothelial function compared to cigarette smoking

Background: Cigarette smoking is a well known risk factor for cardiovascular disease, however, little is known regarding water pipe (WP) smoking. High sensitivity C-reactive protein (hs-CRP) and flow mediated dilatation (FMD) are well recognized methods to assess cardiovascular risks. Objectives: To study the effect of WP smoking on hs-CRP level and endothelial function compared to cigarette smoking. Methods: The study included 77 male subjects (30 WP smokers, 30 cigarette smokers, and 17 controls). Hs-CRP level was measured using the ELISA technique and the threshold of high risk level was 3 mg/l. FMD was assessed in the brachial artery. Subjects with FMD < 10% were considered to have endothelial dysfunction. The composite of high risk hs-CRP level and endothelial dysfunction was considered as high risk profile. Results: Hs-CRP level was slightly higher in smokers than controls (2.21 ± 1.6 versus 1.73 ± 1.19 mg/l, P = 0.25). FMD was significantly lower in smokers (12 ± 6.66 versus 17.45 ± 11.29%, P = 0.016). There were no significant differences between WP smokers and cigarette smokers regarding hs-CRP level (P = 0.19) and FMD (P = 0.91). In an adjusted regression model, age (P = 0.002) and cigarette smoking (P = 0.046) were found to be significant predictors for high risk profile, whereas WP smoking did not have a predictive effect (P = 0.91). Conclusions: WP smokers and cigarette smokers had comparable degrees of inflammation and endothelial dysfunction. However, cigarette smoking was a stronger predictor for high risk profile

Assessment of some micronutrients serum levels in children with severe acute malnutrition with and without cerebral palsy- A follow up case control studyTable of contentsWhat's known on this subjectWhat this paper adds

Summary: Objective: Zinc, copper and selenium are essential for normal development and function of the central nervous system. This study aimed at assessment of serum levels of zinc, copper and selenium in children with severe acute malnutrition (SAM) with & without cerebral palsy both before and after nutritional rehabilitation. Methods: A prospective case control study involved 2 groups (Group I); included160 children with SAM of both sex, aged 6–59 months, this group was subdivided into 2equal subgroups; subgroup A: SAM without cerebral palsy, subgroup B: SAM with cerebral palsy. Group II (control group) included 96 apparently healthy children matching age and sex with the first group. Both groups were subjected to a detailed history including nutritional history. Anthropometric measurements were recorded and laboratory assessment for serum levels of (copper, zinc, & selenium) before and after nutritional rehabilitation were performed for all children. Results: Group I (A&B) showed a significant decrease in anthropometric measurements, serum zinc, serum selenium but normal copper level before nutritional rehabilitation in comparison to control. After nutritional rehabilitation, all cases of the group I showed a significant improvement of the three parameters except for (45%) of cerebral palsy cases, experienced a resistant low selenium. Conclusion: Nutritional rehabilitation significantly improved micronutrients’ serum level in SAM children with and without cerebral palsy. Selenium supplementation is advised for children with cerebral palsy in order to reach normal values with observation of effect on neurological state. Keywords: Severe malnutrition, Cerebral palsy, Zinc, Copper, Seleniu

Value of Speckle Tracking Echocardiography in Prediction of Left Ventricular Reverse Remodeling in Patients with Chronic total Occlusion Undergoing Percutaneous Coronary Interventions

Background: Revascularization procedures for chronic complete occlusion (CTO) are technically challenging but aim to improve left ventricular (LV) function. The aim of this study is to evaluate the value of global longitudinal strain (GLS) measured by 2D-speckle tracking echocardiography( 2D-STE) in the assessment of LV reverse remodeling in patients with CTO undergoing revascularization by percutaneous coronary intervention (PCI).Methods: Our study included 54 patients with CTO treated by PCI. We evaluate LV systolic function by measurement of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and the GLS within 24 hours before the PCI and after 3 months post-procedure.&nbsp;Results: The mean age of the patients was 56.65 &plusmn; 7.65 years; 74.1% were males. There was a significant improvement in the LVESV (p &lt; 0.001), LVEF (p &lt; 0.001), and GLS (p &lt; 0.001) at 3 months post-PCI, and by multivariate regression analysis, the GLS was the single most significant predictor of LV reverse remodeling post revascularization (p &lt; 0.001).Conclusion: Revascularization of coronary CTO lesions by PCI is associated with a significant improvement in regional and global LV function. The GLS measured by 2D-STE is a strong predictor of LV reverse remodeling post-CTO interventions

Efficacious realization of Ba0.5Sr0.5TixM1−xO3 (M = Mn2+, Co2+) perovskite nanostructures through oxalate precursor strategy

International audienceNowadays, barium strontium titanate (BST; Ba0.5Sr0.5TiO3) as a versatile material is a prospect candidate in different electronic and magnetic applications. In this study, cubic BST nanoparticles have been prosperity fabricated based on the oxalate precursor method. Afterwards, the formed precursor powders are further annealed at temperature 1000 A degrees C for time 2 h. Meanwhile, the insertion of Mn2+ or Co2+ ions as an acceptor substitution to BST crystal was described at different concentrations from 0.1 to 0.3 molar ratios. Accordingly, the crystallite size and cell unit volume were found to enhance due to the introduction of acceptor ions. The Mn2+ or Co2+ ions replacements have the magnificent impact on the morphology, optical as well as dielectric and magnetic properties compared to the pure one. For instance, the optical transparency of BST material was found to increase with increasing Mn2+ or Co2+ ion content. Typically, the band gap energy and the refractive index were increased with acceptor doped ions. The dielectric performance in terms of different substitutions was decreased with Co2+ ions and increased with Mn2+ ions compared with pure BST sample. Eventually, the magnetic peculiarities were improved by addition of Mn2+ or Co2+ ions at different molar ratios