Kartagener Syndrome With Focal Segmental Glomerulosclerosis

Primary ciliary dyskinesia is characterized by congenital impairment of mucociliary clearance. Kartagener syndrome (KS) is a clinical variant of primary ciliary dyskinesia which is involved in situs inversus associated with chronic respiratory infections. In addition, glomerular disease in KS syndrome is rare and reported cases are limited. We had a 27-year-old female patient with KS who presented with proteinuria, hematuria, normal kidney function, and a family history of systemic lupus erythematosus. Kidney biopsy showed segmental scar with adhesion to Bowman capsule, which was indicative of focal segmental glomerulosclerosis

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Oxydase de l'acide 1-aminocyclopropane carboxylique : mode d'action et inactivation

L’oxydase de l’acide 1-AminoCyclopropane Carboxylique (ACC Oxydase, ACCO) catalyse la formation de l’éthylène, hormone essentielle à la vie des plantes. L’ACCO catalyse l’oxydation de l’ACC en éthylène en présence de dioxygène et de deux électrons (fournis in vitro par l’ascorbate). L'activité de l'enzyme requière également, pour des raisons encore incomprises, la présence de CO2 sous la forme d'ions bicarbonates. Il s’agit d’une enzyme qui contient un ion fer(II) dans un environnement non-hémique au site actif. Etant donné l’importance de l’éthylène chez les plantes, l’ACCO, ainsi que les autres enzymes impliquées dans sa biosynthèse, ont été très étudiées durant les vingt dernières années. Cependant, peu d’études ont porté sur le rôle de l’ion métallique et le mécanisme d’action ou sur les surprenants processus d’inactivation subis par l’enzyme. L’ACCO est en effet une enzyme connue pour son instabilité. Nous avons tout d’abord entrepris une caractérisation physicochimique et biochimique de l’enzyme. Le matériel protéique utilisé a tout d’abord été analysé une coupure entre les résidus Ala 290 et Gly 291 a été observée au cours de la purification de l'enzyme. Puis, grâce à l'utilisation de techniques spectroscopiques, nous avons cherché à obtenir plus d'informations sur la fixation des substrats/cofacteurs au site actif. Enfin l’étude des mutants et des complexes modèles de l’ACCO a été réalisée afin de mieux comprendre le mécanisme catalytique et de rechercher de nouvelles activités. Nous nous sommes aussi intéressés aux mécanismes d’inactivation de l’ACCO. En présence des effecteurs en excès, cette inactivation se traduit par une fragmentation et une modification de charge. Lorsque la concentration en fer est limitée, aucune modification physique de l’enzyme inactive n’est observée et l'enzyme garde un contenu global en aminoacide et une conformation tridimensionnelle intègres. Des processus oxydatifs se déroulant directement au site actif de l’enzyme sont susceptibles d’engendrer une telle perte d’activité par l'oxydation d'un nombre limité d'acides aminés. Des études en spectrométrie de masse ont été entreprises et sont toujours en cours afin d'identifier les modifications responsables de la perte d'activité de l'enzyme.Enfin nous avons recherché d’éventuelles partenaires protéiques qui pourraient conférer à l’ACCO une meilleure stabilité. Des études préliminaires ont été entreprises et des données de microscopie suggèrent que l'ACCO est localisée près des membranes de la vacuole.The 1-AminoCyclopropane Carboxylic acid oxidase (ACC Oxidase, ACCO) catalyzes the last step of the biosynthesis of the plant hormone, ethylene. ACCO catalyzes the oxidation of ACC into ethylene in the presence of dioxygen and two electrons (provided in vitro by ascorbate). Carbon dioxide (or bicarbonate ions) are also required for optimum activity. ACCO is an non-heme iron(II) containing enzyme. Given the importance of ethylene in plants, studies on ACCO, as well as on the other enzymes involved in its biosynthesis, have attracted much attention in the past two decades. However, few studies focus on the role of the metal ion and on the catalytic mechanism or the intriguing inactivation processes. ACCO is indeed known for its instability. We first purified and characterised the enzyme. During the purification, a cleavage between residues Ala 290 and Gly 291 was observed. Then, using spectroscopic techniques, we intended to get more information on cofactor's binding in the active site. Finally studies of mutants and model complexes of ACCO were performed in order to get a better understanding of the catalytic mechanism and to look for new activities.We were also interested in the inactivation processes of ACCO. In the presence of an excess of effectors, this inactivation resulted in fragmentation and in pI modification. When the concentration of iron is limited, no modifications of the inactive enzyme were observed. The inactive enzyme maintained its amino acid content and three-dimensional conformation. The loss of activity is therefore likely to derive from oxidative processes directly at the active site. Mass spectrometry experiments were initiated and are still under progress. Finally we were interested in identifying possible protein partners of ACCO that could provide a better stability. Preliminary studies were thus initiated and from microscopy results, ACCO was found located close to the vacuole membrane

Thermally Insulating Cellulose Nanofiber Aerogels from Brewery Residues

Brewery spent grain(BSG), the main waste of the brewery industry,is often disposed of or sold as an animal feed at low prices, neglectingthe potential for further valorization. In this work, BSG was usedfor the first time to produce cellulose nanofiber aerogels for greenthermal insulating applications. Cellulose nanofibers (CNFs) wereextracted from BSG through microfluidization with and without TEMPO-oxidationpretreatment to obtain bio-based building blocks for aerogels. TheTEMPO-treated CNFs exhibited a finer diameter (5.4 nm) with a morehomogeneous size distribution (2-10 nm) than that of nonoxidizedsamples. All of the produced aerogels demonstrated low densities (0.009-0.031g/cm(3)), low thermal conductivities (32.3-37.7 mW/mK),and a compressive Young's modulus in the range of 4-311kPa. Unidirectional freezing and TEMPO-oxidation showed a distinctimprovement in the thermal conductivity and mechanical propertiesof the aerogels compared to the random frozen samples. Specifically,the unidirectional frozen aerogel with the highest investigated CNFconcentration of 3 wt % exhibited the lowest thermal conductivity(32.4 mW/mK), highest Young's modulus (311 kPa), and good thermalstability. These results show that the BSG-derived nanocellulose isa valuable resource for producing eco-friendly, biodegradable, andthermally insulating aerogels.ISSN:2168-048

Dual Anti-Metastatic and Anti-Proliferative Activity Assessment of Two Probiotics on HeLa and HT-29 Cell Lines

Objective Lactobacilli are a group of probiotics with beneficial effects on prevention of cancer. However, there is scant data in relation with the impacts of probiotics in late-stage cancer progration, especially metastasis. The present original work was aimed to evaluate the anti-metastatic and anti-proliferative activity of lactobacillus rhamnosus supernatant (LRS) and lactobacillus crispatus supernatant (LCS) on the human cervical and colon adenocarcinoma cell lines (HeLa and HT-29, respectively). Materials and Methods In this experimental study, the anti-proliferative activities of LRS and LCS were determined through MTT assay. MRC-5 was used as a normal cell line. Expression analysis of CASP3, MMP2, MMP9, TIMP1 and TIMP2 genes was performed by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR), following the cell synchronization. Results Supernatants of these two lactobacilli had cytotoxic effect on HeLa, however LRS treatment was only effective on HT-29 cell line. In addition, LRS had no side-effect on normal cells. It was shown that CASP3 gene expression has been reduced after treatment with supernatants of two studied lactobacilli. According to our study, LRS and LCS are efficacious in the prevention of metastasis potency in HeLa cells with decreased expression of MMP2, MMP9 and increased expression of their inhibitors. In the case of HT-29 cells, only LRS showed this effect. Conclusion Herein, we have demonstrated two probiotics which have anti-metastatic effects on malignant cells and they can be administrated to postpone late-stage of cancer disease. LRS and LCS are effective on HeLa cell lines while only the effect of LRS is significant on HT-29, through cytotoxic and anti-metastatic mechanisms. Further assessments are required to evaluate our results on the other cancer cell lines, in advance to use these probiotics in other extensive trial studies

Sedation with etomidate-fentanyl versus propofol-fentanyl in colonoscopies: A prospective randomized study

Abstract Background: The combination of propofol-fentanyl for sedation during colonoscopy is characterized by the frequent incidence of side effects. Etomidate-fentanyl provides fewer hemodynamic and respiratory complications. The aim of our study was to compare the safety and efficacy of propofol-fentanyl and etomidate-fentanyl for conscious sedation in elective colonoscopy. Methods: This double-blind clinical trial was conducted on 90 patients aged between 18 and 55 years old who were candidates for elective colonoscopy. Patients were randomized to receive sedation with fentanyl plus propofol or etomidate. Two minutes after injecting 1 micro/kg of fentanyl, the patients received propofol (0.5 mg/kg followed 25 micro/kg/min) or etomidate (0.1 mg/kg followed 15 micro/kg/min). Pulse rate, mean arterial blood pressure, respiratory rate, and saturation of peripheral oxygen (SPO2) were monitored. Indeed, the patient and colonoscopist satisfaction, the recovery time, sedation and pain score in both groups were assessed. Results: Sedation score in propofol group was higher. Pain score as well as the physician and patient satisfaction showed no significant difference in two study groups. Hemodynamic changes and arterial saturation were the same in both groups. The duration of recovery was 1.27±0.82 minutes in the etomidate group whereas, it was 2.57±2.46 minutes in the propofol group (P=0.001). Hospital discharge in the propofol group was 5.53±4.67 minutes and in the etomidate group was 2.68±3.14 minutes (p=0.001). Conclusion: The combination of fentanyl and etomidate provides an acceptable alternative to sedation with fentanyl and propofol with the advantage of significantly faster recovery time, which are of relevance in the outpatient setting

Zetacism and Sigmatism in proto-turkic

Donated by Klaus Kreise

1-Aminocyclopropane-1-carboxylic acid oxidase: insight into cofactor binding from experimental and theoretical studies

International audience1-Aminocyclopropane-1-carboxylic acid oxi-dase (ACCO) is a nonheme Fe(II)-containing enzyme that is related to the 2-oxoglutarate-dependent dioxygenase family. The binding of substrates/cofactors to tomato ACCO was investigated through kinetics, tryptophan fluorescence quenching, and modeling studies. a-Amin-ophosphonate analogs of the substrate (1-aminocyclopro-pane-1-carboxylic acid, ACC), 1-aminocyclopropane-1-phosphonic acid (ACP) and (1-amino-1-methyl)ethyl-phosphonic acid (AMEP), were found to be competitive inhibitors versus both ACC and bicarbonate (HCO 3-) ions. The measured dissociation constants for Fe(II) and ACC clearly indicate that bicarbonate ions improve both Fe(II) and ACC binding, strongly suggesting a stabilization role for this cofactor. A structural model of tomato ACCO was constructed and used for docking experiments, providing a model of possible interactions of ACC, HCO 3-, and ascorbate at the active site. In this model, the ACC and bicarbonate binding sites are located close together in the active pocket. HCO 3-is found at hydrogen-bond distance from ACC and interacts (hydrogen bonds or electrostatic interactions) with residues K158, R244, Y162, S246, and R300 of the enzyme. The position of ascorbate is also predicted away from ACC. Individually docked at the active site, the inhibitors ACP and AMEP were found coordinating the metal ion in place of ACC with the phosphonate groups interacting with K158 and R300, thus interlocking with both ACC and bicarbonate binding sites. In conclusion, HCO 3-and ACC together occupy positions similar to the position of 2-oxoglutarate in related enzymes, and through a hydrogen bond HCO 3-likely plays a major role in the stabilization of the substrate in the active pocket

Raw data. 23 Urine Samples (OAB & Controls).rar

In the current study, we aimed to compare the urine microbiota of female patients with overactive bladder syndrome and healthy control by 16s rRNA metagenomic sequencing.</p