Health-Related Quality of Life in patients with chronic hepatitis C receiving Sofosbuvir-Based Treatment, with and without Interferon: a prospective observational study in Egypt

Background: The Egyptian government introduced the first directly acting antivirals (DAAs) into Egypt through the government funded National Treatment Program. As yet, there has been no investigation into the effects of these new DAAs therapies on patient reported outcomes (PROs). This study aimed to (1) assess the PROs (health-related quality of life (HRQoL), mental health and perceived social support) of HCV patients receiving DAAs therapy prior, during and at the end of therapy; (2) evaluate PROs of Interferon-free (dual) users versus Interferon-containing (triple) users cross the three different time periods; and (3) identify the predictors of HRQoL of DAAs therapy users cross the three different time periods.  Methods: A prospective observational design was used. Patients with chronic HCV undergoing treatment following the Egyptian National Guidelines at one of the national treatment centers were approached. Data collection occurred in the period from February to October 2015. Data was collected at three time points: (1) baseline (time 0: T0), before initiating therapy); (2) 5/6 weeks after initiation of therapy (time 1 of therapy: T1) and at the end of the therapy (Time 2: T2). Four PROs questionnaires were utilized for data collection: (1) Multidimensional Scale of Perceived Social Support (MSPSS), (2) The Depression Anxiety Stress Scales (DASS-21), (3) the Liver Disease Symptom Index-2.0 (LDSI-2.0) for testing disease specific HRQoL and (4) the Center for Adherence Support Evaluation (CASE) Index, alongside the background data sheet.  Results: Sixty-two patients participated. There was a change in HRQoL, symptom experience and mental health across the three different time periods. HRQoL was impaired more after starting the course of therapy (T1) than at baseline (T0) and end of therapy (T2), z ≥ -2.04, p ≤ .04. Also, symptom experience deteriorated more during the treatment period than at the baseline, Z ≥ -1.97, p ≤ .04. Anxiety and stress were significantly higher during the treatment period than at the end of treatment. Perceived social support was significantly higher during the treatment period than at baseline and end of therapy, Z ≥ -2.27, p ≤.023. During the course of therapy, triple users were more likely to report poorer HRQoL and anxiety than dual users (p ≤ .04). By the end of therapy, the two arms of therapy had no significant differences in any of the PROs.  At baseline, the predictor model significantly (p=.000) explained 37.5% of the variation in the HRQoL prior to therapy. Depression was the main variable that contributed to (41.3%) predicting change in HRQoL prior to therapy. During therapy, the model significantly (p=.000) explained 76% of the variation in the HRQoL-T1. Stress-T1, body mass index (BMI)-T1 and HRQoL-T0 significantly and respectively predicted 44.4%, 46.5% and 31.1% of the variation in HRQoL-T1. At the end of therapy, the model significantly (p=.000) predicted 80.5% of the variation in the HRQoL-T2. HRQoL-T1 and anxiety-T2 significantly predicted 72.3% and 61.6% of the variation in HRQoL-T2.  Conclusions: Baseline HRQoL, depression and BMI should be systematically assessed before starting the antiviral therapy for early detection and the improvement of the impairment before the initiation of therapy. Anxiety should be frequently assessed and followed up through the course of antiviral therapy. The triple group required more nursing and practitioner attention due to increased anxiety levels and impaired HRQoL during the treatment therapy

A multiplex approach of MS, 1D-, and 2D-NMR metabolomicsin plant ontogeny A case study on Clusia minor L. organs (leaf, flower, fruit, and seed)

Introduction The genus Clusia L. is mostly recognised for the production of prenylated benzophenones and tocotrienol derivatives. Objectives The objective of this study was to map metabolome variation within Clusia minor organs at different developmental stages. Material and Methods In total 15 organs/stages (leaf, flower, fruit, and seed) were analysed by UPLC-MS and 1H- and heteronuclear multiple-bond correlation (HMBC)-NMR-based metabolomics. Results This work led to the assignment of 46 metabolites, belonging to organic acids(1), sugars(2) phenolic acids(1), flavonoids(3) prenylated xanthones(1) benzophenones(4) and tocotrienols(2). Multivariate data analyses explained the variability and classification of samples, highlighting chemical markers that discriminate each organ/stage. Leaves were found to be rich in 5-hydroxy-8-methyltocotrienol (8.5 μg/mg f.w.), while flowers were abundant in the polyprenylated benzophenone nemorosone with maximum level detected in the fully mature flower bud (43 μg/mg f.w.). Nemorosone and 5-hydroxy tocotrienoloic acid were isolated from FL6 for full structural characterisation. This is the first report of the NMR assignments of 5-hydroxy tocotrienoloic acid, and its maximum level was detected in the mature fruit at 50 μg/mg f.w. Seeds as typical storage organ were rich in sugars and omega-6 fatty acids. Conclusion To the best of our knowledge, this is the first report on a comparative 1D-/2D-NMR approach to assess compositional differences in ontogeny studies compared with LC-MS exemplified by Clusia organs. Results derived from this study provide better understanding of the stages at which maximal production of natural compounds occur and elucidate in which developmental stages the enzymes responsible for the production of such metabolites are preferentially expressed

Temperature dependence of J–V and C–V characteristics of n-InAs/p-GaAs heterojunctions prepared by flash evaporation technique and liquid phase epitaxy

In this work, n-type of InAs films have been successfully fabricated on p-GaAs monocrystalline substrates by both flash evaporation technique and liquid phase epitaxy. The elemental composition of the prepared films has been confirmed by energy dispersive X-ray (EDX) spectroscopy. The morphology of the films has been characterized by scanning electron microscopy (SEM). The current transport mechanisms of n-InAs/p-GaAs heterojunctions in the temperature range 300-400 K have been investigated. Temperature-dependent dark current density-voltage (J–V) studies under forward and reverse bias have been carried out for this purpose. In the temperature range studied, the dark current contribution in the low bias range is believed to be due to the generation-recombination of minority carriers in the space-charge region. A change in the preparation technique does not seem to have altered the dark current conduction mechanism. Capacitance-voltage (C–V) at various temperatures has been measured to identify the junction type as well as determination of the important junction parameters

Rice Bran as an Alternative Feedstuff in Broiler Nutrition and Impact of Liposorb® and Vitamin E-Se on Sustainability of Performance, Carcass Traits, Blood Biochemistry, and Antioxidant Indices

The impact of dietary rice bran with or without feed additives on the performance, carcasses, and blood profiles of chickens was examined. A total of 245 unsexed one-week-old broiler chicks were divided into seven groups, with seven replications of five chicks each. The treatments were: (1) control, (2) 5% rice bran, (3) 5% rice bran + 0.5 g/kg of Liposorb®, (4) 5% rice bran + 1 g/kg of vitamin E-Se, (5) 10% rice bran, (6) 10% rice bran + 0.5 g/kg Liposorb®, and (7) 10% rice bran + 1 g/kg of vitamin E–selenium. Considering the entire experimental period, it did not affect the in vivo performance of the broilers. However, all the experimental diets decreased dressing % compared with the control (p < 0.01) and the worst values were obtained for the 10% RB groups (75.7, 75.9, and 75.8%, respectively, for 10%RB, 10%RB + Liposorb, and 10%RB + Vit. E-Se groups). All the experimental diets decreased (p < 0.01) the albumin/globulin ratio due to an increased level of serum globulins. Differences in lipid profiles, antioxidants, and immunity parameters in plasma were not related to dietary treatments. In conclusion, the use of rice bran up to 10% in diets had no harmful effect on the overall growth performance of the broilers from 1 to 5 weeks of age. Still, carcass characteristics were negatively affected, except for heart percentage. In addition, the supplementation of Liposorb® or vitamin E-Se to rice bran diets did not recover these harmful effects. Thus, rice bran could be utilized at 10% in broiler diets when growth performance was considered; further research is required

Effect of the Generalized Uncertainty Principle on Post-Inflation Preheating

We examine effects of the Generalized Uncertainty Principle, predicted by various theories of quantum gravity to replace the Heisenberg's uncertainty principle near the Planck scale, on post inflation preheating in cosmology, and show that it can predict either an increase or a decrease in parametric resonance and a corresponding change in particle production. Possible implications are considered.Comment: v1: 9 pages, revtex4, no figures, accepted for publication in JCAP; v2: one reference added and various cosmetic (but no physics) changes to match published versio

Observing intermediate-mass black holes and the upper--stellar-mass gap with LIGO and Virgo

Using ground-based gravitational-wave detectors, we probe the mass function of intermediate-mass black holes (IMBHs) wherein we also include BHs in the upper mass gap $\sim 60-130~M_\odot$. Employing the projected sensitivity of the upcoming LIGO and Virgo fourth observing (O4) run, we perform Bayesian analysis on quasi-circular non-precessing, spinning IMBH binaries (IMBHBs) with total masses 50\mbox{--} 500\, M_\odot, mass ratios 1.25, 4, and 10, and dimensionless spins up to 0.95, and estimate the precision with which the source-frame parameters can be measured. We find that, at $2\sigma$, the mass of the heavier component of IMBHBs can be constrained with an uncertainty of $\sim 10-40\%$ at a signal-to-noise ratio of $20$. Focusing on the stellar-mass gap with new tabulations of the $^{12}\text{C}(\alpha, \gamma)^{16} \text{O}$ reaction rate and its uncertanties, we evolve massive helium core stars using \MESA\, to establish the lower and upper edge of the mass gap as $\simeq$\,59$^{+34}_{-13}$\,$M_{\odot}$ and $\simeq$\,139$^{+30}_{-14}$\,$M_{\odot}$ respectively, where the error bars give the mass range that follows from the $\pm 3\sigma$ uncertainty in the $^{12}\text{C}(\alpha, \gamma) ^{16} \text{O}$ nuclear reaction rate. We find that high resolution of the tabulated reaction rate and fine temporal resolution are necessary to resolve the peak of the BH mass spectrum. We then study IMBHBs with components lying in the mass gap and show that the O4 run will be able to robustly identify most such systems. Finally, we re-analyse GW190521 with a state-of-the-art aligned-spin waveform model, finding that the primary mass lies in the mass gap with 90\% credibility

Sensitivity and specificity of a neuropathic screening tool (Self-report Leeds Assessment of Neuropathic Symptoms and Signs, S-LANSS) in adolescents with moderate-severe chronic pain

Neuropathic screening tools improve recognition of neuropathic pain in adults. Although utilized in pediatric populations, the sensitivity, specificity and methodology of screening tool delivery have not been compared in children. We evaluated the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) in adolescents (10-18 years) referred to a tertiary pediatric pain clinic. History and examination by specialist clinicians and multidisciplinary assessment informed classification of the primary pain type. In a prospective cohort, scores were obtained at interview (S-LANSS interview; n=161, 70% female), and following substitution of self-reported signs with examination findings in the primary pain region (LANSS-examination). Secondly, we retrospectively retrieved questionnaires self-completed by adolescents at their initial clinic appointment (S-LANSS self-completed; n=456, 73% female). Thirdly, we explored relationships between patient-reported outcomes and S-LANSS scores. S-LANSS interview scores varied with pain classification, and S-LANSS self-completed scores were similarly highest with neuropathic pain (median[IQR]: 18[11,21]) and complex regional pain syndrome (21[14,24]), variable with musculoskeletal pain (13[7,19]) and lowest with visceral pain (6.5[2,11.5]) and headache (8.5[4,14]). As in adults, the cutpoint score of 12/24 was optimal. Sensitivity was highest with inclusion of examination findings and lowest with self-completion (LANSS-examination vs interview vs self-completed: 86.3% vs 80.8% vs 74.7%), but specificity was relatively low (37.8% vs 36.7% vs 48%). High S-LANSS scores in non-neuropathic groups were associated with female sex and high pain catastrophizing. The S-LANSS is a sensitive screening tool for pain with neuropathic features in adolescents, but needs to be interpreted in the context of clinical evaluation. (clinicaltrials.gov NCT03312881

Subject-controlled, on demand, dorsal genital nerve stimulation to treat urgency urinary incontinence:a pilot

Contains fulltext : 171558.pdf (publisher's version ) (Open Access)OBJECTIVES: To evaluate the effect of subject-controlled, on-demand, dorsal genital nerve (DGN) stimulation on non-neurogenic urgency urinary incontinence (UUI) in a domestic setting. MATERIALS AND METHODS: Non-neurogenic patients >18 years with overactive bladder symptoms and UUI were included. Exclusion criteria were mainly stress urinary incontinence. Patients underwent 1 week of subject-controlled, on-demand, DGN stimulation, delivered by a percutaneously placed electrode near the DGN connected to an external stimulator (pulse-rate 20 Hz, pulse-width 300 mus). Patients activated the stimulator when feeling the urge to void and stimulated for 30 s. The amplitude was set at the highest tolerable level. A bladder diary including a severity score of the UUI episodes/void (scores: 0 = none, 1 = drops, 2 = dashes, 3 = soaks) and a padtest was kept 3 days prior to, during, and 3 days after the test period. The subjective improvement was also scored. RESULTS: Seven patients (4 males/3 females) were enrolled, the mean age was 55 years (range 23-73). Six completed the test week. In the remaining patient the electrode migrated and was removed. 5/6 finalized the complete bladder diary, 1/6 recorded only the heavy incontinence episodes (score = 3). 4/6 completed the padtest. In all patients who finalized the bladder diary the number of UUI episodes decreased, in 3/5 with >/=60%. The heavy incontinence episodes (score = 3) were resolved in 2/6 patients, and improved >/=80% in the other 4. The severity score of the UUI episodes/void was improved with >/= 60% in 3/5 patients. The mean subjective improvement was 73%. CONCLUSION: This feasibility study indicates that subject-controlled, on-demand DGN stimulation using a percutaneously placed electrode is possible over a longer time period, in a home setting, with a positive effect on non-neurogenic overactive bladder symptoms with UUI. Although the placement is an easy procedure, it is difficult to fixate the electrode to keep it in the correct position. Improvements in hardware, like a better fixated electrode and an easy to control stimulator, are necessary to make SODGNS a treatment possibility in the future

Determinants of Endogenous Fibrinolysis in Whole Blood Under High Shear in Patients With Myocardial Infarction

This work was supported in part by a grant from Alpha MD, London, United Kingdom. Dr Mutch was supported by the British Heart Foundation PG/15/82/31721 and Friends of Anchor. Dr Gorog has received institutional research grants from Bayer, Medtronic, Alpha MD, and Boehringer Ingelheim; has received speaker’s fees from AstraZeneca and Boehringer Ingelheim; and is related through family to a company director in Thromboquest Ltd, but neither she, nor her spouse or children, have financial involvement or equity interest in and they have received no financial assistance, support, or grants from the aforementioned. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.Peer reviewedPublisher PD