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Articles Related to NSE

The Presence of Minority HIV Drug Resistance Variants in The Protease and Gag Regions Confers Poor Response to Therapy Among Subtype A And D Patients

Objective: To determine the prevalence of minority drug resistance variants in the protease and Gag regions among patients failing a protease inhibitor (PI) based regimen with or without a susceptible genotype based on Sanger sequencing technology. Methods: Samples were obtained from patients who were failing on a protease inhibitor-based regimen (n = 500). Sanger based sequencing was performed as part of the standard of care. Mutation analysis was performed using the Stanford HIV drug Resistance database. A subset of these patient samples was grouped into two categories: those failing a PI based with mutations in the protease region (n = 100) and those failing on a PI based regimen without mutations in the protease region (n = 128). These samples were then analyzed in the protease and Gag regions using Next Generation Sequencing (NGS) technology and analysis of the drug resistance mutations was performed at the 20% and 1% cutoffs. Results: An initial analysis of the protease region for patients failing with drug resistance mutations revealed that most patients harbored mutations that confer resistance to Lopinavir and Atazanavir, but these mutations had little effect on Darunavir. Furthermore, NGS revealed that in patients failing with and without drug resistance mutations, minority drug resistance mutations were present at each of the drug resistance codons and at codons that confer multi-drug resistance to protease inhibitors. Further analysis of the Gag gene revealed more genetic diversity among patients failing with no mutations in the protease as evidenced by the proportion of polymorphisms at each codon. Conclusion: Based on Sanger sequencing, a proportion of patients fail a PI based regimen with a susceptible genotype. However, these patients harbor minority variants in the protease and numerous polymorphisms in the Gag region which when combined these could explain their poor response to therapy. Therefore, in order to improve patient care in low resource settings, there is need to adapt NGS as the standard genotyping technique so that minority variants are captured much earlier. In addition, since mutations in the Gag region also play a role in response to PIs, this region should be included in the routine monitoring for response to therapy in patients on a PI based regimen.
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Effects of Gabapentin Enacarbil on Cortical Arousals, Heart Rate, Blood Pressure and Anterior Tibialis EMG Responses Associated with PLMs in Restless Legs Syndrome

Objective: This study was conducted to investigate the effects of gabapentin enacarbil (GEn) on sleep EEG, heart rate (HR), blood presssure, anterior tibialis EMG activity (PLMs power) and subjective complaints in subjects with moderate to severe RLS and disturbed sleep. Methods: This was a single site, single-blind, placebo run-in, fixed dose single group polysomnography (PSG) study. Eligible subjects (age 24-66 years) were treated with placebo for one week and GEn (600 mg/day) for 4 weeks. Two in-laboratory PSGs were collected for adaptation and baseline at the end of the placebo run-in period and for re-adaptation and efficacy assessment at the end of the 4-week treatment period. The primary endpoint was the difference in PSG derived cortical arousal intensity (arousal scale, 0-9) associated with PLMs between 4 weeks of treatment with GEn and placebo. Secondary endpoints included changes in HR responses (ΔHR), nocturnal systolic blood pressure (SBP) changes (>10 mmHg) secondary to PLMs and PLMs power. Other PSG and subjective measures were assessed. Results: Of 20 subjects enrolled, 18 completed the study. Subjects treated with GEn did not show significant improvements in cortical arousal intensity and ΔHR. However, subjects showed reduced PLMs power (p= 0.013) and associated reductions in nocturnal SBP per hour of sleep (p= 0.041) GEn showed significant improvement in other PSG parameters and subjective endpoints. Conclusion: The data suggests that GEn reduces the frequency and power of PLMs and the corresponding SBP changes in subjects with RLS. Despite reducing the total number of PLM associated arousals and nocturnal HR, the study did not demonstrate consistent effects of GEn on cortical arousal intensity and corresponding HR changes associated with PLMs. Clinical Trial Registration: ClinicalTrials.gov identifier: NCT02424695
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A Case Report: Delayed Onset Urinary Tract Injury after Laparoscopic Hysterectomy

Lower urinary tract injury in hysterectomy is rare, but once it occurs, the consequence can be deteriorating. We experienced late onset urinary tract injury that developed as late as 15 days after laparoscopic hysterectomy. The objective of this case report is to alert all gynecological laparoscopists that such late onset complication may happen to any of patients.
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A Novel Coenzyme Q8A Mutation in a Case with Juvenile-Onset Coenzyme Q10D4: Case Report and Literature Review

Primary coenzyme Q10 deficiency-4 (CoQ10D4) is an autosomal recessive disorder characterized by childhood-onset of cerebellar ataxia and exercise intolerance. Molecular pathology responsible for clinical findings is mitochondrial respiratory chain dysfunction. The main clinical manifestation involves early-onset exercise intolerance, progressive cerebellar ataxia and movement disorders. Some affected individuals develop seizures and have mild mental impairment, indicating variable severity.
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Health Care Workers and Self-Assessed Communication with Language Diverse Patients in the St. Louis Region at the Onset and One Year into COVID-19

Self-assessment (SA) of English speaking ability by patients has been an important reference for the health workforce, and in the past 10 years, research examining health literacy in the USA has continued to emphasize the patient. In the current study, 338 Health Care Workers (HCWs) (82% female and 63% nurses) reported on their current communications with patients (one year into the COVID-19 pandemic) and recalled what communication was like at the onset of the pandemic. Through SA as a way for HCWs to analyze communication, this study investigated information available from community and healthcare facilities, oral communication with patients, and the training of healthcare professionals.
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A Data-Based Adjustment for Fisher Exact Test

Fisher exact test is one of most popularly used methods in modern data analyses. However, it is conservative because of discreteness. The mid-p method may reduce the conservativeness but it is defined by the factor 1/2, an extra term beyond data. This paper considers an adjustment defined by a data-based factor. The adjusted test is compared with other ten tests. Special attention is given to the comparison between the data-based factor and the factor 1/2. The standardized version of the adjusted test is asymptotically standard normal.
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Unexpected Opioid Responses in Infants: A Retrospective Case Series

Opioids are commonly prescribed for acute pain management. Complications such as nausea, vomiting, itch and constipation are not uncommon. Two unusual and unexpected complications that can arise in the acute setting are opioid-induced hyperalgesia (OIH) and acute opioid tolerance (AOT). The diagnostic challenges of these two entities are mainly attributed to their unpredictable onset and lack of strict diagnostic criteria. In the pediatric setting, additional confounding factors such as separation anxiety, hunger, thirst and poor verbal communication further complicate discerning between the two phenomena.
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Optimizing Outcomes with Multifocal Intraocular Lenses

Current present-day cataract surgery evolves from a visual restoration to a refractive approach. Greater independence from glasses and improvement of the quality of life were provided after surgery with the appearance of multifocal intraocular lenses (MF-IOLs). Since its creation in the 1980s, MFIOLs has undergone various technical improvements, including trifocal implants and implants with extended depth of vision. Excellent results were achieved thorough preoperative check, including the visual needs of the patients and the inherent eye anatomy. This analysis offers a broad overview of the various types of Mf-IOLs and rules for optimizing results through full preoperative screening and treatment postoperatively complications.
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Consistent Confidence Limits, P Values, and Power of the Non-Conservative, Size – α Modified Fisher exact Test

The classical Fisher exact test [1], which is unconditionally the uniformly most powerful unbiased (UMPU) test, requires randomization at the critical value(s) to be of size α. Obviously, one needs a non-randomized version of this. Rejecting the null only if the test-statistic’s outcome is more extreme than the critical values, reduces the actual size considerably. The modified Fisher exact test introduced in [2] additionally rejects the null when the test attains the critical value c(t) and the randomization probability γ(t) (that depend on the total number of successes T) exceeds a threshold γ0, which is determined such that, for all values of the nuisance parameter, the size of the unconditional modified test is smaller, but as close as possible to α. This greatly improves the size and power of the test as compared to, for example, the conservative nonrandomized Fisher exact test, while controlling the Type 1 error rate.
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Effect of Killing Methods on the Insect Fauna and Succession on African Giant Rat Cricetomys gambianus

The rise in insecurity and criminal activities remains one of the major challenges facing Nigeria. This has resulted in loss of lives in violent crimes, in addition to the deaths occurring naturally and from suicide deaths using chemicals. Collecting evidences at a crime scene requires that the evidences are accurately interpreted for proper investigation and use in court of law.
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Exhaled Volatile Organic Compounds and Vagal Tone are Different in Patients with Overweight or with Obesity: Practical Consequencies

Urinary Volatile Organic Compounds have been associated with type 2 diabetes mellitus and overweight and may correlate with Exhaled Volatile Organic Compounds (E-VOCs).
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Covid-19: Which Baseline Co-Factors are Associated with a Worse Prognosis?

Critically ill Covid-19 patients are characterized by an uncontrolled cytokine storm that reflects a profoundly dysregulated immune response and represents probably the major factor contributing to mortality. Cytokines can lead to vascular leakage, activation of complement, and activation of the coagulation cascade, which in turn cause acute respiratory distress syndrome (ARDS), myocardial dysfunction, hypotension, and coagulopathy [1-3].
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Seasonal Abundance of the Seychelles Scale, Icerya Seychellarum (Westwood) (Hemiptera: Monophlebidae) Infesting Guava Trees

The main objective of the present work was to study the population trend of the Seychelles scale, Icerya seychellarum (Westwood) (Hemiptera: Monophlebidae) on guava trees at Abu-Suwair district in Ismailia Governorate, Egypt during two consecutive years (2018-19). The results showed that insect population was recorded on guava trees all the year round and has three peaks of seasonal activity per year i.e., June, August/September and November.
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A Case of Lambda AL Type Skeletal Amyloidosis with Vascular Myopathy Achieved Clinical Response after Autologous Stem Cell Transplant

Amyloidosis involving the vascular musculoskeletal system is rare and currently, there is no standard treatment protocol for the treatment of skeletal muscle AL amyloidosis associated with vascular myopathies. Furthermore, the data on the efficacy and safety of autologous stem cell transplant is unclear. In this rare case, a biopsy-proven diagnosis of AL type amyloidosis with an unusual presentation of proximal muscle weakness significantly improved with high dose melphalan followed by autologous stem cell transplantation. The patient achieved and maintained remission for a year post-transplant
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A Facil Water Treatment Rendering Cement Kiln Dust Reusable in Clinker Manufacturing

Worldwide, stockpiled cement kiln dust (CKD) has been neither properly disposed, nor profitably utilized. Mostly it contains ≥6 wt % alkali metal salts; therefore, it cannot be reused as a raw material in clinker manufacturing in cement industry. In the present work, a facile water treatment, before and after calcination (at 500-1000 oC) of CKD, was designed and found to help leaching out the salt content that renders CKD reusable in the clinker manufacturing.
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Editorial Board Members Related to NSE

JACQUES MARESCAUX

Professor
Department of Surgery
Research Institute Against Digestive Cancer
France

Chunying Li

Assistant Professor
Department of Biochemistry and Molecular Biology
Wayne State University School of Medicine
United States

Juan Jose Alava

Research Associate
Faculty of Science
The University of British Columbia
Canada

Alex Kojo Anderson

Associate Professor
Department of Foods and Nutrition
University of Georgia
United States

Nelson Pérez Guerra

Professor
Department of Biochemistry
University of Vigo
Spain

Zhenghong Wu

Professor
Department of Pharmaceutics
China Pharmaceutical University
China

Hasan Kilic

Department of Chemistry
Marmara University
Turkey

Yadigar Imamverdiyev

Institute of Information Technology
Azerbaijan National Academy of Sciences
Azerbaijan

Catherine Ortega

Department of Physical Therapy
University of Texas Health Science Center At San Antonio
USA

J Vernon Odom

Professor
Department of Ophthalmology
West Virginia University
United States
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