Successful Management of a Patient with Florid Diabetic Retinopathy

Florid diabetic retinopathy is an unusual, aggressive type of diabetic retinopathy. It is seen in young patients with poor metabolic control. Despite advances in treatment the overall prognosis of this condition remains poor. A 21-year old female patient was seen by us and found to have florid diabetic retinopathy despite an adequate metabolic control by oral hypoglycemic agents. The patient underwent multiple laser and orbital floor triamcinolone acetonide injections. Later the left eye developed persistent vitreous hemorrhage for which a vitrectomy with silicone oil injection was done. During a 4 year follow-up she has shown a visually and anatomical stable response

Quantifying the improvement of surrogate indices of hepatic insulin resistance using complex measurement techniques

We evaluated the ability of simple and complex surrogate-indices to identify individuals from an overweight/obese cohort with hepatic insulin-resistance (HEP-IR). Five indices, one previously defined and four newly generated through step-wise linear regression, were created against a single-cohort sample of 77 extensively characterised participants with the metabolic syndrome (age 55.6±1.0 years, BMI 31.5±0.4 kg/m2; 30 males). HEP-IR was defined by measuring endogenous-glucose-production (EGP) with [6–62H2] glucose during fasting and euglycemic-hyperinsulinemic clamps and expressed as EGP*fasting plasma insulin. Complex measures were incorporated into the model, including various non-standard biomarkers and the measurement of body-fat distribution and liver-fat, to further improve the predictive capability of the index. Validation was performed against a data set of the same subjects after an isoenergetic dietary intervention (4 arms, diets varying in protein and fiber content versus control). All five indices produced comparable prediction of HEP-IR, explaining 39–56% of the variance, depending on regression variable combination. The validation of the regression equations showed little variation between the different proposed indices (r2 = 27–32%) on a matched dataset. New complex indices encompassing advanced measurement techniques offered an improved correlation (r = 0.75, P<0.001). However, when validated against the alternative dataset all indices performed comparably with the standard homeostasis model assessment for insulin resistance (HOMA-IR) (r = 0.54, P<0.001). Thus, simple estimates of HEP-IR performed comparable to more complex indices and could be an efficient and cost effective approach in large epidemiological investigations

Numerical investigation of the integration of heat transfer devices into a wind tower

Increasing focus on reducing energy consumption has raised public awareness of renewable energy resources, particularly the integration of natural ventilation devices in buildings such as wind tower systems. Wind towers have traditionally been used in Middle Eastern architecture for many centuries to provide natural ventilation and thermal comfort. The purpose of this study is to integrate heat transfer devices in a wind tower to meet the internal comfort criteria in extreme external condtions. Heat transfer devices were installed inside the passive terminal of the wind tower unit, highlighting the potential to achieve minimal restriction in the external air flow stream while ensuring maximum contact time, thus optimzing the cooling duty of the device. A geometrical representation of a full scale wind tower configuration, micro-climate and macro-climate was modeled. Computational Fluid Dynamics (CFD) was used to develop a numerical model of a new wind tower system and simulate the air flow pattern and pressure coefficients around and through the wind tower to the test room. Results have indicated that the average internal airflow rate was reduced following the integration of the vertical and horizontal heat transfer device configuration, reductions of 4.11 % and 8.21 % was obtained from the achieved numerical models. The work compared the effect of evaporative cooling and heat transfer devices on the thermal performance of the passive ventilation device. The proposed cooling system was capable of reducing the air temperatures by 12-15 K, depending on the configuration and operating conditions

Numerical investigation of the integration of heat transfer devices into wind towers

The purpose of this study is to incorporate heat transfer devices inside the passive terminal of a wind tower unit, highlighting the potential to achieve minimal restriction in the external air flow stream while ensuring maximum contact time, thus optimising the cooling duty of the device. Computational Fluid Dynamics (CFD) was used to develop a numerical model of a wind tower system and simulate the air flow pattern around and through the device to the test room. Results have indicated that the average internal airflow rate was reduced following the integration of the vertical and horizontal heat transfer device configuration, reductions of 4.11 % and 8.21 % was obtained respectively. Furthermore, the proposed cooling system was capable of reducing the air temperatures by up to 15 K. The technology presented here is subject to IP protection under the QNRF funding guidelines

OPTIMIZATION OF EDM SMALL HOLE DRILLING PROCESS USING TAGUCHI APPROACH

ABSTRACT Electrical Discharge Machining (EDM) is a process used to remove or cut a material into desired shape through the action of spark discharge between the tool and work piece. The objective of this paper is to optimize the independent variables to achieve better accuracy in EDM small hole drilling by using Taguchi method. The L9 orthogonal array is employed to study the performance characteristics in drilling operations of mild steel (AS3679) as workpiece by using 1 mm copper (Cu) pipe electrode. Three drilling parameters namely, pulse off time, peak current and servo standard voltage are considered to optimize drilling hole diameter. The result concluded that use of greater pulse off time, greater peak current and medium servo standard voltage give the better hole diameter for the specific test range. Further study in this topic could consider different factor such as pulse on time, material removal rate (MRR) and coolants to investigate how these factors would affect hole diameter

The importance of alternative host plants as reservoirs of the cotton leaf hopper, Amrasca devastans, and its natural enemies

Many agricultural pests can be harboured by alternative host plants but these can also harbour the pests’ natural enemies. We evaluated the capacity of non-cotton plant species (both naturally growing and cultivated) to function as alternative hosts for the cotton leaf hopper Amrasca devastans (Homoptera: Ciccadellidae) and its natural enemies. Forty-eight species harboured A. devastans. Twenty-four species were true breeding hosts, bearing both nymphal and adult A. devastans, the rest were incidental hosts. The crop Ricinus communis and the vegetables Abelmoschus esculentus and Solanum melongena had the highest potential for harbouring A. devastans and carrying it over into the seedling cotton crop. Natural enemies found on true alternative host plants were spiders, predatory insects (Chrysoperla carnea, Coccinellids, Orius spp. and Geocoris spp.) and two species of egg parasitoids (Arescon enocki and Anagrus sp.). Predators were found on 23 species of alternative host plants, especially R. communis. Parasitoids emerged from one crop species (R. communis) and three vegetable species; with 39 % of A. devastans parasitised. We conclude that the presence of alternative host plants provides both advantages and disadvantages to the cotton agro-ecosystem because they are a source of both natural enemy and pest species. To reduce damage by A. devastans, we recommend that weeds that harbour the pest should be removed, that cotton cultivation with R. communis, A. esculentus, and S. melongena should be avoided, that pesticides should be applied sparingly to cultivate alternative host plants and that cotton crops should be sown earlier

Canagliflozin inhibits interleukin-1β-stimulated cytokine and chemokine secretion in vascular endothelial cells by AMP-activated protein kinase-dependent and -independent mechanisms

YesRecent clinical trials of the hypoglycaemic sodium-glucose co-transporter-2 (SGLT2) inhibitors, which inhibit renal glucose reabsorption, have reported beneficial cardiovascular outcomes. Whether SGLT2 inhibitors directly affect cardiovascular tissues, however, remains unclear. We have previously reported that the SGLT2 inhibitor canagliflozin activates AMP-activated protein kinase (AMPK) in immortalised cell lines and murine hepatocytes. As AMPK has anti-inflammatory actions in vascular cells, we examined whether SGLT2 inhibitors attenuated inflammatory signalling in cultured human endothelial cells. Incubation with clinically-relevant concentrations of canagliflozin, but not empagliflozin or dapagliflozin activated AMPK and inhibited IL-1β-stimulated adhesion of pro-monocytic U937 cells and secretion of IL-6 and monocyte chemoattractant protein-1 (MCP-1). Inhibition of MCP-1 secretion was attenuated by expression of dominant-negative AMPK and was mimicked by the direct AMPK activator, A769662. Stimulation of cells with either canagliflozin or A769662 had no effect on IL-1β-stimulated cell surface levels of adhesion molecules or nuclear factor-κB signalling. Despite these identical effects of canagliflozin and A769662, IL-1β-stimulated IL-6/MCP-1 mRNA was inhibited by canagliflozin, but not A769662, whereas IL-1β-stimulated c-jun N-terminal kinase phosphorylation was inhibited by A769662, but not canagliflozin. These data indicate that clinically-relevant canagliflozin concentrations directly inhibit endothelial pro-inflammatory chemokine/cytokine secretion by AMPK-dependent and -independent mechanisms without affecting early IL-1β signalling.Project Grant (PG/13/82/30483 to IPS and TMP) and PhD studentships (FS/16/55/32731 and FS/14/61/31284 to DB and AS) from the British Heart Foundation and an equipment grant (BDA11/0004309 to IPS and TMP) from Diabetes UK. OJK was supported by a Scholarship from the Iraqi Ministry of Higher Education and Scientific Research. TAA was supported by a Libyan Ministry of Education PhD Studentship

Does true Gleason pattern 3 merit its cancer descriptor?

Nearly five decades following its conception, the Gleason grading system remains a cornerstone in the prognostication and management of patients with prostate cancer. In the past few years, a debate has been growing whether Gleason score 3 + 3 = 6 prostate cancer is a clinically significant disease. Clinical, molecular and genetic research is addressing the question whether well characterized Gleason score 3 + 3 = 6 disease has the ability to affect the morbidity and quality of life of an individual in whom it is diagnosed. The consequences of treatment of Gleason score 3 + 3 = 6 disease are considerable; few men get through their treatments without sustaining some harm. Further modification of the classification of prostate cancer and dropping the label cancer for Gleason score 3 + 3 = 6 disease might be warranted

Genomic analysis of 6,000-year-old cultivated grain illuminates the domestication history of barley

The cereal grass barley was domesticated about 10,000 years ago in the Fertile Crescent and became a founder crop of Neolithic agriculture. Here, we report genome sequences of five 6,000-year-old barley grains excavated at a cave in the Judean Desert close to the Dead Sea. Comparison to whole exome sequence data from a diversity panel of present-day barley accessions revealed the close affinity of ancient samples to extant landraces from the Southern Levant and Egypt, consistent with a proposed origin of domesticated barley in the Upper Jordan Valley. Our findings suggest that barley landraces grown in present-day Israel in the past six millennia have not experienced a major lineage turnover although there is evidence for gene flow between cultivated and sympatric wild populations. We show the utility of ancient genomes from desiccated archaeobotanical remains in informing research into the origin, early domestication and subsequent migration of crop species

Uncertainty in the Tail of the Variant Creutzfeldt-Jakob Disease Epidemic in the UK

Despite low case numbers the variant Creutzfeldt-Jakob disease epidemic poses many challenges for public health planning due to remaining uncertainties in disease biology and transmission routes. We develop a stochastic model for variant CJD transmission, taking into account the known transmission routes (food and red-cell transfusion) to assess the remaining uncertainty in the epidemic. We use Bayesian methods to obtain scenarios consistent with current data. Our results show a potentially long but uncertain tail in the epidemic, with a peak annual incidence of around 11 cases, but the 95% credibility interval between 1 and 65 cases. These cases are predicted to be due to past food-borne transmissions occurring in previously mostly unaffected genotypes and to transmissions via blood transfusion in all genotypes. However, we also show that the latter are unlikely to be identifiable as transfusion-associated cases by case-linking. Regardless of the numbers of future cases, even in the absence of any further control measures, we do not find any self-sustaining epidemics