Search Results (29)

Dendritic cells (DCs) play a crucial role in controlling viral infections. Little is known about the changes in frequencies of the DC subsets in patients with chronic hepatitis C (CHC), particularly in the era of interferon-free regimens. We aimed to evaluate the impact of sofosbuvir/daclatasvir on the frequency of different peripheral DC subsets, the expression of the inhibitory CD200R and its ligand CD200 on DC, and their relation to the treatment outcome. A total of 1000 patients with CHC were enrolled and treated with a fixed oral dose of 400 mg of sofosbuvir and 60 mg of daclatasvir for 12 weeks. A total of 940 patients achieved sustained virologic response (SVR), and only 60 patients were non-responders (NRs). The frequencies of the peripheral plasmacytoid (pDC) and myeloid (mDCs) subsets and their surface expressions of CD200R and CD200 molecules were analyzed using flow cytometry. This analysis included 60 non-responders (NR group), 60 randomly selected sustained virologic responders (SVR group) at baseline, and at the end of treatment, and 60 healthy controls. HCV infection was associated with a down-regulation in the frequency of mDC, compared to healthy controls. In addition, mDC in HCV-infected patients showed lower levels of CD200R. However, neither the pDC frequency nor their CD200R expression was significantly altered. Interestingly, by the end of therapy, the frequencies of circulating mDCs and CD200R⁺mDC increased significantly in the SVR group and were even comparable to healthy controls. The levels of these cells were not normalized in the NR group. Percentages of mDCs and CD200R⁺mDC subsets showed good prognostic accuracy for predicting virologic response to therapy. Our results showed that HCV infection was associated with modulation of the mDC frequency and their surface expression of CD200R. Successful daclatasvir and sofosbuvir combined therapy was associated with the normalization of the percentages of mDC and CD200R⁺mDC. Full article

Introduction: Children born small or sick are at risk of death and poor development, but many lack access to preventative follow-up services. We assessed the impact of Pediatric Development Clinics (PDC), which provide structured follow-up after discharge from hospital neonatal care units, on children’s survival, nutrition and development in rural Rwanda. Methods: This quasi-experimental study compared a historic control group to children receiving PDC in Kayonza and Kirehe districts. Study populations in both districts included children born preterm or with birthweight < 2000 g and discharged alive. Kirehe additionally included children with hypoxic ischemic encephalopathy (HIE). Home-based cross-sectional surveys were conducted in Kayonza among children with expected chronological age 11–36 months in 2014 (controls) and 2018 (PDC group) and in Kirehe among children with expected chronological age 17–39 months in 2018 (controls) and 2019 (PDC group). Outcomes were measured using anthropometrics and the Ages and Stages Questionnaires. We used weighted logistic regression to control for confounding and differential non-participation. Results: PDC children (n = 464/812, 57.1%) were significantly more likely to participate in surveys (83.0% vs. 65.5%), have very low birthweight (27.6% vs. 19.0%), and be younger at the survey (26.2 vs. 31.1 months). 6.9% (n = 56) died before the survey. PDC was associated with reduced odds of death (aOR = 0.49, 95% CI: 0.26–0.92) and reduced odds of developmental delay (aOR = 0.48, 95% CI: 0.30–0.77). In Kayonza, PDC was associated with reduced stunting (aOR = 0.52, 95% CI: 0.28–0.98). PDC was not associated with reduced underweight or wasting. Conclusions: PDC was associated with improved survival and development among children born preterm, with low birthweight, or with HIE. Increased access to PDC, scale-up across Rwanda, and implementation of similar services and early intervention in other low-resource settings could support children born small or sick. Full article

Modelling and controlling an electrical Power Generation System (PGS), which consists of an Internal Combustion Engine (ICE) linked to an electric generator, poses a significant challenge due to various factors. These include the non-linear characteristics of the system’s components, thermal effects, mechanical vibrations, electrical noise, and the dynamic and transient impacts of electrical loads. In this study, we introduce a fuzzy modelling identification approach utilizing the Takagi–Sugeno (T–S) structure, wherein model and control parameters are optimized. This methodology circumvents the need for deriving a mathematical model through energy balance considerations involving thermodynamics and the non-linear representation of the electric generator. Initially, a non-linear mathematical model for the electrical power system is obtained through the fuzzy c-means algorithm, which handles both premises and consequents in state space, utilizing input–output experimental data. Subsequently, the Particle Swarm Algorithm (PSO) is employed for optimizing the fuzzy parameter m of the c-means algorithm during the modelling phase. Additionally, in the design of the Parallel Distributed Compensation Controller (PDC), the optimization of parameters pertaining to the poles of the closed-loop response is conducted also by using the PSO method. Ultimately, numerical simulations are conducted, adjusting the power consumption of an inductive load. Full article

In this paper, a stability analysis and the controller improvement of T-S fuzzy Descriptor system are studied. Firstly, by making full use of the related theory of fuzzy affiliation function and combining the design method of fuzzy Lyapunov function with the method of inequality deflation, a stability condition with wider admissibility and less system conservatism is proposed. The advantage of this method is that it is not necessary to ensure that each fuzzy subsystem is progressively stable. We also maximise the boundary of the derivatives of the affiliation function mined. Secondly, a PDC controller and a Non-PDC controller are designed, and the deflation conditions for the linear matrix inequalities of the two controllers are constructed. Finally, some arithmetic simulations and practical examples are given to demonstrate the effectiveness of the method studied in this paper, and the results obtained are less conservative and have larger feasible domains than previous methods. Full article

Background/Objectives: Glomerulopathy is a term used to describe a broad spectrum of renal diseases, characterized by dysfunction of glomerular filtration barrier, especially of podocytes. Several podocyte-associated proteins have been found and proved their usefulness as urine markers of podocyte dysfunction. Two of them are nephrin (NEP) and prodocalyxin (PDC). This study aims to evaluate the association of podocyte damage, as it is demonstrated via the concentrations of urinary proteins, with clinical and histological data from patients with several types of glomerulonephritis. Methods: We measured urine levels of two podocyte-specific markers, NEP and PDC (corrected for urine creatinine levels), in patients with a wide range of glomerulopathies. Serum and urine parameters as well as histological parameters from renal biopsy were recorded. Results: In total, data from 37 patients with glomerulonephritis and 5 healthy controls were analyzed. PDC and NEP concentrations correlated between them and with serum creatinine levels (p = 0.001 and p = 0.013 respectively), and with histological lesions associated with chronicity index of renal cortex, such as severe interstitial fibrosis, severe tubular atrophy and hyalinosis (for PDC/NEP, all p < 0.05). In addition, the PDC and NEP demonstrated statistically significant correlations with interstitial inflammation (p = 0.018/p = 0.028). Regarding electron microscopy evaluation, PDC levels were correlated with distinct characteristics, such as fibrils and global podocyte foot process fusion, whereas the NEP/CR ratio was uniquely significantly associated with podocyte fusion only in non-immune-complex-mediated glomerulonephritis (p = 0.02). Among the other clinical and histological parameters included in our study, a strong correlation between proteinuria >3 g/24 h and diffuse fusion of podocyte foot processes (p = 0.016) was identified. Conclusions: Podocalyxin and nephrin concentrations in urine are markers of podocyte dysfunction, and in our study, they were associated both with serum creatinine and histological chronicity indices. Full article

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are novel oral anti-hyperglycemic drugs that demonstrate cardiovascular and metabolic benefits for patients with type 2 diabetes (T2D), heart failure (HF), and chronic kidney disease (CKD). There is limited knowledge of real-world data to predict adherence to SGLT-2i in an ambulatory setting. The study aims to predict SGLT-2i adherence in patients with T2D and/or HF and/or CKD by building a prediction model using electronic prescription claims data presented within EPIC datasets. This is a retrospective study of 174 adult patients prescribed SGLT-2i at UC San Diego Health ambulatory pharmacies between 1 January 2020 to 30 April 2021. Adherence was measured by the proportion of days covered (PDC). R packages were used to identify regression and non-linear regression predictive models to predict adherence. Age, gender, race/ethnicity, hemoglobin A1c, and insurance plan were included in the model. Diabetes control based on hemoglobin A1c (HbA1c) and the glomerular filtration rate (GFR) was also evaluated using Welch t-test with a p-value of 0.05. The best predictive model for measuring adherence was the simple decision tree. It had the highest area under the curve (AUC) of 74% and accuracy of 82%. The model accounted for 21 variables with the main node predictors, including glycated hemoglobin, age, gender, and insurance plan payment amount. The adherence rate was inversely proportional to HbA1c and directly proportional to the plan payment amount. As for secondary outcomes, HbA1c values from baseline till 90 days post-treatment duration were consistently higher in the non-compliant group: 7.4% vs. 9.6%, p < 0.001 for the PDC ≥ 0.80 and PDC < 0.80, respectively. Baseline eGFR was 55.18 mL/min/1.73m² vs. 54.23 mL/min/m² at 90 days. The mean eGFR at the end of the study (minimum of 90 days of treatment) was statistically different between the groups: 53.1 vs. 59.6 mL/min/1.73 m², p < 0.001 for the PDC ≥ 0.80 and PDC < 0.80, respectively. Adherence predictive models will help clinicians to tailor regimens based on non-adherence risk scores. Full article

Background: The risk of palatally displaced canines (PDCs) rises in patients with tooth agenesis. The orthodontic extrusion and alignment of PDCs require adequate anchorage to enable tooth movement and control the side effects. There is no paper presenting treatment in the case of severe oligodontia with simultaneous PDCs and the use of mini-implants (MIs) for their orthodontic extrusion. Case presentation: A 15-year-old patient presented with non-syndromic oligodontia and bilateral PDCs. Cone beam computed tomography revealed that both PDCs were in proximity to the upper incisors’ roots. There was no evident external root resorption of the incisors. The “canines first” approach was chosen. MIs were used both as direct and indirect anchorage. First, the extrusive forces of cantilevers were directed both occlusally and distally. Next, the buccal directions of forces were implemented. Finally, fixed appliances were used. PDCs were extruded, aligned, and torqued. Proper alignment and occlusion were achieved to enable further prosthodontic restorations. Conclusions: The use of MIs made it possible to avoid collateral effects, reduce the risk of complications, and treat the patient effectively. MIs provide adequate anchorage in demanding cases. The use of MIs for the extrusion of PDCs made it possible to offer this treatment option to patients with severe oligodontia. The presented protocol was effective and served to circumvent treatment limitations associated with an inadequate amount of dental anchorage and a high risk of root resorption. Full article

In the field of non-oxide ceramics, the polymer-derived ceramic (PDC) approach appears to be very promising, especially for obtaining easily shaped and homogeneous materials in terms of structure and composition. However, in order to reach a suitable form during the process, it is often necessary to study the rheology of preceramic polymers while they are modified during polymerisation or crosslinking reactions. Given this need in the understanding of the real-time rheology of macromolecules during their synthesis, a rheometer coupled with both an infrared spectrometer and a Raman probe is described as a powerful tool for monitoring in situ synthesised polycarbosilanes. Indeed, this original device allows one to control the viscosity of a hyberbranched polycarbosilane from defined difunctional and tetrafunctional monomers. Meanwhile, it links this evolution to structural modifications in the macromolecular structure (molar masses, dispersity and conformation), based on SEC-MALS analyses, synchronised by the monomer conversion determined by using Raman and infrared spectroscopies, a common denominator of the aforementioned instrumental platform. Full article

Background: Chronic obstructive pulmonary disease (COPD) is an inflammatory disorder and has been proposed to have an imbalance between pro-inflammatory and anti-inflammatory factors. Methods: This study was conducted on 41 participants {18 COPD patients (smokers, COPD S (n = 9); reformed smokers, COPD RS (n = 9)) and 23 controls (non-smokers, CNS (n = 14); smokers, CS (n = 9))}. Flow cytometry was used to identify circulatory immune cells and correlated with serum cytokines. Results: On comparison, significantly lower frequency of CD3+ T cells were observed in COPD S as compared to CNS (p < 0.01) and CS (p < 0.01); CD4+ T cells were lower in COPD S (p < 0.05), COPD RS (p < 0.05) and CNS (p < 0.01) as compared to CS. CD8+ T cells were elevated in COPD S as compared to CS (p < 0.05). Lower frequency of cDCs were observed in COPD S as compared to CS (p < 0.05) and COPD RS as compared to CNS (p < 0.01) and CS (p < 0.01). Lower frequency of pDCs were observed in COPD RS as compared to COPD S (p < 0.05), CNS (p < 0.05) and CS (p < 0.01). Lower frequency of Tregs was observed in COPD S as compared to CNS (p < 0.05) and CS (p < 0.05). Conclusions: Characteristic changes observed indicate a significant impact of immune cells in the progression of the disease. Full article

Non-adherence to asthma controllers increases morbidity among school-aged children. This study aimed to determine non-adherence risk factors in preschool children with asthma. We investigated 172 children <6 years diagnosed with asthma in 2018 and analyzed baseline characteristics and loss of control events extracted from the medical records for four years following diagnosis. At end of follow-up, 79 children had a prescription of inhaled corticosteroids (ICS) and were included in the analyses. Adherence was assessed in a two-year period through pharmacy claims using percentage of days covered (PDC) analyzed dichotomously with non-adherence defined as PDC < 80% and using adherence ratio (AR) defined as days with medical supply divided by days without. Of the 79 children, 59 (74.7%) were classified as non-adherent. In analyses adjusted for sex, age and exacerbations prior to inclusion, adherence was positively associated with having had a loss of control event requiring a step-up in asthma controller (_aAR:2.34 [1.10;4.98], p = 0.03), oral corticosteroids (_aAR:2.45 [1.13;5.34], p = 0.026) or redeeming a short-acting b2-agonist prescription (_aAR:2.91 [1.26;6.74], p = 0.015). Further, atopic comorbidity was associated with increased adherence (_aAR:1.18 [1.01;1.37], p = 0.039), whereas having a first degree relative with asthma was associated with worse adherence (_aAR:0.44 [0.23;0.84], p = 0.015). This study found poor adherence to ICS among three quarters of preschool children with asthma. Increasing adherence was associated with atopic comorbidity and loss of control events, whereas lower adherence was associated with atopic predisposition. These findings should be considered to improve adherence in preschool children with asthma. Full article

Tuberculosis, which is an infectious airborne disease remained the main leading cause of death in South Africa for three consecutive years from 2016 to 2018. In 2020 alone, the country had an estimated 328,000 people who suffered from TB, with 61,000 dying from it. Collins Chabane Municipality had 129 and 192 new TB cases recorded in 2017 and 2018, respectively, which is far from reaching the END TB STRATEGY targets. WHO scientific evidence demonstrates that TB control measures are effective in reducing the spread and development of new cases. Though scientific evidence revealed negative attitudes towards the recommended TB control measures in public hospitals of the Vhembe district, a deeper understanding of these attitudes is needed to remedy the situation. This study aimed to describe healthcare workers’ perceptions of TB control measures at Collins Chabane Municipality in South Africa. A qualitative, exploratory case study design was adopted. Multi-stage sampling technique was used to select both the healthcare facilities and the participants. Only 24 healthcare workers trained on tuberculosis management were voluntarily recruited. However, data were saturated at the twelfth (12) participant purposively selected from six healthcare facilities of Collins Chabane Municipality. Data collected through unstructured in-depth individual interviews were analyzed thematically. The proposal for this study was ethically cleared by the University of Venda Ethics Committee (SHS/20/PDC/35/1111). Results indicate that TB administrative, environmental and respiratory control measures are well understood by health workers even though there are challenges with implementation concerning some, such as closing windows during winter, UVGI lights that are non-functional and taking too long to be fixed, no specimen collection during weekends and holidays thereby delaying TB diagnosis and lack of skills concerning how to use respirators and cough etiquette. The Vhembe district TB control programme should intensify infection control training and continue monitoring giving the needed support. Full article

In a pot experiment, we explored the regulatory pathways through which melatonin (MT) protects wheat growth and grain yield loss from waterlogging injury. Two wheat cultivars, Yangmai 18 and Yannong 19, were exposed to seven days of soil waterlogging at flowering. Melatonin (100 μmol·L⁻¹) was sprayed before and after waterlogging to explore its regulation on root growth, photosynthetic characteristics, dry matter accumulation, and grain yield. Soil waterlogging intensified malondialdehyde (MDA) and O₂⁻ production rates in wheat tissues, impairing leaf photosynthesis, biomass accumulation, and final grain yield formation. In this study, the roots waterlogged at 7 days after anthesis (DAA) accumulated 20.9%, 76.2%, 17.6%, 28.5%, and 5.6% higher MDA content, O₂⁻ production rate, pyruvate decarboxylase (PDC), lactate dehydrogenase (LDH), and alcohol dehydrogenase (ADH) activities, respectively, in Yangmai 18, and 25.7%, 74.8%, 35.8%, 70.8%, and 30.7% higher in Yannong 19, respectively, compared with their respective non-waterlogged controls. Further, Yangmai 18 achieved a maximum net photosynthetic rate (Pn) reduction of 22.1% at 7 DAA, while the maximum Pn reduction of Yannong 19 was 27.4% at 14 DAA, respectively, compared with their respective non-waterlogged plants. Thus, waterlogging decreased total dry matter accumulation, 1000-grain weight (TGW), and total grain yield by 14.0%, 13.8%, and 16.2%, respectively, in Yangmai 18, and 16.0%, 8.1%, and 25.1%, respectively, in Yannong 19. Our study also suggests that exogenously applied melatonin can protect wheat root tissues from waterlogging-induced oxidative injury by upregulating antioxidant enzymes and sustaining leaf photosynthesis. The plants treated with melatonin showed better water status and less oxidative damage, which was conducive to maintaining a higher photosynthetic capacity, thereby improving the waterlogging tolerance of wheat. For example, compared with waterlogged plants, melatonin treatments significantly reduced MDA content, O₂⁻ production rate, PDC, LDH, and ADH activities by 7.7%, 25.4%, 2.6%, 32.1%, and 3.2%, respectively, in Yangmai 18, and 6.7%, 17.9%, 4.1%, 22.0%, and 15.3%, respectively, in Yannong 19. MT treatments significantly increased total dry matter accumulation, TGW, and yield by 5.9%, 8.7%, and 14.9%, respectively, in Yangmai 18, and 3.2%, 7.3%, and 26.0%, respectively, in Yannong 19. Full article

In the direct-acting antiviral (DAA) era, it is important to understand the immunological changes after HCV eradication in HCV monoinfected (mHCV) and in HIV/HCV coinfected (HIV/HCV) patients. In this study, we analyzed sub-populations of monocytes, dendritic cells (DCs), T-lymphocytes and inflammatory biomarkers following initiation of DAA in 15 mHCV and 16 HIV/HCV patients on effective antiretroviral therapy at baseline and after sustained virological response at 12 weeks (SVR12). Fifteen age- and sex-matched healthy donors (HD) were enrolled as a control group. Activated CD4+ and CD8+ T-lymphocytes, mDCs, pDCs, MDC8 and classical, non-classical and intermediate monocytes were detected using flow cytometry. IP-10, sCD163 and sCD14 were assessed by ELISA while matrix metalloproteinase-2 (MMP-2) was measured by zymography. At baseline, increased levels of IP-10, sCD163 and MMP-2 were found in both HIV/HCV and mHCV patients compared to HD, whereas sCD14 increased only in HIV/HCV patients. After therapy, IP-10, sCD163 and sCD14 decreased, whereas MMP-2 persistently elevated. At baseline, activated CD8+ T-cells were high in HIV/HCV and mHCV patients compared to HD, with a decrease at SVR12 only in HIV/HCV patients. Activated CD4+ T-cells were higher in HIV/HCV patients without modification after DAAs therapy. These results suggest complex interactions between both viruses and the immune system, which are only partially reversed by DAA treatment. Full article

Controlling morphology of polysiloxane blends crosslinked by the hydrosilylation reaction followed by pyrolysis constitutes a robust strategy to fabricate polymer-derived ceramics (PDCs) for a number of applications, from water purification to hydrogen storage. Herein, we introduce a dissipative particle dynamics (DPD) approach that captures the phase separation in binary and ternary polymer blends undergoing hydrosilylation. Linear polyhydromethylsiloxane (PHMS) chains are chosen as preceramic precursors and linear vinyl-terminated polydimethylsiloxane (v-PDMS) chains constitute the reactive sacrificial component. Hydrosilylation of carbon–carbon unsaturated double bonds results in the formation of carbon–silicon bonds and is widely utilized in the synthesis of organosilicons. We characterize the dynamics of binary PHMS/v-PDMS blends undergoing hydrosilylation and ternary blends in which a fraction of the reactive sacrificial component (v-PDMS) is replaced with the non-reactive sacrificial component (methyl-terminated PDMS (m-PDMS), polyacrylonitrile (PAN), or poly(methyl methacrylate) (PMMA)). Our results clearly demonstrate that the morphology of the sacrificial domains in the nanostructured polymer network formed can be tailored by tunning the composition, chemical nature, and the degree of polymerization of the sacrificial component. We also show that the addition of a non-reactive sacrificial component introduces facile means to control the self-assembly and morphology of these nanostructured materials by varying the fraction, degree of polymerization, or the chemical nature of this component. Full article

This paper presents a new control technique based on uncertain fuzzy models for handling uncertainties in nonlinear dynamic systems. This approach is applied for the stabilization of a multimachine power system subject to disturbances. In this case, a state-feedback controller based on parallel distributed compensation (PDC) is applied for the stabilization of the fuzzy system, where the design of control laws is based on the Lyapunov function method and the stability conditions are solved using a linear matrix inequalities (LMI)-based framework. Due to the high number of system nonlinearities, two steps are followed to reduce the number of fuzzy rules. Firstly, the power network is subdivided into sub-systems using Thevenin’s theorem. Actually, each sub-system corresponds to a generator which is in series with the Thevenin equivalent as seen from this generator. This means that the number of sub-systems is equal to the number of system generators. Secondly, the significances of the nonlinearities of the sub-systems are ranked based on their limits and range of variation. Then, nonlinearities with non-significant variations are assumed to be uncertainties. The proposed strategy is tested on the Western systems coordinating council (WSCC) integrated with a wind turbine. The disturbances are assumed to be sudden variations in wind power output. The effectiveness of the suggested fuzzy controller is compared with conventional regulators, such as an automatic voltage regulator (AVR) and power system stabilizers (PSS). Full article