Tourniquet Test for Dengue Diagnosis: Systematic Review and Meta-analysis of Diagnostic Test Accuracy.

BACKGROUND: Dengue fever is a ubiquitous arboviral infection in tropical and sub-tropical regions, whose incidence has increased over recent decades. In the absence of a rapid point of care test, the clinical diagnosis of dengue is complex. The World Health Organisation has outlined diagnostic criteria for making the diagnosis of dengue infection, which includes the use of the tourniquet test (TT). PURPOSE: To assess the quality of the evidence supporting the use of the TT and perform a diagnostic accuracy meta-analysis comparing the TT to antibody response measured by ELISA. DATA SOURCES: A comprehensive literature search was conducted in the following databases to April, 2016: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, BIOSIS, Web of Science, SCOPUS. STUDY SELECTION: Studies comparing the diagnostic accuracy of the tourniquet test with ELISA for the diagnosis of dengue were included. DATA EXTRACTION: Two independent authors extracted data using a standardized form. DATA SYNTHESIS: A total of 16 studies with 28,739 participants were included in the meta-analysis. Pooled sensitivity for dengue diagnosis by TT was 58% (95% Confidence Interval (CI), 43%-71%) and the specificity was 71% (95% CI, 60%-80%). In the subgroup analysis sensitivity for non-severe dengue diagnosis was 55% (95% CI, 52%-59%) and the specificity was 63% (95% CI, 60%-66%), whilst sensitivity for dengue hemorrhagic fever diagnosis was 62% (95% CI, 53%-71%) and the specificity was 60% (95% CI, 48%-70%). Receiver-operator characteristics demonstrated a test accuracy (AUC) of 0.70 (95% CI, 0.66-0.74). CONCLUSION: The tourniquet test is widely used in resource poor settings despite currently available evidence demonstrating only a marginal benefit in making a diagnosis of dengue infection alone. REGISTRATION: The protocol for this systematic review was registered at PROSPERO: CRD42015020323

Surviving rapid climate change in the deep sea during the Paleogene hyperthermals

Predicting the impact of ongoing anthropogenic CO2 emissions on calcifying marine organisms is complex, owing to the synergy between direct changes (acidification) and indirect changes through climate change (e.g. warming, changes in ocean circulation, and deoxygenation). Laboratory experiments, particularly on longer-lived organisms, tend to be too short to reveal the potential of organisms to acclimatize, adapt, or evolve and usually do not incorporate multiple stressors. We studied two examples of rapid carbon release in the geological record, Eocene Thermal Maximum 2 (∼53.2 Ma) and the Paleocene Eocene Thermal Maximum (PETM, ∼55.5 Ma), the best analogs over the last 65 Ma for future ocean acidification related to high atmospheric CO2 levels. We use benthic foraminifers, which suffered severe extinction during the PETM, as a model group. Using synchrotron radiation X-ray tomographic microscopy, we reconstruct the calcification response of survivor species and find, contrary to expectations, that calcification significantly increased during the PETM. In contrast, there was no significant response to the smaller Eocene Thermal Maximum 2, which was associated with a minor change in diversity only. These observations suggest that there is a response threshold for extinction and calcification response, while highlighting the utility of the geological record in helping constrain the sensitivity of biotic response to environmental change.info:eu-repo/semantics/publishe

Mollusks in the Northeastern Chukchi Sea

Infaunal and epifaunal mollusks of the northeastern Chukchi Sea were sampled and 139 molluscan taxa were identified. The pattern of spatial distribution of molluscan species was determined by cluster analysis, which resulted in six infaunal and five epifaunal station groups. Species characterizing various faunal groups are defined. Stepwise multiple discriminant analysis was applied to correlate benthic biological associations with environmental variables. Delineation of infaunal groups was mainly due to percentage of sand and bottom salinity, while epifaunal groups were separated by percent gravel and bottom temperature. An increase in abundance and biomass of infaunal mollusks occurred adjacent to and north and northwest of an identified bottom front between the Bering Shelf and Resident Chukchi Water and Alaska Coastal Water. Epifaunal molluscan abundance and biomass were highest near the coast. Mollusks, especially smaller species and the juvenile stages of larger species, represent a food resource for bottom-feeding predators in the study area.Key words: Chukchi Sea, mollusk, benthic, infauna, epifauna, bottom front, bottom-feeding predators, cluster analysis, discriminant analysisOn a fait un échantillonnage des mollusques de l'endofaune et de l'épifaune du nord-est de la mer des Tchouktches et on a identifié 139 taxons de mollusques. On a déterminé le schéma de répartition géographique des espèces de mollusques au moyen d'une analyse typologique, qui a donné six groupes de stations dans l'endofaune et cinq dans l'épifaune. On définit des espèces caractéristiques des divers groupes fauniques. On a appliqué une analyse discriminante multiple séquentielle pour corréler les associations biologiques du benthos aux variables de l'environnement. La délimitation des groupes de l'endofaune était due en grande partie au taux de sable et de salinité au fond, tandis que les groupes de l'épifaune étaient répartis en fonction du taux de gravier et de température au fond. Une augmentation dans la quantité et la biomasse des mollusques de l'endofaune apparaissait près du nord et du nord-ouest d'un front de fond compris entre le plateau continental, les eaux non brassées de la mer des Tchouktches et les eaux côtières de l'Alaska. C'est près de la côte qu'on retrouvait l'abondance et la biomasse maximales des mollusques de l'épifaune. Les mollusques, surtout ceux des petites espèces et ceux des grandes espèces qui étaient au stade juvénile, représentaient une source alimentaire pour les prédateurs benthiques vivant dans la zone d'étude.Mots clés : mer des Tchouktches, mollusque, benthique, enfofaune, épifaune, front au fond, prédateurs benthiques, analyse typologique, analyse discriminant

Multiparametric Cardiac 18F-FDG PET in Humans: Kinetic Model Selection and Identifiability Analysis

Cardiac 18F-FDG PET has been used in clinics to assess myocardial glucose metabolism. Its ability for imaging myocardial glucose transport, however, has rarely been exploited in clinics. Using the dynamic FDG-PET scans of ten patients with coronary artery disease, we investigate in this paper appropriate dynamic scan and kinetic modeling protocols for efficient quantification of myocardial glucose transport. Three kinetic models and the effect of scan duration were evaluated by using statistical fit quality, assessing the impact on kinetic quantification, and analyzing the practical identifiability. The results show that the kinetic model selection depends on the scan duration. The reversible two-tissue model was needed for a one-hour dynamic scan. The irreversible two-tissue model was optimal for a scan duration of around 10 minutes. If the scan duration was shortened to 2 minutes, a one-tissue model was the most appropriate. For global quantification of myocardial glucose transport, we demonstrated that an early dynamic scan with a duration of 10 minutes and irreversible kinetic modeling was comparable to the full one-hour scan with reversible kinetic modeling. Myocardial glucose transport quantification provides an additional physiological parameter on top of the existing assessment of glucose metabolism, which may be used as a surrogate of myocardial blood flow to enable single tracer multiparametric imaging in the myocardium.Comment: 10 pages, 8 figure

Cognitive Reserve in Model Systems for Mechanistic Discovery: The Importance of Longitudinal Studies.

The goal of this review article is to provide a resource for longitudinal studies, using animal models, directed at understanding and modifying the relationship between cognition and brain structure and function throughout life. We propose that forthcoming longitudinal studies will build upon a wealth of knowledge gleaned from prior cross-sectional designs to identify early predictors of variability in cognitive function during aging, and characterize fundamental neurobiological mechanisms that underlie the vulnerability to, and the trajectory of, cognitive decline. Finally, we present examples of biological measures that may differentiate mechanisms of the cognitive reserve at the molecular, cellular, and network level

HSP90 Inhibitor, NVP-AUY922, Improves Myelination in Vitro and Supports the Maintenance of Myelinated Axons in Neuropathic Mice.

Hereditary demyelinating neuropathies linked to peripheral myelin protein 22 (PMP22) involve the disruption of normal protein trafficking and are therefore relevant targets for chaperone therapy. Using a small molecule HSP90 inhibitor, EC137, in cell culture models, we previously validated the chaperone pathway as a viable target for therapy development. Here, we tested five commercially available inhibitors of HSP90 and identified BIIB021 and AUY922 to support Schwann cell viability and enhance chaperone expression. AUY922 showed higher efficacy, compared to BIIB021, in enhancing myelin synthesis in dorsal root ganglion explant cultures from neuropathic mice. For in vivo testing, we randomly assigned 2-3 month old C22 and 6 week old Trembler J (TrJ) mice to receive two weekly injections of either vehicle or AUY922 (2 mg/kg). By the intraperitoneal (i.p.) route, the drug was well-tolerated by all mice over the 5 month long study, without influence on body weight or general grooming behavior. AUY922 improved the maintenance of myelinated nerves of both neuropathic models and attenuated the decline in rotarod performance and peak muscle force production in C22 mice. These studies highlight the significance of proteostasis in neuromuscular function and further validate the HSP90 pathway as a therapeutic target for hereditary neuropathies