An exhaustive analysis of the use of image moments for second-order calibration. A comparison with multivariate curve resolution-alternating least-squares.

BACKGROUND: the chemometric processing of second-order chromatographic-spectral data is usually carried out with the aid of multivariate curve resolution-alternating least-squares (MCR-ALS). Recently, an alternative procedure was described based on the estimation of image moments for each data matrix and subsequent application of multiple linear regression after suitable variable selection. RESULTS: The analysis of both simulated and experimental data leads to the conclusion that the image moment method, although can cope with chromatographic lack of reproducibility across injections, it only performs well in the absence of uncalibrated interferents. MCR-ALS, on the other hand, provides good analytical results in all studied situations, whether the test samples contain uncalibrated interferents or not. SIGNIFICANCE: The results are useful to assess the real usefulness of newly proposed methodologies for second-order calibration in the case of chromatographic-spectral data sets, especially when samples contain unexpected chemical constituents.

A Case Report on the Atypical Symptoms of the Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) Syndrome: Could COVID-19 Be a Cause?

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, a rare disorder with a spectrum of manifestations and overlapping osseous and cutaneous symptoms, shares pathogenesis with various autoimmune diseases. SARS-CoV-2 has been previously linked to various autoimmune diseases like Guillain-Barré syndrome (GBS), a multi-inflammatory syndrome in children (MIS-C), or rheumatoid arthritis, but there is no existing work showing a link between SAPHO syndrome and COVID-19 yet. Here, we present a case of a middle-aged Asian male who presented with minimum swelling of his right second toe, 21 days post-COVID. After a series of investigations, namely, MRI scans, 99mTc-methylene diphosphonate three-phase bone scan, and bone biopsy, followed by a positive culture and sensitivity test of the same toe, a trial of vancomycin was given to the patient to treat bacterial osteomyelitis. This resulted in no improvement, pointing toward a misdiagnosis. A conclusion of sterile osteomyelitis of his right second and third metatarsal heads and phalanges due to SAPHO syndrome, as a possible complication of SARS-CoV-2 infection, was made. There are a number of classification systems for diagnosing this syndrome, one of which was modified by Kahn and was used in our case. Atypical presentations of rare disorders like SAPHO syndrome and their relation to SARS-CoV-2 infection are still to be fully discovered and investigated. Their prevention, timely diagnosis, and management may help in alleviating the discomfort and fear associated with the unknown for the patients.

A new constraint to model background signals when processing chromatographic-spectral second-order data with multivariate curve resolution.

BACKGROUND: the chemometric processing of second-order chromatographic-spectral data is usually carried out with the aid of multivariate curve resolution-alternating least-squares (MCR-ALS). When baseline contributions occur in the data, the background profile retrieved with MCR-ALS may show abnormal lumps or negative dips at the position of the remaining component peaks. RESULTS: The phenomenon is shown to be due to remaining rotational ambiguity in the obtained profiles, as confirmed by the estimation of the boundaries of the range of feasible bilinear profiles. To avoid the abnormal features in the retrieved profile, a new background interpolation constraint is proposed and described in detail. Both simulated and experimental data are employed to support the need of the new MCR-ALS constraint. In the latter case, the estimated analyte concentrations agreed with those previously reported. SIGNIFICANCE: The developed procedure helps to reduce the extent of rotational ambiguity in the solution and to better interpret the results on physicochemical grounds.

Small Bowel Adenocarcinoma: A Rare Case of Iron Deficiency Anemia.

Neoplasms of the small bowel are relatively rare, with less than 5% occurrence among other GI cases. Primary adenocarcinoma, an aggressive sub-type of small bowel cancers, usually presents with vague blood loss and abdominal pain symptoms, causing a delayed diagnosis at an advanced stage of the disease and a poor prognosis. The preferable treatment of choice is surgical resection with chemotherapy, which has shown to have survival benefits. Here we present a case of a 66-year-old male patient with persistent iron deficiency anemia requiring multiple blood transfusions and an unexplained weight loss. A series of diagnostic tests, including upper and lower GI endoscopy, Tc-99 RBC scintigraphy, barium follow-through, CT scans, bone marrow biopsy, esophagogastroduodenoscopy and colonoscopy were inconclusive. He was later diagnosed with a small bowel adenocarcinoma on exploratory laparotomy and surgically treated. Adjuvant chemotherapy was also started. Our case report highlights the course of SBA presenting in an unusual way which was challenging to diagnose with the standard investigations to help physicians/surgeons suspect it at an early stage in the future. This may save patients and help avoid delayed diagnosis or misdiagnosis, especially in patients with an unusual presentation like our patient who presented only with iron deficiency anemia.

Effect of Metformin on Vitamin B12 Deficiency in Patients With Type 2 Diabetes Mellitus and Factors Associated With It: A Meta-Analysis.

The current meta-analysis aims to explore the effect of metformin use on vitamin B12 deficiency in patients with type 2 diabetes mellitus (T2DM) and the factors associated with it. This meta-analysis followed the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines and the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. We searched PubMed and EMBASE from January 1, 2010, to October 31, 2022, to collect the studies that reported the effect of metformin on the deficiency of vitamin B12 in patients with T2DM and the factors associated with it. A total of 17 studies were included in the current meta-analysis. Among all the included studies, 13 were cross-sectional studies, 3 were retrospective cohorts, and one was a case-control study. The pooled rate of deficiency of vitamin B12 in patients receiving metformin (23.16%) was significantly higher compared to patients who were not on metformin (17.4%) (OR: 2.95, 95% CI: 2.18-4.00, p-value: 0.001). Factors significantly associated with vitamin B12 deficiency in patients with T2DM and receiving metformin include the duration of metformin use and a greater dose of metformin. In conclusion, our meta-analysis found that the prevalence of vitamin B12 deficiency is greater in patients receiving metformin compared to patients who did not receive metformin. Given the importance of vitamin B12 in nutrition, metformin-induced B12 decrease may be harmful to patients with T2DM. Supplemental vitamin B12 may be advantageous for those on metformin.

Efficacy of Intravenous Albumin for Spontaneous Bacterial Peritonitis Infection Among Patients With Cirrhosis: A Meta-Analysis of Randomized Control Trials.

Albumin is an important component in the standard therapeutic approach to spontaneous bacterial peritonitis (SBP). This meta-analysis aimed to determine the impact of intravenous human albumin in patients with cirrhosis and SBP. This study was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two reviewers independently searched relevant studies using electronic databases including PubMed, Embase and Cochrane Library from the date of database inception to October 2022. The outcomes assessed in the current meta-analysis include 30-day mortality, renal impairment, changes in serum creatinine levels (mg/dl) and resolution of bacterial infection. It was found that the risk of all-cause mortality and renal impairment was significantly lower in patients receiving albumin compared to the control group. However, no significant difference was reported between the two groups in relation to changes in mean creatinine levels and resolution of infection.

Excitation-emission fluorescence-kinetic third-order/four-way data: Determination of bisphenol A and nonylphenol in food-contact plastics.

The endocrine disrupting chemicals bisphenol A (BPA) and 4-nonylphenol (NP) were simultaneously quantified through third-order/four-way calibration. Excitation-emission fluorescence matrix-kinetic (EEFM-K) third-order data were generated by measuring the EEFMs of these priority xenoestrogens as a function of reaction time during their Fenton degradation. Third-order/four-way calibration notably improves the sensitivity of the method and provides the required selectivity for quantifying analytes with critically overlapped fluorescence signals. In fact, collinearity between BPA and NP emission spectra prevented their quantification using EEFM second-order data and three-way PARAFAC (parallel factor analysis); however, the addition of a third instrumental mode allowed the correct chemometric modeling with four-way PARAFAC. In this way, the compliance of Kruskal's theorem extended to higher-order data was verified. The method was applied for the determination of the analytes in samples of different plastic materials, which are in contact with food and/or beverages. In these cases, where unmodelled constituents are present, good results for BPA were achieved with four-way PARAFAC, but the predictions for NP using this model were deficient. A better predictive capability for NP in real samples was achieved when either U-PLS/RTL (unfolded partial least-squares combined with residual trilinearization) or MCR-ALS (multivariate curve resolution with alternating least-squares) was applied for data processing, demonstrating the power of these latter models for the resolution of more complex systems.

Pelvic radiotherapy for cervical cancer affects importantly the reproducibility of cytological alterations evaluation.

BACKGROUND: to evaluate the intraobserver and interobserver reproducibility of cervical cytopathology according to previous knowledge of whether patients received radiotherapy (RT) treatment or not. METHODS: The study analyzed a sample of 95 cervix cytological slides; 24 with cytological abnormalities (CA) and presence of RT; 21 without CA and presence of RT; 25 without CA and without previous RT; 25 with CA and without previous RT. Two cytopathology (CP) evaluations of the slides were carried out. For the first CP re-evaluation, the cytotechnologist was blinded for the information of previous RT. For the second CP re-evaluation, the cytotechnologist was informed about previous RT. The results were analyzed through inter and intraobserver agreement using the unweighted and weighted kappa. RESULTS: Post radiotherapy effects were identified in 44.4% of cases that undergone previous pelvic RT. The agreement for RT status was 66.32% (unweighted K = 0.31, 95%CI: 0.13; 0.49, moderate agreement). The intraobserver agreement, regarding the cytological diagnoses, regardless of radiotherapy status, was 80.32% (weighted K = 0.52, 95%CI: 0.34; 0.68). In no RT group, the intraobserver agreement was 70% (weighted K = 0.47, 95%CI: 0.27;0.65) and in patients that received RT, the intraobserver agreement was 84.09% (unweighted K = 0.37, 95%CI: 0.01;0.74). The interobserver agreement between cytopathology result (abnormal or normal) in the group with RT, considering normal and abnormal CP diagnosis was 14.0% and 12.5%, respectively. There was no association between the cytological alterations and the median time between the end of RT and the cytological diagnosis. CONCLUSION: This study showed that RT has an important impact in CP diagnosis because the agreement, also in interobserver and intraobserver analysis, had high discrepancy in patients that received RT. Also, demonstrated that it is difficult to recognize the presence of RT in cytological slides when this information is not provided.

Multivariate curve resolution strategy for non-quadrilinear type 4 third-order/four way liquid chromatography-excitation-emission fluorescence matrix data.

For the first time, a third-order/four-way system having instrumental modes depending on each other was experimentally generated and it was successfully resolved. Non-quadrilinear type 4 data, constituted by liquid chromatographic elution times (LC) and excitation-emission fluorescence matrices (EEFMs), were on-line measured using conventional equipment. Thus, third-order/four-way data, valuable for giving rise to highly sensitive and selective methods, were obtained minimizing significantly the experimental work and time, in comparison with the reported strategies for the acquisition of LC-EEFM data. The usefulness of MCR-ALS (multivariate curve resolution-alternating least square) for attaining reliable results from data with two mutually dependent instrumental modes, namely elution time and excitation wavelength modes, was established through the simultaneous quantitation of benz[a]anthracene, chrysene, benzo[b]fluoranthene, and benzo[a]pyrene. Limits of detection in the range 1.0-1.4 ng mL-1 were achieved for the target polycyclic aromatic hydrocarbons, allowing their determination in about 9 min per sample in leaves of different types of tea.

On-line generation of third-order liquid chromatography-excitation-emission fluorescence matrix data. Quantitation of heavy-polycyclic aromatic hydrocarbons.

For the first time, third-order liquid chromatography with excitation-emission fluorescence matrix detection (LC-EEFM) data were generated on-line and chemometrically processed for the simultaneous quantitation of the heavy-polycyclic aromatic hydrocarbons fluoranthene, pyrene, benz[a]anthracene, chrysene, benzo[b]fluoranthene, benzo[k]fluoranthene, benzo[a]pyrene, and dibenz[a,h]anthracene. The applied experimental strategy is very simple, and is based on the reduction of the linear flow rate by fitting a larger diameter connecting-tube between the column outlet and the fluorimetric detector. In this way, EEFMs were successfully recorded on-line, without involving a large total analysis time. Because in the studied system quadrilinearity was fulfilled, four-way parallel factor (PARAFAC) analysis was applied for data processing. The second-order advantage, which is an intrinsic property of data of at least second-order, allowed the quantification of the analytes in interfering media. Moreover, resolution of the system with a high degree of collinearity was achieved thanks to the third-order advantage. In addition to a selectivity improvement, third-order/four-way calibration increased the sensitivity, with limits of detection in the range of 0.4-2.9ngmL-1. After a solid-phase extraction procedure with C18 membranes, considerably lower concentrations (between 0.033-2.70ngmL-1) were determined in real waters, with most recoveries in the range 90-106%.

Progression of liver fibrosis can be controlled by adequate chelation in transfusion-dependent thalassemia (TDT).

A substantial proportion of patients with transfusion-dependent beta-thalassemia major suffer from chronic liver disease. Iron overload resulting from repeated transfusions and HCV infection has been implicated in the development of liver fibrosis. Hepatic siderosis and fibrosis were assessed in 99 transfusion-dependent thalassemia (TDT) patients using transient elastography (TE) and liver iron concentration (LIC) assessed by T2*MRI at baseline and after 4 years. Data were analyzed retrospectively. At baseline, the overall mean liver stiffness measurement (LSM) was 7.4 ± 3.2 kPa and the mean LIC was 4.81 ± 3.82 mg/g dw (n = 99). Data available at 4 ± 1.5 years showed a significant reduction in LSM (6.6 ± 3.2 kPa, p 0.017) and hepatic siderosis measured by LIC (3.65 ± 3.45 mg/g dw, p 0.001). This result was confirmed when considering patients with iron overload at the time of the first measurement (n = 41) and subjects treated with a stable dose of deferasirox over the entire period of observation (n = 39). A reduction of LSM, yet not statistically significant, was achieved in patients on combined deferoxamine + deferiprone, while the group on deferoxamine (n = 11) remained stable over time. HCV-RNA positivity was found in 33 patients at T0, 20 of which were treated during the observation period. Patients who underwent anti-HCV therapy showed a more evident reduction in LSM (9 ± 3 vs 7 ± 3.1 kPa, p 0.016). Adequate chelation therapy is mandatory in order to prevent liver disease progression in TDT. Patients could benefit from regular non-invasive assessment of liver fibrosis by TE to indirectly monitor treatment adequacy and therapeutic compliance.

Excitation-emission fluorescence-kinetic data obtained by Fenton degradation. Determination of heavy-polycyclic aromatic hydrocarbons by four-way parallel factor analysis.

For the first time, a simple and environmentally friendly third-order/four-way calibration was applied for the simultaneous determination of five heavy-polycyclic aromatic hydrocarbons (PAHs) in interfering environments. The kinetic evolution of the Fenton degradation of benzo[a]pyrene, dibenz[a,h]anthracene, benzo[b]fluoranthene, benzo[k]fluoranthene and benz[a]anthracene was followed by recording full excitation-emission fluorescence matrices (EEFMs) of the samples at different reaction times, obtaining third-order EEFM-kinetic (EEFM-K) data. The sensitivity of the method was increased by carrying out the reaction in the presence of methyl-ß-cyclodextrin. The four-way parallel factor (PARAFAC) algorithm, which was used for data processing, exploits the second-order advantage, allowing analyte concentrations to be estimated even in the presence of an uncalibrated fluorescent background. The clear superiority of the applied approach in comparison with second-order/three-way calibration performed with unreacting EEFMs is demonstrated, using two sets of samples with foreign compounds with particular spectral profiles. In one of the latter sets, the existence of a third-order advantage was explored and discussed. The feasibility to directly determine parts-per-trillion concentration levels of PAHs after a very simple solid-phase extraction with C18 membranes is established with natural water samples containing uncalibrated constituents.

Dental health status in crack/cocaine-addicted men: a cross-sectional study.

The aim of this study was to evaluate the association between crack/cocaine addiction and dental health in men. Forty crack/cocaine-addicted patients and 120 nonaddicted patients (≥18 years) underwent full-mouth dental examinations. Decayed, missing, and filled teeth (DMFT) were identified using the criteria recommended by the World Health Organization. Crack/cocaine addiction was determined, based on the medical records and interviews of each patient. All drug-addicted patients used both crack and cocaine. The chi-square test and logistic regression analysis were used to assess the association between DMFT and crack/cocaine addiction (p ≤ 0.05). Decayed teeth showed a positive association with crack/cocaine addiction (odds ratio (OR) = 3.65; 95% confidence interval (CI), 1.68-7.92; p = 0.001), whereas filled and missing teeth showed a negative association (filled teeth: OR = 0.37; 95% CI, 0.18-0.76; p = 0.008; missing teeth: OR = 0.33; 95% CI, 0.13-0.81; p = 0.02). The DMFT was only associated with age (OR = 2.12; 95% CI, 1.11-4.08, p = 0.023). In the present population, crack/cocaine addiction was associated with a greater decayed teeth index and a lower filled and missing teeth index. Programs aimed to encourage self-esteem and encourage individuals to seek dental care are required for this population. Further studies using a larger sample size and studies with women are required to confirm the results.

Opiate regulation of behavioral selection during lactation.

Treatment of postpartum female rats with morphine inhibits maternal behavior. The same type of treatment stimulates foraging in adult animals. The aim of the present study was to investigate, in lactating rats, the functional role of opioid systems in the choice between caring for pups versus hunting insects. Experiment 1 was designed to test how acute morphine treatment with 3.0 mg/kg interferes with choosing between caring for pups versus predatory behavior. Morphine-treated dams decreased maternal behavior while increasing efficiency in hunting insects. The next step was to test the opioid antagonist naloxone in the same context of maternal versus predatory behavior. Naloxone restored maternal care and reduced hunting in morphine-treated rats. Finally, in order to test the role of endogenous opioidergic stimulation in this scenario, lactating rats were treated with the opioid antagonist naloxone alone. Consistently, naloxone treatment induced a decrease in number of insects captured and an increase in the percentage of animals displaying nursing behavior. These results provide important insight into the role of opioidergic transmission in the regulation of behavioral selection during lactation. The present results suggest that endogenous opioids may stimulate hunting by replacing maternal behavior during lactation.

Matriz dermal acelular em cirurgia periodontal: aplicações clinicas / Acelular Dermal Matrix in Periodontal Surgery: Clinicals Applications

Originalmente, a Matriz Dermal (MOA) Acelular foi introduzida na medicina, em cirurgia plástica, para o tratamento de feridas de queimaduras de espessura total (terceiro grau). Na periodontia, esta matriz é utilizada como uma alternativa para o enxerto de mucosa palatal autógena, com o intuito de se obter um aumento na largura da faixa de gengiva inserida; para o tratamento de recessões gengivais e recobrimento de raízes; como membrana protetora para regeneração óssea guiada dentre outras. Esta matriz dermal alógena é acelularizada, congelada e ressecada, constituída por um complexo de membrana basal e matriz extracelular estruturalmente integradas, na qual fibras colágenas e fibras elásticas são os principais componentes. A MOA apresenta muitas vantagens, dentre elas, a redução da morbidade e maior conforto para o paciente, por eliminar um segundo sítio cirúrgico, estética desejável. quantidade disponível ilimitada, menor dor pós-operatória e maior aceitação da terapia cirúrgica pelo paciente pediátrico. Baseado nesses aspectos, o propósito deste trabalho é compilar dados descritos em trabalhos científicos sobre a Matriz Dermal Acelular (Alloderm@) e suas aplicações na Bioengenharia Tecidual Periodontal. com o objetivo de esclarecer as modalidades de sua aplicação em cirurgias plásticas periodontais, que podem utilizar essa matriz como fonte doadora de tecido.