High-energy muon and electron neutrinos yield a non-negligible flux of tau neutrinos as they propagate through Earth. In this Letter, we address the impact of this additional component in the PeV and ...EeV energy regimes for the first time. Above 300 TeV, this contribution is predicted to be significantly larger than the atmospheric background, and it alters current and future neutrino telescopes' capabilities to discover a cosmic tau-neutrino flux. Further, we demonstrate that Earth-skimming neutrino experiments, designed to observe tau neutrinos, will be sensitive to cosmogenic neutrinos even in extreme scenarios without a primary tau-neutrino component.
Objectives. This study aimed to evaluate the effects of different cleaning regimes of acrylic-based removable orthodontic appliances on bacterial biofilm formation and whether the surface ...modification, i.e., polished acrylic fitting surface, reduces biofilm formation. Materials and Methods. This double-blind, parallel, randomized clinical trial involved thirty-nine orthodontic patients indicated for removable orthodontic appliances. The patients were allocated into three groups according to the cleaning method: brushing with a denture brush and chlorhexidine (CHX) toothpaste, Lacalut cleaning tablet, and a combination of both cleaning methods. Each patient wore an upper removable appliance containing eight wells fitted with eight detachable acrylic tiles (four polished and four unpolished) for seven days. Five types of oral microbiota were evaluated using selective growth media and biochemical tests. The biofilm cleaning efficacy was assessed using the colony-forming unit (CFU) and scanning electron microscopy (SEM). Statistical Analysis. Data from the CFU using different cleansing regimes were compared, following log transformation, using one-way analysis of variance (ANOVA). The polished and unpolished tiles were compared for biofilm formation on each cleansing method using an independent t-test. Results. There was no significant difference among the three cleaning methods on the polished or unpolished tiles. However, in polished tiles, streptococci were significantly reduced in all cleaning methods, whereas staphylococci and Staphylococcus aureus were markedly decreased in brushing and combination cleaning methods. However, the total number of anaerobic bacteria was significantly reduced in polished tiles using the combination method only. Conclusions. Polishing the fitting surface of an acrylic-based orthodontic appliance reduced the tested bacterial biofilm formation and may enhance cleaning efficiency. Brushing and combination methods showed superior cleaning effects compared to cleaning tablets. This trial is registered with NCT05707221.
It was aimed to detect extracellular traps structures from sheep polymorphonuclear leukocytes (PMN) after being confronted with Echinococcus granulosus protoscoleces in vitro. Also, the effect of ...cyst fluid was examined on the development of extracellular traps. At the end of the incubation for 1 h, the extracellular traps augmented with neutrophil elastase, histone (H3) and myeloperoxidase were visualized in the protoscoleces-PMN co-culture microscopically. Some protoscoleces lysed and the chitinous hooks released were surrounded by the extracellular traps. The other protoscoleces were still intact and the extracellular trap structures were observed around them. The relationship between the extracellular DNA contents and the protoscoleces concentration was not found statistically significant (P > 0.05). The extracellular DNA amount in the co-cultures diluted in RPMI-1640 increased with the incubation time (P < 0.05). However, the time-dependent relationship was not found in the co-cultures diluted in the cyst fluid (P > 0.05). The difference in the extracellular DNA amount was detected as statistically significant (P < 0.05) between the two co-culture groups (diluted in RPMI-1640 or the cyst fluid), except for 30 min incubation. To the Author's knowledge, NETosis reaction was firstly observed in sheep PMN after being confronted with protoscoleces in vitro. The cyst fluid had some negative effects on the development of extracellular traps from sheep PMNs at the 1-h incubation time. It should be investigated which molecules are responsible for NETosis inhibition in hydatid cyst fluid. Future studies may clarify whether neutrophils fight with protoscoleces by using their different mechanisms.
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•NETosis reaction was firstly observed in sheep PMN: Protoscoleces co-culture.•Cyst fluid effected negatively on the extracellular traps development.•Some protoscoleces lysed and the hooks were surrounded by the extracellular traps.•Some protoscoleces were intact and the extracellular trap structures were observed.
Purpose
To determine the component fit by radiography or computed tomography after total knee arthroplasty and the relation of imaging with clinical examination of residual knee pain.
Methods
The ...study was conducted in 172 patients with residual knee pain after total knee arthroplasty. The patients were examined to determine whether they experienced pain upon palpation at nine regions surrounding the tibial and femoral components, and the results were noted. The Knee Society Clinical Rating System and The Western Ontario and McMaster Universities Arthritis Index pain scale score forms were completed for all patients. Radiologic evaluation was performed using computed tomography and anteroposterior, lateral, and oblique radiographs to determine component overhang/underhang status at these nine regions. Overhang, underhang, and cortical fit groups were created based on the position of the component at the bone margin. A statistical relationship was sought between the clinical scores and the values measured to determine which imaging method showed the best correlation with clinical scores. Consistency of CT and Rx measurements was compared using the McNemar–Bowker test. Comparisons between groups were made using Student’s t test for normally distributed data, and the Mann–Whitney U test.
Results
Computed tomography and radiographic measurements were similar in the medial, anterior, and lateral tibial regions. However, no similarities were observed in the anteromedial, anterolateral, posteromedial, and posterolateral tibial regions, and in the distal-medial and distal-lateral aspects of the femur. Statistical relationships among decreased clinical scores, pain with palpation, and the presence of overhang/underhang were only observed in the medial tibial region for imaging using radiography. A statistically significant relationship was observed in the medial, posteromedial, and posterolateral tibial regions, and in the distal-medial region of the femur for imaging based on computed tomography.
Conclusions
Radiography could only aid in assessing the component fit in the anteromedial, medial, and lateral regions of the tibia in patients with residual knee pain following knee arthroplasty, but it was not sufficient in comparison with computed tomography in six other regions.
Level of evidence
Prospective study, level of evidence II.
Experts have given much attention on the use of waste in asphalt paving because of its significance from a sustainability perspective. This paper evaluated the performance properties of asphalt ...concrete mixes modified with Crumb Rubber (CR) as a partial replacement for two grade sizes of fine aggregate (2.36, and 0.3 mm) at six replacement rates: 0%, 2%, 4%, 6%, 8%, and 10% by weight. Asphalt concrete mixes were prepared at their Optimum Asphalt Content (OAC) and then tested for their engineering properties. Marshall properties, fatigue, rutting, ideal CT index test, Scanning Electron Microscopy (SEM), and Energy-Dispersive X-ray (EDX) spectroscopy were deployed to examine the crystalline structure and elemental composition of the CR-modified and unmodified asphalt concrete mixtures. The results showed a difference in Marshall's characteristics. The CT index revealed that the optimum cracking tolerance was achieved with a 2% CR substitution. Wheel track test results indicated that a 4% CR addition improved the rutting resistance of the asphalt mixture. SEM and EDX analyses exhibited significant changes in microstructure and elemental composition with the addition of CR. The main findings reveal that the use of 2% CR as a partial replacement of fine aggregate contributes to the production of more durable asphalt concrete mixtures with better serviceability. However, these results are based on laboratory experiments and require field verification to ensure practical applicability and long-term performance.
We report a 53-year-old Turkish female presented with progressive weakness and mild dyspnea. Laboratory results demonstrated severe hypokalemia with hyperchloremic metabolic acidosis. The urinary ...anion gap was positive in the presence of acidemia, thus she was diagnosed with hypokalemic paralysis from a severe distal renal tubular acidosis (RTA). Immunologic work-up showed a strongly positive ANA of 1:3,200 and positive antibodies to SSA and SSB. Schirmer’s test was abnormal. Autoimmune and other tests revealed Sjögren syndrome as the underlying cause of the distal renal tubular acidosis. Renal involvement in Sjogren’s syndrome (SS) is not uncommon and may precede sicca complaints. The pathology in most cases is a tubulointerstitial nephritis causing among other things, distal RTA, and, rarely, hypokalemic paralysis. Treatment consists of potassium repletion, alkali therapy, and corticosteroids. Primary SS could be a differential in women with acute weakness and hypokalemia.
Sweet Syndrome following SARS‐CoV‐2 CoronaVac vaccine Ben Salah, N.; Korbi, M.; Ben Fadhel, N. ...
Journal of the European Academy of Dermatology and Venereology,
November 2022, Letnik:
36, Številka:
11
Journal Article
Monitoring protocols have been developed because patients taking atypical antipsychotics are more prone to developing metabolic syndrome, which leads to possible increased mortality and morbidity. ...The aim of this study was to assess the degree of adherence to the recommendations of metabolic syndrome monitoring.
This study was conducted in two large psychiatric facilities in the Eastern Province of Saudi Arabia. A retrospective analysis of the medical records of 350 patients taking antipsychotic medications was done, and an assessment was made of the frequency of metabolic monitoring at each of the intervals as suggested by the American Diabetes Association. Data was analyzed using SPSS; descriptive statistics. were computed and Chi-square test was used to determine statistical significance for association between categorical variable.
The mean age of the patients was 34.9 ± 18 years; 64.6% were males. Olanzapine was the most prescribed medication (43.7%,
= 153), followed by quetiapine (17.4%,
= 61). Only one-third of the patients (29.6%) completed all the baseline parameters. Documentation of baseline parameters was low for glucose level (38.9%), lipid panel (17.3%), weight (25.2%), and waist circumference (1.4%). Adherence to yearly monitoring was much lower than at baseline (mean percentage: 29.6% vs. 1.7%). Furthermore, 45% of the patients were classified as obese and 10% had metabolic comorbidity.
Individuals with mental illness who were taking antipsychotics did not undergo proper metabolic screening during antipsychotic treatment. Barriers to adherence to the monitoring guidelines should be examined and addressed. Giving assistance to practitioners to recall the required laboratory tests and vitals at certain intervals could help improve metabolic monitoring practices.
The American Academy of Orthopaedic Surgeons (AAOS) recently developed an Appropriate Use Criteria (AUC) for pediatric supracondylar humerus fractures (PSHF). The AUC is intended to improve quality ...of care by informing surgeon decision making. The aim of our study was to cross-reference the management of operatively treated PSHF with the AAOS-published AUC.
The AUC for PSHF include 220 patient scenarios, based on different combinations of 6 factors. For each patient scenario, 8 treatment options are evaluated as "appropriate," "maybe appropriate," and "rarely appropriate." We retrospectively reviewed the medical charts and radiographs of all operatively treated PSHF at our hospital from January 2013 to December 2014 and determined the appropriateness of the treatment.
Over the study period, 94 children (mean age: 5.2 y; 51 male, 43 female) were admitted with PSHF and underwent a surgical procedure (type IIA: 7, type IIB: 14, type III: 70, flexion type: 3). Only 8 of the 220 scenarios were observed in our patient cohort. The most frequent scenario was represented by a type III fracture, palpable distal pulse, no nerve injury, closed soft-tissue envelope, no radius/ulna fracture, and typical swelling. Of the 94 fractures, the AUC was "appropriate" for 84 cases and "maybe appropriate" for 9 cases. There was only 1 case of "rarely appropriate" management. Closed reduction with lateral pinning and immobilization was the most prevalent treatment option (58.5%). The rate of appropriateness was not affected by the operating surgeon. However, the definition of a case as emergent had a significant impact on the rate of appropriateness.
Application of the AUC to actual clinical data was relatively simple. The majority of operatively treated PSHF (89.4%) were managed appropriately. With the introduction of electronic medical charts, an AUC application becomes attractive and easy for orthopaedic surgeons to utilize in clinical practice. However, validity studies of the AUC in different clinical settings are still required.
Level IV.
This study aims to investigate the patient profile at a medium-volume hospital located in the earthquake zone among patients who received orthopedic treatment within the first five days after the ...natural disaster that was considered a major earthquake.
Between February 6
, 2023 and February 10
, 2023, a total of 338 patients (156 males, 182 females; mean age: 42.2±9.7 years; range, 0 to 87 years) who received orthopedic treatment in our center were retrospectively analyzed. The patients were divided into four groups according to age as follows: infants (younger than one year of age), children (one to 13 years), adults (14 to 59 years), and elderly (60 years or older).
Considering the age distribution, 291 (86%) patients were young adults. A total of 173 orthopedic surgeries were performed, including internal fixation in 63 patients, external fixation in 11 patients, upper/lower extremity fasciotomy in 47 patients, amputation in 39 patients, and soft tissue debridement in 13 patients.
It is of utmost importance to recognize the principles of emergency fracture fixation and fasciotomy to successfully perform orthopedic surgeries after a natural disaster such as a major earthquake, particularly when the number of earthquake victims is considerably high.
