Electrochemical and statistical study of Nickel ion assessment in daily children intake samples relying on magnesium aluminate spinel nanoparticles.

Lately, children's daily consumption of some products, such as cereals and candies, has been rising, which provides a compelling rationale for determining any metallic substances that may be present. Monitoring the concentration of certain metals, like nickel, in these products is necessary due to medical issues in humans when consumed regularly. So, in this work, a novel and highly selective carbon paste as a Ni(II) ion-selective sensor was prepared and investigated using ceramic magnesium aluminum spinel nanoparticles as the ionophore and tritolyl phosphate (TOCP) as a plasticizer. A modified co-precipitation method was used to synthesize the spinel nanoparticles. X-ray diffraction, scanning electron microscope with EDAX, transmission electron microscope, and BET surface area were used to determine the phase composition, microstructure, pores size, particle size, and surface area of the synthesized nanoparticles. The spinel nanoparticle was found to have a nano crystallite size with a cubic crystal system, a particle size ranging from 17.2 to 51.52 nm, mesoporous nature (average pore size = 8.72 nm), and a large surface area (61.75 m2/g). The composition ratio of graphite carbon as a base: TOCP as binder: spinal as ionophore was 67.3:30.0:2.7 (wt%) based on potentiometric detections over concentrations from 5.0 × 10-8 to 1.0 × 10-2 mol L-1 with LOD of 5.0 × 10-8 mol L-1. A measurement of 29.22 ± 0.12 mV decade-1 over pH 2.0-7.0 was made for the Nernstian slope. This sensor demonstrated good repeatability over nine weeks and a rapid response of 8 s. A good selectivity was shown for Ni(II) ions across many interferents, tri-, di-, and monovalent cations. The Ni(II) content in spiked real samples, including cocaine, sweets, coca, chocolate, carbonated drinks, cereals, and packages, were measured. The results obtained indicated no significant difference between the proposed potentiometric method and the officially reported ICP method according to the F- and t-test data. In addition to utilizing ANOVA statistical analysis, validation procedures have been implemented, and the results exceed the ICP-MS methodology.

Morphometrics and Phylogenomics of Coca (Erythroxylum spp.) Illuminate Its Reticulate Evolution, With Implications for Taxonomy.

South American coca (Erythroxylum coca and E. novogranatense) has been a keystone crop for many Andean and Amazonian communities for at least 8,000 years. However, over the last half-century, global demand for its alkaloid cocaine has driven intensive agriculture of this plant and placed it in the center of armed conflict and deforestation. To monitor the changing landscape of coca plantations, the United Nations Office on Drugs and Crime collects annual data on their areas of cultivation. However, attempts to delineate areas in which different varieties are grown have failed due to limitations around identification. In the absence of flowers, identification relies on leaf morphology, yet the extent to which this is reflected in taxonomy is uncertain. Here, we analyze the consistency of the current naming system of coca and its four closest wild relatives (the "coca clade"), using morphometrics, phylogenomics, molecular clocks, and population genomics. We include name-bearing type specimens of coca's closest wild relatives E. gracilipes and E. cataractarum. Morphometrics of 342 digitized herbarium specimens show that leaf shape and size fail to reliably discriminate between species and varieties. However, the statistical analyses illuminate that rounder and more obovate leaves of certain varieties could be associated with the subtle domestication syndrome of coca. Our phylogenomic data indicate extensive gene flow involving E. gracilipes which, combined with morphometrics, supports E. gracilipes being retained as a single species. Establishing a robust evolutionary-taxonomic framework for the coca clade will facilitate the development of cost-effective genotyping methods to support reliable identification.

Pollen identification of three notorious illicit drug plants and its potential applications in forensic practice.

Opium poppy, coca and cannabis are raw materials for three notorious illicit drugs. For a long time, drug lords have been growing and smuggling these drugs in a variety of ways and channels and are continually finding new ways of trafficking their wares, which has led to the increasing difficulty of global drug enforcement. In the present paper, we propose an innovative pollen identification system for these important drug plants, which provides a tool for screening and detection of the drugs to aid in drug enforcement. By utilizing the characteristics of these fine particles, their abundant production, and high resistance to decay, we believe this tool could be applied in the following scenarios: detecting and dynamically monitoring drug cultivation activities; determining whether a suspect has been to fields of drug plants and determining whether the site has ever been planted with a drug plant and/or was involved in drug production. In the future, combined with microscope automatic image acquisition technology and intelligent image recognition technology, this pollen identification system is expected to be used to screen three notorious illicit drug plants, thus enhancing the efficiency of drug related crime investigations.

Has Coca-Cola treatment become the first-line therapy for gastric bezoars, both in general and specifically for western countries?

Phytobezoars is a rare disease and less common in Western countries. The stomach is the primary site for these formations, and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective approach. However, medical treatments using enzymatic and chemical agents, such as cellulase and Coca-Cola, aimed at dissolving the bezoars, have also been utilized, showing varying degrees of resolution success. Notably, the oral dissolution treatment with Coca-Cola has emerged as a promising, simpler, and more cost-effective method. The study by Liu et al represents an important step in clinical research on this topic, despite some limitations that need addressing for a more comprehensive understanding of its findings. Key considerations for future research include sample size calculation, endoscopic procedure details, outpatient vs. inpatient treatment, and detailed cost calculations. The study's exclusions, such as patients with upper gastric surgery, phytobezoars older than 14 d, and cases of gastroparesis, limit its applicability to broader populations, especially in Western countries. Given the promising outcomes of the Coca-Cola treatment, it's advocated as a first-line therapy for phytobezoars. Nonetheless, further research is essential to overcome these limitations. However special situations such as perforation or small bowel obstruction will require surgical treatment.

Coca-Cola consumption vs fragmentation in the management of patients with phytobezoars: A prospective randomized controlled trial.

BACKGROUND: Gastric phytobezoars (GPBs) are very common in northern China. Combined therapy involving carbonated beverage consumption and endoscopic lithotripsy has been shown to be effective and safe. Existing studies on this subject are often case reports highlighting the successful dissolution of phytobezoars through Coca-Cola consumption. Consequently, large-scale prospective investigations in this domain remain scarce. Therefore, we conducted a randomized controlled trial to examine the effects of Coca-Cola consumption on GPBs. AIM: To evaluate the impact of Coca-Cola on GPBs, including the dissolution rate, medical expenses, ulcer rate, and operation time. METHODS: A total of 160 consecutive patients diagnosed with GPBs were allocated into two groups (a control group and an intervention group) through computer-generated randomization. Patients in the intervention group received a Coca-Cola-based regimen (Coca-Cola 2000-4000 mL per day for 7 d), while those in the control group underwent emergency fragmentation. RESULTS: Complete dissolution of GPBs was achieved in 100% of the patients in the intervention group. The disparity in expenses between the control group and intervention group (t = 25.791, P = 0.000) was statistically significant, and the difference in gastric ulcer occurrence between the control group and intervention group (χ2 = 6.181, P = 0.013) was also statistically significant. CONCLUSION: Timely ingestion of Coca-Cola yields significant benefits, including a complete dissolution rate of 100%, a low incidence of gastric ulcers, no need for fragmentation and reduced expenses.

Effect of Coca-Cola on the Dissolution of Persimmon-Related Phytobezoar in a Tertiary Care Hospital.

Introduction Bezoars, masses of indigestible foreign bodies formed in the gastrointestinal tract, pose challenges in their management. Phytobezoars are particularly problematic due to their difficult diagnosis and resilience towards treatment. Recently, Coca-Cola has emerged as a potential solution due to its acidic composition and mucolytic properties. However, existing evidence is limited, highlighting the need for comprehensive studies. This research explores the efficacy of Coca-Cola in dissolving persimmon-related phytobezoars, aiming to contribute valuable insights to non-invasive treatment options. Material and methods Conducted as a descriptive case series, this study employed gastric cola lavage using non-probability purposive sampling. Patients aged 18-70 with persimmon-related phytobezoars were included. Two nasogastric tubes were inserted for cola lavage over 12 hours, utilizing three liters of cola until the disappearance of symptoms. When the bezoar disappeared, it was considered as complete success to the treatment. Results Out of 31 patients, 45.2% were male and 54.8% were female, with a mean age of 56.77 ± 9.01 years. Efficacy was noted in 54.8% of cases. Age less than 50 and no history of diabetes mellitus were associated with higher chances of treatment success (p-value ≤0.05). Conclusion Ingestion of Coca-Cola was highly effective, safe, and reliable for the dissolution of persimmon-related phytobezoars, as the frequency of efficacy was high in our study. Coca-Cola ingestion is a non-invasive and cost-effective mode of phytobezoar dissolution that should be taken as a first-line initial treatment option to attain desired outcomes.

La Viabilidad y Funcionalidad de Leucocitos Humanos en presencia de un Extracto Hidro-alcohólico de E. coca / The Viability and Functionality of Human Leukocytes in the presence of a Hydro-alcoholic Extract of E. coca.

Introducción : Para estudiar el efecto de cualquier producto natural, aunque sea de uso habitual de la medicina tradicional, es necesario establecer previamente los márgenes de seguridad para su utilización en humanos. En el caso de Erythroxylum coca, para trazar sus perspectivas de uso como fitofármaco o de producto industrial, es necesario conocer si tiene algún grado de toxicidad o si es completamente inocuo, no obstante, su larga tradición de consumo. Objetivo : Explorar el efecto de un extracto hidro-alcohólico de E. coca sobre granulocitos y mononucleares de voluntarios donadores humanos, en condiciones de cultivo celular. Se examinó, por un lado, el efecto sobre la viabilidad celular y la actividad del sistema mitocondrial/citoplasmático de óxido-reductasas y, por otra parte, se exploró su efecto sobre la funcionalidad celular a través de la determinación de la capacidad fagocítica, la quimiotaxis, la endocitosis y la actividad microbicida, en el ámbito de la inmunidad innata, y la capacidad de liberación o estimulación de citoquinas en el ámbito de la respuesta inflamatoria. Materiales y Métodos : Se evaluó la viabilidad por Azul Tripan, la actividad de oxido reductasas por reducción de MTT, la capacidad endocitica de levaduras, quimiotaxis en gel de agarosa hacia el péptido Fmlp y actividad microbicida sobre S.aureus. Las liberaciones de citoquinas se evaluaron por ELISA. Resultados : Se encontró que a las dosis equivalentes a la del consumo habitual humano, los leucocitos conservan su viabilidad (0,13µg/ml), la que se mantiene hasta dosis relativamente altas (130µg/ml). En esta franja de seguridad se encontró que E. coca no altera la capacidad de las enzimas mitocondriales y citoplasmáticas de óxido- reducción, al contrario, en dosis bajas es capaz de estimular dicha actividad. La actividad quimiotactica no es afectada por el extracto hidroalcoholico de coca por el contrario a dosis intermedias esta actividad se eleva de manera ostensible. La capacidad endocitica no se ve afectada y por el contrario se pudo observar un estímulo de la misma; en la actividad microbicida no existe cambios significativos. Conclusiones : Se concluye que, este producto a las dosis equivalentes a las recomendadas por la medicina tradicional no tiene efectos deletéreos sobre la viabilidad y funcionalidad de los leucocitos humanos. En lo que respecta a la actividad del extracto sobre la producción de citoquinas, se encontró que E. coca tiene efecto de estimulación en la liberación de TNF e inhibición de IL-10 modulando así mayor actividad proinflamatoria.

Introduction : In order to study the effect of any natural product, even if it is commonly used in traditional medicine, it is necessary to previously establish the safety margins for its use in humans. In the case of Erythroxylum coca, in order to trace its prospects of use as a phytopharmaceutical or industrial product, it is necessary to know if it has any degree of toxicity or if it is completely innocuous, despite its long tradition of consumption. Objective : To explore the effect of a hydro-alcoholic extract of E. coca on granulocytes and mononuclear cells of human donor volunteers, under cell culture conditions. We examined, on the one hand, the effect on cell viability and the activity of the mitochondrial/cytoplasmic oxidoreductase system and, on the other hand, it was explored its effect on cellular functionality through the determination of phagocytic capacity, chemotaxis, endocytosis and microbicidal activity, in the field of innate immunity, and the capacity of release or stimulation of cytokines in the field of inflammatory response. Materials and Methods : Viability by Trypan Blue, oxidoreductase activity by MTT reduction, endocytic capacity of yeast, chemotaxis in agarose gel towards Fmlp peptide and microbicidal activity on S.aureus were evaluated. Cytokine release was evaluated by ELISA. Results : It was found that at doses equivalent to the usual human consumption, leukocytes retain their viability (0.13µg/ml), which is maintained up to relatively high doses (130µg/ml). In this safety range it was found that E. coca does not alter the capacity of mitochondrial and cytoplasmic oxidation-reduction enzymes, on the contrary, at low doses it is able to stimulate such activity. The chemotactic activity is not affected by the hydroalcoholic extract of coca, on the contrary, at intermediate doses this activity is ostensibly elevated. The endocytic capacity is not affected and, on the contrary, a stimulus of the same was observed; in the microbicidal activity there are no significant changes. Conclusions : It is concluded that this product, at doses equivalent to those recommended by traditional medicine, has no deleterious effects on the viability and functionality of human leukocytes. Regarding the activity of the extract on the production of cytokines, it was found that E. coca has a stimulating effect on the release of TNF and inhibition of IL-10, thus modulating greater proinflammatory activity.

Navigating Chemical Toxicity in Coca Production in the Colombian Borderlands of Putumayo.

In Putumayo, a jungle borderland in southern Colombia, thousands of farmers derive their livelihood from the cultivation and processing of coca leaf, exposing themselves to fertilizers, pesticides, and other toxic chemicals on a daily basis. In this article, we show how the coca growers' relationship with chemicals and the health risks to which they are exposed, are politically and institutionally structured. We discuss the specific impact of anti-narcotics policy in a broader context of deep inequalities and document the emergent and adaptive day-to-day attempts of the farmers to navigate the structural risk environment.

Successful Dissolution of a Large Gastric Phytobezoar Through Nonsurgical and Nonendoscopic Fragmentation.

A phytobezoar is the result of poorly digestible vegetable matter that accumulates in the gastrointestinal tract often forming a hard mass in the stomach. We present a case of a phytobezoar in a patient without predisposing risk factors, resulting in significant stomach distension initially believed to require high-risk surgical intervention but which ultimately resolved after 3 days of conservative treatment with prokinetic agents. The patient was discharged uneventfully and was recommended a low-fiber diet indefinitely while undergoing further workup for motility disorders.

Caring for coca, living with chemicals: Towards ecological harm reduction.

In this paper, we show how the materialisation of chemical harms linked to the cultivation of coca and its processing into coca paste reside in a wider politics of structural violence which is also situated ecologically. Drawing on the qualitative interview accounts of coca farmers in Putumayo, Colombia, we attend to practices of care in the field and in the laboratory. We look first at chemicals used in coca's cultivation (herbicides, fertilizers, pesticides), and second at chemicals (such as sulphuric acid, sodium carbonate, magnesium permanganate) used in the processing of coca leaf into paste (before the paste is sold on for refinement into cocaine). Our analysis highlights the tensions which inevitably arise in the balance and multiplicities of care - for crops, livelihood, and environment. We trace how farmers' narratives of the neutralisation of chemical risks habituate chemical harms as mundane, even uneventful, in an economic imperative to 'carry on as normal' in the coca economy. We emphasise health and harm as matters of care which not only affect humans but living environments. Accounts of 'risk environment' can give insufficient attention to Nature, and this leads us to consider 'ecological harm reduction'.

Effect of variety and malting conditions on proteolytic activity, free amino nitrogen, and soluble protein contents of two maize varieties (Atp-Y and Coca-sr): amylolytic activity and physico-chemical and functional properties of optimal sample.

Introduction: The utilization of sprouted meals in beer production and enhancing the physicochemical properties of supplementary foods is widespread in Africa. This work aimed to determine the influence of soaking, germination, maturation and variety conditions on the physicochemical properties, proteolytic activity, free amino nitrogen (FAN) and soluble protein contents of Coca-sr and Atp-Y maize varieties. Methods: To achieve this, the central composite design (CCD) was used for the optimization of five parameters, namely soaking time (18-42 h), plant salt concentration (0.5-1.2%), soaking temperature (25-41°C), sprouting time (80-195 h) and ripening time (17.50-42 h), and following dependent variables were investigated: proteolytic activity, FAN content and soluble protein. Optimal samples flours obtained were then subsequently subjected to physicochemical and functional analysis. Results: The analysis of results showed that the linear, interactive and quadratic effects of the factors significantly (p<0.05) affected the proteolytic activity, FAN and soluble protein contents of both varieties. The direction of each factor's variation and its effects were not similar in the two varieties. The optimal malting conditions were 7.31 h soaking with 1.678% vegetable salt at a temperature of 34.65°C followed by sprouting for 245.59 h and maturation for 0.765 h for the Atp-Y variety. For the Coca-sr variety, it requires 1.608 h of soaking with 1.678% vegetable salt at a temperature of 51.93°C followed by 273.94 h and 58.73 h for sprouting and ripening time respectively. The meals of Coca-sr produces using these optimal conditions showed a significantly (p<0.05) higher proteolytic activity, FAN and soluble protein content. The amylolytic activity was more pronounced in the Atp-Y variety, as was the content of essential amino acids. The above optimal conditions reduced the content of anti-nutrients (phytates, saponins, oxalates, condensed and hydrolysable tannins), improved the availability of minerals (Ca and Mg), reduced the pH, mass density, water retention capacity and swelling rate. Conclusion: As a result, the optimal flours of these two maize varieties could be applied in the formulation of supplementary foods, bakery products and beer by industrialists.

A Comparative Evaluation of the Effect of Different Beverages on Colour Stability and Surface Micromorphology of Nanocomposite Restorative Material.

AIM: This investigation was carried out to evaluate the color stability of a nanocomposite restorative material and the erosive potential of carbonated soft drinks (Coca-Cola; The Coca-Cola Company, Atlanta, Georgia, United States) and packaged orange juice (Real Fruit Power Orange; Dabur Ltd, Ghaziabad, Uttar Pradesh, India) on its surface micromorphology. MATERIALS AND METHODS: Sixty discs (2mm thick and 10mm diameter) of nanocomposite material (Herculite Précis; KaVo Kerr, Brea, California, United States) were prepared using a silicon cylindrical mold. Initially, all the specimens were stored in artificial saliva in five Petri dishes; 12 specimens in each dish. In the Petri dishes, the specimens were immersed in the respective beverages once or twice a day. Before and after each immersion, the specimens were stored in artificial saliva at room temperature. Artificial saliva was changed each day, i.e., every 24 hours. The whole procedure was carried out for three months and then evaluated for color stability using a spectrophotometer and surface micromorphology using a scanning electron microscope. Now, the exposure of specimens to aerated drinks (Coca-Cola) and packaged orange juice (Real Orange) was put to a halt, and specimens were kept continuously in artificial saliva. This procedure was carried out for one month and then evaluated for color stability. The information was analyzed using PASW Statistics for Windows, Version 18.0 (Released 2009; SPSS Inc., Chicago, United States). A p-value of 0.05 was considered significant. RESULTS: The p-value after three months, which is < 0.001 (p<0.05) indicates that the mean color difference values for groups I, II, III, IV, and V show a statistically significant change between the five groups, and similarly, the p-value after one month, which is < 0.001 (p<0.05) indicates that the mean color difference values for groups I, II, III, IV, and V show a statistically significant change between the five groups. Specimens immersed in the carbonated drink twice a day showed clinically more color change than packaged orange juice and artificial saliva on the composite restorative material. Coca-Cola, an aerated drink, was shown to have a higher erosive potential on the composite restorative material than Real Fruit Power Orange and fake saliva. CONCLUSION: The findings are consistent with the hypothesis that repeated exposure to carbonated beverages (such as Coca-Cola and packaged juice) degrades the surface qualities of dental restorations.

Safety assessment of the process Coca-Cola HBC, based on the NGR technology, used to recycle post-consumer PET into food contact materials.

The EFSA Panel on Food Contact Materials, Enzymes and Processing Aids (CEP) assessed the safety of the recycling process Coca-Cola HBC (EU register number RECYC285), which uses the NGR technology. The input is washed and dried poly(ethylene terephthalate) (PET) flakes mainly originating from collected post-consumer PET containers, with no more than 5% PET from non-food consumer applications. The flakes are dried (step 2), melted in an extruder (step 3) and decontaminated during a melt-state polycondensation step ■■■■■ (step 4). In step 5, the material is granulated. Having examined the challenge test provided, the Panel concluded that the melt-state polycondensation (step 4) is critical in determining the decontamination efficiency of the process. The operating parameters to control the performance of the critical step are the pressure, the temperature, the residence time (depending on the mass and throughput of the melt) and the characteristics of the reactor. It was demonstrated that this recycling process is able to ensure that the level of migration of potential unknown contaminants into food is below the conservatively modelled migration of 0.1 µg/kg food. Therefore, the Panel concluded that the recycled PET obtained from this process is not of safety concern when used at up to 100% for the manufacture of materials and articles for contact with all types of foodstuffs, including drinking water, for long-term storage at room temperature, with or without hotfill. The final articles made of this recycled PET are not intended to be used in microwave and conventional ovens and such uses are not covered by this evaluation.

The political economy of a failed drug reform: Insights from Peru's main legal coca valley.

As the world's second largest coca producer, Peru has a flourishing market for coca for non-narcotic uses. With more than 20,000 hectares and approximately 35,000 officially registered farmers in the Peruvian legal scheme for coca cultivation and commercialization, this market is formally under the monopoly of the National Enterprise of Coca (ENACO). Nonetheless, ENACO only captures 2% of all coca produced nationally and has experienced a sustained reduction of farmers' participation and coca purchases within the legal trade. At different times, these problems have opened the way to demands from left-wing political parties, subnational governments, coca growers' organizations and even Peru's central drug control institutions to reform the legal coca market in Peru. However, none of these attempts have succeeded. Based on a policy analysis of the legal coca trade and analysis of official data, together with a case study of Peru's main legal coca valley (La Convención) this article seeks to understand the current crisis of the legal coca trade as well as the repeated failures of reform. Peru's political centralism and the historical marginalization of Andean culture help to explain the successful blocking of reform attempts to the legal coca trade.

Molecular Subtyping and Survival Analysis of Osteosarcoma Reveals Prognostic Biomarkers and Key Canonical Pathways.

Osteosarcoma (OS) is a common bone malignancy in children and adolescents. Although histological subtyping followed by improved OS treatment regimens have helped achieve favorable outcomes, a lack of understanding of the molecular subtypes remains a challenge to characterize its genetic heterogeneity and subsequently to identify diagnostic and prognostic biomarkers for developing effective treatments. In the present study, global analysis of DNA methylation, and mRNA and miRNA gene expression in OS patient samples were correlated with their clinical characteristics. The mucin family of genes, MUC6, MUC12, and MUC4, were found to be highly mutated in the OS patients. Results revealed the enrichment of molecular pathways including Wnt signaling, Calcium signaling, and PI3K-Akt signaling in the OS tumors. Survival analyses showed that the expression levels of several genes such as RAMP1, CRIP1, CORT, CHST13, and DDX60L, miRNAs and lncRNAs were associated with survival of OS patients. Molecular subtyping using Cluster-Of-Clusters Analysis (COCA) for mRNA, lncRNA, and miRNA expression; DNA methylation; and mutation data from the TARGET dataset revealed two distinct molecular subtypes, each with a distinctive gene expression profile. Between the two subtypes, three upregulated genes, POP4, HEY1, CERKL, and seven downregulated genes, CEACAM1, ABLIM1, LTBP2, ISLR, LRRC32, PTPRF, and GPX3, associated with OS metastasis were found to be differentially regulated. Thus, the molecular subtyping results provide a strong basis for classification of OS patients that could be used to develop better prognostic treatment strategies.

An Update on Medical School Accreditation in the United States: Implications for the Single Graduate Medical Education (GME) Era.

In the United States, medical schools are accredited by either the Liaison on Committee Medical Education (LCME) or the Commission on Osteopathic College Accreditation (COCA), which assesses the quality and standards of Doctor of Medicine (MD)-granting and Doctor of Osteopathic Medicine (DO)-granting institutions, respectively. Thereafter, new MD and DO physicians complete graduate medical education (GME) training. Historically, the two physician licensure pathways have been predominantly separate, but in 2020, the Accreditation Council for Graduate Medical Education and American Osteopathic Association finalized a single accreditation GME system. Now, other elements of MD and DO physician training that have traditionally remained separate, such as undergraduate medical education (UME), are increasingly being scrutinized. Since 2010, when the accreditation of UME was last qualitatively criticized, the standards and competencies set forth by LCME and COCA have converged. COCA, in particular, has updated its requirements to emphasize scholarly activity, improve inpatient clinical rotation requirements, engage medical students, and enhance clinical faculty qualifications. Such convergence brings to question the continuing need for two independent accreditation pathways and barriers that may prevent a single accreditation. We argue that although MD and DO physicians are unique, the natural confluence of UME accreditation represents an opportunity to simplify and improve physician training in the United States. Our analysis suggests the major barriers to implementing a single accreditation system surround the requirement of Osteopathic Manipulative Medicine (OMM)-focused faculty by COCA and the two separate licensing exams (USMLE (United States Medical Licensing Examination) and COMLEX (Comprehensive Osteopathic Medical Licensing Examination)). However, with a continuing decline in osteopathic physicians practicing OMM and growing debate over a new single licensing exam, a single accreditation UME system may be practically achieved.

Multivariate Base Rates of Low Score on Neuropsychological Tests of Individuals with Coca Paste Use Disorder.

OBJECTIVE: The aim of this study was to determine the prevalence of low scores on eight commonly used neuropsychological tests to evaluate learning and memory, language, and executive functions in individuals with coca paste use disorders (CPUD) and to identify the differences with respect to a group of healthy nonconsuming subjects (HCs). METHODS: 162 Colombian adults with CPUD and a group of 162 Colombian adult HCs participated in this comparative study. Eight tests (eighteen test scores) were grouped into three categories: learning and memory, language, and executive functions. Each participant was categorized based on the number of low scoring tests in specific percentile cut-off groups (25th, 16th, 10th, 5th, and 2nd). RESULTS: In the learning and memory domain, 89.5% of individuals with CPUD and 55.6% of HCs scored below the 25th percentile on at least one of the five test scores, in the language domain, 80.7% of individuals with CPUD and 58% of HCs and in the executive function domain, 92% of individuals with CPUD and 67.3% of HCs. Having two or more scores below the 10th percentile or 10 or more at the 5th percentile shows an optimal cut-off for determining the sensitivity and specificity for discriminating between the two groups. CONCLUSIONS: The individuals with CPUD had a higher percentage of low scores than the HCs in the domains of learning and memory, language, and executive function. It is important for clinicians to be aware of low scores in individuals with CPUD to avoid false-positive diagnoses of cognitive impairment.

Efecto del extracto etanólico Erythroxylum novogranatense var. truxillense y Erythroxylum coca var. coca frente al Streptococcus mutans / Effect of the ethanolic extract of Erythroxylum novogranatense var. truxillense and Erythroxylum coca var. coca front to Streptococcus mutans

RESUMEN Objetivos : Comparar el efecto antibacteriano in vitro de los extractos etanólico de dos variedades de hoja de coca: Erythroxylum coca var. coca y Erythroxylum novogranatense var. truxillense sobre el Streptococcus mutans. Material y métodos: Mediante el método de difusión por discos, se procedió a la aplicación de los extractos etanólicos de las dos variedades a las concentraciones 100%, 50%, 25% y 12,5% con controles positivo de Clorhexidina 0,12 % y negativo de Alcohol 96º en los cultivos de la cepa de Streptococcus mutans (ATCC 25175) sembrados en Agar Tripticasa Soya. La incubación se realizó a 37 °C por 48 horas en condiciones de anaerobiosis parcial. El análisis estadístico se realizó con el programa SPSS Versión 22. Mediante la Prueba U de Mann Whitney y Kruskal Wallis. Resultados: El extracto etanólico de Erythroxylum coca var. coca al 100% y 50% presentaron mayor halo de inhibición 18,65± 2,434 y 17,10 ± 2,654 con respecto al extracto etanólico de Erythroxylum novogranatense var. truxillense que fueron de 15,30 ± 1,895 y 14,05 ± 1.932. respectivamente. Conclusiones: Se determinó que el extracto etanólico de Erythroxylum coca var. coca al 100% y 50% tiene mayor efecto antibacteriano que la variedad Erythroxylum novogranatense var. truxillense al 100% frente al Streptococcus mutans.

ABSTRACT Objectives : To compare the antibacterial effect of the ethanolic extracts of two varieties of coca leaf "in vitro": Erythroxylum coca var. coca and Erythroxylum novogranatense var. truxillense on Streptococcus mutans. Material and methods: Using the method of diffusion by discs, the ethanolic extracts of the two varieties were applied at concentrations 100%, 50%, 25% and 12.5% with positive controls of Chlorhexidine 0.12% and negative of 96º Alcohol in the cultures of the Streptococcus mutans strain (ATCC 25175) sown in Tripticasa Soya Agar. Incubation was performed at 37 ° C for 48 hours under conditions of partial anaerobiosis. The statistical analysis was carried out with the SPSS Version 22 program by means of the Mann Whitney U Test and Kruskal Wallis. Results: Erythroxylum coca var. coca 100% and 50% had a greater inhibition halo 18.65 ± 2.434 and 17.10 ± 2.654 with respect to the ethanolic extract of Erythroxylum novogranatense var. truxillense that were 15.30 ± 1.895 and 14.05 ±1.932. respectively. Conclusions : It was determined that the ethanolic extract of Erythroxylum coca var. coca 100% and 50% has a greater antibacterial effect than the Erythroxylum novogranatense var. truxillense 100% against Streptococcus mutans.

Surface Evaluation of Aligners after Immersion in Coca-Cola and Orange Juice.

Orthodontic removable appliances made of transparent thermoplastic materials-aligners-are becoming increasingly popular in contemporary orthodontic practice. It is important for the clinician to fully understand the mechanical properties and behavior of the appliance used. Because of that, the aim of our study was to investigate the changes in aligner surface after immersion in Coca-Cola and orange juice. For surface evaluation, fractal analysis, texture analysis, and wetting angle measurement were performed. Statistically significant changes were found between some of the groups in the fractal dimension analysis. In texture analysis, all but one intergroup comparison showed statistically significant differences. For wetting angle assessment, statistically significant differences were found. These were, however, more numerous when assessing glycol droplets, rather than water droplets. Fractal dimension analysis confirmed a correlation between the intensity of changes in the aligner surface with immersion time in the liquids assessed. Texture analysis showed a high sensitivity to the changes in aligner surface. It failed, however, to reveal changes relative to immersion time. Wetting angle analysis revealed aligner surface degradation for Coca-Cola. It did not, however, prove the dependence of the intensity of this degradation as a function of time. Both Coca-Cola and orange juice can cause aligner surface degradation.