Symptomatic asymmetry in the first six months of life: differential diagnosis

Asymmetry in infancy is a clinical condition with a wide variation in appearances (shape, posture, and movement), etiology, localization, and severity. The prevalence of an asymmetric positional preference is 12% of all newborns during the first six months of life. The asymmetry is either idiopathic or symptomatic. Pediatricians and physiotherapists have to distinguish symptomatic asymmetry (SA) from idiopathic asymmetry (IA) when examining young infants with a positional preference to determine the prognosis and the intervention strategy. The majority of cases will be idiopathic, but the initial presentation of a positional preference might be a symptom of a more serious underlying disorder. The purpose of this review is to synthesize the current information on the incidence of SA, as well as the possible causes and the accompanying signs that differentiate SA from IA. This review presents an overview of the nine most prevalent disorders in infants in their first six months of life leading to SA. We have discovered that the literature does not provide a comprehensive analysis of the incidence, characteristics, signs, and symptoms of SA. Knowledge of the presented clues is important in the clinical decision making with regard to young infants with asymmetry. We recommend to design a valid and useful screening instrument

Identification of CRISPR and riboswitch related RNAs among novel noncoding RNAs of the euryarchaeon Pyrococcus abyssi

<p>Abstract</p> <p>Background</p> <p>Noncoding RNA (ncRNA) has been recognized as an important regulator of gene expression networks in Bacteria and Eucaryota. Little is known about ncRNA in thermococcal archaea except for the eukaryotic-like C/D and H/ACA modification guide RNAs.</p> <p>Results</p> <p>Using a combination of <it>in silico </it>and experimental approaches, we identified and characterized novel <it>P</it>. <it>abyssi </it>ncRNAs transcribed from 12 intergenic regions, ten of which are conserved throughout the Thermococcales. Several of them accumulate in the late-exponential phase of growth. Analysis of the genomic context and sequence conservation amongst related thermococcal species revealed two novel <it>P</it>. <it>abyssi </it>ncRNA families. The CRISPR family is comprised of crRNAs expressed from two of the four <it>P</it>. <it>abyssi </it>CRISPR cassettes. The 5'UTR derived family includes four conserved ncRNAs, two of which have features similar to known bacterial riboswitches. Several of the novel ncRNAs have sequence similarities to orphan OrfB transposase elements. Based on RNA secondary structure predictions and experimental results, we show that three of the twelve ncRNAs include Kink-turn RNA motifs, arguing for a biological role of these ncRNAs in the cell. Furthermore, our results show that several of the ncRNAs are subjected to processing events by enzymes that remain to be identified and characterized.</p> <p>Conclusions</p> <p>This work proposes a revised annotation of CRISPR loci in <it>P</it>. <it>abyssi </it>and expands our knowledge of ncRNAs in the Thermococcales, thus providing a starting point for studies needed to elucidate their biological function.</p

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

POST-EXERCISE HYPOTENSIVE RESPONSES TO ACUTE ISOVOLUMETRIC STRENGTH AND ENDURANCE EXERCISE

Madison Colson, Matthew D. Ruiz, Ruth N. Henry, Laurel A. Littlefield. Lipscomb University, Cookeville, TN. BACKGROUND: Post-exercise hypotension (PEH) has been documented following acute resistance training sessions that range from approximately 40 - 80% of the 1-repetition maximum (1 RM). Most authors report statistically significant reductions in systolic blood pressure (SBP), with more varied results related to diastolic blood pressure (DBP). The purpose of this study was to determine the effect of acute isovolumetric resistance training sessions at 40% and 80% 1RM on post-exercise blood pressure in a group of healthy participants from a local community fitness facility. METHODS: Twelve individuals (Age = 23 ± 5 years; BMI = 27.9 + 6.8 kg/m2; SBP = 121 + 8 mmHg; DBP = 69 + 7 mmHg) completed 1 RM testing following ACSM’s guidelines prior to completing 3 experimental sessions: non-exercise control, exercise at 40% 1RM, and exercise at 80% 1RM. Exercise conditions were matched for volume and included 7 exercises that were completed using resistance machines (Matrix, Cottage Grove, WI). Blood pressure and heart rate (HR) were measured pre-exercise and every 15 minutes post-exercise for 1-hour (Greater Goods, Balance, USA). Dependent variables were analyzed using 3x4 factorial ANOVAs with repeated measures. Tukey post-hoc testing was used to determine differences between individual group means. Alpha was set at 0.05. RESULTS: DBP (p = 0.01) and MAP (p \u3c 0.01) were lower and HR (p = 0.01) higher following both exercise conditions when compared to non-exercise control. In addition, there were statistically significant main effects for time for SBP (p = 0.03), DBP (p \u3c 0.01), MAP (p \u3c 0.01), and HR (p \u3c 0.01). SBP was lower at 30 when compared to 60 minutes, while DBP was lower at 15 when compared to 45 and 60 minutes. MAP was reduced at 15 and 30 compared to 60 minutes, and HR was higher at 15 when compared to 30, 45, and 60 minutes, and at 30 when compared to 45 and 60 minutes. CONCLUSIONS: Contrary to other studies, we report no main effect for SBP following acute resistance exercise. Blood pressure was lower at 15 and/or 30 when compared to 60 minutes following exercise. Acute resistance exercise at both 40 and 80% of 1 RM is effective at lowering DBP and MAP in the hour following exercise despite maintained elevations in heart rate

Managing Operational Risk Related to Microfinance Lending Process using Fuzzy Inference System based on the FMEA Method: Moroccan Case Study

Managing operational risk efficiently is a critical factor of microfinance institutions (MFIs) to get a financial and social return. The purpose of this paper is to identify, assess and prioritize the root causes of failure within the microfinance lending process (MLP) especially in Moroccan microfinance institutions. Considering the limitation of traditional failure mode and effect analysis (FMEA) method in assessing and classifying risks, the methodology adopted in this study focuses on developing a fuzzy logic inference system (FLIS) based on (FMEA). This approach can take into account the subjectivity of risk indicators and the insufficiency of statistical data. The results show that the Moroccan MFIs need to focus more on customer relationship management and give more importance to their staff training, to clients screening as well as to their business analysis.JEL Codes - G21; G32; C0