Gout is a well known metabolic disorder characterized by the formation of urate crystals in joints resulting in recurrent attacks of acute inflammatory arthritis following which tophi can occur in joints or subcutaneous tissues. We report a rare localization of gouty tophi in a 52 years old male. The tophi had formed over the stainless steel implant used for the fixation of a lateral malleolus fracture 20 years ago.
Positive transcription elongation factor b (P-TEFb), which comprises cyclin-dependent kinase 9 (CDK9) kinase and cyclin T subunits, is an essential kinase complex in human cells. Phosphorylation of the negative elongation factors by P-TEFb is required for productive elongation of transcription of protein-coding genes by RNA polymerase II (pol II). In addition, P-TEFb-mediated phosphorylation of the carboxyl-terminal domain (CTD) of the largest subunit of pol II mediates the recruitment of transcription and RNA processing factors during the transcription cycle. CDK9 also phosphorylates p53, a tumor suppressor that plays a central role in cellular responses to a range of stress factors. Many viral factors affect transcription by recruiting or modulating the activity of CDK9. In this review, we will focus on how the function of CDK9 is regulated by viral gene products. The central role of CDK9 in viral life cycles suggests that drugs targeting the interaction between viral products and P-TEFb could be effective anti-viral agents.
To inform case definition for neck/shoulder pain in epidemiological research, we compared levels of disability, patterns of association, and prognosis for pain that was limited to the neck or shoulders (LNSP) and more generalised musculoskeletal pain that involved the neck or shoulder(s) (GPNS). Baseline data on musculoskeletal pain, disability, and potential correlates were collected by questionnaire from 12,195 workers in 47 occupational groups (mostly office workers, nurses, and manual workers) in 18 countries (response rate = 70%). Continuing pain after a mean interval of 14 months was ascertained through a follow-up questionnaire in 9150 workers from 45 occupational groups. Associations with personal and occupational factors were assessed by Poisson regression and summarised by prevalence rate ratios (PRRs). The 1-month prevalence of GPNS at baseline was much greater than that of LNSP (35.1% vs 5.6%), and it tended to be more troublesome and disabling. Unlike LNSP, the prevalence of GPNS increased with age. Moreover, it showed significantly stronger associations with somatising tendency (PRR 1.6 vs 1.3) and poor mental health (PRR 1.3 vs 1.1); greater variation between the occupational groups studied (prevalence ranging from 0% to 67.6%) that correlated poorly with the variation in LNSP; and was more persistent at follow-up (72.1% vs 61.7%). Our findings highlight important epidemiological distinctions between subcategories of neck/shoulder pain. In future epidemiological research that bases case definitions on symptoms, it would be useful to distinguish pain that is localised to the neck or shoulder from more generalised pain that happens to involve the neck/shoulder region.
MeSH terms: Adult; Age Factors; Female; Follow-Up Studies; Disabled Persons*; Humans; International Cooperation; Male; Mental Health; Middle Aged; Occupational Diseases/epidemiology*; Surveys and Questionnaires; Risk Factors; Prevalence; Epidemiologic Studies; Age Distribution; Young Adult
The drying of fruits and vegetables is a complex operation that demands much energy and time. In practice, the drying of fruits and vegetables increases product shelf-life and reduces the bulk and weight of the product, thus simplifying transport. Occasionally, drying may lead to a great decrease in the volume of the product, leading to a decrease in storage space requirements. Studies have shown that dependence purely on experimental drying practices, without mathematical considerations of the drying kinetics, can significantly affect the efficiency of dryers, increase the cost of production, and reduce the quality of the dried product. Thus, the use of mathematical models in estimating the drying kinetics, the behavior, and the energy needed in the drying of agricultural and food products becomes indispensable. This paper presents a comprehensive review of modeling thin-layer drying of fruits and vegetables with particular focus on thin-layer theories, models, and applications since the year 2005. The thin-layer drying behavior of fruits and vegetables is also highlighted. The most frequently used of the newly developed mathematical models for thin-layer drying of fruits and vegetables in the last 10 years are shown. Subsequently, the equations and various conditions used in the estimation of the effective moisture diffusivity, shrinkage effects, and minimum energy requirement are displayed. The authors hope that this review will be of use for future research in terms of modeling, analysis, design, and the optimization of the drying process of fruits and vegetables.
Honey is a popular natural food product with a very complex composition mainly consisting of both organic and inorganic constituents. The composition of honey is strongly influenced by both natural and anthropogenic factors, which vary based on its botanical and geographical origins. Although minerals and heavy metals are minor constituents of honey, they play vital role in determining its quality. There are several different analytical methods used to determine the chemical elements in honey. These methods are typically based on spectroscopy or spectrometry techniques (including atomic absorption spectrometry, atomic emission spectrometry, inductively coupled plasma mass spectrometry, and inductively coupled plasma optical emission spectrometry). This review compiles available scientific information on minerals and heavy metals in honey reported from all over the world. To date, 54 chemical elements in various types of honey have been identified and can be divided into 3 groups: major or macroelements (Na, K, Ca, Mg, P, S, Cl), minor or trace elements (Al, Cu, Pb, Zn, Mn, Cd, Tl, Co, Ni, Rb, Ba, Be, Bi, U, V, Fe, Pt, Pd, Te, Hf, Mo, Sn, Sb, La, I, Sm, Tb, Dy, Sd, Th, Pr, Nd, Tm, Yb, Lu, Gd, Ho, Er, Ce, Cr, As, B, Br, Cd, Hg, Se, Sr), and heavy metals (trace elements that have a specific gravity at least 5 times higher than that of water and inorganic sources). Chemical elements in honey samples throughout the world vary in terms of concentrations and are also influenced by environmental pollution.
MeSH terms: Cadmium; Environmental Pollution; Honey; Lead; Mercury; Minerals; Plasma; Specific Gravity; Spectrophotometry, Atomic; Mass Spectrometry; Thallium; Trace Elements; Water; Zinc; Metals, Heavy
Mimosa pudica Linn. (Family: Mimosaceae) is used as an ornamental plant due to its thigmonastic and nyctinastic movements. M. pudica is also used to avoid or cure several disorders like cancer, diabetes, hepatitis, obesity, and urinary infections. M. pudica is famous for its anticancer alkaloid, mimosine, along with several valuable secondary metabolites like tannins, steroids, flavonoids, triterpenes, and glycosylflavones. A wide array of pharmacological properties like antioxidant, antibacterial, antifungal, anti-inflammatory, hepatoprotective, antinociceptive, anticonvulsant, antidepressant, antidiarrheal, hypolipidemic activities, diuretic, antiparasitic, antimalarial, and hypoglycemic have been attributed to different parts of M. pudica. Glucuronoxylan polysaccharide extruded from seeds of M. pudica is used for drug release formulations due to its high swelling index. This review covers a thorough examination of functional bioactives as well as pharmacological and phytomedicinal attributes of the plant with the purpose of exploring its pharmaceutical and nutraceutical potentials.
This case report describes the management of an impacted and dilacerated upper permanent incisor in an 11 year old girl who also presented with a congenitally missing lateral incisor in the same quadrant. The two treatment options commonly chosen for the management of an impacted incisor are surgical exposure followed by orthodontic traction and extraction of the tooth itself. This case posed an extra challenge as the adjacent lateral incisor was congenitally missing. Instead of resorting to the use of dentures, an alternative treatment involving the surgical repositioning of the impacted tooth was done. This method not only satisfied the patient’s aesthetic requirement but ensured preservation of alveolar bone height and thickness in the upper anterior segment. Surgical repositioning of an impacted and/or dilacerated tooth can be considered as an alternative treatment option when surgical exposure and traction of the tooth is not possible.
Objectives: To assess the prevalence of handedness and its impact on the perceived difficulty in clinical training amongst undergraduate dental students in Malaysia. Materials and Methods: A cross-sectional survey using a self-administered questionnaire was conducted in 5 dental schools around the Klang Valley. Samples consisted of year 4 and year 5 clinical undergraduate dental students. Information on the socio-demographic data, the determination of handedness and assesment of perceived difficulty in carrying out certain clinical procedures were collected. Results: A total sample of 347 participants of which 76.9% were females was obtained. The distribution of year 4 and year 5 students in the sample were equal. Eighty five percent of the samples were right-handed, 9.5% were ambidextrous and 5.5% were left-handed. Statistically significant difference was found between handedness groups for the combined clinical procedures variable: F (2.100), P
used with bonded retainers. Setting: Department of Orthodontics, UCL Eastman Dental Institute, United Kingdom. Methods: Flowable composite resins (Transbond TM Supreme LV, StarFlowTM and Tetric EvoFlow®) and non -flowable control resin (TransbondTM LR) were made into cylinders prior to bonding to hydoxyapatite discs. They were then mounted into jigs and tested in the InstronTM Universal Testing Machine in both shear and tensile modes. Results: The highest mean shear bond strength was seen with StarFlow TM (14.09 MPa), which was significantly higher than both TransbondTM LR (9.48 MPa) and TransbondTM Supreme LV (8.20 MPa). The mean shear bond strength of Tetric EvoFlow® (11.86 MPa) was also significantly higher than TransbondTM Supreme LV. The highest mean tensile bond strength was seen with Tetric EvoFlow® (2.14 MPa), which was significantly higher than TransbondTM LR (1.15 MPa) and TransbondTM Supreme LV (0.61 MPa) but not significantly different to StarFlowTM (1.47 MPa). For shear loading, StarFlowTM had the highest 50th percentile survival estimate at 15.10 MPa, followed by Tetric EvoFlow® (13.00 MPa) and TransbondTM Supreme LV (7.50 MPa). TransbondTM LR had a 50th percentile estimate at 9.00 MPa. For tensile loading, Tetric EvoFlow® had the highest 50th percentile survival estimate at 2.50 MPa, followed by StarFlowTM (1.30 MPa) and TransbondTM Supreme LV (0.50 MPa). TransbondTM LR had a 50th percentile estimate at 1.00 MPa. Conclusions: Mean shear bond strengths for all of the resins were significantly higher than the mean tensile bond strengths. StarFlowTM and Tetric EvoFlow® could potentially be suitable clinical alternatives to TransbondTM LR due to its low viscosity flow characteristics and adequate shear and tensile bond strengths.
Objectives: The aim of the study is to evaluate the effect of the time and instant coffee solution on the color stability of three types of composite resin based veneer systems. Materials and Methods: 24 composite resin veneer samples were selected and divided into three groups: two groups of prefabricated veneers (Edelweiss, Ultradent Inc™ (EDL) and Componeer, Coltène/ Whaledent AGTM (CMP)) and one group of laboratory made (Nexco, Ivoclar Vivadent (NEX)) veneer system were tested (n=8). Specimens were prepared and stored in staining solution (instant coffee) and assessed color changes with Minolta spectrophotometer every three days for a period of 27 days, after which color differences (ΔE*) were calculated. Data collection and analysis was done using one-way ANOVA and Student’s t-test (α=0.05). Results: One-way ANOVA revealed a significant difference in color stability between the two veneer systems. NEX group veneer system exhibited the highest color stability (ΔE*= 0.73 ± 0.5) as compared to prefabricated veneer groups (EDL 10.07 ± 5.15, CMP 7.41 ± 4.64) with p value
MeSH terms: Acrylic Resins; Analysis of Variance; Coffee; Color; Composite Resins; Cytidine Monophosphate; Humans; Polyurethanes; Staining and Labeling; Waxes
Fitting accuracy of dental prostheses is essential for clinical success. An ideal marginal and internal fit will minimize plaque accumulation, gingival irritation, cement dissolution and micro leakage as well as enhancing the mechanical behaviour of a fixed partial denture (FPD) (1). Unfortunately, there is disagreement about acceptable marginal and internal fit discrepancies of FPD’s (2) from 75-200μm. There are two main manufacturing routes of CAD/CAM FPD’s: the subtractive and the additive route. The subtractive route is a top-down approach which involves milling the desired article out of a block of the material of choice using a series of burs. This route is currently the most common CAD/CAM technique for the fabrication of metal alloy FPD’s. The additive route is a bottom-up approach where the desired article is fabricated layer by layer out of the material of choice. Examples include selective laser sintering and selective laser melting for metal alloy FPD’s.
A measurement is presented of differential cross sections for Higgs boson (H) production in pp collisions at [Formula: see text][Formula: see text]. The analysis exploits the [Formula: see text] decay in data corresponding to an integrated luminosity of 19.7[Formula: see text] collected by the CMS experiment at the LHC. The cross section is measured as a function of the kinematic properties of the diphoton system and of the associated jets. Results corrected for detector effects are compared with predictions at next-to-leading order and next-to-next-to-leading order in perturbative quantum chromodynamics, as well as with predictions beyond the standard model. For isolated photons with pseudorapidities [Formula: see text], and with the photon of largest and next-to-largest transverse momentum ([Formula: see text]) divided by the diphoton mass [Formula: see text] satisfying the respective conditions of [Formula: see text] and [Formula: see text], the total fiducial cross section is [Formula: see text][Formula: see text].
MeSH terms: Aircraft; Biomechanical Phenomena; Motion; Personal Satisfaction; United States; Photons; Text Messaging
The cross section for [Formula: see text] production in the all-jets final state is measured in pp collisions at a centre-of-mass energy of 8 [Formula: see text] at the LHC with the CMS detector, in data corresponding to an integrated luminosity of 18.4 [Formula: see text]. The inclusive cross section is found to be [Formula: see text] [Formula: see text]. The normalized differential cross sections are measured as a function of the top quark transverse momenta, [Formula: see text], and compared to predictions from quantum chromodynamics. The results are reported at detector, parton, and particle levels. In all cases, the measured top quark [Formula: see text] spectra are significantly softer than theoretical predictions.
New sets of parameters ("tunes") for the underlying-event (UE) modelling of the pythia8, pythia6 and herwig++ Monte Carlo event generators are constructed using different parton distribution functions. Combined fits to CMS UE proton-proton ([Formula: see text]) data at [Formula: see text] and to UE proton-antiproton ([Formula: see text]) data from the CDF experiment at lower [Formula: see text], are used to study the UE models and constrain their parameters, providing thereby improved predictions for proton-proton collisions at 13[Formula: see text]. In addition, it is investigated whether the values of the parameters obtained from fits to UE observables are consistent with the values determined from fitting observables sensitive to double-parton scattering processes. Finally, comparisons are presented of the UE tunes to "minimum bias" (MB) events, multijet, and Drell-Yan ([Formula: see text] lepton-antilepton+jets) observables at 7 and 8[Formula: see text], as well as predictions for MB and UE observables at 13[Formula: see text].
MeSH terms: Aircraft; Monte Carlo Method; Protons; United States; Text Messaging
From February 1, 2014, through June 30, 2015, 13,289 insulin-injecting patients from 423 centers in 42 countries participated in one of the largest surveys ever performed in diabetes. The first results of this survey are published elsewhere in this issue. Herein we report that the most common complication of injecting insulin is lipohypertrophy (LH), which was self-reported by 29.0% of patients and found by physical examination in 30.8% by health care professionals (HCPs). Patients with LH consumed a mean of 10.1 IU more insulin daily than patients without LH. Glycated hemoglobin levels averaged 0.55% higher in patients with vs without LH. Lipohypertrophy was associated with higher rates of unexplained hypoglycemia and glycemic variability as well as more frequent diabetic ketoacidosis, incorrect rotation of injection sites, use of smaller injection zones, longer duration of insulin use, and reuse of pen needles (each P
MeSH terms: Adult; Aged; Aged, 80 and over; Diabetes Mellitus, Type 2/diagnosis*; Diabetes Mellitus, Type 2/drug therapy*; Female; Humans; Hypoglycemic Agents/administration & dosage*; Injections/adverse effects; Injections/methods*; Insulin/administration & dosage*; Male; Middle Aged; Patient Education as Topic*; Physician's Role*; Surveys and Questionnaires
From February 1, 2014, through June 30, 2015, 13,289 insulin-injecting patients from 423 centers in 42 countries took part in one of the largest surveys ever performed in diabetes. The goal was to assess patient characteristics, as well as historical and practical aspects of their injection technique. Results show that 4- and 8-mm needle lengths are each used by nearly 30% of patients and 5- and 6-mm needles each by approximately 20%. Higher consumption of insulin (as measured by total daily dose) is associated with having lipohypertrophy (LH), injecting into LH, leakage from the injection site, and failing to reconstitute cloudy insulin. Glycated hemoglobin values are, on average, 0.5% higher in patients with LH and are significantly higher with incorrect rotation of sites and with needle reuse. Glycated hemoglobin values are lower in patients who distribute their injections over larger injection areas and whose sites are inspected routinely. The frequencies of unexpected hypoglycemia and glucose variability are significantly higher in those with LH, those injecting into LH, those who incorrectly rotate sites, and those who reuse needles. Needles associated with diabetes treatment are the most commonly used medical sharps in the world. However, correct disposal of sharps after use is critically suboptimal. Many used sharps end up in public trash and constitute a major accidental needlestick risk. Use of these data should stimulate renewed interest in and commitment to optimizing injection practices in patients with diabetes.
Study sites: 423 centers in 42 countries (Malaysia contributed 51 patients from two hospital study sites)
MeSH terms: Adult; Aged; Aged, 80 and over; Diabetes Mellitus, Type 2/diagnosis*; Diabetes Mellitus, Type 2/drug therapy*; Female; Humans; Hypoglycemic Agents/administration & dosage*; Injections/methods*; Insulin/administration & dosage*; Male; Middle Aged; Surveys and Questionnaires; Needlestick Injuries
The recognition of protein folds is an important step in the prediction of protein structure and function. Recently, an increasing number of researchers have sought to improve the methods for protein fold recognition. Following the construction of a dataset consisting of 27 protein fold classes by Ding and Dubchak in 2001, prediction algorithms, parameters and the construction of new datasets have improved for the prediction of protein folds. In this study, we reorganized a dataset consisting of 76-fold classes constructed by Liu et al. and used the values of the increment of diversity, average chemical shifts of secondary structure elements and secondary structure motifs as feature parameters in the recognition of multi-class protein folds. With the combined feature vector as the input parameter for the Random Forests algorithm and ensemble classification strategy, we propose a novel method to identify the 76 protein fold classes. The overall accuracy of the test dataset using an independent test was 66.69%; when the training and test sets were combined, with 5-fold cross-validation, the overall accuracy was 73.43%. This method was further used to predict the test dataset and the corresponding structural classification of the first 27-protein fold class dataset, resulting in overall accuracies of 79.66% and 93.40%, respectively. Moreover, when the training set and test sets were combined, the accuracy using 5-fold cross-validation was 81.21%. Additionally, this approach resulted in improved prediction results using the 27-protein fold class dataset constructed by Ding and Dubchak.
MeSH terms: Algorithms; Proteins; Protein Structure, Secondary
In diabetes mellitus dyslipidemia is one of the major risk factors for cardiovascular disease. In type 2 diabetes mellitus early detection and treatment of dyslipidemia can avoid risk for cardiovascular disorder. The present study was carried to determine the prevalence and pattern of hyperlipidemia in patients with hyperglycemia. The cross sectional study was done in different laboratories of Pakistan, the laboratories served patients referred from different government and private hospitals between July 2014 and June 2015. All known cases of diabetes mellitus were evaluated for their lipid profile. Totally 200 diabetic patients were included in the study in which 120 (60%) were males and 80 (40%) were females. Prevalence of dyslipidemia among diabetic males was 97.18% while for females 87.15%. Among dyslipidemic male the proportion with mixed dyslipidemic patients was 17.5%, combined two parameters dyslipidemia was 47.5% and isolated single parameter dyslipidemia was 35%. In females these proportions in mixed, combined two parameters and isolated single parameter were 16.25%, 51.25% and 32.5%, respectively. Majority of hyperglycemic patients were dyslipidemic. The most prevalent pattern among male was combined dyslipidemia with high triglycerides (TG) and low High Density Lipoprotein (HDL) and in female it was high Low Density Lipoprotein (LDL) and low HDL. The most prevalent lipid abnormality in our study was low HDL followed by high TG.
Decision-making on behalf of an incapacitated patient at the end of life is a complex process, particularly in family-centric societies. The situation is more complex when attempts are made to accommodate Eastern concepts of end-of-life care with more conventional Western approaches. In this case report of an incapacitated 74-year-old Singaporean man of Malay descent with relapsed Stage 4 diffuse large B cell lymphoma who was without an established lasting power of attorney, we highlight the difficult deliberations that ensue when the patient's family, acting as his proxy, elected to administer lingzhi through his nasogastric tube (NGT). Focusing on the questions pertaining to end-of-life decision-making in Asia, we consider the issues surrounding the use of NGT and lingzhi in palliative care (PC) and the implementation of NGT for administering lingzhi in a PC setting, particularly in light of a dearth of data on such treatment measures among PC patients.