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Κυριακή 27 Αυγούστου 2017

Scalable, “Dip-and-Dry” Fabrication of a Wide-Angle Plasmonic Selective Absorber for High-Efficiency Solar–Thermal Energy Conversion

A galvanic-displacement-reaction-based, room-temperature "dip-and-dry" technique is demonstrated for fabricating selectively solar-absorbing plasmonic-nanoparticle-coated foils (PNFs). The technique, which allows for facile tuning of the PNFs' spectral reflectance to suit different radiative and thermal environments, yields PNFs which exhibit excellent, wide-angle solar absorptance (0.96 at 15°, to 0.97 at 35°, to 0.79 at 80°), and low hemispherical thermal emittance (0.10) without the aid of antireflection coatings. The thermal emittance is on par with those of notable selective solar absorbers (SSAs) in the literature, while the wide-angle solar absorptance surpasses those of previously reported SSAs with comparable optical selectivities. In addition, the PNFs show promising mechanical and thermal stabilities at temperatures of up to 200 °C. Along with the performance of the PNFs, the simplicity, inexpensiveness, and environmental friendliness of the "dip-and-dry" technique makes it an appealing alternative to current methods for fabricating selective solar absorbers.

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A simple, room-temperature, "dip-and-dry" technique is demonstrated for fabricating optically selective plasmonic-nanoparticle-coated foils (PNFs) for use as selective solar absorbers (SSAs). The technique, which exploits galvanic displacement reactions between metals, is inexpensive, environmentally friendly, and yields PNFs with an excellent, high wide-angle solar absorptance that exceeds, and low thermal emittance that is on par with, those of previously reported SSAs.



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Examining the predictors of academic outcomes for indigenous Maori, Pacific and rural students admitted into medicine via two equity pathways: a retrospective observational study at the University of Auckland, Aotearoa New Zealand

Objective

To determine associations between admission markers of socioeconomic status, transitioning, bridging programme attendance and prior academic preparation on academic outcomes for indigenous Māori, Pacific and rural students admitted into medicine under access pathways designed to widen participation. Findings were compared with students admitted via the general (usual) admission pathway.

Design

Retrospective observational study using secondary data.

Setting

6-year medical programme (MBChB), University of Auckland, Aotearoa New Zealand. Students are selected and admitted into Year 2 following a first year (undergraduate) or prior degree (graduate).

Participants

1676 domestic students admitted into Year 2 between 2002 and 2012 via three pathways: GENERAL admission (1167), Māori and Pacific Admission Scheme—MAPAS (317) or Rural Origin Medical Preferential Entry—ROMPE (192). Of these, 1082 students completed the programme in the study period.

Main outcome measures

Graduated from medical programme (yes/no), academic scores in Years 2–3 (Grade Point Average (GPA), scored 0–9).

Results

735/778 (95%) of GENERAL, 111/121 (92%) of ROMPE and 146/183 (80%) of MAPAS students graduated from intended programme. The graduation rate was significantly lower in the MAPAS students (p<0.0001). The average Year 2–3 GPA was 6.35 (SD 1.52) for GENERAL, which was higher than 5.82 (SD 1.65, p=0.0013) for ROMPE and 4.33 (SD 1.56, p<0.0001) for MAPAS. Multiple regression analyses identified three key predictors of better academic outcomes: bridging programme attendance, admission as an undergraduate and admission GPA/Grade Point Equivalent (GPE). Attending local urban schools and higher school deciles were also associated with a greater likelihood of graduation. All regression models have controlled for predefined baseline confounders (gender, age and year of admission).

Conclusions

There were varied associations between admission variables and academic outcomes across the three admission pathways. Equity-targeted admission programmes inclusive of variations in academic threshold for entry may support a widening participation agenda, however, additional academic and pastoral supports are recommended.



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The end of forceps deliveries? [Letters]



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Tackling Pharma corruption in Ukraine [News]



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Its time to allow assisted injection in supervised injection sites [Commentary]



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Medical cannabinoids [Correction]



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Perinatal suicide in Ontario, Canada: a 15-year population-based study [Research]

BACKGROUND:

Death by suicide during the perinatal period has been understudied in Canada. We examined the epidemiology of and health service use related to suicides during pregnancy and the first postpartum year.

METHODS:

In this retrospective, population-based cohort study, we linked health administrative databases with coroner death records (1994–2008) for Ontario, Canada. We compared sociodemographic characteristics, clinical features and health service use in the 30 days and 1 year before death between women who died by suicide perinatally, women who died by suicide outside of the perinatal period and living perinatal women.

RESULTS:

The perinatal suicide rate was 2.58 per 100 000 live births, with suicide accounting for 51 (5.3%) of 966 perinatal deaths. Most suicides occurred during the final quarter of the first postpartum year, with highest rates in rural and remote regions. Perinatal women were more likely to die from hanging (33.3% [17/51]) or jumping or falling (19.6% [10/51]) than women who died by suicide non-perinatally (p = 0.04). Only 39.2% (20/51) had mental health contact within the 30 days before death, similar to the rate among those who died by suicide non-perinatally (47.7% [762/1597]; odds ratio [OR] 0.71, 95% confidence interval [CI] 0.40–1.25). Compared with living perinatal women matched by pregnancy or postpartum status at date of suicide, perinatal women who died by suicide had similar likelihood of non–mental health primary care and obstetric care before the index date but had a lower likelihood of pediatric contact (64.5% [20/31] v. 88.4% [137/155] at 30 days; OR 0.24, 95% CI 0.10–0.58).

INTERPRETATION:

The perinatal suicide rate for Ontario during the period 1994–2008 was comparable to international estimates and represents a substantial component of Canadian perinatal mortality. Given that deaths by suicide occur throughout the perinatal period, all health care providers must be collectively vigilant in assessing risk.



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New CMAJ policy on sharing study data [Editorial]



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Pediatric longitudinal melanonychia [Practice]



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The authors reply to "The end of forceps deliveries?" and "Beware selection bias" [Letters]



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Goodbye, Jo [Humanities]



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Research Canada calls for public investment in health research [News]



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Beware selection bias [Letters]



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Minors buy e-cigs online with ease. What about pot? [News]



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Long-term outcomes of narrow diameter implants in posterior jaws: A retrospective study with at least 8-year follow-up

Abstract

Objective

The aim of this study was to evaluate the long-term survival, complications, peri-implant conditions, marginal bone loss, and patient satisfaction of fixed dental prostheses supported by narrow diameter implants (NDIs) in the posterior jaws.

Materials and methods

This study was designed as a retrospective cohort study with a mean follow-up time of 10.1 years (SD: 2.5 years). Patients receiving NDIs in posterior jaw were reviewed. Implant survival, hardware complication, modified plaque index (mPI), peri-implant probing depth (PPD), percentage of bleeding on probing (BOP%), marginal bone loss (MBL), and patient satisfaction were evaluated. Log-rank test and t test were used to detect the influence of implant location and restoration type.

Results

Sixty-seven patients with 98 NDIs (Premolar site: 81, Molar site: 17, Single crowns: 33, Splinted restorations: 65) were included. The overall implant survival rates were 96.9% at implant level and 97.0% at patient level. Veneer chipping was the most common hardware complication. The veneer chipping rates were 19.4% at patient level and 18.4% at implant level. All patients showed acceptable oral hygiene. Thus, the average MBL was 1.19 mm at implant level and 1.15 mm at patient level. Eight implants (8.5%) and six patients (9.2%) were diagnosed with peri-implantitis. Fifty-eight patients (89.2%) were satisfied with the esthetics of the restorations, while 55 patients (84.6%) were satisfied with the function of the restorations.

Conclusion

Narrow diameter implants could be a predictable treatment option in the long term. High survival rates, high patient satisfaction, acceptable complication rates and marginal bone loss could be achieved. Further long-term studies are needed to evaluate the predictability of NDIs in molar sites.



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Household food insecurity, coping strategies, and nutritional status of pregnant women in rural areas of Northern Ghana

Abstract

There is limited information on the magnitude and determinants of household food insecurity (HFI) and how it relates to the nutritional status of pregnant women in Northern Ghana. The magnitude, determinants of HFI, and how it relates to the nutritional status of pregnant women were evaluated in the Africa RISING West Africa project intervention communities in Northern Ghana. The prevalence of moderate and severe household hunger was 25.9% (95% CI: 19.0, 34.3) and 6.8% (95% CI: 4.2, 10.9) respectively. The independent predictors of maternal thinness were region of residence, gestational age and maternal age. Compared to women in the first trimester, women in the third trimester were 2.2 times more likely of being underweight adjusted odds ratio (AOR = 2.19, CI: 1.02, 4.70). Women who were under 20 years of age were 11.9 times more likely of being thin compared to women aged more than 35 years (AOR = 11.97, CI: 2.55, 5. 67). Food insecurity was highly prevalent but it was not associated with maternal thinness of pregnant women. The risk of maternal thinness increased as the gestational age increased and this has a great potential of adversely influencing pregnancy outcomes and overall quality of life.

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The magnitude, determinants of household food insecurity (HFI), and how it relates to the nutritional status of pregnant women were evaluated in the Africa RISING West Africa project intervention communities in Northern Ghana. Food insecurity was highly prevalent but it was not associated with maternal thinness of pregnant women.



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Fatty acid profiles of the main lipid classes of green seaweeds from fish pond aquaculture

Abstract

The lipid composition of five species of green seaweeds (Chaetomorpha linum, Rhizoclonium riparium, Ulva intestinalis, Ulva lactuca, and Ulva prolifera) grown in fish pond aquaculture systems was studied. In particular, the overall fatty acid (FA) profile and the FA profile of each main lipid class found in these seaweed species were thoroughly analyzed. It was found that every seaweed had a specific FA profile, whose specificities were rendered more obvious with the study of the FA profile per lipid class. However, between U. lactuca and U. intestinalis, there were only minor differences. Nonetheless, it was possible to identify significant differences between the palmitic acid content in the phospholipid (PL) and glycolipid (GL) classes of each seaweed. A clear distinction between the FA profiles of R. riparium and C. linum, which belong to the Cladophorales order, and those of Ulva genus, Ulvales order, was also determined. Moreover, there were also differences among lipid classes, yielding large contrasts between PLs + GLs and triacylglycerols (TAGs) as well as between monoacylglycerols (MAGs) and free fatty acids (FFAs). This study also found evidence supporting the location of particular FAs in specific TAG positions. FA profiles have the potential to be used as a chemotaxonomic tool in green seaweeds, providing a simple method to check authenticity of seaweed used as food.

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Fatty acid profiles have the potential to be used as a chemotaxonomic tool in green seaweeds, providing a simple method to check authenticity of seaweed used as food. Moreover, there were also differences among lipid classes, yielding large contrasts between PLs and triacylglycerols (TAGs) as well as between monoacylglycerols (MAGs) and free fatty acids (FFAs). This study also found evidence supporting the location of particular FAs in specific TAG positions.



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Influence of development, postharvest handling, and storage conditions on the carbohydrate components of sweetpotato (Ipomea batatas Lam.) roots

Abstract

Changes in total starch and reducing sugar content in five sweetpotato varieties were investigated weekly during root development and following subjection of the roots to different postharvest handling and storage conditions. Freshly harvested (noncured) roots and cured roots (spread under the sun for 4 days at 29–31°C and 63–65% relative humidity [RH]) were separately stored at ambient conditions (23°C–26°C and 70–80% RH) and in a semiunderground pit (19–21°C and 90–95% RH). Changes in pasting properties of flour from sweetpotato roots during storage were analyzed at 14-day intervals. Significant varietal differences (p < .05) in total starch, sucrose, glucose, maltose, and fructose concentrations were registered. The total starch and sucrose content of the roots did not change significantly (p < .05) during root development (72.4 and 7.4%, respectively), whereas the average concentrations of glucose, maltose, and fructose decreased markedly (0.46–0.18%, 0.55–0.28%, and 0.43–0.21%), respectively. Storage led to decrease in total starch content (73–47.7%) and increase in sucrose and glucose concentrations (8.1–11.2% and 0.22–1.57%, respectively). Storage also resulted in reduction in sweetpotato flour pasting viscosities. Curing resulted in increased sucrose and glucose concentrations (9.1–11.2% and 0.45–0.85%, respectively) and marked reduction (p < .05) in total starch content (72.9–47.6%). This resulted in low pasting viscosities compared to flour from storage of uncured roots. These findings show that significant changes occur in the carbohydrate components of sweetpotato roots during storage compared to development and present an opportunity for diverse utilization of flours from sweetpotato roots in the food industry.

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Changes in total starch and reducing sugars were investigated weekly during sweetpotato root development and following subjection of the roots to different postharvest handling and storage conditions. Total starch and sucrose content did not change much during root development, but glucose, fructose and maltose content decreased. Storage led to decrease in total starch and flour pasting viscosities and increase in sucrose and glucose with curing registering marked effect on all the study variables.



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Nutritional variation in baobab (Adansonia digitata L.) fruit pulp and seeds based on Africa geographical regions

Abstract

Baobab (Adansonia digitata L.) is an indigenous fruit tree associated with the Savannah drylands of sub-Saharan Africa. Local communities mainly utilize the leaves, pulp, and seeds of baobab as a source of food and for income generation. The present study was conducted to determine the nutritive attributes of baobab fruit pulp and seeds across provenances in east, west, and southern Africa and to determine whether the nutrient content varied with the provenance of origin. Pulp and seed proximate composition and mineral element concentration were determined using the AOAC 1984 methods and inductively coupled plasma atomic emission spectroscopy (ICP-AES), respectively. The results showed that there exist significant variation (p < .05) in pulp moisture, protein, fiber, ash, and elemental content among provenances. The highest mean pulp crude fiber (8.68 g 100 g−1 dw) was recorded in Kenya. At country level, Malawi had the highest mean pulp potassium (22.2 mg g−1), calcium (4,300 mg kg−1), magnesium (2,300 mg kg−1), sodium (1,000 mg kg−1), and phosphorus (1,100 mg kg−1) levels. Kenya had the highest mean pulp iron (57.4 μg g−1) and manganese (27.2 μg g−1) content, while Mali had the lowest iron (13.1 μg g−1) and manganese (8.6 μg g−1). At country level, the mean seed calcium content was highest (3,200 mg kg−1) in Malawi and lowest (2,000 mg kg−1) in Kenya. The highest mean iron content of 63.7 μg g−1 was recorded in seeds from Kenya, while the lowest (25.8 μg g−1) was in Mali. Baobab seed mineral and proximate content varied significantly (p < .001) among the selected countries. Overall, baobab fruit pulp and seeds contain significant amounts of nutritionally essential minerals and proximate components but the amounts varied significantly among the selected countries. This variation offers opportunities for selecting provenances to concentrate on during germplasm collection for conservation and domestication of baobab.

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The proximate composition and mineral element content of both baobab fruit pulp and seeds are of nutritional significance. Also, the nutrient content varied significantly across African geographical regions. This variation offers opportunities for species conservation and domestication.



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Effects of thermal processing on the nutritional and functional properties of defatted conophor nut (Tetracarpidium conophorum) flour and protein isolates

Abstract

Conophor nut (Tetracarpidium conophorum) was processed using different heat treatments to explore its full potential as food ingredients. The raw, boiled, and toasted nuts were defatted and the proteins isolated by alkaline solubilization and isoelectric precipitation. The variously processed nuts were analyzed for the proximate and amino acid compositions, and functional properties. The protein contents of the isolate ranges between 86.86 g/100g and 87.74 g/100 g, about 1.5-fold higher than those of the defatted flour samples. The essential amino acids of the isolates ranged between 40.57%–41.55%. Glutamic acid, aspartic acid, and arginine were the most predominant amino acids, while methionine and lysine were the first and second limiting amino acids, respectively. The protein efficiency ratio, biological values as well as the functional properties of the proteins were improved with processing. These properties may enhance the potential use of conophor nut protein isolates as high-quality protein ingredient in food systems.

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Conophor nut is an oil-rich seed which has great potential in food ingredient. Heat processing was found to improve the protein efficiency ratio, biological value, and functional properties of the protein. These properties will enhance its use in food system.



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Insulin Resistance in Early Rheumatoid Arthritis Is Associated with Low Appendicular Lean Mass

In established rheumatoid arthritis (RA), the presence of insulin resistance (IR) is well proven but, in the early stage of the disease, data are inconclusive. We evaluated the presence of IR and associations with body composition (BC) parameters among early RA (ERA) and control subjects. The study group consisted of 92 ERA and 321 control subjects. Using homeostatic model assessment of IR (HOMA-IR), the cut-off value for IR was 2.15. 56% of the ERA patients and 25% of the controls had IR. Of the BC parameters, patients with early RA had less fat-free mass and appendicular lean mass (ALM). In multivariable model, ERA group (-Coefficient) (4.8, CI: 2.6–8.8), male gender (7.7, CI: 2.7–22.1), and fat mass index (1.2, CI: 1.1–1.4) were associated with IR. Insulin-resistant ERA patients had higher inflammatory markers and higher disease activity. In the multivariable model in the ERA group, IR was associated with male gender (-Coefficient) (7.4, CI: 153–34.9), high disease activity (6.2, CI: 1.7–22.2), and lower ALM (0.03, CI: 0.001–0.97). IR develops in the early stage of RA in the majority of patients. IR is more common among males and is associated with RA disease activity and lower ALM.

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Efficacies of Various Anaerobic Starter Seeds for Biogas Production from Different Types of Wastewater

Various anaerobic starter seeds from different sources were investigated for their efficacies in treatment of different types of wastewater. Six combinations of starter seeds and wastewaters were selected out of 25 combination batch experiments and operated in semicontinuous reactors. It was noticed that the efficacies of various anaerobic starter seeds for biogas production from different types of wastewater in terms of reactor performance and stability were depended on wastewater characteristics and F/M ratio affecting microbial community and their microbial activities. However, exogenous starter seed can be used across different types of wastewater with or without acclimatization. Four reactors reached the targeted OLR of 2 kg COD/m3·d with high performance and stability except for concentrated rubber wastewater (RBw), even using high active starter seeds of cassava starch (CSs) and palm oil (POs). The toxic compounds in RBw such as ammonia and sulfate might also adversely affect methanogenic activity in CSsRBw and POsRBw reactors. DGGE analysis showed that propionate utilizers, Smithella propionica strain LYP and Syntrophus sp., were detected in all samples. For Archaea domain, methylotrophic, hydrogenotrophic, and acetoclastic methanogens were also detected. Syntrophic relationships were assumed between propionate utilizers and methanogens as acetate/H2 producers and utilizers, respectively.

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Association between maternal vitamin D deficiency and small for gestational age: evidence from a meta-analysis of prospective cohort studies

Objective

To determine whether maternal vitamin D deficiency during pregnancy is associated with small for gestational age (SGA).

Methods

A comprehensive literature search of PubMed, the Cochrane Library, Embase, and the Elsevier ScienceDirect library was conducted to identify relevant articles reporting prospective cohort studies in English, with the last report included published in February 2017. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to evaluate the correlation in a random effects model.

Results

A total of 13 cohort studies were included in this meta-analysis with a sample of 28 285 individuals from seven countries. The pooled overall OR for babies born SGA was 1.588 (95% CI 1.138 to 2.216; p<0.01) for women with vitamin D deficiency. The prevalence of vitamin D deficiency during pregnancy varied from 13.2% to 77.3%. Subgroup analyses identified no significant differences in the association between vitamin D deficiency and SGA based on study quality, gestational week during which blood sampling was performed, cut-off vitamin D levels, sample size, adjustment for critical confounders and method for measuring vitamin D.

Conclusion

This meta-analysis suggests that vitamin D deficiency is associated with an increased risk of SGA.



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Squamoid Morules in the Pseudoinvasive Foci of Colonic Polyp Morphologically Mimic Invasive Carcinoma

Colorectal adenomas can show focal squamous differentiation or squamoid morules. We describe histologic findings of squamoid morules in the pseudoinvasive foci of colorectal polyps mimicking invasive carcinoma. Five colonic polyps with squamoid morules in the pseudoinvasive foci were collected. Histologic review and immunostains for cytokeratin (CK) 5/6, p63, synaptophysin, and chromogranin were performed on cases with squamoid morules. Forty-seven consecutive colorectal polyps with pseudoinvasion, none of which showed squamoid morules by histology review, and their clinicopathologic features were compared with the cases containing squamoid morules.

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Multicentric visceral epithelioid hemangioendothelioma, with extremity dermal deposits, unusual late recurrence on the nasal bridge and TFE3 gene rearrangement

Epithelioid hemangioendothelioma (EHE) is a malignant neoplasm with vascular differentiation that most frequently occurs within soft tissues, bone, lung and liver. It is histologically typified by epithelioid or spindle cells present singly or in cords or clusters, many with cytoplasmic vacuoles that can contain intraluminal erythrocytes (in keeping with primitive vascular differentiation), within myxohyaline or sclerotic matrix. Up to 50% present with synchronous lesions as multifocal disease. The WWTR1–CAMTA1 fusion has been demonstrated in EHEs at a variety of sites and is considered to represent its genetic hallmark.

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Organotypic Hippocampal Slice Cultures As a Model to Study Neuroprotection and Invasiveness of Tumor Cells

Organotypic hippocampal slice cultures (OHSC) represent an in vitro model that simulates the in vivo situation very well. Here we describe a vibratome-based improved slicing protocol to obtain high quality slices for use in assessing the neuroprotective potential of novel substances or the biological behavior of tumor cells.

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Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation

In determining the best approach for antithrombotic therapy in patients with atrial fibrillation who are undergoing percutaneous coronary intervention (PCI), it can be difficult to balance the prevention of thrombosis with the risk of bleeding. Oral anticoagulation is indicated in patients with…

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Procedural Anticoagulation in Myocardial Infarction

The prognosis for patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) is improved with the use of percutaneous coronary intervention (PCI). Choosing the best procedural anticoagulation regimen to balance the risks of ischemia and bleeding during PCI is essential…

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Bivalirudin versus Heparin Monotherapy in Myocardial Infarction

Anticoagulation with heparin or bivalirudin, in combination with antiplatelet agents such as aspirin, P2Y12 inhibitors, and glycoprotein IIb/IIIa inhibitors, is routinely used to improve angiographic and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) for acute…

http://ift.tt/2vsQlqq

Wu-Mei-Wan Reduces Insulin Resistance via Inhibition of NLRP3 Inflammasome Activation in HepG2 Cells

Wu-Mei-Wan (WMW) is a Chinese herbal formula used to treat type 2 diabetes. In this study, we aimed to explore the effects and mechanisms of WMW on insulin resistance in HepG2 cells. HepG2 cells were pretreated with palmitate (0.25 mM) to impair the insulin signaling pathway. Then, they were treated with different doses of WMW-containing medicated serum and stimulated with 100 nM insulin. Results showed that palmitate could reduce the glucose consumption rate in HepG2 cells and impair insulin signaling related to phosphorylation of insulin receptor (IR) and insulin receptor substrate-1 (IRS-1), thereby regulating the downstream signaling pathways. However, medicated serum of WMW restored impaired insulin signaling, upregulated the expression of phospho-IR (pIR), phosphatidylinositol 3-kinase p85 subunit, phosphoprotein kinase B, and glucose transporter 4, and decreased IRS serine phosphorylation. In addition, it decreased the expression of interleukin-1β and tumor necrosis factor-α, which are the key proinflammatory cytokines involved in insulin resistance; besides, it reduced the expression of NLRP3 inflammasome. These results suggested that WMW could alleviate palmitate-induced insulin resistance in HepG2 cells via inhibition of NLRP3 inflammasome and reduction of proinflammatory cytokine production.

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Neurosyphilis with Concomitant Cryptococcal and Tuberculous Meningitis in a Patient with AIDS: Report of a Unique Case

Meningitis in individuals living with acquired immunodeficiency syndrome (AIDS) is most frequently infectious in origin and usually due to opportunistic infections. The most common pathogens are Cryptococcus neoformans and Mycobacterium tuberculosis. Treponema pallidum causes neurosyphilis and can complicate HIV infections at any time after the initial infection. Simultaneous infections of the central nervous system caused by these pathogens are very uncommon even in the setting of severe immunosuppression. We report the case of a newly diagnosed HIV/AIDS young man who was found to have neurosyphilis with Cryptococcus meningitis. After a few weeks of treatment and initiation of antiretroviral therapy, he was also diagnosed with tuberculous meningitis, which was probably unmasked by the development of immune reconstitution inflammatory syndrome (IRIS). To the best of our knowledge, this is the only case of reported neurosyphilis and meningitis caused concomitantly by Cryptococcus and Mycobacterium tuberculosis.

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Retracted: Long Noncoding RNA KIAA0125 Potentiates Cell Migration and Invasion in Gallbladder Cancer



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Decreased Plasma COMP and Increased Plasma CTX-II Levels in a Chinese Pseudoachondroplasia Family with Novel COMP Mutation

Pseudoachondroplasia (PSACH) is an autosomal dominant osteochondrodysplasia caused by mutations in the gene encoding cartilage oligomeric matrix protein (COMP). Accurate clinical diagnosis of PSACH is sometimes difficult. Here, we identified a novel COMP mutation (c.1675G>A, p.Glu559Lys) in a Chinese PSACH family. We detected the plasma levels of COMP and type II collagen (CTX-II) in the four affected individuals. The results showed the levels of plasma COMP significantly decreased and plasma CTX-II significantly increased in the three PSACH patients with COMP mutation. However, both plasma levels of COMP and CTX-II were not to have found significant difference between the presymptomatic carrier and the age-matched subjects. In vitro analysis and immunofluorescence displayed wild type COMP homogenously expressed in cytoplasm, but mutant proteins were irregularly accumulated inside the HEK-293 cells. Western blot revealed that the quantity of the mutant COMP was more compared to wild type COMP in cells after transfection for 12 hours and 24 hours. Subsequently, 3D structural analysis showed three changes have taken place in secondary structure of the mutant COMP. In conclusion, the novel mutation of COMP may result in intracellular accumulation of the mutant protein. Decreased plasma COMP and increased plasma CTX-II may potentially serve as diagnostic markers of PSACH but may not be applicable in the presymptomatic carrier.

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Procedural Anticoagulation in Myocardial Infarction

The prognosis for patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) is improved with the use of percutaneous coronary intervention (PCI). Choosing the best procedural anticoagulation regimen to balance the risks of ischemia and bleeding during PCI is essential…

http://ift.tt/2wSx0SS

Bivalirudin versus Heparin Monotherapy in Myocardial Infarction

Anticoagulation with heparin or bivalirudin, in combination with antiplatelet agents such as aspirin, P2Y12 inhibitors, and glycoprotein IIb/IIIa inhibitors, is routinely used to improve angiographic and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) for acute…

http://ift.tt/2vsQlqq

Anti-Gouty Arthritis and Antihyperuricemia Effects of Sunflower (Helianthus annuus) Head Extract in Gouty and Hyperuricemia Animal Models

This study was performed to investigate the therapeutic effects and possible mechanisms of sunflower (Helianthus annuus) head extract (SHE) on gout. First, the components of sunflower head powder and SHE were analyzed systematically. SHE, especially SHEB (extracted with 20% ethanol and 80% double-distilled water), strongly suppressed the swelling of the ankles in rats with acute gout induced by monosodium urate (MSU) crystals and reduced the levels of uric acid and xanthine oxidase (XO) in mice with hyperuricemia induced by oteracil potassium and yeast extract powder. Hematoxylin and eosin staining indicated that SHEB reduced inflammation cells and increased the joint space in the ankle compared with the control rats with MSU-induced gout. In the rats with acute gout, among 13 detected inflammatory cytokines, SHEB significantly enhanced the serum levels of interleukin-10 and the monocyte chemoattractant protein 1α. In the mice with hyperuricemia, SHEB reduced the levels of glutathione peroxidase, superoxide dismutase, malondialdehyde, and nitrogen monoxide in liver tissues. The potential therapeutic effects of SHE on gout are probably due to the production of anti-inflammatory cytokines and the suppression of XO activity via the modulation of oxidative stress status.

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Integrated results from the COPERNICUS and GALILEO studies

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The Long-Term Course of Outcomes for Lumbar Intervertebral Disc Herniation following Integrated Complementary and Alternative Medicine Inpatient Treatment: A Prospective Observational Study

A prospective observational study was conducted in 524 lumbar intervertebral disc herniation (LDH) inpatients to report the long-term effects of complementary and alternative medicine (CAM) treatment. Participants received integrative CAM treatment during hospitalization, from June 2012 to May 2013, and long-term outcomes were assessed from July to August 2016. Numerical rating scales (NRSs) of back and leg pain, the Oswestry disability index (ODI), satisfaction, surgery, recurrence, and current care status were investigated. Baseline characteristics were analyzed to determine factors that predicted long-term satisfaction. A total of 367 patients were available for follow-up. The long-term change in NRS of back and leg pain and ODI was 3.53 (95% CI, 3.22, 3.83), 2.72 (2.34, 3.11), and 32.89 (30.21, 35.57), respectively, showing that improvements were well sustained. Regarding satisfaction, 86.11% responded that they were "slightly improved" or better. Range of lumbar flexion ≤ 60° and both legs' pain at admission were significant predictors of "much improved" or better satisfaction in the long term. Overall, LDH patients who received CAM treatment maintained favorable states in the long term. However, as an uncontrolled observational study, further studies with placebo and/or active controls are warranted. Trial Registration. This trial is registered with ClinicalTrials.gov  NCT02257723 (date of registration: October 2, 2014).

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Imaging Diagnosis of Right Ventricle Involvement in Chagas Cardiomyopathy

Right ventricle (RV) is considered a neglected chamber in cardiology and knowledge about its role in cardiac function was mostly focused on ventricular interdependence. However, progress on the understanding of myocardium diseases primarily involving the RV led to a better comprehension of its role in health and disease. In Chagas disease (CD), there is direct evidence from both basic and clinical research of profound structural RV abnormalities. However, clinical detection of these abnormalities is hindered by technical limitations of imaging diagnostic tools. Echocardiography has been a widespread and low-cost option for the study of patients with CD but, when applied to the RV assessment, faces difficulties such as the absence of a geometrical shape to represent this cavity. More recently, the technique has evolved to a focused guided RV imaging and myocardial deformation analysis. Also, cardiac magnetic resonance (CMR) has been introduced as a gold standard method to evaluate RV cavity volumes. CMR advantages include precise quantitative analyses of both LV and RV volumes and its ability to perform myocardium tissue characterization to identify areas of scar and edema. Evolution of these cardiac diagnostic techniques opened a new path to explore the pathophysiology of RV dysfunction in CD.

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Genetic Variants in the Hedgehog Interacting Protein Gene Are Associated with the FEV1/FVC Ratio in Southern Han Chinese Subjects with Chronic Obstructive Pulmonary Disease

Background. Convincing evidences have demonstrated the associations between HHIP and FAM13a polymorphisms and COPD in non-Asian populations. Here genetic variants in HHIP and FAM13a were investigated in Southern Han Chinese COPD. Methods. A case-control study was conducted, including 989 cases and 999 controls. The associations between SNPs genotypes and COPD were performed by a logistic regression model; for SNPs and COPD-related phenotypes such as lung function, COPD severity, pack-year of smoking, and smoking status, a linear regression model was employed. Effects of risk alleles, genotypes, and haplotypes of the 3 significant SNPs in the HHIP gene on FEV1/FVC were also assessed in a linear regression model in COPD. Results. The mean FEV1/FVC% value was 46.8 in combined COPD population. None of the 8 selected SNPs apparently related to COPD susceptibility. However, three SNPs (rs12509311, rs13118928, and rs182859) in HHIP were associated significantly with the FEV1/FVC% ( = 4.1 × 10−4) in COPD adjusting for gender, age, and smoking pack-years. Moreover, statistical significance between risk alleles and the FEV1/FVC% ( = 2.3 × 10−4), risk genotypes, and the FEV1/FVC% ( = 3.5 × 10−4) was also observed in COPD. Conclusions. Genetic variants in HHIP were related with FEV1/FVC in COPD. Significant relationships between risk alleles and risk genotypes and FEV1/FVC in COPD were also identified.

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Phonomyography as a non-invasive continuous monitoring technique for muscle ischemia in an experimental MODEL OF acute compartment syndrome

Publication date: Available online 26 August 2017
Source:Injury
Author(s): Adriana P. Martinez, Thomas P. Moser, Neil Saran, Marilène Paquet, Thomas Hemmerling, Greg K. Berry
BackgroundIn acute compartment syndrome (ACS), clinicians have difficulty diagnosing muscle ischemia provoked by increased intra-compartmental pressure in a timely and non-invasive manner. Phonomyography records the acoustic signal produced by muscle contraction. We hypothesize that alterations in muscle contraction caused by muscle ischemia can be detected with phonomyography, serving as a potential non-invasive technique in the detection of ACS.MethodsThe left hind limb of 15 Sprague-Dawley rats was submitted to a reversible ischemic model of limb injury for 30min and 1, 2, 4, 6h (3 rats in each group). The right limb served as control. Phonomyography microphones were placed over the posterior calf of both limbs and the sciatic nerve was stimulated percutaneously at 10-minute intervals to evaluate muscle contraction. Histopathological analysis of muscles and nerves biopsies was performed and correlation was made between duration of injury, phonomyography output and degree of muscle and nerve necrosis.ResultsThere was a statistically significant decrease in the phonomyography signal output in the ischemic limb that correlated with the duration of ischemia and histological findings of muscle and nerve necrosis. The phonomyography signal decrease and histological findings were respectively: 55.5% (n=15;p=0.005) with rare muscle and nerve necrosis at 30min, 65.6% (n=12;p=0.005) with 5-10% muscle necrosis at 1h, 68.4% (n=9;p=0.015) with 100% muscle necrosis and little nerve damage at 2h, 72.4% (n=6;p=0.028) with 100% muscle necrosis and severe nerve damage at 4h, and 92.8% (n=3;p=0.109) with 100% muscle necrosis and severe nerve degeneration at 6h.ConclusionChanges in phonomyography signal are observed in early ischemic injury prior to the onset of nerve or muscle necrosis. Therefore, phonomyography could serve as a non-invasive technique to detect early ischemic muscle changes in acute compartment syndrome.Clinical relevanceThe detection of abnormal muscle contraction in a timely fashion and non-invasive manner is of interest in clinical settings where the presence of ischemia is not easy to diagnose.



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The influence of the hips position on measurements of posterior tilt in a valgus-impacted femoral neck fracture

Publication date: Available online 26 August 2017
Source:Injury
Author(s): Sigurd Erik Hoelsbrekken, Filip C. Dolatowski
IntroductionLateral radiographs are important for the evaluation of Garden I and II femoral neck fractures. These fractures appear undisplaced in the anteroposterior view, but posterior tilt of the femoral head may still be present in the lateral view. The influence of posterior tilt is, however, debated, which could be caused by the use of non-standardized cross-table radiographs in the conflicting reports. The aim of this bone-model study was therefore to evaluate the influence of the hips position on measurements of posterior tilt.Materials and methodsWe generated models of a Garden I–II femoral neck fracture and the non-injured contralateral femur from CT reconstructions with a 3D-printer. Lateral radiographs of the models were obtained in positions ranging from 90° internal rotation (IR) to 90° external rotation (ER) and 0−80° flexion. Two investigators independently measured posterior tilt on 27 lateral radiographs obtained from each model.ResultsThe inter-tester ICC was 0.91 (0.84–0.94), standard error of measurement (SEM) 2.6, and minimal detectable change (MDC) 7.2. The median (range) posterior tilt for the fracture model was 21.9° (5.0, 33.8) and 23.6° (2.2, 28.6) for observer 1 and observer 2, respectively. The corresponding posterior tilt within the range of 10° IR to 40° ER and 0 to 30° flexion of the fracture model, was 27.3° (24.0, 33.8) and 26.3° (24.8, 28.6).DiscussionThe range of posterior tilt measurements for positions of the proximal femur restricted from 10° IR to 40° ER and 0 to 30° flexion, was above the MDC for observer 1, and below the MDC for observer 2. These findings indicate that rotation and flexion affect measurements of posterior tilt, but the influence may be negligible for positions of the injured extremity that are clinically relevant during cross-table lateral radiographs. A larger study that accounts for variations in anatomy and fracture displacement is required to confirm these findings.



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Dementia and fragility fractures: Issues and solutions

Publication date: Available online 26 August 2017
Source:Injury
Author(s): James S.H. Vun, Milad Ahmadi, Michalis Panteli, Ippokratis Pountos, Peter V. Giannoudis
Dementia and fragility fractures are two conditions that pose significant morbidity and mortality to the elderly population. The occurrence of the 'gerontic' boom as a result of improved healthcare meant a continued increase in the prevalence of fragility fractures and dementia. This represents a major public health problem with significant socioeconomic repercussions. It is therefore important for healthcare professionals to gain a better understanding on the relationship between these two commonly co-existing conditions.In this review, we present the available literature surrounding the relationship between fragility fractures and dementia, and the common challenges faced in the management of these two conditions. Combining evidence from the literature along with our current clinical practice, we propose a management pathway aimed at early diagnosis, prevention and management of these two often co-existing conditions. This alongside with a multidisciplinary approach will not only translate to improved patient outcomes and survivorship, but also reduced healthcare cost and socio-economic burden.To date, there is insufficient evidence from the literature to suggest whether dementia is the cause or effect for fragility fractures, or if indeed there is a bidirectional relationship between the two conditions. Further studies are required to shed light onto this important clinical topic.



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Letter to Editor regarding “Can intermittent pneumatic compression (IPC) reduce time to surgery for malleolar fractures?" by K.B. Arndt et al.

Publication date: Available online 26 August 2017
Source:Injury
Author(s): Lokesh Kumar




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Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures

Publication date: Available online 26 August 2017
Source:Injury
Author(s): I. Aguado-Maestro, M. Panteli, M. García-Alonso, A. Bañuelos-Díaz, P.V. Giannoudis
ObjectivesOur aim was to investigate whether patients presenting with fragility fractures of the proximal femur are receiving osteoporosis treatment and to assess the number of other fragility fractures they have sustained prior to admission.MethodsAll patients presenting to our institution with fragility fractures of the proximal femur within an 18-month period (January 2012–August 2013) were included. Patient demographics; fracture classification (AO/OTA); American Society of Anesthesiologists (ASA) grade; Abbreviated Mental Test Score (AMTS) on admission; type of operation; time to operation; peri-operative complications; length of hospital stay (LOS); walking status; osteoporotic medication; Dual-energy X-ray absorptiometry (DEXA) results; additional fragility fractures; and mortality were collected and analysed.ResultsA total of 1004 patients (278 male) met the inclusion criteria and were included into the study. The mean age was 82.01 years and mean LOS was 19.54days. Fifty-four per cent of the patients were admitted from their own homes whereas 43% were capable to walk indoors without any aids before their injury. Mean time to surgery was 2.06days (Median: 1.31, range: 0–26days).Three hundred and six patients (30.5%) had at least another fragility fracture before the index episode (mean 1.40 fractures; SD: 0.71 fractures; range: 1–6 fractures). Only 16.4% were under complete osteoporosis treatment on admission, defined as receiving calcium with vitamin D and a bisphosphonate or an alternative agent.When we compared patients without a history of a previous fragility fracture (Group A) and patients with at least another previous fragility fracture (Group B), we found that patients in Group B had a significantly lower AMTS score, lower bone mineral density (BMD) as evident on the DEXA scan, an inferior mobility before admission and a higher incidence of extracapsular fractures (p<0.05).On discharge, patients in Group B had a higher chance of receiving complete bone protection compared to group A (27.9% versus 41.7%; p<0.01).Following discharge, 11.2% of the patients sustained an additional fragility fracture. The mean time from the index episode to the additional fracture was 0.65 years, whilst these injuries were more frequent in Group B (RR=1.638; p<0.05).ConclusionPatients presenting with a hip fracture are generally under-treated for osteoporosis. Post-operative assessment by a designated geriatrician and use of a standardised protocol is of paramount importance for reducing the risk of additional fragility fractures. Additionally, screening of the elderly population for identifying the patients who suffer from osteoporosis can potentially reduce the risk of sustaining a further fragility fracture.



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Risk Factors for Achilles Tendon Rupture: A Matched Case Control Study

Publication date: Available online 26 August 2017
Source:Injury
Author(s): Peter C. Noback, Eugene S. Jang, Derly O. Cuellar, Mani Seetharaman, Emiliano Malagoli, Justin K. Greisberg, J.Turner Vosseller
PurposeThe purpose of this study was to elucidate whether body mass index (BMI), activity level, and other risk factors predispose patients to Achilles tendon ruptures.Materials and methodsA retrospective review of 279 subjects was performed (93 with Achilles tendon rupture, matched 1:2 with 186 age/sex matched controls with ankle sprains). Demographic variables and risk factors for rupture were tabulated and compared.ResultsThe rupture group mean BMI was 27.77 (95% CI, 26.94-28.49), and the control group mean BMI was 26.66 (95% CI, 26.06-27.27). These populations were found to be statistically equivalent (p=0.047 and p <0.001 by two one-sided t-test). A significantly higher proportion of those suffering ruptures reported regular athletic activity at baseline (74%) versus controls (59%, p=0.013).ConclusionThere was no clinically significant difference found in BMI between patients with ruptures and controls. Furthermore, it was found that patients who sustained ruptures were also more likely to be active at baseline than their ankle sprain counterparts.



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Response to Letter to the Editor on “The outcome of unstable proximal femoral fracture treated with reverse LISS plates”

Publication date: Available online 26 August 2017
Source:Injury
Author(s): Shih-Jie Lin, Tsan-Wen Huang




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Hip osteoarthritis as a predictor of the fracture pattern in proximal femur fractures

Publication date: Available online 26 August 2017
Source:Injury
Author(s): I. Aguado-Maestro, M. Panteli, M. García-Alonso, I. García-Cepeda, P.V. Giannoudis
IntroductionSeveral authors have suggested a correlation between the fracture patterns of proximal femur fractures and the degree of hip osteoarthritis (HOA), but the current evidence to support this are insufficient. The aim of our study was to demonstrate whether there is an association between the grade of HOA and fracture pattern observed, in patients presenting with a fragility fracture of the proximal femur.Materials and methodsWe contacted a retrospective review of all patients presenting to our institution with fragility fractures involving the proximal femur, between March 2012 and October 2013. Pathological fractures, high-energy injuries and patients with less than one year of follow-up were excluded from further analysis. Admission radiographs and severity of HOA were assessed according to Kellgren and Lawrence scale (minimal: Grades 1–2; severe: Grades 3–4). Fractures were classified according to AO/OTA classification.ResultsA total of 1003 patients (725 females; 1003 fractures) met the inclusion criteria, having a mean age of 81.5 (46–106 years). With regards to fracture classification, 417 (41.6%) fractures were classified as extracapsular and 586 (58.4%) as intracapsular. A total of 939 (93.9%) patients presented with minimal HOA, whilst 61 (6.1%) of the patients presented with severe HOA. Of the 61 patients presenting with severe HOA, 42 patients (68.9%) sustained a 31A-interthrocanteric fracture and 19 patients (31.1%) sustained a 31B-intracapsular fracture. Regarding the patients presenting with minimal HOA (832 patients in total), 323 patients (38.8%) sustained 31A-intertrochanteric fracture and 509 patients (61.2%) sustained a 31B-intracapsular fracture. Patients presenting with severe HOA were found to have a statistically significant chance to present with an extracapsular fracture (p<0.01).ConclusionsThe degree of HOA is related to the fracture pattern in patients presenting following simple mechanical falls. More specifically, higher grades of HOA are associated with extracapsular fracture patterns, whereas lower grades of HOA are associated with intracapsular fracture patterns.



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Predictors of Falls in Recreational Snowboard Jumping: An Observational Study

Publication date: Available online 26 August 2017
Source:Injury
Author(s): Nico Kurpiers, Paul McAlpine, Uwe G. Kersting
PurposeJumping is popular in the sport of snowboarding. Epidemiological research has shown an increased risk of injury associated with this activity. Falls are common when jumping and although there is a logical connection between falling and injury occurrence, thus far little attention has been given to factors involved in the jumping-fall relationship. The current study aimed to add to the current knowledge base by identifying predictors of falling during intentional snowboard jumping within terrain park facilities.MethodsSeven hundred and four jumps were video recorded and qualitatively coded using a custom template of predetermined parameters related to manoeuvre choice, landing technique and jump success.ResultsFalling was common within the sample population at a rate of one fall for every five jump attempts. Landings made on the flat or knuckle of the snow jump as well as incorrect board positioning at landing were found to be significant predictors of falling. Additionally the choice of manoeuvre was found to influence the risk of falls, with spinning jumps associated with a greater fall risk when compared to non spinning jumps. No clear relationship was identified between jump length measures and falling risk.ConclusionIt is likely that jumping will remain popular in snowboarding and thus research efforts should focus on minimising the risk of injury associated with this skill. Reducing the overall incidence of falling, identified in the current study to be high, is a potential area for improvement. The potential for fall risk reduction through technique and decision making changes provides justification for further research in this area.



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Skin Wound Healing Potential and Mechanisms of the Hydroalcoholic Extract of Leaves and Oleoresin of Copaifera langsdorffii Desf. Kuntze in Rats

The wound healing is a complex process which, sometimes, can be a problem in public health because of the possibility of physical disability or even death. Due to the lack of a gold standard drug in skin wound treatment and aiming at the discovery of new treatments in skin repair and the mechanisms involved in the process, we used oleoresin (OR) from Copaifera langsdorffii and hydroalcoholic extract of the leaves (EH) to treat rat skin wounds. For that, male Wistar rats were divided into groups (): Lanette, Collagenase, 10% EH, or 10% OR and, after anesthesia, one wound of 2 cm was made in the back of animals. The wounds were treated once a day for 3, 7, or 14 days and the wound areas were measured. The rats were euthanized and skin samples destined to biochemical, molecular, and immunohistochemical analysis. The results showed a macroscopic retraction of the wounds of 10% EH and 10% OR creams and both treatments showed anti-inflammatory activity. Molecular and immunohistochemical results demonstrated the activity of Copaifera langsdorffii creams in angiogenesis, reepithelialization, wound retraction, and remodeling mechanisms.

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