Background: Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique that is designed to remove substances with a large molecular weight. The TPE procedure includes removal of antibodies, alloantibodies, immune complexes, monoclonal protein, toxins or cytokines, and involves the replenishment of a specific plasma factor. The aim of the study was to describe the clinical response to TPE in various neurological patients, and to assess the clinical response to this therapy. Methods: The study was retrospective. We analyzed the medical records of 77 patients who were treated at the Department of Neurology, University Clinical Center (UCC) Tuzla from 2011 to 2016. Results: 83 therapeutic plasma exchanges were performed in the 77 patients. There was a slight predominance of male patients (54.5%), with an average age of 51±15.9 years. The most common underlying neurological diseases were Guillain–Barré syndrome (GBS) (37.7%), then chronic inflammatory demyelinating polyneuropathy (CIDP) (23.4%), multiple sclerosis (MS) (11.7%) and myasthenia gravis (10.4%). Less frequent neurological diseases that were encountered were paraneoplastic polyneuropathies (5.2%), neuromyelitis optica (also known as Devic’s disease) (3.9%), motor neuron disease (3.9%), polymyositis (2.6%) and multifocal motor neuropathy (1.2%). Conclusions: Six years experience of therapeutic plasma exchange in neurological patients in our department have shown that, following evidence-based guidelines for plasmapheresis, the procedure was most effective in patients with GBS, CIDP and myasthenia gravis.

Abstract Objectives SB2 is a biosimilar to the reference infliximab (INF). Similar efficacy, safety and immunogenicity between SB2 and INF up to 30 weeks were previously reported. This report investigates such clinical similarity up to 54 weeks, including structural joint damage. Methods In this phase III, double-blind, parallel-group, multicentre study, patients with moderate to severe RA despite MTX were randomized (1:1) to receive 3 mg/kg of either SB2 or INF at 0, 2, 6 and every 8 weeks thereafter. Dose escalation by 1.5 mg/kg up to a maximum dose of 7.5 mg/kg was allowed after week 30. Efficacy, safety and immunogenicity were measured at each visit up to week 54. Radiographic damage evaluated by modified total Sharp score was measured at baseline and week 54. Results A total of 584 patients were randomized to receive SB2 (n = 291) or INF (n = 293). The rate of radiographic progression was comparable between SB2 and INF (mean modified total Sharp score difference: SB2, 0.38; INF, 0.37) at 1 year. ACR responses, 28-joint DAS, Clinical Disease Activity Index and Simplified Disease Activity Index were comparable between SB2 and INF up to week 54. The incidence of treatment-emergent adverse events and anti-drug antibodies were comparable between treatment groups. Such comparable trends of efficacy, safety and immunogenicity were consistent from baseline up to 54 weeks. The pattern of dose increment was also comparable between SB2 and INF. Conclusion SB2 maintained similar efficacy, safety and immunogenicity with INF up to 54 weeks in patients with moderate to severe RA. Radiographic progression was comparable at 1 year. Trial registration ClinicalTrials.gov (http://clinicaltrials.gov; NCT01936181) and EudraCT (https://www.clinicaltrialsregister.eu; 2012-005733-37)

Partial wave amplitudes of meson photoproduction reactions are an important source of information in baryon spectroscopy. We investigate a new approach in single-energy partial wave analyses of these reactions. Instead of using a constraint to theoretical models in order to achieve solutions which are continuous in energy, we enforce the analyticity of the amplitudes at fixed values of the Mandelstam variable $t$. We present an iterative procedure with successive fixed-$t$ amplitude analyses which constrain the single-energy partial wave analyses and apply this method to the $\gamma p \to \eta p$ reaction. We use pseudo data, generated by the EtaMAID model, to test the method and to analyze ambiguities. Finally, we present an analytically constrained partial wave analysis using experimental data for four polarization observables recently measured at MAMI and GRAAL in the energy range from threshold to $\sqrt{s}=1.85$ GeV.

Pulmonary surfactant (PS) reduces surface tension at the air-liquid interface in the alveolar epithelium of the lung, which is required for breathing and for the pulmonary maturity of the developing foetus. However, the origin of PS had never been thoroughly investigated, although it was assumed to be secreted from the foetal developing lung. Human amniotic membrane (hAM), particularly its epithelial cell layer, composes the amniotic sac enclosing the amniotic fluid. In this study, we therefore aimed to investigate a potential contribution of the cellular components of the hAM to pulmonary surfactant found in amniotic fluid. We identified that cells within the native membrane contain lamellar bodies and express all four surfactant proteins as well as ABCA3. Lipidomic profiling by nanoESI – MS/MS revealed the presence of the essential lipid species as found in PS. Also, the biophysical activity of conditioned cell culture supernatant obtained from hAM was tested with captive bubble surfactometry. hAM supernatant showed the ability to reduce surface tension, similar to human PS obtained from bronchoalveolar lavage. This means that hAM produces the essential PS-associated components and can therefore contribute as second potential source of PS in amniotic fluid aside from the foetal lung.

This study presents genetic data for nine Native American populations from northern North America. Analyses of genetic variation focus on the Pacific Northwest (PNW). Using mitochondrial, Y chromosomal, and autosomal DNA variants, we aimed to more closely address the relationships of geography and language with present genetic diversity among the regional PNW Native American populations. Patterns of genetic diversity exhibited by the three genetic systems were consistent with our hypotheses: genetic variation was more strongly explained by geographic proximity than by linguistic structure. Our findings were corroborated through a variety on analytic approaches, with the unrooted trees for the three genetic systems consistently separating inland from coastal PNW populations. Furthermore, analyses of molecular variance support the trends exhibited by the unrooted trees, with geographic partitioning of PNW populations (FCT = 19.43%, p = 0.010 ± 0.009) accounting for over twice as much of the observed genetic variation as linguistic partitioning of the same populations (FCT = 9.15%, p = 0.193 ± 0.013). These findings demonstrate a consensus with previous PNW population studies examining the relationships of genome-wide variation, mitochondrial haplogroup frequencies, and skeletal morphology with geography and language.

This paper proposes a new approach on the novel current control strategy for grid-tied voltage-source inverters (VSIs) with circumstances of asymmetrical voltage conditions. A standard grid-connected inverter (GCI) allows the degree of freedom to integrate the renewable energy system to enhance the penetration of total utility power. However, restrictive grid codes require that renewable sources connected to the grid must support stability of the grid under grid faults. Conventional synchronously rotating frame dq current controllers are insufficient under grid faults due to the low bandwidth of proportional-integral (PI) controllers. Hence, this work proposes a proportional current controller with a first-order low-pass filter disturbance observer (DOb). The proposed controller establishes independent control on positive, as well as negative, sequence current components under asymmetrical grid voltage conditions. The approach is independent of parametric component values, as it estimates nonlinear feed-forward terms with the low-pass filter DOb. A numerical simulation model of the overall power system was implemented in a MATLAB/Simulink (2014B, MathWorks, Natick, MA, USA). Further, particular results show that double-frequency active power oscillations are suppressed by injecting appropriate negative-sequence currents. Moreover, a set of simulation results provided in the article matches the developed theoretical background for its feasibility.

Introduction.The aim of the study was to find out the determinants of the quality of life in primary health care patients with type 2 diabetes. Methods. The cross-sectional study included 181 patients, aged 37 to 89 years, with diabetes mellitus type 2, registered with four family medicine practices. The assessment of health status was conducted using medical history, objective examination, laboratory analyses, dilated eye exam, screening for distal symmetric neuropathy and ankle-brachial index measurement. In evaluating the impact of diabetes mellitus on patients’ health status, a generic instrument, the self-administered WHOQOL-BREF questionnaire, was used. Multivariate linear regression models were used to analyze the variables associated with the quality of life. Results. Out of 181 adult patients with type 2 diabetes mellitus, 73 (40.3%) had diabetes for less than 5 years. The mean glycated hemoglobin (A1C) was 7.55% and the mean serum levels of fasting glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were above the recommended values. Most of the patients had comorbidities, chronic diabetes complications and used oral hypoglycemic agents in combination with insulin. The multivariate regression analysis showed that the age, psychological health, nephropathy and environment were associated with the domain of physical health. The determinants of psychological health were age, marital status and environment. Older and single patients had lower scores, whereas those with a better living environment had higher scores in the domain of social relationship. The levels of glycemic control and gender have not been shown to be significant determinants of any of the four domains. Conclusion. The factors associated with the different domains of quality of life in patients with type 2 diabetes are multiple, but mainly relate to age, living environment and diabetes complications. The results can be used as a guideline for defining measures that can improve the quality of life of patients with type 2 diabetes

Uvod. Dijabetes znacajno utice na radnu sposobnost i kvalitet života oboljelih. Profesionalna radna angažovanost ima uticaj na tok bolesti i kvalitet života. Cilj rada je ispitivanje kvaliteta života pacijenata sa dijabetesom u zavisnosti od radnog statusa i izloženosti zaposlenih stetnostima radnog mjesta. Metode. Istraživanje je obavljeno u Domu zdravlja Pale i Domu zdravlja Istocno Sarajevo u periodu od maja 2012. do novembra 2012. godine. Istraživanjem je obuhvaceno 150 bolesnika sa dijabetesom oba tipa (tipa I i tipa II), a koji su insulin zavisni u odnosu na terapijski tretman, prosjecne starosti od 56,1 godine. Bolesnici su prema statusu zaposlenosti podijeljeni na zaposlene i nezaposlene. Za ispitivanje kvaliteta života koristen je upitnik SF-36 kao i opsti upitnik kreiran za potrebe ispitivanja. Statisticka znacajnost razlika između grupa određena je primjenom χ2 testa i t-testa. Rezultati. Vrijednosti svih domena kvaliteta života kod nezaposlenih ispitanika su manje nego kod zaposlenih, kao i vrijednosti sumarnog fizickog skora (42.6 ± 9.8, p<0,001) i sumarnog mentalnog skora (37,5± 13,5, p=0,010). Vrijednosti domena: fizicko funkcionisanje, uloga-fizicka, tjelesni bol i opste zdravlje su vece kod zaposlenih koji nisu izloženi stetnostima na radnom mjestu od vrijednosti kod ispitanika izloženih stetnostima. Vrijednosti domena: vitalnost, socijalni odnosi, uloga-emocionalna i mentalno zdravlje ispitanika neizloženih stetnostima na radnom mjestu znacajno su vece od vrijednosti onih izloženih stetnostima. Zakljucak Radna angažovanost znacajno utice na kvalitet života oboljelih od dijabetesa, a profesionalne stetnosti dodatno negativno uticu na kvalitet života osoba oboljelih od dijabetesa.