[Polymyositis-dermatomyositis recognized during the follow-up of a patient with type 2 diabetes].

Polymyositis-dermatomyositis is a rare systemic autoimmune disease which belongs to the class of idiopathic inflammatory myopathies. The disease exhibits high inter-individual variability, but chronic myositis is a common feature. As different manifestations often appear in atypical forms, establishing the precise diagnosis can be rather complicated. The prognosis and the patient's life expectations highly depend on whether the clinician considers this possibility in the diagnostic process or not. The authors present the case of a 50-year-old woman who was referred to hospital with suspected myopathy by her general practitioner. The history of the patient, the overall clinical picture and some marked laboratory abnormalities raised the possibility of polymyositis-dermatomyositis, which was unequivocally confirmed by immunological tests. Drug therapy was started immediately with the administration of high dose corticosteroid (1-2 mg/kg/day methylprednisolone), which was found to be an effective strategy leading to fast and remarkable improvement in the patient's condition. From the first hospital day, the patient also received insulin therapy in order to prevent any potential corticosteroid-induced imbalance in her carbohydrate metabolism. The long-term patient management was provided by an interdisciplinary team the members of which (both clinicians and other health care professionals) worked according to a co-ordinated, complex care plan, and managed not only the "physiological functions" but the different psychological and social problems as well, which are usually associated with the disease. The follow-up period of this polyphase disease process lasted for 4.5 years, during which only two relapses occurred, and muscle strength typically varied between 3 and 4 on a five grade scale with the exception of the relapse periods. Good outcome was attributed to the strict follow-up and individualized therapy/care. Orv. Hetil., 2012, 153, 467-474

Polyhedral approach to weighted connected matchings in general graphs

A connected matching in a graph G consists of a set of pairwise disjoint edges whose covered vertices induce a connected subgraph of G. While finding a connected matching of maximum cardinality is a well-solved problem, it is NP-hard to determine an optimal connected matching in an edge-weighted graph, even in the planar bipartite case. We present two mixed integer programming formulations and a sophisticated branch-and-cut scheme to find weighted connected matchings in general graphs. The formulations explore different polyhedra associated to this problem, including strong valid inequalities both from the matching polytope and from the connected subgraph polytope. We conjecture that one attains a tight approximation of the convex hull of connected matchings using our strongest formulation, and report encouraging computational results over DIMACS Implementation Challenge benchmark instances. The source code of the complete implementation is also made available.publishedVersio

The economic impact of political instability and mass civil protest

Previous work has investigated whether political instability has a negative effect on economic growth, with mixed results, largely because political instability can take various forms. Using synthetic control methodology, which constructs a counterfactual in the absence of political instability, we estimate the output effect of 38 regime crises in the period 1970-2011. A crucial factor is whether crises are accompanied by mass civil protest. In the crises accompanied by mass civil protest, there is typically an immediate fall in output which is never recovered in the subsequent five years. In crises unaccompanied by protest, there are usually no significant effects

Extended Spectrum β-Lactamases among Gram-Negative Bacterial Isolates from Clinical Specimens in Three Major Hospitals in Northern Jordan

Background and Objectives. Extended spectrum β-lactamase (ESBL) production is increasing all over the world, and organisms other than E. coli and K. pneumoniae are acquiring this character. ESBL production is detectable by automation, E-test, double disk diffusion (DDD), and PCR. This study aimed to determine the prevalence of ESBL production among clinical isolates of gram-negative rods, and to evaluate the effectiveness of augmentation of clavunate with Cefotaxime, Ceftazoxime, Aztreonam, Ceftriaxone, and Cefpodoxime in detecting ESBL production. Methods. 472 clinical gram-negative isolates identified by standard methods were tested for ESBL-production by (DDD) method using six cephalosporins and amoxicillin-clavulinate discs. Results. 108/472 (22.9%) of the isolates were ESBL producers, and were prevalent in tertiary care hospitals. 88.2% of E. cloacae, 71.4% of K. pneumoniae, 28.6% of K. oxytoca, 12.5% of C. freundii, 11.1% of A. calcoacceticus, and 10.8% of E. coli were ESBL producers. The DDD test demonstrated some variations in the efficacy of the different cephalosporins in detecting all the ESBL producers. The inclusion of ceftizoxime discs increased the efficacy of the test. It is concluded that ESBL-producing bacteria were prevalent among our hospitalized patients, and involved genera other than Klebsiella and Escherichia, and the inclusion of ceftizoxime increased the efficacy of ESBL detection by the DDD test

A technical note: The role of liliequist membrane fenestration during the pterional approach for anterior circulation aneurysm clipping

The Liliequist membrane is a critical membrane located at the base of the brain separating the supratentorial from the infratentorial cisterns. The advantages of Liliequist membrane fenestration as a critical part of the pterional trans-Sylvian approach for ruptured anterior circulation aneurysm clipping is not well established. We demonstrated that the fundamental role of Liliequist membrane fenestration is brain relaxation through the egress of CSF that is not usually gained from other modalities (e.g., placement of a lumbar drain, fenestration of lamina terminalis) in this specific setting

THE EFFECT OF PRETREATMENT WITH TOLL-LIKE RECEPTOR 4 ANTAGONIST RESATORVID ON METHOTREXATE-INDUCED LIVER INJURY IN RATS: HISTOPATHOLOGICAL STUDY

Objective: This research aims to evaluate the histopathological changes after pretreatment with resatorvid against methotrexate induced-liver injury.Methods: 28 male albino-wistar rats divided into random 4 groups (7 rats in each). Control group: Rats left untreated. Vehicle pre-treated group: Rats were administered dimethyl sulfoxide (DMSO) followed by methotrexate (MTX). Methotrexate treated group: Rats left untreated then administered MTX. Resatorvid pre-treated group: Rats were administered resatorvid followed by MTX. 24 h after the end of treatment, the animals were sacrificed. Liver tissue samples dissected out immediately and fixed in 10% formalin. The traditional procedures (paraffin-embedded method) was used to prepare liver tissue for microscopic evaluation by none alcoholic fatty liver disease (NAFLD) Activity Score Components.Results: Liver tissue sections of MTX-treated group show moderate-to-severe steatosis of hepatic cells and micro- and macro- hepatocellular fatty degeneration and giant fatty cysts with chronic inflammatory cells infiltration. While liver tissue sections of the resatorvid pre-treated group show moderate hepatic cellular fatty degeneration, with a decreased number of fatty cysts chains and the inflammation disappeared.Conclusion: Resatorvid hepatoprotective effect against MTX-induced injury was promising throughout resolving the accompanying inflammation and partial restoring histopathological fatty alterations

Dynamic Hardy type inequalities via alpha-conformable derivatives on time scales

We prove new Hardy-type $\alpha$-conformable dynamic inequalities on time scales. Our results are proved by using Keller's chain rule, the integration by parts formula, and the dynamic H\"{o}lder inequality on time scales. When $\alpha=1$, then we obtain some well-known time-scale inequalities due to Hardy. As special cases, we obtain new continuous, discrete, and quantum inequalities.Comment: 27 page

Spi-1, Fli-1 and Fli-3 (miR-17-92) Oncogenes Contribute to a Single Oncogenic Network Controlling Cell Proliferation in Friend Erythroleukemia

Clonal erythroleukemia developing in susceptible mice infected by Friend virus complex are associated with highly recurrent proviral insertions at one of three loci called Spi-1, Fli-1 or Fli-3, leading to deregulated expression of oncogenic Spi-1 or Fli-1 transcription factors or miR-17-92 miRNA cluster, respectively. Deregulated expression of each of these three oncogenes has been independently shown to contribute to cell proliferation of erythroleukemic clones. Previous studies showed a close relationship between Spi-1 and Fli-1, which belong to the same ETS family, Spi-1 activating fli-1 gene, and both Spi-1 and Fli-1 activating multiple common target genes involved in ribosome biogenesis. In this study, we demonstrated that Spi-1 and Fli-1 are also involved in direct miR-17-92 transcriptional activation through their binding to a conserved ETS binding site in its promoter. Moreover, we demonstrated that physiological re-expression of exogenous miR-17 and miR-20a are able to partially rescue the proliferation loss induced by Fli-1 knock-down and identified HBP1 as a target of these miRNA in erythroleukemic cells. These results establish that three of the most recurrently activated oncogenes in Friend erythroleukemia are actually involved in a same oncogenic network controlling cell proliferation. The putative contribution of a similar ETS-miR-17-92 network module in other normal or pathological proliferative contexts is discussed

Dependency Schemes in QBF Calculi: Semantics and Soundness

We study the parametrisation of QBF resolution calculi by dependency schemes. One of the main problems in this area is to understand for which dependency schemes the resulting calculi are sound. Towards this end we propose a semantic framework for variable independence based on ‘exhibition’ by QBF models, and use it to express a property of dependency schemes called full exhibition that is known to be sufficient for soundness in Q-resolution. Introducing a generalised form of the long-distance resolution rule, we propose a complete parametrisation of classical long-distance Q-resolution, and show that full exhibition remains sufficient for soundness. We demonstrate that our approach applies to the current research frontiers by proving that the reflexive resolution path dependency scheme is fully exhibited

The Safe Learning Environment in the United Arab Emirates Schools and Its Relationship to the Development of Creative Thinking Among Students

The study aimed to assess the relationship between a safe learning environment in Emirati schools and the development of student's creative thinking. Using a descriptive method with stratified random sampling, the researchers selected a sample of 500 male and female teachers. Two questionnaires were employed: one assessing the safe learning environment (20 items) and another measuring creative thinking (20 items). Results indicated a high teacher perception of a safe learning environment, with statistically significant chi-square values for all items. Similarly, teachers perceived a high level of creative thinking development, with significant chi-square values for all items. Gender and experience did not show statistically significant differences in the perception of a safe learning environment. However, teachers with over 10 years of experience demonstrated higher levels of creative thinking development. Notably, a significant correlation was found between a safe learning environment and the development of students' creative thinking in Emirati schools. This study aligns with the UAE Ministry of Education's mission to create a safe and creative educational system that meets the needs of a globally competitive knowledge society. Doi: 10.28991/ESJ-2023-SIED2-014 Full Text: PD