Clinical outcomes of lingual nerve repair Atkins, S.; Kyriakidou, E.
British journal of oral & maxillofacial surgery,
January 2021, 2021-01-00, 20210101, Letnik:
59, Številka:
1
Journal Article
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Lingual nerve injury, a well-described complication of third molar removal, may result in permanent lingual sensory deficit leading to symptoms including lost or altered sensation, inadvertent tongue ...biting, and the development of unpleasant neuropathic pain, with consequent impaired quality of life. We analysed outcomes of a prospective case series to determine whether direct anastomosis of the lingual nerve results in improved sensory recovery and reduced neuropathic pain, and whether delayed surgery is worthwhile. In 114 patients who underwent nerve repair at our nerve injury clinic following damage sustained during mandibular third molar removal, sensory deficit was assessed before and after surgery using a questionnaire and visual analogue scales (VAS) to assess pain, tingling, and discomfort. Neurosensory tests were utilised to evaluate light touch, pin-prick, and two-point discrimination thresholds. Subjectively, 94% patients felt their sensation had improved following nerve repair, with significant reductions in the incidence of tongue biting (p<0.0001), impaired speech (p<0.0001), and neuropathic pain (p=0.0017). Quantitative neurosensory data showed highly significant improvements in light touch, pin-prick, and two-point discrimination (all p<0.0001), and VAS scores for pain (p=0.0145), tingling (p<0.0025), and discomfort (p<0.0001) were significantly reduced. Patients with high levels of pain preoperatively (VAS>40) showed highly significant reductions in pain (p<0.0001). No correlation was found between surgical outcome and patient’s age or delay until surgery. Lingual nerve repair results in good sensory outcomes and significant improvements in the incidence and degree of neuropathic pain, even when delayed.
This article argues for a new interpretation of Ephesians based on its self-referentiality. Taking as my starting point the standard view that Eph 3:3–4 refers to the preceding portion of Ephesians, ...I explore how the text works rhetorically. I argue that in Ephesians 3:3–4 the author reflexively authorizes Ephesians as a revelatory text that provides privileged access to “the mystery” and to “Paul” as its mediator figure. Eph 3:3–4 thereby commends its readers to approach the epistle as textualized revelation. I advance this thesis through a contextual examination of Eph 3:2–13 with attention to three sets of comparanda. First, the Pesharim and Hodayot provide relevant witnesses to the textualization of revelation in early Judaism. Second, Quintilian’s depiction of ideal reading and the reception of Eph 3:3–4 by Origen and Jerome provide an opportunity to reimagine the epistle in light of ancient readerly landscapes. Third, depictions of inspired individuals endowed with divinely granted “insight” provide a revelatory framework for understanding σύνεσις in Eph 3:4. To conclude, I suggest further avenues of research that the present interpretation of Ephesians might open, including light it sheds on Ephesians’s pseudepigraphy.
Teika Atkins, Paul S
2017, 20170228, 2017-02-28
eBook
Fujiwara no Teika (1162-1241) was born into an illustrious lineage of poets just as Japan's ancien régime was ceding authority to a new political order dominated by military power. Overcoming ...personal and political setbacks, Teika and his allies championed a new style of poetry that managed to innovate conceptually and linguistically within the narrow confines of the waka tradition and the limits of its thirty-one syllable form. Backed by powerful patrons, Teika emerged finally as the supreme arbiter of poetry in his time, serving as co-compiler of the eighth imperial anthology of waka, Shin Kokinshū (ca. 1210) and as solo compiler of the ninth.
This first book-length study of Teika in English covers the most important and intriguing aspects of Teika's achievements and career, seeking the reasons behind Teika's fame and offering distinctive arguments about his oeuvre. A documentary biography sets the stage with valuable context about his fascinating life and times, followed by an exploration of his "Bodhidharma style," as Teika's critics pejoratively termed the new style of poetry. His beliefs about poetry are systematically elaborated through a thorough overview of his writing about waka. Teika's understanding of classical Chinese history, literature, and language is the focus of a separate chapter that examines the selective use of kana, the Japanese phonetic syllabary, in Teika's diary, which was written mainly in kanbun, a Japanese version of classical Chinese. The final chapter surveys the reception history of Teika's biography and literary works, from his own time into the modern period. Sometimes venerated as demigod of poetry, other times denigrated as an arrogant, inscrutable poet, Teika seldom inspired lukewarm reactions in his readers.
Courtier, waka poet, compiler, copyist, editor, diarist, and critic, Teika is recognized today as one of the most influential poets in the history of Japanese literature. His oeuvre includes over four thousand waka poems, his diary, Meigetsuki, which he kept for over fifty years, and a fictional tale set in Tang-dynasty China. Over fifteen years in the making, Teika is essential reading for anyone interested in Japanese poetry, the history of Japan, and traditional Japanese culture.
Abstract
Nearshore (littoral) habitats of clear lakes with high water quality are increasingly experiencing unexplained proliferations of filamentous algae that grow on submerged surfaces. These ...filamentous algal blooms (FABs) are sometimes associated with nutrient pollution in groundwater, but complex changes in climate, nutrient transport, lake hydrodynamics, and food web structure may also facilitate this emerging threat to clear lakes. A coordinated effort among members of the public, managers, and scientists is needed to document the occurrence of FABs, to standardize methods for measuring their severity, to adapt existing data collection networks to include nearshore habitats, and to mitigate and reverse this profound structural change in lake ecosystems. Current models of lake eutrophication do not explain this littoral greening. However, a cohesive response to it is essential for protecting some of the world's most valued lakes and the flora, fauna, and ecosystem services they sustain.
Burkholderia pseudomallei is a soil-dwelling organism present throughout the tropics. It is the causative agent of melioidosis, a disease that is believed to kill 89,000 people per year. It is ...naturally resistant to many antibiotics, requiring at least two weeks of intravenous treatment with ceftazidime, imipenem or meropenem followed by 6 months of orally delivered co-trimoxazole. This places a large treatment burden on the predominantly middle-income nations where the majority of disease occurs. We have established a high-throughput assay for compounds that could be used as a co-therapy to potentiate the effect of ceftazidime, using the related non-pathogenic bacterium Burkholderia thailandensis as a surrogate. Optimization of the assay gave a Z' factor of 0.68. We screened a library of 61,250 compounds and identified 29 compounds with a pIC50 (-log10(IC50)) greater than five. Detailed investigation allowed us to down select to six "best in class" compounds, which included the licensed drug chloroxine. Co-treatment of B. thailandensis with ceftazidime and chloroxine reduced culturable cell numbers by two orders of magnitude over 48 hours, compared to treatment with ceftazidime alone. Hit expansion around chloroxine was performed using commercially available compounds. Minor modifications to the structure abolished activity, suggesting that chloroxine likely acts against a specific target. Finally, an initial study demonstrates the utility of chloroxine to act as a co-therapy to potentiate the effect of ceftazidime against B. pseudomallei. This approach successfully identified potential co-therapies for a recalcitrant Gram-negative bacterial species. Our assay could be used more widely to aid in chemotherapy to treat infections caused by these bacteria.
Tuberculosis (TB) has been repeatedly shown to have socioeconomic impacts in both individual-level and ecological studies; however, much less is known about this effect among children and adolescents ...and the extent to which being affected by TB during childhood and adolescence can have life-course implications. This paper describes the results of the development of a conceptual framework and scoping review to review the evidence on the short- and long-term socioeconomic impact of tuberculosis on children and adolescents.
To increase knowledge of the socioeconomic impact of TB on children and adolescents.
We developed a conceptual framework of the socioeconomic impact of TB on children and adolescents, and used scoping review methods to search for evidence supporting or disproving it. We searched four academic databases from 1 January 1990 to 6 April 2021 and conducted targeted searches of grey literature. We extracted data using a standard form and analysed data thematically.
Thirty-six studies (29 qualitative, five quantitative and two mixed methods studies) were included in the review. Overall, the evidence supported the conceptual framework, suggesting a severe socioeconomic impact of TB on children and adolescents through all the postulated pathways. Effects ranged from impoverishment, stigma, and family separation, to effects on nutrition and missed education opportunities. TB did not seem to exert a different socioeconomic impact when directly or indirectly affecting children/adolescents, suggesting that TB can affect this group even when they are not affected by the disease. No study provided sufficient follow-up to observe the long-term socioeconomic effect of TB in this age group.
The evidence gathered in this review reinforces our understanding of the impact of TB on children and adolescents and highlights the importance of considering effects during the entire life course. Both ad-hoc and sustainable social protection measures and strategies are essential to mitigate the socioeconomic consequences of TB among children and adolescents.
Obesity confers an independent risk for carcinogenesis. In the liver, steatosis often proceeds cancer formation; however, the mechanisms by which steatosis promotes carcinogenesis is unknown. We ...hypothesize that steatosis alters the microenvironment to promote proliferation of tumor initiating cells (TICs) and carcinogenesis. We used several liver cancer models to address the mechanisms underlying the role of obesity in cancer and verified these findings in patient populations. Using bioinformatics analysis and verified by biochemical assays, we identified that hepatosteatosis resulting from either Pten deletion or transgenic expression of HCV core/NS5A proteins, promotes the activation of Wnt/β-catenin. We verified that high fat diet lipid accumulation is also capable of inducing Wnt/β-catenin. Caloric restriction inhibits hepatosteatosis, reduces Wnt/β-catenin activation and blocks the expansion of TICs leading to complete inhibition of tumorigenesis without affecting the phosphatase and tensin homologue deleted on chromosome 10 (PTEN) loss regulated protein kinase B (AKT) activation. Pharmacological inhibition or loss of the Wnt/β-catenin signal represses TIC growth in vitro, and decreases the accumulation of TICs in vivo. In human liver cancers, ontology analysis of gene set enrichment analysis (GSEA)-defined Wnt signature genes indicates that Wnt signaling is significantly induced in tumor samples compared with healthy livers. Indeed, Wnt signature genes predict 90% of tumors in a cohort of 558 patient samples. Selective depletion of macrophages leads to reduction of Wnt and suppresses tumor development, suggesting infiltrating macrophages as a key source for steatosis-induced Wnt expression. These data established Wnt/β-catenin as a novel signal produced by infiltrating macrophages induced by steatosis that promotes growth of tumor progenitor cells, underlying the increased risk of liver tumor development in obese individuals.
The objective of this study is to test the feasibility and impact of a 10-wk after-school exercise program for children with attention deficit hyperactivity disorder and/or disruptive behavior ...disorders living in an urban poor community.
Children were randomized to an exercise program (n = 19) or a comparable but sedentary attention control program (n = 16). Cognitive and behavioral outcomes were collected pre-/posttest. Intent-to-treat mixed models tested group-time and group-time-attendance interactions. Effect sizes were calculated within and between groups.
Feasibility was evidenced by 86% retention, 60% attendance, and average 75% maximum HR. Group-time results were null on the primary outcome, parent-reported executive function. Among secondary outcomes, between-group effect sizes favored exercise on hyperactive symptoms (d = 0.47) and verbal working memory (d = 0.26), and controls on visuospatial working memory (d = -0.21) and oppositional defiant symptoms (d = -0.37). In each group, within-group effect sizes were moderate to large on most outcomes (d = 0.67 to 1.60). A group-time-attendance interaction emerged on visuospatial working memory (F1,33 = 7.42, P < 0.05), such that attendance to the control program was related to greater improvements (r = 0.72, P < 0.01), whereas attendance to the exercise program was not (r = 0.25, P = 0.34).
Although between-group findings on the primary outcome, parent-reported executive function, were null, between-group effect sizes on hyperactivity and visuospatial working memory may reflect adaptations to the specific challenges presented by distinct formats. Both groups demonstrated substantial within-group improvements on clinically relevant outcomes. Findings underscore the importance of programmatic features, such as routines, engaging activities, behavior management strategies, and adult attention, and highlight the potential for after-school programs to benefit children with attention deficit hyperactivity disorder and disruptive behavior disorder living in urban poverty where health needs are high and services resources few.
► Rational design of hybrid peptides from natural parents. ► Direct antimicrobial activity improved over parents. ► Activity against Bacillus anthracis, Francisella tularensis and Burkholderia spp. ► ...Further modification reduces hemolysis and improves therapeutic index.
Antimicrobial peptides (AMPs) are a naturally occurring component of the innate immune response of many organisms and can have activity against both Gram-negative and Gram-positive bacterial species. In order to optimize and improve the direct antimicrobial effect of AMPs against a broad spectrum of bacterial species, novel synthetic hybrids were rationally designed from cecropin A, LL-37 and magainin II. AMPs were selected based on their α-helical secondary structure and fragments of these were analyzed and combined in silico to determine which hybrid peptides would form the best amphipathic cationic α-helices. Four hybrid peptides were synthesized (CaLL, CaMA, LLaMA and MALL) and evaluated for direct antimicrobial activity against a range of bacterial species (Bacillus anthracis, Burkholderia cepacia, Francisella tularensis LVS and Yersinia pseudotuberculosis) alongside the original ‘parent’ AMPs. The hybrid peptides showed greater antimicrobial effects than the parent AMPs (in one case a parent is completely ineffective while a hybrid based on it removes all traces of bacteria by 3h), although they also demonstrated higher hemolytic properties. Modifications were then carried out to the most toxic hybrid AMP (CaLL) to further improve the therapeutic index. Modifications made to the hybrid lowered hemolytic activity and also lowered antimicrobial activity by various degrees. Overall, this work highlights the potential for rational design and synthesis of improved AMPs that have the capability to be used therapeutically for treatment of bacterial infections.
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