Ischemia Triggered Glutamate Excitotoxicity Manuscript Review

Specific Review Requirements
- A peer-reviewed manuscript published within the last three years (2016) (using ebscohost, pubmed, or google scholar will be appropriate)
- The manuscript review should include the following points
  - What is being tested
  - Model used, including
  - Overview and interpretation of results
  - Caveats to the study/findings – both by you and the authors

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General Review Requirements
- Essay form.
- Minimum of 500 words (approximately 1.5-2 double-spaced page).
- here is the article in which the response is based upon.
  https://www.frontiersin.org/articles/10.3389/fncel…

Models Used in Research

The research used multiple imputation models for variables between 6%-20%. The imputation models used include linear, logistic, ordered logistic, and predictive mean matching. For instance, linear imputation executes customarily distributed variables. Logistic executes binary variable, predictive mean matching uses continuous skewed variables and ordered logistic imputation model uses ordinal variables. The technique used was logistic regression, where combined results from Rubin rules determined variability in estimates. The parameters of disease progression were bacterial infection and viral infections. The research compared patients with bacterial infections to those with a viral infection, leaving out the patients with viral and bacterial infections.

The type of experimental model used was multivariate logistic regression models. Logistic regression models depend on the dependent variables. For example, in this case, the multivariate logistic regression depends on bacterial infection, viral infection, or death as a dependent variable. Therefore, in this model, all factors in the models are included when doing a univariate analysis.

Overview and Interpretation of Results

Diagnostic laboratory tests were carried out to confirm etiology in patients with bacterial or viral infections. The diagnostic tests include seroconversion, detection of pathogens in blood, and cerebrospinal in the central nervous system. After a series of test results to detect pathogens, it was confirmed that etiology was present. Therefore, etiology confirmed that patients with mono infections were more, whereas patients with co-infections were fewer. From the results, it is empirical that a higher percentage of etiology cases were patients with enterovirus, while a lower percentage of nonenterovirus patients were rarely affected by etiology. The nonentorovirus cases were primarily children.

Caveats to the Findings

The first caveat of the findings is that the study used the Japanese encephalitis virus (JEV), yet it has a low predictive value. The JEV makes the findings to be overestimated. The second caveat is that the study used patients who had received an antibiotic before lumbar puncture. The presence of an antibiotic in a patient’s body reduces the bacterial load used in molecular detection. The presence of antibiotics in the body leads to the underestimation of bacterial substances in the system. There was a high mortality rate in the study. The high mortality rate can be associated with poor patient management in the research. However, the epidemiology studies vary from one geographical area to another. Therefore, studies carried within a specific geographical area cannot apply or be used in a different geographical area. Also, the study used partially stored samples. There was a lack of postmortem examination and missing values. There were no brain scans and magnetic resonance imaging in some of the cases used in the study.

Findings for Potential Therapeutic Targeting

The study has focused on etiology patients with viral and bacterial infections. The study should not have classified patients into different groups to avoid non-distinguishable manifestations. Bacteria in the body as a result of Central nervous system infection leads to diabetes. Therefore, diabetes is a risk stimulation in a bacterial central nervous system infection. Also, as bacterial infection in the body increases the level of blood glucose resulting in diabetes. From the research, there are two methods of improving patient survival. The first method is the use of antibiotic guidelines. The second method is to strengthen the high-dependency units.