Characterization of IHF Binding to DNA Four-Way Junctions and Forks

The objective of the study is to characterise the mechanical properties of Ti-15Zr binary alloy dental implants and to describe their biomechanical behaviour as well as their osseointegration capacity compared with the conventional Ti-6Al-4V (TAV) alloy implants. The mechanical properties of Ti-15Zr binary alloy were characterised using Roxoli

Therapeutic effect of hyperbaric oxygen in psoriasis vulgaris: two case reports and a review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Psoriasis is an inflammatory and immunological cutaneous disease. The high morbidity in patients with psoriasis results from severe clinical manifestations and/or adverse effects of treatment. The Undersea and Hyperbaric Medical Society and Federal Medicare and Medicaid Services have approved the use of hyperbaric oxygen (HBO₂) for more than 15 indications, including wound healing, infections and late effects of radiation, which are largely unresponsive to conventional treatments. Accumulated data show that HBO₂ has anti-inflammatory effects and other positive influences on the immune system, making it a rational treatment in the management of psoriasis plaques and arthritis.</p> <p>Case presentation</p> <p>We present the cases of two patients with long histories of psoriasis vulgarus who exhibited marked improvement with use of HBO_2. The first patient was 40 years old and had pustular psoriasis and psoriatic arthritis. He was treated with six sessions of HBO₂ (at 2.8 atmospheres of pressure for 60 minutes), which successfully controlled his symptoms. At the 18-month post-treatment follow up, the patient exhibited complete remission of psoriasis and marked improvement in psoriatic arthritis without medication. The second patient was 55 years old with extensive psoriatic lesions, and exhibited marked improvement within 15 sessions of HBO₂. No adverse effects of HBO₂ were identified.</p> <p>Conclusions</p> <p>HBO₂ may possess potential therapeutic efficacy in the management of psoriasis. We outline the pathogenesis of psoriasis and the selective anti-inflammatory and immunosuppressive effects of HBO₂. We hope that this will provide a basis for elucidating the mechanisms of action and consequently pave the way for further controlled studies.</p

Acceptability and feasibility of a virtual community of practice to primary care professionals regarding patient empowerment: A qualitative pilot study

Background: Virtual communities of practice (vCoPs) facilitate online learning via the exchange of experiences and knowledge between interested participants. Compared to other communities, vCoPs need to overcome technological structures and specific barriers. Our objective was to pilot the acceptability and feasibility of a vCoP aimed at improving the attitudes of primary care professionals to the empowerment of patients with chronic conditions. Methods: We used a qualitative approach based on 2 focus groups: one composed of 6 general practitioners and the other of 6 practice nurses. Discussion guidelines on the topics to be investigated were provided to the moderator. Sessions were audio-recorded and transcribed verbatim. Thematic analysis was performed using the ATLAS-ti software. Results: The available operating systems and browsers and the lack of suitable spaces and time were reported as the main difficulties with the vCoP. The vCoP was perceived to be a flexible learning mode that provided up-to-date resources applicable to routine practice and offered a space for the exchange of experiences and approaches. Conclusions: The results from this pilot study show that the vCoP was considered useful for learning how to empower patients. However, while vCoPs have the potential to facilitate learning and as shown create professional awareness regarding patient empowerment, attention needs to be paid to technological and access issues and the time demands on professionals. We collected relevant inputs to improve the features, content and educational methods to be included in further vCoP implementation. Trial registration: ClinicalTrials.gov, NCT02757781. Registered on 25 April 2016.This study was financed by Instituto de Salud Carlos III and Cofinanced by Fondo Europeo de Desarrollo Regional (FEDER). Ministerio de Economía y Competitividad. Gobierno de España. (PI15/00164, PI15/00586, PI15/00566

Variability in the performance of preventive services and in the degree of control of identified health problems: A primary care study protocol

Background: Preventive activities carried out in primary care have important variability that makes necessary to know which factors have an impact in order to establish future strategies for improvement. The present study has three objectives: 1) To describe the variability in the implementation of 7 preventive services (screening for smoking status, alcohol abuse, hypertension, hypercholesterolemia, obesity, influenza and tetanus immunization) and to determine their related factors; 2) To describe the degree of control of 5 identified health problems (smoking, alcohol abuse, hypertension, hypercholesterolemia and obesity); 3) To calculate intraclass correlation coefficients. Design: Multi-centered cross-sectional study of a randomised sample of primary health care teams from 3 regions of Spain designed to analyse variability and related factors of 7 selected preventive services in years 2006 and 2007. At the end of 2008, we will perform a cross-sectional study of a cohort of patients attended in 2006 or 2007 to asses the degree of control of 5 identified health problems. All subjects older than16 years assigned to a randomised sample of 22 computerized primary health care teams and attended during the study period are included in each region providing a sample with more than 850.000 subjects. The main outcome measures will be implementation of 7 preventive services and control of 5 identified health problems. Furthermore, there will be 3 levels of data collection: 1) Patient level (age, gender, morbidity, preventive services, attendance); 2) Health-care professional level (professional characteristics, years working at the team, workload); 3) Team level (characteristics, electronic clinical record system). Data will be transferred from electronic clinical records to a central database with prior encryption and dissociation of subject, professional and team identity. Global and regional analysis will be performed including standard analysis for primary health care teams and health-care professional level. Linear and logistic regression multilevel analysis adjusted for individual and cluster variables will also be performed. Variability in the number of preventive services implemented will be calculated with Poisson multilevel models. Team and health-care professional will be considered random effects. Intraclass correlation coefficients, standard error and variance components for the different outcome measures will be calculated

Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type

Aim To investigate the putative modifying effect of dual antiplatelet therapy (DAPT) use on the incidence of stent thrombosis at 3 years in patients randomized to Endeavor zotarolimus-eluting stent (E-ZES) or Cypher sirolimus-eluting stent (C-SES). Methods and results Of 8709 patients in PROTECT, 4357 were randomized to E-ZES and 4352 to C-SES. Aspirin was to be given indefinitely, and clopidogrel/ticlopidine for ≥3 months or up to 12 months after implantation. Main outcome measures were definite or probable stent thrombosis at 3 years. Multivariable Cox regression analysis was applied, with stent type, DAPT, and their interaction as the main outcome determinants. Dual antiplatelet therapy adherence remained the same in the E-ZES and C-SES groups (79.6% at 1 year, 32.8% at 2 years, and 21.6% at 3 years). We observed a statistically significant (P = 0.0052) heterogeneity in treatment effect of stent type in relation to DAPT. In the absence of DAPT, stent thrombosis was lower with E-ZES vs. C-SES (adjusted hazard ratio 0.38, 95% confidence interval 0.19, 0.75; P = 0.0056). In the presence of DAPT, no difference was found (1.18; 0.79, 1.77; P = 0.43). Conclusion A strong interaction was observed between drug-eluting stent type and DAPT use, most likely prompted by the vascular healing response induced by the implanted DES system. These results suggest that the incidence of stent thrombosis in DES trials should not be evaluated independently of DAPT use, and the optimal duration of DAPT will likely depend upon stent type (Clinicaltrials.gov number NCT00476957

Modelación de la disponibilidad hídrica del rio Piura - Peru, considerando la incidencia del cambio climático

Esta investigación evaluó los impactos del cambio climático en la oferta hídrica superficial en la subcuenca media y alta del río Piura, Perú, con el modelo hidrológico Soil and Water Assessment Tool (SWAT) a mediados del siglo XXI. El modelo SWAT fue calibrado y validado para un periodo de 23 años (1986 - 2008) utilizando datos de clima diarios en seis ubicaciones, y caudales mensuales en una ubicación. Para las evaluaciones a futuro, se adoptaron los datos climáticos HADGEM2-ES y CSI-RO-Mk3-6-0, de los modelos climáticos globales (MCG), Coupled Model Intercomparison Project Phase 5 (CMIP5), en los escenarios RCP4.5 y RCP8.5. Los datos sesgados futuros (2025‐2054) se corrigieron utilizando los datos del clima del período de referencia, y se redujeron de escala con el generador de clima MarkSim. La temperatura y precipitación en los escenarios de cambio climático proyectan un aumento promedio de + 2,9°C y 39,3%, respectivamente, respecto del periodo observado. La evapotranspiración futura mostro una tendencia general a disminuir, con un ligero aumento en el lado noroccidental de la cuenca. En particular, la tendencia promedio de la escorrentía mensual al 2050, en los cuatro escenarios, indica para los meses entre octubre a abril un aumento de + 71,8%, aprox. 55,9 m3/s; con el mayor incremento en noviembre. Por otro lado, entre los meses de mayo a setiembre, se tiene una disminución de ‐66,1%, aprox. 12 m3/s, con el mayor descenso en julio.  AbstractThis research evaluated climate change impacts on the streamflow offer in the middle and up-per Piura river basin in Peru using the Soil and Water Assessment Tool (SWAT) by the middle of the 21s century. The SWAT model was calibrated and validated for a period of 23 years (1986 - 2008) with daily weather data at six locations and monthly streamflow data at one location. For future evaluation, the HADGEM2-ES and CSIRO-Mk3-6-0, global climate models (GCM), climate data by Coupled Model Intercomparison Project Phase 5 (CMIP5) RCP4.5 and RCP8.5 of the Intergovernmental Panel on Climate Change (IPCC) were adopted. The future biased data (2025‐2054) were corrected using weather data of baseline period, and downscaled by the statistical method of MarkSim weather generator. The temperature and precipitation in the climate change scenarios projected an average increase of + 2.9°C and 39.3%, respectively, compared to the baseline condition. The future evapotranspiration showed a general tendency to decrease, with a slight increase in the north western region of the basin. In particular, the average trend of monthly streamflow to 2050s, in the four scenarios, indicates an increase of +71.8%, approx. 55.9 m3/s, from October to April with the highest increase in November. Whereas, from May to September, there is a decrease of -66.1%, approx. 12 m3/s, with the largest decrease in July.Key words: Climate Change, CMIP5, General Circulation Models, Hydrological Modeling, SWAT