Group IIIB Research Articles

Improving the Power of the American Society of Anesthesiology Classification System to Risk Stratify Vascular Surgery Patients Based on National Surgical Quality Improvement Project–Defined Functional Status

Recently published reports have shown that the American Society of Anesthesiology (ASA) classification system has limited applicability in vascular surgery patients. Most patients undergoing vascular procedures are designated as ASA class III, limiting discrimination in preoperative risk assessment. The 2006 National Surgical Quality Improvement Project (NSQIP), containing over 170,000 surgical cases, demonstrated that functional status is an important predictor of mortality. We propose that dividing ASA class III into 2 subgroups, based on NSQIP-defined functional status, improves the predictive value of the ASA scheme. The 2006 NSQIP database was queried for ASA class III patients undergoing vascular surgery procedures. Patients were divided into groups IIIA and IIIB based on independent or dependent (partial or complete) functional status, respectively. Difference in 30-day survival between subgroups was evaluated using Kaplan-Meier and logistic regression analyses. Differences in postoperative morbidity and length of stay were compared using the unpaired t-test. ASA class III patients having undergone vascular surgery procedures numbered 11,555 (68%). Of those 9,913 (85.7%) patients were independent (IIIA), and 1,642 (14.3%) were dependent (IIIB). Mean 30-day mortality was 1.3% in subgroup IIIA, and 6.5% in IIIB (logrank P<0.001, χ2, 137.8). Mean lengths of stay between subgroups IIIA and IIIB were 5.4 and 13.2days (P<0.001). The risk of NSQIP-defined postoperative complications was 0.16 in IIIA and 0.32 in IIIB (P<0.001). A 5-fold difference in mortality was observed between patients who were functionally independent and dependent. A significant increase in length of stay and incidence of postoperative complications was also observed in subgroup IIIB. Subdividing ASA class III vascular surgery patients markedly improves the value of the ASA classification system. Given the "high-risk" nature of patients with vascular disease, the addition of functional status to the preoperative assessment will assist in predicting outcomes in this patient population.

History of very thick film and bulk sample group IIIB, IVB, VB, and rare earth materials for various vacuum applications

Thick occluder film and bulk hydride materials are extremely hard to produce without flaking or cracking. This paper discusses methods of how to prepare thick films and bulk samples (i.e., rods and wires) that have reduced stress for many applications. These include accelerator research for cancer therapy, intense neutron sources, particle-beam fusion diagnostic beam focusing studies, and mass spectrometer calibration. Thick films of ∼(≥3000 to 150 000 nm thickness of various hydrides are sensitive to oxidation and are easily contaminated by improper handling. They must be specially prepared to reduce internal stresses due to temperature variations during processing, stresses due to hydriding, and substrate configuration (i.e., curved surfaces). Discussed are techniques developed at the General Electric Neutron Devices Department, in Largo, FL, in the mid-1970s to the late 1990s to produce flaking and crack free samples of thick films and bulk samples. Items studied include Er, Sc, and Ti thick film hydrides on a Cr underlay, on various substrates, Er and Sc bulk rod samples for the first basic material heat capacity and thermal diffusivity studies as a function of hydride loading, Nb and V wires in bundles of ∼30 wires, for the first tritide neutron vibration spectra studies, and Ti wires for mass spectrometer calibration studies. Film samples were prepared by standard E-beam evaporation techniques and then non-air-exposure loaded. Bulk samples were loaded with a Sievert's precise gas quantity loading system. To produce reduced intrinsic stress (strain) in samples of Er, Sc, and Ti thick films, and bulk samples of Er, Sc, Nb, V, and Ti, special processing employing slow bakeout heating and cool down rates, slow film deposition rates, slow leak in pressure hydriding rates, followed by slow cooling rates to room temperature were used. Using the process described, very successful results were obtained.

Computer-Assisted Quantitative Assessment of Prostatic Calcifications in Patients with Chronic Prostatitis

Background: The aim of this study was the development of quantitative assessment of prostatic calcifications at prostatic ultrasound examination by the use of an image analyzer. Materials and Methods: A group of 82 patients was evaluated by medical history, physical, and transrectal ultrasound examination. Patients had a urethral swab, a 4-specimen study and culture of the seminal fluid. Patients were classified according to National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of Health. Subjective symptoms were scored by Chronic Prostatitis Symptom Index (CPSI) questionnaire. Ultrasound images were analyzed by the digital processing software Image J to quantitatively assess the presence of calcifications. Results: Computer-assessed calcified areas were significantly higher in chronic bacterial prostatitis (n = 18; group II; 6.76 ± 8.09%) than in the chronic pelvic pain syndrome group IIIa (n = 26; 2.07 ± 1.01%) and IIIb (n = 38; 2.31 ± 2.18%). The area of calcification of the prostate was significantly related to the CPSI score for domains of micturition (r = 0.278, p = 0.023), Prostatic Specific Antigen values (r = 0341, p = 0.005), postvoiding residual urine (r = 0.262, p = 0.032), total prostate volume (r = 0.592, p = 0.000), and adenoma volume (r = 0.593; p = 0.000). Conclusions: The presence of calcifications is more frequently observed in patients with chronic bacterial prostatitis and is related to urinary symptoms.

STUDY THE EXPRESSION OF TETRASPANIN (CD81) ON B CELLS IN RESPONSE TO INTERFERON THERAPY IN CHRONIC HCV PATIENTS

ABSTRACT Hepatitis C virus (HCV) infection causes life threatening disease due to its persistence in the liver, over time leading to cirrhosis and hepatocellular carcinoma. Therapeutic intervention with interferon (INF) - alpha combined with ribavirin is aimed at viral clearance, Interferon and ribavirin might discontinue the virus induced hepatocytes damage, thus slowing down the progress to end- stage liver disease. It has been demonstrated that HCV virion, via major structure envelop (E) protein 2 or EIE2 complex could specifically bind to human CD81 molecule, thereby altering the cellular activities in B cells, T cells and natural killer (NK) cells. CD81, a surface protein belonging to the tetraspanin family, facilitates B–T cell interaction in the process of antigen presentation Evidence has revealed that CD81 on B and T cells substantially enhanced T helper IL-4 secretion and NK-cell CD81 enabled E2-mediated reduction of the IFN-gamma levels Those data suggest that CD81 might activate the pathway leading to a predominant type-2 immune response, and as such be prone to cause a strong antibody production but weak or insufficient cytotoxic activities to clear the.The aim of this work was to investigate the clinical relevance and the possible mechanism of CD81 down-regulation under IFN-alpha treatment to detect possible role of CD 81in response to INF therapy of chronic HCV patients. Subjects and Methods: The study included: Group I: 10 healthy subjects. And 60 HCV patients classified into 3 groups: Group II: 20 chronic HCV patients have not received treatment Group IIIa: 20 chronic HCV patients have received treatment responsive to treatment Group IIIb: 20 chronic HCV patients have received treatment not responsive to treatment .the patients were subjected to: (CBC) .liver and kidney function tests and special investigation CD 81, CD19, CD 22. Results: TLC and PLT higher in group I while ALT and AST were significantly higher in group II, while T. bilirubin was significantly higher in group IIIb, Direct bilirubin was significantly higher in group II ,and Alb was significantly higher in group I ,ASMA and ANA more higher in group IIIb, AFP and TSH were significantly higher in group IIIb , there was negative correlation between CD81 and TLC positive correlation between ALT, AST and CD81 were positively correlated to T Bilirubin , D Bilirubin and CD81.There was also significant negative correlation between Albumin and CD81. CD81, CD19, CD22 and Lymphocytes were significantly higher in group IIIb. Conclusion: In conclusion, CD81 down-regulation is a primary host response to interferon-alpha-based therapy and an immunophenotype associated with anti-HCV sustained virological response (SVR) Key words:HCV,CD81 ,interferone

Plasma soluble CD 163 level as a marker of oesophageal varices in cirrhotic patients

BackgroundVariceal bleeding (VB), the most common lethal complication of cirrhosis, associated with high mortality. Timely prediction of esophageal varices (EV) represents a real challenge for the medical team. This study evaluated the level of plasma soluble CD 163 as a marker of the presence of EVs and to compare it with other noninvasive clinical, laboratory and ultrasonographic parameters as well as endoscopy. MethodsThis prospective controlled study was conducted on 80 adults. Gp I had no oesophageal varices, gp II had small varices, gp IIIa had large varices, gp IIIb are the same patients of gp IIIa but after eradication of varices and gp IV as healthy controls. Serum samples were assayed for soluble CD 163. Resultssoluble CD163 was statistically significant different between controls and all liver cirrhosis. it showed a statistically significant difference between group I and II (p=0.009) and between group I and IIIa (p<0.001) and between group II and IIIa (p<0.001) but, no difference between group IIIa and IIIb (p=0.179). ConclusionSerum soluble CD163 is a good noninvasive predictor for the presence of EVs and it may be used for grading of EVs. Its level does not change after esophageal varices eradication.Trial registration: IRB No: 00007589 FWA No: 00015712 The Ethics Committee of the faculty of medicine Alexandria University.

Association of Human Interleukin-35 Level in Gingival Crevicular Fluid and Serum in Periodontal Health, Disease, and after Nonsurgical Therapy: A Comparative Study.

Background:Innovating newer methods to diagnose a multifactorial disease such as periodontitis is always challenging for a clinician. Gingival crevicular fluid (GCF) which is closely associated with the periodontal tissue environment has been used a viable alternative to saliva for the diagnosis of periodontitis.Aim:The aim of the present study was to estimate and compare the interleukin-35 (IL-35) levels in GCF and serum among healthy, gingivitis, and chronic periodontitis (CP) individuals as well as to evaluate the effect of nonsurgical periodontal treatment (NSPT) on IL-35 level among patients with CP.Settings and Design:The study was conducted at the Department of Periodontics, Srirama Chandra Bhanja Dental College and Hospital, Cuttack, Odisha, India. It is a comparative study.Materials and Methods:A total of 60 participants were divided into healthy (Group I; n = 20), gingivitis (Group II; n = 20), and CP (Group IIIA; n = 20). GCF samples collected from each individual at baseline and 6 weeks after NSPT for Group III individuals (Group IIIB; n = 20) were quantified for IL-35 levels using enzyme-linked immunosorbent assay.Statistical Analysis:All analyses were performed using Shapiro–Wilk test, analysis of variance, Tukey's honestly significant difference post hoc test, and multiple regression analysis.Results:The mean IL-35 concentration in GCF was significantly high (P < 0.05) for Group IIIA (70.26 ± 4.0 pg/ml), as compared to Group I (54.81 ± 22.3 pg/ml) and Group IIIB (55.72 ± 10.2 pg/ml).Conclusion:In the present study, GCF and serum IL-35 concentration among CP individuals was highest among all the groups. Individuals receiving NSPT showed a significant reduction in IL-35 levels as compared to CP individuals.

Effect of alcoholic beverages on shear bond strength of composites to enamel.

Background:Longevity of composite restoration in the oral cavity is dependent on various factors. One such factor is exposure to various foods and beverages which could alter the properties of the material.Aim:The aim of this in vitro study was to evaluate the effect of most widely consumed alcoholic beverages on shear bond strength of composites to enamel.Material and Methods:A total of seventy human premolars were embedded in acrylic resin blocks. Labial enamel surfaces was flattened, etched, bonded, and restored with composite resin (Tetric N Ceram – Ivoclar Vivadent AG, Schaan, Liechtenstein). The specimens were randomly divided into four groups: Group I: beer; Group II: wine; Group III: whiskey, and Group IV: artificial saliva. Group I to Group III were again divided into moderate (Group IA, IIA, and IIIA) and heavy (Group IB, IIB, and IIIB) consumption subgroups. The specimens were soaked in their respective groups for 90 min daily in Group IA, IIA, and IIIA and for 30 min every alternate day in Group IB, IIB, and IIIB until 30 days. Universal testing machine was used to determine the shear bond strength of composite with enamel.Statistical Analysis Used:The values obtained were statistically analyzed using two-way analysis of variance followed by post hoc test with the significant level set at P < 0.05, using GraphPad prism software version 6.01.Results:Group IIB showed the highest reduction in shear bond strength, with a mean value of 6.6 ± 1.2 Mpa in comparison to control with a mean value of 21.8 ± 1.6 Mpa.Conclusion:As the content of alcohol and time of exposure increased along with a decrease in the pH of alcoholic beverages, shear bond strength between composite and enamel decreased.

Ultrasound assessment of soft tissue augmentation around implants in the aesthetic zone using a connective tissue graft and xenogeneic collagen matrix – 1-year randomised follow-up

PurposeA comparative, ultrasound evaluation of the thickness of keratinized mucosa (TKT) around implants one year after gingival augmentation (GA) by means of a connective tissue graft (CTG) and the xenogeneic collagen matrix (CMX). Materials and methodsA total of 75 bone level tapered implants (Conelog® Camlog) were inserted in 57 patients in the aesthetic area of both jaws. The patients were divided into 3 groups: control group I- without GA; group II- GA 3 months before implantation, and group III- GA 3 months after implantation. Groups II and III were divided into two subgroups depends on type of material used for GA: (a) CMX (Mucograft®, Geistlich Pharma AG) and (b) CTG. The patients underwent a clinical and ultrasound examination before, then after 3 and 12 months following GA respectively to evaluate TKT at two points using ultrasound equipment (Pirop®, Echoson). Point 1 was considered to be in the middle of the line connecting the cemento-enamel junction (CEJ) to the adjacent teeth, and point 2 on the mucogingival junction (MGJ). ResultsThree months after GA, the highest increase in gingival thickness was noted in group IIIb (point 1 – 0.95mm, 2 – 1.01mm). However, 12 months after GA the highest gingival thickness was observed in group IIb (point 1 – 1.76mm, 2 – 1.36m) and next IIIb (point 1 – 1.52mm, 2 – 1.15mm). ConclusionsBoth CTG and Geistlich Mucograft® increased TKT, but higher values were noted using CTG augmentation before implantation. An ultrasonic device can be used as a non-invasive, reliable, and reproducible method for evaluating TKT.

The Systems Li-Tl, Na-Tl and K-Tl

It is a well-known and often-used heuristic in chemistry to compare properties of chemically related systems. In the present case, the physical chemistry of binary systems of thallium with alkali metals Li, Na and K are presented together to show similarities and differences. In each case, the literature was mined to retrieve original experimental data for the phase diagram, thermodynamic properties of solutions and compounds, structural information for compounds and effects of pressure. Special attention is given to the phase diagram, by plotting data and showing assessed phase boundaries. Whether stated by investigators or nor, mutual solid solubility of the components at the composition extremes was evaluated. In some cases, investigators omitted the presence of αTl (low temperature solid structure) in their reports. In these cases, the assessed phase diagrams include suggested possible phase boundaries to indicate the existence of two forms of solid Tl. Thallium is the heaviest member of the triel group of elements B → Nh (Group 13 new notation, Group IIIB old notation). These elements tend to form clusters or cages, as concluded from neutron diffraction measurements on liquid solutions (Verkerk et al. in J Phys Condens Matter 6(Suppl. 23A):A255–A260, 1994, Van der Aart et al. in Phys B 234–236:362–363, 1997, Van der Aart et al. in J Non-Cryst 250–252(Part 1):241–244, 1999). They may be represented by [Tln]m−, where n may take values from 4 to 13, and m from 5 to 11. The particular values of m and n depend on the number and identity of cations in the structure (Dong and Corbett in J Am Chem Soc 117(24):6447–6455, 1995, Corbett in Angew Chem 112(4):682–704, 2000, Wang et al. in J Am Chem Soc 134(48):19884–19894, 2012). The structures are described as “hypoelectronic” (electron-poor). This multiplicity of structures probably accounts for the fact that, in some systems, not all synthesized compounds appear in the phase diagram, and some may have mislabelled stoichiometries.

XTHs from Fragaria vesca: genomic structure and transcriptomic analysis in ripening fruit and other tissues

BackgroundFragaria vesca or ‘woodland strawberry’ has emerged as an attractive model for the study of ripening of non-climacteric fruit. It has several advantages, such as its small genome and its diploidy. The recent availability of the complete sequence of its genome opens the possibility for further analysis and its use as a reference species. Fruit softening is a physiological event and involves many biochemical changes that take place at the final stages of fruit development; among them, the remodeling of cell walls by the action of a set of enzymes. Xyloglucan endotransglycosylase/hydrolase (XTH) is a cell wall-associated enzyme, which is encoded by a multigene family. Its action modifies the structure of xyloglucans, a diverse group of polysaccharides that crosslink with cellulose microfibrills, affecting therefore the functional structure of the cell wall. The aim of this work is to identify the XTH-encoding genes present in F. vesca and to determine its transcription level in ripening fruit.ResultsThe search resulted in identification of 26 XTH-encoding genes named as FvXTHs. Genetic structure and phylogenetic analyses were performed allowing the classification of FvXTH genes into three phylogenetic groups: 17 in group I/II, 2 in group IIIA and 4 in group IIIB. Two sequences were included into the ancestral group. Through a comparative analysis, characteristic structural protein domains were found in FvXTH protein sequences. In complement, expression analyses of FvXTHs by qPCR were performed in fruit at different developmental and ripening stages, as well as, in other tissues. The results showed a diverse expression pattern of FvXTHs in several tissues, although most of them are highly expressed in roots. Their expression patterns are not related to their respective phylogenetic groups. In addition, most FvXTHs are expressed in ripe fruit, and interestingly, some of them (FvXTH 18 and 20, belonging to phylogenic group I/II, and FvXTH 25 and 26 to group IIIB) display an increasing expression pattern as the fruit ripens.ConclusionA discrete group of FvXTHs (18, 20, 25 and 26) increases their expression during softening of F. vesca fruit, and could take part in cell wall remodeling required for softening in collaboration with other cell wall degrading enzymes.

COMPARATIVE EVALUATION OF DIFFERENT DOSES OF VINPOCETINE ALONE AND IN COMBINATION WITH SULFASALAZINE IN EXPERIMENTALLY INDUCED INFLAMMATORY BOWEL DISEASE IN RATS

Objective: Inflammatory bowel disease (IBD) is a disorder characterized by chronic inflammation of the gastrointestinal tract and its exact etiopathology is still unclear. Most of the currently available drugs provide the symptomatic improvement, and their long-term use can lead to various unwanted effects also. This study was done to observe the effects of vinpocetine alone and in combination with sulfasalazine on IBD in rats.Methods: Adult Wistar rats of either sex were used (n=36). Experimental colitis was produced by intracolonic administration of acetic acid (10% v/v, 0.20 ml/rat) given per rectally. Rats were divided into six groups (n=6): Group I - normal control (0.9% w/v saline, intracolonic administration + 0.5% w/v carboxymethyl cellulose, i.e., CMC, p.o); Group II - acetic acid (10% v/v, intracolonic administration+0.5% w/v CMC, p.o); Group IIIA - acetic acid + vinpocetine (5 mg/kg, p.o); Group IIIB - acetic acid + vinpocetine (10 mg/kg, p.o); Group IV - acetic acid + sulfasalazine (360 mg/kg, p.o.); Group V - acetic acid + sulfasalazine + vinpocetine (360 mg/kg, p.o. + 5 mg/kg, p.o). The study period was of 15 days in which animals were treated with acetic acid solution on day 1 and treatment was started 4 hrs after the administration of acetic acid till the 14th day. On 15th day, the animals were sacrificed for the investigation of various macroscopic, microscopic, and biochemical parameters.Results: The higher dose of orally administered vinpocetine (10 mg/kg) and combination of sulfasalazine + vinpocetine (360 mg/kg + 5 mg/kg) were found to be the most effective in reducing the severity of mucosal damage which was similar to the reference drug sulfasalazine (360 mg/kg). Both the doses of vinpocetine curtailed the histopathological scores. The combination therapy of sulfasalazine + vinpocetine (360 mg/kg + 5 mg/kg) was equally effective to standard drug but not found to be the most effective treatment. Myeloperoxidase levels were significantly reduced in vinpocetine treated groups as compared to acetic acid control group, while the glutathione levels were increased significantly. Similarly, vinpocetine significantly decreased the malondialdehyde level in the intestinal tissue of the rats with acetic acid induced colitis, and thus the severity of the tissue damage.Conclusion: The results of this study indicated that vinpocetine possesses anti-inflammatory activity and are therapeutically effective in acetic acid induced ulcerative colitis at a dose of 5 mg/kg. More pronounced effects were observed at higher dose, i.e., 10 mg/kg. The combination of sulfasalzine + vinpocetine was also found to be effective as compared to high dose of vinpocetine (10 mg/kg).

Study on the Desulfurization Performance of N-Type and P-Type Semiconductor Pyrolysis Char Composite Catalyst

Ordos coal pyrolysis product roasted under 750oC was used as desulfurization sorbents to investigate the effect of flue gas desulfurization performance of supported metal catalyst. There were 14 kinds of metal oxides from groups IA, IIA, VIB, VIIB, VIII, IB and IIIB chosen as active components to prepare metal oxide supported catalysts by equivalent volume impregnation method. And the mechanism of pyrolysis was studied. The similarities of desulfurization performance among the same group of metal oxides were related to the structure of their outer electrons. In addtion, the influence of transition metal oxides on the desulfurization performance was related to metal oxide semiconductor type. Finally, the influence of the VIII group oxide catalyst of iron (Fe), Cobalt (Co), Nickel (Ni) on the desulfurization performance showed the characteristics of diversity related to their d percentage (%).

Handling, transfer, storage, and shipping of commercial thin film hydride disk target samples

Thin film hydride (i.e., elements that can react with hydrogen or its isotopes to form a chemical compound) targets are important for many applications, including accelerator research, oil-well logging, cancer research, various neutron devices, nuclear waste assay, process control studies, contraband detection, and for many other novel uses. They are very sensitive to air-oxidation and easily contaminated by improper handling. Targets must be handled very carefully after processing to minimize contamination from physical handling, particulate contamination, and air-exposure, which oxidize sensitive groups IIIB, IVB, and rare earth thin film materials, thus reducing their operating characteristics such as neutron output, and can produce arcing if used in neutron devices. This paper will discuss the development of handling techniques, special vacuum transfer, and shipping containers for thin film hydride target samples from postprocessing to transfer and shipment to a customer. Initial work began at the General Electric Neutron Devices Department, in Largo, FL, in the mid-1970s and was refined at the Los Alamos National Laboratory in Los Alamos, NM, in the mid to late 1990s. Studies were performed to determine the best physical handling techniques, procedures for reducing particulate contamination and for reducing air-exposure and moisture from targets. Items studied were argon or dry nitrogen filled gloveboxes, desiccators, vacuum shipping containers, and a new design loader in a glovebox (in 1993), with an International Organization for Standardization class 4 clean room dry nitrogen environment, with particle and moisture removal and measurements. Test samples of hydride thin films were used to study surface oxide contamination as a function of handling, transfer, and storage times utilizing Auger argon sputter thin film depth profiling techniques. Results have shown that argon filled gloveboxes and dry nitrogen filled desiccators, along with techniques used to minimize target air-exposure, and various vacuum ∼≤1 × 10−3 Torr (1.33 × 10−1 Pa) internal environment shipping containers initially pumped down to ∼1 × 10−7 Torr (1.33 × 10−5 Pa) or less, were adequate to supply customers with thin film hydride targets with surface oxides from 70 to 475 Å or 7.0 to 47.5 nm, as it takes ∼&amp;gt;500 nm to affect neutron output in neutron devices. A special dry nitrogen glovebox controlled clean room loader with a high-efficiency particulate air filter/fan module, and oxygen and water vapor monitors was developed to produce a pristine super clean environment with very low particulate and film surface oxide contamination. The authors demonstrated that we can ship thin film hydride targets of optimum quality adequate for many applications and can supply pristine targets when requested which are in a condition very close to that as processed directly out of a non-air-exposed loader. In addition, our results showed the relative oxidation susceptibility for the four occluder thin films studied: Sc &amp;gt; Zr &amp;gt; Er &amp;gt; Ti.

Effect of causes of surgical delay on early and late mortality in patients with proximal hip fracture

The purpose of this study was to investigate the reasons for delayed surgery in patients with proximal hip fracture and to compare differences in mortality between delayed surgery cases and non-delayed surgery cases. In addition, we evaluated causal factors for delayed surgery that affected differences in mortality. From 2003 to 2013, 1290 patients (1290 hips) with unilateral femoral neck or intertrochanteric fractures who underwent surgery were categorized into Group Ia (402 patients, early surgery group) and Group Ib (888 patients, delayed surgery group). The delayed surgery group was categorized as Group IIa (270 patients, pre-hospital delay group) and Group IIb (618 patients, post-hospital delay group). Among 618 patients with post-hospital delay, 165 patients in Group IIIa were defined as delayed surgery cases due to patient factors, and 453 patients in Group IIIB were defined as delayed surgery cases due to hospital factors. Early and late mortality was compared between each group. Of 1290 patients, 888 patients underwent delayed surgery (mean 7.5days, range 3-167days) after hip fracture. The cumulative mortality rate at 30, 60days, 3, and 12months was 0.7, 2.0, 3.0, and 9.5% in Group Ia, respectively, and 2.4, 4.5, 5.2, and 14.5% in Group Ib, respectively (p = 0.047, p = 0.027, p = 0.078, and p = 0.012, respectively). Of 618 patients with post-hospital surgery delay, the cumulative mortality rate at 30days and 12months was 4.8 and 21.2% in Group IIIa, respectively, and 1.8, and 12.6% in Group IIIb, respectively (p = 0.033 and p = 0.008, respectively). After adjustments, patient factors for delayed surgery (HR 2.780; 95% CI 1.012-7.640, p = 0.047) were significantly associated with death after hip fracture. This study demonstrated that delayed surgery was significantly related to 30-day and 1-year mortality. Surgery delay due to drugs' hold and medical comorbidity was related to 30-day mortality after adjustment.

Polarizability Effects Dominate the Chromatographic Retention Behavior of Spheroidal and Elipsoidal Metallofullerene Nanospheres

The chromatographic retention behavior of spherical and elipsodial metallofullerenes provides a unique class for studying subtle intermolecular dispersive (London effect) and inductive (Debye effect) solution-state/solid-phase interactions. The known trimetallic nitride endohedral metallofullerene A3N@C80 isomers are nearly spherical A3N@C80-Ih and ellipsoidal A3N@C80-D5h. These metallofullerene isomers are readily available with group IIIB and lanthanide trimetallic nitride clusters (A3N)6+. In the current study, chromatographic HPLC retention behavior is monitored for two different HPLC stationary phases, pentabromobenzyl and pyrenylethyl and augmented by density functional theory computational results. Although dipole moments, lanthanide contraction, and charge transfer from the internal cluster (A3N)6+ are important factors controlling chromatographic retention, our results suggest that the fullerene cage polarizability is the dominant factor controlling chromatographic separation of A3N@C80-Ih and el...

СОВЕРШЕНСТВОВАНИЕ ТАКТИКИ ЛЕЧЕНИЯ ТЯЖЁЛОЙ СОЧЕТАННОЙ ЧЕРЕПНО-МОЗГОВОЙ ТРАВМЫ С УЧЁТОМ КЛИНИЧЕСКИХ ПРОЯВЛЕНИЙ СИНДРОМА ЖИРОВОЙ ЭМБОЛИИ

Objective: The reduction the lethality in the acute period of severe combined craniocerebral injury (SCCI) by improving the treatment tactics, in terms of the clinical manifestations of fat embolism syndrome (FES). Methods: The results of treatment of 393 patients with SCCI at the age of 14 to 68 years are analyzed. Patients were divided into three groups: I group (traditional treatment) – 144 (36.7%); group II (optimized tactics) – 194 (49.3%); group III – children and adolescents aged 14-18 years – 55 (14.0%). In turn, patients of the II group are divided into the following subgroups: IIA (FES) – 33 (8.4%); IIB (SCCI) – 99 (25.6%); IIC (FES + SCCI) – 62 (15.7%). Results: The implementation of optimized treatment tactics in combination with the identification and pathogenetic treatment of FES contributed to a reduction in deaths compared to traditional approaches. Overall mortality was 31.0%; 40.3% in group I; 12.2% in group IIA; 23.2% in group IIB; 40.3% in group IIB, and group IIIB – 21.8%. In a differentiated analysis, postoperative lethality as a whole was 26.5%; in group I – 34.1%; in group IIA – 5.3%; in group IIB – 20.8%; in group IIB – 33.9%, and in III group – 14.3%. Mortality after conservative treatment was 55.7%; in group I – 83.3%; in group IIA – 21.4%; in group IIB – 100.0%; in group IIB – 100.0%, and in group III – 35.0%. Conclusion: The suggested approaches in the treatment of SCCI by improving tactics, properly the clinical manifestations of FES refer to effective ways to reduce the lethality in the acute period of traumatic illness. Keywords: Severe combined craniocerebral injury, fat globulemia, fat embolism syndrome, optimized treatment tactics, lethality.

"Ormocer an innovative technology": A replacement for conventional cements and veneer? A comparative in vitro analysis.

Objective:This in vitro study was designed to assess shear bond strength (SBS) of ormocer flowable (OF) resin as a luting agent, ormocer as an indirect veneer material with portrayal of modes of failures using scanning electron microscope (SEM).Materials and Methods:Sixty maxillary central incisors were divided into Group I, II, and III with 20 samples each based on luting cement used. They were OF, self-adhesive (SA) cement, and total etch (TE) cement. These groups were subdivided into “a” and “b” of ten each based on the type of veneering materials used. Veneer discs were fabricated using Ormocer restorative (O) and pressable ceramic (C). Specimens were thermocycled and loaded under universal testing machine for SBS. The statistical analysis was done using one-way ANOVA post hoc Tukey honest significant difference method.Results:A significant difference was observed between the Groups I and II (P < 0.05). The highest mean bond strength when using ormocer veneer was obtained with the Group Ia (19.11 ± 1.92 Mpa) and lowest by Group IIa (8.1 ± 1.04 Mpa), whereas the highest mean bond strength while using ceramic veneer was of similar range for Group Ib (18.04 ± 4.08 Mpa) and Group IIIb (18.07 ± 1.40 Mpa). SEM analysis revealed OF and TE presented mixed type of failure when compared with SA where failure mode was totally adhesive.Conclusion:OF was found equally efficient like TE. Bond strength of ormocer as a veneer was not inferior to ceramic making it one of the promising additions in the field of dentistry.

Comparative evaluation of antimicrobial efficacy of an alternative natural agent for disinfection of toothbrushes.

Objective:The aim of this study was to assess the antimicrobial potency of aqueous extract of Psidium guajava leaves in two different concentrations as a toothbrush disinfectant against three oral bacterial species.Materials and Methods:Aqueous extracts of P. guajava leaves were prepared at 20% and 30% concentrations and 0.2% chlorhexidine was used as control. The toothbrushes were equally divided into 9 groups with 10 toothbrushes per disinfectant, which were contaminated with Streptococcus mutans, Lactobacillus acidophilus, and Enterococcus faecalis. Microbial culture was done after 5 min and 3 h of decontamination.Results:Group Ia and Ib showed that the presence of E. faecalis was observed in 8 (40%) of 20 toothbrushes. Group IIa and IIb showed a significant reduction in colony forming unit/toothbrush during 3 h evaluation. Group IIIa and IIIb showed nil growth during 3 h evaluation. Nil growth was observed with the control group for all three organisms. Statistically significant values were obtained for 5 min (P < 0.001) and 3 h (P < 0.001) disinfection period against L. acidophilus at two different concentrations.Conclusion:Aqueous extracts of guava leaves can be used as an alternative organic product for disinfection of toothbrushes.

Effect of vitamin D supplementation on respiratory functions and laboratory parameters in asthmatic patients

Objectives The present work was designed to investigate whether vitamin D status has a relationship with the pulmonary function test results of asthmatics and assess the impact of vitamin D on interleukin-10 (IL-10). Background The incidence of bronchial asthma and other allergic disorders has increased over the past decades in nearly all nations. Many studies have suggested the role of vitamin D deficiency in both T-helper-1 and T-helper-2 diseases. Asthma is characterized by a shift toward a Th2 cytokine-like disease, either as overexpression of Th2 or as underexpression of Th1; however, the association between vitamin D, IL-10, and asthma remains uncertain. In this study, the associations of vitamin D level and IL-10 with asthma were evaluated. Patients and methods This study was conducted on 75 adult participants, aged 18 years or above, who were divided into three groups. Group I consisted of 25 adults with bronchial asthma who were treated with a classic regimen; group II consisted of another 25 adults with bronchial asthma who were treated with a combination of classic regimen and vitamin D supplementation at a dose of 2000 IU (50 mg) for 3 months; and group III consisted of 25 adults who served as controls. All patients were assessed at the beginning of the study (groups Ia, IIa, and IIIa) and at the end of 3 months (groups Ib, IIb, and IIIb). Results There was an inverse relationship between BMI in asthmatic patients and vitamin D level. Vitamin D level had direct and significant correlations with both IL-10 (r1 = 0.206,P≤ 0.001) and predicted forced expiratory volume in 1 s (FEV1) (r2 = 0.083,P≤ 0.001). There were significant associations between vitamin D level and the number of hospitalizations or unscheduled visits (P Conclusion These results showed that serum 25-hydroxy vitamin D levels were deficient in asthmatics, and there was a direct and significant relationship between vitamin D levels, IL-10, and pulmonary function test outcomes in asthmatic patients.

Scandium in the open ocean: A comparison with other group 3 trivalent metals

AbstractLittle is known about the distribution of scandium (Sc) in the open ocean. Since the 1970s there has been only one published depth profile of dissolved Sc. The work presented here reports depth profiles of dissolved Sc from GEOTRACES cruises in the North Atlantic, North Pacific, and South Pacific. This work also compares the reactivity of Sc with its trivalent periodic table groupmates in Group IIIB, yttrium (Y) and lanthanum (La), and Group IIIA, aluminum (Al) and gallium (Ga). Yttrium and La are classic nutrient‐type metals that increase in concentration in aging deep water; Al and Ga are classic scavenged‐type metals that do the opposite. Results indicate that Sc is a hybrid‐type metal with an inferred residence time on the order of 1000 years, and that Sc's inorganic speciation and reactivity are similar to Fe's and have the potential to give insights into the nonnutrient side of oceanic Fe cycling.