SIGNIFICANCE: Mutant HRAS drives metastasis of head and neck cancer by switching off the Hippo pathway to activate the YAP1-AXL axis and to stimulate lymphovascular angiogenesis.
METHODS AND ANALYSIS: This is a prospective direct observational study that will be conducted in five neonatal intensive care units. A minimum sample size of 820 drug preparations and administrations will be observed. Data including patient characteristics, drug preparation-related and administration-related information and other procedures will be recorded. After each round of observation, the observers will compare his/her observations with the prescriber's medication order, hospital policies and manufacturer's recommendations to determine whether MAE has occurred. To ensure reliability, the error identification will be independently performed by two clinical pharmacists after the completion of data collection for all study sites. Any disagreements will be discussed with the research team for consensus. To reduce overfitting and improve the quality of risk predictions, we have prespecified a priori the analytical plan, that is, prespecifying the candidate predictor variables, handling missing data and validation of the developed model. The model's performance will also be assessed. Finally, various modes of presentation formats such as a simplified scoring tool or web-based electronic risk calculators will be considered.
PATIENTS AND METHODS: PM reports from the previous 16-year period were reviewed. Cases of DRD were extracted. All available demographic, clinical, and autopsy data including laboratory analyses was retrieved.
RESULTS: 9/1376 (0.7%) DRD cases were identified. This was attributed to Diabetic Ketoacidosis in 7 and to Death in Bed Syndrome in 2. 4/9 cases were known diabetic and on insulin; whilst in 5/9 cases the diagnosis of DM was at PM. The mean age was 11.6 years (range 2.5-15). At PM, 4 cases were undernourished. The histology demonstrated pancreatic changes in keeping with DM in 3/9 and unremarkable pancreatic findings in 6/9. 3 cases also had autoimmune thyroiditis (1 also had myocarditis and Armanni-Ebstein nephropathy). Toxicological and biochemical analysis showed raised: β-hydroxybutyrate in 6, ketone bodies in 5 cases and raised HbA1c in 3c.
CONCLUSION: Type 1 DM is an infrequent but yet potentially preventable cause of death in children. Our findings highlight the value of routine biochemical and toxicological analysis in all PM examinations of infants and children dying suddenly and unexpectedly.
MATERIAL AND METHODS: 35 composite specimens of the same shade (A2), thickness (2mm) and shape of both types of composite were prepared. The specimens were cured and polished according to the manufacturer's instructions. The initial shade of the specimens was measured using a calibrated EasyShade spectrophotometer. The initial surface roughness of the specimens was measured by AFM. Afterwards, the specimens were subjected to an accelerated aging procedure through thermo-cycling, a coffee stain challenge and brushing to simulate two years in the oral environment. The shade and surface roughness of the specimens were measured again after the accelerated aging procedure.
RESULTS: The mean ΔE was significantly larger than 3.368 in Ceram.x® group (-p-value<0.001) and SDR® Plus group (-p-value<0.001). The mean surface roughness has significantly increased for both groups after aging with no significant difference between the two groups. It however remained clinically acceptable.
CONCLUSIONS: SDR® Plus and Ceram.x® showed similar surface roughness when subjected to the same testing conditions. Concerning the color stability, both composites displayed noticeable discoloration, with higher ΔE values registered for Ceram.x®. Key words:Composite resins, spectrophotometry, atomic force microscopy, dental material, resin-based material.