Order preserving and order reversing operators on the class of convex functions in Banach spaces

A remarkable result by S. Artstein-Avidan and V. Milman states that, up to pre-composition with affine operators, addition of affine functionals, and multiplication by positive scalars, the only fully order preserving mapping acting on the class of lower semicontinuous proper convex functions defined on $\mathbb{R}^n$ is the identity operator, and the only fully order reversing one acting on the same set is the Fenchel conjugation. Here fully order preserving (reversing) mappings are understood to be those which preserve (reverse) the pointwise order among convex functions, are invertible, and such that their inverses also preserve (reverse) such order. In this paper we establish a suitable extension of these results to order preserving and order reversing operators acting on the class of lower semicontinous proper convex functions defined on arbitrary infinite dimensional Banach spaces.Comment: 19 pages; Journal of Functional Analysis, accepted for publication; a better presentation of certain parts; minor corrections and modifications; references and thanks were adde

A Health Needs Assessment of Arab-Americans in the Washington, DC Area

Although Arab-Americans often face various health challenges due to the stress associated with immigration, cultural conflict in the U.S., and limited knowledge of the complex U.S. health system, there is a paucity of research examining health risks and behaviors among this ethnic group. This cross-sectional study assessed the health needs among Arabs living in the Washington, DC metropolitan area. Participants were recruited to take the survey online, reporting on health care access and utilization, risk behaviors, and health status. It also measured for associations between reported depression, discrimination, acculturation, and health. Quantitative analysis showed correlations between age and current tobacco use, however no differences between men and women. Depression was significantly correlated with gender, age, and place of birth. Men were more likely to report having diabetes, high cholesterol, and hypertension than women. Results suggest that health promotion programs for Arabs in the DC area may help reduce health risks

Vitamin D Level in Relation to Depression Symptoms During Adolescence

BACKGROUND: This study aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D) and depression symptoms among adolescents in Kuwait, a country with a high prevalence of vitamin D deficiency. METHODS: A school based cross-sectional study was conducted on randomly selected 704 adolescents in middle schools. Data on depression symptoms were collected using the Children\u27s Depression Inventory (CDI). Data on covariates were collected from the parents by self-administered questionnaire and from adolescents by face-to-face interview. Blood samples were analyzed in an accredited laboratory; and 25(OH)D was measured using liquid chromatography-tandem mass spectrometry. RESULTS: Of 704 adolescents, 94 (13.35%; 95%CI:10.35-17.06%) had depression symptom (a score of 19 or more on the CDI). There was no significant difference in the median CDI score between different vitamin D status (p = 0.366). There was also no significant correlation between serum 25(OH)D concentration and CDI score (Spearman\u27s rank correlation = 0.01; p = 0.825).There was no significant association between 25(OH)D and depression symptoms whether 25(OH)D was fitted as a continuous variable (crude odds ratio (OR) 0 .99 [95%CI: 0.98, 1.01], p = 0.458 and adjusted OR 1.01 [95%CI: 0.99, 1.02], p = 0.233), categorical variable as per acceptable cut-of points (crude analysis p = 0.376 and adjusted analysis p = 0.736), or categorical variable as quartiles (crude analysis p = 0.760 and adjusted analysis p = 0.549). CONCLUSION: Vitamin D status does not seem to be associated with depression symptoms among adolescents in our setting. Nevertheless, it is important to have sufficient vitamin D levels during adolescence for several other health benefits

Fracture Resistance and Microleakage of Endocrowns Utilizing Three CAD-CAM Blocks

This study assessed marginal leakage and fracture resistance of computer-aided design/computer-aided manufacturing (CAD/CAM) fabricated ceramic crowns with intracoronal extensions into the pulp chambers of endodontically treated teeth (endocrowns) using either feldspathic porcelain (CEREC Blocks [CB], Sirona Dental Systems GmbH, Bensheim, Germany), lithium disilicate (e.max [EX], Ivoclar Vivadent, Schaan, Liechtenstein), or resin nanoceramic (Lava Ultimate [LU], 3M ESPE, St Paul, MN, USA).). Thirty extracted human permanent maxillary molars were endodontically treated. Standardized preparations were done with 2-mm intracoronal extensions of the endocrowns into the pulp chamber. Teeth were divided into three groups (n=10); each group was restored with standardized CAD/CAM fabricated endocrowns using one of the three tested materials. After cementation with resin cement, specimens were stored in distilled water at 37°C for one week, subjected to thermocycling, and immersed in a 5% methylene-blue dye solution for 24 hours. A compressive load was applied at 35 degrees to long axis of the teeth using a universal testing machine until failure. Failure load was recorded, and specimens were examined under a stereomicroscope for modes of failure and microleakage. Results were analyzed using one-way analysis of variance and Bonferroni post hoc multiple comparison tests (α=0.05). LU showed significantly (p<0.05) higher fracture resistance and more favorable fracture mode (ie, fracture of the endocrown without fracture of tooth) as well as higher dye penetration than CB and EX. In conclusion, although using resin nanoceramic blocks for fabrication of endocrowns may result in better fracture resistance and a more favorable fracture mode than other investigated ceramic blocks, more microleakage may be expected with this material

The Effect of Different Irrigant Activation Methods on Postoperative Pain After Endodontic Retreatment

Objective: This study was designed to evaluate the effect of different irrigant activation methods on post operative pain after endodontic retreatment. Materials and Methods : Seventy eight patients need non surgical retreatment in mandibular first molar were involved in the study. The retreatment was performed in two visits ,at first visit cases were randomly divided into three groups according to methods of irrigant activation after root canal retreatment with protaper next rotary Ni-TI system. Group A (n=26) Root canals were irrigated using 2.6% sodium hypochlorite (NaOCl) with manual dynamic agitation using master cone Group B (n=26) Root canals were irrigated using 2.6% sodium hypochlorite (NaOCl) using ultrasonic machine (ultra-x) for 60 seconds. Group C (n=26) Root canals were irrigated using 2.6% sodium hypochlorite (NaOCl) with NaviTip (29-gauge 27 mm) with double side tip. At second visit after one week, obturation was performed using modified single cone technique ans access cavity was filled with coronal restoration. After two visits root canal treatment and a specific method of agitation, depending on each group, the patients were given a questionnaire on which the patient would mark the degree of pain in a scale from 0 to 10 at 6, 12, 24, 48 72 hrs and one week post-obturation. Data were statistically analyzed with a significance level of P ≤0.05. Results: At 6,12,24 hrs, there was significant difference between the groups in pain intensity where control group C (Navitip with side vented needle) showed more pain scores than in the intervention groups (Ultra X and manual dynamic agitation). On the other hand, at 48, 72 hours and 7 days post- operative ,there was no statistically significant difference in pain among tested groups. Conclusion: Agitation of the irrigation is reliable safe to clinican and effective as final step irrigation protocol with successful management of postoperative pain in retreatment cases. The intensity of postoperative pain decreased with time regardless of final irrigation protocol used

Predictors of Acne Vulgaris Among Adolescents in Kuwait

Objectives: The prevalence of acne vulgaris (AV) among adolescents in Kuwait has remained mostly unknown. This study aimed to estimate the prevalence of AV and its predictors among adolescents in Kuwait. Subjects and Methods: A cross-sectional study was conducted on 714 participants who were randomly selected from public schools using multistage cluster random sampling. The presence or absence of AV, as well as severity of AV, were assessed using the Global Acne Grading Scale. Data on risk factors and potential confounders were collected from the parents through a self-administered questionnaire, and from the adolescents by face-to-face interview. Weight and height were measured in a standardized manner. Results: Of 714 participants, 320 (44.8%; 95% CI 41.1–48.6%) self-reported AV. By clinical examination, AV was found among 479 (67.1%; 95% CI 63.5–70.5%) participants. Factors that were found to be significantly associated with AV in multivariable analysis were age, gender, nationality, and BMI categories. Females compared to males (adjusted prevalence ratio [APR] 1.16 [95% CI 1.05–1.25]; p = 0.006) and overweight or obese adolescents compared to normal weight (APR 1.15 [95% CI 1.02–1.26] and 1.14 [95% CI 1.02–1.23], respectively; p = 0.026) were more likely to have AV. None of the food items studied showed an association with AV in multivariable analysis. Conclusion: The prevalence of self-reported AV seems to be lower than that reported in other settings, while the prevalence of AV by clinical examination resembles that reported in many other countries. BMI was the only modifiable risk factor associated with AV in multivariable analysis, and none of the food items studied was related to the presence or absence of AV in multivariable analysis

Survey of community pharmacists' perception of electronic cigarettes in London

OBJECTIVES: To seek community pharmacists' perception on use, safety and possible effectiveness of e-cigarettes as quit smoking tools, and their future regulation. SETTING: A survey of a sample of 154 community pharmacies across London, UK. CONTEXT: E-cigarettes have exclusively established themselves in the market through consumers-led demand. To date, e-cigarettes still remain unregulated and can be easily purchased in shops, over the internet, but more controversially also in pharmacies in the UK. Pharmacists find themselves with a shortage of information on their safety and efficacy, and may experience an ethical dilemma when consulted by patients/customers. KEY FINDINGS: Response rate: 60% (n=92). Independent pharmacies accounted for 90% of the sample. The majority of participants (73%) sell e-cigarettes. A minority of participants (20%) have been presented with adverse effects such as cough and dry mouth. As possible reasons for their use, pharmacists ranked ‘aid in stop smoking’ as the most important (56%), with ‘cheaper alternative’ (43%) and ‘social/recreational use’ (31%) being the least important ones. Safety issues were raised as statements such as ‘e-liquid in cartridges may be toxic’ were agreed by 52% of respondents. The majority of pharmacists (97%) were supportive of e-cigarettes being regulated, expressing current concerns regarding excipients (42%) and nicotine content (34%). Participants indicated that they would require training in the form of information packs (88%), online tutorials (67%), continuous professional development (CPD) workshops (43%) to cover safety, counselling, dosage instructions, adverse effects and role in the smoking cessation care pathway in the future. CONCLUSIONS: Pharmacists expressed concerns about the safety of e-cigarettes, especially regarding the amounts of excipients and nicotine as these still remain unregulated. Currently, there are no guidelines for pharmacists regarding e-cigarettes. Community pharmacists look forward to regulations so to conduct their duties in a more confident and legislated fashion

Contrasting effects of sleep fragmentation and angiotensin-II treatment upon pro-inflammatory responses of mice

Disordered sleep promotes inflammation in brain and peripheral tissues, but the mechanisms that regulate these responses are poorly understood. One hypothesis is that activation of the sympathetic nervous system (SNS) from sleep loss elevates blood pressure to promote vascular sheer stress leading to inflammation. As catecholamines produced from SNS activation can directly regulate inflammation, we pharmacologically altered blood pressure using an alternative approach-manipulation of the renin-angiotensin system (RAS). Male C57BL6/J mice were treated with angiotensin or captopril to elevate and reduce blood pressure, respectively and then exposed to 24-h of sleep fragmentation (SF) or allowed to sleep (control). Pro- and anti-inflammatory cytokine gene expression and as endothelial adhesion gene expression as well as serum glucocorticoids (corticosterone) were measured. RAS manipulation elevated cytokines and endothelial adhesion expression in heart and aorta while SF increased cytokine expression in peripheral tissues, but not brain. However, there were interactive effects of angiotensin-II and SF upon cytokine gene expression in hippocampus and hypothalamus, but not prefrontal cortex. SF, but not RAS manipulation, elevated serum corticosterone concentration. These findings highlight the contrasting effects of RAS manipulation and SF, implying that inflammation from SF is acting on different pathways that are largely independent of RAS manipulation

Validated Spectrofluorimetric Determination of Gemifloxacin in Pharmaceutical Preparations and Spiked Human Plasma

 A simple, sensitive and rapid spectrofluorimetric method was developed and validated for the determination of Gemifloxacin mesylate (GFX), in bulk powder, pharmaceutical preparations and biological fluids. The proposed method was based on complexation of GFX with AlCl3 as complexing agent then measuring the fluorescence of the resulted complex after enhancement with sodium dodecyl sulphate (SDS) in borate buffer (pH 8) at emission wavelength of 401 nm after excitation at 264 nm. Different experimental parameters affecting the fluorescence intensity were carefully studied and optimized to obtain the maximum fluorescence intensity. The developed method was validated according to International Conference on Harmonisation guidelines in terms of specificity, linearity, lower limit of quantification (LOQ) 0.54 ng.ml-1, lower limit of detection (LOD) 0.18 ng.ml-1, accuracy and precision. The proposed method was found to be rectilinear over the concentration range of 1-20 ng.ml-1with recovery percentage of 99.85±0.84. The proposed method was applied successfully for the determination of GFX in pharmaceutical preparations and spiked human plasma with recovery percentage of 99.97±0.79 and 99.96±1.73 respectively. The results were statistically analyzed and compared with a reference method and no significance difference was found between both methods