Moderate Inverse Correlation Research Articles

Patient Height, Weight, BMI and Age as Predictors of Gracilis Muscle Free-Flap Mass in Lower Extremity Reconstruction.

Gracilis muscle flap is commonly used for the reconstruction of defects of the lower extremities. Preoperative evaluation of gracilis muscle dimension is a key aspect in surgical planning. This study aimed to determine whether patient height, weight, body mass index (BMI) and age are reliable proxy measurements of the mass of gracilis muscle flap. Twenty-two patients treated for lower extremity reconstruction with free gracilis flap between December 2010 and December 2014 were considered. The relationships between the mass of gracilis muscle and patient height, weight, BMI and age were assessed with Pearson's product moment correlation coefficient. Defect size, mass of gracilis muscle resected and surgical outcomes were also evaluated. There was a moderate correlation between the mass of the gracilis muscle and patient height (r=0.4), weight (r=0.4), and BMI (r=0.3), and moderate inverse correlation with age (r=-0.04). Lower extremities defects ranged in size from 3×4 cm (12 cm2) to 26×11 cm (286 cm2) with a mean of 81.6 cm2 All defects were reconstructed with the gracilis muscle, which required a resection ranging between 3 g and 105 g (mean=37.4 g) to adapt the flap to the recipient site. Complete flap loss was observed in one case. In our series, the mass of the gracilis muscle flap was predictable in relation to height, weight, BMI, and age, which can be considered reliable proxy measurements. This will contribute to adequate flap selection for microsurgical reconstruction of lower extremity defects.

Greater Stance Time Variability is Associated with Lower Step Activity in Older Adults

Previous research has shown that older adults with greater gait variability are at a higher risk for falling. Falls increase fear of falling and may subsequently result in mobility disability manifesting as decreased physical activity. Physical activity is commonly gauged from continuous step activity monitoring. While decreased step activity has been associated with impaired gait, the associations between gait variability and step activity are not understood. PURPOSE: To examine the relationship between gait variability and step activity in older adults. METHODS: Spatiotemporal gait parameters were recorded for 19 healthy older adults (mean age 74.5 ± 6.3 years; 9 males/ 10 females) walking at a normal walking speed across a GAITRite walkway for 5 trials. Step activity (# of steps) was collected using a research-grade step activity monitor for 7 consecutive days. Average number of steps for the 7 days was used. Coefficient of variation (defined as % of SD over mean) of gait speed, stride length, step width, swing time, stance time and double support time were calculated. Pearson’s and Spearman’s correlation coefficients were used based on normality to determine the relationship between gait variability and step activity. RESULTS: Stance time variability showed significant moderate inverse correlation with step activity (rho = -0.482, p = 0.036). Swing time variability showed moderate inverse correlation with step activity with a trend towards significance (r = -0.451, p = 0.052). Variability of gait speed (rho = -0.349, p = 0.143), stride length (r = -0.3, p = 0.212), step width (rho = -0.088, p = 0.721), and double support time (rho = -0.249, p = 0.304) showed weak inverse but not significant correlation with step activity. CONCLUSION: In general, gait variability seems to be inversely related to step activity in older adults meaning those with greater gait variability showed lower step activity. In particular, stance time variability has earlier shown to be critical in identifying older adults with mobility disability and those older adults at risk for future disability. Our finding of decreased step activity in those older adults with increased stance time variability suggests that step activity monitoring could provide surrogate and complimentary measures to identify mobility disability in older adults.

18F-FDG PET/CT in immunocompetent patients with primary central nervous system lymphoma: Differentiation from glioblastoma and correlation with DWI

Objectives18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is useful for the detection of cancerous lesions, and FDG uptake is related to the apparent diffusion coefficient (ADC) derived from diffusion-weighted imaging (DWI) of extracranial tumors. The purpose of our study was to investigate the ability of FDG PET/CT in distinguishing primary central nervous system lymphoma (PCNSL) from glioblastoma multiforme (GBM) and to explore the relationship between 18F-FDG uptake and the ADC in patients with PCNSL. MethodsWe reviewed 92 patients (40 with PCNSL and 52 with GBM) who underwent FDG PET/CT scans at disease onset. The maximum standardized uptake value (SUVmax), tumor to normal contralateral cortex activity (T/N) ratio, SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of tumor lesions were calculated. Receiver operating characteristic (ROC) curves were generated to determine the diagnostic performance for FDG PET-related parameters to differentiate PCNSL from GBM. Twenty-eight patients with PCNSL (with 34 lesions) also underwent diffusion-weighted imaging. Pearson’s correlation analysis was used to assess the relation between SUV- and ADC-derived parameters. ResultsThe SUVmax, T/N ratio, SUVmean, and TLG values were significantly higher in PCNSL than in GBM. Comparative ROC analysis indicated that the SUVmax had a greater area under the curve (AUC) of 0.910 than the T/N ratio (0.905, P = .85), SUVmean (0.836, P = .0006), or TLG (0.641, P < 0.0001). The T/N ratio had the highest specificity (94.23%) for differentiating PCNSL from GBM, while the SUVmax had the most optimal sensitivity (92.31%). Further combined analysis of the indices did not significantly improve the AUC. Moderate inverse correlations between the SUVmax, SUVmean, TLG, and the ADC ratio (rADC) were found in PCNSLs (r = −0.526, P = .002; r = −0.504, P = .004; and r = −0.483, P = .006; respectively). ConclusionsThe SUVmax and T/N ratio may be reliable measures for differentiating PCNSLs from GBMs. Additionally, FDG metabolism indices were inversely proportional to the rADCs of PCNSL lesions.

Contribution of susceptibility- and diffusion-weighted magnetic resonance imaging for grading gliomas.

The aim of the present study was to assess the value of susceptibility-weighted imaging (SWI) and diffusion-weighted imaging (DWI) in the grading of gliomas and to evaluate the correlation between these quantitative parameters derived from SWI and DWI. A total of 49 patients with glioma were assessed by DWI and SWI. The evaluation included the ratio of apparent diffuse coefficient values between the solid portion of tumors and contralateral normal white matter (rADC) and the degree of intratumoral susceptibility signal intensity (ITSS) within tumors. Receiver operating characteristic curve (ROC) analyses were performed and the area under the ROC curve was calculated to compare the diagnostic performance, determine optimum thresholds for tumor grading, and calculate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for identifying high-grade gliomas. The correlation between DWI- and SWI-derived parameters was also evaluated. The rADC and the degrees of ITSS within tumors were significantly higher in high-grade gliomas than those in low-grade gliomas. ROC curve analysis indicated that the rADC was a better index for grading gliomas than the ITSS degree. Statistical analysis demonstrated a threshold value of 1.497 for rADC to provide a sensitivity, specificity, PPV and NPV of 86.2, 85.0, 89.3 and 81.0%, respectively, for determining high-grade gliomas. A degree of ITSS of 1.5 was defined as the threshold to identify high-grade gliomas and sensitivity, specificity, PPV and NPV of 82.8, 75.0, 82.8 and 75.0% were obtained, respectively. Furthermore, a moderate inverse correlation between rADC and the ITSS degree was revealed. Combination of SWI with DWI may provide valuable information for glioma grading.

A functional polymorphism in the pre-miR-146a gene is associated with the risk of nonsyndromic orofacial cleft.

microRNAs (miRNAs) are widely involved in craniofacial development, and genetic variants of miRNAs may be associated with the risk of nonsyndromic orofacial cleft (NSOC). Here, we systematically selected five single nucleotide polymorphisms (SNPs) of miRNAs and investigated the associations between these variants and NSOC susceptibility in a two-stage case-control study including 1,406 NSOC patients and 1,578 controls from the Chinese population. We found that compared with the C allele, the rs2910164 G allele of pre-miR-146a was associated with an increased risk of NSOC (additive model: odds ratio [OR]=1.17, 95% confidence interval [CI]: 1.06-1.30, P=0.002), including both cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO). Bioinformatic prediction and functional assays revealed that the C allele of rs2910164 was significantly associated with inhibited HEK-293 and HEPM cell proliferation and decreased abundance of TRAF6. Both miR-146a and TRAF6 were expressed in the lip tissue samples of NSOC patients, and a moderate inverse correlation was observed between them. Taken together, these results demonstrated that miR-146a/rs2910164 is associated with susceptibility to NSOC, providing novel insights into the genetic etiology and underlying biology of NSOC.

DNA methylation profiling of asbestos-treated MeT5A cell line reveals novel pathways implicated in asbestos response.

Occupational and environmental asbestos exposure is the main determinant of malignant pleural mesothelioma (MPM), however, the mechanisms by which its fibres contribute to cell toxicity and transformation are not completely clear. Aberrant DNA methylation is a common event in cancer but epigenetic modifications involved specifically in MPM carcinogenesis need to be better clarified. To investigate asbestos-induced DNA methylation and gene expression changes, we treated Met5A mesothelial cells with different concentrations of crocidolite and chrysotile asbestos (0.5 ÷ 5.0µg/cm2, 72h incubation). Overall, we observed 243 and 302 differentially methylated CpGs (≥ 10%) between the asbestos dose at 5µg/cm2 and untreated control, in chrysotile and crocidolite treatment, respectively. To examine the dose-response effect, Spearman's correlation test was performed and significant CpGs located in genes involved in migration/cell adhesion processes were identified in both treatments. Moreover, we found that both crocidolite and chrysotile exposure induced a significant up-regulation of CA9 and SRGN (log2 fold change > 1.5), previously reported as associated with a more aggressive MPM phenotype. However, we found no correlation between methylation and gene expression changes, except for a moderate significant inverse correlation at the promoter region of DKK1 (Spearman rho = - 1, P value = 0.02) after chrysotile exposure. These results describe for the first time the relationship between DNA methylation modifications and asbestos exposure. Our findings provide a basis to further explore and validate asbestos-induced DNA methylation changes, that could influence MPM carcinogenesis and possibly identifying new chemopreventive target.

Patient dignity inventory (PDI) questionnaire: the validation study in Italian patients with solid and hematological cancers on active oncological treatments.

In Oncology, little is known about dignity-related distress and the issues that influence the sense of dignity for patients. We validated the Patient Dignity Inventory (PDI) questionnaire in Italian patients on oncological active treatments. After the translation procedures, the PDI was administered to 266 patients along with other questionnaires to assess the psychometric properties of the Italian version of PDI. Factor structure was tested by both explorative and confirmatory factor analyses. Concurrent validity was tested through convergent and divergent validity with validated questionnaires inquiring about physical and psychological symptoms, and religiosity. The test/retest reliability was assessed through the concordance coefficient of Linn (two-week interval, 80 patients). The explorative analysis suggested one factor only loading highly on all the 25 items (>.45) and explaining the 48% variance; confirmative analysis and Cronbach alpha (0.96) confirmed the adequacy of the one-factor model. In the 2-week test-retest study, a concordance coefficient of 0.73 (95% CI, 0.64-0.83) was found. High correlations of problems with dignity were found with both physical and psychological symptoms (0.52 and 0.64 rho coefficient, respectively), and a moderate inverse correlation with spiritual well being (-.40). The dignity construct, as measured by PDI, proved to be orthogonal to that of religiosity (-.02). The Italian version of PDI is a valid and reliable tool to evaluate the dignity related-distress in out-patients with solid and hematological cancers, on active oncological treatments, in non advanced stages of the disease.

Health related quality of life of people with non-epileptic seizures: The role of socio-demographic characteristics and stigma

PurposePeople with non-epileptic seizures (NES) consistently report poorer Health-Related Quality of Life (HRQoL) than people with epilepsy. Yet, unlike in epilepsy, knowledge of how social factors influence the HRQoL of adults with NES is limited. To add to the evidence base, this study explores the relationship between HRQoL and perceived stigma among adults with NES, and the role of socio-demographic characteristics. MethodsData was gathered from a survey of 115 people living with the condition, recruited from online support groups. Participants provided socio-demographic and health-related data and completed a series of questions investigating their HRQoL (QOLIE-31) and stigma perceptions (10-item Epilepsy Stigma Scale). ResultsParticipants were found to experience high levels of perceived stigma (median 5.2, mean 4.9). A significant and moderate inverse correlation was observed between HRQoL and stigma (rs − 0.474, p = < 0.001); suggesting higher perceptions of stigma contribute to poorer HRQoL among adults with NES. Stigma perceptions were found to be most strongly associated with the seizure worry (rs = − 0.479), emotional wellbeing (rs = − 0.421), and social functioning (rs = 0.407) HRQoL domains. Participants who reported being in employment or education were found to have significantly better HRQoL than those who were not (p = < 0.001). ConclusionMore (qualitative and quantitative) research is justified to understand how – and why – those with the condition experience stigmatisation, and the factors that impede and help facilitate the participation of people with NES in education and employment.

Progesterone receptor expression and Ki-67 labelling index of meningiomas in the Lagos university teaching hospital.

Meningioma in Nigeria has been poorly studied. Its location within the intracranial cavity is associated with significant morbidity and mortality. Even when completely excised, it has a tendency to recur and this is associated with repeat operations and shortened survival. The World Health Organization (WHO) grade, progesterone receptor (PR) expression and Ki-67 index are predictive for recurrence and are, therefore, useful for individualised management. The aim of this study was therefore to determine the PR expression and Ki-67 index of meningiomas received in our institution. A retrospective review of the forms, slides and results of meningiomas received at the Department of Anatomic and Molecular Pathology, Lagos University Teaching Hospital, from January 2005 to December 2014, was undertaken. Immunohistochemistry for PR and Ki-67 was performed and correlated with other histologic parameters. Meningioma was the most common primary CNS tumour seen. The male-to-female ratio was 1:3.8; with a peak in the 4th decade. Most cases were WHO Grade I tumours (86.1%) and transitional histologic subtype (31.8%). PR immunoreactive score and Ki-67 index varied widely within WHO Grade I tumours and overlapped considerably with Grade II tumours. PR expression reduced and Ki-67 index increased with increasing WHO grade (P = 0.000). A moderate inverse correlation was found between Ki-67 index and PR score (R = -0.7371). The peak age of meningioma in our patients is five decades earlier than in western populations. Although PR expression reduces and Ki-67 index increases with increasing grade, there is nevertheless a considerable overlap. Management therefore must be individualised.

Elevated Surfactant Protein Levels and Increased Flow of Cerebrospinal Fluid in Cranial Magnetic Resonance Imaging.

Surfactant proteins (SPs) are a multifunctional group of proteins, responsible for the regulation of rheological properties of body fluids, host defense, and cellular waste clearance. Their concentrations are changed in cerebrospinal fluid (CSF) of patients suffering from communicating hydrocephalus. Hydrocephalic conditions are accompanied by altered CSF flow dynamics; however, the association of CSF-SP concentrations and CSF flow has not yet been investigated. Hence, the aim of this study was to evaluate the association between SP concentrations in the CSF and marked CSF flow phenomena at different anatomical landmarks of CSF spaces. Sixty-one individuals (15 healthy subjects and 46 hydrocephalus patients) were included in this study. CSF specimens were analyzed for SP-A, SP-B, SP-C, and SP-D concentrations by the use of enzyme-linked immunosorbent assays (ELISA). CSF flow was evaluated in axial T2_turbo inversion recovery magnitude (TIRM)-weighted and sagittal T2-weighted magnetic resonance imaging sections using a 4-grade scale (1-no flow, 2-subtle flow, 3-moderate flow, and 4-strong flow). CSF-SP concentrations (mean ± standard deviation) of the overall collective were as follows: SP-A = 0.73 ± 0.58ng/ml, SP-B = 0.17 ± 0.93ng/ml, SP-C = 0.95 ± 0.75ng/ml, and SP-D = 7.43 ± 5.17ng/ml. The difference between healthy controls and hydrocephalic patients regarding CSF concentrations of SP-A (0.34 ± 0.22 vs. 0.81 ± 0.59ng/ml) and SP-C (0.48 ± 0.29 vs. 1.10 ± 0.79ng/ml) revealed to be statistically significant as calculated by means of ANOVA (p values of 0.022 and 0.007, respectively). CSF flow voids were detectable at all investigated landmarks of the CSF spaces (foramina of Monro, third ventricle, mesencephalic aqueduct, prepontine cistern, fourth ventricle, cisterna magna, and craniocervical junction). CSF flow voids, reported as mean ± standard deviation, revealed to be significantly increased in hydrocephalic patients compared to controls as calculated by means of ANOVA (respective p values are given in brackets following values of descriptive statistics) at the following sites: foramina of Monro (1.60 ± 0.91 vs. 2.37 ± 0.99, p = 0.01), fourth ventricle (1.67 ± 0.98 vs. 2.52 ± 1.05, p = 0.007), and the cisterna magna (1.93 ± 1.10 vs. 2.72 ± 1.13, p = 0.022). Spearman's rank order calculation identified significant correlations for CSF flow voids at the foramina of Monro and the third ventricle with SP-A (r = 0.429, p = 0.001 and r = 0.464, p < 0.001) and CSF flow void at the mesencephalic duct with SP-D (r = - 0.371, p = 0.039). Furthermore, SP-C showed a moderate inverse correlation with age (r = - 0.302, p = 0.022). The present study confirmed statistically significant differences in SP-CSF concentrations between healthy controls and hydrocephalic patients. Additionally, significant correlations between SP concentrations in CSF with increased CSF flow were identified. These findings underline the role of SPs as regulators of CSF rheology.

Investigation of TGFβR2 SNP rs4522809, Osteopontin, TGF β1 and their association with dilatative pathology of ascending thoracic aorta

BackgroundDilatative pathology of the ascending thoracic aorta (DPATA) is characterized by the aortic wall expansion more than 1.5 and could be accompanied by aortic wall rupture. Mutations of TGFBR2 gene demonstrated an association with syndromic DPATA and altered pathway of transforming growth factor beta (TGF-β). Elevated TGF-β1 level has been found in blood samples in DPATA group. Moreover, elevated osteopontin (OPN) level was associated with mutations of TGFBR2 gene. Based on recently published findings, we aimed to evaluate genotyping results of TGFBR2 rs4522809 and the association with circulating OPN and TGF-β1 concentrations within DPATA patients. Methods and findingsTGFBR2 SNP genotyping assay was performed by quantitative real-time PCR, TGF-β1 and OPN concentrations were measured using enzyme-linked immunosorbent assay. Genotyping results showed G allele to be associated with DPATA (p = .01), the presence of G allele significantly increased the possibility of DPATA by 1.67 times (OR = 1.67, 95%, CI = 1.12–2.47). TGF-β1 concentration was significantly higher in DPATA subjects compared with Reference group (p = 0,001). Finally, we found moderate inverse correlation (r = −0,524) between circulating TGF-β1 and OPN levels within DPATA subjects (p = 0,002), as increasing levels of TGF-β1 cytokine significantly decrease concentration of OPN. ConclusionsThis is the first report on the association between previously defined TGFβR2 SNP rs4522809 linked with dilatation of ascending thoracic aorta. Also, for the first time we report the inversed correlation between circulating TGF-β1 and OPN concentrations in DPATA subjects indicating the possible biomarkers for DPATA.

Níveis de estresse e qualidade de vida de professores do ensino superior

Objetivo: avaliar os níveis de estresse e de qualidade de vida de professores de uma instituição federal de nível superior. Método: estudo transversal, realizado com 35 professores de um Instituto Federal, no Rio de Janeiro, em dezembro de 2015. Os participantes foram avaliados através do Inventário de Sintomas de Stress para Adultos de Lipp e do questionário World Health Organization Quality Of Life-Bref. Foi realizada correlação entre estresse e qualidade de vida, e valores de p&lt;0,05 foram considerados significativos. Resultados: verificou-se que 46% da amostra possuem sintomas de estresse. A média da qualidade de vida dos professores foi considerada como regular. Uma correlação inversa moderada foi observada entre estresse e qualidade de vida (r=-0,5; p&lt;0,03). Conclusões: parte da amostra possui sintomas de estresse e estes podem proporcionar uma piora da qualidade de vida. Estes sintomas podem não estar unicamente relacionados com fatores ocupacionais.

“Ineffective Esophageal Motility” Is Associated With Impaired Bolus Clearance but Does Not Correlate With Severity of Dysphagia

Introduction: The most recent Chicago Classification (CC) for esophageal motility disorders simplified the definition of minor motility disorders. Ineffective esophageal motility (IEM) is now defined as a distal contractile integral (DCI) <450 mmHg/s/cm in at least 50% of ten liquid swallows on high resolution esophageal manometry (HREM). It remains unclear whether this definition correlates with degree of dysphagia symptoms. Methods: Between 2013-2016, patients presenting for HREM prospectively rated their symptoms using the Eckardt score (Figure 1). Inclusion criteria were patients with non-obstructive dysphagia, and Eckardt dysphagia score of ≥1. Patients with major motility disorders were excluded. We retrospectively reviewed topography plots in order to classify patients according to CC version 3. Symptom scores between patients with IEM (group A) and patients with normal HREM (group B) were compared using two-tailed t-tests. Spearman's correlation coefficient was calculated to determine correlation between symptoms and % bolus clearance using impedance in both groups.Figure: Moderate inverse correlation between dysphagia score and % bolus clearance.Results: 241 patients were screened for inclusion; 33 patients (26 female) met criteria for Group A and 44 patients (36 female) for Group B. There was no difference between the two groups in mean symptom severity scores for dysphagia (1.63 vs. 1.61, P=0.89), chest pain (0.67 vs. 0.75, P=0.64), regurgitation (1.06 vs. 0.85, P=0.32), or weight loss (0.85 vs. 0.49, P=0.11). The % bolus clearance was significantly lower in group A (46.5% vs. 76.7%, P>0.01). There was a moderate inverse correlation between dysphagia score and % bolus clearance (R=-0.37) in group A, but no correlation between dysphagia score and % bolus clearance in group B (R=0.09), (Figure 2). Conclusion: The definition of IEM has evolved over the years, with the latest classification system simplifying its definition. Theoretically, patients with greater percentage of weak or failed swallows would have greater degrees of dysphagia compared to those with <50%, as the latter is considered a normal motor pattern. In our study, the classification of IEM did not discriminate from normal studies for symptom severity. However, patients with IEM did have a correlation between dysphagia score and bolus clearance whereas those without IEM did not. Therefore, adding impedance information to motor pattern classification increases the yield and should be considered in the assessment of dysphagia severity in minor motility disorders.Table: Eckardt Score.

Heart rate and blood pressure variations after transvascular patent ductus arteriosus occlusion in dogs

The objective of the study was to retrospectively analyse the cardiovascular effects that occurs following the transvascular occlusion of patent ductus arteriosus in dogs.Sixteen anaesthesia records were included. Variables were recorded at the time of placing the arterial introducer, occlusion of the ductus, and from 5 to 60min thereafter, including, among the other, heart rate, systolic, diastolic and mean arterial blood pressure. The maximal percentage variation of the aforementioned physiological parameters within 60min of occlusion, compared with the values recorded at the introducer placing, was calculated. The time at which maximal variation occurred was also computed. Correlations between maximal percentage variation of physiological parameters and the diameter of the ductus and systolic and diastolic flow velocity through it were evaluated with linear regression analysis.Heart rate decreased after occlusion of the ductus with a mean maximal percentage variation of 41.0±14.8% after 21.2±13.7min. Mean and diastolic arterial blood pressure increased after occlusion with a mean maximal percentage variation of 30.6±18.1 and 55.4±27.1% after 19.6±12.1 and 15.7±10.8min, respectively. Mean arterial blood pressure variation had a significant and moderate inverse correlation with diastolic and systolic flow velocity through the ductus.Transvascular patent ductus arteriosus occlusion in anaesthetised dogs causes a significant reduction in heart rate and an increase in diastolic and mean blood arterial pressure within 20min of closure of the ductus.

THE INFLUENCE OF HIV INFECTION DURATION BEFORE ANTIRETROVIRAL THERAPY ON IMMUNOLOGICAL TREATMENT FAILURE.

Some patients with HIV infection receiving virologically effective antiretroviral therapy (ART) did not show any growth in CD4 cell count during treatment. Despite the long-term treatment of patients, immunodeficiency persisted. In the observational cohort retro/prospective study we investigated the effect of the duration of HIV infection before starting the antiretroviral therapy on the development of immunological treatment failure. In a group of 140 HIV-infected patients a moderate inverse correlation was found between the duration of HIV infection and CD4 cell gain after 6 months, 1, 2 and 3 years of ART (r = -0.33, p < 0.01; r = -0.3, p < 0.01; r = -0.3, p < 0.01; r = -0.29, p < 0.01, respectively). In the case of ART starting at CD4 count of 200-350 cells/mcl statistically significant differences were revealed in the levels of relative CD4 count at 6 months, 1, 2 and 3 years of ART in sub-groups with durations of HIV infection prior to initiating therapy of 1-8 years and > 8 years (p = 0.035; p = 0.015; p = 0.05; p = 0.05, respectively). In patients who started ART with CD4 levels > 200 cells/mcl after 8 years of HIV infection, the risk of immunological treatment failure is 4 times higher as compared to patients with the same CD4 level, but lesser duration of HIV infection. The shorter the duration of HIV infection, the greater the increase in CD4 cell count. When starting ART at CD4 level of 200-350 cells/mcl, restoration of CD4 count is more intense in the group with lesser period of HIV infection. A negative effect of the >8-year infection duration before the start of ART on the development of the immunological treatment failure was observed in a subgroup with a starting level of CD4 > 200 cells /mcl.

Impact of light transmittance mode on polymerisation kinetics in bulk-fill resin-based composites

Objectivesto determine the mode of light transmission and its impact on the polymerisation kinetic in modern bulk-fill resin-based composites (B-RBC). Materials and methodsFour low-viscosity methacrylate-based and one high-viscosity ormocer-based B-RBCs were considered. One material was available in three different shades that were all analyzed. Polymerization kinetic and light transmittance were assessed in 2 and 4mm specimen depths. Incident and transmitted irradiance and radiant exposure were measured in real-time on a laboratory-grade spectrometer. ResultsA progressive enhanced light transmittance during polymerisation was identified in all materials except for TetricEvoFlow BulkFill, which became progressively opaque in all shades. One-way ANOVA and multivariate analysis (α=0.05) were performed. The parameter material has a significant (p<0.001) effect on DC (ηP2=0.856) and light transmittance parameters (irradiance, ηP2=0.965; radiant exposure, ηP2=0.956); specimen depth influences only transmittance (ηP2=0.978; 0.980). DC variation in time was best described by an exponential sum function (R2>0.95), differentiating between the gel- and the glass-phase and revealing a faster initiation of polymerization and a slower transition into the glass-phase by lowering the filler volume. Depth retarded the transition into the glass-phase, but did not alter DC measured 300s post-irradiation. Moderate inverse correlation was identified among DC and filler volume% (−0.646) or filler weight% (−0.403), while no correlation among DC and light transmittance (p=0.141; 0.125). The maximal rate of carbon-carbon double bond conversion varied within the analyzed materials but was independent from specimen’s depths. ConclusionsLight transmission changes during polymerization do not alter polymerization kinetics in modern B-RBCs. DC 300s post-irradiation was maintained with depth, while light was attenuated, the faster the more translucent the material was. DC and quality of curing cannot be related to light transmittance in B-RBCs.

From Environment to Mating Competition and Super-K in a Predominantly Urban Sample of Young Adults.

Recent research suggests human life history strategy (LHS) may be subsumed by multiple dimensions, including mating competition and Super-K, rather than one. In this study, we test whether a two-dimensional structure best fit data from a predominantly urban sample of young adults ages 18–24. We also test whether latent life history dimensions are associated with environmental harshness and unpredictability as predicted by life history theory. Results provide evidence that a two-dimensional model best fit the data. Furthermore, a moderate inverse residual correlation between mating competition and Super-K was found, consistent with a life history trade-off. Our findings suggest that parental socioeconomic status may enhance investment in mating competition, that harshness might persist into young adulthood as an important correlate of LHS, and that unpredictability may not have significant effects in young adulthood. These findings further support the contention that human LHS is multidimensional and environmental effects on LHS are more complex than previously suggested. The model presented provides a parsimonious explanation of an array of human behaviors and traits and can be used to inform public health initiatives, particularly with respect to the potential impact of environmental interventions.

Peripheral Arterial Tonometry in Pulmonary Vasculitis.

Vascular wall inflammation in primary vasculitides results in diminished vessel dilation and finally impaired blood flow, causing multiple organs dysfunction and ultimate damage. In granulomatosis with polyangiitis (GPA), the inflammatory process concerns small and medium sized vessels and its pulmonary location is often predominant. The pivotal role in the development of that pathology plays vascular endothelium. Endothelial vasodilatory function strongly depends on the instant production and release of nitrogen oxide (NO), a potent local factor controlling vascular tonus. NO output is triggered by a variety of stimuli, especially by ischemia. The endothelial vasodilatory ability can be measured indirectly by a few of methods, one of them is peripheral arterial tonometry (PAT). The method assesses reactive hyperemia, mediated mostly by NO release, as a response to vessel occlusion. The vasodilatory reaction depends on the quality of the endothelium which deteriorates with time of GPA disease progression. The aim of the present study was to estimate a correlation between the clinical status, reflected by the disease extent index (DEI), and the vasodilatory endothelial function reflected by the index of arterial reactive hyperemia (RHI), measured by PAT in 27 patients with GPA, having a significant pulmonary involvement. We found a moderate inverse correlation between DEI and log-transformed RHI (r=-0.46, p<0.05). The conclusion is that impaired endothelial function, as assessed by RHI-PAT, might predict the GPA progression.

Ground-Penetrating Radar Water Content Mapping of Golf Course Green Sand Layers

Information on the spatial distribution of water content across the sand layer component of a golf course green can be important to golf course superintendents for evaluating drainage effectiveness and scheduling irrigation. To estimate the bulk volumetric water content of the sand layer at point locations across the green, a technique was developed that combined (1) depth (or thickness) of the sand layer measured with a steel shaft tile probe, (2) radar signal two-way travel time from the base of the sand layer obtained using a ground-penetrating radar (GPR) system with 900 MHz antennas, and (3) an empirical equation relating porous media dielectric constant to water content. To test this technique, two GPR surveys were conducted on the Nursery Green at the Double Eagle Golf Club near Galena, Ohio, and two additional GPR surveys were carried out on the 9th Hole Green at the Delaware Golf Club near Delaware, Ohio. For comparison, time-domain reflectometry (TDR) water content values for the sand layer near the ground surface were obtained concurrent with each of the four GPR surveys. Results of the four golf course green GPR/TDR surveys carried out on September 8 and 9, 2014 (Double Eagle Golf Club - before and after irrigation, respectively), and April 21 and 29, 2015 (Delaware Golf Club) show that the sand layer water contents determined with GPR respectively averaged, 18.8%, 25.2%, 12.2%, and 11.3%, which were quite similar to the respective TDR sand layer water content averages of 20.3%, 25.7%, 11.0%, and 14.1%. The spatial correlation coefficients (r) between the GPR-based sand layer water content values versus the TDR sand layer water content values for these four GPR/TDR surveys were 0.76 (September 8, 2014), 0.73 (September 9, 2014), 0.55 (April 21, 2015), and 0.70 (April 29, 2015). Sand layer water content was found to have moderate inverse spatial correlation with ground surface elevation (r = −0.44 to −0.56) and elevation at the base of the sand layer (r = −0.43 to −0.53). Consequently, the findings of this study clearly indicate that if sand layer depth values are available, then GPR can be utilized in a non-destructive manner to accurately map sand layer water content across a golf course green, and conversely, in cases where sand layer water content (hence, radar velocity) spatial patterns are already known, then this information can be employed to provide more accurate GPR-based sand layer depth values.

Central Atrophy Early in Multiple Sclerosis: Third Ventricle Volumetry versus Planimetry.

Cerebral atrophy has been suggested to be a reliable magnetic resonance imaging (MRI) predictor of subsequent disability in all stages of multiple sclerosis (MS). However, no accepted methodology for routine clinical use exists to date. We sought an easy to apply and fast technique to evaluate cerebral ventricular volume in patients with MS with similar accuracy as a semiautomatic volumetric method. The study included 104 patients, 61 diagnosed with MS and 43 with clinically isolated syndrome. In addition, 30 healthy controls were enrolled. Physical disability was assessed with the expanded disability status scale and cognitive disability with the Multiple Sclerosis Inventory Cognition (MUSIC) test. All subjects received standardized 3-dimensional (3D) MR-imaging on a 3 T scanner. Third ventricle volume (3VV) was obtained from 3D T1-weighted images using a semiautomated technique, and compared against planimetric assessment of the width of the third ventricle aligned (a3VW) and unaligned (u3VW) to anatomical landmarks. a3VW was obtained within seconds with excellent intra- and interrater agreement, and outperformed volumetric measurements regarding the differentiation of MS patients from healthy controls. a3VW had the strongest correlations with 3VV (r = .78, P < .001) and showed moderate inverse correlation with MUSIC cognition score (r = -.310, P < .005). a3VW is a time-effective and robust biomarker that has strong correlations with volumetric measurements and can be established as standard in the MRI quantification of central brain atrophy in patients with early MS.