Acute painful diabetic neuropathy: an uncommon, remittent type of acute distal small fibre neuropathy.

INTRODUCTION: Acute painful diabetic neuropathy (APDN) is a distinctive diabetic polyneuropathy and consists of two subtypes: treatment-induced neuropathy (TIN) and diabetic neuropathic cachexia (DNC). The characteristics of APDN are (1.) the small-fibre involvement, (2.) occurrence paradoxically after short-term achievement of good glycaemia control, (3.) intense pain sensation and (4.) eventual recovery. In the face of current recommendations to achieve quickly glycaemic targets, it appears necessary to recognise and understand this neuropathy. METHODS AND RESULTS: Over 2009 to 2012, we reported four cases of APDN. Four patients (three males and one female) were identified and had a mean age at onset of TIN of 47.7 years (±6.99 years). Mean baseline HbA1c was 14.2% (±1.42) and 7.0% (±3.60) after treatment. Mean estimated time to correct HbA1c was 4.5 months (±3.82 months). Three patients presented with a mean time to symptom resolution of 12.7 months (±1.15 months). One patient had an initial normal electroneuromyogram (ENMG) despite the presence of neuropathic symptoms, and a second abnormal ENMG showing axonal and myelin neuropathy. One patient had a peroneal nerve biopsy showing loss of large myelinated fibres as well as unmyelinated fibres, and signs of microangiopathy. CONCLUSIONS: According to the current recommendations of promptly achieving glycaemic targets, it appears necessary to recognise and understand this neuropathy. Based on our observations and data from the literature we propose an algorithmic approach for differential diagnosis and therapeutic management of APDN patients.

The Development of a Survey to Assess the Type of Capacity within Nonprofit Sport Organizations

The topic of organizational capacity and organizational capacity-building has gained importance among Canadian nonprofit sport organizations. This is illustrated by practitioners calling for increased attention to the capacity-building matters of nonprofit organizations, and two critical Canadian federal government documents outlining strategic direction for the nonprofit sport sector. Consequently, the purpose of this quantitative research study was to develop a valid and reliable survey to categorize nonprofit sport organizations into capacity types identified by Stevens (Stevens, 2006). This quantitative research study offers a preliminary development towards achieving a reliable and valid tool for assessing types of nonprofit sport organizational capacity. This research provides interesting insight into what capacity means by organizing the all-encompassing literature into an easy to understand framework. In addition, it sets the stage for future researchers to build upon this survey development process to achieve a reliable and valid capacity measuring tool.

Impact of type of drug insurance on adherence, persistence and costs of antidepressant drugs : a Quebec population-based study

Contexte: À date, il existe peu de données sur l’adhésion, la persistance et les coûts associés aux antidépresseurs selon le type d’assurance médicament (privé ou public). Objectif: Comparer selon le régime d’assurance médicament (privé ou public), l'adhésion, la persistance et les coûts des antidépresseurs. Méthodes de recherche: Une étude de cohorte appariée a été réalisée en utilisant des bases de données du Québec. Sujets: Nous avons sélectionné 194 patients assurés par un régime privé et 1923 patients assurés par le régime public de la Régie de l’assurance maladie du Québec (RAMQ) (18-64 ans) qui ont rempli au moins une ordonnance pour un antidépresseur entre décembre 2007 et septembre 2009. Mesures: L’adhésion, mesurée sur une période d’un an, a été estimée en utilisant le proportion of prescribed days covered (PPDC). Un modèle de régression linéaire a été utilisé afin d’estimer la différence moyenne en PPDC entre les patients assurés par un régime privé et ceux assurés par le régime public de la RAMQ. La persistance a été comparé entre ces deux groupes avec un modèle de régression de survie Cox, et le coût mensuel d'antidépresseurs ($ CAN) a été comparé entre ces deux groupes en utilisant un modèle de régression linéaire. Résultats: Le PPDC parmi les patients assurés par un régime privé était de 86,4% (intervalle de confiance (IC) 95%: 83,3%-89,5%) versus 81,3% (IC 95%: 80,1%-82,5%) pour les patients assurés par le régime public de la RAMQ, pour une différence moyenne ajustée de 6,7% (IC 95%: 3,0%-10,4%). La persistance après un an parmi les patients assurés par un régime privé était de 49,5% versus 18,9% pour les patients assurés par le régime public de la RAMQ (p <0,001), et le rapport de risque ajusté était de 0,48 (IC 95%: 0,30-0,76). Comparativement aux patients assurés par le régime public de la RAMQ, les patients ayant une assurance privée ont payé 14,94 $ CAD (95% CI: $12,30-$17,58) de plus par mois en moyenne pour leurs antidépresseurs. Conclusion: Les patients assurés par un régime privé avaient une meilleure adhésion, persistance, mais avaient aussi un plus haut coût pour leurs antidépresseurs que ceux assurés par le régime public de la RAMQ. Cette différence de coûts peut être due aux différentes exigences de paiement en pharmacie entre les deux régimes ainsi qu’aux limites des honoraires des pharmaciens imposés par le régime public.

Emergence of a new type of porcine circovirus (PCV) in swine: a type 1 and type 2 PCV recombinant.

In late September 2008, tissue samples from piglets experiencing an acute outbreak of porcine reproductive and respiratory syndrome (PRRS) were submitted to the Veterinary diagnostic service of the University of Montreal. Several diagnostic assays were performed including a multiplex real-time quantitative PCR assay (mrtqPCR) for the detection and differentiation of porcine circovirus (PCV) type 2a and 2b genotypes in the lung and lymph nodes. The pig samples were found to be positive for PCV2a using the mrtqPCR but odd results were obtained. The Ct values obtained with mrtqPCR probes targeting the ORF1 and ORF2 of PCV2 were not as expected which suggested the presence of genomic variations in the PCV2 viral genome. Ultimately, a total of three diagnostic cases with mrtqPCR unusual results were investigated. After virus isolation and sequence analyses, a new type of PCV was identified in those three cases. Based on sequence analyses, this new PCV genome contains the ORF1 of PCV1 and the ORF2 of PCV2a and its entire viral genome nucleotide identity compared to PCV1, PCV2a and 2b are 86.4%, 88.7% and 86.5%, respectively. It is proposed to name this new PCV by taking into account the nomenclature of Segales et al. (2008) and by indicating the origin of the ORF1 at first and the origin of the ORF2 in second. Consequently, the name proposed for this new PCV is PCV1/2a. The prevalence of PCV1/2a seems to be very low in Quebec, Canada (2.5% of PCV positive cases), and its origin is now in debate.

Development of a new type of simulated scalar feed

This thesis presents the results of an investigation conducted for the development of a new type of feed horn antenna called "Simulated Scalar Feed". A schematic presentation of the work is given below. A review of the past important work done in the field of conventional/multimode electromagnetic horn antennas is presented in the first part of the second chapter. The work carried out on corrugated horns and surfaces are included in the second part of the review. In the third part, work on dielectric and dielectric loaded metal horns are reviewed. In all the parts of the review, special emphasis is given to theoretical design considerations. The methodology adopted for the experimental investigations is presented in the third chapter. The instrumentation utilized and thThis thesis presents the results of an investigation conducted for the development of a new type of feed horn antenna called "Simulated Scalar Feed". A schematic presentation of the work is given below. A review of the past important work done in the field of conventional/multimode electromagnetic horn antennas is presented in the first part of the second chapter. The work carried out on corrugated horns and surfaces are included in the second part of the review. In the third part, work on dielectric and dielectric loaded metal horns are reviewed. In all the parts of the review, special emphasis is given to theoretical design considerations. The methodology adopted for the experimental investigations is presented in the third chapter. The instrumentation utilized and the details of fabrication ofe details of fabrication of the new simulated scalar feed are described. The method of measurements of radiation characteristics of the antenna are also explained in this chapter. In the fourth chapter the outcome of the experimental results of the investigations carried out on horn antennas fabricated with different physical dimensions and different parameters for the E—plane boundary walls are highlighted. The theoretical explanation used to explain the experimental results is given in the fifth chapter of the thesis. A comparison between the experimental and the theoretical results is also presented in this chapter. In chapter six, the conclusions drawn from the experimental as well as the theoretical investigations are discussed. The advantages and features of the newly developed simulated scalar feed is examined in this chapter. Scope of further investigations in this field is also discussed at the end of this chapter.

Educational inequalities in quantity, duration and type of tobacco consumption among lung cancer patients in Asturias : Epidemiological analices

Resumen tomado de la publicaci??n

Are discourse comprehension and cognitive processes influenced by the type of language language (English and Spanish)? A cross-language study based on elaborative inferences generation

Resumen basado en el de la publicación

Exploring the factorial structure of the Sport Anxiety Scale-2 : invariance across language, gender, age and type of sport

Resumen tomado de la publicaci??n

New Ruthenium complexes containing N, P and S-donor type of ligands: coordination chemistry, characterization and application to asymetric and non-asymetric catalysis

Síntesi de nous complexos de Ruteni amb lligands no quirals que tenen per fórmula [Ru(phen)([9]aneS3)X] (on X = H2O, py i MeCN). Caracterització espectroscòpica electroquímica i estructural d'aquesta família de complexos. Estudi de les seves propietats catalítiques en front a l'oxidació de substrats orgànics com l'alcohol benzílic en reaccions d'electrocatàlisi. Avaluació cinètica dels mecanismes de substitució entre els complexos Ru-py i Ru-MeCN. Generació d'un interruptor molecular foto-induït. Síntesi de nous complexos quirals de Ru atropoisomèricament purs amb lligands oxazolínics que tenen per fórmula [Ru(trpy)(Ph-box-R)X] on (X = Cl, H2O, py, MeCN, 2-OH-py). Caracterització estructural exhaustiva en estat sòlid (Raig-X) en solució (RMN) i en fase gas (càlculs DFT). Avaluació de la seva activitat catalítica en reaccions asimmetriques d'epoxidació de substrats proquirals. Síntesi de nous lligands polipiridílics quirals amb simetria C3. Estudi de la seva química de coordinació i avaluació de la seva activitat catalítica en reaccions asimmetriques d'oxidació i reducció.

Auditory speech-discrimination as a function of age and type of audiogram

This paper reviews a study to determine if loss of speech discrimination is related to age and patients with audiograms showing steep high-frequency losses.

Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial

Background: Insulin sensitivity (Si) is improved by weight loss and exercise, but the effects of the replacement of saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) or carbohydrates of high glycemic index (HGI) or low glycemic index (LGI) are uncertain. Objective: We conducted a dietary intervention trial to study these effects in participants at risk of developing metabolic syndrome. Design: We conducted a 5-center, parallel design, randomized controlled trial [RISCK (Reading, Imperial, Surrey, Cambridge, and Kings)]. The primary and secondary outcomes were changes in Si (measured by using an intravenous glucose tolerance test) and cardiovascular risk factors. Measurements were made after 4 wk of a high-SFA and HGI (HS/HGI) diet and after a 24-wk intervention with HS/HGI (reference), high-MUFA and HGI (HM/HGI), HM and LGI (HM/LGI), low-fat and HGI (LF/HGI), and LF and LGI (LF/LGI) diets. Results: We analyzed data for 548 of 720 participants who were randomly assigned to treatment. The median Si was 2.7 × 10−4 mL · μU−1 · min−1 (interquartile range: 2.0, 4.2 × 10−4 mL · μU−1 · min−1), and unadjusted mean percentage changes (95% CIs) after 24 wk treatment (P = 0.13) were as follows: for the HS/HGI group, −4% (−12.7%, 5.3%); for the HM/HGI group, 2.1% (−5.8%, 10.7%); for the HM/LGI group, −3.5% (−10.6%, 4.3%); for the LF/HGI group, −8.6% (−15.4%, −1.1%); and for the LF/LGI group, 9.9% (2.4%, 18.0%). Total cholesterol (TC), LDL cholesterol, and apolipoprotein B concentrations decreased with SFA reduction. Decreases in TC and LDL-cholesterol concentrations were greater with LGI. Fat reduction lowered HDL cholesterol and apolipoprotein A1 and B concentrations. Conclusions: This study did not support the hypothesis that isoenergetic replacement of SFAs with MUFAs or carbohydrates has a favorable effect on Si. Lowering GI enhanced reductions in TC and LDL-cholesterol concentrations in subjects, with tentative evidence of improvements in Si in the LF-treatment group. This trial was registered at clinicaltrials.gov as ISRCTN29111298.

Effective elements of cognitive behaviour therapy for psychosis: results of a novel type of subgroup analysis based on principal stratification

Background. Meta-analyses show that cognitive behaviour therapy for psychosis (CBT-P) improves distressing positive symptoms. However, it is a complex intervention involving a range of techniques. No previous study has assessed the delivery of the different elements of treatment and their effect on outcome. Our aim was to assess the differential effect of type of treatment delivered on the effectiveness of CBT-P, using novel statistical methodology. Method. The Psychological Prevention of Relapse in Psychosis (PRP) trial was a multi-centre randomized controlled trial (RCT) that compared CBT-P with treatment as usual (TAU). Therapy was manualized, and detailed evaluations of therapy delivery and client engagement were made. Follow-up assessments were made at 12 and 24 months. In a planned analysis, we applied principal stratification (involving structural equation modelling with finite mixtures) to estimate intention-to-treat (ITT) effects for subgroups of participants, defined by qualitative and quantitative differences in receipt of therapy, while maintaining the constraints of randomization. Results. Consistent delivery of full therapy, including specific cognitive and behavioural techniques, was associated with clinically and statistically significant increases in months in remission, and decreases in psychotic and affective symptoms. Delivery of partial therapy involving engagement and assessment was not effective. Conclusions. Our analyses suggest that CBT-P is of significant benefit on multiple outcomes to patients able to engage in the full range of therapy procedures. The novel statistical methods illustrated in this report have general application to the evaluation of heterogeneity in the effects of treatment.

How level and type of deafness affects user perception of multimedia video clips

Our research investigates the impact that hearing has on the perception of digital video clips, with and without captions, by discussing how hearing loss, captions and deafness type affects user QoP (Quality of Perception). QoP encompasses not only a user's satisfaction with the quality of a multimedia presentation, but also their ability to analyse, synthesise and assimilate informational content of multimedia . Results show that hearing has a significant effect on participants’ ability to assimilate information, independent of video type and use of captions. It is shown that captions do not necessarily provide deaf users with a ‘greater level of information’ from video, but cause a change in user QoP, depending on deafness type, which provides a ‘greater level of context of the video’. It is also shown that post-lingual mild and moderately deaf participants predict less accurately their level of information assimilation than post-lingual profoundly deaf participants, despite residual hearing. A positive correlation was identified between level of enjoyment (LOE) and self-predicted level of information assimilation (PIA), independent of hearing level or hearing type. When this is considered in a QoP quality framework, it puts into question how the user perceives certain factors, such as ‘informative’ and ‘quality’.

Relationship Between Expression of Voltage-Dependent Anion Channel (VDAC) Isoforms and Type of Hexokinase Binding Sites on Brain Mitochondria

Voltage-dependent anion channels (VDAC) are pore-forming proteins found in the outer mitochondrial membrane of eukaryotes. VDACs are known to play an essential role in cellular metabolism and in early stages of apoptosis. In mammals, three VDAC isoforms have been identified. A proteomic approach was exploited to study the expression of VDAC isoforms in rat, bovine, and chicken brain mitochondria. Given the importance of mitochondrially bound hexokinase in regulation of aerobic glycolysis in brain, we studied the possibility that differences in the relative expression of VDAC isoforms may be a factor in determining the species-dependent ratio of type A/type B hexokinase binding sites on brain mitochondria. The spots were characterized, and the signal intensities among spots were compared. VDAC1 was the most abundantly expressed of the three isoforms. Moreover the expression of VDAC1 plus VDAC2 was significantly higher in bovine than in rat brain. Chicken brain mitochondria showed the highest VDAC1 expression and the lowest of VDAC2. Bovine brain mitochondria had the highest VDAC2 levels. We concluded that the nature of hexokinase binding site is not determined by the expression of a single VDAC isoform.