Κυριακή, 9 Ιουλίου 2017

Selenium-Doped Cathodes for Lithium–Organosulfur Batteries with Greatly Improved Volumetric Capacity and Coulombic Efficiency

For the first time a new strategy is reported to improve the volumetric capacity and Coulombic efficiency by selenium doping for lithium–organosulfur batteries. Selenium-doped cathodes with four sulfur atoms and one selenium atom (as the doped heteroatom) in the confined structure are designed and synthesized; this structure exhibits greatly improved volumetric/areal capacities, and a Coulombic efficiency of almost 100% for highly stable lithium–organosulfur batteries. The doping of Se significantly enhances the electronic conductivity of battery electrodes by a factor of 6.2 compared to pure sulfur electrodes, and completely restricts the production of long-chain lithium polysulfides. This allows achievement of a high gravimetric capacity of 700 mAh g−1 close to its theoretical mass capacity, an exceptional volumetric capacity of 2457 mAh cm−3, and excellent capacity retention of 92% after 400 cycles. Shuttle effect is efficiently weakened since no long-chain polysulfides are detected from in situ UV/vis results throughout the entire cycling process arising from selenium doping, which is theoretically confirmed by density functional theory calculations.

Thumbnail image of graphical abstract

A new type of selenium-doped organosulfur polymer cathode with four sulfur atoms and one selenium atom (as the doped heteroatom) in the confined structure is designed and synthesized. The resulting Se-doped electrodes exhibit greatly improved volumetric capacities and a Coulombic efficiency of almost 100% for highly stable lithium–organosulfur batteries.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tZfaMW

Recent Advances in Adhesive Bonding: The Role of Biomolecules, Nanocompounds, and Bonding Strategies in Enhancing Resin Bonding to Dental Substrates

Abstract

Purpose of review

To present an overview on the main agents (i.e. biomolecules and nanocompounds) and/or strategies currently available to amplify or stabilize resin-dentin bonding.

Recent findings

According to studies retrieved for full-text reading (2014–2017), there are currently six major strategies available to overcome resin-dentin bond degradation: (1) use of collagen crosslinking agents, which may form stable covalent bonds with collagen fibrils, thus strengthening the hybrid layer; (2) use of antioxidants, which may allow further polymerization reactions over time; (3) use of protease inhibitors, which may inhibit or inactivate metalloproteinases; (4) modification of the bonding procedure, which may be performed by using the ethanol-wet bonding (EWB) technique or by applying an additional adhesive (hydrophobic) coating, thereby strengthening the hybrid layer; (5) laser treatment of the substrate prior to bonding, which may cause specific topographic changes in the surface of dental substrates, increasing bonding efficacy; and (6) reinforcement of the resin matrix with inorganic fillers and/or remineralizing agents, which may positively enhance physicomechanical properties of the hybrid layer.

Summary

With the present review, we contributed to the better understanding of adhesion concepts and mechanisms of resin-dentin bond degradation, showing the current prospects available to solve that problematic. In addition, adhesively-bonded restorations may be benefited by the use of some biomolecules, nanocompounds or alternative bonding strategies in order to minimize bond strength degradation.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u8aIfq
via IFTTT

Postmastectomy Conundrum

alertIcon.gif

Publication date: 1 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 98, Issue 5
Author(s): Janet K. Horton




from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uHmTg3

Meetings

alertIcon.gif

Publication date: 1 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 98, Issue 5





from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u8f4mV

Effectiveness of Disease Prevention in Community Health Center Dental Programs

Abstract

Purpose of Review

The goal of this paper is to describe and analyze oral health disease prevention at Community Health Center (CHC) dental programs in order to summarize the effectiveness of activities at the individual and community levels.

Recent Findings

Recent efforts to expand oral health prevention and care with children at community health centers have shown positive results. Although there is considerable literature regarding oral health disease prevention aimed at individuals and communities, there are few articles that specifically address preventive oral health programs at CHC.

Summary

CHC dental programs are well positioned to address the prevention of dental diseases as an integral part of care based on their organization and strong community-based orientation. Recent trends in the integration of medical and dental care at CHC support dental disease prevention activities to increase oral health and provide opportunities for further research in monitoring effectiveness of disease prevention in CHC.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v1GqaA
via IFTTT

PMRT: Please Mind Randomized Trials

alertIcon.gif

Publication date: 1 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 98, Issue 5
Author(s): Anthony C. Wong, Steven J. Chmura




from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uH7tsh

Issue Highlights

alertIcon.gif

Publication date: 1 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics, Volume 98, Issue 5





from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u85Nek

Remediation of Phenanthrene-Contaminated Soil by Persulfate Activated with Fe-Modified Diatomite: Kinetic and Statistical Approaches

Abstract

An innovative diatomite-supported iron catalyst has been developed by using an impregnation process with a mixture of ferrous (Fe2+) and ferric (Fe3+) ions in the form of precipitated iron hydroxides. Raw and modified diatomite samples have been characterized by X-ray fluorescence and scanning electron microscopy. The main characterization results have revealed that modified diatomites are amorphous and have higher iron concentrations than raw diatomite. The results also indicate that the modified materials provided significant catalytic activity on phenanthrene degradation by using sodium persulfate. Satisfactory results were obtained with 45 g/L of sodium persulfate and 1 g of modified diatomite, thus degrading 98% of phenanthrene during 168 h of treatment. Kinetic and statistical approaches were developed for the remediation process herein, which have been validated with experimental data, thence yielding suitable results.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sFuwT1
via IFTTT

Cancer risk among Holocaust survivors in Israel—A nationwide study

BACKGROUND

Holocaust survivors during World War II were exposed to various factors that are associated with cancer risk. The objective of this study was to determine whether Holocaust survivors had an increased risk for developing cancer.

METHODS

The study population included 152,622 survivors. The main analysis was based on a comparison between individuals who were entitled to compensation for suffering persecution during the war and individuals who were denied such compensation. A complementary analysis compared survivors who were born in countries governed by Nazi Germany with survivors born in nonoccupied countries. A Cox proportional hazards model was used, with the time at risk of cancer development starting on either January 1, 1960, or the date of immigration to the date of cancer diagnosis or death or the date of last follow-up (December 31, 2006).

RESULTS

Cancer was diagnosed in 22.2% of those who were granted compensation versus 16% of those who were denied compensation (P < .0001). Adjusting for birth cohort, sex, country of origin, and period of immigration, both analyses revealed significant increased risks of developing cancer in those who were exposed. For those who were granted versus denied compensation, the hazard ratios were 1.06 (P < .001) for all sites, 1.12 (P = .07) for colorectal cancer, and 1.37 (P = .008) for lung cancer. For those born in occupied countries versus nonoccupied countries, the hazard ratios were 1.08 (P < .001), 1.08 (P = .003), and 1.12 (P = .02), respectively.

CONCLUSIONS

The current results, based on a large cohort of Holocaust survivors who were exposed to a variety of severe deprivations, add to the conflicting and sparse knowledge on this issue and support the notion that this group has a small but consistent increase in cancer development. [See related editorial on pages 000-000, this issue.] Cancer 2017. © 2017 American Cancer Society.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sFHvnO
via IFTTT

Temporal changes in predicted risk of type 2 diabetes in Germany: findings from the German Health Interview and Examination Surveys 1997-1999 and 2008-2011

Objective

Over time, prevalence changes in individual diabetes risk factors have been observed for Germany and other European countries. We aimed to investigate the temporal change of a summary measure of type 2 diabetes risk in Germany.

Design

Comparison of data from two cross-sectional surveys that are about 12 years apart.

Setting

Two nationwide health examination surveys representative for the non-institutionalised population aged 18–79 years in Germany.

Participants

The study included participants without diagnosed diabetes from the national health examination surveys in 1997–1999 (n=6457) and 2008–2011 (n=6095).

Outcome measures

Predicted 5-year type 2 diabetes risk was calculated using the German Diabetes Risk Score (GDRS), which considers information on age, anthropometry, lifestyle factors, hypertension and family history of diabetes.

Results

Between the two survey periods, the overall age- and sex-standardised predicted 5-year risk of type 2 diabetes decreased by 27% from 1.5% (95% CI 1.4% to 1.6%) to 1.1% (1.0% to 1.2%). The decrease in red meat intake and waist circumference had the highest impact on the overall decrease in diabetes risk. In stratified analyses, diabetes risk decreased among both sexes and within strata of age and body mass index. Diabetes risk also decreased among highly educated persons, but remained unchanged among persons with a middle or low educational level.

Conclusions

Monitoring type 2 diabetes risk by a summary measure such as the GDRS could essentially contribute to interpret the dynamics in diabetes epidemiology.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sVx0k8

Normative visual acuity in Chinese preschoolers aged 36 to

Objectives

To document population-based normative data for uncorrected visual acuity (UCVA) in Chinese preschoolers aged 36 to <48 months without any sight-affecting abnormalities and to evaluate its effectiveness for vision referral.

Methods

In a population-based cohort of children in the Yuhuatai Pediatric Eye Disease Study, UCVA was measured by using the linear HOTV chart, followed by other ocular examinations. Reference population was defined as children without ophthalmic abnormalities or refractive error. Normative UCVA was obtained from the reference population. The UCVA referral cut-off was defined as the lowest fifth percentile of the normative distribution of UCVA.

Results

The analysis cohort consisted of 1606 Chinese preschoolers aged 36 to <48 months. Among them, a total of 791 children were included in the reference population. The 5th, 50th and 95th percentiles of the UCVA distribution in the reference population were 20/40, 20/32 and 20/25, respectively. UCVA improved with increasing age (p<0.0001), but worsen if prematurity was presented (p=0.041). Using the fifth percentile, UCVA cut-off from the reference population generated referral rates of 26.9% in the general population, and detected more than 86% of amblyopia cases.

Conclusions

We propose that UCVA no better than 20/40 measured by linear HOTV chart should be a referral cut-off for Chinese preschoolers aged 36 to <48 months. Most amblyopia cases can be identified with this age-specific and chart-specific UCVA cut-off.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tEk937

A systematic review of the worldwide prevalence of survivors of poliomyelitis reported in 31 studies

Background

Accurate prevalence figures estimating the number of survivors of poliomyelitis (disease causing acute flaccid paralysis) following poliovirus infection are not available. We aim to undertake a systematic review of all literature concerning the prevalence of survivors of poliomyelitis.

Methods

Electronic databases were searched from 1900 up to May 2016 for peer-reviewed studies using a population-based approach witha defined denominator and some form of diagnostic or clinical verification of polio. Exclusion criteria were any prevalence data that were unable to be extracted or calculated and studies reporting on incidence only. The quality of each included study was assessed using an existing tool modified for use in prevalence studies. Average crude prevalence rates were used to calculate worldwide estimates.

Results

Thirty-one studies met criteria with 90% of studies conducted in low-income to lower middle-income countries. Significant variability in the prevalence of survivors of poliomyelitis was revealed, in low- income to lower middle-income (15 per 100 000 in Nigeria to 1733 in India) and upper-middle to high-income countries (24 (Japan) to 380 per 100 000 (Brazil). The total combined prevalence of survivors of poliomyelitis for those studies at low to moderate risk of bias ranged from 165 (high-income countries) to 425 (low-income to lower middle-income countries) per 100 000 person-years. Historical lameness surveys of children predominated, with wide variation in case definition and assessment criteria, and limited relevance to current prevalence given the lack of incidence of poliovirus infection in the ensuing years.

Conclusions

These results highlight the need for future epidemiological studies of poliomyelitis to examine nationally representative samples, including all ages and greater focus on high-income countries. Such efforts will improve capacity to provide reliable and more robust worldwide prevalence estimates.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sVwZg4

Extreme population-level events: Do they have an impact on cancer?

The report by Sadetzki and colleagues in this issue showcases the impact of a horrendous event—the Holocaust—on subsequent health decades after the occurrence. Two additional calamities—country-wide famines and population-level discrimination—are provided as examples of this phenomenon to add evidence to the causal pathway identified by Sadetzki et al. See also pages 000-000.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tZ9uCC
via IFTTT

BacterioFiles 301 - Cells Simulate City Structures

This episode: Ancient microbes built underwater structures that look like sunken, ancient cities!

(10.6 MB, 11.7 minutes)

Show notes: 


Microbe of the episode:

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ty2ICP
via IFTTT

20Q: Combining Electric and Acoustic Hearing - Hearing Preservation and Bimodal Listening

1.  It’s been a while since we last spoke here at 20Q. We were last talking about hybrid cochlear implant systems, if I recall correctly?  Yes, it’s been over 6 years since we last sat down to chat about hybrid cochlear implant (CI) systems, also referred to as combined electric and acoustic stimulation (EAS) systems.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sVD64e
via IFTTT

Introduction to the New Tempus Platform and the World's Smallest Rechargeable Solution

Review of the features and benefits of Unitron’s new Tempus™ hearing instrument platform.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sVJPem
via IFTTT

The Tumor Entity Denominated “ clear cell-papillary renal cell carcinoma” According to the WHO 2016 new Classification , have the Clinical Characters of a Renal Cell Adenoma as does Harbor a Benign Outcome

Abstract

The new WHO 2016 classification of renal neoplasia encounters the new entity called “clear cell papillary renal cell carcinoma” (ccpRCC). The ccpRCC has been long included as a subtype of clear cell RCC histotype and it actually ranges from 2 to 9% in different routinely available cohort of renal carcinomas. Of important note, ccpRCC does not show any recurrences or metastases or lymph-node invasion and the outcome is always good. We reviewed twenty-four publications with available follow-up for patients (no. 362) affected by clear cell papillary RCCs/renal adenomatoid tumours and notably ccpRCC harbors an indolent clinical behavior after a mean of 38 months (3,5 years) of follow-up. This paper reviews the histological, molecular and clinical features characterizing ccpRCC, with the goal of focusing the knowledge of the benign fashion of this new tumour entity, supporting the idea of a new renal cell adenoma recruited morphologically from ex conventional clear cell RCC tumours.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uHk6Uk

Large left main coronary artery aneurysm following mitral and aortic valve replacement

Abstract

Left main coronary artery aneurysm is an extremely uncommon coronary pathology that can present with angina, myocardial infarction, pericardial tamponade, or sudden death, and whose treatment still remains controversial. Here, we present a 64-year-old woman admitted due to angina with a previous mitral and aortic valve replacement. Transthoracic echocardiogram revealed an aortic prosthesis dysfunction and preoperative angiogram showed a large left main coronary artery aneurysm. Surgical aneurysm exclusion with concomitant coronary artery bypass grafting and aortic prosthesis replacement were performed after defining the aneurysm’s anatomical details and relationship using contrast-enhanced computed tomography.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uGSoXM

The Importance of Parameters: MPV, MPV/Thrombocyte Ratio and Neutrophil/Lymphocyte Ratio in Sorafenib Treatment Response of Patients with Hepatocellular Cancer



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tYktw0

Systematic Review and Meta-analysis: Use of Statins Is Associated with a Reduced Incidence of Oesophageal Adenocarcinoma

Abstract

Purpose

Laboratory studies have suggested that statins may have useful anti-cancer effects against Barrett’s epithelial cancer lines. A variety of effects have been reported in clinical studies.

Methods

We performed a systematic review and meta-analysis of the association between statin use and the development of oesophageal cancer. Multiple databases were searched for studies reporting the association of statin use and oesophageal cancer. Meta-analysis on the relationship between statin use and cancer incidence was performed.

Results

Twenty publications met eligibility criteria, yielding 22 datasets for meta-analysis. All were observational studies. Population-level studies included 372,206 cancer cases and 6,086,906 controls. Studies examining adenocarcinoma development in Barrett’s oesophagus included 1057 cancers and 17,741 controls. In patients with Barrett’s oesophagus, statin use was associated with a reduced incidence of adenocarcinoma (pooled adjusted odds ratio (OR) 0.59 (95% confidence intervals 0.50–0.68)), with no heterogeneity between 11 studies. Population-based studies demonstrated more heterogeneity but showed that statin use was associated with a lower incidence of both oesophageal adenocarcinoma (OR 0.57 (0.43–0.76)) and all oesophageal cancers (OR 0.82 (0.7–0.88)). Information on statin type, dose, and duration was reported too infrequently for statistical analysis but individual studies showed a tendency to a dose- and duration-dependant decrease in cancer incidence.

Conclusions

Statin use is associated with a significantly lower incidence of oesophageal adenocarcinoma. This is seen in both Barrett’s cohorts and general populations. Further studies should focus on drug, dose, and duration and the interaction with other risk and preventative factors.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tY9QcB

Angiogenesis and Lymphangiogenesis in the Adrenocortical Tumors

Abstract

Adrenocortical tumors (ACT) are common adrenal tumors. The majority of ACTs are non-functioning and benign, while adrenocortical carcinomas (ACC) are rare, usually very aggressive and often metastasized when first diagnosed. Our aim was to assess whether blood and lymph vessel density within ACTs correlate with the malignancy character or tumor functionality. For that, the microvascular distribution was evaluated by immunohistochemistry staining with D2–40 antibody, for lymph vessels and CD-31 antibody, for blood vessels, in ACCs (n = 15), adenomas with Cushing syndrome (n = 9) and non-functioning adenomas (n = 10). The percentage of stained area was quantified by computerized morphometric analysis. D2–40 expression was significantly lower in ACC as compared to adenomas with Cushing syndrome (p < 0.01) and correlated positively with the expression of the steroidogenic acute regulatory protein (StAR) (R2 = 0.553, p < 0.001). CD31 expression was found to be significantly higher in ACC as compared to adenomas with Cushing syndrome (p < 0.05). Our results show that angiogenesis is increased in ACC, suggesting that this phenomenon may have an important role in ACT biological behavior, while lymph vascular density seems to be more closely related to the tumor functional status than malignancy.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u8cDk3
via IFTTT

The Tumor Entity Denominated “ clear cell-papillary renal cell carcinoma” According to the WHO 2016 new Classification , have the Clinical Characters of a Renal Cell Adenoma as does Harbor a Benign Outcome

Abstract

The new WHO 2016 classification of renal neoplasia encounters the new entity called “clear cell papillary renal cell carcinoma” (ccpRCC). The ccpRCC has been long included as a subtype of clear cell RCC histotype and it actually ranges from 2 to 9% in different routinely available cohort of renal carcinomas. Of important note, ccpRCC does not show any recurrences or metastases or lymph-node invasion and the outcome is always good. We reviewed twenty-four publications with available follow-up for patients (no. 362) affected by clear cell papillary RCCs/renal adenomatoid tumours and notably ccpRCC harbors an indolent clinical behavior after a mean of 38 months (3,5 years) of follow-up. This paper reviews the histological, molecular and clinical features characterizing ccpRCC, with the goal of focusing the knowledge of the benign fashion of this new tumour entity, supporting the idea of a new renal cell adenoma recruited morphologically from ex conventional clear cell RCC tumours.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uHk6Uk
via IFTTT

The Importance of Parameters: MPV, MPV/Thrombocyte Ratio and Neutrophil/Lymphocyte Ratio in Sorafenib Treatment Response of Patients with Hepatocellular Cancer



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tYktw0
via IFTTT

Systematic Review and Meta-analysis: Use of Statins Is Associated with a Reduced Incidence of Oesophageal Adenocarcinoma

Abstract

Purpose

Laboratory studies have suggested that statins may have useful anti-cancer effects against Barrett’s epithelial cancer lines. A variety of effects have been reported in clinical studies.

Methods

We performed a systematic review and meta-analysis of the association between statin use and the development of oesophageal cancer. Multiple databases were searched for studies reporting the association of statin use and oesophageal cancer. Meta-analysis on the relationship between statin use and cancer incidence was performed.

Results

Twenty publications met eligibility criteria, yielding 22 datasets for meta-analysis. All were observational studies. Population-level studies included 372,206 cancer cases and 6,086,906 controls. Studies examining adenocarcinoma development in Barrett’s oesophagus included 1057 cancers and 17,741 controls. In patients with Barrett’s oesophagus, statin use was associated with a reduced incidence of adenocarcinoma (pooled adjusted odds ratio (OR) 0.59 (95% confidence intervals 0.50–0.68)), with no heterogeneity between 11 studies. Population-based studies demonstrated more heterogeneity but showed that statin use was associated with a lower incidence of both oesophageal adenocarcinoma (OR 0.57 (0.43–0.76)) and all oesophageal cancers (OR 0.82 (0.7–0.88)). Information on statin type, dose, and duration was reported too infrequently for statistical analysis but individual studies showed a tendency to a dose- and duration-dependant decrease in cancer incidence.

Conclusions

Statin use is associated with a significantly lower incidence of oesophageal adenocarcinoma. This is seen in both Barrett’s cohorts and general populations. Further studies should focus on drug, dose, and duration and the interaction with other risk and preventative factors.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tY9QcB
via IFTTT

Young and advanced tumor—some 2D electrodynamic distinctions: melanoma and satellite during a vascular occlusion test: feasibility study

Abstract

Conventional methods of electrobioimpedance imaging are not suited for adequate visualization of the skin electrical impedance landscape (SEL) because they do not provide high spatial resolution at large enough area of view. The skin electrodynamics introscopy (SEI) enabled dynamic spectral imaging of the SEL at 32 × 64 mm2 area with 1 mm spatial resolution. The focus of the study was to investigate the SEL distinguishing features between early and advanced-stage cancer at the model object of melanoma and its satellite. The analysis of the test-induced SEL metamorphoses was carried out at the periods of blood-stop and blood-restoration. It was found that the young tumor could be reliably visualized and distinguished by its antiphase hypoxia-induced response as compared to that of the advanced one. In response to the blood-restoration, an appearance of newly formed SEL clusters pointed out apparently at vascular abnormalities associated with the tumor. Similar SEL clusterization can be supposedly expected in response to any other test factors which affect cell permeability or/and blood viscosity. The proposed approach might be useful for more thorough mapping and staging malignancies.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tXXYHS

A survey of context recognition in surgery

Abstract

With the introduction of operating rooms of the future context awareness has gained importance in the surgical environment. This paper organizes and reviews different approaches for recognition of context in surgery. Major electronic research databases were queried to obtain relevant publications submitted between the years 2010 and 2015. Three different types of context were identified: (i) the surgical workflow context, (ii) surgeon’s cognitive and (iii) technical state context. A total of 52 relevant studies were identified and grouped based on the type of context detected and sensors used. Different approaches were summarized to provide recommendations for future research. There is still room for improvement in terms of methods used and evaluations performed. Machine learning should be used more extensively to uncover hidden relationships between different properties of the surgeon’s state, particularly when performing cognitive context recognition. Furthermore, validation protocols should be improved by performing more evaluations in situ and with a higher number of unique participants. The paper also provides a structured outline of recent context recognition methods to facilitate development of new generation context-aware surgical support systems.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sF0fn9

Recent Advances in Adhesive Bonding: The Role of Biomolecules, Nanocompounds, and Bonding Strategies in Enhancing Resin Bonding to Dental Substrates

Abstract

Purpose of review

To present an overview on the main agents (i.e. biomolecules and nanocompounds) and/or strategies currently available to amplify or stabilize resin-dentin bonding.

Recent findings

According to studies retrieved for full-text reading (2014–2017), there are currently six major strategies available to overcome resin-dentin bond degradation: (1) use of collagen crosslinking agents, which may form stable covalent bonds with collagen fibrils, thus strengthening the hybrid layer; (2) use of antioxidants, which may allow further polymerization reactions over time; (3) use of protease inhibitors, which may inhibit or inactivate metalloproteinases; (4) modification of the bonding procedure, which may be performed by using the ethanol-wet bonding (EWB) technique or by applying an additional adhesive (hydrophobic) coating, thereby strengthening the hybrid layer; (5) laser treatment of the substrate prior to bonding, which may cause specific topographic changes in the surface of dental substrates, increasing bonding efficacy; and (6) reinforcement of the resin matrix with inorganic fillers and/or remineralizing agents, which may positively enhance physicomechanical properties of the hybrid layer.

Summary

With the present review, we contributed to the better understanding of adhesion concepts and mechanisms of resin-dentin bond degradation, showing the current prospects available to solve that problematic. In addition, adhesively-bonded restorations may be benefited by the use of some biomolecules, nanocompounds or alternative bonding strategies in order to minimize bond strength degradation.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u8aIfq
via IFTTT

Recent Advances in Adhesive Bonding: The Role of Biomolecules, Nanocompounds, and Bonding Strategies in Enhancing Resin Bonding to Dental Substrates

Abstract

Purpose of review

To present an overview on the main agents (i.e. biomolecules and nanocompounds) and/or strategies currently available to amplify or stabilize resin-dentin bonding.

Recent findings

According to studies retrieved for full-text reading (2014–2017), there are currently six major strategies available to overcome resin-dentin bond degradation: (1) use of collagen crosslinking agents, which may form stable covalent bonds with collagen fibrils, thus strengthening the hybrid layer; (2) use of antioxidants, which may allow further polymerization reactions over time; (3) use of protease inhibitors, which may inhibit or inactivate metalloproteinases; (4) modification of the bonding procedure, which may be performed by using the ethanol-wet bonding (EWB) technique or by applying an additional adhesive (hydrophobic) coating, thereby strengthening the hybrid layer; (5) laser treatment of the substrate prior to bonding, which may cause specific topographic changes in the surface of dental substrates, increasing bonding efficacy; and (6) reinforcement of the resin matrix with inorganic fillers and/or remineralizing agents, which may positively enhance physicomechanical properties of the hybrid layer.

Summary

With the present review, we contributed to the better understanding of adhesion concepts and mechanisms of resin-dentin bond degradation, showing the current prospects available to solve that problematic. In addition, adhesively-bonded restorations may be benefited by the use of some biomolecules, nanocompounds or alternative bonding strategies in order to minimize bond strength degradation.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u8aIfq

Association between Sugar Intake, Oral Health, and the Impact on Overall Health: Raising Public Awareness

Abstract

Purpose of Review

The role of sugar consumption and oral health refocused largely due to associations between systemic diseases and conditions (type 2 diabetes, obesity) and oral health. This review examines the evidence supporting the impact of sugars on oral diseases and the role of sugars in oral-systemic complications.

Recent Findings

The increased consumption of dietary sugars, including sugar-sweetened beverages, and the increasing percentage of sugars as a component of the US diet affect oral health in the population. It is important for dental professionals to know public health implications and strategies to effectively communicate this risk to patients’ oral health.

Summary

Local and state governments experienced success with the regulation of sodas and sugar-sweetened beverages and studies demonstrated that these regulations are largely successful in decreasing consumption among adolescents. It is the role of the dental professional to support these activities to promote healthy dietary choices for patients.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v0wNsE

Resilient communities train citizens to be first responders

Training civilians in lifesaving care of family, friends and neighbors can increase a community's resilience to tornadoes, hurricanes and other natural disasters

from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u6ZpUQ

Association between Sugar Intake, Oral Health, and the Impact on Overall Health: Raising Public Awareness

Abstract

Purpose of Review

The role of sugar consumption and oral health refocused largely due to associations between systemic diseases and conditions (type 2 diabetes, obesity) and oral health. This review examines the evidence supporting the impact of sugars on oral diseases and the role of sugars in oral-systemic complications.

Recent Findings

The increased consumption of dietary sugars, including sugar-sweetened beverages, and the increasing percentage of sugars as a component of the US diet affect oral health in the population. It is important for dental professionals to know public health implications and strategies to effectively communicate this risk to patients’ oral health.

Summary

Local and state governments experienced success with the regulation of sodas and sugar-sweetened beverages and studies demonstrated that these regulations are largely successful in decreasing consumption among adolescents. It is the role of the dental professional to support these activities to promote healthy dietary choices for patients.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v0wNsE
via IFTTT

Mo. bill targets ambulance calls to abortion clinics

The bill would make it illegal for abortion clinic staff to ask ambulances to respond to calls at their facilities without sirens or lights

from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uYYVwq

Woman killed, 8 wounded at Ohio party for pregnant woman

The pregnant woman said she lost her baby after being shot in the leg

from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u0sLmR

A Continuous Flow Method for the Desulfurization of Substituted Thioimidazoles Applied to the Synthesis of New Etomidate Derivatives

A simple yet robust flow set-up for the efficient desulfurization of a series of thioimidazoles is presented generating the corresponding imidazole derivatives in high yields. The strategic choice of peristaltic over piston pumps allowed reliable delivery of the heterogeneous stream of thioimidazole substrate into a T-piece where it reacted with NaNO2 in the presence of acetic acid. This approach enabled the controlled and safe formation of the reactive nitrosonium species without uncontrolled exposure to hazardous nitrous oxide by-products as observed in related batch protocols. The value of the resulting imidazole products was further demonstrated by their conversion into various esters representing new derivatives of the known analgesic etomidate via an efficient one pot Corey-Gilman-Ganem oxidation procedure.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uGV87J

Differences between gastric signet-ring cell carcinoma and poorly differentiated adenocarcinoma: A comparison of histopathologic features determined by mucin core protein and trefoil factor family peptide immunohistochemistry

We investigated differences between the pathological features of gastric signet-ring cell carcinoma (sig) and poorly differentiated adenocarcinoma (por) by examining the expressions of the trefoil factor family peptides (TFFs) and mucin core proteins (MUCs). Ninety-seven tissues of 97 gastric cancer patients were selected for this study. After gastrectomy, the major histopathologic types were determined to be sig, solid-type poorly differentiated adenocarcinoma (por1), non-solid type poorly differentiated adenocarcinoma (por2), and well-differentiated tubular adenocarcinoma (tub1). We evaluated the prevalence of positive staining for MUCs (MUC5AC and MUC2) and TFFs (TFF1 and TFF3) and assessed the correlation between MUCs and TFFs in each histopathological type. The rate of MUC2 expression significantly differed between sig and por2 (50.0% vs 11.7%, P = 0.011). TFF3 expression in sig significantly differed from TFF3 expression in both por2 (100% vs 17.6%, P < 0.0001) and por1 (100% vs 33.3%, P = 0.0004). MUC5AC and TFF1 expressions were significantly correlated in por1 (r = 0.705, P = 0.002), por2 (r = 0.535, P = 0.0009), and tub1 (r = 0.470, P = 0.0034), while MUC2 and TFF3 expressions were significantly correlated only in sig (r = 0.593, P = 0.040). The expression and correlation patterns of the TFFs and MUCs suggest that the histopathologic features of gastric sig differ from those of por.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uGA54X

Differences between gastric signet-ring cell carcinoma and poorly differentiated adenocarcinoma: A comparison of histopathologic features determined by mucin core protein and trefoil factor family peptide immunohistochemistry

We investigated differences between the pathological features of gastric signet-ring cell carcinoma (sig) and poorly differentiated adenocarcinoma (por) by examining the expressions of the trefoil factor family peptides (TFFs) and mucin core proteins (MUCs). Ninety-seven tissues of 97 gastric cancer patients were selected for this study. After gastrectomy, the major histopathologic types were determined to be sig, solid-type poorly differentiated adenocarcinoma (por1), non-solid type poorly differentiated adenocarcinoma (por2), and well-differentiated tubular adenocarcinoma (tub1). We evaluated the prevalence of positive staining for MUCs (MUC5AC and MUC2) and TFFs (TFF1 and TFF3) and assessed the correlation between MUCs and TFFs in each histopathological type. The rate of MUC2 expression significantly differed between sig and por2 (50.0% vs 11.7%, P = 0.011). TFF3 expression in sig significantly differed from TFF3 expression in both por2 (100% vs 17.6%, P < 0.0001) and por1 (100% vs 33.3%, P = 0.0004). MUC5AC and TFF1 expressions were significantly correlated in por1 (r = 0.705, P = 0.002), por2 (r = 0.535, P = 0.0009), and tub1 (r = 0.470, P = 0.0034), while MUC2 and TFF3 expressions were significantly correlated only in sig (r = 0.593, P = 0.040). The expression and correlation patterns of the TFFs and MUCs suggest that the histopathologic features of gastric sig differ from those of por.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uGA54X
via IFTTT

Bis(selone) Complexes of Palladium(II), Platinum(II) and Gold(III): Synthesis and Structural Studies

A new class of bis(selone) based metal complexes, [MnLxCly], (M = Pd, L = 3, 3'-((2-bromo-1,3-phenylene)bis(methylene))bis(1-mesityl-1,3-dihydro-2H-imidazole-2-selone (15), n = 2, x = 2, y = 4, C64H66N8Cl4Br2Se4Pd2) (17), (M = Pt, L = 15, n = 2, x = 2, y = 4, C64H66N8Cl4Br2Se4Pt2) (18) and (M = Au, L = 15, n = 1, x = 1, y = 1, C32H33N4Se2BrAuCl) (19) were synthesized by the reaction of bis-selone (15) with Pd(COD)Cl2 (yield = 31%), Pt(COD)Cl2 (yield = 34%) and [AuCl(SMe2)] (yield = 57%) respectively. The single crystal X-ray analysis reveals that 17 and 18 exist as [2+2] dinuclear self assembled 24-membered metallamacrocycles. While the spectroscopic data for the gold(III) complex (19) indicate that it exists as novel organogold(III) bromide where a facile oxidative addition occurs across the C-Br bond. NBO analysis showed the variation of NPA charge on Se atoms from negative to positive after complexation (15: -0.25, 17: 0.08 and 18: 0.09-0.13). Moreover, the NPA (Natural population analysis) charge on metal atoms is found negative; for complex 17 and 18 (Pd: -0.133(17) and on Pt: -0.23 and -0.251 (18). However, for complex 19, gold carries a positive charge (0.15).



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uGTyCA

Designing metal sulfide sphere counter electrode catalysts for ZnO nanorod array based quantum dots-sensitized solar cells

To increase the competitiveness of quantum dots-sensitized solar cells (QDSCs) among various photovoltaic devices, it is necessary to develop new counter electrode (CE) catalysts to replace traditional expensive Pt CE. Herein, a series of metal sulfide spheres (e.g. FeS2, Co9S8, NiS, CuS, and ZnS) are designed and synthesized as CE catalysts for QDSCs. As inferred from cyclic voltammetry, electrochemical impedance spectroscopy, and Tafel polarization curves results, except ZnS, all of the sulfide spheres perform better than Pt toward Sx2-/S2- redox couple regeneration, among of which NiS shows the highest catalytic activity, followed by Co9S8, CuS, and FeS2. The power conversion efficiencies of ZnO nanorod arrays photoanode based QDSCs with sulfides sphere CEs are 2.45% (NiS), 2.17% (Co9S8), 1.83% (CuS), and 0.80% (FeS2), much higher than that of Pt CE based counterpart (0.30%).



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u7TgYC

Angioedema: Challenges and Insights.

Related Articles

Angioedema: Challenges and Insights.

Immunol Allergy Clin North Am. 2017 Aug;37(3):xv-xvi

Authors: Riedl MA

PMID: 28687115 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v00v13

Angioedema: An Orphan Symptom with Its Own Orphan Disease.

Related Articles

Angioedema: An Orphan Symptom with Its Own Orphan Disease.

Immunol Allergy Clin North Am. 2017 Aug;37(3):xiii-xiv

Authors: Tilles SA

PMID: 28687114 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v0amE0

Pharmacoeconomics of Orphan Disease Treatment with a Focus on Hereditary Angioedema.

Related Articles

Pharmacoeconomics of Orphan Disease Treatment with a Focus on Hereditary Angioedema.

Immunol Allergy Clin North Am. 2017 Aug;37(3):617-628

Authors: Lumry WR

Abstract
This article discusses orphan diseases, their prevalence, legislative incentives to encourage development of therapies, and the impact of treatment on health care payment systems. Specifically, the cost burden of hereditary angioedema on patients, health care systems, and society is reviewed. The impact of availability of and access to novel and specific therapies on morbidity, mortality, and overall burden of disease is explored. Changes in treatment paradigms to improve effect and reduce cost of treatment are presented.

PMID: 28687113 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v00x9b

Burden of Illness and Quality-of-Life Measures in Angioedema Conditions.

Related Articles

Burden of Illness and Quality-of-Life Measures in Angioedema Conditions.

Immunol Allergy Clin North Am. 2017 Aug;37(3):597-616

Authors: Caballero T, Prior N

Abstract
Burden of illness studies and evaluation of health-related quality of life using validated questionnaires have become an important task in the comprehensive management of angioedema conditions, mainly angioedema associated with chronic spontaneous urticaria and hereditary angioedema caused by C1-inhibitor deficiency. A review of the principal tools and studies is presented. Both diseases present a higher proportion of psychiatric disorders, impair work and studies productivity, and produce high direct and indirect costs. These assessments also have been useful to evaluate the positive impact of new drugs and interventions. More studies are desirable, especially in other types of angioedema disorders, such as hereditary angioedema with normal C1 inhibitor.

PMID: 28687112 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uZUPnN

Emerging Therapies in Hereditary Angioedema.

Related Articles

Emerging Therapies in Hereditary Angioedema.

Immunol Allergy Clin North Am. 2017 Aug;37(3):585-595

Authors: Chen M, Riedl MA

Abstract
Remarkable progress has been made in the treatment of bradykinin-mediated angioedema with the advent of multiple new therapies. Patients now have effective medications available for prophylaxis and treatment of acute attacks. However, hereditary angioedema is a burdensome disease that can lead to debilitating and dangerous angioedema episodes associated with significant costs for individuals and society. The burden of treatment must be addressed regarding medication administration difficulties, treatment complications, and adverse side effects. New therapies are being investigated and may offer solutions to these challenges. This article reviews the emerging therapeutic options for the treatment of HAE.

PMID: 28687111 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v0grjY

Hereditary Angioedema with Normal C1 Inhibitor: Update on Evaluation and Treatment.

Related Articles

Hereditary Angioedema with Normal C1 Inhibitor: Update on Evaluation and Treatment.

Immunol Allergy Clin North Am. 2017 Aug;37(3):571-584

Authors: Magerl M, Germenis AE, Maas C, Maurer M

Abstract
A new form of hereditary angioedema (HAE) was identified in the year 2000. Its clinical appearance resembles HAE types I and II, which are caused by mutations that result in a deficiency of C1 inhibitor (C1-INH). In patients with the new form of HAE, C1-INH plasma levels and function values are normal, so it's termed HAE with normal C1-INH (HAE-nC1). HAE-nC1, in a subgroup of patients, is thought to be caused by mutations that affect the F12 gene. The diagnosis of HAE-nC1 is based on history and clinical criteria. There are no licensed drugs with proven treatment effects for HAE-nC1.

PMID: 28687110 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v00tWZ

Prophylactic Therapy for Hereditary Angioedema.

Related Articles

Prophylactic Therapy for Hereditary Angioedema.

Immunol Allergy Clin North Am. 2017 Aug;37(3):557-570

Authors: Longhurst H, Zinser E

Abstract
Long-term prophylaxis is needed in many patients with hereditary angioedema and poses many challenges. Attenuated androgens are effective in many but are limited by side effect profiles. There is less evidence for efficacy of tranexamic acid and progestagens; however, the small side effect profile makes tranexamic acid an option for prophylaxis in children and progestagens an option for women. C1 inhibitor is beneficial, but at present requires intravenous delivery and may need dose titration for maximum efficacy. Short-term prophylaxis should be considered for all procedures. New therapies are promising in overcoming many problems encountered with current options for long-term prophylaxis.

PMID: 28687109 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v09m2y

Acute Management of Hereditary Angioedema Attacks.

Related Articles

Acute Management of Hereditary Angioedema Attacks.

Immunol Allergy Clin North Am. 2017 Aug;37(3):541-556

Authors: Katelaris CH

Abstract
Several treatment modalities have become available for management of acute hereditary angioedema (HAE) attacks in the last 15 years. Most are now available to patients in North America, Europe, United Kingdom, and Australia, but few options exist in developing countries. Preferred contemporary use of the treatments to be discussed is "on demand," because control remains with the patient and delays in treatment access avoided. Four treatments-plasma-derived C1 inhibitor concentrate, recombinant C1 inhibitor concentrate, ecallantide, and icatibant-are reviewed in this article. All have been shown to be superior to placebo and effective in the management of all HAE attacks.

PMID: 28687108 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uZPnRF

Laboratory Approaches for Assessing Contact System Activation.

Related Articles

Laboratory Approaches for Assessing Contact System Activation.

Immunol Allergy Clin North Am. 2017 Aug;37(3):527-539

Authors: Christiansen SC, Zuraw BL

Abstract
Hereditary angioedema (HAE) is a rare autosomal dominant disease clinically characterized by recurrent, often unpredictable attacks of subcutaneous and mucosal swelling. Acute episodes are debilitating, painful, disfiguring, and potentially fatal. HAE type I and type II result from a deficiency in the plasma level of functional C1 inhibitor. HAE with normal levels of C1 inhibitor has been recognized. There is evidence that contact activation underlies the recurrent attacks of swelling. This article reviews laboratory parameters to detect contact system activation and implications for diagnosis of HAE and other forms of bradykinin-mediated angioedema.

PMID: 28687107 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uZVVjr

Pathogenesis of Hereditary Angioedema: The Role of the Bradykinin-Forming Cascade.

Related Articles

Pathogenesis of Hereditary Angioedema: The Role of the Bradykinin-Forming Cascade.

Immunol Allergy Clin North Am. 2017 Aug;37(3):513-525

Authors: Kaplan AP, Joseph K

Abstract
Hereditary angioedema (HAE) is an autosomal-dominant disorder owing to mutations in the C1 inhibitor gene. Type I is characterized by a low C1 inhibitor protein level and diminished functional activity, whereas type II has a normal (or elevated) protein level but diminished function. When functional levels drop beyond 40% of normal, attacks of swelling are likely to occur due to overproduction of bradykinin. Angioedema can be peripheral, abdominal, or laryngeal. The typical duration of episodes is 3 days. Therapies include C1 inhibitor replacement for prophylaxis or acute therapy, whereas inhibition of kallikrein or blockade at the bradykinin receptor level can interrupt acute episodes of swelling.

PMID: 28687106 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v03aYt

Acquired C1 Inhibitor Deficiency.

Related Articles

Acquired C1 Inhibitor Deficiency.

Immunol Allergy Clin North Am. 2017 Aug;37(3):497-511

Authors: Otani IM, Banerji A

Abstract
Acquired angioedema due to C1-INH deficiency (C1-INH-AAE) can occur when there are acquired (not inherited) deficiencies of C1-INH. A quantitative or functional C1-INH deficiency with negative family history and low C1q is diagnostic of C1-INH-AAE. The most common conditions associated with C1-INH-AAE are autoimmunity and B-cell lymphoproliferative disorders. A diagnosis of C1-INH-AAE can precede a diagnosis of lymphoproliferative disease and confers an increased risk for developing non-Hodgkin lymphoma. Treatment focuses on symptom control with therapies that regulate bradykinin activity (C1-INH concentrate, icatibant, ecallantide, tranexamic acid, androgens) and treatment of any underlying conditions.

PMID: 28687105 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uYibdm

Angiotensin-converting Enzyme Inhibitor and Other Drug-associated Angioedema.

Related Articles

Angiotensin-converting Enzyme Inhibitor and Other Drug-associated Angioedema.

Immunol Allergy Clin North Am. 2017 Aug;37(3):483-495

Authors: Stone C, Brown NJ

Abstract
Nonsteroidal antiinflammatory agents, β-lactam antibiotics, non-β lactam antibiotics, and angiotensin-converting enzyme inhibitors are the most common classes of drugs that cause angioedema. Drug-induced angioedema is known to occur via mechanisms mediated by histamine, bradykinin, or leukotriene, and an understanding of these mechanisms is crucial in guiding therapeutic decisions. Nonallergic angioedema occurs in patients with genetic variants that affect metabolism or synthesis of bradykinin, substance P, prostaglandins, or leukotrienes, or when patients are taking drugs that have synergistic mechanisms. The mainstay in treatment of nonallergic drug-induced angioedema is cessation of the offending agents.

PMID: 28687104 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v03d6B

Histaminergic Angioedema.

Related Articles

Histaminergic Angioedema.

Immunol Allergy Clin North Am. 2017 Aug;37(3):467-481

Authors: Busse PJ, Smith T

Abstract
Angioedema is frequently categorized into histamine- or bradykinin-mediated disease. It is critical to determine the underlying mediator of symptoms as it directs treatment. Histaminergic angioedema is the most frequent cause of angioedema. It is classified as either acute (lasting <6 weeks) or chronic (symptoms >6 weeks). It is further classified into angioedema presenting with or without urticaria. Some patients with acute angioedema may have disease that becomes chronic. Mast cells and basophils are central to the underlying pathophysiology of histamine-mediated angioedema. The underlying treatments of histamine-mediated angioedema are antihistamines, corticosteroids, and epinephrine.

PMID: 28687103 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u1sGzl

The Clinical Evaluation of Angioedema.

Related Articles

The Clinical Evaluation of Angioedema.

Immunol Allergy Clin North Am. 2017 Aug;37(3):449-466

Authors: Gill P, Betschel SD

Abstract
The clinical evaluation of angioedema is reliant on obtaining a thorough patient and family history with an assessment of risk factors and presenting symptoms unique to each subtype. It is important to distinguish between angioedema with and without urticaria as a primary step in the evaluation; thereafter, laboratory parameters and investigations allow for subsequent stratification. There is a significant disease burden associated with angioedema and thus it is essential for health care practitioners to establish a prompt and accurate diagnosis, and a comprehensive care plan that addresses the patient's physical and mental well-being alike.

PMID: 28687102 [PubMed - in process]



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u1C3iE

EMS QI: Focus on what matters to patients

Patients should receive the same quality care no matter which paramedic or EMT shows up to take the call

from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tXsoK3

The best resources to find NREMT practice tests

You can never be too prepared for the NREMT

from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2txvfZm

7 types of paramedics: A dispatcher's perspective

Being that I work in both the field and dispatch, I have a unique view from both sides of the radio

from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2t3Dgl4

Impact of Carbohydrate-Electrolyte Beverage Ingestion on Heart Rate Response While Climbing Mountain Fuji at ~3000 m

We sought to investigate whether carbohydrate-electrolyte beverage ingestion reduced heart rate (HR) in twenty-three healthy young adults while climbing Mount Fuji at a given exercise intensity. Twenty-three healthy adults were randomly divided into two groups: the tap water (11 males [M] and 1 female [F]) and the carbohydrate-electrolyte group (10 M and 1 F). HR and activity energy expenditure (AEE) were recorded every min. The HRs for the first 30 minutes of climbing were not significantly different between the groups [121 ± 2 beats per min (bpm) in the tap water and 116 ± 3 bpm in the carbohydrate-electrolyte]; however, HR significantly increased with climbing in the tap water group (129 ± 2 bpm) but showed no significant increase in the carbohydrate-electrolyte group (121 ± 3 bpm). In addition, body weight changes throughout two days ascending and descending on Mount Fuji were inversely related to changes in resting HR. Further, individual variation of body weight changes was suppressed by carbohydrate-electrolyte drink. Collectively, carbohydrate-electrolyte beverage intake may attenuate an increase in HR at a given AEE while mountaineering at ~3000 m compared with tap water intake.

from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uZWjy2

Identifying High-Cost, High-Risk Patients Using Administrative Databases in Tuscany, Italy

Objective. (1) Assessing the performance of the algorithm in terms of sensitivity and positive predictive value, considering General Practitioners’ (GPs) judgement as benchmark, and (2) describing adverse events (hospitalisation, death, and health services’ consumption) of complex patients compared to the general population. Data Sources. (i) Tuscany administrative database containing health data (2013-5); (ii) lists of complex patients indicated by GPs; and (iii) annual health registry of Tuscany. Study Design. The present study is a validation study. It compares a list of complex patients extracted through an administrative algorithm (criteria of high health consumption) to a gold standard list of patients indicated by GPs. GPs’ decision was subjective but fairly well reasoned. The study compares also adverse outcomes (Emergency Room visits, hospitalisation, and death) between identified complex patients and general population. Principal Findings. Considering GPs’ judgement, the algorithm showed a sensitivity of 72.8% and a positive predictive value of 64.4%. The complex cases presented here have higher incidence rates/100,000 (death 46.8; ER visits 223.2, hospitalisations 110.87, laboratory tests 1284.01, and specialist examinations 870.37) compared to the general population. Conclusions. The final validated algorithm showed acceptable sensitivity and positive predictive value.

from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u1gXki

Space-based bias of covert visual attention in complex regional pain syndrome

Abstract
Some patients with complex regional pain syndrome report that movements of the affected limb are slow, more effortful, and lack automaticity. These symptoms have been likened to the syndrome that sometimes follows brain injury called hemispatial neglect, in which patients exhibit attentional impairments and problems with movements affecting the contralesional side of the body and space. Psychophysical testing of patients with complex regional pain syndrome has found evidence for spatial biases when judging visual targets distanced at 2 m, but not in directions that indicate reduced attention to the affected side. In contrast, when judging visual or tactile stimuli presented on their own body surface, or pictures of hands and feet within arm’s reach, patients with complex regional pain syndrome exhibited a bias away from the affected side. What is not yet known is whether patients with complex regional pain syndrome only have biased attention for bodily-specific information in the space within arm’s reach, or whether they also show a bias for information that is not associated with the body, suggesting a more generalized attention deficit. Using a temporal order judgement task, we found that patients with complex regional pain syndrome processed visual stimuli more slowly on the affected side (relative to the unaffected side) when the lights were projected onto a blank surface (i.e. when no bodily information was visible), and when the lights were projected onto the dorsal surfaces of their uncrossed hands. However, with the arms crossed (such that the left and right lights projected onto the right and left hands, respectively), patients’ responses were no different than controls. These results provide the first demonstration of a generalized attention bias away from the affected side of space in complex regional pain syndrome patients that is not specifically related to bodily information. They also suggest a separate and additional bias of visual attention away from the affected hand. The strength of attention bias was predicted by scores on a self-report measure of body perception distortion; but not by pain intensity, time since diagnosis, or affected body side (left or right). At an individual level, those patients whose upper limbs were most affected had a higher incidence of inattention than those whose lower limbs were most affected. However, at a group level, affected limb (upper or lower) did not predict bias magnitude; nor did three measures designed to assess possible asymmetries in the distribution of movements across space. It is concluded that inattention in near space in complex regional pain syndrome may arise in parallel with a distorted perception of the body.awx152media15495542665001

from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sEP65O

Space-based bias of covert visual attention in complex regional pain syndrome

Abstract
Some patients with complex regional pain syndrome report that movements of the affected limb are slow, more effortful, and lack automaticity. These symptoms have been likened to the syndrome that sometimes follows brain injury called hemispatial neglect, in which patients exhibit attentional impairments and problems with movements affecting the contralesional side of the body and space. Psychophysical testing of patients with complex regional pain syndrome has found evidence for spatial biases when judging visual targets distanced at 2 m, but not in directions that indicate reduced attention to the affected side. In contrast, when judging visual or tactile stimuli presented on their own body surface, or pictures of hands and feet within arm’s reach, patients with complex regional pain syndrome exhibited a bias away from the affected side. What is not yet known is whether patients with complex regional pain syndrome only have biased attention for bodily-specific information in the space within arm’s reach, or whether they also show a bias for information that is not associated with the body, suggesting a more generalized attention deficit. Using a temporal order judgement task, we found that patients with complex regional pain syndrome processed visual stimuli more slowly on the affected side (relative to the unaffected side) when the lights were projected onto a blank surface (i.e. when no bodily information was visible), and when the lights were projected onto the dorsal surfaces of their uncrossed hands. However, with the arms crossed (such that the left and right lights projected onto the right and left hands, respectively), patients’ responses were no different than controls. These results provide the first demonstration of a generalized attention bias away from the affected side of space in complex regional pain syndrome patients that is not specifically related to bodily information. They also suggest a separate and additional bias of visual attention away from the affected hand. The strength of attention bias was predicted by scores on a self-report measure of body perception distortion; but not by pain intensity, time since diagnosis, or affected body side (left or right). At an individual level, those patients whose upper limbs were most affected had a higher incidence of inattention than those whose lower limbs were most affected. However, at a group level, affected limb (upper or lower) did not predict bias magnitude; nor did three measures designed to assess possible asymmetries in the distribution of movements across space. It is concluded that inattention in near space in complex regional pain syndrome may arise in parallel with a distorted perception of the body.awx152media15495542665001

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sEP65O
via IFTTT

Report on the Hamlyn Surgical Robot Challenge

Hamlyn.jpg

Guest post by Renáta Elek and the BARK team:
"The Hamlyn Surgical Robot Challenge 2017 is an international competition that promises to be a compelling contest between some of the leading surgical robotics groups from around the world. The aim of this challenge is to exploit the unique expertise of the consortium in medical robotics to develop low-cost robot-assisted surgical and diagnostic devices that can benefit the NHS as well as be used as solutions for global health. Our aim is to enable the creation of new concepts for affordable systems especially with potential for applications in the developing world.
Instead of focusing on complex, high cost systems, the emphasis is on systems that rely on robotic platforms that allow macro to micro-scale intervention with shared autonomy between the surgeon and the robot, focusing specifically on novel soft robotics design and micro-actuators and delivery systems.

The research issues to be addressed include:

  1. Bioinspired actuation and locomotion Integrated sensing and navigation;
  2. Micro-fabrication and new materials; control and autonomy;
  3. Robot kinematics and mechanisms; mapping and navigation within complex anatomy based on intra-operative imaging and cellular level tissue characterization;
  4. Mobility (self contained locomotion, active magnetic control);
  5. Sensing (co-registration of multiple imaging and sensing data);
  6. Autonomy (balance between human/robot control).

The  research should also addresses:

  1. Safe symbiotic co-working in challenging clinical scenarios: focused on ubiquitous safe operation and more effective human-robot interaction methods;
  2. Manipulation and assembly of complex and non-rigid components across scales (from macro to micro): focused on localisation, grasping, and manipulation (under contact) of complex components with variable and changeable rigidity;
  3. Rapidly deployable autonomous robots: focused on reducing programming and integration effort through, for example, learning from demonstration, tele-operation with shared autonomy, and collaboration/task sharing within networked robotics;
  4. Virtual validation of mixed autonomous system: focused on analytical or empirical validation techniques in virtual environments before actual physical deployment.

Underpinning technologies should include:

  1. Tactile/force sensing for remote palpation;
  2. Micro-fabrication techniques for robot assisted endoluminal interventions and low cost platforms for digestive-tract screening in low income countries;
  3. Soft robotics for minimally invasive surgery; low-cost robotic solutions for emergency treatment in difficult, possibly none-sterile environments;
  4. Robotic assisted endomicroscopy for optical biopsy in global health settings;
  5. Low-cost capsule robots and in vivo diagnostic systems;
  6. Low-cost haptic simulators for the training of surgeons and other clinicians;
  7. Development of easy-to-use interactive medical devices using human factors;
  8. Socially aware robots enabling remote diagnosis and therapy in developing countries; ultra-low power platforms;
  9. Machine intelligence and computational support for autonomous operation, navigation and diagnostic decision support through advanced vision.’
(source: http://ift.tt/1rK9rmH)

After the first round the judging panel chose the 10 finalist team. The participated teams at the final round were:
  • Automated Blunt Dissection, Antal Bejczy Center for Intelligent Robotics (iRob), Óbuda University, Budapest, Hungary  
  • Robot Assisted Ultrasound Imaging for Localisation Control During Radiotherapy, Heilbronn University, Medical Informatics, Germany
  • Stormram 4: An MRI-compatible Robotic System for Breast Biopsy, Robotics and Mechatronics group, University of Twente, Enschede, The Netherlands, Department of Radiology, Ziekenhuisgroep Twente, Almelo, The Netherlands
  • Smart Autonomous Unknown Deformable Object Manipulation Using the da Vinci Research Kit: From Soft Tissues to Continuum Robots Manipulation, Johns Hopkins University, USA, The Chinese University of Hong Kong, China
  • Robotic Assistance Technology for Safe and Successful Retinal Vein Cannulation, Dep. of Mechanical Engineering University of Leuven, 3001 Heverlee, Belgium, Dep. of Ophthalmology, University of Leuven, 3000 Leuven, Belgium
  • Bipolar Robotic Neurosurgical Tool (BRNT) for the DVRK, Centre for Image-Guided Innovation and Therapeutic Intervention at The Hospital for Sick Children, University of Toronto, Canada
  • The Intuitive Imaging Sensing and Kinematically Enhanced Quadri Robotic Platform for Ear Nose Throat Surgery: The i2Snake, The Hamlyn Centre for Robotic Surgery, Imperial College London, UK
  • Collaborative Robotic Platform for Laparoscopic Surgery, ISIR - Université Pierre et Marie Curie, France
  • Three-Dimensional Robotic-Assisted Endomicroscopy with a Force Adaptive Robotic Arm, The Hamlyn Centre for Robotic Surgery, Imperial College London, UK
  • Constrained Semi-Autonomous Telemanipulated Palpation with Assistive Virtual Fixtures, Vanderbilt University, USA, The Johns Hopkins University, USA

The finalists had to demonstrate their work on the local robotic platforms. After the live demos the teams took a formal presentation in front of the judging panel. Based on the panel’s decision the final winners were:
  • Best Innovation Prize: Smart Autonomous Unknown Deformable Object Manipulation Using the da Vinci Research Kit: From Soft Tissues to Continuum Robots Manipulation
  • Best Application Prize: Robotic Assistance Technology for Safe and Successful Retinal Vein Cannulation
  • Best Design Prize: The Intuitive Imaging Sensing and Kinematically Enhanced Quadri Robotic Platform for Ear Nose Throat Surgery: The i2Snake
  • Best Video Prize: Stormram 4: An MRI-compatible Robotic System for Breast Biopsy

Congratulations to all winners and participants!"

ll266udmFJgNTIbsiAdKRABkXtlrbLZOwb-C448e
Source: Hamlyn center 


from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u7kRsN

Preparation of an Au-Pt alloy free from artifacts in magnetic resonance imaging

S0730725X.gif

Publication date: Available online 9 July 2017
Source:Magnetic Resonance Imaging
Author(s): Tomonobu Kodama, Ryusuke Nakai, Kenji Goto, Kunihiro Shima, Hiroo Iwata
PurposeWhen magnetic resonance imaging (MRI) is performed on patients carrying metallic implants, artifacts can disturb the images around the implants, often making it difficult to interpret them appropriately. However, metallic materials are and will be indispensable as raw materials for medical devices because of their electric conductivity, visibility under X-ray fluoroscopy, and other favorable features. What is now desired is to develop a metallic material which causes no artifacts during MRI.Materials and methodsIn the present study, we prepared a single-phase and homogeneous Au-Pt alloys (Au; diamagnetic metal, and Pt; paramagnetic metal) by the processing of thermal treatment. Volume magnetic susceptibility was measured with a SQUID Flux Meter and MRI artifact was evaluated using a 1.5-T scanner.ResultsAfter final thermal treatment, an entirely recrystallized homogeneous organization was noted. The Au-35Pt alloy was shown to have a volume magnetic susceptibility of −8.8ppm, causing almost free from artifacts during MRI.ConclusionsWe thus prepared an Au-35Pt alloy which had a magnetic susceptibility very close to that of living tissue and caused much fewer artifacts during MRI. It is promising as a material for spinal cages, intracranial electrodes, cerebral aneurysm embolization coils, markers for MRI and so on.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uZLWdI

Endothelial cells: From innocent bystanders to active participants in immune responses

grey_pxl.gif

Publication date: Available online 8 July 2017
Source:Autoimmunity Reviews
Author(s): A. Al-Soudi, M.H. Kaaij, S.W. Tas
The endothelium is crucially important for the delivery of oxygen and nutrients throughout the body under homeostatic conditions. However, it also contributes to pathology, including the initiation and perpetuation of inflammation. Understanding the function of endothelial cells (ECs) in inflammatory diseases and molecular mechanisms involved may lead to novel approaches to dampen inflammation and restore homeostasis. In this article, we discuss the various functions of ECs in inflammation with a focus on pathological angiogenesis, attraction of immune cells, antigen presentation, immunoregulatory properties and endothelial-to-mesenchymal transition (EndMT). We also review the current literature on approaches to target these processes in ECs to modulate immune responses and advance anti-inflammatory therapies.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u0UWSM

Circulating CXCL10 is increased in non-segmental vitiligo, in presence or absence of autoimmune thyroiditis

S15689972.gif

Publication date: Available online 8 July 2017
Source:Autoimmunity Reviews
Author(s): Silvia Martina Ferrari, Poupak Fallahi, Giulia Santaguida, Camilla Virili, Ilaria Ruffilli, Francesca Ragusa, Marco Centanni, Alessandro Antonelli
Recently the importance of CXCL10 in the pathogenesis of non-segmental vitiligo (NSV) and autoimmune thyroid disorders (AITD) has been shown. No data are present about chemokines CXCL10 (Th1 prototype) and CCL2 (Th2 prototype) circulating levels in NSV patients with/without thyroiditis (AT).Serum CXCL10 and CCL2 have been measured in 50 consecutive NSV patients, in 40 consecutive patients with NSV and AT (NSV+AT), in 50 sex- and age-matched controls without AT (control 1) and in 40 sex- and age-matched patients with AT without NSV (control 2).Serum CXCL10 levels were significantly higher in control 2, than in control 1 (P=0.001; ANOVA). NSV patients have serum CXCL10 levels significantly higher than control 1, or control 2 (P=0.001). NSV+AT patients have serum CXCL10 levels higher than control 1, or 2 (P<0.001), and than NSV (P=0.01).In conclusion, we first demonstrate high serum CXCL10 in NSV patients, overall in presence of AT and hypothyroidism, suggesting the importance of a common Th1 immune response in their immune-pathogenesis. To evaluate if serum CXCL10 might be used as a clinical marker of NSV and/or AT further studies are needed.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u0Wzjh

Biomarkers of disease activity in vitiligo: A systematic review

S15689972.gif

Publication date: Available online 8 July 2017
Source:Autoimmunity Reviews
Author(s): R. Speeckaert, M. Speeckaert, S. De Schepper, N. van Geel
The pathophysiology of vitiligo is complex although recent research has discovered several markers which are linked to vitiligo and associated with disease activity. Besides providing insights into the driving mechanisms of vitiligo, these findings could reveal potential biomarkers. Activity markers can be used to monitor disease activity in clinical trials and may also be useful in daily practice. The aim of this systematic review was to document which factors have been associated with vitiligo activity in skin and blood. A second goal was to determine how well these factors are validated in terms of sensitivity and specificity as biomarkers to determine vitiligo activity. Both in skin (n=42) as in blood (n=66) an adequate number of studies fulfilled the predefined inclusion criteria. These studies used diverse methods and investigated a broad range of plausible biomarkers. Unfortunately, sensitivity and specificity analyses were scarce. In skin, simple histopathology with or without supplemental CD4 and CD8 stainings can still be considered as the gold standard, although more recently chemokine (C-X-C motif) ligand (CXCL) 9 and NLRP1 have demonstrated a good and possibly even better association with progressive disease. Regarding circulating biomarkers, cytokines (IL-1β, IL-17, IFN-γ, TGF-β), autoantibodies, oxidative stress markers, immune cells (Tregs), soluble CDs (sCD25, sCD27) and chemokines (CXCL9, CXCL10) are still competing. However, the two latter may be preferable as both chemokines and soluble CDs are easy to measure and the available studies display promising results. A large multicenter study could make more definitive statements regarding their sensitivity and specificity.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uZBHpY

Spasticity in multiple sclerosis: Contribution of inflammation, autoimmune mediated neuronal damage and therapeutic interventions

S15689972.gif

Publication date: Available online 8 July 2017
Source:Autoimmunity Reviews
Author(s): Robert Patejdl, Uwe K. Zettl
In contrast to other diseases that go along with spasticity (e.g. spinal cord injury), spasticity in chronic autoimmune diseases involving the CNS is complicated by the ongoing damage of neuronal networks that leads to permanent changes in the clinical picture of spasticity.Multiple sclerosis (MS) is the most frequent autoimmune disease of the central nervous system (CNS) and spasticity is one of the most disabling symptoms. It occurs in more than 80% MS patients at some point of the disease and is associated with impaired ambulation, pain and the development of contractures.Besides causing cumulative structural damage, neuroinflammation occurring in MS leads to dynamic changes in motor circuit function and muscle tone that are caused by cytokines, prostaglandins, reactive oxygen species and stress hormones that affect neuronal circuits and thereby spasticity.The situation is complicated further by the fact that therapeutics used for the immunotherapy of MS may worsen spasticity and drugs used for the symptomatic treatment of spasticity have been shown to have the potential to alter immune cell function and CNS autoimmunity itself. This review summarizes the current knowledge on the immunologic pathways that are involved in the development, maintenance, dynamic changes and pharmacological modulation of spasticity in MS.



from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uFDC3F