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Κυριακή, 13 Νοεμβρίου 2016

Awareness of pubertal changes and reproductive health in adolescent girls: a comparative study

2016-11-13T23-38-57Z
Source: International Journal of Community Medicine and Public Health
Rakhi Jain, Puneet Anand.
Background: Adolescent period is characterized by physical, psychological and behavioural changes and girls can show different reactions to these changes. Proper information can help them in handling these changes without any stress. Tribal females are a vulnerable population and lack health care facilities. Limited data is available on awareness of pubertal changes and reproductive health among tribal adolescent girls. Aims of the study were to study and compare the level of awareness about pubertal changes and reproductive health between tribal and urban adolescent girls. Methods: The study population consisted of 200 adolescent girls between 10-19 years age 100 each, from urban and tribal setting. A predesigned questionnaire, which consisted of questions designed to evaluate the awareness about pubertal changes and reproductive health was used for data collection. Data was analysed using SPSS software, student t test, Chi- square test and co-relation test. Results: Mean age of the study population was 13.76±1.2 years. Mean awareness of urban adolescent girls about pubertal changes and reproductive health was significantly greater than tribal adolescent girls. Awareness was more in older age and more literate adolescent girls. Conclusions: Information, education and communication (IEC) campaigns have to be strengthened to increase awareness on menstrual hygiene practices and sexually transmitted diseases among tribal adolescent girls as these are a vulnerable group.


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A Previously Undescribed Presentation of Mixed Adenoneuroendocrine Carcinoma

We report a case of mixed adenoneuroendocrine carcinoma (MANEC) of stomach with tubular adenoma and well-differentiated neuroendocrine tumor (WD-NET) in the primary tumor in the stomach giving rise to biphenotypic regional nodal metastases. A 35-year-old woman with abdominal pain was found to have a 1.8-cm gastric lesion, diagnosed as WD-NET (intermediate grade) on the biopsy. The resection specimen contained residual WD-NET; there was also a gastric adenoma adjacent to the NET and nodal metastasis with both adeno- and neuroendocrine components. The tumor was classified as MANEC. Of note, the entire gastric tissue was submitted and multiple deeper levels of the adenomatous lesion were examined; no adenocarcinoma was present in the primary lesion. While association of gastric adenoma with neuroendocrine neoplasm is rare, presence of biphenotypic metastasis originating from such a lesion is highly unusual and to the best of our knowledge has not been reported.

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Reassessing the Role of the Active TGF-β1 as a Biomarker in Systemic Sclerosis: Association of Serum Levels with Clinical Manifestations

Objective. To determine active TGF-1 (aTGF-1) levels in serum, skin, and peripheral blood mononuclear cell (PBMC) culture supernatants and to understand their associations with clinical parameters in systemic sclerosis (SSc) patients. Methods. We evaluated serum samples from 56 SSc patients and 24 healthy controls (HC). In 20 SSc patients, we quantified spontaneous or anti-CD3/CD28 stimulated production of aTGF-1 by PBMC. The aTGF-1 levels were measured by ELISA. Skin biopsies were obtained from 13 SSc patients and six HC, and TGFB1 expression was analyzed by RT-PCR. Results. TGF-1 serum levels were significantly higher in SSc patients than in HC (p

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Facile Synthesis, Characterization, and Cytotoxic Activity of Europium-Doped Nanohydroxyapatite

The objective of this study was to synthetize europium-doped nanohydroxyapatite using a simple aqueous precipitation method and, thereafter, characterize and impregnate selected samples with 5-fluorouracil in order to explore the properties and the releasing capacity of this material. The nanohydroxyapatite was doped with 3, 5, 10, and 20 wt% of europium. The obtained samples were characterized after they were dried at 80°C and hydrothermal treated at 120°C by 2 hours. The samples were analyzed by transmission electron microscopy, X-ray diffraction analysis, Fourier transform infrared spectroscopy, and photoluminescence. Also, impregnation and release of 5-fluorouracil were assessed in PBS. The toxicity effects of all samples were studied using viability assays on human fibroblasts cells (HGF-1) in vitro. The sizes of the crystallites were about 10–70 nm with irregular morphology and present the phase corresponding to the JCPDS card 9–0432 for hydroxyapatite. The results of the toxicity experiments indicated that doped and undoped powders are biocompatible with fibroblasts cells. Hydroxyapatite samples doped with 5% of europium and loaded with 5-fluorouracil release almost 7 mg/L of the drug after 60 minutes in PBS and decrease the viability of HeLa cells after 24 hours.

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The Role of the Cognitive Control System in Recovery from Bilingual Aphasia: A Multiple Single-Case fMRI Study

Aphasia in bilingual patients is a therapeutic challenge since both languages can be impacted by the same lesion. Language control has been suggested to play an important role in the recovery of first (L1) and second (L2) language in bilingual aphasia following stroke. To test this hypothesis, we collected behavioral measures of language production (general aphasia evaluation and picture naming) in each language and language control (linguistic and nonlinguistic switching tasks), as well as fMRI during a naming task at one and four months following stroke in five bilingual patients suffering from poststroke aphasia. We further applied dynamic causal modelling (DCM) analyses to the connections between language and control brain areas. Three patients showed parallel recovery in language production, one patient improved in L1, and one improved in L2 only. Language-control functions improved in two patients. Consistent with the dynamic view of language recovery, DCM analyses showed a higher connectedness between language and control areas in the language with the better recovery. Moreover, similar degrees of connectedness between language and control areas were found in the patients who recovered in both languages. Our data suggest that engagement of the interconnected language-control network is crucial in the recovery of languages.

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Piloting Psychology Annual Reviews as a Method of Measuring Psychological Distress and Quality of Life in Paediatric Renal Transplant Patients

Psychosocial distress and poorer quality of life after renal transplantation are common in children and young people. This has implications for medication adherence and survival. Posttransplant psychology annual reviews were introduced in one Paediatric Renal Service in the UK as a means of measuring psychological distress and quality of life, as well as facilitating identification of patients and parents/carers who would benefit from psychological intervention. The process of completing posttransplant psychology annual reviews is discussed within this paper. The posttransplant psychology annual review appointments identified patients experiencing depression and/or anxiety and problems in quality of life. These assessments have led to appropriate referrals to, and engagement with, the renal psychology service as well as with community tier 3 child and adolescent mental health services. The posttransplant psychology annual review will continue to be completed at this UK site and discussions will be undertaken with other paediatric renal transplant services to consider whether these could be introduced at a national level to facilitate collection of longitudinal data regarding long-term psychosocial impact of paediatric renal transplantation and its effect on quality of life.

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Comparison of Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolates from Drinking Well Water and Pit Latrine Wastewater in a Rural Area of China

The present study was conducted to gain insights into the occurrence and characteristics of extended-spectrum beta-lactamase- (ESBL-) producing Escherichia coli (E. coli) from drinking well water in the rural area of Laiwu, China, and to explore the role of the nearby pit latrine as a contamination source. ESBL-producing E. coli from wells were compared with isolates from pit latrines in the vicinity. The results showed that ESBL-producing E. coli isolates, with the same antibiotic resistance profiles, ESBL genes, phylogenetic group, plasmid replicon types, and enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) fingerprints, were isolated from well water and the nearby pit latrine in the same courtyard. Therefore, ESBL-producing E. coli in the pit latrine may be a likely contributor to the presence of ESBL-producing E. coli in rural well water.

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Optical Simulation and Experimental Verification of a Fresnel Solar Concentrator with a New Hybrid Second Optical Element

Fresnel solar concentrator is one of the most common solar concentrators in solar applications. For high Fresnel concentrating PV or PV/T systems, the second optical element (SOE) is the key component for the high optical efficiency at a wider deflection angle, which is important for overcoming unavoidable errors from the tacking system, the Fresnel lens processing and installment technology, and so forth. In this paper, a new hybrid SOE was designed to match the Fresnel solar concentrator with the concentration ratio of 1090x. The ray-tracing technology was employed to indicate the optical properties. The simulation outcome showed that the Fresnel solar concentrator with the new hybrid SOE has a wider deflection angle scope with the high optical efficiency. Furthermore, the flux distribution with different deviation angles was also analyzed. In addition, the experiment of the Fresnel solar concentrator with the hybrid SOE under outdoor condition was carried out. The verifications from the electrical and thermal outputs were all made to analyze the optical efficiency comprehensively. The optical efficiency resulting from the experiment is found to be consistent with that from the simulation.

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Assessment of Natural Radioactivity Levels and Radiation Hazards in Agricultural and Virgin Soil in the State of Kedah, North of Malaysia

The activity concentrations of naturally occurring radionuclides 226Ra, 232Th, and 40K were determined in 30 agricultural and virgin soil samples randomly collected from Kedah, north of Malaysia, at a fertile soil depth of 0–30 cm. Gamma-ray spectrometry was applied using high-purity germanium (HPGe) gamma-ray detector and a PC-based MCA. The mean radioactivity concentrations of 226Ra, 232Th, and 40K were found to be 102.08 ± 3.96, 133.96 ± 2.92, and 325.87 ± 9.83 Bq kg−1, respectively, in agricultural soils and 65.24 ± 2.00, 83.39 ± 2.27, and 136.98 ± 9.76 Bq kg−1, respectively, in virgin soils. The radioactivity concentrations in agricultural soils are higher than those in virgin soils and compared with those reported in other countries. The mean values of radium equivalent activity (), absorbed dose rates (nGy h−1), annual effective dose equivalent, and external hazard index () are 458.785 Bq kg−1, 141.62 nGy h−1, and 0.169 mSv y−1, respectively, in agricultural soils and 214.293 Bq kg−1, 87.47 nGy h−1, and 0.106 mSv y−1, respectively, in virgin soils, with average of 0.525. Results were discussed and compared with those reported in similar studies and with internationally recommended values.

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Healthcare Providers’ Knowledge and Current Practice of Pain Assessment and Management: How Much Progress Have We Made?

Context. Despite improvement in pain management and availability of clinical treatment guidelines, patients in Jordan are still suffering from pain. Negative consequences of undertreated pain are being recognized as a reason for further illnesses and poor quality of life. Healthcare providers (HCPs) are responsible for relieving pain of their patients. Objective. To evaluate the knowledge and attitudes of HCPs toward pain management in Jordan. Methods. A 16-item questionnaire with agree or disagree options was given to 662 HCPs in seven hospitals in Jordan who volunteered to participate in the study. Following data collection, the responses were coded and entered into SPSS. Results. There was a statistically significant difference () in percentage scores between physicians (36%) and pharmacists (36%) versus nurses (24%). The level of knowledge was the best among physicians, followed by pharmacists specifically in the area of cancer pain management. Nurses scored the lowest for knowledge of pain assessment and management among HCPs. However, HCPs overall scores indicated insufficient knowledge specifically in relation to pain assessment and management among children.

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Elevated Plasma Endothelin-1 Levels in Normal Tension Glaucoma and Primary Open-Angle Glaucoma: A Meta-Analysis

Purpose. The aim of this meta-analysis was to clarify the association between the plasma endothelin-1 level and the risks of normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG). Methods. Relevant publications were collected from three databases including PubMed, EMBASE, and the Web of Science through December 31, 2015. In this study, the terms “(endothelin OR ET) AND glaucoma” were searched. Review Manager 5.2 was used to process the data. Results. Seven studies (212 cases, 164 controls) were included for the NTG analysis. The mean plasma endothelin-1 level in the NTG subjects was 0.60 pg/mL (, 95% CI: 0.17–1.04) higher than that of the healthy controls. Six studies (160 cases, 174 controls) were included for the POAG analysis, and the endothelin-1 level was 0.63 pg/mL (, 95% CI: 0.12–1.15) higher in the POAG subjects than in the healthy controls. Additionally, two studies influenced the meta-analysis results regarding the association of plasma endothelin-1 with POAG by sensitivity analysis, and the probability of publication bias was low. Conclusions. The observation that NTG and POAG subjects showed significantly elevated endothelin-1 plasma concentrations suggests that a higher plasma level of endothelin-1 might increase the risk of NTG and POAG development.

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Ecomorphology



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Erratum



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Referees



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High iron levels are associated with risk of gestational diabetes, study finds

Elevated iron levels may raise the risk of developing gestational diabetes, show the results of a prospective study that potentially questions routine iron supplementation in pregnant women with...
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Healthy lifestyle halves heart risk in people at high genetic risk, study finds

A healthy lifestyle, including regular physical activity, eating healthily, and avoiding obesity and smoking, nearly halves the risk of coronary events in people at high genetic risk for coronary...
recent?d=yIl2AUoC8zA recent?d=dnMXMwOfBR0 recent?i=nfXR9rF6n7o:em0E-2zdajU:V_sGLiP recent?d=qj6IDK7rITs recent?i=nfXR9rF6n7o:em0E-2zdajU:gIN9vFw recent?d=l6gmwiTKsz0 recent?d=7Q72WNTAKBA recent?i=nfXR9rF6n7o:em0E-2zdajU:F7zBnMy recent?i=nfXR9rF6n7o:em0E-2zdajU:-BTjWOF


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Role of staging laparoscopy to evaluate feasibility of performing optimal cytoreductive surgery in epithelial ovarian cancers

2016-11-13T23-03-50Z
Source: International Journal of Research in Medical Sciences
Sathyanarayanan M. Shivkumaran, Ganesh S. Mandakulutur, Keerthi R. Banavara.
Background: The main stay of treatment for epithelial ovarian cancers is surgical cytoreduction. CT scan and staging laparotomy are methods used to assess feasibility to carry out optimal cytoreduction. We evaluated the role of staging laparoscopy in assessing operability for optimal cytoreduction as well as avoidance of unnecessary laparotomies. Methods: Between September 2014-2016, 23 patients of epithelial ovarian cancer underwent staging laparoscopy as part of evaluation method to check feasibility to carry out optimal cytoreductive surgery. The findings were correlated with clinical findings as well as CT scan findings. The impact of laparoscopy to predict operability was studied as well as its use to avoid unnecessary laparotomies. Results: Laparoscopy could correctly evaluate the nature of abdominal mass in 91.3% patients. It picked up omental and peritoneal deposits in 87% and 95.7% patients respectively as compared to 60.9% and 39% picked up on CT scan. More importantly laparoscopy could diagnose mesenteric and small bowel deposits in 34.8% of patients which were never reported on CT scan. The overall impact was reduction in unnecessary laparotomies. Conclusions: Laparoscopic evaluation is a useful adjunct prior to performing a formal laparotomy in epithelial ovarian cancer cytoreductive surgery.


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Effects of Carbopol® 934 proportion on nanoemulsion gel for topical and transdermal drug delivery: a skin permeation study

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Sulfonate-modified phenylboronic acid-rich nanoparticles as a novel mucoadhesive drug delivery system for vaginal administration of protein therapeutics: improved stability, mucin-dependent release and effective intravaginal placement

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Osteopontin inhibition of miR-129-3p enhances IL-17 expression and monocyte migration in rheumatoid arthritis

Publication date: Available online 13 November 2016
Source:Biochimica et Biophysica Acta (BBA) - General Subjects
Author(s): Chun-Hao Tsai, Shan-Chi Liu, Yu-Han Wang, Chen-Ming Su, Chien-Chung Huang, Chin-Jung Hsu, Chih-Hsin Tang
BackgroundOsteopontin (OPN) is an important proinflammatory cytokine in rheumatoid arthritis (RA). Levels of OPN have been shown to be significantly correlated with interleukin-17 (IL-17) production and expression of Th17 cells in the synovial fluid of RA patients. Here, we investigated the role of OPN in monocyte migration, IL-17 production and osteoblasts.MethodsOPN and IL-17 expression profiles in osteoarthritis (OA) and RA synovial fluid were determined by enzyme-linked immunosorbent assay (ELISA). The expression of the microRNA, miR-129-3p, in osteoblasts was analyzed by real-time quantitative polymerase chain reaction (qPCR). Immunoreactive proteins were spotted by Western blotting. We used the collagen-induced arthritis (CIA) mouse model to investigate the role of OPN in monocyte migration during RA.ResultsOPN and IL-17 expression were higher in RA synovial fluid as compared to OA samples. We also found that OPN promotes IL-17 expression in osteoblasts and thereby enhances monocyte migration via the Syk/PI3K/Akt signaling pathway. miR-129-3p expression was found to be negatively regulated by OPN via the Syk/PI3K/Akt signal cascade. In contrast, lentiviral vectors expressing short hairpin RNA inhibited OPN expression and ameliorated articular swelling, cartilage erosion and monocyte infiltration in the ankle joints of CIA mice.ConclusionTo our knowledge, our study is the first to describe how OPN promotes monocyte migration by upregulating IL-17 expression in osteoblasts in RA disease.SignificanceThese findings indicate that OPN could serve as a potential therapeutic target for the treatment of RA.



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Interdomain electron transfer in cellobiose dehydrogenase is governed by surface electrostatics

Publication date: Available online 13 November 2016
Source:Biochimica et Biophysica Acta (BBA) - General Subjects
Author(s): Alan Kadek, Daniel Kavan, Julien Marcoux, Johann Stojko, Alfons K.G. Felice, Sarah Cianférani, Roland Ludwig, Petr Halada, Petr Man
BackgroundCellobiose dehydrogenase (CDH) is a fungal extracellular oxidoreductase which fuels lytic polysaccharide monooxygenase with electrons during cellulose degradation. Interdomain electron transfer between the flavin and cytochrome domain in CDH, preceding the electron flow to lytic polysaccharide monooxygenase, is known to be pH dependent, but the exact mechanism of this regulation has not been experimentally proven so far.MethodsTo investigate the structural aspects underlying the domain interaction in CDH, hydrogen/deuterium exchange (HDX-MS) with improved proteolytic setup (combination of nepethesin-1 with rhizopuspepsin), native mass spectrometry with ion mobility and electrostatics calculations were used.ResultsHDX-MS revealed pH-dependent changes in solvent accessibility and hydrogen bonding at the interdomain interface. Electrostatics calculations identified these differences to result from charge neutralization by protonation and together with ion mobility pointed at higher electrostatic repulsion between CDH domains at neutral pH. In addition, we uncovered extensive O-glycosylation in the linker region and identified the long-unknown exact cleavage point in papain-mediated domain separation.ConclusionsTransition of CDH between its inactive (open) and interdomain electron transfer-capable (closed) state is shown to be governed by changes in the protein surface electrostatics at the domain interface. Our study confirms that the interdomain electrostatic repulsion is the key factor modulating the functioning of CDH.General significanceThe results presented in this paper provide experimental evidence for the role of charge repulsion in the interdomain electron transfer in cellobiose dehydrogenases, which is relevant for exploiting their biotechnological potential in biosensors and biofuel cells.

Graphical abstract

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Murmur

Murmur: A sound due to vibrations from the flow of blood through the heart or great vessels. A murmur may be innocent and be of no significance. Or it may be pathologic and reflect disease. A murmur is usually heard with a stethoscope.



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Viruses, Vol. 8, Pages 305: KSHV Entry and Trafficking in Target Cells—Hijacking of Cell Signal Pathways, Actin and Membrane Dynamics

Kaposi’s sarcoma associated herpesvirus (KSHV) is etiologically associated with human endothelial cell hyperplastic Kaposi’s sarcoma and B-cell primary effusion lymphoma. KSHV infection of adherent endothelial and fibroblast cells are used as in vitro models for infection and KSHV enters these cells by host membrane bleb and actin mediated macropinocytosis or clathrin endocytosis pathways, respectively. Infection in endothelial and fibroblast cells is initiated by the interactions between multiple viral envelope glycoproteins and cell surface associated heparan sulfate (HS), integrins (α3β1, αVβ3 and αVβ5), and EphA2 receptor tyrosine kinase (EphA2R). This review summarizes the accumulated studies demonstrating that KSHV manipulates the host signal pathways to enter and traffic in the cytoplasm of the target cells, to deliver the viral genome into the nucleus, and initiate viral gene expression. KSHV interactions with the cell surface receptors is the key platform for the manipulations of host signal pathways which results in the simultaneous induction of FAK, Src, PI3-K, Rho-GTPase, ROS, Dia-2, PKC ζ, c-Cbl, CIB1, Crk, p130Cas and GEF-C3G signal and adaptor molecules that play critical roles in the modulation of membrane and actin dynamics, and in the various steps of the early stages of infection such as entry and trafficking towards the nucleus. The Endosomal Sorting Complexes Required for Transport (ESCRT) proteins are also recruited to assist in viral entry and trafficking. In addition, KSHV interactions with the cell surface receptors also induces the host transcription factors NF-κB, ERK1/2, and Nrf2 early during infection to initiate and modulate viral and host gene expression. Nuclear delivery of the viral dsDNA genome is immediately followed by the host innate responses such as the DNA damage response (DDR), inflammasome and interferon responses. Overall, these studies form the initial framework for further studies of simultaneous targeting of KSHV glycoproteins, host receptor, signal molecules and trafficking machinery that would lead into novel therapeutic methods to prevent KSHV infection of target cells and consequently the associated malignancies.

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Catalytic Photodegradation of Pharmaceuticals - Homogeneous and Heterogeneous Photocatalysis

Photochem. Photobiol. Sci., 2016, Accepted Manuscript
DOI: 10.1039/C6PP00164E, Paper
Sarka Klementova, David Kahoun, Lucie Doubkova, Kristyna Frejlachova, Michaela Dusakova, Martin Zlamal
Photocatalytic degradation of pharmaceuticals (hydrocortisone, estradiol, verapamil) and personal care products additives (parabens-methyl, ethyl, and propyl derivatives) was investigated in the homogeneous phase (with ferric ions as the catalyst) and...
The content of this RSS Feed (c) The Royal Society of Chemistry


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STAGING OF THIRD MOLAR DEVELOPMENT IN RELATION TO CHRONOLOGICAL AGE OF 5-16 YEAR OLD INDIAN CHILDREN

Age estimation of juveniles and adolescents is commonly required in most civilized countries, since age thresholds of social or legal relevance lie between ages 12 to 25. While the developmental process of teeth is one of the most valuable biomarkers for age estimation in childhood, the accuracy inevitably decreases in adolescence, when the development of teeth is nearly completed. During this period, roughly between the middle teens and early 20s, all the hand-wrist bones have achieved their adult morphologies and their epiphyses have fused and the onset of secondary sex characteristics has occurred.

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STAGING OF THIRD MOLAR DEVELOPMENT IN RELATION TO CHRONOLOGICAL AGE OF 5-16 YEAR OLD INDIAN CHILDREN

Age estimation of juveniles and adolescents is commonly required in most civilized countries, since age thresholds of social or legal relevance lie between ages 12 to 25. While the developmental process of teeth is one of the most valuable biomarkers for age estimation in childhood, the accuracy inevitably decreases in adolescence, when the development of teeth is nearly completed. During this period, roughly between the middle teens and early 20s, all the hand-wrist bones have achieved their adult morphologies and their epiphyses have fused and the onset of secondary sex characteristics has occurred.

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The new issue is now available.Chikyukagaku

Vol.13 No.1

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The new issue is now available.Journal of Osaka Dental University

Vol.31 No.1_2

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The new issue is now available.THE SHINSHU MEDICAL JOURNAL

Vol.64 No.5

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The new issue is now available.The Journal of the Japanese Society of Clinical Cytology

Vol.55 No.5

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Regulation and Function of Lentiviral Vector-Mediated TCIRG1 Expression in Osteoclasts from Patients with Infantile Malignant Osteopetrosis: Implications for Gene Therapy

Abstract

Infantile malignant osteopetrosis (IMO) is a rare, recessive disorder characterized by increased bone mass caused by dysfunctional osteoclasts. The disease is most often caused by mutations in the TCIRG1 gene encoding a subunit of the V-ATPase involved in the osteoclasts capacity to resorb bone. We previously showed that osteoclast function can be restored by lentiviral vector-mediated expression of TCIRG1, but the exact threshold for restoration of resorption as well as the cellular response to vector-mediated TCIRG1 expression is unknown. Here we show that expression of TCIRG1 protein from a bicistronic TCIRG1/GFP lentiviral vector was only observed in mature osteoclasts, and not in their precursors or macrophages, in contrast to GFP expression, which was observed under all conditions. Thus, vector-mediated TCIRG1 expression appears to be post-transcriptionally regulated, preventing overexpression and/or ectopic expression and ensuring protein expression similar to that of wild-type osteoclasts. Codon optimization of TCIRG1 led to increased expression of mRNA but lower levels of protein and functional rescue. When assessing the functional rescue threshold in vitro, addition of 30 % CB CD34+ cells to IMO CD34+ patient cells was sufficient to completely normalize resorptive function after osteoclast differentiation. From both an efficacy and a safety perspective, these findings will clearly be of benefit during further development of gene therapy for osteopetrosis.



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Laser-Sintered Constructs with Bio-inspired Porosity and Surface Micro/Nano-Roughness Enhance Mesenchymal Stem Cell Differentiation and Matrix Mineralization In Vitro

Abstract

Direct metal laser sintering can produce porous Ti–6Al–4V orthopedic and dental implants. The process requires reduced resources and time and can provide greater structural control than machine manufacturing. Implants in bone are colonized by mesenchymal stem cells (MSCs), which can differentiate into osteoblasts and contribute to osseointegration. This study examined osteoblast differentiation and matrix mineralization of human MSCs cultured on laser-sintered Ti–6Al–4V constructs with varying porosity and at different time scales. 2D solid disks and low, medium and high porosity (LP, MP, and HP) 3D constructs based on a human trabecular bone template were laser sintered from Ti–6Al–4V powder and further processed to have micro- and nanoscale roughness. hMSCs exhibited greater osteoblastic differentiation and local factor production on all 3D porous constructs compared to 2D surfaces, which was sustained for 9 days without use of exogenous factors. hMSCs cultured for 8 weeks on MP constructs in osteogenic medium (OM), OM supplemented with BMP2 or collagen-coated MP constructs in OM exhibited bone-like extracellular matrix mineralization. Use of bio-inspired porosity for the 3D architecture of additively manufactured Ti–6Al–4V enhanced osteogenic differentiation of hMSCs beyond surface roughness alone. This study suggests that a 3D architecture may enhance the osseointegration of orthopedic and dental implants in vivo.



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Associations Between Fat Mass, Lean Mass, and Knee Osteoarthritis: The Fifth Korean National Health and Nutrition Examination Survey (KNHANES V)

Abstract

As little is known about the associations between body composition (fat mass and lean mass) and knee OA, especially regarding body parts (upper body and lower limbs), the purpose of this study was to identify the association between the former and the prevalence of the latter according to body parts. This study was designed as a cross-sectional analysis, with 4194 people (1801 men and 2393 women) from the fifth Korean National Health and Nutrition Examination Survey (KNHANES V, 2010–2011) included. Body composition (fat mass and lean mass) was measured by using dual-energy X-ray absorptiometry, and knee OA was diagnosed based on the level of Kellgren–Lawrence grade. In multivariate logistic regression analysis, upper body composition was not significantly correlated with radiographic knee OA (P > 0.05), while participants with higher lean mass of lower limbs were less likely to have radiographic knee OA (aOR 0.57; 95 % CI 0.32–0.99). In stratified analysis, participants with higher lean mass of lower limbs were less likely to have a radiographic knee OA in 40–54 kg (P for trend = 0.05) and 55–70 kg stratum (P for trend = 0.03), while this trend slightly attenuated in 70–85 kg stratum (P for trend = 0.15). In conclusion, the increase in lean mass of lower limbs is inversely related to the prevalence of knee OA while upper body composition is not. This study suggests that the lean mass of lower limbs might be associated with reduction in the risk of knee OA.



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The Role of Tumor Necrosis Factor Alpha and TNF Superfamily Members in Bone Damage in Patients with End-Stage Chronic Obstructive Lung Disease Prior to Lung Transplantation

Abstract

A disequilibrium of tumor necrosis superfamily (TNF) members, including the serum osteoprotegerin, soluble receptor activator of nuclear factor-κB ligand, soluble TNF-related apoptosis-inducing ligand and TNF-α, was associated with the occurrence of a reduced skeletal mass and osteoporosis in male patients with end-stage chronic obstructive pulmonary disease (COPD). The purpose of this study was to explore the associations between serum biomarkers of tumor necrosis factor (TNF) superfamily and body and bone compositions in end-stage COPD males. Pulmonary function, T-score at the lumbar spine and femoral neck, lean mass, serum osteoprotegerin (OPG), soluble receptor activator of nuclear factor-κB ligand (sRANKL), TNF-α and its receptors (sTNFR-I, sTNFR-II) and soluble TNF-related apoptosis-inducing ligand (sTRAIL) levels were evaluated in 48 male patients with end-stage COPD and 36 healthy male volunteers. OPG was lower in male COPD patients than in control subjects, whereas sRANKL, TNF-α and its receptors were higher. The serum sTRAIL level showed a tendency to increase compared with that of healthy subjects (P = 0.062). Serum OPG showed a positive correlation with bone density. In contrast, serum TNF-α, sRANKL and sTRAIL were inversely associated with pretransplant bone density. We have noted the appearance of statistically significant inverse relationships between lean mass values and TNF-α, sTNFR-I and II and sRANKL levels in male COPD patients. Moreover, there was a negative correlation between sTRAIL levels with airway obstruction (P = 0.005) and hypercapnia (P = 0.042) in advanced COPD patients. Through a multiple linear regression analysis, our study revealed that a disequilibrium of TNF family members was strongly associated with the occurrence of a reduced skeletal mass and osteoporosis. These results provide further evidence that abnormal levels of TNF superfamily molecules may cause not only a decrease in BMD, but also lower muscle mass in end-stage COPD.



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Bone Mass Distribution of the Distal Tibia in Normal, Osteopenic, and Osteoporotic Conditions: An Ex Vivo Assessment Using HR-pQCT, DXA, and Computational Modelling

Abstract

Osteoporosis leads to bone loss and structural deterioration, which increase the risk of fractures. The aim of this study was to characterize the three-dimensional (3D) bone mass distributions of the distal tibia in normal, osteopenic, and osteoporotic conditions. High-resolution peripheral quantitative computed tomography (HR-pQCT) of the 33 % of the distal tibia and local dual-energy X-ray absorptiometry were applied to 53 intact, fresh-frozen tibiae. The HR-pQCTs were graded to assign local T-scores and merged into three equally sized average normal, osteopenic, and osteoporotic surface models. Volumetric bone mineral density (vBMD) was determined using categorized T-scores, volumetric visualization, and virtual bore probes at the dia-, meta-, and epiphyseal sites (T-DIA, T-META, and T-EPI). We observed a distinct 3D bone mass distribution that was gradually uninfluenced by T-score categories. T-DIA was characterized by the lowest bone mass located in the medullary cavity and a wide homogenous cortex containing the maximum vBMD. The T-META showed decreased cortical thickness and maximal vBMD. At the T-EPI, the relatively low vBMD of the mostly trabecular bone was similar to the maximal cortical vBMD in this sub-region. Four trabecular regions of low bone mass were identified in the recesses. The bone content gradually decreased at all sites, whereas the pattern of bone mass distribution remained essentially unchanged, with the exception of disproportionate losses at T-DIA, T-META, and T-EPI that consistently showed increased endocortical, intracortical, and trabecular bone loss. Extra information can be obtained from the specific pattern of bone mass distribution, potential disproportionate bone losses, and method used.



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Bone Metabolism and the c.-223C > T Polymorphism in the 5′UTR Region of the Osteoprotegerin Gene in Patients with Inflammatory Bowel Disease

Abstract

Osteoporosis is more frequent in inflammatory bowel disease (IBD) patients. A reduction in bone mineral mass in these individuals is caused not only by inflammatory processes in the bowel, because osteoporosis occurs already in very young IBD patients and in newly diagnosed individuals who have not yet undergone any pharmacological treatment. One of individual determinants of the bone turnover parameters is osteoprotegerin (OPG) encoded by the TNFRSF11B gene. The c.-223C > T polymorphism in this gene has been extensively studied in post-menopausal osteoporosis patients. However, no such studies exist for osteoporosis related to IBD. The aim of our study was to determine whether the c.-223C > T (rs2073617) polymorphism in the 5′UTR region of the gene encoding osteoprotegerin is a functional polymorphism which may change the gene expression and resulting OPG levels, and so be associated with osteopenia and osteoporosis, and impaired bone metabolism in Crohn’s disease and ulcerative colitis patients. Our study included 198 IBD patients and 41 healthy controls. Lumbar spine and femoral neck bone mineral density, T-score, Z-score as well as OPG, RANKL, vitamin D, calcium and interleukin 4 and 10 concentrations were determined for all study subjects. Genotyping of the TNFRSF11B polymorphic site was performed by restriction fragment length polymorphism technique. Statistical analyses were conducted using Statistica software. Odds ratios, 95 % confidence intervals, and P values were calculated using the HWE calculator. Our results did not allow determining an unequivocal association between the polymorphic variants of the TNFRSF11B 5′UTR region and a susceptibility to osteoporosis in IBD patients. We have shown, however, that the c.-223T allele was twice as more frequent in Crohn’s disease (CD) patients than among controls (OR = 1.99, P value = 0.009). Interestingly, average osteoprotegerin levels in CD patients did not significantly differ from those in controls, whereas in ulcerative colitis patients, OPG levels were significantly lower. We have concluded that low OPG levels may be associated with osteoporosis in ulcerative colitis, but it is not correlated with the c.-223C > T polymorphism in the TNFRSF11B gene. In CD patients, in turn, we observed increased RANKL levels. Our observations confirm different pathogeneses of Crohn’s disease and ulcerative colitis as well as different molecular backgrounds of osteoporosis associated with these two diseases.



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Bone Mineral Density and Body Composition are Associated with Circulating Angiogenic Factors in Post-menopausal Women

Abstract

Lean mass (LM) and fat mass (FM) are closely related to bone mass (BM) in post-menopausal women, although their relative importance is unclear. Angiogenic factors which control angiogenesis may influence BM, LM and FM. The aim of the study was to compare the contribution of LM and FM to bone mineral density (BMD) and the association between these tissues and circulating angiogenic factors. The study population comprised of 392 post-menopausal women aged mean [SD] 61.8 [6.4] years. BMD was measured at the lumbar spine (LS), neck of femur and total hip (TH) by dual-energy X-ray absorptiometry (DXA). DXA scan was also used to determine LM and FM. Angiopoietin-1 and 2 (ANG-1, ANG-2) were measured by sandwich enzyme-linked immunosorbent assay. Following adjustment for confounders, significant positive independent associations were seen between LM with BMD at all skeletal sites (TH: p < 0.0001) and FM with BMD at the hip sites (TH: p = 0.004). When BMD and LM were regressed against the angiogenic factors, positive associations were seen between ANG-2 with LM (p = 0.002) and LS BMD (p = 0.05). Negative associations were observed between the ratio of ANG-1/ANG-2 with LS BMD (p = 0.014), TH BMD (p = 0.049) and LM (p = 0.029). FM and fat distribution (android/gynoid fat ratio) were negatively associated with ANG-1 (p = 0.006) and ANG-2 (p = 0.004), respectively. ANG-1 and ANG-2 may be involved in the maintenance of bone, muscle and fat mass.



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Osthole Promotes Endochondral Ossification and Accelerates Fracture Healing in Mice

Abstract

Osthole has been found to restore bone mass in preclinical osteoporotic models. In the present study, we investigated the effects of osthole on bone fracture repair in mice. Adult C57BL/6 mice were subjected to transverse femoral fractures and administrated orally with 20 mg/kg osthole and vehicle solvent daily from week 1 post-operation. Fracture callus were analyzed by plain radiography, micro-computed tomography, histology, molecular imaging and immunohistochemistry and tartrate-resistant acid phosphatase staining. Results demonstrated that osthole treatment enhanced removal of cartilage and bony union during reparative stage without significant interfering on remodeling process. In vivo molecular imaging showed bone formation rate of the treatment group was almost twofold of control group at week 2 post-operation. Osthole augmented the expression of alkaline phosphatase and collagen type X in hypertrophic chondrocytes as well as expression of bone morphogenetic protein-2, osteocalcin and alkaline phosphatase in osteoblastic cells, indicating it promoted mineralization of hypertrophic cartilage and woven bone growth simultaneously during endochondral healing. In summary, osthole promotes endochondral ossification via upregulation of maturation osteogenic marker genes in chondrocytes and subsequently accelerates fracture repair and bony fusion.



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Diets High in Fat or Fructose Differentially Modulate Bone Health and Lipid Metabolism

Abstract

Diets high in fat or carbohydrates can lead to obesity and diabetes, two interrelated conditions that have been associated with osteoporosis. Here, we contrasted the effects of a high fat (HF) versus fructose-enriched carbohydrate (CH) versus regular chow (SC) diet on bone morphology, fat content and metabolic balance in BALB/cByJ mice over a 15-week period. For 13 weeks, there were no differences in body mass between groups with small differences in the last 2 weeks. Even without the potentially confounding factor of altered body mass and levels of load bearing, HF consumption was detrimental to bone in the distal femur with lower trabecular bone volume fraction and thinner cortices than controls. These differences in bone were accompanied by twofold greater abdominal fat content and fourfold greater plasma leptin concentrations. High-fat feeding caused a decrease in de-novo lipid synthesis in the liver, kidney, white adipose and brown adipose tissue. In contrast to HF, the fructose diet did not significantly impact bone quantity or architecture. Fructose consumption also did not significantly alter leptin levels or de-novo lipid synthesis but reduced epididymal adipose tissue and increased brown adipose tissue. Cortical stiffness was lower in the CH than in HF mice. There were no differences in glucose or insulin levels between groups. Together, a diet high in fat had a negative influence on bone structure, adipose tissue deposition and lipid synthesis, changes that were largely avoided with a fructose-enriched diet.



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Bazedoxifene Ameliorates Homocysteine-Induced Apoptosis and Accumulation of Advanced Glycation End Products by Reducing Oxidative Stress in MC3T3-E1 Cells

Abstract

Elevated plasma homocysteine (Hcy) level increases the risk of osteoporotic fracture by deteriorating bone quality. However, little is known about the effects of Hcy on osteoblast and collagen cross-links. This study aimed to investigate whether Hcy induces apoptosis of osteoblastic MC3T3-E1 cells as well as affects enzymatic and nonenzymatic collagen cross-links and to determine the effects of bazedoxifene, a selective estrogen receptor modulator, on the Hcy-induced apoptosis and deterioration of collagen cross-links in the cells. Hcy treatments (300 μM, 3 mM, and 10 mM) increased intracellular reactive oxygen species (ROS) production in a dose-dependent manner. Propidium iodide staining showed that 3 and 10 mM Hcy induced apoptosis of MC3T3-E1 cells. Moreover, the activities of caspases-8, 9, and 3 were increased by 3 mM Hcy. The detrimental effects of 3 mM Hcy on apoptosis and ROS production were partly reversed by bazedoxifene and 17β estradiol. In addition, real-time PCR, immunostaining and Western blot showed that 300 μM Hcy decreased the expression of lysyl oxidase (Lox). Furthermore, 300 μM Hcy increased extracellular accumulation of pentosidine, an advanced glycation end product. Treatment with bazedoxifene ameliorated Hcy-induced suppression of Lox expression and increase in pentosidine accumulation. These findings suggest that high-dose Hcy induces apoptosis of osteoblasts by increasing oxidative stress, and low-dose Hcy decreases enzymatic collagen cross-links and increases pentosidine accumulation, resulting in the deterioration of bone quality. Bazedoxifene treatment effectively prevents the Hcy-induced detrimental reactions of osteoblasts. Thus, bazedoxifene may be a potent therapeutic drug for preventing Hcy-induced bone fragility.



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Bone-Derived Factors: A New Gateway to Regulate Glycemia

Abstract

Type 2 diabetes mellitus (T2DM) and osteoporosis are two major disorders which prevalence increases with aging and is predicted to worsen in the coming years. Preclinical investigations suggest common mechanisms implicated in the pathogenesis of both disorders. Recent evidence has established that there is a clear link between glucose and bone metabolism. The emergence of bone as an endocrine regulator through FGF23 and osteocalcin has led to the re-evaluation of the role of bone cells and bone-derived factors in the development of metabolic diseases such as T2DM. The development of bone morphogenetic proteins, fibroblast growth factor 23, and osteoprotegerin-deficient mice has allowed to elucidate their role in bone homeostasis, as well as revealed their potential important function in glucose homeostasis. This review proposes emerging perspectives for several bone-derived factors that may regulate glycemia through the activation or inhibition of bone remodeling or directly by regulating function of key organs such as pancreatic beta cell proliferation, insulin expression and secretion, storage and release of glucose from the liver, skeletal muscle contraction, and browning of the adipose tissue. Connections between organs including bone-derived factors should further be explored to understand the pathophysiology of glucose metabolism and diabetes.



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Erratum to: Reference Values of Total Lean Mass, Appendicular Lean Mass, and Fat Mass Measured with Dual-Energy X-ray Absorptiometry in a Healthy Mexican Population



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Molecular Communication from Skeletal Muscle to Bone: A Review for Muscle-Derived Myokines Regulating Bone Metabolism

Abstract

Besides the mechanical loading-dependent paradigm, skeletal muscle also serves as an endocrine organ capable of secreting cytokines to modulate bone metabolism. In this review, we focused on reviewing the myokines involved in communication from skeletal muscle to bone, i.e. (1) myostatin and myostatin-binding proteins including follistatin and decorin, (2) interleukins including interleukin-6 (IL-6), interleukin-7 (IL-7) and interleukin-15 (IL-15), (3) insulin-like growth factor 1 (IGF-1) and its binding proteins, (4) other myokines including PGC-1α-irisin system and osteoglycin (OGN). To better understand the molecular communication from skeletal muscle to bone, we have summarized the recent advances in muscle-derived cytokines regulating bone metabolism in this review.



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Novel Faces of Fibroblast Growth Factor 23 (FGF23): Iron Deficiency, Inflammation, Insulin Resistance, Left Ventricular Hypertrophy, Proteinuria and Acute Kidney Injury

Abstract

FGF23 is a hormone that appears as the core regulator of phosphate metabolism. Great deal of data has accumulated to demonstrate increased FGF23 secretion from the bone to compensate for even subtle increases in serum phosphorus long before intact PTH. However, recent evidence points to the fact that actions and interactions of FGF23 are not limited solely to phosphate metabolism. FGF23 may be implicated in iron metabolism and erythropoiesis, inflammation, insulin resistance, proteinuria, acute kidney injury and left ventricular hypertrophy. In this review, we will summarize latest experimental and clinical data examining impact of FGF23 on aforementioned pathophysiologic pathways/disorders.



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Letter to the Editor



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Diabetes Drug Effects on the Skeleton

Abstract

Diabetes be it type 1 or type 2 is associated with an increased risk of fragility fractures. The mechanisms underlying this increased risk are just being elucidated. Anti-diabetes medications are crucial for maintaining glucose control and for preventing micro- and macrovascular complications in diabetes. However, they may modulate fracture risk in diabetes in different ways. Thiazolidinediones have demonstrated an unfavorable effect on the skeleton, while metformin and sulfonylureas may have a neutral if not beneficial effect on bone. The use of insulin has been associated with an increased risk of fragility fractures though it is not clear whether it is due to direct influence of insulin or whether it is mediated through hypoglycemia and increased falls risk. The overall effect of incretin mimetics appears to be beneficial; however, this has to be elucidated further. The bone effects of pramlintide, a synthetic analog of amylin, have not been explored fully. Finally, issues regarding bone safety of SGLT2 (sodium-dependent glucose transporter 2) inhibitors, the newest anti-diabetic medications on the market are of concern. The purpose of this review is to provide a comprehensive overview of the effect of these medications on bone metabolism and the studies exploring the risk or lack thereof of these medications on bone loss and fragility fractures.



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Comment on “Reference Values of Total Lean Mass, Appendicular Lean Mass, and Fat Mass Measured with Dual-Energy X-ray Absorptiometry in a Healthy Mexican Population”



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Maternal Dietary Nutrient Intake During Pregnancy and Offspring Linear Growth and Bone: The Vitamin D in Pregnancy Cohort Study

Abstract

Magnesium, phosphorus, zinc, calcium, potassium and protein all play integral roles in maintaining bone health in adults; however, less is known about the importance of these minerals in utero. We aimed to determine associations between maternal dietary consumption of these nutrients during gestation and birth measures in offspring. Of 475 pregnant women recruited from a single antenatal clinic before 16-week gestation (2002–2003) as part of the vitamin D in pregnancy study, 346 with recorded maternal dietary intakes at 28- to 32-week gestation and offspring measures at birth were included. At birth, trained personnel measured the infant’s weight, knee-heel length, crown-heel length and head circumference. At age 11, returning offspring underwent assessment of bone mass by dual-energy X-ray absorptiometry (n = 171). Crown-heel length was positively and weakly correlated with maternal intakes of all measured nutrients except calcium, fat and carbohydrate (r = 0.15–0.17; all p ≤ 0.05). The associations with protein, phosphorus and potassium were not attenuated after adjustment for maternal and offspring characteristics. No sustained associations were seen with other birth measures. Further, associations with some nutrients persisted with offspring height at age 11 years. Offspring bone area was associated with maternal diet, but no other measure of bone mass at age 11. After adjustment for height, associations were not significant. These data highlight that whilst some nutritional factors during pregnancy are associated with offspring linear growth in utero and childhood, this does not necessarily translate into an effect on offspring bone measures in childhood.



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Comparative Foraging Efficiency of Two Sympatric Jackals, Silver-Backed Jackals (Canis mesomelas) and Golden Jackals (Canis aureus), in the Ngorongoro Crater, Tanzania

The foraging efficiency of two sympatric species of jackals, silver-backed jackals (Canis mesomelas) and golden jackals (Canis aureus), was studied in the Ngorongoro crater from July 2014 through May 2015. The focal animal observation method was used and individuals of both species were followed as they foraged from morning to evening. Observations of individuals of both jackal species were made from a vehicle using binoculars and a spotting scope. Three major parameters were used for determination of foraging efficiency: distance travelled while foraging, time spent foraging, and amount of food secured in foraging period. The Mann–Whitney test showed no significant difference () in distance travelled per unit time of foraging between the two species in the dry and wet seasons, respectively. Golden jackals secured a significantly higher amount of food than the silver-backed jackals in the wet season (Mann–Whitney test, , ). Hunting of prey larger than Thomson’s gazelle (Eudorcas thomsonii) fawns was not common. Both species mainly fed on smaller prey such as invertebrates and rodents and scavenged opportunistically. Efficient foraging is crucial for both jackal species especially during their breeding season when they are provisioning dependent pups.

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SABE Colombia: Survey on Health, Well-Being, and Aging in Colombia—Study Design and Protocol

Objective. To describe the design of the SABE Colombia study. The major health study of the old people in Latin America and the Caribbean (LAC) is the Survey on Health, Well-Being, and Aging in LAC, SABE (from initials in Spanish: SAlud, Bienestar & Envejecimiento). Methods. The SABE Colombia is a population-based cross-sectional study on health, aging, and well-being of elderly individuals aged at least 60 years focusing attention on social determinants of health inequities. Methods and design were similar to original LAC SABE. The total sample size of the study at the urban and rural research sites (244 municipalities) was 23.694 elderly Colombians representative of the total population. The study had three components: (1) a questionnaire covering active aging determinants including anthropometry, blood pressure measurement, physical function, and biochemical and hematological measures; (2) a subsample survey among family caregivers; (3) a qualitative study with gender and cultural perspectives of quality of life to understand different dimensions of people meanings. Conclusions. The SABE Colombia is a comprehensive, multidisciplinary study of the elderly with respect to active aging determinants. The results of this study are intended to inform public policies aimed at tackling health inequalities for the aging society in Colombia.

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Modelling and Experimental Study on Active Energy-Regenerative Suspension Structure with Variable Universe Fuzzy PD Control

A novel electromagnetic active suspension with an energy-regenerative structure is proposed to solve the suspension’s control consumption problem. For this new system, a 2-DOF quarter-car model is built, and dynamics performances are studied using the variable universe fuzzy theory and the PD control approach. A self-powered efficiency concept is defined to describe the regenerative structure’s contribution to the whole control consumption, and its influent factors are also discussed. Simulations are carried out using software Matlab/Simulink, and experiments are conducted on the B-class road. The results demonstrate that the variable universe fuzzy control can recycle more than 18 percent vibration energy and provide over 11 percent power for the control demand. Furthermore, the new suspension system offers a smaller body acceleration and decreases dynamic tire deflection compared to the passive ones, so as to improve both the ride comfort and the safety.

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Transnasal, Transethmoidal Endoscopic Removal of a Foreign Body in the Medial Extraconal Orbital Space

Intraorbital foreign bodies are located within the orbit but outside the ocular globe. Though not uncommon, removal of these objects poses a challenge for surgeons. External approaches have been the most frequently used but are associated with increased complications and morbidity. An endoscopic endonasal approach can be an appropriate and less complicated technique in these cases. We report a case of a chronic intraorbital foreign body located within the medial extraconal space lateral to the lamina papyracea and behind the lacrimonasal duct, which was successfully removed using a transnasal, transethmoidal endoscopic technique. Neither postoperative complications nor ocular impairment was reported. The patient improved and remains asymptomatic. The transnasal transethmoidal endoscopic approach can be used as a safer and less invasive alternative when removing foreign bodies from the medial orbital compartment.

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The Relationship between MC1R Mutation and Plumage Color Variation in Pigeons

The polymorphisms of MC1R gene play a crucial role in coat color variation in mammals; however, the relationship is still unclear in pigeons. In this study, we sequenced 741 bp fragment of the MC1R for 39 individuals with five plumage color patterns (gray plumage, ; black plumage, ; white plumage, ; spotted plumage, ; red plumage, ). A total of three single nucleotide polymorphisms (SNPs) were detected, including G199A, G225A, and A466G, which subsequently determined four haplotypes (H1–H4). Among them, H1 is the predominant haplotype. Association analysis revealed that H1 and H3 were significantly associated with the black plumage trait (), while the H4 was significantly associated with gray plumage trait (). Furthermore, only diplotype H1H1 was significantly associated with black and gray traits of pigeons. Collectively, our study suggested an association between genetic variation of MC1R and plumage color in pigeon.

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Prevalence and Clinical Features of Atopic Dermatitis in China

Background. The epidemiology of atopic dermatitis (AD) in Chinese outpatients is yet to be clarified. Objectives. To investigate population-based prevalence and clinical features of AD in Chinese outpatients. Methods. A multicenter cross-sectional study was conducted in outpatients with eczema or dermatitis from 39 tertiary hospitals in 15 provinces. Results. This study included 682 patients diagnosed with AD, with the mean age of years and the median course of years. AD patients had more severe itching (30.4% versus 13.8%, ) and clinically suspected bacterial infection (21.7% versus 16.1%, ) than those of other types of dermatitis. Older patients were more susceptible to have a history of flexion dermatitis (), bacterial infection (), and severe itching (). Outpatients with clinically suspected bacterial infection had 3.53-fold increased risk of AD than those without it (). The morbidity rate of AD in the (20–25°N) region is 2.86 times higher than that in the (40–45°N) region [OR (95% CI): 0.352 (0.241–0.514), ]. Conclusions. AD is characterized by unique clinical/demographic features. Bacterial infection and latitude region may have an impact on the incidence of AD in China.

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Factors Affecting Recruitment and Attrition in Randomised Controlled Trials of Complementary and Alternative Medicine for Pregnancy-Related Issues

Background. Randomised controlled trials (RCTs) investigating Complementary and Alternative Medicine (CAM) for pregnancy-related issues have encountered issues with recruitment and attrition. Little is known about the cause of these issues. Methods. Data was gathered from an antenatal CAM randomised controlled trial. During foetal anomaly appointments, women meeting inclusion criteria were invited to participate in the trial. Numbers of women invited and eligible were recorded. Reasons for noninterest were noted and analysed. Focus groups exploring trial experience of participants were also conducted. Findings. Of the 428 women invited to participate, 376 were eligible and just under a quarter participated. Reasons for nonparticipation included concerns about CAM and lack of interest in participation in research. Other factors negatively affecting recruitment included recruitment timing, competition for participants, limited support from staff, and inadequate trial promotion. Factors encouraging recruitment included being interested in research and seeking pain relief. Reasons for dropping out were time constraints, travel issues, work commitments, and pregnancy issues. Several women in the sham and usual care group dropped out due to dissatisfaction with treatment allocation. Conclusion. CAM researchers must explore problems encountered with recruitment and attrition so that evidence-based implementation strategies to address the issues can be developed.

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Neuroinflammation Induced by Surgery Does Not Impair the Reference Memory of Young Adult Mice

Postoperative cognitive dysfunction (POCD) increases morbidity and mortality after surgery. But the underlying mechanism is not clear yet. While age is now accepted as the top one risk factor for POCD, results from studies investigating postoperative cognitive functions in adults have been controversial, and data about the very young adult individuals are lacking. The present study investigated the spatial reference memory, IL-1β, IL-6, and microglia activation changes in the hippocampus in 2-month-old mice after anesthesia and surgery. We found that hippocampal IL-1β and IL-6 increased at 6 hours after surgery. Microglia were profoundly activated in the hippocampus 6 to 24 hours after surgery. However, no significant behavior changes were found in these mice. These results indicate that although anesthesia and surgery led to neuroinflammation, the latter was insufficient to impair the spatial reference memory of young adult mice.

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Association between Sleep Duration and Measurable Cardiometabolic Risk Factors in Healthy Korean Women: The Fourth and Fifth Korean National Health and Nutrition Examination Surveys (KNHANES IV and V)

Study Objectives. To examine the association between sleep duration and prevalence of metabolic syndrome (MetS) and its components in healthy Korean women. Design. Cross-sectional study, using the Fourth and Fifth Korean National Health and Nutrition Examination Surveys. Methods. Among 8505 women (25–70 years) from KNHANES IV and V, participants were classified into five sleep groups based on self-reported sleep duration. MetS and its components were defined using the criteria set forth in National Cholesterol Education Program-Adult Treatment Panel III. We used multivariate logistic regression analysis. Results. After adjusting for various confounders, shorter sleep duration (≤6 h) was found to have an association with low risk of reduced high-density lipoprotein cholesterol and increased triglycerides, whereas very long sleep duration was found to have high risk of increased triglycerides. However, abdominal obesity showed an opposite trend: short sleep duration was associated with higher risk of abdominal obesity than long sleep duration. Fasting glucose levels increased as sleep duration increased, but without significance. Moreover, blood pressure was not significantly associated with sleep duration. Consequently, MetS was less prevalent in those with short sleep duration. Conclusions. Sleep duration was positively associated with MetS, especially dyslipidemia and fasting hyperglycemia, but inversely associated with abdominal obesity.

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Angiofibroma Originating outside the Nasopharynx: A Management Dilemma

Background. Angiofibroma is a benign tumor, consisting of fibrous tissue with varying degrees of vascularity, characterized by proliferation of stellate and spindle cells around the blood vessels. It most commonly arises from the nasopharynx, although it may rarely arise in extranasopharyngeal sites. Case Report. A 46-year-old male presented with left side nasal obstruction and epistaxis for one month. Clinical nasal examination revealed left sided polypoidal mass arising from the vestibular region of the lateral nasal wall. Results. CT scan and MRI showed highly vascular soft tissue mass occupying the anterior part of the left nostril. Preoperative selective embolization followed by transnasal excision was performed. Histopathological examination confirmed the diagnoses of nasal vestibular angiofibroma. Conclusion. Extranasopharyngeal angiofibroma is a very rare pathology. It should be kept in mind as a differential diagnosis with any unilateral nasal vestibular mass causing nasal obstruction and epistaxis. A biopsy without further investigation can cause life threatening bleeding in the patient.

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Intergroup Joint Scheduling for Mitigating Asymmetric Uplink Interference in Self-Organizing Virtual Cell Networks

We introduce the concept of self-organizing VCN (virtual cell network). Here self-organizing VCN topology for efficient operation will be configured, and the functions of the each element will be defined. Also, the operation scenarios of VCN will be described. Then, we propose an efficient scheduling algorithm that considers the asymmetry of interference between downlink and uplink to mitigate intercell interference with little computing overhead. The basic concept is to construct scheduling groups that consist of several users. Each user in a scheduling group is affiliated with a different cell. Then, the intercell groups are managed efficiently in the proposed VCNs. There is no need for the exchange of a lot of information among base stations to schedule the users over the entire network.

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A New Software Reliability Growth Model: Multigeneration Faults and a Power-Law Testing-Effort Function

Software reliability growth models (SRGMs) based on a nonhomogeneous Poisson process (NHPP) are widely used to describe the stochastic failure behavior and assess the reliability of software systems. For these models, the testing-effort effect and the fault interdependency play significant roles. Considering a power-law function of testing effort and the interdependency of multigeneration faults, we propose a modified SRGM to reconsider the reliability of open source software (OSS) systems and then to validate the model’s performance using several real-world data. Our empirical experiments show that the model well fits the failure data and presents a high-level prediction capability. We also formally examine the optimal policy of software release, considering both the testing cost and the reliability requirement. By conducting sensitivity analysis, we find that if the testing-effort effect or the fault interdependency was ignored, the best time to release software would be seriously delayed and more resources would be misplaced in testing the software.

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Fetal Hemodynamic Parameters in Low Risk Pregnancies: Doppler Velocimetry of Uterine, Umbilical, and Middle Cerebral Artery

Objective. To elaborate curves of longitudinal reference intervals of pulsatility index (PI) and systolic velocity (SV) for uterine (UtA), umbilical (UA), and middle cerebral arteries (MCA), in low risk pregnancies. Methods. Doppler velocimetric measurements of PI and SV from 63 low risk pregnant women between 16 and 41 weeks of gestational age. Means (±SD) for intervals of gestational age and percentiles 5, 50, and 95 were calculated for each parameter. The Intraclass Correlation Coefficients (ICC) were also estimated for assessing intra- and intervariability of measurements. Results. Mean PI of UtA showed decreasing values during pregnancy, but no regular pattern was identified for mean SV. For UA, PI decreased and SV increased along gestation. MCA presented PI increasing values until 32–35 weeks. SV showed higher levels with increasing gestation. High ICC values indicated good reproducibility. Conclusions. Reference intervals for the assessment of SV and PI of UtA, UA, and MCA were established. These reference intervals showed how a normal pregnancy is expected to progress regarding these Doppler velocimetric parameters and are useful to follow high risk pregnancies. The comparison between results using different curves may provide insights about the best patterns to be used.

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Nanocomposites of Magnetite and Layered Double Hydroxide for Recyclable Chromate Removal

Nanocomposites containing magnetic iron oxide (magnetite) nanoparticles and layered double hydroxide (LDH) nanosheets were prepared by two different methods, exfoliation-reassembly and coprecipitation, for aqueous chromate adsorbent. According to X-ray diffraction, scanning electron microscopy, and atomic force microscopy, both nanocomposites were determined to develop different nanostructures; LDH nanosheets well covered magnetite nanoparticles with house-of-cards-like structure in exfoliation-reassembly method, while coprecipitation resulted in LDH particle formation along with magnetite nanoparticles. Zeta-potential measurement also revealed that the magnetite surface was effectively covered by LDH moiety in exfoliation-reassembly compared with coprecipitation. Time, pH, concentration dependent chromate adsorption tests, and magnetic separation experiments exhibited that both nanocomposites effectively adsorb and easily collect chromate. However, exfoliation-reassembly nanocomposite was determined to be slightly effective in chromate removal by ~10%. Chromate adsorbed nanocomposites could be regenerated by treating with bicarbonate and the regenerated nanocomposites preserved ~80% of chromate adsorption efficacy after three times of recycling.

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Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of containing obesity, diabetes, and metabolic syndrome in order to reduce the burden of cardiovascular disease in the women affected.

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Comprehensive Screening of Cell Surface Markers Expressed by Adult-Derived Human Liver Stem/Progenitor Cells Harvested at Passage 5: Potential Implications for Engraftment

Mesenchymal stromal cells (MSCs) are known to have potential therapeutic benefits for a number of diseases. However, many studies report low engraftment levels, regardless of the target organ. One possible explanation could be that MSCs do not express the necessary receptors for engraftment. Indeed, MSCs appear to use a similar mechanism to leukocytes to engraft into injured organs, relying on various receptors for rolling, firm adhesion, and transmigration. In this study, we conducted an extensive surface molecule screening of adult-derived human liver stem/progenitor cells (ADHLSC) in an attempt to shed some light on this subject. We observed that ADHLSCs lack expression of most of the costimulatory molecules tested. Furthermore, study of the adhesion molecule profile of ADHLSCs revealed that they do not express selectin ligands or LFA-1 which are, respectively, involved in the rolling process and the firm adhesion. In addition, ADHLSCs slightly express VLA-4 and lose expression of CXCR4 altogether on their surface during culture expansion. However, ADHLSCs express all the integrin couples and matrix metalloproteinases needed to bind and integrate the extracellular matrix once the endothelial barrier is crossed. Collectively, these results suggest that binding to the endothelium may be the critical weak point in the engraftment process.

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Properties of Quasi-Oscillator in Position-Dependent Mass Formalism

Schrödinger equation is considered within position-dependent mass formalism with a quasi-oscillator interaction term. Wave functions and energy spectra have been obtained analytically. Thermodynamic properties, information entropy, and uncertainty in coordinate and momentum spaces are calculated. To provide a better physical insight into the solutions, some figures are included.

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Teaching Life-Saving Manoeuvres in Primary School

Introduction. In the event of sudden cardiac arrest (SCA) early intervention provided by a layperson can be life-saving. Teaching first aid in primary school may increase the lifelong ability and motivation of young people to take action in an emergency. Objective. The aim of this article is to report a training experience on BLSD (Basic Life Support and Defibrillation) designed for a group of pupils in an Italian primary school, with assessment of its effectiveness at a distance. Methods. The assessment was carried out using a multiple choice questionnaire on a sample of 130 pupils aged 11-12, 62 trained in BLSD and 68 as a control group. The trained group also performed an emergency simulation to assess their learning of practical skills. Results. Using the test, significant differences emerged in the questionnaire scores between the case-control group. The results of the skill test were positive, even for the most difficult manoeuvres such as opening airways, assessing breathing, or using an AED (Automated External Defibrillator). Conclusion. Although there are still some open questions regarding the ability to retain these skills in the medium/long term, the study shows that life-saving manoeuvres can be effectively taught to primary school pupils.

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Bimatoprost Induced Serous Macular Detachment after Cataract Surgery

We report a case of bimatoprost induced serous macular detachment and choroidal folds following uneventful cataract surgery. A 66-year-old male using topical bimatoprost in both eyes for open angle glaucoma underwent uneventful cataract surgery in the right eye. Postoperatively, he was restarted on topical bimatoprost and antibiotic-steroids combination drops. One week after surgery, he presented with conjunctival hyperemia, serous macular detachment, and choroidal folds at the posterior pole. Fundus fluorescein angiography showed perifoveal leaks in early stage with pooling of dye in late stage. Discontinuation of bimatoprost led to resolution of serous detachment and choroidal folds within 3 weeks with significant improvement in visual acuity. Occurrence of serous macular detachment and choroidal folds in this case could be probably related to the proinflammatory property of bimatoprost. Hence, it should be used with caution in the immediate postoperative period after cataract surgery.

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Effect of Die Head Temperature at Compounding Stage on the Degradation of Linear Low Density Polyethylene/Plastic Film Waste Blends after Accelerated Weathering

Accelerated weathering test was performed on blends of linear low density polyethylene (LLDPE) and plastic film waste constituting the following percentages of polyolefin polymers (wt.%): LLDPE (46%), low density polyethylene (LDPE, 51%), high density polyethylene (HDPE, 1%), and polypropylene (PP, 2%). Compounded blends were evaluated for their mechanical and physical (optical) properties. The impact of photodegradation on the formulated blends was studied, and loss of mechanical integrity was apparent with respect to both the exposure duration to weathering and waste content. The effect of processing conditions, namely, the die head temperature (DHT) of the blown-film assembly used, was investigated in this work. It was witnessed that surpassing the melting point of the blends constituting polymers did not always result in a synergistic behaviour between polymers. This was suspected to be due to the loss of amorphous region that polyolefin polymers get subjected to with UV exposure under weathering conditions and the effect of the plastic waste constituents. The total change in colour () did not change with respect to DHT or waste content due to rapid change degradation on the material’s surface. Haze (%) and light transmission (%) decreased with the increase in waste content which was attributed to lack of miscibility between constituting polymers.

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Antibacterial Action of Curcumin against Staphylococcus aureus: A Brief Review

Curcumin, the major constituent of Curcuma longa L. (Zingiberaceae family) or turmeric, commonly used for cooking in Asian cuisine, is known to possess a broad range of pharmacological properties at relatively nontoxic doses. Curcumin is found to be effective against Staphylococcus aureus (S. aureus). As demonstrated by in vitro experiment, curcumin exerts even more potent effects when used in combination with various other antibacterial agents. Hence, curcumin which is a natural product derived from plant is believed to have profound medicinal benefits and could be potentially developed into a naturally derived antibiotic in the future. However, there are several noteworthy challenges in the development of curcumin as a medicine. S. aureus infections, particularly those caused by the multidrug-resistant strains, have emerged as a global health issue and urgent action is needed. This review focuses on the antibacterial activities of curcumin against both methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA). We also attempt to highlight the potential challenges in the effort of developing curcumin into a therapeutic antibacterial agent.

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Resolvent for Non-Self-Adjoint Differential Operator with Block-Triangular Operator Potential

A resolvent for a non-self-adjoint differential operator with a block-triangular operator potential, increasing at infinity, is constructed. Sufficient conditions under which the spectrum is real and discrete are obtained.

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HIV-1 Epidemiology, Genetic Diversity, and Primary Drug Resistance in the Tyumen Oblast, Russia

Introduction. Specific molecular epidemic features of HIV infection in Tyumen Oblast (TO), Russia, were studied. Methods. The genome sequences encoding HIV-1 protease-reverse transcriptase, integrase, and major envelope protein were examined for 72 HIV-1 specimens isolated from the TO resident infected in 2000–2015. Results. The recorded prevalence of HIV-1 subtype A (A1) is 93.1%; HIV-1 subtype B continues to circulate in MSM risk group (1.4%). Solitary instances of HIV-1 recombinant forms, CRF63_02A1 (1.4%) and CRF03_AB (1.4%), were detected as well as two cases of HIV-1 URF63_A1 (2.8%). Phylogenetic analysis showed no HIV-1 clustering according to the duration of infection and risk groups but revealed different epidemic networks confirming that HIV infection spread within local epidemic foci. A high incidence of CXCR4-tropic HIV-1 variants and a higher rate of secondary mutations influencing the virus fitness (K20R, L10V, and I) are observed among the virus specimens isolated from newly infected individuals. Conclusions. The current HIV-1 epidemic in TO develops within the local epidemic networks. Similar to the previous period, HIV-1 subtype A is predominant in TO with sporadic cases of importation of HIV-1 recombinant forms circulating in adjacent areas.

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Robust Quadratic Stabilizability and Control of Uncertain Linear Discrete-Time Stochastic Systems with State Delay

This paper mainly discusses the robust quadratic stability and stabilization of linear discrete-time stochastic systems with state delay and uncertain parameters. By means of the linear matrix inequality (LMI) method, a sufficient condition is, respectively, obtained for the stability and stabilizability of the considered system. Moreover, we design the robust state feedback controllers such that the system with admissible uncertainties is not only quadratically internally stable but also robust controllable. A sufficient condition for the existence of the desired robust controller is obtained. Finally, an example with simulations is given to verify the effectiveness of our theoretical results.

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Cardiovascular Effects of the Essential Oil of Croton argyrophylloides in Normotensive Rats: Role of the Autonomic Nervous System

Cardiovascular effects of the essential oil of Croton argyrophylloides Muell. Arg. (EOCA) were investigated in normotensive rats. In saline-pretreated anesthetized or conscious rats, intravenous (i.v.) injection of the EOCA induced dose-dependent hypotension. Dose-dependent tachycardia was observed only in conscious rats. In anesthetized rats, cervical bivagotomy failed to enhance EOCA-induced hypotension but unmasked significant bradycardia. In conscious rats, i.v. pretreatment with methylatropine, but not with atenolol or L-NAME, reduced both hypotensive and tachycardiac responses to EOCA. However, hexamethonium pretreatment reverted the EOCA-induced tachycardia into significant bradycardia without affecting the hypotension. In aortic ring preparations precontracted with phenylephrine, EOCA induced a concentration-dependent relaxation that was significantly reduced by vascular endothelium removal and pretreatment with atropine, indomethacin, or glibenclamide but remained unaffected by pretreatment with L-NAME or TEA. It is concluded that i.v. treatment with EOAC decreased blood pressure probably through an active vascular relaxation rather than withdrawal of sympathetic tone. Muscarinic receptor stimulation, liberation of the endothelium-derived prostacyclin, and opening KATP channels are partially involved in the aortic relaxation induced by EOCA and in turn in the mediation of EOCA-induced hypotension. EOCA-induced tachycardia in conscious rats appears to be mediated reflexly through inhibition of vagal drive to the heart.

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Molecular Dynamics Simulation of Nanoindentation of Cu/Au Thin Films at Different Temperatures

Two methods, deposition method and ideal modeling based on lattice constant, are used to prepare three modulation periods’ (1.8 nm Cu/3.6 nm Au, 2.7 nm Cu/2.7 nm Au, and 3.6 nm Cu/1.8 nm Au) thin films for nanoindentation at different temperatures. The results show that the temperature will weaken the hardness of thin films. The deposition method and the formation of coherent interface will result in a lot of defects in thin films. These defects can reduce the residual stress in the thin films which is caused by the external force. The proposed system will provide potential benefits in designing the microstructures for thin films.

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Ollier’s Disease of the Iliac Bone with Sacroiliac Joint Involvement in an Adolescent Patient

Ollier’s disease of the hip bone involving the sacroiliac joint has not yet been reported in the English-language literature in both the mature and immature skeletons. The authors present such a unique case in an adolescent girl that posed a significant diagnostic challenge secondary to the rarity of the lesion and atypical clinical picture.

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Vitamin D Effects on Osteoblastic Differentiation of Mesenchymal Stem Cells from Dental Tissues

1α,25-Dihydroxyvitamin D3 (1,25(OH)2D3), the active metabolite of vitamin D (Vit D), increases intestinal absorption of calcium and phosphate, maintaining a correct balance of bone remodeling. Vit D has an anabolic effect on the skeletal system and is key in promoting osteoblastic differentiation of human Mesenchymal Stem Cells (hMSCs) from bone marrow. MSCs can be also isolated from the immature form of the tooth, the dental bud: Dental Bud Stem Cells (DBSCs) are adult stem cells that can effectively undergo osteoblastic differentiation. In this work we investigated the effect of Vit D on DBSCs differentiation into osteoblasts. Our data demonstrate that DBSCs, cultured in an opportune osteogenic medium, differentiate into osteoblast-like cells; Vit D treatment stimulates their osteoblastic features, increasing the expression of typical markers of osteoblastogenesis like RUNX2 and Collagen I (Coll I) and, in a more important way, determining a higher production of mineralized matrix nodules.

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Pneumomediastinum Secondary to Barotrauma after Recreational Nitrous Oxide Inhalation

We present a case of a seventeen-year-old patient, admitted in the care of the surgical team following inhalation of nitrous oxide at high pressure, leading to extensive pneumomediastinum and surgical emphysema. We discuss the subsequent investigations and management for this patient. In the absence of history of airway injury and respiratory problems including asthma and with no oesophageal perforation on investigations, the diagnostic and management challenges encountered have been discussed which will help in future management of similar cases.

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Multistage A-O Activated Sludge Process for Paraformaldehyde Wastewater Treatment and Microbial Community Structure Analysis

In recent years, the effect of formaldehyde on microorganisms and body had become a global public health issue. The multistage combination of anaerobic and aerobic process was adopted to treat paraformaldehyde wastewater. Microbial community structure in different reaction stages was analyzed through high-throughput sequencing. Results showed that multistage A-O activated sludge process positively influenced polyformaldehyde wastewater. The removal rates of formaldehyde were basically stable at more than 99% and those of COD were about 89%. Analysis of the microbial diversity index indicated that the microbial diversity of the reactor was high, and the treatment effect was good. Moreover, microbial community had certain similarity in the same system. Microbial communities in different units also showed typical representative characteristics affected by working conditions and influent concentrations. Proteobacteria, Firmicutes, and Bacteroidetes were the dominant fungal genera in the phylum level of community composition. As to family and genus levels, Peptostreptococcaceae was distributed at various stages and the dominant in this system. This bacterium also played an important role in organic matter removal, particularly decomposition of the acidified middle metabolites. In addition, Rhodobacteraceae and Rhodocyclaceae were the formaldehyde-degrading bacteria found in the reactor.

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Diagnosis of Peripheral Lung Lesions via Conventional Flexible Bronchoscopy with Multiplanar CT Planning

Background. Conventional flexible bronchoscopy has limited sensitivity in the diagnosis of peripheral lung lesions and is dependent on lesion size. However, advancement of CT imaging offers multiplanar reconstruction facilitating enhanced preprocedure planning. This study aims to report efficacy and safety while considering the impact of patient selection and multiplanar CT planning. Method. Prospective case series of patients with peripheral lung lesions suspected of having lung cancer who underwent flexible bronchoscopy (forceps biopsy and lavage). Endobronchial lesions were excluded. Patients with negative results underwent CT-guided transthoracic needle aspiration, surgical biopsy, or clinical-radiological surveillance to establish the final diagnosis. Results. 226 patients were analysed. The diagnostic yield of bronchoscopy was 80.1% (181/226) with a sensitivity of 84.2% and specificity of 100%. In patients with a positive CT-Bronchus sign, the diagnostic yield was 82.4% compared to 72.8% with negative CT-Bronchus sign (). Diagnostic yield was 84.9% in lesions > 20 mm and 63.0% in lesions ≤ 20 mm (). Six (2.7%) patients had transient hypoxia and 2 (0.9%) had pneumothorax. There were no serious adverse events. Conclusion. Flexible bronchoscopy with appropriate patient selection and preprocedure planning is more efficacious in obtaining a diagnosis in peripheral lung lesions compared to historical data. This trial is registered with ClinicalTrials.gov Identifier: NCT01374542.

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Mitigating the Risk of Transfusion-Transmitted Dengue in Australia

Dengue viruses (DENV 1–4) are a risk to transfusion safety, with several transfusion-transmitted (TT) cases reported globally. DENV 1–4 are endemic in over 100 countries, with seasonal outbreaks occurring in northeastern Australia. To mitigate TT-DENV risk in Australia, fresh blood components are not manufactured from donors returning from any area (domestic/overseas) with known dengue transmission. Alternatively, TT-DENV risk may be mitigated using an appropriate blood donor screening assay. We aimed to determine the rate of dengue infection in donors during dengue outbreaks in Australia. Plasma samples were collected from blood donors during local dengue outbreaks. All samples were tested for the presence of DENV RNA and selected samples were tested for DENV antigen (nonstructural protein 1, NS1) with two assays. No donors residing in high risk areas had detectable levels of DENV RNA or NS1 and no cases of DENV viremia were detected in blood donors residing in areas of Australia experiencing DENV outbreaks. Definitive conclusions could not be drawn from this study; however, the lack of detection of DENV RNA or antigen in donations suggests that the current risk of TT-DENV is low and maintaining the fresh component restriction for “at-risk” donors is appropriate.

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Use of maintenance endocrine therapy after chemotherapy in metastatic breast cancer

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Publication date: Available online 12 November 2016
Source:European Journal of Cancer
Author(s): S. Sutherland, D. Miles, A. Makris
BackgroundFor women with oestrogen receptor+ metastatic breast cancer (MBC), the options for systemic treatment include endocrine therapy (ET) and chemotherapy. For women whose disease is also HER2+, anti-HER2 therapies are also routinely used either with chemotherapy or less commonly with ET. Where chemotherapy is used as initial therapy, treatment is often discontinued due to cumulative toxicity in the absence of disease progression. In this setting, there is the option of introducing ET with the aim of prolonging response and delaying relapse.MethodsLiterature review revealed four trials addressing the question of whether there is a benefit from introducing ET following chemotherapy for MBC. We also sought evidence for alternative approaches, including concurrent chemotherapy and ET and continuing chemotherapy until disease progression.ResultsThe evidence for the use of ET after chemotherapy in MBC is limited, and the trials done were small. Furthermore, they were performed at a time when both the chemotherapy regimens and ET were different from those used currently. Despite these limitations, there is probably a modest improvement in time to progression for the sequential use of ET after chemotherapy but with no overall survival benefit. An alternative approach, particularly considering agents with relatively low toxicity, such as orally bioavailable fluoropyrimidines, is to continue chemotherapy until disease progression.ConclusionWhere chemotherapy for MBC is discontinued due to toxicity, in the absence of progression, the use of ET, with its relatively low toxicity, is a reasonable approach with the aim of delaying relapse.



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Plasmablastic lymphoma: oral presentation in patient suffering from osteradionecrosis of the jaw.

Plasmablastic lymphoma: oral presentation in patient suffering from osteradionecrosis of the jaw.

Int J Surg Case Rep. 2016 Nov 3;29:94-97

Authors: Kichenbrand C, Egloff C, Guillet J, Delaître B, Bastien C, Leroux A, Dolivet G, Phulpin B

Abstract
INTRODUCTION: We describe here an unusual presentation of a plasmablastic lymphoma in a patient suffering from an osteoradionecrosis of the jaw.
PRESENTATION OF CASE: We report the case of a 64-year-old patient who was followed up on oncology because of an oropharyngeal cancer treated by a combined procedure of both surgery and radio-chemotherapy procedure. This patient developed an osteoradionecrosis of the jaw. In the vicinity of this necrotic area appeared an ulceration which could evoke a new necrotic area. Given the persistence of this ulceration, a biopsy was performed which highlighted a plasmablastic lymphoma oral localization.
DISCUSSION: The plasmablastic lymphoma, belonging to the diffuse large B-cell lymphoma family, is a very aggressive and unusual form of cancer with poor prognosis. If it is found mainly in patients with positive HIV, in whom it was first described, it is also found in immunosuppressed patients such as transplanted patients or patients suffering from leukaemia.
CONCLUSION: Plasmablastic lymphoma is a rare and an aggressive pathology in immunocompetent patients.

PMID: 27837702 [PubMed - as supplied by publisher]



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In vivo dosimetry in the field junction area for 3D-conformal radiation therapy in breast and head & neck cancer cases: A quality assurance study.

In vivo dosimetry in the field junction area for 3D-conformal radiation therapy in breast and head & neck cancer cases: A quality assurance study.

J BUON. 2016 Sept-Oct;21(5):1104-1112

Authors: Diamantopoulos S, Thalassinou S, Efstathopoulos E, Dilvoi M, Patatoukas G, Kouloulias V, Platoni K

Abstract
PURPOSE: To investigate the accuracy of field junctioning planning techniques (monoisocentric and rotating couch technique) for 3D-conformal radiotherapy (3D-CRT).
METHODS: In vivo dosimetry has been performed using thermo- luminescence dosimeters (TLDs) in 10 head and neck cancer patients (treated with monoisocentric technique) and 10 breast cancer patients (treated with rotating couch technique) irradiated with a 6 MV photon beam. Entrance dose measurements were performed in selected regions including the field junction area.
RESULTS: The mean deviation between measured and expected dose in the region of junction was significantly higher in breast cases compared to head and neck irradiation (-2.8±15.4% and 0.2±8.2% respectively; Mann-Whitney U test: p=0.002). A comparison between lateral head and neck fields and tangential breast fields revealed that the latter was associated with larger dose discrepancies (-2.2 ± 4.6% vs -3.5 ± 5.7% respectively; Mann-Whitney U test: p=0.029).
CONCLUSIONS: The results indicate the superiority of monoisocentric technique compared to the rotating couch technique in terms of dose delivery accuracy for treatments with field junctioning planning techniques.

PMID: 27837611 [PubMed - in process]



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