Search Results (13)

Background: Psoriatic arthritis (PsA) is characterized by enthesitis. As persistent inflammation around joints results in bone and cartilage destruction and physical impairment, a detailed assessment of inflammation is essential. We previously reported the difference between clinical assessment (tenderness) and ultrasound (US) assessment (inflammation) of entheses. Herein, we investigated whether clinical or US assessment of joints and entheses can predict the progression of joint destruction in Japanese patients with PsA. Methods: Thirty joints and 14 entheses in 47 patients were assessed using US and clinical examination. The US greyscale (GS) and power Doppler (PD) scores at the ultrasonographic synovitis, the US active enthesitis count, and the clinical tender joint/entheses count were assessed. Additionally, the yearly radiographic progression of the Sharp–van der Heijde scoring method for PsA was assessed. Their correlations were investigated. Results: About half of the patients with PsA experienced joint destruction during a follow-up period of 20.4 months. Progression of joint destruction in patients with PsA only correlated with joint GS and PD scores, reflecting the severity of ultrasonographic synovitis, not with the tender joint/entheses count. Conclusions: US examinations are essential for preventing joint destruction and physical impairment in patients with PsA. Full article

Ungulates play a large role in shaping ecosystems and communities by influencing plant composition, structure, and productivity. We investigated the summer diets of feral burros in two ecosystems in which they are found in the United States: a subtropical desert in Arizona and a temperate juniper shrubland in Utah. Between 24 June and 16 July of 2019, we gathered 50 burro fecal samples from each location and used plant DNA metabarcoding to determine the burros’ diets. We found that during our sampling period the burros in the Sonoran Desert consumed a higher proportion of woody browse and had a narrower dietary niche breadth and lower degree of diet diversity compared to the burros in the juniper shrubland ecosystem, where the burros consumed higher proportions of graminoids and forbs and had a higher diet diversity index and broader dietary niche breadth. The burros in the Sonoran Desert relied primarily on Prosopis spp. (mesquite) and Poaceae grasses, whereas the burros in the juniper shrubland relied on a wider variety of forb and grass species, likely due to the greater variability in the forage species temporally and spatially available in that temperate ecosystem. We found that feral burros are highly adaptable with respect to diet and appear to be employing a mixed feeding strategy, similar to their ancestor, the African wild ass, to meet their nutritional needs in whichever ecosystem they are found. Full article

(1) Background: This study examines the survival of patients after their first presentation with diabetic foot ulcers (DFUs) to the regional Diabetes, Nutrition, and Metabolic Diseases Clinic within the Emergency Clinical Hospital “Sf. Spiridon”, Iaşi, and analyzes the factors associated with this outcome. (2) Methods: In this retrospective study, patients with DFUs consecutively referred between 1 January 2007 and 31 December 2017 were followed up until 31 December 2020 (for 13 years). The study group included 659 subjects. (3) Results: During the study period, there were 278 deaths (42.2%) and the average survival time was 9 years. The length of hospitalization, diabetic nephropathy, chronic kidney disease, glomerular filtration rate, cardiovascular disease, hypertension, anemia, and DFU severity were the most significant contributors to the increase in mortality. Patients with severe ulcers, meaning DFUs involving the tendon, joint, or bone, had a higher mortality risk than those with superficial or pre-ulcerative lesions on initial presentation (Texas classification HR = 1.963, 95% CI: 1.063–3.617; Wagner–Meggitt classification HR = 1.889, 95% CI: 1.024–3.417, SINBAD Classification System and Score HR = 2.333, 95% CI: 1.258–4.326) after adjusting for confounding factors. (4) Conclusions: The findings of this study suggested that patients presenting with severe ulcers involving the tendon, joint, or bone exhibited a significantly higher risk of mortality, even when potential confounders were taken into consideration. Full article

Despite clear evidence of inadequate angiogenesis in ischemic diabetic foot syndrome (DFS) pathogenesis, angiogenic factor level changes in patients with ischemic DFS remain inconsistent. This study aimed to assess circulating angiogenic factors concerning ischemic DFS advancement and describe their relationships with patients’ clinical characteristics, microvascular parameters, and diabetic control. The study included 41 patients with ischemic DFS (67.3 (8.84) years; 82.9% males). Angiogenic processes were assessed by identifying circulating concentrations of five pro- and two anti-angiogenic factors. We found that penetrating ulcers were related to a significantly higher FGF-2 level (8.86 (5.29) vs. 5.23 (4.17) pg/mL, p = 0.02). Moreover, plasma FGF-2 showed a significant correlation with the SINBAD score (r = 0.32, p = 0.04), platelet count (r = 0.43, p < 0.01), white cell count (r = 0.42, p < 0.01), and age (r = −0.35, p = 0.03). We did not observe any significant linear relationship between the studied biomarkers and microcirculatory parameters, nor for glycemic control. In a univariate analysis using logistic regression, an increase in plasma FGF-2 was tied to greater odds of high-grade ulcers (OR 1.16; 95% CI 1.02–1.38, p = 0.043). This suggests that circulating FGF-2 may serve as a potential biomarker for predicting DFU advancement and progression. It is necessary to conduct further studies with follow-up observations to confirm this hypothesis. Full article

The energy group structure of a multi-group cross section library matched with a deterministic method has a significant influence on shielding calculation. The complex resonance cross section of Fe-56 has a significant influence on accuracy with different energy group structures when processing multi-group cross section data. In this study, in order to more accurately test the influence of the iron resonance phenomenon on shielding calculations, this group structure is modified by the 199-group with 69 points interpolated into its group boundaries at an energy range from 1.1 keV to 3.1164 MeV. The new 269-group library is then tested with selected SINBAD iron sphere benchmarks and compared with the results of 199-group, 299-group, and 172-group libraries and measurements. Upon analysis, it is shown that the resonance of Fe-56 has a great influence on the accuracy of the calculated leakage. Further, it is noted that the finer the energy group division, the greater the calculated leakage fluctuation, and the deeper the neutron passes through the iron sphere, the larger the calculated leakage fluctuation. This study and its leakage results may provide a good reference for the development of new multi-group structures for present and future shielding design. Full article

The shielding calculation of neutron streaming problems with ducts is characterized by the strong anisotropy of angular flux, which poses a challenge for the analysis of nuclear installations. The discrete ordinate method is one of the most commonly deterministic techniques to solve the neutron transport equation, in which the accuracy and efficiency neutron are crucial to ensure the reliability of the streaming shielding simulation. We implemented the goal-oriented multi-collision source algorithm in the 3D transport code ARES. This algorithm can determine the importance factor based on the adjoint transport calculation, obtain the response function to enable problem-dependent, goal-oriented spatial decomposition, and provide the error estimation as a driving force behind the dynamic quadrature to optimize the source iteration. This study focuses on verifying the goal-oriented multi-collision source algorithm under the neutron streaming problems, and the capabilities of the algorithm have been tested on IRI-TUB benchmark of SINBAD database. The numerical results show that the algorithm can effectively control the angular discretization error for the neutron streaming problems, which is more economical than the traditional discrete ordinate calculation. Full article

Over the years, the generation and acceleration of ultra-short, high quality electron beams has attracted more and more interest in accelerator science. Electron bunches with these properties are necessary to operate and test novel diagnostics and advanced high-gradient accelerating schemes, such as plasma accelerators and dielectric laser accelerators. Furthermore, several medical and industrial applications require high-brightness electron beams. The dedicated R&D facility ARES at DESY (Deutsches Elektronen-Synchrotron) will provide such probe beams in the upcoming years. After the setup of the normal-conducting, radio-frequency (RF) photoinjector and linear accelerating structures, ARES successfully started the beam commissioning of the RF gun. This paper gives an overview of the ARES photoinjector setup and summarizes the results of the gun commissioning process. The quality of the first electron beams is characterized in terms of charge, momentum, momentum spread and beam size. Additionally, the dependencies of the beam parameters on RF settings are described. All measurement results of the characterized beams fulfill the requirements for operating the ARES linac with this RF photoinjector. Full article

Consistent consumption of high salt diet (HSD) has been associated with increased cellular generation of free radicals, which has been implicated in the derangement of some vital organs and etiology of cardiovascular disorders. This study was designed to investigate the combined effect of some commonly employed medicinal plants on serum lipid profile and antioxidant status of aorta, kidney, and liver of high salt diet-fed animals. Out of the total fifty male Wistar rats obtained, fifteen were used for acute toxicity study, while the remaining thirty-five were divided into 5 groups of 7 animals each. Group 1 and 2 animals were fed normal rat chow (NRC) and 16% high salt diet (HSD) only, respectively. Animals in groups 3, 4 and 5 were fed 16% HSD with 800, 400, and 200 mg/kg bw poly-herbal extract (PHE), respectively, once for 28 consecutive days. Serum low-density lipoprotein (LDL), triacylglycerol (TG), total cholesterol (TC) and high-density lipoprotein (HDL), malondialdehyde, nitric oxide, catalase, superoxide dismutase, glutathione peroxidase, glutathione concentration, and activities were assessed in the aorta, kidney, and liver. Poly-herbal extract (p < 0.05) significantly reduced malondialdehyde and nitric oxide concentrations and also increased antioxidant enzymes and glutathione activity. Elevated serum TG, TC, LDL, and TC content in HSD-fed animals were significantly (p < 0.05) reduced to normal in PHE-treated rats while HDL was significantly elevated (p < 0.05) in a concentration-dependent manner in PHE treated animals. Feeding with PHE attenuated high-salt diet imposed derangement in serum lipid profile and antioxidant status in the organs of the experimental rats. Full article

Background: This study reviews the mortality of patients with diabetic foot ulcers (DFU) from the first consultation with a Multidisciplinary Diabetic Foot Team (MDFT) and analyzes the main cause of death, as well as the relevant clinical factors associated with survival. Methods: Data of 338 consecutive patients referred to the MDFT center for a new DFU during the 2008–2014 period were analyzed. Follow-up: until death or until 30 April 2020, for up to 12.2 years. Results: Clinical characteristics: median age was 71 years, 92.9% had type 2 diabetes, and about 50% had micro-macrovascular complications. Ulcer characteristics: Wagner grade 1–2 (82.3%), ischemic (49.2%), and infected ulcers (56.2%). During follow-up, 201 patients died (59.5%), 110 (54.7%) due to cardiovascular disease. Kaplan—Meier curves estimated a reduction in survival of 60% with a 95% confidence interval (95% CI), (54.7–65.3) at 5 years. Cox regression analysis adjusted to a multivariate model showed the following associations with mortality, with hazard ratios (HRs) (95% CI): age, 1.07 (1.05–1.08); HbA1c value < 7% (53 mmol/mol), 1.43 (1.02–2.0); active smoking, 1.59 (1.02–2.47); ischemic heart or cerebrovascular disease, 1.55 (1.15–2.11); chronic kidney disease, 1.86 (1.37–2.53); and ulcer severity (SINBAD system) 1.12 (1.02–1.26). Conclusion: Patients with a history of DFU have high mortality. Two less known predictors of mortality were identified: HbA1c value < 7% (53 mmol/mol) and ulcer severity. Full article

The amputation rate in patients with diabetes is 15 to 40 times higher than in patients without diabetes. To avoid major complications, the identification of high-risk in patients with diabetes through early assessment highlights as a crucial action. Clinician assessment tools are scales in which clinical examiners are specifically trained to make a correct judgment based on patient outcomes that helps to identify at-risk patients and monitor the intervention. The aim of this study is to carry out a systematic review of valid and reliable Clinician assessment tools for measuring diabetic foot disease-related variables and analysing their psychometric properties. The databases used were PubMed, Scopus, SciELO, CINAHL, Cochrane, PEDro, and EMBASE. The search terms used were foot, ankle, diabetes, diabetic foot, assessment, tools, instruments, score, scale, validity, and reliability. The results showed 29 validated studies with 39 Clinician assessment tools and six variables. There is limited evidence on all of the psychometric characteristics of the Clinician assessment tools included in this review, although some instruments have been shown to be valid and reliable for the assessment of diabetic neuropathy (Utah Early Neuropathy Scale or UENS); ulceration risk (Queensland High Risk Foot Form or QHRFF); diabetic foot ulcer assessment, scoring, and amputation risk (Perfusion, extent, depth, infection and sensation scale or PEDIS and Site, Ischemia, Neuropathy, Bacterial Infection, and Depth score or SINBAD); and diabetic foot ulcer measurement (Leg Ulcer Measurement Tool LUMT). Full article

Laser driven Wake-Field Acceleration (LWFA) has proven its capability of accelerating electron bunches (e-bunches) to up to 4 GeV energy in a single stage while reaching gradients up to hundreds of GV/m. Because of the short period of the accelerating field (typically ranging from 100 fs to 1 ps duration) and the requirement of extremely small beam size (typically smaller than 1 $\mathsf{\mu }$ m) to match the channel, e-bunches can reach extremely high densities. They can be either extracted directly from the plasma or externally injected. The study of the external injection is interesting for two main reasons. On the one hand this method allows better control of the quality of the input beam and on the other hand it is in general necessary when a staged approach of the accelerator is considered. The interest in producing, characterizing and transporting high brightness ultra-short e-bunches has grown together with the interest in LWFA and other novel high-gradient acceleration techniques. In this paper we will review the principal techniques for producing and shaping ultra-short electron bunches with the example of the SINBAD-ARES (Accelerator Research Experiment at SINBAD) linac at the Deutsches Elektronen-Synchrotron (DESY). Our goal is to show how the design of the SINBAD-ARES linac satisfies the requirements for generating high brightness LWFA probes. In the last part of the paper we shall also comment on the technical challenges for electron control and characterization. Full article

Sphenocentrum jollyanum Pierre is a member of a diverse family of plants known as Menispermaceae. They are famous for a plethora of important biological functions. S. jollyanum is a shrub native to the tropical forest zones of West Africa and thrives in deep shade. It is widely cultivated in Cameroun, Sierra Leone, Nigeria, Ghana, and Côte d’Ivoire. S. jollyanum is employed in folk medicine as a cure for wounds, fever, coughs, high blood pressure, breast tumor, constipation, and as an aphrodisiac. Phytochemical investigations revealed that the plant is a rich source of secondary metabolites such as annin, alkaloids, saponins, and flavonoids. Pharmacological activities include anti-diabetic, anti-inflammatory, anti-bacterial, anti-viral, anti-malarial, angiogenic, and anxiogenic. Thus, this present review summarizes the phytochemical and nutritional constituents and important biological studies on various crude extracts, fractions, and isolated principles of all morphological organs of S. jollyanum. Full article

The present study examines the effect of methanolic extract of T. violacea rhizomes on high cholesterol (2%) diet fed rats (HCD). At the end of 4 weeks, serum total protein, albumin, reduced glutathione (GSH), and markers of oxidative stress viz., catalase (CAT), superoxide dismutase (SOD), thiobarbituric acid reactive substances (TBARS—a marker of lipid peroxidation), glutathione-S-transferase (GST) and glutathione peroxidase (GPx) in the serum, aorta, liver and heart of HCD and normal rats were assessed and compared. A significant (p < 0.05) elevation in TBARS, and a reduction (p < 0.05) in serum total protein, albumin, GSH and antioxidant enzyme activities was observed in tissues of HCD fed rats compared with the normal group. Co-administration of crude extracts of T. violacea rhizomes protected the liver, heart, serum and aorta against HCD-induced lipid peroxidation in a dose dependant manner. The activities of the extract (500 mg/kg) compared favorably with gemfibrozil. The extracts also protected against HCD-induced reduction in serum total protein, GSH and restored the activities of antioxidant tissues (liver, heart and aorta) enzymes to near normal values. This result suggested that consumption of T. violacea rhizome may help to protect against hypercholesterolemia- induced oxidative stress diseases in the heart and liver. Full article