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To determine whether patients would have equivalent or improved outcomes when receiving non-surgical management versus surgical removal for vocal process granulomas.
A chart review was performed for 53 adults with vocal process granulomas. All patients received baseline anti-reflux treatment consisting of twice-daily proton pump inhibitors and vocal hygiene education. Further treatment approaches were divided into non-surgical (i.e. inhaled corticosteroids, voice therapy, botulinum toxin injections) and surgical groups. Subjective parameters (Voice Handicap Index 10 and Reflux Symptom Index) and outcomes were tabulated and statistically compared. Cause of granuloma was also analysed to determine if this influenced outcomes.
Of 53 patients, 47 (89 per cent) experienced reduction in granuloma size, while 37 (70 per cent) experienced complete resolution. The rate of complete granuloma resolution after initial treatment strategy alone was significantly higher in non-surgical compared to surgical patients (67 and 30 per cent, respectively; p = 0.039). No difference in outcome was seen between iatrogenic and idiopathic granulomas.
Non-surgical patients were more likely to experience initial treatment success than those who underwent surgical removal. Continued emphasis should be placed on conservative treatment options prior to surgery for patients with this condition.
We describe Hedruris dratini n. sp. (Nematoda, Hedruridae) from Hydromedusa tectifera and Phrynops hilarii in Argentina based on morphological and molecular characters. Also, we provide information about its life cycle. The new species differs from other species of the genus by possessing the excretory pore, nerve ring and deirids at equal distance from the anterior end. Additionally, H. dratini n. sp. has mammilated eggs and males possess nine pairs of caudal papillae. The subadults and adults of H. dratini n. sp and H. orestiae were characterized by sequencing the small subunit ribosomal DNA (18S). We present for the first time a life cycle of a species of Hedruris that includes an amphipod as intermediate host and a reptile as definitive host. Furthermore, we analysed the host and geographic distribution of all Hedruris species. Although the genus has a cosmopolitan distribution and parasitizes a great host diversity, the majority of species have a Gondwanian distribution, with amphibians being the preferred hosts.
Tick-borne diseases (TBDs) can sometimes cause severe symptoms and lead to hospitalisation, but they often go unnoticed in the Emergency Department (ED). The aim of this study was twofold: (i) to describe the profile of patients hospitalised by TBDs; and (ii) to evaluate the data collected in the medical records from the ED in order to analyse their potential clinical consequences. A total of 84 cases that included all TBD diagnoses registered in the ED records were identified and analysed. These corresponded to all the hospitalisations by TBDs in the last 10 years (2009–2019) in two tertiary hospitals in Granada, Spain. Statistical analyses were made using RStudio. Coinciding with the absence of patient's report of exposure to ticks, 64.3% of TBDs were not suspected in the ED. Intensive care unit admission was required in 8.3% of cases, and the mortality rate was 2.4%. Non-suspected cases showed longer hospital stay (P < 0.001), treatment duration (P = 0.02) and delay in the initiation of antibiotic treatment (P < 0.001). Our findings indicate that symptoms associated with TBDs are highly non-specific. In the absence of explicit information related to potential tick exposure, TBDs are not initially suspected. As a consequence, elective treatment administration is delayed and hospitalisation time is prolonged. In conclusion, our results highlight the importance of addressing potential exposure to ticks during the ED contact with patients presenting with febrile syndrome.
The application of clay minerals in therapeutics is becoming important due to their structural and surface physicochemical properties. 5-aminosalicylic acid (5-ASA) is a very common pharmaceutical drug and is used worldwide. The interactions between the 5-ASA molecule and both the aluminol and siloxane surfaces of kaolinite are studied by means of atomistic calculations using force fields based on empirical interatomic potentials and quantum mechanics calculations based on density functional theory. A conformational analysis of 5-ASA has been performed and the anion of 5-ASA was also studied. The calculated adsorption energy values indicate that 5-ASA is likely to be adsorbed on the kaolinite surfaces with greater affinity to the aluminol surface. Hence, kaolinite may be considered as a promising pharmaceutical carrier of 5-ASA.
Polyurethanes (PUs) were synthesized with polyols derived from castor oil and isophorone diisocyanate. The materials were evaluated for their mechanical properties using stress–strain curves, thermogravimetric analysis, differential scanning calorimetry, and contact angle analysis. The biological response of the materials was evaluated by determining their cell viability in vitro, antimicrobial activity against Escherichia coli and Pseudomonas aeruginosa, and biological response in vivo of PUs by means of implanting them in Wistar rats. The cell proliferation on the materials was analyzed using mouse fibroblast L929, human fibroblast MRC-5, and adult human dermal fibroblast (HDFa) cells by the ISO 10993-5 method. The materials showed no toxic effects and promoted cell proliferation. Experiments performed in vivo for 30 days in mice showed that the materials neither affected the wound healing process nor caused adverse effects or severe injuries in the dorsal mid-cervical tissue or organs on histological evaluation. PUs synthesized can be used in biomedical devices.
Polyurethane/cellulose composites were synthesized from castor-oil-derived polyols and isophorone diisocyanate using dibutyltin dilaurate (DBTDL) as the catalyst. Materials were obtained by adding 2% cellulose in the form of either microcrystals (20 μm) or nanocrystals obtained by acid hydrolysis. The aim was to assess the effects of filler particle size and the use of a catalyst on the physicochemical properties and biological response of these composites. The addition of the catalyst was found to be essential to prevent filler aggregations and to enhance the tensile strength and elongation at break. The cellulose particle size influenced the composite properties, as its nanocrystals heighten hydrogen bond interactions between the filler surface and polyurethane domains, improving resistance to hydrolytic degradation. All hybrids retained cell viability, and the addition of DBTDL did not impair their biocompatibility. The samples were prone to calcification, which suggests that they could find application in the development of bioactive materials.
Analysis of the total surface energy γT and its three components as established by the van Oss-Chaudhury-Good Theory (vOCG) is conducted via Three Liquid Contact Angle Analysis (3LCAA). γT is correlated with the composition of the top monolayers (ML) obtained from High-Resolution Ion Beam Analysis (HR-IBA). Control of γT enables surface engineering for wafer bonding (Nano-BondingTM) and/or epitaxial growth. Native oxides on boron-doped p-Si(100) are found to average γT of 53 ± 1.4 mJ/m2) and are always hydrophilic. An HF in methanol or aqueous HF etch for 60 s always renders Si(100) hydrophobic. Its γT decreases by 20% to 44 ± 3 mJ/m2 in HF in methanol etch and by 10% to 48 ± 3 mJ/m2 in aqueous HF. On the contrary, GaAs(100) native oxides are found to always be hydrophobic. Tellurium n+-doped GaAs(100) yields an average of γT of 37 ± 2 mJ/m2, 96% of which is due to the Lifshitz-Van der Waals molecular interactions (γLW = 36 ± 1 mJ/m2). However, hydrophobic GaAs(100) can be made highly hydrophilic. After etching, γT increases by almost 50% to 66 ± 1.4 mJ/m2. 3LCAA shows that the γT increase is due to electron acceptor and donor interactions, while the Lifshitz-van der Waals energy γLW remains constant. IBA combining the 3.039 ± 0.01 MeV oxygen nuclear resonance with <111> channeling, shows that oxygen on Si(100) decreases by 10% after aqueous HF etching, from 13.3 ± 0.3 monolayers (ML) to 11.8 ± 0.4 ML 1 hour after etch.Te-doped GaAs(100) exhibits consistent oxygen coverage of 7.2 ± 1.4 ML, decreasing by 50% after etching to a highly hydrophilic surface with 3.6 ± 0.2 oxygen ML. IBA shows that etching does not modify the GaAs surface stoichiometry to within 1% . Combining 3LCAA with HR-IBA provides a quantitative metrology to measure how GaAs and Si surfaces can be altered to a different hydroaffinity and surface termination.
The purpose of this work is to study the effect of SiO2- and Al2O3-NPs on the microstructure and mechanical properties of the weld bead (WB) created by a process of Submerged Arc Welding (SAW) between two AISI 1025 steel plates. Also it was necessary consider the chemical compositions of slags and burned fluxes, in order to determine the elements that are deposited and contribute in the final microstructure of WB. The welding materials to form each WB were a M12K electrode, a commercial fused flux (CFF) and AISI 1025 steel plates bevelled at 45°. In addition SiO2- or Al2O3-NPs an ethylic alcohol mixture were applied directly to the beveled surfaces, just before the SAW process, which was carried out according to the AWS A5.17 norm. Microstructural and phase changes at the Heat Affected Zone (HAZ) and Welding Zone (WZ) were analysed by metallographic Optical and Scanning Electron Microscopies. The mechanical properties of the WBs were determined through Tensile, Charpy impact and Vickers Hardness tests. By means of metallography of WBs, it was determined that the length of the AF needles increases in 113 and 183 % when adding SiO2- or Al2O3-NPs, respectively. Related to the mechanical properties of the WB, the tensile and yield strength decreases with both additions, SiO2- or Al2O3-NPs. The microhardness at WZ was found to decrease by adding such oxide-NPs. Moreover, the impact energy absorbed by the WBs increases approximately by 83 or 57% due to SiO2- or Al2O3-NPs addition, respectively.
The effects of crystal orientation and doping on the surface energy, γT, of native oxides of Si(100) and Si(111) are measured via Three Liquid Contact Angle Analysis (3LCAA) to extract γT, while Ion Beam Analysis (IBA) is used to detect Oxygen. During 3LCAA, contact angles for three liquids are measured with photographs via the “Drop and Reflection Operative Program (DROP™). DROP™ removes subjectivity in image analysis, and yields reproducible contact angles within < ±1°. Unlike to the Sessile Drop Method, DROP can yield relative errors < 3% on sets of 20-30 drops. Native oxides on 5 x 1013 B/cm3 p- doped Si(100) wafers, as received in sealed, 25 wafer teflon boats continuously stored in Class 100/ISO 5 conditions at 24.5°C in 25% controlled humidity, are found to be hydrophilic. Their γT, 52.5 ± 1.5 mJ/m2, is reproducible between four boats from three sources, and 9% greater than γT of native oxides on n- doped Si(111), which averages 48.1 ± 1.6 mJ/m2 on four 4” Si(111) wafers. IBA combining 16O nuclear resonance with channeling detects 30% more oxygen on native oxides of Si(111) than Si(100). While γT should increase on thinner, more defective oxides, Lifshitz-Van der Waals interactions γLW on native oxides of Si(100) remain at 36 ± 0.4 mJ/m2, equal to γLW on Si(111), 36 ± 0.6 mJ/m2, since γLW arises from the same SiO2 molecules. Native oxides on 4.5 x 1018 B/cm3 p+ doped Si(100) yield a γT of 39 ± 1 mJ/m2, as they are thicker per IBA. In summary, 3LCAA and IBA can detect reproducibly and accurately, within a few %, changes in the surface energy of native oxides due to thickness and surface composition arising from doping or crystal structure, if conducted in well controlled clean room conditions for measurements and storage.
Previous reviews suggest there is minimal evidence for an association between duration of untreated psychosis (DUP) and neurocognition. This is based on tallied findings of studies with small samples and neurocognition viewed as a single construct. We aimed to conduct a systematic review and meta-analysis examining the association between DUP and individual neurocognitive domains and tests in first-episode psychosis (FEP).
MOOSE and PRISMA guidelines were followed. Forty-three studies involving 4647 FEP patients were included. For studies providing correlations between DUP and neurocognition, 12 separate meta-analyses were performed based on neurocognitive domains/indices. The influence of demographic/clinical variables was tested using weighted linear meta-regression analyses.
The relationship between DUP and most neurocognitive domains/indices was not significant. Longer DUP was associated with a larger cognitive deterioration index, i.e. current minus premorbid intellectual functioning (N = 4; mean ES −0.213, 95% confidence interval (CI) (−0.344 to −0.074), p = 0.003). Findings were homogeneous, with no evidence of publication bias or significant influence from moderators. For studies providing mean and standard deviations for neurocognitive measures and DUP, 20 meta-regressions were performed on individual neurocognitive tests. One significant finding emerged showing that longer DUP was associated with fewer Wisconsin Card Sorting Test-perseverative errors (mean ES −0.031, 95% CI (−0.048 to −0.013), p < 0.001). Exploratory meta-regressions in studies with mean DUP <360 days showed longer DUP was significantly associated with poorer performance on Trail Making Test A and B and higher Full-Scale IQ.
There may not be a generalised association between DUP and neurocognition, however, specific cognitive functions may be associated with longer DUP or delayed help-seeking.
We present radiocarbon (14C) in tree rings from Mexico City and a reconstruction of fossil CO2 concentrations for the last five decades, as part of a research program to understand the 14C dynamics in this complex urban area. Background values were established by 14C concentrations in tree rings from a nearby clean area. Agreement between background and NH-zone 2 values indicate Taxodium mucronatum is a good biomonitor for annual atmospheric 14C variations. Values for the urban tree rings were significantly lower than background values, indicating a 14C depletion from fossil CO2 emissions. There is an increasing trend of fossil CO2 between 1960 and 1990, in agreement with the population growth and the increasing demand for fossil fuels in Mexico City. Between 1990 and 2000, there is an apparent decrease in fossil CO2 concentration, increasing again after 2000. The decrease in 2000, despite being of the same magnitude as the overall uncertainty, may reflect environmental policies that improved the energy efficiency and reduced CO2 emissions in the area. The increase in fossil CO2 concentration between 2000 and 2010 may be attributable to the significant growth of motor vehicle usage in Mexico City, which made transportation the main energy-demanding and -emitting sector.
This study investigated the potential application of genomic selection under a multi-breed scheme in the Spanish autochthonous beef cattle populations using a simulation study that replicates the structure of linkage disequilibrium obtained from a sample of 25 triplets of sire/dam/offspring per population and using the BovineHD Beadchip. Purebred and combined reference sets were used for the genomic evaluation and several scenarios of different genetic architecture of the trait were investigated. The single-breed evaluations yielded the highest within-breed accuracies. Across breed accuracies were found low but positive on average confirming the genetic connectedness between the populations. If the same genotyping effort is split in several populations, the accuracies were lower when compared with single-breed evaluation, but showed a small advantage over small-sized purebred reference sets over the accuracies of subsequent generations. Besides, the genetic architecture of the trait did not show any relevant effect on the accuracy with the exception of rare variants, which yielded slightly lower results and higher loss of predictive ability over the generations.
We explore the properties of sound and human sound recognition as a means to enhance and accelerate visual-only data analysis methods. The aim of this work is to enable and improve the analysis of large data sets, data requiring rapid analysis, multi-dimensional data, and signal detection in data with low signal-to-noise ratio. We present a prototype tool, StarSound, to sonify data such as astronomical transient light curves, spectra, and power spectra. Stereophonic sound is used to ‘visualise’ and localise the data under examination, and 3-D sound is discussed in conjunction with virtual reality technology, as a means to enhance analysis efficiency and efficacy, including rapid data assessment and training machine learning software. In addition, we explore the use of higher-order harmonics as a means to examine simultaneously multi-dimensional data sets. Such an approach can allow the data to be interpreted in a holistic manner and facilitates the discovery of previously unseen connections and relationships. Furthermore, we exploit the capability of the human brain for selective or focused hearing that enables the identification of desired signals in noisy data, or amidst similar or more significant signals. Finally, we provide research examples that benefit directly from data sonification. The work presented here aims to help tackle the challenges of the upcoming era of Big Data and help optimise, speed up and expand aspects of data analysis requiring human interaction.
Polyurethane-based bioadhesive was synthesized with polyols derived from castor oil (chemically modified and unmodified) and hexamethylene diisocyanate with chitosan addition as a bioactive filler. The objective was to evaluate the effect of type of polyols with the incorporation of low-concentrations of chitosan on the mechanical and biological properties of the polymer to obtain suitable materials in the design of biomaterials. The results showed that increasing physical crosslinking increased the mechanical and adhesive properties. An in vitro cytotoxic test of polyurethanes showed cellular viability. The biocompatibility of the polyurethanes favors the adhesion of L929 cells at 6, 24, and 48 h. The polyurethanes showed bacterial inhibition depending on the polyol and percentage of chitosan. The antibacterial effect of the polyurethanes for Escherichia coli decreased 60–90% after 24 h. The mechanical and adhesive properties together with biological response in this research suggested these polyurethanes as external application tissue bioadhesives.
The aim of this study was to determine if the problem-solving therapy (PST) helps control metabolic variables in patients with type 2 diabetes mellitus (T2DM) who show depressive and anxiety symptoms.
T2DM is a chronic-degenerative multifactorial disease. It is considered one of the main public health problems in the world, and it represents an important social and economic burden. It is frequently associated with major depression and anxiety disorders, which are related with high glycated hemoglobin (HbA1c) concentrations and poor metabolic control.
We initially included 123 patients diagnosed with T2DM from five primary care centers (PCC) in Mexico City. HbA1c, central glucose, and lipid profile were measured in each patient. In addition, the Kessler psychological distress scale (K-10), the Beck Depression Inventory, and the Beck Anxiety Inventory were applied at the beginning and, to those who continued, at the end of the PST, as well as four months later.
In total, 36 patients completed the PST and the follow-up. There was a significant decrease in depressive and anxiety symptoms (P<0.001), as well as in total cholesterol (P=0.002), HbA1c (P=0.05), and low-density lipoprotein (LDL) (P=0.022). The PST helps reduce depressive and anxiety symptoms and may help stabilize glucose and cholesterol up to four months. Further studies on this area are recommended. If our findings are confirmed, the PST could help improve the quality of life of thousands of individuals with psychiatric-metabolic co-morbidity who only visit PCC.
Our previous work revealed substantial heterogeneity in the cognitive profile of bipolar disorder (BD) due to the presence of three underlying cognitive subgroups characterized as: globally impaired, selectively impaired, or cognitively intact. In an effort to determine whether these subgroups are differentially related to genetic risk for the illness, we investigated whether cognitive deficits were more pronounced in unaffected siblings (UAS) of BD probands within identified clusters.
Cluster analysis was used to identify cognitive clusters in BD (N = 60). UAS (N = 49) were classified into groups according to their proband sibling's cluster assignment; comparisons were made across all clusters and healthy controls (HCs; N = 71).
Three cognitive clusters in BD emerged: a globally impaired (36.7%), a selectively impaired (30%), and a cognitively intact cluster (33.3%). UAS showed a qualitatively similar pattern to their BD siblings; UAS of the globally impaired BD cluster showed verbal memory and general cognitive impairments relative to HCs. In contrast, UAS of the other two clusters did not differ from HCs.
This study corroborates findings from prior work regarding the presence of cognitive heterogeneity in BD. UAS of subjects in the globally impaired BD cluster presented with a qualitatively similar cognitive profile to their siblings and performed worse than all other BD clusters and UAS groups. This suggests that inherited risk factors may be contributing to cognitive deficits more notably in one subgroup of patients with BD, pointing toward differential causes of cognitive deficits in discrete subgroups of patients with the disorder.
Background: Verbal memory (VM) impairment is prominent in bipolar disorder (BD) and is linked to functional outcomes. However, the intricacies of VM impairment have not yet been studied in a large sample of BD patients. Moreover, some have proposed VM deficits that may be mediated by organizational strategies, such as semantic or serial clustering. Thus, the exact nature of VM break-down in BD patients is not well understood, limiting remediation efforts. We investigated the intricacies of VM deficits in BD patients versus healthy controls (HCs) and examined whether verbal learning differences were mediated by use of clustering strategies. Methods: The California Verbal Learning Test (CVLT) was administered to 113 affectively stable BD patients and 106 HCs. We compared diagnostic groups on all CVLT indices and investigated whether group differences in verbal learning were mediated by clustering strategies. Results: Although BD patients showed significantly poorer attention, learning, and memory, these indices were only mildly impaired. However, BD patients evidenced poorer use of effective learning strategies and lower recall consistency, with these indices falling in the moderately impaired range. Moreover, relative reliance on semantic clustering fully mediated the relationship between diagnostic category and verbal learning, while reliance on serial clustering partially mediated this relationship. Conclusions: VM deficits in affectively stable bipolar patients were widespread but were generally mildly impaired. However, patients displayed inadequate use of organizational strategies with clear separation from HCs on semantic and serial clustering. Remediation efforts may benefit from education about mnemonic devices or “chunking” techniques to attenuate VM deficits in BD. (JINS, 2017, 23, 358–366)