Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00306932607174: 10/24/17

Τρίτη 24 Οκτωβρίου 2017

Development of recyclable carbon fiber-reinforced plastics (CFRPs) with controlled degradability and stability using acetal linkage-containing epoxy resins

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Wie kommt man auf die Idee, dass Kuhmist Allergien vorbeugt?

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Treatment of hemorrhagic head and neck lesions by direct puncture and nBCA embolization

Life-threatening bleeding in the head and neck region requires urgent management. These hemorrhagic lesions, for example, a ruptured pseudoaneurysm, are often treated by transarterial embolization (TAE), but prior intervention or surgery, inflammation, anatomic variants, and vessel tortuosity may render an endovascular approach challenging, time-consuming, and sometimes impossible. We report two cases of severe head and neck hemorrhages successfully embolized with n-butyl cyanoacrylate via direct puncture, and propose this approach as a fast, safe, and effective alternative to TAE.

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Correlation of Circulating CD64 + /CD163 + Monocyte Ratio and stroma/peri-tumoral CD163 + Monocyte Density with Human Papillomavirus Infected Cervical Lesion Severity

Abstract

HPV infected cervical cells secrete mediators that are gradually changed and have influence on infiltrating M2 phenotypic monocytes in cervical lesions. However, profiles of circulating immune cells in women with cervical lesions and M2 phenotypic monocyte activity in HPV infected cervical lesions are limited. This study aimed to investigate circulating monocyte populations correlated with M2 phenotype density and its activity in HPV infected cervical lesions. HPV DNA was investigated in cervical tissues using PCR. High risk HPV E6/E7 mRNA was detected using in situ hybridization. CD163 immunohistochemical staining was performed for M2 macrophage. CD163 and Arg1 mRNA expression were detected using real-time PCR. Circulating monocyte subpopulations were analyzed using flow cytometry. CD163 and Arg1 mRNA expression were increased according to cervical lesion severity and corresponding with density of M2 macrophage in HSIL and SCC in stroma and peri-tumoral areas. Additionally, the relationship between M2 macrophage infiltration and high risk HPV E6/E7 mRNA expression was found and corresponded with cervical lesion severity. Circulating CD14⁺CD16⁺ and CD14⁺CD163⁺ monocytes were elevated in No-SIL and cervical lesions. Interestingly, CD14⁺CD64⁺ monocyte was greatly elevated in HSIL and SCC, whereas intracellular IL-10⁺ monocytes were not significantly different between cervical lesions. The correlation between increasing ratio of circulating CD64⁺/CD163⁺ monocyte and density of infiltrating CD163⁺ monocytes was associated with severity of HPV infected cervical lesions. The elevated circulating CD64⁺/CD163⁺ monocyte ratio correlates to severity of HPV infected cervical lesions and might be a prognostic marker in cervical cancer progression.

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RELA fusion-positive anaplastic ependymoma: molecular characterization and advanced MR imaging

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HSA, dentists warn against popular DIY teeth whitening kit

Cold Light Teeth Whitening Kit, contains 4 per cent hydrogen peroxide, well above the 0.1 per cent limit allowed for home use without a prescription. SINGAPORE: It is easy to find do-it-yourself teeth whitening products on online marketplaces such as Carousell, with some users posting glowing testimonies of how smoke- or tea-stained teeth became white again.

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Maxillofacial surgery: the impact of the Great War on both sides of the trenches

Abstract

"War is the father and King of all", Heraclitus the obscure philosopher, declares. It certainly appears that the specialty of maxillofacial surgery was greatly advanced during WWI. This article focuses on the circumstances under which the specialty was developed, the significant events and the important figures that played a leading role in the advancement of a new fascinating surgical specialty. The literature leaves no doubt that trench warfare despite its devastating outcome for humanity has forged the shape of modern maxillofacial surgery.

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Rare case report of an aggressive follicular lymphoid hyperplasia in maxilla

Abstract

Follicular lymphoid hyperplasia is a very rare though benign reactive process of an unknown pathogenesis that may resemble a follicular lymphoma, clinically and histologically. Oral reactive follicular hyperplasia (RFH) has been described on the hard or soft palate and at the base of the tongue. We describe here the first case of RFH presenting as an aggressive tumor on the right posterior side of the maxilla in a 24-year-old male patient. The lesion had a clinical evolution of 18 months and was noticed after the surgical extraction of the right third molar, although we cannot assume a cause-effect relation with that surgical event whatsoever. His medical history was unremarkable. Following an incisional biopsy, histological examination revealed lymphoid follicles comprised by germinal centers surrounded by well-defined mantle zones. The germinal centers were positive for Bcl-6, CD10, CD20, CD21, CD23, CD79a, and Ki-67, while negative for Bcl-2, CD2, CD3, CD5, and CD138. The mantle and interfollicular zones were positive for Bcl-2, CD2, CD3, CD5, CD20, and CD138. Both areas were diffusively positive for kappa and lambda, showing polyclonality. The patient underwent a vigorous curettage of the lesion with no reoccurrences at 36 months of follow-up. This case report demonstrates that morphologic and immunohistochemical analyses are crucial to differentiate RFH from follicular lymphoma, leading to proper management.

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Basic school teachers’ perspective to digital teaching and learning in Ghana

Abstract

This study proposes a model for describing the situation of Digital Teaching and Learning (TD-TaL) in Ghanaian schools using the perspectives of basic school teachers. The Digital Teaching and Learning model was developed based on the theories of Valsiner's Zone of Free Movement (ZFM) and Zone of Promoted Action (ZPA) and Vygotsky's Zone of Proximal Development (ZPD). The model proposes to look at the effects of ZFM in schools (comprising Digital environment factors and Personal attitudinal and Digital Culture factors) and ZPA (comprising Teacher Training factor) on the Teachers' Digital Knowledge, Competence and Action ( TDKCA) factors to influence teachers in their Zone of Proximal Development. The model was tested in Ghana's case using the survey data collected from 256 teachers from 45 schools across six districts in the Western Region of Ghana. The findings from Regression path analysis revealed that Personal and Digital Culture factors, but most of all teachers' Digital Attitudes effected directly on Teachers' Digital Activities they claimed to be doing, whereas from Environmental factors only Schools' Digital Agenda was impacting Teachers' Digital Action both directly and indirectly through Teachers' Digital Training (ZPA). The model specifically highlighted that in observed Ghanaian schools the ZFM factors Digital Infrastructure and Digital Support to Digital Teaching did not associate with the ZPA factor Digital Teacher Training and overall to Teachers' Digital Knowledge, Competence and Action factors.

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10/23/17 PHD comic: 'End Times'

Piled Higher & Deeper by Jorge Cham		www.phdcomics.com

title: "End Times" - originally published 10/23/2017 For the latest news in PHD Comics, CLICK HERE!

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PreOp® Infection Control Video Center - Patient Education

PreOp® Infection Control Video Center - Patient Education
http://ift.tt/2iyadH5
PreOp® Infection Control Video Center Collection offers our six discharge videos within a video player that may be embedded within a web page, email, and opened on a mobile device.

These videos are in English and Spanish.

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Supervised toothbrushing for children and adolescents

Four studies were included in this review of supervised toothbrushing in children and adolescents. The evidence identified provides no conclusive evidence. However previous Cochrane reviews have suggested benefits on caries from supervised brushing.

The post Supervised toothbrushing for children and adolescents appeared first on National Elf Service.

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Recurrent Metastatic Medullary Thyroid Carcinoma: A Case of Sustained Response to Prolonged Treatment with Somatostatin Analogues

Thyroid , Vol. 0, No. 0.

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A frequently asked question: Is it normal not to feel my baby's movements yet?

This study aims to investigate average gestational week in which mothers feel their baby's movements for the first time, and the maternal–fetal factors affecting this time.

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Molecular characterization of glycopeptide and macrolide resistance genes among multidrug-resistant Enterococcus faecalis strains

Multiple-drug-resistant enterococci and vancomycin-resistant enterococci (VRE) are major cause of healthcare associated infections due to their antibiotic resistance traits. Among the enterococci, Enterococcus faecalis is an important opportunistic pathogen causing various hospital-acquired infections.

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The value of medical student radiology education: A comparison of 1-week, 2-week, electives, and compulsories

Basic radiology interpretive skill is essential for all physicians. We developed a vertical type of radiology education, including basic radiology in the students' first clinical year and added the other 1-week or 2-week dedicated radiology rotation in the later clinical year. The objective of this study was to present a valuable radiology education to undergraduate medical students.

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Maxillofacial surgery: the impact of the Great War on both sides of the trenches

Abstract

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Rare case report of an aggressive follicular lymphoid hyperplasia in maxilla

Abstract

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Effects of extrusion with CO 2 injection on physical and antioxidant properties of cornmeal-based extrudates with carrot powder

Abstract

Carrot powder and cornmeal were extruded at ratios of 0:100, 10:90, and 20:80 with and without CO₂ injection at die temperatures of 80, 100, and 120 °C. The effects of the composition of the extrudate, die temperature, and CO₂ injection on physicochemical and antioxidant properties of extruded products were studied. The results showed that die temperature had a significant effect on expansion ratio (ER), specific length, piece density, color, water absorption index (WAI), and water solubility index (WSI) (p < 0.05). The injection of CO₂ significantly affected the ER, WAI, WSI, lightness, redness, microstructure, total phenolic content, and the 2,2-diphenyl-1-picrylhydrazyl radical-scavenging activity of extrudates (p < 0.05). Increasing the proportion of carrot powder in extrudates resulted in better antioxidant properties and higher levels of crude ash, crude fat, crude protein, and redness; however, it resulted in lower WAI, lightness, and yellowness (p < 0.05). The study demonstrated that extrusion with CO₂ injection and addition of carrot powder may improve the nutritional quality and structure-forming ability of extrudates.

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Complicated Root Canal Morphology of Mandibular Lateral Incisors Is Associated with the Presence of Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in a Taiwanese Population

The aim of this study was to assess the root canal configurations in permanent mandibular lateral incisors (PMLIs) and the correlation between the root canal configurations of PMLIs with the appearance of a distolingual root (DLR) in permanent mandibular first molars (PMFMs) using cone-beam computed tomographic (CBCT) imaging.

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Dehydration Induces Cracking in Root Dentin Irrespective of Instrumentation: A Two-dimensional and Three-dimensional Study

Water loss strongly affects the mechanical behavior of dentin. Micro–computed tomography (μCT) studies exploring the influence of endodontic procedures on root cracking often lack information on the hydration state of the scanned samples. This study explores the relationship between dehydration and crack formation in root dentin with and without endodontic instrumentation.

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Intracanal Cryotherapy Reduces Postoperative Pain in Teeth with Symptomatic Apical Periodontitis: A Randomized Multicenter Clinical Trial

A prospective, multicentered, randomized clinical trial was designed to assess if controlled irrigation with cold saline could result in less incidence and intensity of postoperative pain in patients presenting with pulp necrosis and symptomatic apical periodontitis.

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Cytokine Expression of Stem Cells Originating from the Apical Complex and Coronal Pulp of Immature Teeth

The aim of this study was to measure and compare the expression levels of cytokines from developing apical complex cells (DACCs) and dental pulp stem cells (DPSCs) of the immature tooth.

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Large Periapical or Cystic Lesions in Association with Roots Having Open Apices Managed Nonsurgically Using 1-step Apexification Based on Platelet-rich Fibrin Matrix and Biodentine Apical Barrier: A Case Series

Teeth having open apices in the absence of a natural apical constriction pose several challenges during conventional endodontic treatment, especially when establishing an apical seal. Treatment is further challenging when these teeth are associated with large periapical or cystic lesions having resulted in expansion and/or thinning of adjacent cortical plates. Although surgical intervention is commonly adopted in the management of such cases, a conservative treatment option offering equally good prognosis is always desirable.

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Ultrasound Assessment of Bone Healing after Root-end Surgery: Echoes Back to Patient's Safety

The aim of this study was to present ultrasound imaging (UI) techniques as promising and safe tools for the follow-up of root-end surgery (RES) in vivo.

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Cyclic and Torsional Fatigue Resistance of XP-endo Shaper and TRUShape Instruments

The purpose of this study was to evaluate the cyclic and torsional fatigue resistance of the XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) and TRUShape (Dentsply Tulsa Dental Specialties, Tulsa, OK) instruments.

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Differential Expression of Long Noncoding RNAs in Normal and Inflamed Human Dental Pulp

Dental pulp inflammation is an excellent model for the interaction between tissue inflammation and regenerative processes. It is worthwhile to better understand molecular signaling of repair and regeneration in inflammatory processes. Emerging evidence suggests that long noncoding RNA (lncRNA) participates in immune system inflammatory processes. Here we investigate the expression of lncRNAs in pulpitis, the inflammation of dental pulp tissue, and identify lncRNAs that possibly participate in inflammation responses and odontogenesis.

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Bleaching of a Discolored Tooth with Retrieval of Remnants after Successful Regenerative Endodontics

This report presents the retrieval of remnants from a discolored mandibular right second premolar (tooth #29) of a 17-year-old female after a successful regenerative endodontic procedure (REP).

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Minced Pulp as Source of Pulpal Mesenchymal Stem Cells with Odontogenic Differentiation Capacity

Pulp tissue regeneration is becoming a reality after discovery of mesenchymal stem cells (MSCs) residing in the pulp tissues through various clinical innovations, although MSC transplantation into the pulp space has met with challenges of in vitro cell expansion and cultures. As a way to circumvent the regulatory and technical complexities of in vitro MSC culture, we investigated the use of minced pulp tissues as a source of pulpal MSCs for tissue regeneration.

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Biocompatibility of New Pulp-capping Materials NeoMTA Plus, MTA Repair HP, and Biodentine on Human Dental Pulp Stem Cells

The aim of the present study was to evaluate the in vitro cytotoxicity of MTA Repair HP, NeoMTA Plus, and Biodentine, new bioactive materials used for dental pulp capping, on human dental pulp stem cells (hDPSCs).

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Evaluation of the Periodontal Disease Effect on Pulp Volume

The success of periodontal and endodontic treatments depends on the total recovery from both conditions regardless of their occurrence as independent or combined lesions. There is strong presumptive evidence that teeth with periodontal disease may cause pulpal inflammation and degeneration. Therefore, the goal of this study was to establish a correlation between periodontitis and pulp volume.

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Improving margin revision: Characterization of tumor bed margins in early oral tongue cancer

Margin evaluation is performed to assess the adequacy of tumor removal [1]. One of the quality initiatives introduced by the American Head and Neck Society deals with the management of patients with oral squamous cell carcinoma (SCC) extending to margins [2]. There are two major approaches to the sampling of margins [3–7]. In the specimen-driven approach, margin clearance is assessed from en bloc resection specimens. Studies have shown that the most relevant margins are those derived from the resection specimen [8–16].

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Improving margin revision: Characterization of tumor bed margins in early oral tongue cancer

Margin evaluation is performed to assess the adequacy of tumor removal [1]. One of the quality initiatives introduced by the American Head and Neck Society deals with the management of patients with oral squamous cell carcinoma (SCC) extending to margins [2]. There are two major approaches to the sampling of margins [3–7]. In the specimen-driven approach, margin clearance is assessed from en bloc resection specimens. Studies have shown that the most relevant margins are those derived from the resection specimen [8–16].

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Posterior reversible encephalopathy syndrome (PRES) induced by pazopanib, a multi-targeting tyrosine kinase inhibitor, in a patient with soft-tissue sarcoma: case report and review of the literature

Summary

Posterior reversible encephalopathy syndrome (PRES) is a clinical entity characterized by acute neurological symptoms such as severe headache, seizures, and visual disturbance, and by typical reversible lesion on brain magnetic resonance (MR) images. Since PRES is thought to be caused by vascular endothelial injury due to cytotoxic agents or acute systemic hypertension, the number of reports on PRES associated with angiogenesis inhibitors has been increasing. Although five cases that developed PRES due to pazopanib for renal cell carcinoma have already been reported, none of PRES due to pazopanib for soft-tissue sarcoma has been reported thus far. We describe a case of a 49-year-old woman with retroperitoneal soft-tissue sarcoma who developed PRES during pazopanib administration. Pazopanib at 800 mg/day was administered as her third-line treatment at relapse. After 38 days of pazopanib, she was admitted to our hospital with severe headache, vomiting, and systemic hypertension. The next day, she developed consciousness deterioration and visual disturbance together with exacerbated systemic hypertension. Brain MR images revealed hyper-intense signals on FLAIR sequences in the bilateral occipital lobes and the left thalamus. Intravenous nicardipine injection was immediately started to control her blood pressure and pazopanib was discontinued. Her symptoms gradually improved and disappeared on the fifth hospital day. After 2 weeks, hyper-intense signals on a FLAIR sequence disappeared completely. She restarted a low dose of pazopanib under good blood pressure control and experienced no subsequent recurrence of PRES.

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Reconciling contradictory findings: Glucose transporter 1 (GLUT1) functions as an oligomer of allosteric, alternating access transporters [Enzymology]

Recent structural studies suggest that glucose transporter 1 (GLUT1)-mediated sugar transport is mediated by an alternating access transporter that successively presents exofacial (e2) and endofacial (e1) substrate-binding sites. Transport studies, however, indicate multiple, interacting (allosteric), and co-existent, exo- and endofacial GLUT1 ligand-binding sites. The present study asks whether these contradictory conclusions result from systematic analytical error or reveal a more fundamental relationship between transporter structure and function. Here, homology modeling supported the alternating access transporter model for sugar transport by confirming at least four GLUT1 conformations, the so-called outward, outward-occluded, inward-occluded, and inward GLUT1 conformations. Results from docking analysis suggested that outward and outward-occluded conformations present multiple β-D-glucose and maltose interaction sites, whereas inward-occluded and inward conformations present only a single β-D-glucose interaction site. Gln-282 contributed to sugar binding in all GLUT1 conformations via hydrogen bonding. Mutating Gln-282 to alanine (Q282A) doubled the Km(app) for 2-deoxy-D-glucose uptake, eliminated cis-allostery (stimulation of sugar uptake by subsaturating extracellular maltose) but not trans-allostery (uptake stimulation by subsaturating cytochalasin B). Cis-allostery persisted, but trans-allostery was lost in an oligomerization-deficient GLUT1 variant in which we substituted membrane helix 9 with the equivalent GLUT3 sequence. Moreover, Q282A eliminated cis- allostery in the oligomerization variant. These findings reconcile contradictory conclusions from structural and transport studies by suggesting that GLUT1 is an oligomer of allosteric, alternating access transporters in which 1) cis-allostery is mediated by intra-subunit interactions and 2) trans-allostery requires inter-subunit interactions.

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MicroRNA-155 induction via TNF-{alpha} and IFN-{gamma} suppresses expression of programmed death ligand-1 (PD-L1) in human primary cells [RNA]

Programmed death ligand-1 (PD-L1) is a critical regulator of T cell function contributing to peripheral immune tolerance. Although it has been shown that posttranscriptional regulatory mechanisms control PD-L1 expression in cancer, it remains unknown whether such regulatory loops operate also in non-transformed cells. Here we studied PD-L1 expression in human dermal lymphatic endothelial cells (HDLECs), which play key roles in immunity and cancer. Treatment of HDLECs with the pro-inflammatory cytokines IFN-γ and TNF-α synergistically upregulated PDL1 expression. IFN-γ and TNF-α also affected expression of several microRNAs (miRNAs) that have the potential to suppress PD-L1 expression. The most highly upregulated miRNA following IFN-γ and TNF-α treatment in HDLECs was miR- 155, which has a central role in the immune system and cancer. Induction of miR-155 was driven by TNF-α, the effect of which was significantly enhanced by IFN-γ. The PD-L1 3'- UTR contains two functional miR-155 binding sites. Endogenous miR-155 controlled the kinetics and maximal levels of PD-L1 induction upon IFN-γ and TNF-α treatment. We obtained similar findings in dermal fibroblasts, demonstrating that the IFN-γ/TNF-α/miR-155/PD-L1 pathway is not restricted to HDLECs. These results reveal miR- 155 as a critical component of an inflammationinduced regulatory loop controlling PD-L1 expression in primary cells.

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A conserved tryptophan within the WRDPLVDID domain of yeast Pah1 phosphatidate phosphatase is required for its in vivo function in lipid metabolism [Lipids]

PAH1-encoded phosphatidate phosphatase, which catalyzes the dephosphorylation of phosphatidate to produce diacylglycerol at the ER membrane, plays a major role in controlling the utilization of phosphatidate for the synthesis of triacylglycerol or membrane phospholipids. The conserved N-LIP and HAD-like domains of Pah1 are required for phosphatidate phosphatase activity and the in vivo function of the enzyme. Its non-conserved regions, which are located between the conserved domains and at the C-terminus, contain sites for phosphorylation by multiple protein kinases. Truncation analyses of the non-conserved regions showed that they are not essential for the catalytic activity of Pah1 and its physiological functions (e.g., triacylglycerol synthesis). This analysis also revealed that the C-terminal region contains a previously unrecognized WRDPLVDID domain (residues 637-645) that is conserved in yeast, mice, and humans. The deletion of this domain had no effect on the catalytic activity of Pah1, but caused the loss of its in vivo function. Site-specific mutational analyses of the conserved residues within WRDPLVDID indicated that Trp-637 plays a crucial role for Pah1 function. This work also demonstrated that the catalytic activity of Pah1 is required but is not sufficient for its in vivo functions.

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Autoantibodies against the cell surface-associated chaperone GRP78 stimulate tumor growth via tissue factor [Membrane Biology]

Tumor cells display on their surface several molecular chaperones that normally reside in the endoplasmic reticulum (ER). Because this display is unique to cancer cells, these chaperones are attractive targets for drug development. Previous epitope-mapping of autoantibodies (AutoAbs) from prostate cancer patients identified glucose-regulated-78 (GRP78) as one such target. Although we previously showed that anti-GRP78 AutoAbs increase tissue factor (TF) procoagulant activity on the surface of tumor cells, the direct effect of TF activation on tumor growth was not examined. In this study, we explore the interplay between the AutoAbs against cell surface-associated GRP78, TF expression/activity and prostate cancer progression. Firstly, we show that tumor GRP78 expression correlates with disease stage and that anti-GRP78 AutoAb levels parallel prostate-specific antigen (PSA) concentrations in patient-derived serum samples. Secondly, we demonstrate that these anti-GRP78 AutoAbs target cell surface GRP78, activating the unfolded protein response and inducing tumor cell proliferation through a TF-dependent mechanism, a specific effect reversed by neutralization or immunodepletion of the AutoAb pool. Finally, these AutoAbs enhance tumor growth in mice bearing human prostate cancer xenografts and heparin derivatives specifically abrogate this effect by blocking AutoAb binding to cell surface GRP78 and decreasing TF expression/activity. Together, these results establish a molecular mechanism in which AutoAbs against cell surface GRP78 drive TF-mediated tumor progression in an experimental model of prostate cancer. Heparin derivatives counteract this mechanism, and, as such, represent potentially appealing compounds to be evaluated in well-designed translational clinical trials.

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Dissecting the role of conformational change and membrane binding by the bacterial cell division regulator MinE in the stimulation of MinD ATPase activity [Enzymology]

The bacterial cell division regulators MinD and MinE together with the division inhibitor MinC localize to the membrane in concentrated zones undergoing coordinated pole-to-pole oscillation to help ensure that the cytokinetic division septum forms only at the mid-cell position. This dynamic localization is driven by MinD-catalyzed ATP hydrolysis, stimulated by interactions with the MinE anti-MinCD domain. This domain is buried in the 6-β-stranded MinE closed structure, but is liberated for interactions with MinD, giving rise to a 4-β-stranded open structure through an unknown mechanism. Here we show that MinE-membrane interactions induce a structural change into a state resembling the open conformation. However, MinE mutants lacking the MinE membrane targeting sequence stimulated higher ATP hydrolysis rates than the full-length protein, indicating that binding to MinD is sufficient to trigger this conformational transition in MinE. In contrast, conformational change between the open and closed states did not affect stimulation of ATP hydrolysis rates in the absence of membrane binding, although the MinD-binding residue Ile25 is critical for this conformational transition. We therefore propose an updated model where MinE is brought to the membrane through interactions with MinD. After stimulation of ATP hydrolysis, MinE remains bound to the membrane in a state that does not catalyze additional rounds of ATP hydrolysis. While the molecular basis for this inhibited state is unknown, previous observations of higher-order MinE self-association may explain this inhibition. Overall, our findings have general implications for Min protein oscillation cycles, including those that regulate cell division in bacterial pathogens.

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Epigenetic modification of miR-663 controls mitochondria-to-nucleus retrograde signaling and tumor progression [Molecular Bases of Disease]

The normal cellular function requires communication between mitochondria and the nucleus, termed mitochondria-to-nucleus retrograde signaling. Disruption of this mechanism has been implicated in the development of cancers. Many proteins are known modulators of retrograde signaling, but whether microRNAs (miRNAs) are also involved is unknown. We conducted a miRNA microarray analysis using RNA from a parental cell line, a rho0 line lacking mitochondrial DNA (mtDNA) and a rho0 line with restored mtDNA. We found that miR-663 was down-regulated in the mtDNA-depleted rho0 line. mtDNA restoration reversed this miRNA to parental level, suggesting that miR-663 may be epigenetically-regulated by retrograde signaling. By using methylation specific PCR and bisulfite sequencing we demonstrate that miR-663 promoter is epigenetically regulated not only by genetic but also by pharmacological disruption of oxidative phosphorylation (OXPHOS). Restoration of OXPHOS complex I inhibitor-induced miR-663 expression by N-acetylcysteine suggested that reactive oxygen species (ROS) play a key role in epigenetic regulation of miR-663. We determined that miR-663 regulates the expression of nuclear-encoded respiratory chain subunits involved in Complex I, II, III and IV. miR-663 also controlled the expression of the Complex I (NDUFAF1), II (SDHAF2), III (UQCC2) and IV (SCO1) assembly factors and was required for stability of respiratory supercomplexes. Furthermore, using luciferase assays, we found that miR-663 directly regulates UQCC2. The anti-miR-663 reduced OXPHOS complex activity and increased in vitro cellular proliferation and promoted tumor development in vivo in mice. We also found that increased miR-663 expression in breast tumors consistently correlates with increased patient survival. We provide the first evidence for miRNA controlling retrograde signaling, demonstrating its epigenetic regulation and its role in breast tumorigenesis.

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Local energetic frustration affects the dependence of green fluorescent protein folding on the chaperonin GroEL [Computational Biology]

The GroE chaperonin system in Escherichia coli comprises GroEL and GroES and facilitates ATP-dependent protein folding in vivo and in vitro. Proteins with very similar sequences and structures can differ in their dependence on GroEL for efficient folding. One potential but unverified source for GroEL dependence is frustration, wherein not all interactions in the native state are optimized energetically, thereby potentiating slow folding and misfolding. Here, we chose enhanced green fluorescent protein (eGFP) as a model system and subjected it to random mutagenesis, followed by screening for variants whose in vivo folding displays increased or decreased GroEL dependence. We confirmed the altered GroEL dependence of these variants with in vitro folding assays. Strikingly, mutations at positions predicted to be highly frustrated were found to correlate with decreased GroEL dependence. Conversely, mutations at positions with low frustration were found to correlate with increased GroEL dependence. Further support for this finding was obtained by showing that folding of an eGFP variant designed computationally to have reduced frustration is indeed less GroEL-dependent. Our results indicate that changes in local frustration also affect partitioning in vivo between spontaneous and chaperonin-mediated folding. Hence, design of minimally frustrated sequences can reduce chaperonin dependence and improve protein expression levels.

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Active-site adjacent phosphorylation at Tyr-397 by c-Abl kinase inactivates caspase-9 [Protein Structure and Folding]

Caspase-9 (casp-9) is an initiator caspase and plays a central role in activating apoptotic cell death. Control of all caspases is tightly regulated by a series of phosphorylation events enacted by several different kinases. Caspase-9 is the most heavily phosphorylated of all caspases, with phosphorylation of at least 11 distinct residues in all three caspase-9 domains by nine kinases. Caspase-9 phosphorylation by the non-receptor tyrosine kinase c-Abl at Tyr-153 reportedly leads to caspase-9 activation. All other phosphorylation events on caspases have been shown to block their proteolytic function by a number of mechanisms, so we sought to unravel the molecular mechanism of the putative caspase-9 activation by phosphorylation. Surprisingly, we observed no evidence for Tyr-153 phosphorylation of caspase-9 in vitro or in cells, suggesting that Tyr-153 is not phosphorylated by c-Abl. Instead, we identified a new site for c-Abl-mediated phosphorylation, Tyr-397. This residue is adjacent to the caspase-9 active site, but as a member of the second shell, not a residue that directly contacts substrates. Our results further indicated that Tyr-397 is the dominant site of c-Abl phosphorylation both in vitro and upon c-Abl activation in cells. Of note, phosphorylation at this site inhibited caspase-9 activity, and the bulk of the added phosphate moiety appeared to directly block substrate binding. c-Abl plays both proapoptotic and prosurvival roles, and our findings suggest that c-Abl's effects on caspase-9 activity promote the prosurvival mode.

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Unilateral Vocal Fold Paralysis in Parkinson Disease: Case Report and Review of the Literature

The objective of this study was to report the first case of unilateral vocal fold paralysis in a patient with Parkinson disease (PD) and to review the literature.

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Laryngocardiac Reflex: A Case Report and Review of the Literature

The vagus nerve has sensory and motor function in the larynx, as well as parasympathetic function in the thorax and abdomen. Stimulation of the superior laryngeal nerve can cause reflexive bradycardia.

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Is the Voice of Professional Voice Users With no Vocal Cord Lesions Similar to That of Non Professional Voice Users?

The objective of this study was to analyze if the voice of professional voice users (PVU) is comparable with that of a nonprofessional voice users (NPVUs), both of whom have no obvious vocal cord lesions.

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Cross-Cancer Analysis Reveals Novel Pleiotropic Associations—Letter

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Cross-Cancer Analysis Reveals Novel Pleiotropic Associations—Response

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CD39 expression defines cell exhaustion in tumor-infiltrating CD8+ T cells

The ability of CD8+ T lymphocytes to eliminate tumors is limited by their ability to engender an immunosuppressive microenvironment. Here we describe a subset of tumor-infiltrating CD8+ T cells marked by high expression of the immunosuppressive ATP ecto-nucleotidase CD39. The frequency of CD39highCD8+ T cells increased with tumor growth but was absent in lymphoid organs. Tumor-infiltrating CD8+ T cells with high CD39 expression exhibited features of exhaustion, such as reduced production of TNF and IL-2 and expression of co-inhibitory receptors. Exhausted CD39+CD8+ T cells from mice hydrolyzed extracellular ATP, confirming that CD39 is enzymatically active. Furthermore, exhausted CD39+CD8+ T cells inhibited IFNγ production by responder CD8+ T cells. In specimens from breast cancer and melanoma patients, CD39+CD8+ T cells were present within tumors and invaded or metastatic lymph nodes, but were barely detectable within non-invaded lymph nodes and absent in peripheral blood. These cells exhibited an exhausted phenotype with impaired production of IFNγ, TNF, IL-2 and high expression of co-inhibitory receptors. Although T cell receptor engagement was sufficient to induce CD39 on human CD8+ T cells, exposure to IL-6 and IL-27 promoted CD39 expression on stimulated CD8+ T cells from human or murine sources. Our findings show how the tumor microenvironment drives the acquisition of CD39 as an immune regulatory molecule on CD8+ T cells, with implications for defining a biomarker of T cell dysfunction and a target for immunotherapeutic intervention.

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CBX8 exhibits oncogenic activity via AKT/{beta}-Catenin activation in hepatocellular carcinoma

Deregulation of Polycomb proteins influences the development and progression of hepatocellular carcinoma (HCC). Here we show that chromobox 8 (CBX8) expression is increased in HCC and correlates with poor outcome in two independent cohorts containing a total of 879 cases. Ectopic expression of CBX8 facilitated tumor growth and metastasis, whereas CBX8 silencing suppressed these effects. CBX8 efficiently activated AKT/β-catenin signaling via upregulation of the transcription factor EGR1 and miR-365-3p in a non-canonical manner: CBX8 directly bound the EGR1 promoter to enhance its activity. In the nucleus, CBX8 also interacted with EGR1 to prevent its degradation. Furthermore, CBX8 increased the transcription of miR-365a-3p, which promoted the nuclear localization of β-catenin by targeting the 3'-UTR ZNRF1. Inhibiting either EGR1 or miR-365a-3p partially rescued CBX8-mediated malignant phenotypes. In clinical samples, CBX8 expression closely correlated with EGR1, miR-365a-3p and nuclear β-catenin. Collectively, our results show that CBX8 functions as an oncogene to upregulate EGR1 and miR-365-3p to stimulate the AKT/β-catenin pathway. This newly identified signaling axis may suggest new therapeutic strategies against HCC.

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Comparative transcriptome analysis quantifies immune cell transcript levels, metastatic progression and survival in osteosarcoma

Overall survival of patients with osteosarcoma (OS) has improved little in the past three decades and better models for study are needed. OS is common in large dog breeds and is genetically inducible in mice, making the disease ideal for comparative genomic analyses across species. Understanding the level of conservation of inter-tumor transcriptional variation across species and how it is associated with progression to metastasis will enable us to more efficiently develop effective strategies to manage OS and improve therapy. In this study, transcriptional profiles of OS tumors and cell lines derived from humans (n=49), mice (n=103) and dogs (n=34) were generated using RNA-sequencing. Conserved inter-tumor transcriptional variation was present in tumor sets from all three species and comprised gene clusters associated with cell cycle and mitosis and with the presence or absence of immune cells. Further, we developed a novel Gene Cluster Expression Summary Score (GCESS) to quantify inter-tumor transcriptional variation and demonstrated that these GCESS values associated with patient outcome. Human OS tumors with GCESS values suggesting decreased immune cell presence were associated with metastasis and poor survival. We validated these results in an independent human OS tumor cohort and in 15 different tumor data sets obtained from The Cancer Genome Atlas (TCGA). Our results suggest that quantification of immune cell absence and tumor cell proliferation may better inform therapeutic decisions and improve overall survival for OS patients.

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A subpopulation of stromal cells controls cancer cell homing to the bone marrow

Breast and prostate cancer cells home to the bone marrow where they presumably hijack the hematopoietic stem cell niche. We characterize here the elusive premetastatic niche by examining the role of mesenchymal stromal cells (MSC) in cancer cell homing. Decreasing the number of MSC pharmacologically enhanced cancer cell homing to the bone marrow in mice. In contrast, increasing the number of these MSC by various interventions including G-CSF administration diminished cancer cell homing. The MSC subpopulation that correlated best with cancer cells expressed stem, endothelial, and pericytic cell markers suggesting these cells represent an undifferentiated component of the niche with vascular commitment. In humans, a MSC subpopulation carrying markers for endothelial and pericytic cells was lower in the presence of cytokeratin+ cells in bone marrow. Taken together, our data show that a subpopulation of MSC with both endothelial and pericytic cell surface markers suppresses the homing of cancer cells to the bone marrow. Similar to the presence of cytokeratin+ cells in the bone marrow, this mesenchymal stromal cell subpopulation could prove useful in determining the risk of metastatic disease, and its manipulation might offer a new possibility for diminishing bone metastasis formation.

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Evidence for Kaposi's Sarcoma originating from Mesenchymal Stem Cell through KSHV-induced Mesenchymal-to-Endothelial Transition

The major transmission route for Kaposi's sarcoma-associated herpesvirus (KSHV) infection is the oral cavity through saliva. Kaposi's sarcoma (KS) frequently occurs in the oral cavity in HIV-positive individuals and is often the first presenting sign of AIDS. However, the oral target cells for KSHV infection and the cellular origin of KS remain unknown. Here we present clinical and experimental evidences that KS spindle cells may originate from virally modified oral mesenchymal stem cells (MSC). AIDS-KS spindle cells expressed neuroectodermal stem cell marker (Nestin) and oral MSC marker CD29, suggesting an oral/craniofacial MSC lineage of AIDS-associated KS. Furthermore, oral MSC were highly susceptible to KSHV infection, and infection promoted multi-lineage differentiation and mesenchymal-to-endothelial transition (MEndT). KSHV infection of oral MSCs resulted in expression of a large number of cytokines, a characteristic of KS, and upregulation of KS signature and MEndT-associated genes. These results suggest that KS may originate from pluripotent MSC and KSHV infection transforms MSC to KS-like cells through MEndT.

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Effectiveness, Safety, and Predictors of Response to Botulinum Toxin Type A in Refractory Masticatory Myalgia: A Retrospective Study

Masticatory muscle pain disorders respond well to conservative therapy; however, in some patients the pain becomes refractory. Botulinum toxin type A (BoT-A) therapy has been shown to be an effective modality in the management of refractory headache disorders. Conversely, there are conflicting reports in the literature regarding the efficacy, safety, and predictors of therapeutic response to BoT-A therapy for management of refractory masticatory muscle pain.

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AAOMS Author Disclosure forms

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Is It Time to Reexamine Reexamination?

Becoming board certified is, for most, the hallmark that a clinician has demonstrated to peers in their discipline that they possess the knowledge, ethics, and judgment deemed necessary to deliver excellent patient care. Board certification is widely used to determine whether a clinician can receive hospital privileges, malpractice insurance, a position on a healthcare insurance panel, and fellowship status in professional associations. Being board certified also brings a large degree of prestige among one's clinical colleagues and can be used by patients to help select their doctor.

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Editorial Board Page

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Masthead

(ISSN 0278-2391) is published monthly by Elsevier Inc, for the American Association of Oral and Maxillofacial Surgeons, 360 Park Avenue South, New York, NY 10010-1710. Business Office: 1600 John F. Kennedy Blvd, Ste 1800, Philadelphia, PA 19103-2899. Periodicals postage paid at New York, NY and additional mailing offices.

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In Response to “Multiple Calcifying Hyperplastic Dental Follicles: A Case Report and Literature Review”

I read with interest the article "Multiple calcifying hyperplastic dental follicles: A case report and literature review" by Desai et al.1 The information presented gives us all much to think about when faced with cystic lesions of apparent dental follicle origin. Most telling for me, however, was a simple phrase in the last paragraph, which "…emphasizes the importance of submission of every single surgically removed tissue for histopathological examination [italics added]."

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News and Announcements

The 2017 AAOMS Dental Implant Conference in Chicago, IL, will feature seven preconference courses on November 30, followed by general sessions on December 1 and 2. In the exhibit hall, more than 100 companies will display products, equipment and services. The conference serves OMSs, the entire restorative team and referring dentists.

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Unexpected extracardiac multifocal adult rhabdomyomas with 10 lesions of the head and neck: epidemiology, diagnosis and therapy

Adult rhabdomyomas (ARMs) are rare solitary benign neoplasms of the head and neck, which are even rarer when multifocal. Owing to the low incidence and the scanty cognation of this peculiar entity, several patients were reported to be misdiagnosed or overtreated. Here, a patient of multifocal ARMs with as many as 10 synchronous lesions is presented. In addition, all published cases of this entity were reviewed from Pubmed, Embase and Web of Science database up to March 1, 2017. Overall, 10 of 29 reported cases had more than 2 lesions, with a maximum of 10 synchronous masses in our report.

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Targeting the Stat6 pathway in tumor-associated macrophages reduces tumor growth and metastatic niche formation in breast cancer [Research]

Tumor-associated macrophages (TAMs) are the key effector cells in the tumor microenvironment and induce neoangiogenesis, matrix remodeling, and metastasis while suppressing the tumor immune system. These protumoral macrophages display an M2 phenotype induced by IL-4 and IL-13 cytokines. In this study, we hypothesized that the inhibition of the signal transducer and activator of transcription 6 (Stat6) pathway, a common downstream signaling pathway of IL-4 and IL-13, may be an interesting strategy by which to inhibit TAM differentiation and, thus, their protumorigenic activities. In vitro inhibition of the Stat6 pathway by using small interfering RNA or the pharmacologic inhibitor, AS1517499, inhibited the differentiation of mouse RAW264.7 macrophages into the M2 phenotype, as demonstrated by the reduction of Arg-1 (arginase-1) and Mrc-1 (mannose receptor 1) expression and arginase activity. In vivo, AS1517499 significantly attenuated tumor growth and early liver metastasis in an orthotopic 4T1 mammary carcinoma mouse model. Furthermore, in another experiment, we observed an increase in the intrahepatic mRNA expression of F4/80 (EGF-like module-containing mucin-like hormone receptor-like 1; total macrophages) and M2 macrophage markers [Ym-1 (chitinase 3–like protein 3) and Mrc-1] and metastatic niche markers [Mmp-2 (matrix metalloproteinase-2), Postn (periostin), and Cd34] in mice with increasing growth of primary tumors. Of interest, these markers were found to be reduced after treatment with AS1517499. In summary, inhibition of the Stat6 pathway in TAMs is a vital therapeutic approach to attenuate tumor growth and metastasis by inhibiting TAM-induced protumorigenic and prometastatic activities.—Binnemars-Postma, K., Bansal, R., Storm, G., Prakash, J. Targeting the Stat6 pathway in tumor-associated macrophages reduces tumor growth and metastatic niche formation in breast cancer.

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Severe negative energy balance during 21 d at high altitude decreases fat-free mass regardless of dietary protein intake: a randomized controlled trial [Research]

In this 2-phase randomized controlled study, we examined whether consuming a higher protein (HP) diet would attenuate fat-free mass (FFM) loss during energy deficit (ED) at high altitude (HA) in 17 healthy males (mean ± sd: 23 ± 6 yr; 82 ± 14 kg). During phase 1 at sea level (SL, 55 m), participants consumed a eucaloric diet providing standard protein (SP; 1.0 g protein/kg,) for 21 d. During phase 2, participants resided at HA (4300 m) for 22 d and were randomly assigned to either an SP or HP (2.0 g protein/kg) diet designed to elicit a 40% ED. Body composition, substrate oxidation, and postabsorptive whole-body protein kinetics were measured. Participants were weight stable during SL and lost 7.9 ± 1.9 kg (P < 0.01) during HA, regardless of dietary protein intake. Decrements in whole-body FFM (3.6 ± 2.4 kg) and fat mass (3.6 ± 1.3 kg) were not different between SP and HP. HP oxidized 0.95 ± 0.32 g protein/kg per day more than SP and whole-body net protein balance was more negative for HP than for SP (P < 0.01). Based on changes in body energy stores, the overall ED was 70% (–1849 ± 511 kcal/d, no group differences). Consuming an HP diet did not protect FFM during severe ED at HA.—Berryman, C. E., Young, A. J., Karl, J. P., Kenefick, R. W., Margolis, L. M., Cole, R. E., Carbone, J. W., Lieberman, H. R., Kim, I.-Y., Ferrando, A. A., Pasiakos, S. M. Severe negative energy balance during 21 d at high altitude decreases fat-free mass regardless of dietary protein intake: a randomized controlled trial.

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Comparison on anticoagulation and antiplatelet aggregation effects of puerarin with heparin sodium and tirofiban hydrochloride: an in Vitro study

Abstract

Objective

To detect the anticoagulation and antiplatelet effects of different concentrations of puerarin, heparin sodium and tirofiban hydrochloride on the blood samples of healthy volunteers by Sonoclot coagulation and platelet function analyzer.

Methods

Peripheral blood samples were extracted from 20 healthy volunteers, followed by adding different concentrations of puerarin, heparin sodium and tirofiban hydrochloride. Samples were detected for activated clotting time (ACT), clot rate (CR) and platelet function (PF) by Sonoclot coagulation and platelet function analyzer instrument.

Results

For puerarin and heparin sodium, the values of ACT gradually increased, and the values of CR and PF gradually decreased with increasing in drug concentration. There was a linear (or log linear) relationship between ACT, CR, PF value and drug concentration (P<0.01). Corresponding to each value, a regression equation was obtained. For tirofiban hydrochloride, the values of ACT and CR had no significant changes, while PF values gradually decreased with concentration increasing. There was also a linear relationship between PF values and concentrations of tirofiban hydrochloride (P<0.01). Under the same ACT values, the puerarin corresponding CR values (CR = e^{−0.0062ACT+4.31}, P<2.2e-16) were always higher than the corresponding values (CR = e^{−0.0028ACT+2.79}, P-value<2.2e-16) of heparin sodium. For high concentrations of puerarin (e.g. 3.8 mg/600 μL) and tirofiban hydrochloride (e.g. 0.8 μg/600 μL), PF values had no significant difference. However, PF values for high puerarin concentration had a larger variance.

Conclusions

Puerarin has similar anticoagulant and antiplatelet effects with the heparin sodium, and may have a lower hemorrhage risk than heparin sodium when obtained the same anticoagulation effect in the concentration range of this experiment. In addition, for high concentration, puerarin had the same antiplatelet function as tirofiban hydrochloride but with a larger individual variability.

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A New Operative One-Wing Technique to Correct Fronto-Orbital Region in Unilateral Nonsyndromic Plagiocephaly.

Anterior plagiocephaly is a premature closing of unilateral coronal suture. This premature suture fusion causes a series of cranial asymmetry and alteration of the fronto-orbital region. The authors described a new surgical technique to correct the facial asymmetry that reduces the operative time and the possible complications. In a period between 2013and 2016, 12 children affected by nonsyndromic anterior plagiocephaly were treated with this new procedure. Clinical, cranial development, and absence of postoperative complication demonstrated that one-wing surgical bone correction is a useful and innovative technique. (C) 2017 by Mutaz B. Habal, MD.

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Defining and Correcting Asymmetry in Isolated Unilateral Frontosphenoidal Synostosis: Differences in Orbital Shape, Facial Scoliosis, and Skullbase Twist Compared to Unilateral Coronal Synostosis.

Introduction: Isolated frontosphenoidal synostosis (FS) is a rare cause of fronto-orbital plagiocephaly that can be challenging to distinguish from isolated unicoronal synostosis (UC). The purpose of this paper is to analyze differences in fronto-orbital dysmorphology between the 2 conditions, to describe approaches for surgical correction, and to report surgical outcomes between FS and UC patients in a casecontrol fashion. Methods: Patients treated for craniosynostosis over a 12-year period at our institution were retrospectively evaluated under institutional review board approval. Frontosphenoidal synostosis patients who underwent bilateral fronto-orbital correction of anterior plagiocephaly with minimum 2-year follow-up, adequate pre-, and minimum 2-year postoperative computed tomography scans were included in the case-control portion of the study. These patients were randomly age-matched to UC patients meeting the same inclusion criteria. Preoperative and postoperative orbital shape and volumetric analysis was performed using Mimics software. Results: Twelve FS patients were treated during the study period. Seven of these patients met casecontrol inclusion criteria with average follow-up of 47.5 months. The characteristic FS orbit was a relatively wide, short, and shallow trapezoid, while the characteristic UC orbit was a relatively narrow, tall, and deep parallelogram. Frontosphenoidal synostosis orbits were significantly wider, shorter, shallower, and smaller than UC orbits. Surgical correction tailored to the differential dysmorphologies resulted in statistical equalization of these differences between affected and contralateral control orbits at follow-up, with the exception of UC orbital width, which remained significantly narrower than unaffected contralateral control. One patient in each group required cranioplasty for skull defects at follow-up, while no patient underwent surgical readvancement. Conclusions: Frontosphenoidal synostosis and UC orbital shape differ significantly, and can be normalized using fronto-orbital advancement tailored to the distinct orbital dysmorphologies of these 2 groups. (C) 2017 by Mutaz B. Habal, MD.

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Osteogenesis of Crouzon-Mutated Cells in a Murine Model.

Crouzon syndrome is an autosomal-dominant congenital disease due to a mutation in the fibroblast growth factor receptor 2 protein. The purpose of this study is to evaluate wound-healing potential of Crouzon osteoblasts and adipose-derived stem cells (ADSCs) in a murine model. Parietal skull defects were created in Crouzon and mature wild-type (WT) CD-1 mice. One group of WT and Crouzon mice were left untreated. Another group was transplanted with both WT and Crouzon adipose-derived stem cells. Additional groups compared the use of a fibrin glue scaffold and periosteum removal. Skulls were harvested from each group and evaluated histologically at 8-week and/or 16-week periods. Mean areas of defect were quantified and compared via ANOVA F-test. The average area of defect after 8 and 16 weeks in untreated Crouzon mice was 15.37 +/- 1.08 cm2 and 16.69 +/- 1.51 cm2, respectively. The average area of the defect in untreated WT mice after 8 and 16 weeks averaged 14.17 +/- 1.88 cm2 and 14.96 +/- 2.26 cm2, respectively. WT mice with autologous ADSCs yielded an average area of 15.35 +/- 1.34 cm2 after 16 weeks while Crouzon mice with WT ADSCs healed to an average size of 12.98 +/- 1.89 cm2. Crouzon ADSCs transplanted into WT mice yielded an average area of 15.47 +/- 1.29 cm2 while autologous Crouzon ADSCs yielded an area of 14.22 +/- 3.32 cm2. ANOVA F-test yielded P = .415. The fibroblast growth factor receptor 2 mutation in Crouzon syndrome does not promote reossification of critical-sized defects in mature WT and Crouzon mice. Furthermore, Crouzon ADSCs do not possess osteogenic advantage over WT ADSCs. (C) 2017 by Mutaz B. Habal, MD.

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Transorbital Penetrating Intracranial Injury by a Battery.

The authors report a patient of transorbital penetrating intracranial injury by a battery. A 59-year-old man presented with a foreign body in the left orbital region after an explosion during waste combustion. Physical examination revealed his left eyelid had been punctured and the eyeball ruptured by what appeared to be a battery, which was lodged in the left orbit. The patient was neurologically intact. Facial computed tomography showed a ca. 6.2 x 1.7 cm sized metallic foreign body, probably an electric battery, penetrating through the left orbit and orbital roof and terminating in the left anterior cranial fossa. Clinical presentation, treatment course, and follow-up are discussed. (C) 2017 by Mutaz B. Habal, MD.

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Cell Polarity and PAR Complex Likely to Be Involved in Dexamethasone-Induced Cleft Palate.

Accumulating studies demonstrated that PAR complex contributed to the establishment and maintenance of cell polarity which was fundamental to many aspects of cell and developmental biology. The purpose of this study was to investigate whether dexamethasone (DEX) could downregulate the PAR complex and disrupt cell polarity in palatal epithelium during palatal fusion in mice. The C57BL/6J mice were selected for the experiment. Pregnant mice in control group and DEX-treated group were injected intraperitoneally with 0.9% sodium chloride 0.1 mL, which contained DEX 6 mg/kg respectively, every day from E10 to E12. The palatal epithelia morphology was observed with hematoxylin and eosin and scanning electron microscopy. Immunofluorescence staining, western blot, and real-time polymerase chain reaction were performed to detect the expression of PAR3/PAR6/aPKC. After being treated with DEX, the palatal shelves showed delayed development and became shorter and smaller. During the process of palatogenesis, PAR3 and PAR6 expressed in the palatal epithelium, and aPKC expressed in both the epithelium and the mesenchyme. Dexamethasone could downregulate the expression levels of PAR3/PAR6/aPKC in both protein and gene level. In conclusions, DEX affected the PAR complex of mouse embryonic palate, and could perturb the PAR complex and the cell polarity of medial edge epithelium cells, and caused the failure of palatal fusion. (C) 2017 by Mutaz B. Habal, MD.

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Corticotomy With a Palatal Bone-Borne Retractor for Correcting Severe Bimaxillary Protrusion.

Background: This article presents an alternate surgical treatment method to correct a severe anterior protrusion in the adult patient with an extremely thin alveolus. Methods: In the maxilla, a wide linear corticotomy was performed under local anesthesia. Cortical alveolar bone of the upper first bicuspids area was widely removed. Orthopedic force for bony block movement was applied by a palatal bone-borne type retractor supported by skeletal anchorage. Residual extraction space closure was performed by biocreative orthodontics strategy (BOS). In the mandible, an anterior segmental osteotomy (ASO) and extraction of 1st premolars were performed under local anesthesia. Results: In the maxilla, bony block movement followed by the wide linear corticotomy with a palatal bone-borne type retractor was implemented without complications. Remaining extraction space after the bony block movement was closed effectively by BOS. In the mandible, anterior segmental retraction was achieved effectively by ASO. Conclusions: Wide linear corticotomy with a palatal bone-borne type retractor and ASO under local anesthesia can be an effective alternative to orthognathic surgery in adults with protrusion and an extremely thin alveolus. The biocreative strategy also provides a simple and effective method to retract the 6 anterior teeth. (C) 2017 by Mutaz B. Habal, MD.

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Primary Central Nervous System Lymphoma of Optic Chiasma: Endoscopic Endonasal Treatment.

Background: Isolated primary central nervous system lymphoma arising from anterior visual pathway is very rare. Patient Presentation: A 76-year-old immunocompetent previously healthy man presented bilateral decreased visual acuity in 1 month. Pituitary magnetic resonans imaging (MRI) showed a lobulated mass with homogeneous enhancement after gadolinium administration that arising from optic chiasm suggested that inflammatory disease or an optic glioma. The patient underwent an extended endoscopic endonasal transsphenoidal surgery. Postoperative course and outcomes were wonderful. Histopathological diagnosis was diffuse large B-cell lymphoma. The patient underwent investigations for systemic lymphomatous involvement, did not detect any evidence of systemic disease. Conclusion: In this case, we claimed that differential diagnoses of anterior visual pathway lesions are difficult because of similarity of lesions on clinical and radiological examinations. Biopsy is essential for these lesions. As a biopsy technique, endoscopic endonasal transsphenoidal approach is safer and more effective than open procedures. (C) 2017 by Mutaz B. Habal, MD.

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Bioinformatics Associated With Conjoined Twin Separation.

The separation of conjoined twins is a rare event in the medical field and presents many unique challenges to overcome. With the complexities of today's interconnected healthcare technology and electronic medical record, there are many intricate details that need significant attention to guarantee proper care and accurate record keeping for conjoined twins. Items that require attention are how to digitally represent the twins-as 1 patient or 2, how to incorporate the physiological monitors into the medical record, and how to ensure the proper amount of infrastructure, equipment, and space. With careful planning and consideration, technology can be used as an aid in separating conjoined twins at any institution. (C) 2017 by Mutaz B. Habal, MD.

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Method for Securing Methlymethacrylate Bone Cement Using Histoacryl Glue During Cranioplasty for Contour Deformities.

Methylmethacrylate bone cement (MM-BC) is one of the reconstructive methods: during cranioplasty to correct cranial defects following trauma or cranial surgery. Perfect intraoperative immobilization of the MM-BC is crucial to ensure correct subsequent shaping to best improve contour defects. Current immobilization techniques reported are time-consuming and involve complex metalwork. The authors hereby present a technique that may simplify the immobilization process by using histoacryl glue to secure the MM-BC. This provides a quick, inexpensive, and readily available option providing fixation strong enough to withstand final shaping of the MM-BC. (C) 2017 by Mutaz B. Habal, MD.

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Relationship of a Metopic Ridge and Anterior Cranial Volume Measured by a Noninvasive Laser Shape Digitizer.

Cranial dysmorphology observed in patients with metopic craniosynostosis varies along a spectrum of severity including varying degrees of metopic ridging, bitemporal narrowing, and trigonocephaly. Management has been based upon the subjective clinical impression of presence and severity of trigonocephaly. Severity of cranial dysmorphology does not predict the occurrence or severity of associated abnormal neurodevelopment, as children with mild-to-moderate trigonocephaly may also experience developmental delays. The authors sought to determine the relationship between mild-to-moderate trigonocephaly and anterior cranial volume using a noninvasive laser shape digitizer (STARscanner) in patients with abnormal head shape. An IRB-approved retrospective review of a prospectively maintained database and medical records was performed. Two hundred three patients less than 1 year of age with abnormal head shape were categorized as having a metopic ridge with mild-to-moderate trigonocephaly, metopic ridge without trigonocephaly, or no ridge. Measurements of cranial volume, circumference, and symmetry were calculated by the STARscanner, which quantifies three-dimensional shape of the cranial surface. Measures were analyzed using a series of analyses of variance and post-hoc Tukey honest significant difference. The authors results showed ACV was significantly reduced in patients with mild-to-moderate trigonocephaly compared with those without metopic ridge (P = 0.009), and trended toward significance compared with those with a ridge but without trigonocephaly (P = 0.072). The ratio of anterior-to-posterior cranial volume was significantly reduced in those with mild-to-moderate trigonocephaly compared with those without metopic ridge (P = 0.036). In conclusion, patients with milder anterior cranial deformities demonstrated an association between a metopic ridge with mild-to-moderate trigonocephaly and reduced anterior cranial volume. (C) 2017 by Mutaz B. Habal, MD.

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Efficient and High-Color-Purity Light-Emitting Diodes Based on In Situ Grown Films of CsPbX3 (X = Br, I) Nanoplates with Controlled Thicknesses

TOC Graphic

ACS Nano

DOI: 10.1021/acsnano.7b05191

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Schlaf bei psychischen Erkrankungen

Zusammenfassung

Schlaf und psychische Erkrankungen sind wechselseitig miteinander verbunden: So sind Störungen des Schlafs ein sehr häufiges Symptom psychischer Erkrankungen und möglicherweise auch ein unabhängiger Risikofaktor dafür. Es gibt eine Reihe von Hinweisen, dass Schlafstörungen den Therapieerfolg sowohl kurz- als auch langfristig beeinflussen. Auch können sich bestimmte Veränderungen des Schlafs negativ auf kognitive Hirnleistungen auswirken, wie z. B. auf die Gedächtniskonsolidierung oder auf die Emotionsregulierung. Der Behandlung von Schlafstörungen bei psychischen Erkrankungen kommt somit eine herausragende Bedeutung zu. Im vorliegenden Artikel werden abschließend die Effekte der kognitiven Verhaltenstherapie und von Psychopharmaka auf Schlaf und psychische Symptome dargestellt.

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PreOp® Infection Control Uso de guantes desechables Patient Education

PreOp® Infection Control Uso de guantes desechables Patient Education
http://ift.tt/2y34VKg
A Patient Education & Patient Engagement Company
El uso correcto de guantes
ayuda a prevenir la propagación de infecciones
protege a la persona que atiende al paciente y al paciente
se debe practicar el hábito de lavarse bien las manos
Siempre use guantes al tocar cualquier cosa mojada o sucia

- sangre
- orina
- heces
- vómito
- moco

Ejemplos de cuando usted puede estar en contacto con líquidos corporales
- heridas abiertas
- orinal
- baños
- ropa sucia

Este video tiene la intención de servir como instrumento de apoyo para que usted entienda mejor las instrucciones que se le han dado para los cuidados.

No se pretende reemplazar ningún consejo específico, ni ninguna instrucción sobre sus cuidados personales que usted haya recibido por parte de su equipo de atención médica. Si usted tiene cualquier pregunta o problema por favor llame o pida ser atendido.

A Patient Education & Patient Engagement Company

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Thermodynamic modeling of phase equilibria and defect chemistry in the Zn-S system

Publication date: December 2017
Source:Calphad, Volume 59
Author(s): Pin-Wen Guan, Shun-Li Shang, Greta Lindwall, Tim Anderson, Zi-Kui Liu
Though important and fundamental, a satisfactory theoretical framework of modeling multiple point defects in the context of phase equilibria is still lacking. In this work, a methodology that models point defects, electrons, holes and the underlying phase equilibria simultaneously is developed and applied to the Zn-S system. It overcomes some issues in previous works, such as inconsistency in the reference state for electrons. The model parameters are directly related to the Gibbs energy of formation of point defects computed from first-principles phonon calculations. A double exponential function is proposed to parameterize the entropy of formation of point defects as a function of temperature. Using this approach, phase diagrams, concentrations of point defects and free carriers, the majority carrier, and defect-related properties exemplified by the electrical conductivity are obtained under various conditions, in agreement with experimental data. The present methodology provides a way to integrate first-principles calculations and experimental data into the CALPHAD model, enabling description of multi-component semiconductor systems.

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Effect of incubation duration, growth temperature, and abiotic surface type on cell surface properties, adhesion and pathogenicity of biofilm-detached Staphylococcus aureus cells

The goal of this study was to investigate the effect of growth conditions such as the temperature (20, 30 and 37 °C), incubation duration (24 and 48 h) and surface type (stainless steel and polycarbonate) on t...

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Responses of zinc recovery to temperature and mineral composition during sphalerite bioleaching process

Temperature and energy resources (e.g., iron, sulfur and organic matter) usually undergo dynamic changes, and play important roles during industrial bioleaching process. Thus, it is essential to investigate th...

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Comparison on anticoagulation and antiplatelet aggregation effects of puerarin with heparin sodium and tirofiban hydrochloride: an in Vitro study

Abstract

Objective

Methods

Results

Conclusions

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Neovascular Prostate-Specific Membrane Antigen Expression Is Associated with Improved Overall Survival under Palliative Chemotherapy in Patients with Pancreatic Ductal Adenocarcinoma

Aims. Expression of PSMA (prostate-specific membrane antigen) has been demonstrated in various cancers, including pancreatic ductal adenocarcinoma (PDAC). However, PSMA expression in PDAC-associated neovasculature has so far not been systematically analyzed. Methods and Results. We analyzed PSMA expression in 81 PDAC tissue samples from 61 patients. Microvessel density (MVD) was assessed by software-based image analysis and showed a mean MVD of 63.7 microvessels/0.785 mm2. PSMA was practically absent in tumor tissue (5.3%) and PDAC cell lines (0/7) but could be detected in tumor-associated neovasculature in 53.2% of cases. There was no association between neovascular PSMA expression and clinicopathological tumor characteristics. Samples with PSMA+ neovasculature showed increased MVD; however, this result was not statistically significant (). Presence of PSMA+ neovessels correlated with overall survival under palliative chemotherapy (894 versus 400 days; HR 0.42; 95% CI: 0.12 to 0.87; ). Conclusion. PSMA expression in tumor-associated neovasculature is a common feature and associated with improved overall survival under palliative chemotherapy in PDAC. Our results point towards a possible association between PSMA expression and response to therapy which might be based on enhanced intratumoral bioavailability of systemic chemotherapy.

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Smart Cities: Recent Trends, Methodologies, and Applications

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Safety-Guaranteed Trajectory Tracking Control for the Underactuated Hovercraft with State and Input Constraints

This paper develops a safety-guaranteed trajectory tracking controller for hovercraft by using a safety-guaranteed auxiliary dynamic system, an integral sliding mode control, and an adaptive neural network method. The safety-guaranteed auxiliary dynamic system is designed to implement system state and input constraints. By considering the relationship of velocity and resistance hump, the velocity of hovercraft is constrained to eliminate the effect of resistance hump and obtain better stability. And the safety limit of drift angle is well performed to guarantee the light safe maneuvers of hovercraft tracking with high velocities. In view of the natural capabilities of actuators, the control input is constrained. High nonlinearity and model uncertainties of hovercraft are approximated by employing adaptive radical basis function neural networks. The proposed controller guarantees the boundedness of all the closed-loop signals. Specifically, the tracking errors are uniformly ultimately bounded. Numerical simulations are implemented to demonstrate the efficacy of the designed controller.

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Barriers to Physical Activity in Low Back Pain Patients following Rehabilitation: A Secondary Analysis of a Randomized Controlled Trial

Background. Promoting health-enhancing physical activity following rehabilitation is a well-known challenge. This study analysed the barriers to leisure time activity among low back pain patients. Methods. A subset of 192 low back pain patients who participated in a randomized controlled trial promoting physical activity was analysed. Physical activity, barriers, and sociodemographic and indication-related variables were assessed by a questionnaire. Differences in barriers between active and inactive participants were tested by Pearson's chi squared test. A logistic regression model was fitted to identify influencing factors on physical activity at six months following rehabilitation. Results. Inactive and active participants differed significantly in nine of the 19 barriers assessed. The adjusted regression model showed associations of level of education (OR = 5.366 [1.563; 18.425]; value = 0.008) and fear of pain (OR = 0.612 [0.421; 0.889]; value = 0.010) with physical activity. The barriers included in the model failed to show any statistically significant association after adjustment for sociodemographic factors. Conclusions. Low back pain patients especially with a low level of education and fear of pain seem to need tailored support in overcoming barriers to physical activity. This study is registered at German Clinical Trials Register (DRKS00004878).

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Distributed 3D Source Localization from 2D DOA Measurements Using Multiple Linear Arrays

This manuscript addresses the problem of 3D source localization from direction of arrivals (DOAs) in wireless acoustic sensor networks. In this context, multiple sensors measure the DOA of the source, and a central node combines the measurements to yield the source location estimate. Traditional approaches require 3D DOA measurements; that is, each sensor estimates the azimuth and elevation of the source by means of a microphone array, typically in a planar or spherical configuration. The proposed methodology aims at reducing the hardware and computational costs by combining measurements related to 2D DOAs estimated from linear arrays arbitrarily displaced in the 3D space. Each sensor measures the DOA in the plane containing the array and the source. Measurements are then translated into an equivalent planar geometry, in which a set of coplanar equivalent arrays observe the source preserving the original DOAs. This formulation is exploited to define a cost function, whose minimization leads to the source location estimation. An extensive simulation campaign validates the proposed approach and compares its accuracy with state-of-the-art methodologies.

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Ecosystem Drought Response Timescales from Thermal Emission versus Shortwave Remote Sensing

Remote sensing is used for monitoring the impacts of meteorological drought on ecosystems, but few large-scale comparisons of the response timescale to drought of different vegetation remote sensing products are available. We correlated vegetation health products derived from polar-orbiting radiometer observations with a meteorological drought indicator available at different aggregation timescales, the Standardized Precipitation Evapotranspiration Index (SPEI), to evaluate responses averaged globally and over latitude and biome. The remote sensing products are Vegetation Condition Index (VCI), which uses normalized difference vegetation index (NDVI) to identify plant stress, Temperature Condition Index (TCI), based on thermal emission as a measure of surface temperature, and Vegetation Health Index (VHI), the average of VCI and TCI. Globally, TCI correlated best with 2-month timescale SPEI, VCI correlated best with longer timescale droughts (peak mean correlation at 13 months), and VHI correlated best at an intermediate timescale of 4 months. Our results suggest that thermal emission (TCI) may better detect incipient drought than vegetation color (VCI). VHI had the highest correlations with SPEI at aggregation times greater than 3 months and hence may be the most suitable product for monitoring the effects of long droughts.

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Functional Characterization of Preadipocytes Derived from Human Periaortic Adipose Tissue

Adipose tissue can affect the metabolic control of the cardiovascular system, and its anatomic location can affect the vascular function differently. In this study, biochemical and phenotypical characteristics of adipose tissue from periaortic fat were evaluated. Periaortic and subcutaneous adipose tissues were obtained from areas surrounding the ascending aorta and sternotomy incision, respectively. Adipose tissues were collected from patients undergoing myocardial revascularization or mitral valve replacement surgery. Morphological studies with hematoxylin/eosin and immunohistochemical assay were performed in situ to quantify adipokine expression. To analyze adipogenic capacity, adipokine expression, and the levels of thermogenic proteins, adipocyte precursor cells were isolated from periaortic and subcutaneous adipose tissues and induced to differentiation. The precursors of adipocytes from the periaortic tissue accumulated less triglycerides than those from the subcutaneous tissue after differentiation and were smaller than those from subcutaneous adipose tissue. The levels of proteins involved in thermogenesis and energy expenditure increased significantly in periaortic adipose tissue. Additionally, the expression levels of adipokines that affect carbohydrate metabolism, such as FGF21, increased significantly in mature adipocytes induced from periaortic adipose tissue. These results demonstrate that precursors of periaortic adipose tissue in humans may affect cardiovascular events and might serve as a target for preventing vascular diseases.

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Effects of Glutathione on Mechanical Allodynia and Central Sensitization in Chronic Postischemic Pain Rats

Background. The chronic postischemia pain (CPIP) model is an animal model using ischemia/reperfusion injury that mimics the symptoms of complex regional pain syndrome type I. Glutathione (GSH) prevents ischemia/reperfusion injury by scavenging free radicals. We conducted this study to investigate the protective effect of GSH in CPIP rats via changes of mechanical allodynia and phospholyration of the N-methyl-D-aspartate receptor subunit GluN1. Methods. We divided 45 rats into 5 groups: sham, CPIP, CPIP + GSH 100 mg/kg, CPIP + GSH 200 mg/kg, and CPIP + GSH 500 mg/kg. Rats in the sham and CPIP groups received normal saline and rats in the other groups received GSH at the designated doses thirty minutes prior to reperfusion. Withdrawal thresholds were evaluated before sugery as well as 1, 3, and 7 days after surgery. pGluN1 level in the spinal cord was also measured. Results. GSH treated rats show a significant increase in the withdrawal thresholds of both hind paws as compared with the CPIP group dose-dependently. The expression of pGluN1 in the GSH treated rats significantly decreased as compared to the CPIP group (all P

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Corrigendum to “Incorporating Family Function into Chronic Pain Disability: The Role of Catastrophizing”

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Lignin and Cellulose Extraction from Vietnam’s Rice Straw Using Ultrasound-Assisted Alkaline Treatment Method

The process of cellulose and lignin extraction from Vietnam's rice straw without paraffin pretreatment was proposed to improve economic efficiency and reduce environmental pollution. Treatment of the rice straw with ultrasonic irradiation for 30 min increased yields of lignin separation from 72.8% to 84.7%. In addition, the extraction time was reduced from 2.5 h to 1.5 h when combined with ultrasonic irradiation for the same extraction yields. Results from modern analytical methods of FT-IR, SEM, EDX, TG-DTA, and GC-MS indicated that lignin obtained by ultrasound-assisted alkaline treatment method had a high purity and showed a higher molecular weight than that of lignin extracted from rice straw without ultrasonic irradiation. The lignin and cellulose which were extracted from rice straw showed higher thermal stability with 5% degradation at a temperature of over 230°C. The ultrasonic-assisted alkaline extraction method was recommended for lignin and cellulose extraction from Vietnam's rice straw.

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In Vitro Antibacterial Activity of Pomegranate Juice and Peel Extracts on Cariogenic Bacteria

Aim. To evaluate the antimicrobial activity of hydroalcoholic extracts of pomegranate (Punica granatum L.) peel and juice, against the microorganisms considered the main etiologic agents of dental caries. Methods. The values of the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) were determined against Streptococcus mutans Clarke ATCC® 25175™ strain and Rothia dentocariosa clinical isolate. Results. Peel extracts inhibit effectively the growth and survival of S. mutans ATCC 25175 strain and R. dentocariosa clinical isolate with MIC and MBC values of 10 μg/μl and 15 μg/μl, respectively. Furthermore, the pomegranate juice extract showed high inhibitory activity against S. mutans ATCC 25175 strain with a MIC value of 25 μg/μl and a MBC value of 40 μg/μl, whereas, against R. dentocariosa, it has displayed a moderate inhibitory activity, with MIC and MBC values of 20 μg/μl and 140 μg/μl, respectively. Conclusions. In vitro microbiological tests demonstrate that the hydroalcoholic extracts of pomegranate juice and peel are able to contrast the main cariogenic bacteria involved in tooth decay. Although being preliminary data, our results suggest that pomegranate polyphenolic compounds could represent a good adjuvant for the prevention and treatment of dental caries.

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Effects of NSAIDs on the Release of Calcitonin Gene-Related Peptide and Prostaglandin E2 from Rat Trigeminal Ganglia

Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used to treat migraine, but the mechanisms of their effects in this pathology are not fully elucidated. The trigeminal ganglia and calcitonin gene-related peptide (CGRP) have been implicated in the pathophysiology of migraine. The release of CGRP and prostaglandin E2 (PGE2) from freshly isolated rat trigeminal ganglia was evaluated after oral administration of nimesulide, etoricoxib, and ketoprofen, NSAIDs with different pharmacological features. Thirty minutes after oral administration, nimesulide, 10 mg/Kg, decreased the GCRP release induced by an inflammatory soup, while the other NSAIDs were ineffective at this point in time. Two hours after oral nimesulide (5 and 10 mg/Kg) and ketoprofen (10 mg/Kg), but not of etoricoxib, a significant decrease in the CGRP release was observed. All drugs reduced PGE2, although with some differences in timing and doses, and the action on CGRP does not seem to be related to PGE2 inhibition. The reduction of CGRP release from rat trigeminal ganglia after nimesulide and ketoprofen may help to explain the mechanism of action of NSAIDs in migraine. Since at 30 minutes only nimesulide was effective in reducing CGRP release, these results suggest that this NSAID may exert a particularly rapid effect in patients with migraine.

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Endoscopic Sinus Surgery Improves Sleep Quality in Chronic Rhinosinusitis: A Systematic Review and Meta-analysis

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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High-Level Disinfection of Otorhinolaryngology Clinical Instruments: An Evaluation of the Efficacy and Cost-effectiveness of Instrument Storage

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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Clinical Practice Guidelines: AAO-HNSF Process for CPG Development and Topic Selection

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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High-Quality Feedback Regarding Professionalism and Communication Skills in Otolaryngology Resident Education

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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Systematic Review of Drug-Induced Sleep Endoscopy Scoring Systems

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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National Multispecialty Survey Results: Comparing Morbidity and Mortality Conference Practices within and outside Otolaryngology

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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Short- versus Long-term Stenting in Children with Subglottic Stenosis Undergoing Laryngotracheal Reconstruction

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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Dentist fines: Mistakes over addresses hitting thousands

The latest figures show 385,000 fines were issued in the last financial year - but dentists say tens of thousands of A 100 fines have been wrongly applied. Figures from a wider range of NHS fines suggest that the rate for withdrawing penalties after they were found to be incorrect is closer to 50%.

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Programming Enzyme-Initiated Autonomous DNAzyme Nanodevices in Living Cells

TOC Graphic

ACS Nano

DOI: 10.1021/acsnano.7b06728

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Rational Design of Three-Dimensional Graphene Encapsulated with Hollow FeP@Carbon Nanocomposite as Outstanding Anode Material for Lithium Ion and Sodium Ion Batteries

TOC Graphic

ACS Nano

DOI: 10.1021/acsnano.7b06625

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Generation and Characterization of a meta-Aryne on Cu and NaCl Surfaces

TOC Graphic

ACS Nano

DOI: 10.1021/acsnano.7b06137

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Endoscopic Sinus Surgery Improves Sleep Quality in Chronic Rhinosinusitis: A Systematic Review and Meta-analysis

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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High-Level Disinfection of Otorhinolaryngology Clinical Instruments: An Evaluation of the Efficacy and Cost-effectiveness of Instrument Storage

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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Clinical Practice Guidelines: AAO-HNSF Process for CPG Development and Topic Selection

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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High-Quality Feedback Regarding Professionalism and Communication Skills in Otolaryngology Resident Education

Otolaryngology-Head and Neck Surgery, Ahead of Print.

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Anemia at pediatric intensive care unit discharge: prevalence and risk markers

Anemia is prevalent at pediatric intensive care unit (PICU) admission and incident during PICU stay, but little is known about anemia at PICU discharge . Anemia after critical illness is an important issue bec...

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Proton therapy may be better option for elderly patients with oesophageal cancer

A study led by Mayo Clinic researchers has found that proton beam therapy, in combination with chemotherapy, prior to surgery, may be a better option than a combination using traditional radiation therapy techniques with chemotherapy when treating elderly...

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Monoclonal protein reference change value as determined by gel-based serum protein electrophoresis

Publication date: Available online 24 October 2017
Source:Clinical Biochemistry
Author(s): Mina Salamatmanesh, Christopher R. McCudden, Arleigh McCurdy, Ronald A. Booth
IntroductionThe International Myeloma Working Group recommendations for monitoring disease progression or response include quantitation of the involved monoclonal immunoglobulin. They have defined the minimum change criteria of ≧25% with an absolute change of no <5g/L for either minimal response or progression. Limited evidence is available to accurately determine the magnitude of change in a monoclonal protein to reflect a true change in clinical status. Here we determined the analytical and biological variability of monoclonal proteins in stable monoclonal gammopathy of undetermined significance (MGUS) patients.MethodAnalytical variability (CVa) of normal protein fractions and monoclonal proteins were assessed agarose gel-based serum protein electrophoresis. Sixteen clinically stable MGUS patients were identified from our clinical hematology database. Individual biological variability (CVi) was determined and used to calculate a monoclonal protein reference change value (RCV).ResultAnalytical variability of the normal protein fractions (albumin, alpha-1, alpha-2, beta, total gamma) ranged from 1.3% for albumin to 5.8% for the alpha-1 globulins. CVa of low (5.6g/L) and high (32.2g/L) concentration monoclonal proteins were 3.1% and 22.2%, respectively. Individual CVi of stable patients ranged from 3.5% to 24.5% with a CVi of 12.9%. The reference change value (RCV) at a 95% probability was determined to be 36.7% (low) 39.6% (high) using our CVa and CVi.ConclusionsSerial monitoring of monoclonal protein concentration is important for MGUS and multiple myeloma patients. Accurate criteria for interpreting a change in monoclonal protein concentration are required for appropriate decision making. We used QC results and real-world conditions to assess imprecision of serum protein fractions including low and high monoclonal protein fractions and clinically stable MGUS patients to determine CVi and RCV. The calculated RCVs of 36.7% (low) and 39.6% (high) in this study were greater that reported previously and greater than the established criteria for relapse. Response criteria may be reassessed to increase sensitivity and specificity for detection of response.

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Αρχειοθήκη ιστολογίου

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Τρίτη 24 Οκτωβρίου 2017

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Αναζήτηση αυτού του ιστολογίου

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