Reliability of a computerized system for strabismus screening

AIM:To evaluate the reliability of Photo-Hirschberg screening for global strabismus performed by non-specialized personnel.METHODS:Participants at three sites were enrolled.One person at each site was trained in visual acuity measurement and use of the computerized system.Visual acuity was measured,and strabismus testing was performed using two flash photographs.All data from the three primary observers were sent to an experienced assistant researcher,who was blinded to the primary results,for re-evaluation.The primary and re-evaluation results of the Photo-Hirschberg screenings using weighted kappa for agreement were compared.RESULTS:The study included 181 participants(88 males and 93 females)and the results for primary and re-evaluation screenings were corresponded.Ten participants with contrasting results presented with unclear corneal light reflex.Sensitivity and specificity were 100%[95%confidence interval(CI):29.0%-100%]and 99.4%(95%CI:96.6%-100%),respectively,based on the Agresti test of the primary evaluation,considering the re-evaluated classification as true.CONCLUSION:The computerized system can be used for primary strabismus screening by non-specialized personnel,with 98.8%agreement with specialists.However,it cannot be used as a substitute for professional examination.

High-throughput screening system of citrus bacterial cankerassociated transcription factors and its application to the regulation of citrus canker resistance

One of the main diseases that adversely impacts the global citrus industry is citrus bacterial canker(CBC),caused by the bacteria Xanthomonas citri subsp.citri(Xcc).Response to CBC is a complex process,with both proteinDNA as well as protein–protein interactions for the regulatory network.To detect such interactions in CBC resistant regulation,a citrus high-throughput screening system with 203 CBC-inducible transcription factors(TFs),were developed.Screening the upstream regulators of target by yeast-one hybrid(Y1H)methods was also performed.A regulatory module of CBC resistance was identified based on this system.One TF(CsDOF5.8)was explored due to its interactions with the 1-kb promoter fragment of CsPrx25,a resistant gene of CBC involved in reactive oxygen species(ROS)homeostasis regulation.Electrophoretic mobility shift assay(EMSA),dual-LUC assays,as well as transient overexpression of CsDOF5.8,further validated the interactions and transcriptional regulation.The CsDOF5.8–CsPrx25 promoter interaction revealed a complex pathway that governs the regulation of CBC resistance via H2O2homeostasis.The high-throughput Y1H/Y2H screening system could be an efficient tool for studying regulatory pathways or network of CBC resistance regulation.In addition,it could highlight the potential of these candidate genes as targets for efforts to breed CBC-resistant citrus varieties.

Screening and field application of microbial-flooding activator systems

This study aims to further enhance the oil recovery of reservoirs in the Zhong-2 Block of the Gudao Oilfield by identifying the most effective microbial-flooding activator systems and applying them in the field.We began by analyzing the structure of the reservoirs'endogenous microbial communities to understand the potential impact of microbial flooding.This was followed by determining commonly used activator systems based on their abilities to stimulate oil-displacement functional bacteria.Through laboratory experiments on oil displacement efficiency and sweep characteristics,we determined the optimal activator injection method(injection ratio)and the requisite bacterial concentration for maximal microbial-flooding efficacy.Finally,we selected the optimal activator systems and applied them to field tests.Our findings suggest the target block is highly receptive to microbial-flooding.In terms of performance,the activator systems ranked as No.3>No.4>No.1>No.2.Interestingly,a deep activator system,when compared to the top-performing No.3 system,exhibited a higher bacterial concentration peak and longer peaking duration.Optimal oil displacement effects were observed at a 1:4 vol ratio between the No.3 activator and deep activator systems,with bacterial concentrations of up to 106 cells/mL or above.Field tests with the selected activator systems,following a specific injection protocol,demonstrated a notable increase in oil production and a reduction in water cut.

Systematic Analysis of Factors Associated with Late Breast Cancer Screening in Women in Sub-Saharan Africa from 2014 to 2020

Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of late detection, leading to diagnosis at an advanced stage and a reduced chance of survival. Objective: The aim of this study is to identify the factors associated with late detection of breast cancer in women in Sub-Saharan Africa from 2014 to 2020.Setting: This systematic review focuses on sub-Saharan Africa. Methods: We searched for articles in four databases (PubMed, Embase, Global-Health and CINAHL) between 2014 and 2020 and performed a narrative synthesis to organize and group the different factors associated with late breast cancer detection. Result: After reviewing 583 publications, 6 studies were selected, highlighting factors such as lack of awareness, knowledge gaps, difficulties in accessing health services and financial constraints associated with late breast cancer screening. The participants, who ranged in number from 20 to 1776, were mainly aged between 18 and 25, with a mean age of 25 years and 6 months. Conclusion: The analysis enabled us to identify various factors associated with late breast cancer screening. Collaboration between health professionals, community organizations and policy-makers is essential to foster an environment conducive to the prevention and early detection of breast cancer.

Revolutionizing diabetic retinopathy screening and management:The role of artificial intelligence and machine learning

Diabetic retinopathy(DR)remains a leading cause of vision impairment and blindness among individuals with diabetes,necessitating innovative approaches to screening and management.This editorial explores the transformative potential of artificial intelligence(AI)and machine learning(ML)in revolutionizing DR care.AI and ML technologies have demonstrated remarkable advancements in enhancing the accuracy,efficiency,and accessibility of DR screening,helping to overcome barriers to early detection.These technologies leverage vast datasets to identify patterns and predict disease progression with unprecedented precision,enabling clinicians to make more informed decisions.Furthermore,AI-driven solutions hold promise in personalizing management strategies for DR,incorpo-rating predictive analytics to tailor interventions and optimize treatment path-ways.By automating routine tasks,AI can reduce the burden on healthcare providers,allowing for a more focused allocation of resources towards complex patient care.This review aims to evaluate the current advancements and applic-ations of AI and ML in DR screening,and to discuss the potential of these techno-logies in developing personalized management strategies,ultimately aiming to improve patient outcomes and reduce the global burden of DR.The integration of AI and ML in DR care represents a paradigm shift,offering a glimpse into the future of ophthalmic healthcare.

Importance of neonatal screening:A case study of sickle cell disease and cystic fibrosis coexistence

BACKGROUND Neonatal screening(NS)is a public health policy to identify genetic pathologies such as cystic fibrosis(CF),sickle cell disease,and other diseases.Sickle cell disea-se is the comprehensive term for a group of hemoglobinopathies characterized by the presence of hemoglobin S.CF is an autosomal recessive multisystemic disease with pathophysiology involving deleterious mutations in the transmembrane re-gulatory gene that encodes a protein that regulates the activity of chloride and sodium channels in the cell surface epithelium.NS is crucial for early diagnosis and management,which ensures a better quality of life.AIM To report a case of the coexistence of sickle cell anemia(SCA)and CF and perform an integrative literature review.METHODS This is an observational study and a review of the literature focusing on two rare genetic pathologies identified simultaneously in NS from the perspective of a clinical case.The authors identified only 5 cases of SCA associated with CF.No clinical trials or review articles were identified considering the rarity of the coexistence of these two pathologies.RESULTS Herein,the authors reported the case of a girl who after undergoing NS on day 8 of life was diagnosed with SCA with an alteration in the dosage of immunoreactive trypsin.The diagnosis of CF was confirmed by the Coulometry Sweat Test.The rarity of the co-occurrence of these two severe genetic pathologies(CF and SCA)is a challenge for medical science.CONCLUSION This study adds to the few case reports present in the literature that highlight the identification of two severe diseases via NS.

Screening and Isolation of Highly Efficient Cellulose-degrading Microorganisms and Construction of Complex Microbial System

This study almed to screen a highIy efficient ceI uIose-degrading compIex microbial system from soiI and rotten straw and then study its appIication to natural ceI uIose. The isoIated stralns were preIiminariIy screened with Congo red stalning and the ceI uIases activities were determined with DNS method. The non-antagonis-tic highIy efficient ceI uIos-degrading stralns were seIected and cuItured combinedIy for deveIoping a ceI uIose-degrading compIex microbial system. The resuIts showed that the CMC enzyme activity of the mixed cuIture of the three fungi stralns was higher than those of the cuItures of the three singIe stralns. The morphoIogical and moIecuIar bioIogical identification indicated that F1 was Botryosphaeria, F2 was Rhi-zopus oryzae, and F5 was Fusarium oxysporum. When straw was used as carbon source, the CMC enzyme activities of F1, F2 and F5 were 39.2, 31.4 and 40.6 IU/mI, respectiveIy; whiIe the CMC enzyme activity of the mixed cuIture of F1＋F2＋F5 was 50.12 IU/mI, which was increased by 23% compared to that of the singIe straln of F5. The experimental resuIts indicated that the ceI uIose-degrading effect of the compIex microbial system was better than those of the singIe fungi stralns, and the singIe stralns of F1, F2 and F5 had certaln deveIopment potentials.

VOLUMETRIC-SWEPT DISPLAY SYSTEM BASED ON HELIX ROTATING SCREEN AND DMD

Based on the helix rotating screen and the digital micro-mirror device （DMD）, the former proto of volumetric-swept display system is improved. The 3-D display system adopting a helix rotating screen to construct an imaging space meliorate the defects, such as the smaller image space, the fewer voxels and the severer voxel overlap dead zone caused by planar rotating screen. DMD with spatial light modular （SLM） technology increases the transmission bandwidth of 3-D data in the voxel activation subsystem and activate multi-voxel once time. The volumetric-swept system based on helix rotating screen and DMD is developed. The experimental results show that the image space, the vision dead zone, the voxels on slice, and the voxel activation capacity of the designed proto are superior to the plane rotating screen system.

Utility of the Asia-Pacific colorectal screening scoring system and the presence of metabolic syndrome components in screening for sporadic colorectal cancer

AIM: To determine the utility of the Asia-Pacific colorectal screening (APCS) scoring system and metabolic syndrome components in individual screening for sporadic colorectal cancer.

Systematic review of colorectal cancer screening guidelines for average-risk adults: Summarizing the current global recommendations

AIM To summarize and compare worldwide colorectal cancer(CRC) screening recommendations in order to identify similarities and disparities.METHODS A systematic literature search was performed using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge identifying all average-risk CRC screening guideline publications within the last ten years and/or position statements published in the last 2 years. In addition, a hand-search of the webpages of National Gastroenterology Society websites, the National Guideline Clearinghouse, the BMJ Clinical Evidence website,Google and Google Scholar was performed. RESULTS Fifteen guidelines were identified. Six guidelines were published in North America, four in Europe, four in Asia and one from the World Gastroenterology Organization. The majority of guidelines recommend screening average-risk individuals between ages 50 and 75 using colonoscopy(every 10 years), or flexible sigmoidoscopy(FS, every 5 years) or fecal occult blood test(FOBT, mainly the Fecal Immunochemical Test, annually or biennially). Disparities throughout the different guidelines are found relating to the use of colonoscopy, rank order between test, screening intervals and optimal age ranges for screening. CONCLUSION Average risk individuals between 50 and 75 years should undergo CRC screening. Recommendations for optimal surveillance intervals, preferred tests/test cascade as well as the optimal timing when to start and stop screening differ regionally and should be considered for clinical decision making. Furthermore, local resource availability and patient preferences are important to increase CRC screening uptake, as any screening is better than none.

Systematic review of nutrition screening and assessment in inflammatory bowel disease

BACKGROUND Malnutrition is prevalent in inflammatory bowel disease (IBD). Multiple nutrition screening (NST) and assessment tools (NAT) have been developed for general populations, but the evidence in patients with IBD remains unclear. AIM To systematically review the prevalence of abnormalities on NSTs and NATs, whether NSTs are associated with NATs, and whether they predict clinical outcomes in patients with IBD. METHODS Comprehensive searches performed in Medline, CINAHL Plus and PubMed. Included: English language studies correlating NSTs with NATs or NSTs/NATs with clinical outcomes in IBD. Excluded: Review articles/case studies;use of body mass index/laboratory values as sole NST/NAT;age<16. RESULTS Of 16 studies and 1618 patients were included, 72% Crohn’s disease and 28% ulcerative colitis. Four NSTs (the Malnutrition Universal Screening Tool, Malnutrition Inflammation Risk Tool (MIRT), Saskatchewan Inflammatory Bowel Disease Nutrition Risk Tool (SaskIBD-NRT) and Nutrition Risk Screening 2002 (NRS-2002) were significantly associated with nutritional assessment measures of sarcopenia and the Subjective Global Assessment (SGA). Three NSTs (MIRT, NRS-2002 and Nutritional Risk Index) were associated with clinical outcomes including hospitalizations, need for surgery, disease flares, and length of stay (LOS). Sarcopenia was the most commonly evaluated NAT associated with outcomes including the need for surgery and post-operative complications. The SGA was not associated with clinical outcomes aside from LOS. CONCLUSION There is limited evidence correlating NSTs, NATs and clinical outcomes in IBD. Although studies support the association of NSTs/NATs with relevant outcomes, the heterogeneity calls for further studies before an optimal tool can be recommended. The NRS-2002, measures of sarcopenia and developments of novel NSTs/NATs, such as the MIRT, represent key, clinically-relevant areas for future exploration.

Screening for pancreatic cancer in familial high-risk individuals: A systematic review

AIM:To analyze the benefits and harms of pancreatic cancer screening in familial high-risk individuals(HRIs).METHODS:Studies were identified by searching PubMed,EBSCO,ClinicalTrials.gov and the Cochrane database from database inception to June 2014.We also obtained papers from the reference lists of pertinent studies and systematic reviews.Englishlanguage trials and observational studies were searched.The key words used as search terms were "screening" and "surveillance".Cost-effectiveness,diagnostic rate,survival rate,mortality and adverse events were the outcomes of interest.Age,sex,lifestyle and other confounding factors were also considered.However,anticipating only a few of these studies,we also included observational studies with or without control groups.We also included studies concerning the anxiety associated with pancreatic cancer risk and other psychological changes in familial HRIs.We extracted details on study design,objectives,population characteristics,inclusion criteria,year of enrollment,method of screening,adjusted and unadjusted mortality,cost-effectiveness and adverse events from the included studies.Studies were assessed using the Reporting of Observational studies in Epidemiology(STROBE) checklist.RESULTS:Sixteen studies on pancreatic cancer screening were included.Five studies included control groups,nine were observational studies without control groups,and the other two studies investigated the worry associated with pancreatic cancer risk.We found that pancreatic cancer screening resulted in a high curative resection rate(60%vs 25%,P = 0.011),longer median survival time(14.5 mo vs 4 mo,P < 0.001),and higher 3-year survival rate(20%vs 15.0%,P =0.624).We also found that familial HRIs had a higher diagnostic rate of pancreatic tumors than controls(34%vs 7.2%,P< 0.001).In patients who underwent regular physical examinations,more stage I pancreatic cancers were observed(19%vs 2.6%,P= 0.001).In addition,endoscopic ultrasonography,which was the main means of detection,diagnosed 64.3%of pancreatic cancers.In comparison,endoscopic retrograde cannulation of the pancreas,magnetic resonance imaging,and computed tomography diagnosed 28.6%,42.9%,and21.4%,respectively.For mass lesions,instant surgery was recommended because of the beneficial effects of post-operative chemotherapy.However,in patients with intraductal papillary mucinous neoplasms,we did not find a significant difference in outcome between surgery and follow-up without treatment.Moreover,pancreatic cancer screening in familial HRIs had a greater perceived risk of pancreatic cancer(P< 0.0001),higher levels of anxiety regarding pancreatic cancer(P< 0.0001),and increased economic burden.CONCLUSION:Pancreatic cancer screening in familial HRIs is associated with a higher detection rate and longer survival,although screening may influence psychological function and increase the economic burden.

Hypertension Screening and Follow-up Management by Primary Health Care System among Chinese Population Aged 35 Years and Above

Objective To describe hypertension screening and follow-up management among Chinese population aged 35 years and above within the primary health care system. Methods Data from 2010 China Chronic Disease and Risk Factor Surveillance System were used. We investigated previous hypertension diagnosis, screening, and follow-up assessments within the primary health care system. The prevalence of self-reported and criterion-based hypertension, screening rates, demographic and socioeconomic characteristics associated with screening, and patterns of follow-up assessments were recorded. The SAS software system was used for statistical analyses. Results About 17.1% reported a previous hypertension diagnosis. The rate difference between the two measures of prevalence was 27.2%. Among those without self-reported hypertension, 27.7% reported never visiting a clinic during the past I year and 60.4% of those attending a clinic reported ever being screened. Younger age group was associated with lower screening proportion; odds ratios of 35-, 45-, 55-, and 〉65 years were 1.7 （95% CI： 1.5-1.9）, 1.5 （95% CI： 1.3-1.7）, 1.3 （95% CI： 1.2-1.4）, and 1.0, respectively. About 35.1% of the patients had undergone follow-up assessments four or more times during the past I year. Conclusion Majority of the Chinese population aged 35 years and above, particularly the less educated, elderly population, and rural residents were unaware of that they were suffering from hypertension. Most patients did not receive enough management services by the primary health care system. Thus, strengthening both the screening and follow-up management is needed.

A new method of detecting interferogram in differential phase-contrast imaging system based on special structured x-ray scintillator screen

An x-ray scintillator screen with a special structure, functioning as detector and analyser grating, was proposed for collecting the interferogram of differential phase contrast imaging without absorption grating and difficulty of fabrication by a state of the art technique. On the basis of phase grating diffraction, a detecting model of the scintillator screen was built for analysing the phase and absorption information of objects. According to the analysis, a new method of phase retrievals based on two-images and the optimal structure of screen were presented.

Carrier frequency of HLA-DQB1*02 allele in patients affected with celiac disease:A systematic review assessing the potential rationale of a targeted allelic genotyping as a first-line screening

BACKGROUND Celiac Disease(CD)is an immune-mediated disorder,in which the HLA immunogenetic background(DQ2 and DQ8 heterodimers)and environmental trigger(gluten)are well established.Indeed,both factors are necessary–but not sufficient–to develop CD.However,it is very likely that CD is underdiagnosed in both developing and developed countries,due to several aspects,including the fact that a lot of patients present mild and/or atypical symptoms,without the presence of any recognized risk factors.Therefore,the possibility and feasibility of widened screening strategies to identify CD patients are debated.AIM To provide further evidence of the main epidemiological importance of HLADQB1*02 allele in the population of CD patients.METHODS We performed a systematic search in PubMed,EMBASE,Cochrane,Web of Science and Scopus databases,in order to produce a systematic review assessing the carrier frequency of HLA-DQB1*02 allele in the celiac population.Following the PRISMA guidelines,we retrieved all the original articles describing CD patients’HLA-DQB1 genotype in such a way that could allow to assess the HLADQB1*02 carrier frequency among CD patients,along with the evidence of the appropriate diagnostic work-up to achieve a correct and final diagnosis of CD.RESULTS The final output of this systematic search in the medical literature consisted of 38 studies providing the appropriate HLA-DQB1 genotype information of the respective CD population.According to this systematic review,including a pool of 4945 HLA-DQ genotyped CD patients,the HLA-DQB1*02 carrier frequency was 94.94%,meaning that only 5.06%of CD patients were completely lacking this allelic variant.Interestingly,if we consider only the studies whereby the prevalence of CD patients affected with type 1 diabetes mellitus was supposed or clearly established to be very low,the frequency of non-HLA-DQB1*02 carriers among CD patients dropped to 3.65%.CONCLUSION Such a high carrier frequency of the HLA-DQB1*02 allelic variant(which is>95%-96%in CD patients without risk factors,like type 1 diabetes mellitus comorbidity)might be exploited to consider a cost-effective and widened screening approach.If a sustainable strategy could be implemented through a low-cost targeted genetic test to detect the individual presence of HLA-DQB1*02 allele,an appropriate algorithm for serological screening in individuals resulting to be genetically predisposed to CD,might be considered.

Rationale and Design of the Randomized Controlled Trial of Intensive Versus Usual ECG Screening for Atrial Fibrillation in Elderly Chinese by an Automated ECG System in Community Health Centers in Shanghai(AF-CATCH)

Objective:The randomized controlled trial(ClinicalTrials.gov identifier NCT02990741)will investigate whether more frequent electrocardiographic(ECG)recordings and analyses with an automated ECG system would improve detection of atrial fibrillation compared with a single annual ECG screen in elderly Chinese in community health centers.Design:Men and women(≥65 years)will be randomized into intensive(n=3500)and usual(n=3500)screening groups,and within the intensive screening group into intensive screening(n=2625)and more intensive screening(n=875)subgroups.ECG recordings will be performed with an automated ECG analysis system(AliveCor heart monitor)at 1 year in the usual screening group,at 3,6,9,and 12 months in the intensive screening subgroup,and at 1,2,3,and 4 weeks and 3,6,9,and 12 months in the more intensive screening subgroup.The primary outcome is the detection rate of atrial fibrillation between the usual screening group and the intensive screening group.Sample size estimation was based on a projected detection rate of atrial fibrillation of 2.0% by a single ECG recording at 12 months,an improvement of 50% with more frequent ECG recordings,α=0.05,power of 80%,and a one-sided test.Conclusions:The trial will provide evidence on the clinical effectiveness of more frequent ECG recordings by a handheld automated analysis system in the detection of atrial fibrillation.

Systemic changes and adverse effects induced by retinopathy of prematurity screening

AIM: To estimate the potential systemic events during and after retinopathy of prematurity (ROP) screening. ' METHODS: A prospective and descriptive designed study was conducted to detect the physiologic and pathological changes 24h before, during, and 72h after ROP screening. Control blood pressure (BP), saturation, pulse rate, and body temperature were routinely taken at various time internals before and after screening. Adverse effects pertain to cardiovascular system, respiratory system, gastric system, urinary system and nervous system were retrospect 0-72h after ROP screening at a 24-hour interval. RESULTS: Totally 1254 prematurity babies receiving ROP screening during Jan. 1st 2013 to Dec. 31th 2013 were enrolled in our survey. Compared to control vital sign data taken before the examination, there was a fluctuation in the diastolic BP with the increased 3.03 mm Hg (P=0.04) after 3 doses of mydriatic drops. Immediately after the examination, there was a further 12.64 mm Hg (P<0.01) increase in systolic BP and a 7.24 mm Hg (P<0.01) in diastolic BP. The mean pulse rate during examination was 22.4 bpm (P<0.01) higher than the 133.3 +/- 9.0 bpm control level. The oxygen saturation shared an average drop of 5% (P<0.01) during screening. In prematurity with postconceptional age less than 31wk, the incidence of apnea (23.5%), necrotizing enterocolitis (NEC) (8.7%), gastric residual (25.4%) and upper digestive tract hemorrhage (6.4%) also demonstrated a significant rise (P<0.01). CONCLUSION: In our study sample, ROP screening was associated with NEC, gastric residual and upper digestive tract hemorrhage. These gastrointestinal side effects, along with breath activity pattern change and vital signs indicators fluctuation, may be results of additional stress responses.

Study on the Holdup and Mass Transfer Performances for Gas-Liquid-Liquid System in a Screen Plate Column

The gas and dispersed phase holdups and mass transfer coefficients of liquid-iquid were determined for gas-liquid-liquid three phase system in a screen plate column. The flow pattern of gas-liquid-liquid three phase system was studied under different gas velocities. The shape factors showed the geometric properties of screen plates and the corrected drop characteristic velocities were introduced. The phase holdup in two phases was correlated. The research results indicated that mass transfer coefficient for liquid-liquid system in a column with screen plates and gas agitation was found to increase apparently.

Screening of Peripheral Artery Disease by Systematic Measurement of Ankle-Brachial Index among Diabetic Patients in Dakar

Introduction: The peripheral artery disease (PAD) is one of the chronic and frightening vascular complications of the diabetes whose tracking can be done by the Ankle-Brachial Index (ABI) measurement. We conducted in this context a study which consisted in measuring the ABI among hospitalized diabetic patients at Teaching Hospital of Pikine in Dakar, over 18 months’ duration. The aim was to determine the prevalence and evaluate factors correlated to the presence of the PAD. Patients and Method: This cross-sectional descriptive study interested the whole of diabetic patients hospitalized in Internal Medicine/Endocrinology Department, from January 2013 to June 2014. We carried out a complete clinical examination associated with ABI measurement by a Doppler probe for each included patient after having collected the clinical and paraclinical data. Results: Our population of study comprised 209 diabetic patients with a female predominance (126, 60.3%). The sex-ratio man/woman was 0.6. The median age of the population of study was 54 ± 2 years. In our series, 157 (75.1%) patients discovered their diabetes with the waning of an affection while the 52 (24.9%) other patients discovered their diabetes at the time of a systematic assessment. The PAD appeared by an intermittent claudication among 38 patients (18.2%). The ABI was normal for 126 patients (60.3%). The ABI was low for 51 patients (24.4%), unilateral in 3.8% of cases and bilateral in 20.6% of cases. The ABI was high among 32 patients (15.3%), unilateral in 7.2% of cases and bilateral in 8.1% of cases. The ABI extremes values were 0.11 and 2. In the population of study, 46 patients (22%) had a well-compensated PAD. The PAD was low compensated for 3 patients (1.4%) and severe for 2 patients (1%). The ABI was more frequent and significantly among women than men, with 32 cases (25.4%) against 19 (22.9%) cases (p = 0.021). The proportion of low ABI was more important among patients whose diabetes had evolved for more than 5 years (42.3% of cases) with a peak of frequency in the duration of 6 - 10 years (47.7% of cases). Conclusion: The PAD global prevalence among hospitalized diabetic patients appeared high with 24.4% patients presenting low ABI. Its early diagnosis among subjects at risk as for our study population allowed identifying asymptomatic subjects having another cardiovascular damage. Thus, the screening of obstructive arteriopathy of lower limb PAD by the measurement of ABI should be applied to all diabetic patients for a better assessment of atherosclerotic complication.

Development of an in vitro macrophage screening system on the immunomodulating effects of feed components

Background:While feed components capable of modulating the immune system are highly sought after and marketed,often little evidence is available to support functional immune response claims.Thus,a high-throughput in vitro cell screening system was developed to test these compounds for innate immune signaling effects,using Saccharomyces cerevisiae and its cell wall components in addition to lauric acid and its esters as models in two separate experiments.This screening system utilized RAW 264.7 murine macrophages to assess live S.cerevisiae cells and S.cerevisiae-derived cell wall componentsβ-glucan,mannan,and zymosan(a crude cell wall preparation containing bothβ-glucan and mannan).D-mannose was also evaluated as the monomer of mannan.We also examined the effect of a saturated fatty acid(C12:0,lauric acid)and its esters(methyl laurate and glycerol monolaurate)on innate immune cell activation and cellular metabolism.RAW cells were transfected with a vector that drives expression of alkaline phosphatase upon promoter activation of nuclear factorκ-light-chain-enhancer of activated B cells(NFκB),a major inflammatory/immune transcription factor.RAW cells were incubated with 0.01,0.1 or 1 mg/mL of yeast compounds alone or RAW cells were challenged with LPS and then incubated with yeast compounds.In a separate experiment,RAW cells were incubated with 0,0.5,2.5,12.5,62.5,and 312.5μmol/L of lauric acid,methyl laurate,or glycerol monolaurate alone,or RAW cells were challenged with LPS and then incubated with fatty acid treatments.Results:Treatment with zymosan orβ-glucan alone induced NFκB activation in a dose-dependent manner,whereas treatment with D-mannose,mannan,or live S.cerevisiae cells did not.Post-treatment with mannan after an LPS challenge decreased NFκB activation,suggesting that this treatment may ameliorate LPS-induced inflammation.Slight increases in NFκB activation were found when fatty acid treatments were applied in the absence of LPS,yet substantial reductions in NFκB activation were seen when treatments were applied following an LPS challenge.Conclusions:Overall,this cell screening system using RAW macrophages was effective,high-throughput,and sensitive to feed components combined with LPS challenges,indicating modulation of innate immune signaling in vitro.