Dunn's Multiple Comparison Research Articles

Development and Validation of an Automatic Segmentation Algorithm for Quantification of Intracerebral Hemorrhage.

ABC/2 is still widely accepted for volume estimations in spontaneous intracerebral hemorrhage (ICH) despite known limitations, which potentially accounts for controversial outcome-study results. The aim of this study was to establish and validate an automatic segmentation algorithm, allowing for quick and accurate quantification of ICH. A segmentation algorithm implementing first- and second-order statistics, texture, and threshold features was trained on manual segmentations with a random-forest methodology. Quantitative data of the algorithm, manual segmentations, and ABC/2 were evaluated for agreement in a study sample (n=28) and validated in an independent sample not used for algorithm training (n=30). ABC/2 volumes were significantly larger compared with either manual or algorithm values, whereas no significant differences were found between the latter (P<0.0001; Friedman+Dunn's multiple comparison). Algorithm agreement with the manual reference was strong (concordance correlation coefficient 0.95 [lower 95% confidence interval 0.91]) and superior to ABC/2 (concordance correlation coefficient 0.77 [95% confidence interval 0.64]). Validation confirmed agreement in an independent sample (algorithm concordance correlation coefficient 0.99 [95% confidence interval 0.98], ABC/2 concordance correlation coefficient 0.82 [95% confidence interval 0.72]). The algorithm was closer to respective manual segmentations than ABC/2 in 52/58 cases (89.7%). An automatic segmentation algorithm for volumetric analysis of spontaneous ICH was developed and validated in this study. Algorithm measurements showed strong agreement with manual segmentations, whereas ABC/2 exhibited its limitations, yielding inaccurate overestimations of ICH volume. The refined, yet time-efficient, quantification of ICH by the algorithm may facilitate evaluation of clot volume as an outcome predictor and trigger for surgical interventions in the clinical setting.

Ophthalmological Assessment of OCT and Electrophysiological Changes in Migraine Patients.

A cross-sectional study to investigate the morphological and functional changes of the visual pathway taking place in patients with migraine. Fifteen patients (14 female, 1 male) diagnosed with migraine with aura and 23 patients (21 female, 2 male) diagnosed with migraine without aura were compared with 20 healthy volunteers (18 female, 2 male). All the participants underwent optical coherence tomography scan, electroretinogram (ERG), visual evoked potentials, and multifocal electroretinogram (mf-ERG) recording. Assessing ERG recordings, no significant differences in mean N1-P1 amplitudes were measured among the groups. The mean visual evoked potentials N80-P100 amplitudes were not significantly different among the three groups (one way analysis of variance: P = 0.075, F = 2.718). No significant difference was found in P100 latency times among groups. The mean retinal response density of mf-ERG in ring 1 was higher in healthy individuals compared with migraineurs, with statistical significance (Kruskal-Wallis analysis of variance and Dunn multiple comparisons test; P < 0.001, mean rank difference = -24.857 and P < 0.001, mean rank difference = -20.9, for migraine with aura-control and migraine without aura-control comparisons, respectively). In migraine with aura subjects, retinal nerve fiber layer thickness in superior and inferior quadrants was significantly decreased compared with healthy individuals, whereas in migraine without aura group, only the superior quadrant was significantly thinner compared with the control group. Retinal response density in mfERG of all migraineurs was significantly lessened compared with healthy individuals. There was no significant difference in visual evoked potentials N80-P100 amplitudes or P100 latencies among the groups. Moreover, retinal nerve fiber layer thinning observed in patients with migraine compared with control subjects, appeared statistically significant in some quadrants. The authors may be able to defend the retinal blood flow decrease theory in migraine. The results also indicate that several levels of the visual pathway seem to be affected in migraineurs.

Volumetric study of sphenoid sinuses: anatomical analysis in helical computed tomography.

The sphenoid sinus is the most inaccessible part of the face, being inside the sphenoid bone and closely related to numerous vital neural and vascular structures. The objective of this study was to analyze and evaluate the variation of anatomy and the volume of the sphenoid sinus using helical computed tomography and medical imaging software. A total of 47 helical CT scans of sinuses of male and female individuals aged 18-86years were selected. The images were formatted using ITK-SNAP software, consisting of three steps: (1) segmentation; (2) volumetric analysis and (3) 3D reconstruction. The sphenoid sinuses were also classified according to Hammer, i.e., in conchal, pre-sellar, sellar and post-sellar types. A single investigator, who is specialist in dental radiology and was trained and calibrated, performed the volume and image analysis. After 15days, the segmentations were repeated. The Dunn's multiple comparison test revealed significant differences in the volume rankings between the right and left sides (P=0.0002), with the post-sellar type presenting the greatest volume on the right side compared to pre-sellar and sellar types. In the left sphenoid sinuses, the post-sellar type showed the greatest volume. The Lin's correlation coefficient showed excellent reproducibility values. According to the applied methodology, it was found that the volume of the sphenoid sinus was influenced by neither age nor gender (P>0.005). There was difference in the volumes of sphenoid sinus on the right and left sides and in the anatomical classification.

Heterogeneous inflammatory patterns in chronic rhinosinusitis without nasal polyps in Chicago, Illinois

CRSsNP is a heterogenous disease but type 2 inflammation in CRSsNP was more common than type 1 inflammation among patients in Chicago, Illinois. Distinct therapeutic strategies may be needed depending on the type of inflammation found in CRSsNP.

Nutritional content of bat-consumed fruits in a forest fragment in Southern Brazil.

The State Park Mata dos Godoy has 42 identified bat species, among which 21 are frugivorous and belong to the Phyllostomidae family. Current study investigated the concentrations of carbohydrate, lipid and protein in fruits consumed by Artibeus lituratus, Carollia perspicillata and Sturnira lilium to understand their potential differentiated food preferences. The Sampling effort it was from April/2013 to March/2014. Animals captured in mist nets were identified in the field and maintained in cotton bags for 30 minutes to defecate. The diet was inferred from fecal samples analyzed in the laboratory, the fruits whose seeds were found in the feces had the determinations of the nutrients accomplished by centesimal composition method. Kruskal-Wallis test and Dunn's multiple comparison method verified the most abundant nutrients for each species of bat. Whereas Carollia perspicillata and Sturnira lilium feeds mainly in food with carbohydrates that provide them with more energy, the diet of Artibeus lituratus is richer in carbohydrates and lipids. Only fruits considered scarcely represent a complete nutrition for the three bat species, however, the complementarity with other food items such as leaves, pollen, and insects, can provide a complete nutrient diet for these animals.

Is pomegranate peels infusion effective for disinfection of toothbrushes?

Abstract Introduction Methods of decontamination or sanitization of toothbrushes have been questioned. Objective This study assessed the effectiveness of pomegranate peels infusion as a disinfectant of toothbrushes against Streptococcus mutans. Material and method A sample of 16 schoolchildren aged between 7 and 9 years performed brushing 5 days/week, with a careful brushing once a day. After each day of brushing, the toothbrushes were washed and sprayed with one disinfectant solution. This procedure was repeated for 4 weeks using one of the different solutions per week: distilled water (G1; negative control), pomegranate (Punica granatum Linn) peels infusion (G2), 1% sodium hypochlorite (G3) and 0.12% chlorhexidine digluconate (G4). After the fifth day, toothbrushes were collected for laboratory analysis. Toothbrushes heads were subjected to agitation in saline dilution of 10–1, 10–2,10–3, and 25 μL of each dilution were seeded in mitis salivarius agar culture medium for S. mutans colony-forming unit (CFU) counting. One calibrated examiner (Kappa = 0.91) performed the CFU (mL–1 × 104) counts. Kruskal-Wallis and Dunn Multiple Comparison tests were used at a significance level of 5%. Result G1 presented the highest number of CFU (3.9 ± 8.4), followed by G2 (3.2 ± 4.0). No S. mutans growth was observed in G3 and G4. There was no statistically significant difference between G1 and G2 and between G3 and G4 (p&gt;0.05). Conclusion Pomegranate infusion was completely ineffective for the disinfection of toothbrushes against S. mutans when compared with 1% sodium hypochlorite and 0.12% chlorhexidine digluconate solutions.

Defining the optimal animal model for translational research using gene set enrichment analysis.

The mouse is the main model organism used to study the functions of human genes because most biological processes in the mouse are highly conserved in humans. Recent reports that compared identical transcriptomic datasets of human inflammatory diseases with datasets from mouse models using traditional gene‐to‐gene comparison techniques resulted in contradictory conclusions regarding the relevance of animal models for translational research. To reduce susceptibility to biased interpretation, all genes of interest for the biological question under investigation should be considered. Thus, standardized approaches for systematic data analysis are needed. We analyzed the same datasets using gene set enrichment analysis focusing on pathways assigned to inflammatory processes in either humans or mice. The analyses revealed a moderate overlap between all human and mouse datasets, with average positive and negative predictive values of 48 and 57% significant correlations. Subgroups of the septic mouse models (i.e., Staphylococcus aureus injection) correlated very well with most human studies. These findings support the applicability of targeted strategies to identify the optimal animal model and protocol to improve the success of translational research.

Alcohol modulates autophagy and apoptosis in pig liver tissue

BackgroundAutophagy serves as a cellular protective mechanism against alcohol-induced tissue injury but excessive autophagy can also be detrimental leading to apoptosis. Our laboratory has previously shown that moderate alcohol consumption alters expression of proteins in the insulin signaling pathway and worsens glucose metabolism in the liver in a swine model of metabolic syndrome. We examined the effect of alcohol consumption on apoptosis and autophagy signaling in the liver in our clinically relevant animal model of chronic hypercholesterolemia. Material and methodsTwenty-six Yorkshire swine were fed a high-fat diet for 4 wks and were then split into three groups: hypercholesterolemic diet alone (HCC, n = 9), hypercholesterolemic diet with vodka (hypercholesterolemic vodka [HCV], n = 9), and hypercholesterolemic diet with wine (hypercholesterolemic wine [HCW], n = 8) for 7 wks. Animals underwent euthanasia, and liver tissue samples were harvested for analysis. Liver tissue was analyzed via Western blot analysis. Protein density data were normalized to GAPDH and is reported as fold-change values ± standard error of the mean compared to the high-cholesterol diet control group. A Kruskal–Wallis test with a Dunn's multiple comparison test was used to compare the means among groups. ResultsThe HCV group showed significant increases in several proapoptotic proteins (including caspase 3, caspase 8, caspase 9, and cleaved caspase 9) compared with the HCC group. There was a decrease in the proapoptotic protein (BAD) and an increase in anti-apoptotic signal (B-cell lymphoma-2) in the HCW group compared with HCC control. There were increases in pro-survival proteins (AKT, p-AKT, mTOR, p-mTOR) in the HCW and the HCV group compared with control (HCC). There were decreases in autophagy protein LCB-3 in the HCW and HCV compared with the control. ConclusionsWe found that moderate alcohol consumption altered protein expression related to apoptosis and autophagy signaling in pig liver in the setting of hypercholesterolemia. Interestingly, vodka may induce proapoptotic pathways in liver tissue, whereas wine may induce anti-apoptotic signaling. These results provide a mechanism by which vodka may contribute to alcoholic liver disease and supports the notion that wine, containing resveratrol, may prevent cellular apoptosis in liver tissue in the setting of hypercholesterolemia.

Impact of smoking on experimental gingivitis. A clinical, microbiological and immunological prospective study.

The present study assessed the effect of smoking on clinical, microbiological and immunological parameters in an experimental gingivitis model. Twenty-four healthy dental students were divided into two groups: smokers (n = 10); and nonsmokers (n = 14). Stents were used to prevent biofilm removal during brushing. Visible plaque index (VPI) and gingival bleeding index (GBI) were determined 5- on day -7 (running phase), baseline, 21 d (experimental gingivitis) and 28 d (resolution phase). Supragingival biofilm and gingival crevicular fluid were collected and assayed by checkerboard DNA-DNA hybridization and a multiplex analysis, respectively. Intragroup comparison was performed by Friedman and Dunn's multiple comparison tests, whereas the Mann-Whitney U-test was applied for intergroup analyses. Cessation of oral hygiene resulted in a significant increase in VPI, GBI and gingival crevicular fluid volume in both groups, which returned to baseline levels 7 d after oral hygiene was resumed. Smokers presented lower GBI than did nonsmokers (p < 0.05) at day 21. Smokers had higher total bacterial counts and higher proportions of red- and orange complex bacteria, as well as lower proportions of Actinomyces spp., and of purple- and yellow-complex bacteria (p < 0.05). Furthermore, the levels of key immune-regulatory cytokines, including interleukin (IL)-8, IL-17 and interferon-γ, were higher in smokers than in nonsmokers (p < 0.05). Smokers and nonsmokers developed gingival inflammation after supragingival biofilm accumulation, but smokers had less bleeding, higher proportions of periodontal pathogens and distinct host-response patterns during the course of experimental gingivitis.

Dementia in Parkinson's disease is associated with enhanced mitochondrial complex I deficiency.

Dementia is a common feature of Parkinson's disease (PD), but the neuropathological changes associated with the development of Parkinson's disease dementia (PDD) are only partially understood. Mitochondrial dysfunction is a hallmark of PD but has not been studied in PDD. Molecular and biochemical approaches were used to study mitochondrial activity and quantity in postmortem prefrontal cortex tissue. Tissues from pathologically confirmed PD and PDD patients and from age-matched controls were used to analyze the activity of mitochondrial enzyme complex nicotinamide adenine dinucleotide:ubiquinone oxidoreductase, or complex I (the first enzyme in the mitochondrial respiratory chain), mitochondrial DNA levels, and the expression of mitochondrial proteins. Complex I activity was significantly decreased (27% reduction; analysis of variance with Tukey's post hoc test; P < 0.05) in PDD patients, and mitochondrial DNA levels were also significantly decreased (18% reduction; Kruskal-Wallis analysis of variance with Dunn's multiple comparison test; P < 0.05) in PDD patients compared with controls, but neither was significantly reduced in PD patients. Overall, mitochondrial biogenesis was unaffected in PD or PDD, because the expression of mitochondrial proteins in patients was similar to that in controls. Patients with PDD have a deficiency in mitochondrial complex I activity and reduced mitochondrial DNA levels in the prefrontal cortex without a change in mitochondrial protein quantity. Therefore, mitochondrial complex I deficiency and reduced mitochondrial DNA in the prefrontal cortex may be a hallmark of dementia in patients with PD.

Time density curve analysis for C-arm FDCT PBV imaging.

Parenchymal blood volume (PBV) estimation using C-arm flat detector computed tomography (FDCT) assumes a steady-state contrast concentration in cerebral vasculature for the scan duration. Using time density curve (TDC) analysis, we explored if the steady-state assumption is met for C-arm CT PBV scans, and how consistent the contrast-material dynamics in cerebral vasculature are across patients. Thirty C-arm FDCT datasets of 26 patients with aneurysmal-SAH, acquired as part of a prospective study comparing C-arm CT PBV with MR-PWI, were analysed. TDCs were extracted from the 2D rotational projections. Goodness-of-fit of TDCs to a steady-state horizontal-line-model and the statistical similarity among the individual TDCs were tested. Influence of the differences in TDC characteristics on the agreement of resulting PBV measurements with MR-CBV was calculated. Despite identical scan parameters and contrast-injection-protocol, the individual TDCs were statistically non-identical (p < 0.01). Using Dunn's multiple comparisons test, of the total 435 individual comparisons among the 30 TDCs, 330 comparisons (62%) reached statistical significance for difference. All TDCs deviated significantly (p < 0.01) from the steady-state horizontal-line-model. PBV values of those datasets for which the TDCs showed largest deviations from the steady-state model demonstrated poor agreement and correlation with MR-CBV, compared with the PBV values of those datasets for which the TDCs were closer to steady-state. For clinical C-arm CT PBV examinations, the administered contrast material does not reach the assumed 'ideal steady-state' for the duration of scan. Using a prolonged injection protocol, the degree to which the TDCs approximate the ideal steady-state influences the agreement of resulting PBV measurements with MR-CBV.

Temporal sequence of recovery-related events following maximal exercise assessed by heart rate variability and blood lactate concentration.

To analyse the temporal sequence of recovery events related to autonomic nervous system and metabolic processes following maximal exercise, applying linear and nonlinear indices of heart rate variability (HRV) and blood lactate concentration. On the following day of the maximum oxygen consumption test, 20 participants firstly lay down for 20min for resting data collection and then underwent the constant velocity exhaustive test, which consisted in running at 100% of maximal velocity reached on the previous day until exhaustion. Immediately after the end of exercise, the participants kept a supine position for 120min recovering passively. Prior to exercise and at every 10min during the recovery time, blood samples were collected to determine lactate concentration, and heart rate variability analysis (time and frequency domain indices and recurrence plot variables) was performed. Friedman's test, complemented with Dunn's multiple comparison test, was used to compare recovery moments and baseline values. From 70min, no significant differences were detected between lactate concentration and baseline. HRV indices were considered recovered at different timings: at 60min for SD2; at 70min for SDNN and LF; at 80min for RMSSD, HF and SD1 and at 90min for recurrence plot variables. During passive recovery after maximal exercise, restoration processes seem to comply an order, considering analysed HRV indices and lactate removal: at first, lactate concentration reaches normal values, allowing sympathovagal reorganization, and then, parasympathetic function is able to complete its reestablishment followed by system complexity recovering.

Characterization of enzymatic profiles of Aedes aegypti strains from the State of Rio Grande do Norte, Brazil.

This study was conducted in four strains of Aedes aegypti mosquitoes to evaluate the enzymatic activity profiles in the city of Mossoró, Rio Grande do Norte, and correlate them with biochemical mechanisms of resistance to insecticides. Mosquitos were used to quantify the following detoxification enzymes: Mixed-Function Oxidase (MFO), PNPA-esterase (PNPA-EST), and Acetylcholinesterase (AChE). The profiles were compared statistically with profiles from the Rockefeller strain, through the Kruskal-Wallis test and Dunn's multiple comparisons (p < 0.05). The 99 percentile of the values of enzyme activity from the reference strain was calculated for each enzyme, and the percentage of individuals above the 99 percentile was quantified. The enzyme activities were classified as "Unchanged" (< 15%), "Identified change" (> 15% and < 50%), and "Substantially changed" (> 50%). The statistical analysis revealed significant differences in the MFO and AChE profiles, which are fundamental in the determination of profiles of resistance to insecticides. Three populations were classified as "Substantially changed" for MFO. The altered enzymatic activity showed that the changes could have an important role in exposing resistance to insecticides.

Using dynamic contrast-enhanced MRI to predict the histopathologic grade of cerebral gliomas

Objective To evaluate three different tracer-kinetic models used for dynamic contrast-enhanced MRI (DCE-MRI) data processing in the prediction of the histopathologic grade of cerebral gliomas. Methods Forty-one patients with histopathologically graded gliomas (grade Ⅱ 13, grade Ⅲ 14, grade Ⅳ 14) were imaged with DCE-MRI from March,2013 to November,2014. The values of Ktrans of gliomas were obtained by three tracer-kinetic models, which were Patlak model, Tofts model and Extended Tofts Linear model. All data were analyzed statistically by a Graphpad 6.0 statistical software. Comparison of the differences of Ktrans among different grades of gliomas was conducted using the Kruskal-Wallis test and Dunn's multiple comparisons test for the data not conform to normal distribution. Correlations of Ktrans values among those three models were analyzed using linear regression analysis, The differences of Ktrans between low grades and high grades of gliomas was conducted using the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analyses were performed to determine the cut-off values for Ktrans to distinguish different low grades and high grades of gliomas. Results The Ktrans values obtained by Patlak model was 0.008 (0.004-0.043) min-1for grade Ⅱ, 0.021 (0.005-0.088) min-1 for grade Ⅲ, and 0.035 (0.017-0.061) min-1 for grade Ⅳ. The Ktrans values obtained by Tofts model was 0.085 (0.041-0.158) min-1 for grade Ⅱ, 0.140 (0.063-0.315) min-1 for grade Ⅲ, 0.229 (0.126-0.419) min-1 for grade Ⅳ. The Ktrans values obtained by Extended Tofts Linear model was 0.012 (0.004-0.092) min-1 for grade Ⅱ, 0.048 (0.010-0.188) min-1 for grade Ⅲ, 0.094 (0.036-0.215) min-1 for grade Ⅳ. All the Ktrans values obtained by three models increased when the histological grades increased, with statistical significance between grade Ⅱ and Ⅲ (H=18.31, 18.09,20.18,P<0.05). Ktrans values among the three models had good linear correlations. The Ktrans obtained by Extended Tofts Linear model had good linear correlations with both Patlak model and Tofts model (r=0.933, 0.893, P<0.05) , and the Ktrans obtained by Patlak model had less linear correlation with Tofts model (r=0.822, P<0.05). The Ktrans values were statistically different between LGG and HGG (P<0.01). The cut-off value of Ktrans provided good combination of sensitivity and specificity in the differentiation between LGG and HGG, and the Ktrans obtained by Extended Tofts Linear model had the best sensitivity and specificity among the three models (sensitivity 92.3%, specificity 85.7%). Conclusions Ktrans from DCE-MRI has a high performance in predicting the histopathologic grade of brain glioma, and the Extended Tofts Linear model is more suitable for the evaluation of cerebral glioma. Key words: Glioma; Magnetic resonance imaging; Models, theoretical

Quantifying suspended sediment flux in a mixed-land-use urbanizing watershed using a nested-scale study design

Suspended sediment (SS) remains the most pervasive water quality problem globally and yet, despite progress, SS process understanding remains relatively poor in watersheds with mixed-land-use practices. The main objective of the current work was to investigate relationships between suspended sediment and land use types at multiple spatial scales (n=5) using four years of suspended sediment data collected in a representative urbanized mixed-land-use (forest, agriculture, urban) watershed. Water samples were analyzed for SS using a nested-scale experimental watershed study design (n=836 samples×5 gauging sites). Kruskal–Wallis and Dunn's post-hoc multiple comparison tests were used to test for significant differences (CI=95%, p<0.05) in SS levels between gauging sites. Climate extremes (high precipitation/drought) were observed during the study period. Annual maximum SS concentrations exceeded 2387.6mg/L. Median SS concentrations decreased by 60% from the agricultural headwaters to the rural/urban interface, and increased by 98% as urban land use increased. Multiple linear regression analysis results showed significant relationships between SS, annual total precipitation (positive correlate), forested land use (negative correlate), agricultural land use (negative correlate), and urban land use (negative correlate). Estimated annual SS yields ranged from 16.1 to 313.0tkm−2year−1 mainly due to differences in annual total precipitation. Results highlight the need for additional studies, and point to the need for improved best management practices designed to reduce anthropogenic SS loading in mixed-land-use watersheds.

Apical Transportation, Centering Ability, and Cleaning Effectiveness of Reciprocating Single-file System Associated with Different Glide Path Techniques

IntroductionThe aim of this study was to evaluate the apical transportation, the centering ability, and the cleaning effectiveness of a reciprocating single-file system associated to different glide path techniques. MethodsThe mesial root canals of 52 mandibular molars were randomly distributed into 4 groups (n = 13) according to the different glide path techniques used before biomechanical preparation with Reciproc System (RS): KF/RS (sizes 10 and 15 K-files), NGP/RS (no glide path, only reciprocating system), PF/RS (sizes 13, 16, and 19 PathFile instruments), and NP (no preparation). Cone-beam computed tomography analysis was performed before and after instrumentation for apical third images acquisition. Apical transportation and its direction were evaluated by using the formula D = (X1 − X2) – (Y1 − Y2), and the centering ability was analyzed by the formula CC = (X1 − X2/Y1 − Y2 or Y1 − Y2/X1 − X2). The samples were submitted to histologic processing and analyzed under a digital microscope for debris quantification. The values were statistically analyzed (Kruskal-Wallis, the Dunn multiple comparisons test, P < .05). ResultsAll groups had similar apical transportation values, with no significant difference among them (P > .05). Groups had a tendency toward transportation in the mesial direction. No technique had perfect centering ability (=1.0), with no significant difference among them. KF/RS had larger amount of debris, with statistically significant difference in comparison with NGP/RS (P > .05). ConclusionsThe different glide path techniques promoted minimal apical transportation, and the reciprocating single-file system tested remained relatively centralized within the root canal. Also, the different techniques interfered in the cleaning effectiveness of the reciprocating system.

Walking with eyes closed is easier than walking with eyes open without visual cues: The Romberg task versus the goggle task

BackgroundThe Romberg test, with the subject standing and with eyes closed, gives diagnostic arguments for a proprioceptive disorder. Closing the eyes is also used in balance rehabilitation as a main way to stimulate neural plasticity with proprioceptive, vestibular and even cerebellar disorders. Nevertheless, standing and walking with eyes closed or with eyes open in the dark are certainly 2 different tasks. We aimed to compare walking with eyes open, closed and wearing black or white goggles in healthy subjects. MethodsA total of 50 healthy participants were randomly divided into 2 protocols and asked to walk on a 5-m pressure-sensitive mat, under 3 conditions: (1) eyes open (EO), eyes closed (EC) and eyes open with black goggles (BG) and (2) EO, EO with BG and with white goggles (WG). Gait was described by velocity (m·s−1), double support (% gait cycle), gait variability index (GVI/100) and exit from the mat (%). Analysis involved repeated measures Anova, Holm-Sidak's multiple comparisons test for parametric parameters (GVI) and Dunn's multiple comparisons test for non-parametric parameters. ResultsAs compared with walking with EC, walking with BG produced lower median velocity, by 6% (EO 1.26; BG 1.01 vs EC 1.07m·s−1, P=0.0328), and lower mean GVI, by 8% (EO 91.8; BG 66.8 vs EC 72.24, P=0.009). Parameters did not differ between walking under the BG and WG conditions. ConclusionThe goggle task increases the difficulty in walking with visual deprivation compared to the Romberg task, so the goggle task can be proposed to gradually increase the difficulty in walking with visual deprivation (from eyes closed to eyes open in black goggles).

Swelling of self-adhesive resin cement increases long-term push-out bond strength of fiber post to dentin

Aim: To evaluate the long-term post push-out bond strength to dentin, water sorption, solubility and swelling of conventional and self-adhesive dual-cure resin cements. Methods: Forty-eight bovine roots were prepared for fiber post cementation with RelyX ARC and RelyX U100. According to resin cement and storage time (24 h and 6 months), 4 groups were assessed using the push-out test. Water sorption and solubility were performed according to ISO 4049:2009. The swelling coefficient was obtained using cement disks of each material immersed in distilled water until the swelling equilibrium was reached. The mass of dry and swelled polymer and solvent density were used to calculate the coefficient. Statistical data analysis was performed using Student’s t-test for water sorption, solubility and swelling coefficient and the Kruskal-Wallis and Dunn multiple comparison tests for push-out analysis with a significance level of 0.05. Results: The immediate bond strength was not significantly different between RelyX ARC (3.09 MPa) and RelyX U100 (3.78 MPa) (p>0.05). RelyX U100 showed higher (p 0.05) between groups. The swelling coefficient of the RelyX U100 group was significantly higher than that of the RelyX ARC group (p<0.05). Conclusions: RelyX U100 resin cement showed a higher swelling coefficient than RelyX ARC, and the longitudinal push-out bond strength increased after six months. Clinical significance: The clinical longevity of restorative treatment in root-filled teeth is dependent on the long-term properties and behavior of the cement used for post luting. Results of this study suggest that the selfadhesive resin cement may be a reliable alternative.

Does focal incidental 18F-FDG PET/CT uptake in the prostate have significance?

(18)F-FDG PET/CT is used to characterize many malignancies, but is not recommended for localized prostate cancer. This study explores the value of multi-parametric MRI (mpMRI) in characterizing incidental prostate (18)F-FDG uptake. Thirty-one patients who underwent (18)F-FDG PET/CT for reasons unrelated to prostate cancer and prostate mpMRI were eligible for this retrospective study. The mpMRI included T2-weighted (T2W), dynamic contrast enhancement (DCE), apparent diffusion coefficient (ADC), and MR spectroscopy (MRS) sequences. Fourteen patients were excluded (n = 8 insufficient histopathology, n = 6 radical prostatectomy before PET), and final analysis included 17 patients. A nuclear medicine physician, blinded to clinicopathologic findings, identified suspicious areas and maximum standardized uptake values (SUV max) on (18)F-FDG PET/CT. Sector-based imaging findings were correlated with annotated histopathology from whole-mount or MRI/transrectal ultrasound fusion biopsy samples. Positive predictive values (PPVs) were estimated using generalized estimating equations with logit link. Results were evaluated with Kruskal-Wallis and Dunn's multiple comparisons tests. The PPV of (18)F-FDG PET alone in detecting prostate cancer was 0.65. Combining (18)F-FDG PET as a base parameter with mpMRI (T2W, DCE, ADC, and MRS) increased the PPV to 0.82, 0.83, 0.83, and 0.94, respectively. All benign lesions had SUV max < 6. Malignant lesions had higher SUV max values that correlated with Gleason scores. There was a significant difference in SUV max per prostate between the Gleason ≥ 4 + 5 and benign categories (p = 0.03). Focal incidental prostate (18)F-FDG uptake has low clinical utility alone, but regions of uptake may harbor high-grade prostate cancer, especially if SUV max > 6. Using mpMRI to further evaluate incidental (18)F-FDG uptake aids the diagnosis of prostate cancer.

Cytidine-5-diphosphocholine reduces microvascular permeability during experimental endotoxemia.

BackgroundMicrovascular permeability and leukocyte adhesion are pivotal mechanisms in sepsis pathophysiology contributing to the development of shock and mortality. No effective pharmacological therapy is currently available to restore microvascular barrier function in sepsis. Cholinergic mediators have been demonstrated to exert anti-inflammatory effects during inflammation. Cytidine-5-diphosphocholine (CDP-choline) is an extensively studied cholinergic drug due to its brain protective characteristics in cerebrovascular diseases. This study evaluated the effect of CDP-choline on microvascular permeability and leukocyte adhesion during endotoxemia.MethodsMacromolecular leakage, leukocyte adhesion, and venular wall shear rate were examined in mesenteric postcapillary venules of rats by using intravital microscopy (IVM). Lipopolysaccharide (LPS) (4 mg/kg/h) or equivalent volumes of saline were continuously infused following baseline IVM at 0 min. IVM was repeated after 60 and 120 min in endotoxemic and nonendotoxemic animals. CDP-choline (100 mg/kg) was applied as an i.v. bolus. Animals received either saline alone, CDP-choline alone, CDP-choline 10 min before or 30 min after LPS administration, or LPS alone. Due to nonparametric data distribution, Wilcoxon test and Dunn's multiple comparisons test were used for data analysis. Data were considered statistically significant at p < 0.05.ResultsTreatment with LPS alone significantly increased microvascular permeability and leukocyte adhesion and decreased venular wall shear rate. CDP-choline significantly reduced microvascular permeability in animals treated with LPS. Leukocyte adhesion and venular wall shear rate were not affected by CDP-choline during endotoxemia.ConclusionCDP-choline has a protective effect on microvascular barrier function during endotoxemia. Considering the excellent pharmacologic safety profile of CDP-choline, its use could be an approach for the treatment of capillary leakage in sepsis.