Immunohistochemical comparative study of the odontogenic keratocysts and other odontogenic lesions

Objectives: The present study was undertaken to compare the pattern of expression of EGFR, cyclin D1, Ki-67, p-53 and carcinoembryonic antigen (CEA) in the epithelial lining of odontogenic keratocysts, dentigerous cysts, radicular cysts and ameloblastomas. Methods: four micrometers, formalin-fixed, paraffin-embedded tissue sections from 11 odontogenic keratocysts, 10 dentigerous cysts, 10 radicular cysts and 10 ameloblastomas were immunohistochemically studied. Results: There were statistically significant differences between cyclin D1 expression in odontogenic keratocysts and radicular cysts (p= 0.001) and ameloblastomas (p= 0.04). The differences in CEA expression between the four studied lesions were statistically significant (p< 0.0005). Proliferating cells were significantly more prevalent in odontogenic keratocysts (p< 0.0005) with a mean percentage of Ki-67 positively stained nuclei of 40%. In dentigerous cysts this mean was of 17%, of 15.5% in RC and of 7.8 in ameloblastomas. Conclusion: Some of these findings could support the theory that odontogenic keratocysts are neoplastic in origin, but other results clearly support that these lesions are developmental cysts with some neoplastic properties because of the high intrinsic growth potential

The effect of direct and indirect written feedback on spelling in two different populations of efl/esl learners

84 páginasThis study focused on observing and analyzing the highly form-specific issue of accurate spelling by Spanish L1 learners of English with the purpose of contributing to the ongoing debate on feedback’s relative efficacy, centered upon whether errors should be corrected or not and on whether feedback is effective or not. The treatment of direct and indirect written corrective feedback (WCF) was applied to spelling errors in learners of two distinct populations. An experimental action research design was appropriate to the study’s comparison of the two types of written corrective feedback, direct and indirect, on learners’ errors to determine their relative efficacy; and this research design permitted the establishment of relationships between the feedback treatment (direct or indirect) and spelling outcomes. The results indicated no statistically significant differences between and within groups among the two populations, suggesting that there are still no simple answers regarding feedback’s effectiveness. However, although many feedback studies give limited attention to the effects of language learners’ preexisting (L1) schemata, patterns in the spelling errors produced by the participants in the present study suggest that further work on the efficacy of feedback should indeed consider such issues more explicitly, as future research should consider not merely whether feedback can be valuable but how contextual factors can affect what kind of feedback (and responding to what in the learner) may be most valuable

Investigating Changes in Spasticity in Response to Botulinum Toxin A in Children with Cerebral Palsy: A Post Hoc Exploratory Study

Introduction: A common treatment for lower leg spasticity amongst children with cerebral palsy (CP) is Botulinum Toxin A (BoNT-A) injections. While the effectivity of treatment is typically assessed clinically, kinematic and neuromuscular measurements can provide insight on a more objective and physiological level. The aim of this study was to gain a better understanding of the physiological responses of spastic lower leg muscles in children with CP to BoNT-A treatment. Furthermore, the physiological responses were evaluated against clinical assessments to determine agreement in spasticity grading. Methods: Twenty-seven children with CP and lower leg spasticity participating in the WE study were included. Assessing each leg individually, 16 legs received BoNT-A injections in the m. gastrocnemius and m. soleus, 13 received saline (placebo), and 25 were non spastic and not treated. Kinematic (positional markers) and neuromuscular (surface electromyography: sEMG) data was collected during the clinical assessment, being passive stretch of the calf muscles at slow and fast velocity in bent and straight knee positions prior to and 4-, 12-, and 24- weeks after treatment. Outcome measures were clinical catch, range of motion (ROM), peak angular velocity, ROM to peak angular velocity, and peak of the linear envelope of sEMG of the 2 calf muscles and m. tibialis anterior. Results: Linear mixed model analyses did not show significant changes within the BoNT-A treated spastic leg over time, nor a time-leg interaction for any of the outcome measures. When the spasticity decision of the clinical and physiological testing methods were compared, there was a lack of consensus. Conclusion: In this study, BoNT-A did not affect any of the spasticity measures. Moreover, there was no agreement in spasticity grading between clinical assessment and physiological responses. This could be caused by the relatively low spasticity level of the participants included, methodological issues of the assessment and measures, or a low number of participants

Factors associated with remission of post-traumatic brain injury fatigue in the years following traumatic brain injury (TBI): a TBI model systems module study

Post-traumatic brain injury fatigue (PTBIF) is a major problem in the years after traumatic brain injury (TBI), yet little is known about its persistence and resolution. The objective of the study was to identify factors related to PTBIF remission and resolution. TBI Model System registrants at five centres participated in interviews at either one and two years post-injury (Y1-2 Cohort), or two and five years post-injury (Y2-5 Cohort). Characteristics of participants with PTBIF remission were compared to those with PTBIF persistence. Variables studied included the presence of and changes in disability, sleep dysfunction, mood, and community participation. The Functional Independence Measure did not differ significantly between groups or over time. In the Y1-2 Cohort the Fatigue Resolved group scored significantly better on the Disability Rating Scale and Pittsburgh Sleep Quality Index. In the Y2-5 Cohort the Fatigue Resolved group scored significantly higher on a measure of community participation. It was concluded that fewer than half of the sample in each cohort experienced a remission of PTBIF between time points. Persistence of PTBIF 1–2 years post-injury is associated with disability, sleep disturbance, and depression while persistence of fatigue beyond 2 years post-injury appears to be related to participation level, underscoring the potential impact of effective surveillance, assessment, and treatment of this condition in optimising life after TBI. Differences in fatigue progression may point to the presence of different types of PTBIF

Esophageal cooling for protection during left atrial ablation: a systematic review and meta-analysis.

PURPOSE: Thermal damage to the esophagus is a risk from radiofrequency (RF) ablation of the left atrium for the treatment of atrial fibrillation (AF). The most extreme type of thermal injury results in atrio-esophageal fistula (AEF) and a correspondingly high mortality rate. Various strategies for reducing esophageal injury have been developed, including power reduction, esophageal deviation, and esophageal cooling. One method of esophageal cooling involves the direct instillation of cold water or saline into the esophagus during RF ablation. Although this method provides limited heat-extraction capacity, studies of it have suggested potential benefit. We sought to perform a meta-analysis of published studies evaluating the use of esophageal cooling via direct liquid instillation for the reduction of thermal injury during RF ablation. METHODS: We searched PubMed for studies that used esophageal cooling to protect the esophagus from thermal injury during RF ablation. We then performed a meta-analysis using a random effects model to calculate estimated effect size with 95% confidence intervals, with an outcome of esophageal lesions stratified by severity, as determined by post-procedure endoscopy. RESULTS: A total of 9 studies were identified and reviewed. After excluding preclinical and mathematical model studies, 3 were included in the meta-analysis, totaling 494 patients. Esophageal cooling showed a tendency to shift lesion severity downward, such that total lesions did not show a statistically significant change (OR 0.6, 95% CI 0.15 to 2.38). For high-grade lesions, a significant OR of 0.39 (95% CI 0.17 to 0.89) in favor of esophageal cooling was found, suggesting that esophageal cooling, even with a low-capacity thermal extraction technique, reduces the severity of lesions resulting from RF ablation. CONCLUSIONS: Esophageal cooling reduces the severity of the lesions that may result from RF ablation, even when relatively low heat extraction methods are used, such as the direct instillation of small volumes of cold liquid. Further investigation of this approach is warranted, particularly with higher heat extraction capacity techniques

Pérdidas económicas potenciales en la cadena productiva de mandarinas (Citrus reticulata) por ingreso del Huanglongbing en la Costa Central peruana

Universidad Nacional Agraria La Molina. Facultad de Economía y Planificación. Departamento Académico de Economía y PlanificaciónPerú se ha consolidado como exportador de mandarina principalmente al Asia y Europa gracias a su calidad. Esta bonanza está amenazada por el ingreso de la enfermedad del Huanglongbing (HLB), reportada en países de la región donde ha dejado consecuencias nefastas para la producción de cítricos. El objetivo de la tesis fue determinar las pérdidas económicas potenciales que generaría el ingreso del HLB en la cadena productiva de mandarina en la Costa Central del Perú (provincias productoras de Lima e Ica), en diversos escenarios prospectivos para el periodo 2024 - 2040, estimando la relación Beneficio / Costo de potenciales pérdidas económicas evitadas en caso de ponerse en ejecución un Programa Nacional Fitosanitario (PNF). En el análisis prospectivo, se usó un Modelo Lineal simple para la proyección tendencial de la producción, y un modelo epidemiológico para los escenarios con HLB y el impacto de la implementación del PNF. Se realizó un análisis Beneficio / Costo para calcular los costos asociados a la entrada del HLB y el impacto de la implementación del PNF en cultivos de mandarina. Las simulaciones de escenarios confirman el impacto negativo del ingreso del HLB en el año 2024 en la cadena productiva directa de mandarina en la Costa Central, así como los diversos niveles de pérdidas económicas ocasionadas según el nivel de implementación del PNF en los productores de mandarina de esta zona. Se concluye que se confirma que el ingreso del HLB en Costa Central produciría en el año 2040 la caída de la producción de mandarina en un 78 % si no se aplicase el PNF que limite los efectos nocivos y que permita continuar las actividades productivas y comerciales.Peru has established itself as a tangerine exporter mainly to Asia and Europe thanks to its quality. This bonanza is threatened by the entry of the Huanglongbing disease (HLB), reported in countries of the region where it has had disastrous consequences for citrus production. The objective of the thesis was to determine the potential economic losses that the entry of HLB would generate in the mandarin production chain in the Central Coast of Peru (producing provinces of Lima and Ica), in various prospective scenarios for the period 2024 - 2040, estimating the Benefit / Cost ratio of potential economic losses avoided in the event of implementing a National Phytosanitary Program (PNF). In the prospective analysis, a simple Linear Model was used for the trend projection of production, and an epidemiological model for the scenarios with HLB and the impact of the implementation of the PNF. A Benefit / Cost analysis was carried out to calculate the costs associated with the entry of the HLB and the impact of the implementation of the PNF on mandarin crops. The scenario simulations confirm the negative impact of the entry of the HLB in the year 2024 in the direct productive chain of mandarins in the Central Coast, as well as the different levels of economic losses caused according to the level of implementation of the PNF in the mandarin producers of this zone. It is concluded that it is confirmed that the entry of the HLB in the Central Coast would produce a 78% drop in mandarin production in 2040 if the PNF was not applied to limit the harmful effects and to allow productive and commercial activities to continue

Desarrollo de herramientas para la predicción de contactos inter-proteínas.

25 p. : il.-- Bibliogr.: p. 23-25[ES] DEEPCOV es una red neuronal convolucional capaz de predecir estructuras tridimensionales de proteínas con un alto valor de precisión, utilizando datos de covarianza de las secuencias peptídicas fácilmente obtenibles. La red tiene mejores valores de precisión que las técnicas basadas en Análisis de Emparejamiento Directo demostrando que filtra mejor el ruido evolutivo que tanto afecta a estas técnicas cuando son utilizadas sobre proteínas con pocos homólogos conocidos. En este trabajo se pretende, a través de un entrenamiento adaptado de la red convolucional, conseguir un modelo de DEEPCOV válido para la predicción de estructuras de complejos proteicos. En primer lugar, se desarrolló una herramienta para la colecta y procesamiento de los datos del entrenamiento y que trabaja de forma automática. La herramienta fue capaz de generar 2973 archivos de forma autónoma y es útil para su futuro uso, siendo posible adaptarla con facilidad. En segundo lugar, la red fue entrenada con los archivos generados por la herramienta, obteniendo unos valores de precisión de 18’58%, 15’73% y 19’02% en la predicción de top 1, top 5 y top 10 contactos inter-proteína más cercanos respectivamente. El Valor Predictivo Positivo fue de 40’97%. La baja precisión de la red podría ser explicada por el relativamente bajo número de datos utilizados y la generación de ruido extra en el nuevo procedimiento de generación de datos.[EN] DEEPCOV is a convolutional neural network able to predict tridimensional structures of proteins with high precision values using covariance data of the peptide sequences, which is easily obtainable. The network has higher precision values than the Direct Coupling Analysis based techniques, proving that it is better at filtering the evolutive noise. This noise affects the Direct Coupling Analysis techniques so much when used over proteins with few homologues known. This project meant to, by an adapted training of the network, achieve a DEEPCOV model valid for the prediction of protein complexes’ structures. It took a number of steps to harness this. On first place, a tool for automatic data collection and processing was developed. The tool generated 2973 files for the network’s training autonomously. The tool is also usable in the future since its behavior is adapted easily. On second place, the network was trained with the data generated by the tool, obtaining precision values of 18’58%, 15’73% and 19’02% for the prediction of the top1, top5 and top10 closest intra-protein contacts respectively. The positive predictive value was 40’97%. The low prediction values could be explained with the small amount of data used for the network training, or the introduction of some noise generating steps during the data generation

Indicators of injury recovery identified by patients, family members and clinicians

Introduction A focus on what is important to patients has been recognized as an essential pillar in care to ensure safe patient care that focuses on outcomes identified as important by patients. Despite this, asking trauma patients and their families what they consider should be the priorities of care and recovery has been neglected. Methods Adult trauma patients admitted to two centers in Australia for ≥24 h for the treatment of physical injury, and family members of injured patients and clinicians caring for injured patients were invited to participate. Individual interviews were conducted with the patient and family members prior to hospital discharge, and again one and three months post discharge. Individual interviews or focus groups were conducted with clinicians at one point in time. Content analysis of all transcripts was undertaken to determine the indicators of successful recovery over time. Results Participants in the three stakeholder groups were enrolled (patients − 33; family members—22; clinicians—40). Indicators of recovery focused on five main categories including returning to work, resuming family roles, achieving independence, recapturing normality and achieving comfort. Other categories that were less frequently identified included maintaining one’s household, restoring emotional stability, cosmetic considerations and appearance, realignment of life goals, psychological recovery and development of self. Indicators of recovery after physical injury were similar across the three stakeholder groups, although with greater detail identified by patients. In addition, indicators evolved over time with increasing recognition of the importance of the overall impact of the injury in general and on activities of daily living and an unfolding appreciation that life could not be taken for granted. Conclusions Description of the indicators of recovery after traumatic injury that matter to patients, family members and clinicians enable an understanding of similarities and differences. Further testing in a broader cohort of participants is essential to identify patient reported outcome measures that might be used in trauma care and associated research

Reliability assessment of a cooled intraesophageal balloon to prevent thermal injury during RF cardiac ablation: an agar phantom study

[EN] Cooled Balloon Prevents Thermal Injury During RF Ablation. Introduction: The use of a cooled intraesophageal balloon has recently been proposed to minimize the risk of thermal injury in the esophagus during radiofrequency (RF) ablation of the left atrium. However, the capacity of this device to adequately protect the esophagus under different procedural and anatomical conditions remains unknown. Methods and Results: An agar phantom-based model was built that provided temperature readings not only on the cooled balloon (T-b) but also at a hypothetical point between the esophageal lumen and myocardium at a distance of 2 mm (T2-mm). The RF ablations were conducted considering two anatomical factors (total distance between the electrode and balloon and flow rate around the electrode) and two procedural factors (angle and pressure between the electrode and agar surface). The results show that most of the parameters studied have no significant influence on the temperature measured on the cooled balloon (T-b), the exception being a variation in the flow rate, which was found to influence the temperature. On the other hand, T2-mm was affected to a great extent by all the factors considered, the smallest influence being that of the contact pressure. The results also suggest that when an intraesophageal balloon is employed, the applied power is not a good predictor either of the temperature on the balloon or of the temperature measured at a distance 2 mm away. Conclusion: The results suggest that a cooled intraesophageal balloon provides effective thermal protection of the esophageal lumen. However, under certain circumstances, the temperature reached at a distance 2 mm away could possibly put at risk the integrity of the inner layers of the esophagus. (J Cardiovasc Electrophysiol, Vol. 19, pp. 1188-1193, November 2008).This work was partially supported by the "Plan Nacional de Investigacion Cientifica, Desarrollo e Innovaci on Tecnologica del Ministerio de Educacion y Cienciaa of Spain (TEC 2005-04199/TCM) and by an R&D contract (CSIC-20060633) between Edwards Lifescience Ltd. and the Spanish Council for Scientific Research (CSIC).Lequerica, JL.; Berjano, E.; Herrero, M.; Hornero, F. (2008). Reliability assessment of a cooled intraesophageal balloon to prevent thermal injury during RF cardiac ablation: an agar phantom study. Journal of Cardiovascular Electrophysiology. 19(11):1188-1193. https://doi.org/10.1111/j.1540-8167.2008.01229.xS11881193191

Satisfacción del usuario y la atención de calidad de salud de la consulta externa, en el Centro de Salud de Chacra Colorada - Lima, 2016

Este trabajo da cuenta de los aspectos más significativos de la satisfacción del usuario y la atención de calidad de salud de la consulta externa, en el centro de salud de Chacra Colorada– lima, 2016. El objetivo general del trabajo de investigación es determinar estadísticamente como la satisfacción del usuario está relacionada en la calidad de salud de la consulta externa, en el centro de salud de Chacra Colorada – Lima, 2016. La metodología utilizada fue correlacional, con un diseño no-experimental, dado que no hubo intervención del investigador sobre las variables del estudio. La población estuvo conformada por 80 usuarios de la consulta externa en el centro de salud de chacra colorada. Las técnicas para recolectar información fueron 2 cuestionarios: satisfacción del usuario y la atención de calidad de salud aplicada a los 80 usuarios del centro de salud de chacra colorada. Se utilizó el procedimiento estadístico de Kuder Richardson KR (20), para la confiabilidad de los instrumentos, el cual determinó una confiabilidad de 0.8211, el cual es altamente confiable. La prueba de hipótesis se realizó con un nivel de significancia menor de 0.05 = 5%. Se concluyó que la satisfacción del usuario si se relaciona significativamente en la atención de calidad de salud. Se concluyó con relación a la hipótesis específica uno, que las efectividades tienen relación significativa con la atención de calidad de salud. Se concluyó con relación a la hipótesis específica dos, que la seguridad brindada por el personal tiene relación significativa con la atención de calidad de salud. Se concluyó con relación a la hipótesis específica tres, que la empatía del personal tiene relación significativa con la atención de calidad de salud.This work gives an account of the most significant aspects of user satisfaction and quality health care in the outpatient clinic, in the health center of Chacra Coloradalima, 2016. The general objective of the research work is to determine statistically how The satisfaction of the user is related to the quality of health of the outpatient clinic, in the health center of Chacra Colorada - Lima, 2016. The methodology used was correlational, with a non-experimental design, given that there was no intervention by the researcher on the study variables. The population consisted of 80 users of the outpatient clinic in the health center of chara colarada. The techniques to collect information were 2 questionnaires: user satisfaction and quality health care applied to the 80 users of the collated farm health center. We used the statistical procedure of Kuder Richardson KR (20), for the reliability of the instruments, which determined a reliability of 0.8211, which is highly reliable. The hypothesis test was performed with a level of significance less than 0.05 = 5%. It was concluded that user satisfaction is significantly related to quality health care. It was concluded in relation to the specific hypothesis one, that the effectiveness have a significant relationship with health quality care. It was concluded in relation to the specific hypothesis two, that the security provided by the staff has a significant relationship with the quality of health care. It was concluded in relation to the specific hypothesis three, that the empathy of the personnel has a significant relationship with the health quality care