Results: All the studied LAB isolates were versatile extracellular protease producers, whereby extracellular protease activities were detected from acidic to alkaline pH (pH 5, pH 6.5, pH 8) using qualitative and quantitative proteolytic assays. The highest proteolytic activity at pH 5 (15.76 U/mg) and pH 8 (19.42 U/mg) was achieved by Lactobacillus plantarum RG14, while Lactobacillus plantarum RS5 exhibited the highest proteolytic activity of 17.22 U/mg at pH 6.5. As for the results of AA production conducted in de Man, Rogosa and Sharpe medium and analysed by high pressure liquid chromatography system, all LAB isolates were capable of producing an array of AA. Generally, Pediococcus sp. showed greater ability for AA production as compared to Lactobacillus sp. Moreover, the studied LAB were able to produce a few major feed supplement AA such as methionine, lysine, threonine and tryptophan. P. pentosaceus TL-3 recorded the highest methionine and threonine productivity of 3.72 mg/L/h and 5.58 mg/L/h respectively. However, L. plantarum I-UL4 demonstrated a lysine productivity of 1.24 mg/L/h, while P. acidilactici TP-6 achieved up to 1.73 mg/L/h of tryptophan productivity.
Conclusion: All the 17 studied LAB isolates possessed versatile extracellular proteolytic system and have vast capability of producing various amino acids including a few major feed supplement AA such as methionine, lysine, threonine and tryptophan. Despite AA production was strain dependent, the studied LAB isolates possessed vast potential and can be exploited further as a bio-agent or an alternative amino acids and bioactive peptide producers.
MATERIALS AND METHODS: Systematic reviews with meta-analyses in paediatric dentistry were searched in PubMed and Scopus databases from inception to December 2017. Selection of studies by title and abstract screening followed by full-text assessment was independently done by two reviewers. The quality of abstracts was assessed by PRISMA-Abstract checklist comprising of 12 items; one each for title and objective, three items for methods, three items for results, two items for discussion and two items for others. PRISMA-A median scores were calculated and compared with the article characteristics. Statistical significance was set at p
METHODS: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia. The primary outcome was death from any cause at 1 year.
RESULTS: A total of 5400 patients were randomly assigned: 2709 to the volatile anesthetics group and 2691 to the total intravenous anesthesia group. On-pump CABG was performed in 64% of patients, with a mean duration of cardiopulmonary bypass of 79 minutes. The two groups were similar with respect to demographic and clinical characteristics at baseline, the duration of cardiopulmonary bypass, and the number of grafts. At the time of the second interim analysis, the data and safety monitoring board advised that the trial should be stopped for futility. No significant difference between the groups with respect to deaths from any cause was seen at 1 year (2.8% in the volatile anesthetics group and 3.0% in the total intravenous anesthesia group; relative risk, 0.94; 95% confidence interval [CI], 0.69 to 1.29; P = 0.71), with data available for 5353 patients (99.1%), or at 30 days (1.4% and 1.3%, respectively; relative risk, 1.11; 95% CI, 0.70 to 1.76), with data available for 5398 patients (99.9%). There were no significant differences between the groups in any of the secondary outcomes or in the incidence of prespecified adverse events, including myocardial infarction.
CONCLUSIONS: Among patients undergoing elective CABG, anesthesia with a volatile agent did not result in significantly fewer deaths at 1 year than total intravenous anesthesia. (Funded by the Italian Ministry of Health; MYRIAD ClinicalTrials.gov number, NCT02105610.).
METHODS: Microscopy-based malaria notification data and PCR results were obtained from the Sabah Department of Health and State Public Health Laboratory, respectively, from January 2015 to December 2017. From January 2016 this was complemented by a state-wide prospective hospital surveillance study. Databases were matched, and species was determined by PCR, or microscopy if PCR was not available.
RESULTS: A total of 3867 malaria cases were recorded between 2015 and 2017, with PCR performed in 93%. Using PCR results, and microscopy if PCR was unavailable, P. knowlesi accounted for 817 (80%), 677 (88%), and 2030 (98%) malaria cases in 2015, 2016, and 2017, respectively. P. falciparum accounted for 110 (11%), 45 (6%), and 23 (1%) cases, and P. vivax 61 (6%), 17 (2%), and 8 (0.4%) cases, respectively. Of those with P. knowlesi, median age was 35 (IQR 24 - 47) years, and 85% were male.
CONCLUSIONS: Malaysia is approaching elimination of the human-only Plasmodium species. However, the ongoing increase in P. knowlesi incidence presents a major challenge to malaria control and warrants increased focus on knowlesi-specific prevention activities. Wider molecular surveillance in surrounding countries is required.
METHODS: A randomized controlled double-masked crossover trial was conducted in a single tertiary care academic medical center. Patients with longstanding, inactive GO but persistent proptosis (> 20 mm in at least one eye) were recruited. Allowing for a 15% dropout rate, 31 patients (26 females) were randomized in order to identify a treatment effect of 2.0 mm (p=0.05, two-sided paired t-test, power 0.88). Following informed consent, participants were randomized to receive Bimatoprost or placebo for three months after which they underwent a two-month washout, before switching to the opposite treatment. The primary outcome was the change in exophthalmometry readings over the two 3-month treatment periods.
RESULTS: The mean exophthalmometer at baseline was 23.6 (range 20.0-30.5) mm and the mean age was 55 (range 28-74) years. The median duration of GO was 7.6 (IQR 3.6-12.3) years. The majority were still suffering from diplopia (61.3%) with bilateral involvement (61.3%). Using multilevel modeling adjusted for baseline, period and carryover, Bimatoprost resulted in a -0.17 mm (reduction) exophthalmometry change (95% CI -0.67 to +0.32) p=0.490. Intraocular pressure was reduced -2.7 mmHg (95% CI -4.0 to -1.4) p=0.0070. One patient showed periorbital fat atrophy (PAP) on treatment which resolved on stopping treatment. Independent analysis of proptosis by photographic images (all subjects) and subgroup analysis on monocular disease (n=12) did not show any apparent benefit.
CONCLUSION: In inactive GO, Bimatoprost treatment over a 3-month period does not result in an improvement in proptosis.