Placebo treatment can significantly influence subjective symptoms. However, it is widely believed that response to placebo requires concealment or deception. We tested whether open-label placebo ...(non-deceptive and non-concealed administration) is superior to a no-treatment control with matched patient-provider interactions in the treatment of irritable bowel syndrome (IBS).
Two-group, randomized, controlled three week trial (August 2009-April 2010) conducted at a single academic center, involving 80 primarily female (70%) patients, mean age 47 ± 18 with IBS diagnosed by Rome III criteria and with a score ≥ 150 on the IBS Symptom Severity Scale (IBS-SSS). Patients were randomized to either open-label placebo pills presented as "placebo pills made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes" or no-treatment controls with the same quality of interaction with providers. The primary outcome was IBS Global Improvement Scale (IBS-GIS). Secondary measures were IBS Symptom Severity Scale (IBS-SSS), IBS Adequate Relief (IBS-AR) and IBS Quality of Life (IBS-QoL).
Open-label placebo produced significantly higher mean (±SD) global improvement scores (IBS-GIS) at both 11-day midpoint (5.2 ± 1.0 vs. 4.0 ± 1.1, p<.001) and at 21-day endpoint (5.0 ± 1.5 vs. 3.9 ± 1.3, p = .002). Significant results were also observed at both time points for reduced symptom severity (IBS-SSS, p = .008 and p = .03) and adequate relief (IBS-AR, p = .02 and p = .03); and a trend favoring open-label placebo was observed for quality of life (IBS-QoL) at the 21-day endpoint (p = .08).
Placebos administered without deception may be an effective treatment for IBS. Further research is warranted in IBS, and perhaps other conditions, to elucidate whether physicians can benefit patients using placebos consistent with informed consent.
ClinicalTrials.gov NCT01010191.
Con esta investigación se planteó establecer las herramientas informativas para la vigilancia tecnológica en diseños curriculares de universidades públicas, para lo cual se analizaron las bases de ...datos, la cienciometría y SERBILUZ en el Núcleo Técnico de la Universidad del Zulia, mediante un estudio no experimental transeccional descriptivo y de campo. De acuerdo con las herramientas informativas estudiadas, se observa que los informantes claves desconocen si dentro de la universidad se cuenta con este tipo de estadística y registro que le permitan a la comisión curricular de la institución, tener información sobre las estrategias utilizadas en los procesos de transformación curricular anteriores, que permitan ver cómo han evolucionado las competencias necesarias o requeridas por el sector productivo nacional. Así mismo, se desconoce si SERBILUZ maneja sistema de gestión documental de la información con respecto a los procesos curriculares que faciliten la toma de decisiones. A pesar de esta data recopilada, se percibe que actualmente se está llevando a cabo un registro de la información recolectada en este proceso de transformación y todos los análisis de la misma, que servirá de referencia para los próximos procesos curriculares.
El objetivo de la presente investigación es determinar los ejes de la vigilancia tecnológica aplicados en las Universidades del Municipio Maracaibo que ofrecen estudios a distancia, siguiendo los ...aportes teóricos de López et al. (2007), Palop y Vicente (1999), Martinet y Ribault (1989), Escorsa y Valls (2005), Fundación COTEC (1999) y Jakobiak (1995). La investigación es descriptiva, con un diseño no experimental transeccional de campo. La población la conforman doce directores y coordinadores (censo poblacional), a quienes se aplicó un cuestionario con preguntas cerradas y opciones de frecuencia, validado y con alta confiabilidad (0.90). Los datos obtenidos fueron interpretados a través del análisis y discusión de información estadística. Los resultados adquiridos indican que se aplican los ejes de vigilancia tecnológica en las universidades seleccionadas, enfatizando los siguientes elementos de estudio: la vigilancia competitiva, la vigilancia comercial, la vigilancia tecnológica propiamente dicha y la vigilancia de los entornos.
Plaque control is especially important during orthodontic treatment because areas of the teeth near brackets and wires are difficult to clean with a toothbrush, resulting in debris buildup of food or ...dental plaque, thus causing caries and periodontal disease. The objective of this study was to evaluate the antimicrobial properties of silver nanoparticles (AgNPs), titanium dioxide nanoparticles (TiO2NPs), and silver/titanium dioxide nanoparticles (Ag/TiO2NPs), synthesized on the surface of α-alumina ceramic brackets. The AgNPs and TiO2NPs were synthesized by a simple chemical method, and these were characterized by XRD, SEM, and XPS TEM; the antimicrobial activity was tested against Staphylococcus aureus and Escherichia coli by diffusion test. The results of this study demonstrated that by this simple chemical method, silver and titanium dioxide nanoparticles can be synthesized on the surface of α-alumina esthetic brackets, and these NPs possess good antimicrobial activity and the possibility of reducing dental caries, periodontal disease, and white spot generated during orthodontic treatment.
Within the framework of the current COVID-19 pandemic, there is a race against time to find therapies for the outbreak to be controlled. Since vaccines are still tedious to develop and partially ...available for low-income countries, passive immunity based on egg-yolk antibodies (IgY) is presented as a suitable approach to preclude potential death of infected patients, based on its high specificity/avidity/production yield, cost-effective manufacture, and ease of administration. In the present study, IgY antibodies against a recombinant RBD protein of SARS-CoV-2 were produced in specific-pathogen-free chickens and purified from eggs using a biocompatible method.
immunoreactivity was tested, finding high recognition and neutralization values. Safety was also demonstrated prior to efficacy evaluation, in which body weight, kinematics, and histopathological assessments of hamsters challenged with SARS-CoV-2 were performed, showing a protective effect administering IgY intranasally both as a prophylactic treatment or a post-infection treatment. The results of this study showed that intranasally delivered IgY has the potential to both aid in prevention and in overcoming COVID-19 infection, which should be very useful to control the advance of the current pandemic and the associated mortality.
Abstract Background Right bundle branch block (RBBB) evident in the precordial ECG leads may be associated with evidence of left bundle branch involvement in the limb leads. Any of the components of ...the left bundle can be involved, and this complex interventricular conduction abnormality has previously been described in patients with underlying heart disease. Objectives To analyze the electro-vectorcardiographic manifestations of RBBB with left middle septal fiber block (LMSFB), with or without left anterior fascicular block (LAFB) in premature atrial beats of patients without apparent structural heart disease. Methods Twelve patients (8 men/4 women; mean age: 32 ± 8 years) with premature atrial contractions with this conduction abnormality were included. Surface 12 simultaneous lead ECG recordings and the corresponding vectorcardiographic loops were analyzed. Results The QRS complexes with RBBB and also LMSFB persisted for between 150 and 190 ms. There were no q waves in lead I. The maximum spatial vector (72–86 ms) was directed posteriorly, superiorly, and leftward, and the terminal forces were oriented anteriorly, inferiorly and rightward. In 10 patients, small q waves were apparent in leads V1–V2 and the frontal QRS axis was − 60° and − 70°, with the 46 ms vector located at − 50° ± 5. All of these patients most probably had LAFB in addition to LMSFB. In two patients, the initial electrical forces were directed anteriorly, inferiorly, and leftward, and the 46 ms vector axis in the frontal plane was 6° and 11°, respectively, indicating absence of LAFB. Conclusions The combination of RBBB and LMSFB occurring in patients without apparent structural heart disease may be related to the simultaneous occurrence of block of conduction through these components of the Purkinje network. The anterior fascicle of the left bundle may also be involved.
Resumen El objetivo de la presente investigación es determinar los ejes de la vigilancia tecnológica aplicados en las Universidades del Municipio Maracaibo que ofrecen estudios a distancia, siguiendo ...los aportes teóricos de López et al. (2007), Palop y Vicente (1999), Martinet y Ribault (1989), Escorsa y Valls (2005), Fundación COTEC (1999) y Jakobiak (1995). La investigación es descriptiva, con un diseño no experimental transeccional de campo. La población la conforman doce directores y coordinadores (censo poblacional), a quienes se aplicó un cuestionario con preguntas cerradas y opciones de frecuencia, validado y con alta confiabilidad (0.90). Los datos obtenidos fueron interpretados a través del análisis y discusión de información estadística. Los resultados adquiridos indican que se aplican los ejes de vigilancia tecnológica en las universidades seleccionadas, enfatizando los siguientes elementos de estudio: la vigilancia competitiva, la vigilancia comercial, la vigilancia tecnológica propiamente dicha y la vigilancia de los entornos. Abstract The aim of this research is to determine the axes of technological surveillance applied in the universities of Maracaibo Municipality including distance learning, following the theoretical contributions of López et al. (2007), Palop and Vicente (1999), Martinet and Ribault (1989) Escorsa and Valls (2005), COTEC Foundation (1999) and Jakobiak (1995). This research is descriptive, based on a experimental design. The population consisted of twelve directors and coordinators (residents), who answered a questionnaire with closed questions and frequency options. This was validated with high reliability (0.90). The data obtained were interpreted through analysis and discussion of statistical information. The results indicate that the axes of technological surveillance are applied in the selected universities, emphasizing the following elements of study: competitive surveillance, commercial surveillance, technological surveillance itself and surveillance of the environment.
Effective Aedes aegypti control is limited, in part, by the difficulty in achieving sufficient intervention coverage. To maximise the effect of vector control, areas with persistently high numbers of ...Aedes-borne disease cases could be identified and prioritised for preventive interventions. We aimed to identify persistent Aedes-borne disease hotspots in cities across southern Mexico.
In this spatial analysis, geocoded cases of dengue, chikungunya, and Zika from nine endemic Mexican cities were aggregated at the census-tract level. We included cities that were located in southern Mexico (the arbovirus endemic region of Mexico), with a high burden of dengue cases (ie, more than 5000 cases reported during a 10-year period), and listed as high priority for the Mexican dengue control and prevention programme. The Getis-Ord Gi*(d) statistic was applied to yearly slices of the dataset to identify spatial hotspots of each disease in each city. We used Kendall's W coefficient to quantify the agreement in the distribution of each virus.
128 507 dengue, 4752 chikungunya and 25 755 Zika clinical cases were reported between Jan 1, 2008, and Dec 31, 2016. All cities showed evidence of transmission heterogeneity, with a mean of 17·6% (SD 4·7) of their total area identified as persistent disease hotspots. Hotspots accounted for 25·6% (SD 9·7; range 12·8–43·0) of the population and 32·1% (10·5; 19·6–50·5) of all Aedes-borne disease cases reported. We found an overlap between hotspots of 61·7% for dengue and Zika and 53·3% for dengue and chikungunya. Dengue hotspots in 2008–16 were significantly associated with dengue hotspots detected during 2017–20 in five of the nine cities. Heads of vector control confirmed hotspot areas as problem zones for arbovirus transmission.
This study provides evidence of the overlap of Aedes-borne diseases within geographical hotspots and a methodological framework for the stratification of arbovirus transmission risk within urban areas, which can guide the implementation of surveillance and vector control.
USAID, the US Centers for Disease Control and Prevention, the Canadian Institutes of Health Research, International Development Research Centre, Fondo Mixto CONACyT (Mexico)-Gobierno del Estado de Yucatan, and the US National Institutes of Health.
For the Spanish translation of the abstract see Supplementary Materials section.
Purpose: This study evaluated the association of surface degradation and formation of Streptococcus mutans (S. mutans) biofilm in resin-based composites (RBCs) after storage in different acidic ...liquids.Methods: To evaluate microhardness and surface micromorphology, hybrid and nanohybrid RBC discs were stored in artificial gastric acid, cola drink, orange juice, artificial saliva, and distilled water for three intervals of 15 min per day for 7, 15, and 30 days. After 30 days of storage, surface roughness was analyzed, and the RBC discs were placed in a biofilm reactor inoculated with S. mutans to evaluate surface biofilm formation.Results: As compared with nanohybrid RBCs, roughness and surface microhardness values were significantly lower (P < 0.05) for hybrid RBCs stored in artificial gastric acid, followed by specimens stored in cola drink and orange juice. Artificial gastric acid caused greater surface degradation, which increased the biomass of S. mutans on the surface of both RBC types.Conclusion: Surface degradation of hybrid and nanohybrid RBCs correlated with the pH of the liquid, while S. mutans biofilm formation was associated with increased surface roughness in hybrid RBCs.
Circulating myeloma tumor cells (CTCs) as defined by the presence of peripheral blood (PB) clonal plasma cells (PCs) are a powerful prognostic marker in multiple myeloma (MM). However, the biological ...features of CTCs and their pathophysiological role in MM remains unexplored. Here, we investigate the phenotypic, cytogenetic, and functional characteristics as well as the circadian distribution of CTCs vs paired bone marrow (BM) clonal PCs from MM patients. Our results show that CTCs typically represent a unique subpopulation of all BM clonal PCs, characterized by downregulation (P < .05) of integrins (CD11a/CD11c/CD29/CD49d/CD49e), adhesion (CD33/CD56/CD117/CD138), and activation molecules (CD28/CD38/CD81). Fluorescence in situ hybridization analysis of fluorescence-activated cell sorter–sorted CTCs also unraveled different cytogenetic profiles vs paired BM clonal PCs. Moreover, CTCs were mostly quiescent and associated with higher clonogenic potential when cocultured with BM stromal cells. Most interestingly, CTCs showed a circadian distribution which fluctuates in a similar pattern to that of CD34+ cells, and opposite to stromal cell–derived factor 1 plasma levels and corresponding surface expression of CXC chemokine receptor 4 on clonal PCs, suggesting that in MM, CTCs may egress to PB to colonize/metastasize other sites in the BM during the patients' resting period.
•Detailed characterization of myeloma circulating tumor cells shows that these represent a unique subpopulation of BM clonal PCs.•Myeloma CTCs are clonogenic, quiescent, and may represent an ancestral clone potentially driven by circadian rhythms.
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