Congenital Adrenal Hyperplasia: A Case Report with Premature Teeth Exfoliation and Bone Resorption

Congenital adrenal hyperplasia (CAH) is an inherited autosomal recessive disorder characterized by insufficient production of cortisol. The aim of this case report was to present a child with CAH, premature exfoliation of primary teeth and accelerated eruption of his permanent teeth related to bone resorption. A 4.5-year-old Caucasian boy with CAH and long-term administration of glucocorticoids was referred for dental restoration. Clinical examination revealed primary molars with worn stainless steel crowns, severe attrition of the upper canines, and absence of the upper incisors. Before the completion of treatment, abnormal mobility of the first upper primary molars and the lower incisors was detected, and a few days later the teeth exfoliated prematurely. Histologic examination revealed normal tooth structure. Alkaline phosphatase and blood cells values were normal. Eruption of the permanent dentition was also accelerated. Tooth mobility was noticed in the permanent teeth as soon as they erupted, along with bone destruction. Examination revealed an elevated level of receptor activator of nuclear factor-kB ligand and lower-than-normal osteoprotegerin and vitamin D levels. The patient was treated with vitamin D supplements, and his teeth have been stable ever since. CAH is a serious chronic disorder appearing in children with accelerated dental development and possibly premature loss of primary teeth

Influence of supramolecular forces on the linear viscoelasticity of gluten

Stress relaxation behavior of hydrated gluten networks was investigated by means of rheometry combined with μ-computed tomography (μ-CT) imaging. Stress relaxation behavior was followed over a wide temperature range (0–70 °C). Modulation of intermolecular bonds was achieved with urea or ascorbic acid in an effort to elucidate the presiding intermolecular interactions over gluten network relaxation. Master curves of viscoelasticity were constructed, and relaxation spectra were computed revealing three relaxation regimes for all samples. Relaxation commences with a well-defined short-time regime where Rouse-like modes dominate, followed by a power law region displaying continuous relaxation concluding in a terminal zone. In the latter zone, poroelastic relaxation due to water migration in the nanoporous structure of the network also contributes to the stress relief in the material. Hydrogen bonding between adjacent protein chains was identified as the determinant force that influences the relaxation of the networks. Changes in intermolecular interactions also resulted in changes in microstructure of the material that was also linked to the relaxation behavior of the networks

Trunk Control And Standing Tolerance Of A Patient With Paraparesis As A Result Of Transverse Myelitis And Mycotic Aneurysm Rupture: A Case Report

Background and Purpose: Transverse myelitis (TM) is a rare condition in which the spinal cord becomes inflamed resulting in pain, paraparesis or paraplegia, impaired sensation, and/or impaired autonomic function. Approximately two-thirds recover with mild to moderate symptoms, but one-third are left with severe and disabling symptoms. Cerebral mycotic aneurysm (CMA) rupture is a brain injury due to a burst artery resulting in diminished blood supply to the brain. There is literature on beneficial physical therapy (PT) intervention progressions following brain injury, such as bed mobility strategies and pre-gait activities, but there is little published on PT for impairments as a result of concurrent TM and CMA ruptures. The purpose of this case report was to describe the PT interventions provided to a patient with paraparesis as a result of TM and multiple CMA ruptures to progress toward achieving his goals of standing and ambulating with a standard walker and bilateral knee-ankle-foot-orthoses (KAFOs). Case Description: The 28-year-old male patient had been seen for two years at an outpatient clinic with an accredited brain injury program. The patient encountered several barriers throughout his rehabilitation, such as repairs to his KAFOs and low bone mineral density, which resulted in a decrease in standing tolerance over time. Outcomes: The Brain Injury Assessment Tool (BIAT) and manual muscle testing were used to document changes throughout the patient’s period of care. No significant changes were observed. Discussion: This patient, despite minimal improvements over a two-year period, may have the potential to increase his trunk control and standing tolerance if he has an extended period of time with no barriers to his rehabilitation

Influence of pH on mechanical relaxations in high solids lm-pectin preparations

The influence of pH on the mechanical relaxation of LM-pectin in the presence of co-solute has been investigated by means of differential scanning calorimetry, ζ-potential measurements and small deformation dynamic oscillation in shear. pH was found to affect the conformational properties of the polyelectrolyte altering its structural behaviour. Cooling scans in the vicinity of the glass transition region revealed a remarkable change in the viscoelastic functions as the polyelectrolyte rearranges from extended (neutral pH) to compact conformations (acidic pH). This conformational rearrangement was experimentally observed to result in early vitrification at neutral pH values where dissociation of galacturonic acid residues takes place. Time-temperature superposition of the mechanical shift factors and theoretical modeling utilizing WLF kinetics confirmed the accelerated kinetics of glass transition in the extended pectin conformation at neutral pH. Determination of the relaxation spectra of the samples using spectral analysis of the master curves revealed that the relaxation of macromolecules occurs within ~0.1 s regardless of the solvent pH

From C-3PO to HAL: Opening The Discourse About The Dark Side of Multi-Modal Social Agents

The increasing prevalence of communicative agents raises questions about human-agent communication and the impact of such interaction on people's behavior in society and human-human communication. This workshop aims to address three of those questions: (i) How can we identify malicious design strategies - known as dark patterns - in social agents?; (ii) What is the necessity for and the effects of present and future design features, across different modalities and social contexts, in social agents?; (iii) How can we incorporate the findings of the first two questions into the design of social agents? This workshop seeks to conjoin ongoing discourses of the CUI and wider HCI communities, including recent trends focusing on ethical designs. Out of the collaborative discussion, the workshop will produce a document distilling possible research lines and topics encouraging future collaborations

Isolation and characterization of acetylated LM-pectins extracted from okra pods

Pectin was isolated by aqueous extraction at pH 6.0 or 2.0 from okra (Abelmoschus esculentus L.) pods. An isolation protocol was designed to extract pectin and to study the influence of the extraction pH on their composition and physicochemical properties. The extracted pectin was assessed using sugar compositional analysis (neutral sugars, galacturonic acid, acetyl and methyl contents). FT-IR and NMR spectroscopy, size exclusion chromatography (SEC) and dilute solution viscometry were also used to determine the macromolecular characteristics of isolated pectin. The extraction protocols resulted in the isolation of pectin of high purity as evidenced by their high total carbohydrate (70.0–81.8%) and low protein (4.3–6.3%) contents. Samples contained between 46 and 56% galacturonic acid, had broad molecular weight distributions, a low degree of methylation (40.0 and 24.6%) and high degree of acetylation (52.2 and 37.6%). Neutral sugar analysis showed that the pectin extracted at pH 6.0 contained more neutral sugars, particularly, galactose (21.7–25.7 mol%), rhamnose (10.1–13.2 mol%) and arabinose (7.1–7.3 mol%) than that extracted at pH 2.0 indicating variations in fine structure. In addition, molecular parameters of the isolated pectins, such as intrinsic viscosity (2.8–4.4 dL g−1), critical concentration (0.15–0.45 dL g−1) and coil overlap parameter (0.66–1.51), showed that extraction conditions resulted in pectin with different chain morphology. The yield and physico-chemical characteristics of the extracted pectin from okra pods were influenced by the extraction conditions

Evaluation of some important physicochemical properties of starch free grewia gum

Gums obtained by extraction from the inner bark of stems can be found in association with starch, which must be digested in order to obtain a refined polysaccharide isolate. In the present study, grewia gum obtained from the inner bark of the stems of Grewia mollis was shown to co-exist with starch and the effect of starch digestion on the physicochemical properties of the resultant polysaccharide was evaluated. The gum was extracted by maceration of the inner bark in deionized water and isolated by a combination of filtration, centrifugation and finally precipitation with absolute ethanol to produce the crude grewia gum extract (GG). The presence and content of starch in the gum sample was determined followed by enzymatic digestion of the starch using α-amylase (Termamyl 120L) to give a starch-free extract (GGDS). Physicochemical properties of the extracts such as total carbohydrates, total protein, differential sugar composition, NMR, intrinsic viscosity and rheological behaviour of the samples were evaluated. The GG extract had total carbohydrate content of ∼ 60 % out of which 11.8 % was starch, and a protein content of 2.3 %. Samples also contained galacturonic and glucuronic acid which were highly acetylated. Both samples had a higher proportion of galacturonic acid than glucuronic acid and contained rhamnose, arabinose, galactose, glucose and xylose as neutral sugars in varying proportions. Rheological measurements on 2 %w/w dispersions of the extracts show minor differences between both the original extract and the de-starched material but were influenced by changes in pH

Engineering of acidic O/W emulsions with pectin

Pectins with distinct molecular design were isolated by aqueous extraction at pH 2.0 or 6.0 and were examined in terms of their formation and stabilisation capacity of model n-alkane–in–water emulsions at acidic pH (pH 2.0). The properties and stability of the resulting emulsions were examined by means of droplet size distribution analysis, Lifshitz-Slyozov-Wagner modelling, bulk rheology, interfacial composition analysis, large-amplitude oscillatory surface dilatational rheology, electrokinetic analysis and fluorescence microscopy. Both pectin preparations were able to emulsify alkanes in water but exhibited distinct ageing characteristics. Emulsions prepared using pectin isolated at pH 6.0 were remarkably stable with respect to droplet growth after thirty days of ageing, while those prepared with pectin isolated at pH 2.0 destabilised rapidly. Examination of chemical composition of interfacial layers indicated multi-layered adsorption of pectins at the oil-water interface. The higher long-term stability of emulsions prepared with pectin isolated at high pH is attributed to mechanically stronger interfaces, the highly branched nature and the low hydrodynamic volume of the chains that result in effective steric stabilisation whereas acetyl and methyl contents do not contribute to the long-term stability. The present work shows that it is possible by tailoring the fine structure of pectin to engineer emulsions that operate in acidic environments

Probing the Impact of Porosity on Swelling Kinetics of Hydrophilic Matrices

The aim of the present investigation was to understand the swelling behaviour of HPMC and PEO-based matrices and to evaluate the impact of porosity on the swelling kinetics. It was noticed that the HPMC has higher swelling rates but both undergo diffusion oriented swelling mechanism. It could also the concluded that the porosity has a marked influence in the development of gel layer on the surface of these matrices

Pectin at the oil-water interface: Relationship of molecular composition and structure to functionality

The present review examines how macromolecular structure and functional groups of pectin affect its functionality with particular focus on its interfacial activity. We venture into a description of the particularly complex pectin structure and describe the major building blocks and their properties. In the following section, the role of each structural parameter is discussed with particular attention to protein, degree of acetylation and methylation, molecular weight, and branching. Finally, we discuss how modification of the extraction conditions could be tailored to obtain pectin with the desired emulsification properties. It is proposed that pectin with protein content in the range of 3%, with degree of acetylation greater than 10%, molecular weight between 100 and 200 x103 g mol-1 and enriched in RG-I segments is more likely to perform well as an emulsifier. To tailor such a structure, an aqueous extraction protocol with low pH values (between 2.5-3.5) with a strong monoprotic acid (e.g., HCl) and one-step solvent precipitation should be selected. The proposed set of extraction conditions could be used as a first step towards rational design of pectin with desirable interfacial functionality