AP Group Research Articles

Distributed Pricing and Bandwidth Allocation in Crowdsourced Wireless Community Networks

With the rapid growth of global mobile data traffic, Wi-Fi plays an increasingly important role in expanding network capacity. To overcome the geographical coverage limit of Wi-Fi APs, especially for mobile users, the crowdsourced wireless community network has emerged as a cost-effcient way for providing Internet access services. For instance, it is plausible to share their private residential Wi-Fi APs with each other by designing some tailored incentive/pricing mechanisms. Thus motivated, we propose a distributed pricing and bandwidth allocation scheme to maximize the profit of Wi-Fi providers and provide better Internet services to mobile users. Firstly, we study the stationary networks with incomplete information of users and propose distributed pricing and bandwidth allocation algorithms for single-AP regions and AP group regions, respectively. Then, we generalize the study to dynamic networks and explore distributed pricing based on the statistics of users mobility. Further, we design an online bandwidth allocation algorithm according to the real-time user information. Simulation results demonstrate that the proposed distributed pricing and bandwidth allocation scheme, comparing with the operators pricing scheme, has a better performance on both Wi-Fi APs profit and user experience.

Fracture resistance of thin wall endodontically treated teeth without ferrules restored with various techniques.

To evaluate the fracture resistance and failure characteristics of simulated thin wall endodontically treated teeth without ferrules restored with various techniques. Forty-eight human mandibular single-root canal premolars were decoronated and endodontically treated. The 1 mm thick remaining root canal dentin was prepared. The roots were randomly divided into four groups of 12 roots according to the following post and core reconstruction techniques: direct resin composite post and core (CP), multiple fiber posts and resin composite core (FP), CAD/CAM anatomical post and core (AP), and metal cast post and core (MP). Full metal crowns were cemented to the cores. All specimens were subjected to thermocycling for 5000 cycles and submitted to axial compression until failure at a 45°angle using a universal testing machine. The failures were classified into one of the followings: post and/or core fractures, root fractures, and root fractures combined with post and/or core fractures. Average failure loads of groups CP, FP, AP, and MP were 360.0, 655.2, 402.7, and 856.1N, respectively. MP provided the highest failure load, which was significantly higher than those of the other groups (p < 0.05). FP was second, being inferior to MP with a significance level of p=0.039. CP exhibited the least failure load, and it was not significantly different from the AP group (p > 0.05). Root fractures were the major failure mode for most of the specimens except the CP group, in which composite fractures at the cervical level were commonly observed. Metal cast post and core provided the highest fracture resistance for reconstruction of a thin wall in endodontically treated teeth without ferrules, followed by multiple fiber posts and resin composite core. The milled anatomical post and core and a direct resin composite post and core provided significantly lower fracture resistance. Metal cast posts and core and multiple fiber posts with resin composite core techniques were effective for restoring severely compromised endodontically treated teeth.

CHADS2 and CHA2DS2-VASc Scores Can Guide the Evaluation of Cryptogenic Ischemic Stroke.

Cryptogenic ischemic strokes (CIS) are treated with antiplatelets for stroke prevention in routine clinical practice. The objective of this study was to investigate whether the CHADS2 and CHA2DS2-VASc scores may be used to identify the patients with CIS at higher risk of ischemic stroke despite antiplatelet therapy. We calculated CHADS2 and CHA2DS2-VASc scores in patients with first ever CIS; those previously managed with antiplatelets (AP group) and in those without antiplatelets (non-AP group), using the prospectively recorded data of the Istanbul Medical School Stroke Registry from 1996-2014. Of the 4466 IS patients, 886 patients with first ever IS had complete data for score calculation. Seventy-five (39 women) of them were diagnosed with CIS. CHADS2 and CHA2DS2-VASc scores were significantly higher in the AP group of 19 patients in comparison to the non-AP group of 56 patients (P = 0.005 and P = 0.009, respectively). ROC curve analyses showed an area under curve (AUC) of 0.705 (CI: 0.57-0.84; P = 0.008) for CHADS2 score ≥3 and AUC of 0.699 (CI: 0.57-0.82; P = 0.01) for CHA2DS2-VASc score ≥4. Vascular diseases were more frequent in the AP group and these patients were older than the patients in the non-AP group (P = 0.025, P = 0.024; respectively). CHA2DS2-VASc score ≥ 4 and CHADS2 score ≥3 may be used as a predictor of the occurrence of IS despite regular antiplatelet use and suggest an embolic source which will respond better to anticogulation. Our results support that CHADS2 and CHA2DS2-VASc scores may be useful to identify subgroups among patients with CIS for individualizing diagnostic approach, planning future workup and preventive treatment.

Integrating a Disease-Focused Tumor Board as a Delivery-of-Care Model to Expedite Treatment Initiation for Patients With Liver Malignancies.

Patients with hepatobiliary malignancies are especially vulnerable to treatment delays. This study sought to evaluate the impact of implementing a new delivery-of-care model centered around a hepatobiliary multidisciplinary tumor board (HB-MTB) and integrated with an optimized patient workflow process to expedite treatment initiation. A hybrid type 2 study (effectiveness-implementation) was performed. Implementation measures were examined prospectively using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) approach during 5 years after the HB-MTB program deployment (2015-2020). The primary outcome was effectiveness, measured as time to treatment initiation (TTI) using a before and after design (1 year each). The patients were grouped into before (BP) and after (AP) categories based on date of HB-MTB program implementation. Multivariable Cox and linear regression analyses were performed to examine and compare time to treatment initiation between groups. The HB-MTB program enrolled 2457 patients (reach). The RE-AIM measures were favorable and improved over time (P < 0.01 for all). The median TTI was lower for the AP group than for the BP group (17 vs 24 days; P < 0.01). In the multivariable Cox and linear regressions, treatment in the AP group was associated with a faster TTI (hazard ratio, 1.75; 95 % confidence interval, 1.31-2.35; p < 0.01), and a mean of 13 days faster treatment initiation than the BP group (P < 0.01). Implementation of an HB-MTB program integrated with an optimized patient workflow was successful and led to faster treatment initiation. This delivery-of-care model can serve as a blueprint to expedite treatment of patients with cancer.

Risk factors for pancreatitis and pancreatic cancer

To identify and compare the frequency of alcohol consumption, tobacco smoking, levels of main macronutrients, vitamins and mineral elements consumption in patients with acute (AP) and chronic pancreatitis (CP) and pancreatic cancer (PC). At the observational clinical cross-sectional uncontrolled case-study 65 patients with AP or CP (group 1) and 45 patients with PC (group 2) were examined. A survey of patients was carried out: questionnaire on tobacco smoking, a frequency questionnaire on alcohol consumption, a questionnaire for assessing the frequency of food consumption. The frequency of smoking (33.8, 20.0%; p0.05), alcohol consumption 1 times/week during the last year (21.5, 15.6%; p0.05) did not differ significantly between the two groups. The highest consumption rates of total, vegetable, animal protein, total carbohydrates, refined sugar, animal fat, cholesterol, MUFA, dietary fiber, vitamins (-carotene, vitamin B1, B2, C, PP), mineral elements (iron, potassium, calcium, magnesium, sodium, phosphorus) and the daily energy content of the diet were determined in PC than in the AP and CP group. Among patients of group 1, deficient intake of fat-soluble vitamin A (93.3, 54.8%; p=0.009) and vitamin E (80.0, 48.4%; p=0.041) was more common in the subgroup of patients with excretory pancreatic insufficiency than without it, and the chance of having hypercholesterolemia was associated with a deficient intake of vitamin E [Ex(B)=3.3, 95% CI 1.59.3; p=0.027]. There were no differences in the frequency of smoking and alcohol consumption between patients with AP and CP and PC. The highest indices of the main macronutrients, daily energy content of the diet, micronutrients (except for vitamins A, E) were found in PC than in the group of patients with AP and CP. Among patients with AP and CP with excretory pancreatic insufficiency, a lower intake of fat-soluble vitamins was noted and associations of hypercholesterolemia with deficient intake of vitamin E were obtained.

Investigating the effect of captopril on reducing the severity of symptoms of acute respiratory distress syndrome in rats

Introduction: Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in the lungs. Objectives: This study aimed to investigate the effect of captopril in reducing the symptoms of ARDS induced by oleic acid in experimental rats. Materials and Methods: This experimental study was conducted on 14 Wistar male rats of 6-7 weeks weighing 200-250 g. In the first group, they received 1.25 mg/kg of captopril daily in glucose solution for one week, but the second group did not. After one week, these rats were anesthetized by 5% isoflurane respiration and oleic acid (0.1 mg/kg) was injected intraperitoneal for ARDS induction. During the first 6 hours after starting ARDS, the rats were randomly selected and after anesthesia with ether and autopsy, they were cut and the lung histology was conducted. Results: Intensity of lung tissue edema in the group receiving captopril (Cap) was 2.83 ± 0.41 and in the captopril group with oleic acid (Cap+OA) was 2.50±0.55. Additionally, 83.3% of the rats had severe pulmonary edema in the OA group which was statistically significant (P=0.003). The "severity of inflammation and bleeding" in the OA+Cap group was significantly less than OA group (P=0.026). Conclusion: Captopril can play a significant role in reducing the damage of the lung tissue and severity of tissue edema and inflammation and bleeding. Therefore, it may be possible to use this drug in human samples with acute respiratory distress syndrome to prevent further damage.

116. Comparison of long-term clinical and radiographical outcomes between the anterior and combined anterior and posterior approaches for treating lumbosacral tuberculosis

<h3>BACKGROUND CONTEXT</h3> Both the anterior and combined anterior and posterior approaches have been used to treat lumbosacral tuberculosis. However, long-term follow-up studies of each approach have not been conducted. <h3>PURPOSE</h3> We aimed to compare the long-term clinical and radiological outcomes between the two approaches. <h3>STUDY DESIGN/SETTING</h3> Retrospective comparative study. <h3>PATIENT SAMPLE</h3> Fifty-nine patients with lumbosacral tuberculosis who underwent surgical treatment. Twenty-four patients underwent the anterior approach (group A) and 25 underwent the combined anterior and posterior approach (group AP). <h3>OUTCOME MEASURES</h3> We collected clinical data, such as visual analog scale scores, Oswestry Disability Index scores and neurological status, and radiographical data, such as lumbosacral angle and physiological lordosis. Furthermore, operative time, length of stay, and intraoperative and postoperative blood loss (IBL, PBL) were recorded. <h3>Methods</h3> We included 59 patients with a minimum 6-year follow-up between January 2008 to March 2012. Twenty-four patients underwent the anterior approach (group A) and 25 underwent the combined anterior and posterior approach (group AP). We collected clinical data, such as visual analog scale scores, Oswestry Disability Index scores and neurological status, and radiographical data, such as lumbosacral angle and physiological lordosis. Furthermore, operative time, length of stay, and intraoperative and postoperative blood loss (IBL, PBL) were recorded. <h3>Results</h3> Both groups had satisfactory clinical and radiographical outcomes until follow-up. All patients achieved bony fusion, and no group differences were found in any of the clinical indices. Both groups corrected and maintained lumbosacral angle and physiological lordosis. However, operative time, length of stay, maximum Hb drop, IBL, and PBL of group A (140.63 ± 24.73 min, 12.58 ± 2.45 d, 28.33 ± 9.70 g/L, 257.08 ± 110.47 mL, and 430.60 ± 158.27 mL, respectively) was significantly lower than those of group AP (423.60 ± 82.81 min, p < 0.001; 21.32 ± 3.40 d, p < 0.001; 38.48 ± 8.03 g/L, p < 0.001; 571.60 ± 111.04 mL, p < 0.001; and 907.01 ± 231.99 mL, p < 0.001). <h3>Conclusions</h3> This retrospective study demonstrated long-term efficacy of the anterior approach, which was as effective as that of the combined anterior and posterior approach, with the advantage of less trauma. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Disease-Modifying Effect of Japanese Cedar Pollen Sublingual Immunotherapy Tablets

Japanese cedar (JC) pollinosis is a common allergic rhinitis in Japan. JC pollen sublingual immunotherapy (SLIT) tablets are licensed for the treatment of JC pollinosis. To assess the disease-modifying effects of JC pollen SLIT tablets over 5 years (2014-2019), comprising a 3-year treatment period and 2-year follow-up. A total of 1042 patients with JC pollinosis (aged 5-64 years) were included in the study. An optimal dose-finding study was performed in the first 15 months, after which 240 patients in the placebo (P) group and 236 patients in the optimalactive dose (A) group (5000 Japanese allergy units) were re-randomized to receive P or A for an additional 18 months (designated AA, AP, PA, and PP groups). Clinical efficacy was evaluated by the total nasal symptom and medication score (TNSMS) during the peak symptom period of each JC pollen season over 3 years of treatment and 2 years of observation after treatment cessation. The AA, AP, and PA groups exhibited significantly reduced TNSMS; however, the largest relative reduction was seen in the AA group both during the treatment period (third season, 46.3% vs PP, P < .001) and during the 2-year follow-up period (fourth and fifth seasons, 45.3% and 34.0% vs PP, respectively; P < .001). The most common adverse drug reactions were mild reactions at the administration site. JC pollen SLIT tablets show sustained clinical efficacy during 3 years of treatment and sustained disease-modifying effects for at least 2 years after treatment cessation.

Apical periodontitis promotes insulin resistance and alters adaptive immunity markers in rats

ObjectiveApical periodontitis (AP) is a chronic or acute inflammatory disease usually developed from endodontic infections, predominantly due to gram-negative anaerobic bacteria invading the dental pulp. This study aimed to evaluate lymphocyte markers to assess the involvement of adaptive immunity in insulin resistance (IR) in a rat model of AP.Design.Forty-five male Wistar albino rats were divided into 3 groups (control, 1AP and 4AP). AP was induced in the upper right first molar (1AP), and in the first and second upper and lower right molars (4AP). The spleen was collected to evaluate the expression of transcription factors involved in lymphocyte polarization, including T-bet (Th1), GATA3 (Th2), and FOXP3 (Treg). Blood samples were assessed for serum cytokine levels transcribed by the respective lymphocyte polarizations, INF-γ (Th1), IL-4 (Th2) and TGF-β (Treg). In addition, glucose and insulin levels were measured to evaluate IR by the HOMA-IR method. ResultsThe results showed higher T-bet expression on AP groups, along with lower GATA3 and FOXP3 expression in the 1AP, in addition to increased GATA3 and decreased FOXP3 expression in the 4AP group compared to the CN group. There was no difference in the INF-γ levels, while IL-4 was decreased in the AP groups. Taken together, these results suggest that the adaptive immune system, with a predominance of the Th1 polarization, may be involved in the development of IR in rats with AP. ConclusionsAP promotes increase in the expression of T-bet (4AP) and decrease of FOXP3 expressions and IL-4 levels (1AP and 4AP). However, depending on the number of lesions (1 or 4 lesions), the expression of GATA3 appears differently. Thus, innate immunity and adaptive immunity may contribute to the IR observed in rats with AP.

Do anti-platelet drugs improve duration of continuous renal replacement therapy? A retrospective cohort study in cardiac ICU patients.

The objective of this study was to investigate the impact of anti-platelet drug/s on duration of continuous renal replacement therapy (CRRT) in those patients where anti-coagulants were not used due to certain contraindications and in cases where patients were on anti-platelet drugs and were given anti-coagulant during CRRT. This single-center, retrospective cohort study was conducted using the medical records patients treated with CRRT in the cardiac ICU of the inpatient urban facility, located in North India. Data was collected from only those patients who received CRRT for the duration of at least 12 h. Patient's in NAC group were not on any anti-platelet/s and did not receive anti-coagulant during CRRT. AC and AP group patients received anti-coagulant alone or were already on anti-platelet/s and did not receive anti-coagulant respectively while ACAP group patients were on anti-platelet drug/s and also received anti-coagulant during CRRT. Patients in AC, AP, or ACAP group showed significantly (p < 0.001) higher CRRT filter life compared to NAC group. The median CRRT filter life was significantly higher in the ACAP group compared to AC (p < 0.05) and AP (p < 0.001) groups. This study indicates that systemic anti-platelet therapy can provide additional support in critical patients undergoing CRRT even with or without anti-coagulant therapy. However, the increase in CRRT filter life was more profound in patients who were on anti-platelet/s and also received anti-coagulant drug/s during CRRT.

Relationship of complement activation pathway to clinical and pathological characteristics and renal outcome in patients with lupus nephritis.

Involvement of the complement system in the pathogenesis of lupus nephritis (LN) is well accepted, but its exact role remains unclear. The aim of this study was to investigate the relationship of complement activation pathway to clinical and pathological characteristics and renal outcome in patients with LN. Patients with LN were divided into two groups: those in whom the complement system was mainly activated through the classical pathway (low serum C3 and C4 levels; CP group); and those in whom the complement system was solely activated through the alternative pathway (low serum C3 with normal C4 levels; AP group). Clinical and pathological data and renal outcomes were compared between the two groups. Atotal of 102 LN patients were enrolled in this study, 63patients (61.8%) in the CP group and 39patients (38.2%) in the AP group. LN patients in the CP group had significantly higher SLEDAI (p < 0.001), more anti-dsDNA (p = 0.001), higher renal activity index (p < 0.001), and more classIV LN (p = 0.008) than LN patients in the AP group. Mean length of follow-up was 50.6 ± 26.4months. Renal outcome in the form of progression of kidney disease was significantly poorer in the CP group in the AP group (p = 0.037). Our findings suggest that evaluation of the complement activation pattern may be useful for evaluating disease activity and predicting the prognosis of LN.

In Vitro Effect of Denture Cleansers on the Color Stability of Polyetheretherketone and Other Denture Base Polymers

The aim of this in vitro study was to compare the long-term effect of overnight use of denture cleansers with different chemical compositions on the color stability of denture base polymers (DBPs). The four DBPs evaluated were PEEK (PK group), thermoinjection-molded polyamide (PA group), auto-polymerized polymethylmethacrylate (PMMA) (AP group), and heat-polymerized resin PMMA (HP group). The cleaning agents used were Corega tablet (CT), Protefix tablet (PT), and 0.5% sodium hypochlorite (NaOCl) solution (SH). Distilled water (DW) served as a control. Forty-eight disc-shaped specimens (10mm × 2mm) were prepared from each DBP and randomly immersed in the different storage media (n=12 in each group). Color measurements of the specimens before and after immersion in the denture cleansers were made using a spectrophotometer (VITA Easyshade V). The color changes were measured and recorded in L* a* b*. After 120 d, the CIEDE2000 formula was used to calculate color changes (∆E00). For analysis of the data, a multivariate analysis of variance was used (p&lt;0.05). The results of the statistical analysis revealed significant color change differences in the DBPs immersed in the various denture cleansers (p&lt;0.05). Groups PA and PK showed the highest values for all solutions. AP-SH showed the highest ∆E00 value in group AP, no significant difference was found between other solutions. In group HP, there was no statistically significant difference between the average ∆E00 values of all solutions. Long-term daily use of the denture cleansers affected the color stability of all the DBPs, although the level of color change was acceptable. Laboratory and clinical studies on the color stability of PEEK are needed to confirm the results of this study.

COMPARISON OF QUALITY OF LIFE AND EFFECTIVENESS OF LIMBERG FLAP VERSUS LAY OPEN IN SACROCOCCYGEAL PILONIDAL SINUS TREATMENT: A PROSPECTIVE CLINICAL STUDY.

Aim:to compare the quality of life and effectiveness of limberg ap vs lay open in sacrococcygeal pilonidal sinus treatment. Methods: This randomized prospective study was carried out in the Government Hospital Sarwal, Jammu, India among 30 patients. Patients were randomized into two groups; group Awith 15 patients was undergone wide local excision followed by limberg ap primary closure while the other group B with 15 patients was undergone wide local excision followed by Lay open ap (healing by Post operatively assessment of healing time and quality of life at 4 and 8 weeks was done.). Results: Mean age of the subject of the limberg ap group and lay open group was 22.42 years and 22.38 years respectively. 90% of the patient's (27 patients) of the present study were males. In limberg ap group 53.3% patient achieved complete wound healing around 20-30 days while in lay open group 60.0% patient achieved complete wound healing around 51-60 days post operatively Conclusions:Excision with primary closure is a better modality than excision with lay open technique in treatment of pilonidal sinus

A implantação de um protocolo de sepse no atendimento do pronto socorro e o impacto nos custos em um hospital privado na Região Amazônica

Objective: To analyze the economic impact of implementing an early sepsis detection protocol in the emergency department of a private hospital in the city of Belém, Pará, Brazil. Methods: Experimental, cross-sectional, retrospective study, carried out from March 2015 to December 2019 from a highly complex referral Center. The implementation of the protocol took place in March 2015. Results: A total of 257 patients were studied, 128 from the group before the protocol (AP group) and 129 belonging to the group after the protocol (DP group), with similar proportions. in relation to sex. Regarding the mean age and standard deviation, in the AP group it was 73.5 ± 23.3 and in the DP group 76.0 ± 17.0. After the implantation of the protocol, there was a reduction in the time of organ dysfunction, mortality rate, ICU stay and hospital stay, both with statistical difference of p = 0.0015, p = 0.04, p = 0.012 and p = 0.0401, respectively. In the evaluation of hospital costs, a reduction in the average spent with each patient was identified both in the total cost of hospitalization and in the total cost referring only to the length of stay in the ICU. Conclusion: It is noticeable that sepsis costs are a public health problem both nationally and internationally. However, such expenses can be reduced with the implementation of protocols that aim to standardize the care provided to patients and thereby positively influence the reduction of hospital stay, hospitalization costs and mortality.

Psychological Impact of Diabetes Technology on Type 1 Diabetes Pregnancy

Pregnant women with Type 1 Diabetes (T1D) experience challenges with glycemic management, planning for and transitioning into motherhood. Diabetes technology (DT) has been shown to improve glycemic control and pregnancy outcomes. The data on psychological aspects for the use of DT among women and their families during different stages of pregnancy is very sparse. This study characterized the perceived benefits and burdens of DT during T1D pre-, ongoing, and past-pregnancy journey. We surveyed 119 women with T1D from 12 countries (mean age 33.33 ± 5.26 years) as “Planning” (PP), “Attempting” (AP), “Previously” (PrP), or “Currently” (CP) pregnant. We explored the top three perceived “benefits” and “burdens” of DT (and their partners if relevant). Survey questions included: type of CGM device and insulin pump, use of hybrid closed-loop (Medtronic 670 G or Tandem X2 w/ Dexcom G6) or DIY system, insurance coverage, monthly out of pocket costs, breastfeeding. Results: 67 women in PrP group, 38 in CP group, and 7 in both PP and AP groups. A majority used CGM or insulin pump prior to pregnancy (n = 90 for CGM, n = 100 for pump). 11 women did not use any DT prior to pregnancy (n = 1 in CP group, n = 10 in PrP group). Five initiated DT during the first trimester, one during the second trimester, and five did not use any DT. Three women in CP group initiated CGM during the first trimester. Out of 12 women not using CGM in PP group, 7/12 initiated during pregnancy (n = 1 for 14-day Libre, n = 5 for Dexcom G5/6, n = 1 for Guardian 3). Overall these women, and their partners, perceived more benefits than burdens. Top three benefits of DT were “overall improved BS control,” improved confidence in DM control,” and “improved ease of administering insulin” (n = 86, 56, 55 respectively). Top three burdens were “alarms,” “problems with infusion sets,” and “glitches with sensors” (n = 52, 45, 43 respectively). Perceived benefits of DT for partners were the same except for a differing top-ranked benefit of “less worry about overnight hypoglycemia.” Burdens for partners were the same except for a differing top-ranked burden of “obsessiveness (more time thinking about BS).” CGM device usage showed: 68% for Dexcom (G4/5/6), 14.9% for Guardian 3, 9.9% for Libre (10 and 14 -day), and 7% reported no usage. Insulin pump usage showed: 52.2% for Medtronic, 15.7% for Tandem T:slim, 13% for Omnipod, 6% indicated other systems not listed, and 13% reported no usage. 26% of women have used a hybrid closed-loop system and 23% have used a DIY system. Our study is the first one to identify specific psychological benefits and stressors with the use of DT in women and their significant others internationally at various stages around pregnancy. It provides insight to clinicians on how to best counsel women and their families. Having the right expectations will help the with adaptability of DT and increase its use in order to improve pregnancy outcomes.

Pre-inhalation of hydrogen-rich gases protect against caerulein-induced mouse acute pancreatitis while enhance the pancreatic Hsp60 protein expression

BackgroundAcute pancreatitis (AP) lacks targeted prevention and treatment measures. Some key points in the pathogenesis of AP remain unclear, such as early activation of pancreatic enzymes. Several recent reports have shown the protective effect of hydrogen on several AP animal models, and the mechanism is related to antioxidant activity. Heat shock protein 60 (Hsp60) is known to accompany pancreatic enzymes synthesis and secretion pathway of in pancreatic acinar cells, while role of hsp60 in AP remains a topic. Aim of this study was to investigate effect of hydrogen pretreatment on AP and the mechanisms, focusing on pancreatic oxidative stress and Hsp60 expression.Methods80 mice were randomly assigned into four groups: HAP group, AP group, HNS group, and NS group and each group were set 3 observation time point as 1 h, 3 h and 5 h (n = 6–8). Mouse AP model was induced by intraperitoneal injection of 50 μg/kg caerulein per hour for 6 injections both in AP and HAP groups, and mice in NS group and HNS group given normal saline (NS) injections at the same way as control respectively. Mice in HAP group and HNS group were treated with hydrogen-rich gases inhalation for 3 days before the first injection of caerulein or saline, while mice in AP group and NS group in normal air condition. Histopathology of pancreatic tissue, plasma amylase and lipase, plasma IL-1 and IL-6, pancreatic glutathione (GSH) and malondialdehyde (MDA), and Hsp60 mRNA and protein expression were investigated. Comparisons were made by one-way analysis of variance.ResultsThe pancreatic pathological changes, plasma amylase and lipase activity, and the increase of plasma IL-1 and IL-6 levels in AP mice were significantly improved by the hydrogen-rich gases pretreatment, Meanwhile, the pancreatic GSH content increased and the pancreatic MDA content decreased. And, the hydrogen-rich gases pretreatment improved the Hsp60 protein expression in pancreatic tissues of AP mice at 1 h and 5 h.ConclusionsPre-inhalation of hydrogen-rich gases have a good protective effect on AP mice, and the possible mechanisms of reduced oxidative stress and the early increased pancreatic Hsp60 protein deserve attention.

Activated matrix metalloproteinase 8 in serum predicts severity of acute pancreatitis

ObjectivesSevere acute pancreatitis (SAP) has high morbidity and mortality but there are no widely accepted predictive biomarkers in clinical use. Matrix metalloproteinases (MMPs) are active in tissue destruction and inflammatory responses. We studied whether serum levels of activated MMP-8 (aMMP-8), MMP-9 and their regulators tissue inhibitor of matrix metalloproteinases (TIMP)-1, myeloperoxidase (MPO) and human neutrophil elastase (HNE) could predict the development of SAP. MethodsThe study comprised 214 AP patients (revised Atlanta classification: 142 mild, MAP; 54 moderately severe, MSAP; 18 SAP) referred to Helsinki University Hospital. A venous blood sample was taken within 72 h from the onset of symptoms. Serum levels of aMMP-8 were determined using immunofluorometric assay, and those of MMP-9, TIMP-1, MPO and HNE using enzyme-linked immunosorbent assay. AP groups were compared using Jonckheere-Terpstra test and predictive value for SAP was analyzed using receiver operating characteristics (ROC) analysis. ResultsSerum aMMP-8 levels were higher in SAP (median 657 ng/ml, interquartile range 542–738 ng/ml) compared to MSAP (358 ng/ml, 175–564 ng/ml; p < 0.001) and MAP (231 ng/ml, 128–507 ng/ml; p < 0.001). Similar trend was seen with TIMP-1 and MPO. In ROC analysis aMMP-8, MPO and TIMP-1 emerged as potential markers for the development of SAP (areas under ROC curves 0.83, 0.71 and 0.69, respectively). ConclusionsSerum aMMP-8 measured early in the course of AP (within 72 h of symptom onset) predicted the development of SAP.

Assessing reinforcing versus aversive consequences in a real-time secondhand smoke intervention.

Few studies have examined the relative effectiveness of reinforcing versus aversive consequences at changing behavior in real-world environments. Real-time sensing devices makes it easier to investigate such questions, offering the potential to improve both intervention outcomes and theory. This research aims to describe the development of a real-time, operant theory-based secondhand smoke (SHS) intervention and compare the efficacy of aversive versus aversive plus reinforcement contingency systems. Indoor air particle monitors were placed in the households of 253 smokers for approximately three months. Participants were assigned to a measurement-only control group (N = 129) or one of the following groups: 1.) aversive only (AO, N = 71), with aversive audio/visual consequences triggered by the detection of elevated air particle measurements, or 2.) aversive plus reinforcement (AP, N = 53), with reinforcing consequences contingent on the absence of SHS added to the AO intervention. Residualized change ANCOVA analysis compared particle concentrations over time and across groups. Post-hoc pairwise comparisons were also performed. After controlling for Baseline, Post-Baseline daily particle counts (F = 6.42, p = 0.002), % of time >15,000 counts (F = 7.72, p < 0.001), and daily particle events (F = 4.04, p = 0.02) significantly differed by study group. Nearly all control versus AO/AP pair-wise comparisons were statistically significant. No significant differences were found for AO versus AP groups. The aversive feedback system reduced SHS, but adding reinforcing consequences did not further improve outcomes. The complexity of real-world environments requires the nuances of these two contingency systems continue to be explored, with this study demonstrating that real-time sensing technology can serve as a platform for such research.

Effect of repair systems on dentin bonding performance.

The purpose of this study was to investigate the influence of phosphoric acid etching, metal primer or silane coupling agent application on dentin bonding performance of a 2-step self-etch adhesive system. Human dentin surfaces were prepared and divided into four groups depending on the pre-treatment method: no pretreatment (Clearfil SE Bond 2, CONTROL); 40% phosphoric acid (K-Etchant GEL, K); metal primer (Alloy Primer, AP); or silane coupling agent (Porcelain Bond Activator, PB). The specimens were sectioned into beams, separated into 2 subgroups (n=20): no thermocyling or thermocycled (TC), and subjected to a µTBS test and an acid-base challenge for SEM observation. Statistically lower results were observed between K and AP groups, PB and CONTROL, and PB with/without TC (p<0.05). SEM images at the dentin-adhesive interface revealed that all groups produced an acid-base resistant zone (ABRZ), with a funnel-shaped erosion under the ABRZ for the K group.

Serum markers of B‐cell activation in pregnant women with atopic asthma

ProblemAs maternal atopy represents a risk factor for the development of atopy in offspring, we aimed to assess how pregnancy affects B‐cell activation markers in women with atopic asthma and whether they correlate with risk manifestations for allergy in newborns from mothers with atopic asthma.Method of StudyPregnant women with atopic asthma (AP) in the third trimester of gestation and nonpregnant women with atopic asthma (ANP) were prospectively recruited and compared to respective healthy counterparts (HP and HNP). All pregnant women were also assessed during the postpartum period until 6 weeks after delivery (HP/PP and AP/PP). Newborns were clinically evaluated at the age of 6 months. Peripheral blood samples were taken from each woman at each time point. Soluble CD23 (sCD23), B‐cell activating factor (BAFF), IgA, IgG, IgM, kappa (κ), and lambda (λ) free light chains (FLC) were quantified in serum samples.ResultsThe AP group presented increased sCD23 (p < 0.05) and BAFF (p < 0.001) levels compared to the ANP group and even higher levels of sCD23 during the postpartum period (p < 0.001). Moreover, the cutoffs of 6.74 g/L for IgG (sensitivity 90.9%, specificity 77.8%) and of 11.30 mg/L for λ FLC (sensitivity 81.8%, specificity 88.9%) in the AP group were predictive factors for the manifestation of allergy in their offspring.ConclusionsAfter delivery, the dynamics of sCD23 and BAFF changed significantly in the AP group. Furthermore, we found novel predictive factors for allergy manifestations in the children of these women, with potential clinical application.