Evaluation of the effect of BMSCs condition media and methylprednisolone in TGF-ß expression and functional recovery after an acute spinal cord injury.

The purpose of this experimental study is evaluation of the effect of BMSCs Condition Media and Methylprednisolone in TGF-ß expression and functional recovery after acute spinal cord injury in adult wistar rat. MATERIAL AND METHODS: After an acute spinal cord injury, MP and BMSC-CM were injected intraperitoneally and the recovery rate was evaluated by BBB and narrow beam test. Real time PCR, H[et]E staining, cavity formation and stereology was done after 12 weeks post injury. RESULT: There were significant differences in functional recovery between MP+CM group, relative to other groups. TGF-ß1 expression decreased in MP+CM group compared to the control group. Cavity size in experimental groups decreased compared to the control group. The mean volume of spinal cord demonstrated a significant increase in the MP+CM group in comparison to the other experimental groups. CONCLUSION: Simultaneous use of MP and BMSC-CM will improve recovery from the spinal cord injury, reduce inflammation and improve functional recovery (Tab. 1, Fig. 8, Ref. 26).

Exchange, correlation, and scattering effects on surface plasmons in arm-chair graphene nanoribbons.

Using Maxwell's equations for the incoming and outgoing electromagnetic field, in interaction with a metallic arm-chair graphene nanoribbon (AGNR), and the relationship between the density-density response function and the conductivity, we study surface plasmons (SPs) in a AGNR following the Lindhard, random-phase approximation (RPA), and Hubbard approaches. For transverse magnetic (TM) modes we obtain analytical dispersion relations (DRs) valid for q ≤ kF and assess their width dependence. In all approaches we include screening. In the long-wavelength limit q → 0 there is a small but noticeable difference between the DRs of the three approaches. In this limit the respective, scattering-free conductivities differ drastically from those obtained when scattering by impurities is included. We demonstrate that the SP field is proportional to the square of the quality factor Q. The reflection amplitude shows that metallic AGNRs do not support Brewster angles. In addition, AGNRs do not support transverse electric (TE) SPs.

Vaginal progesterone vs intramuscular 17α-hydroxyprogesterone caproate for prevention of recurrent spontaneous preterm birth in singleton gestations: systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: Randomized controlled trials (RCTs) have recently compared intramuscular 17α-hydroxyprogesterone caproate (17-OHPC) with vaginal progesterone for reducing the risk of spontaneous preterm birth (SPTB) in singleton gestations with prior SPTB. The aim of this systematic review and meta-analysis was to evaluate the efficacy of vaginal progesterone compared with 17-OHPC in prevention of SPTB in singleton gestations with prior SPTB. METHODS: Searches of electronic databases were performed to identify all RCTs of asymptomatic singleton gestations with prior SPTB that were randomized to prophylactic treatment with either vaginal progesterone (intervention group) or intramuscular 17-OHPC (comparison group). No restrictions for language or geographic location were applied. The primary outcome was SPTB < 34 weeks. Secondary outcomes were SPTB < 37 weeks, < 32 weeks, < 28 weeks and < 24 weeks, maternal adverse drug reaction and neonatal outcomes. The summary measures were reported as relative risk (RR) with 95% CI. Risk of bias for each included study was assessed. RESULTS: Three RCTs (680 women) were included. The mean gestational age at randomization was about 16 weeks. Women were given progesterone until 36 weeks or delivery. Regarding vaginal progesterone, one study used 90 mg gel daily, one used 100 mg suppository daily and one used 200 mg suppository daily. All included RCTs used 250 mg intramuscular 17-OHPC weekly in the comparison group. Women who received vaginal progesterone had significantly lower rates of SPTB < 34 weeks (17.5% vs 25.0%; RR, 0.71 (95% CI, 0.53-0.95); low quality of evidence) and < 32 weeks (8.9% vs 14.5%; RR, 0.62 (95% CI, 0.40-0.94); low quality of evidence) compared with women who received 17-OHPC. There were no significant differences in the rates of SPTB < 37 weeks, < 28 weeks and < 24 weeks. The rate of women who reported adverse drug reactions was significantly lower in the vaginal progesterone group compared with the 17-OHPC group (7.1% vs 13.2%; RR, 0.53 (95% CI, 0.31-0.91); very low quality of evidence). Regarding neonatal outcomes, vaginal progesterone was associated with a lower rate of neonatal intensive care unit admission compared with 17-OHPC (18.7% vs 23.5%; RR, 0.63 (95% CI, 0.47-0.83); low quality of evidence). For the comparison of 17-OHPC vs vaginal progesterone, the quality of evidence was downgraded for all outcomes by at least one degree due to imprecision (the optimal information size was not reached) and by at least one degree due to indirectness (different interventions). CONCLUSIONS: Daily vaginal progesterone (either suppository or gel) started at about 16 weeks' gestation is a reasonable, if not better, alternative to weekly 17-OHPC injection for prevention of SPTB in women with singleton gestations and prior SPTB. However, the quality level of the summary estimates was low or very low as assessed by GRADE, indicating that the true effect may be, or is likely to be, substantially different from the estimate of the effect. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. COMPARACIÓN ENTRE LA PROGESTERONA VAGINAL Y EL 17Α-HIDROXIPROGESTERONA CAPROATO INTRAMUSCULAR PARA LA PREVENCIÓN DEL PARTO PRETÉRMINO ESPONTÁNEO RECURRENTE EN EMBARAZOS CON FETO ÚNICO: REVISIÓN SISTEMÁTICA Y METAANÁLISIS DE ENSAYOS CONTROLADOS ALEATORIOS: RESUMEN OBJETIVO: Recientemente se han realizado varios ensayos controlados aleatorios (ECA) que comparaban el caproato de 17α-hidroxiprogesterona (17-OHPC, por sus siglas en inglés) por vía intramuscular con la progesterona por vía vaginal para la reducción del riesgo de parto pretérmino espontáneo (PPTE) en embarazos con feto único de gestantes con historial de PPTE. El objetivo de esta revisión sistemática y metaanálisis fue evaluar la eficacia de la progesterona vaginal en comparación con la 17-OHPC en la prevención de embarazos con feto único de gestantes con historial de PPTE. MÉTODOS: Se realizaron búsquedas en bases de datos electrónicas para identificar todos los ECA con embarazos de feto único asintomáticos con historial de PPTE antes de ser asignados al azar a un tratamiento profiláctico, ya fuera con progesterona vaginal (grupo de intervención) o con 17-OHPC intramuscular (grupo de control). No se aplicaron restricciones respecto al idioma o la ubicación geográfica. El resultado primario fue PPTE < 34 semanas. Los resultados secundarios fueron PPTE <37 semanas, < 32 semanas, < 28 semanas y < 24 semanas, la reacción materna adversa al fármaco y los resultados neonatales. Las medidas del resumen se reportaron como riesgo relativo (RR) con IC del 95%. Para cada estudio incluido se evaluó el riesgo de sesgo. RESULTADOS: Se incluyeron tres ECA (680 mujeres). La media de la edad gestacional en el momento de la aleatorización fue de 16 semanas. A las mujeres se les administró progesterona hasta la semana 36 o hasta el parto. Con respecto a la progesterona vaginal, un estudio utilizó gel de 90 mg diariamente, otro utilizó un supositorio diario de 100 mg y el otro utilizó un supositorio diario de 200 mg. Todos los ECA incluidos en el grupo de comparación utilizaron 250 mg semanales de 17-OHPC por vía intramuscular. Las mujeres que recibieron progesterona vaginal tuvieron tasas significativamente más bajas de PPTE < 34 semanas (17,5% vs. 25,0%; RR 0,71 (IC 95%, 0,53-0,95); calidad de la evidencia baja) y < 32 semanas (8,9% vs. 14,5%; RR 0,62 (IC 95%, 0,40-0,94); calidad de evidencia baja), en comparación con las mujeres que recibieron 17-OHPC. No hubo diferencias significativas en las tasas de PPTE < 37 semanas, < 28 semanas y < 24 semanas. La tasa de mujeres que reportaron reacciones adversas a los medicamentos fue significativamente menor en el grupo de progesterona vaginal en comparación con el grupo de 17-OHPC (7,1% vs. 13,2%; RR 0,53 (IC 95%, 0,31-0,91); calidad de la evidencia muy baja). En cuanto a los resultados neonatales, la progesterona vaginal se asoció a una menor tasa de admisiones en la unidad neonatal de cuidados intensivos en comparación con la 17-OHPC (18,7% vs. 23,5%; RR 0,63 (IC 95%, 0,47-0,83); calidad de evidencia baja). Para la comparación del 17-OHPC con la progesterona vaginal se rebajó la calidad de las pruebas para todos los resultados en al menos un grado debido a imprecisiones (no se alcanzó el tamaño óptimo de la información) y en al menos un grado debido al carácter indirecto de los estudios (diferentes intervenciones). CONCLUSIONES: La progesterona vaginal administrada diariamente (ya fuera como supositorio o como gel) desde la semana 16 de gestación es una alternativa razonable, si no mejor, a una inyección semanal de 17-OHPC para la prevención de PPTE en mujeres con embarazos de feto único e historial de PPTE. Sin embargo, el nivel de calidad de las estimaciones del resumen fue bajo o muy bajo según lo evaluado por GRADE, lo que indica que el verdadero efecto puede ser, o es probable que sea, sustancialmente diferente de la estimación del efecto. 17Α-:META: : (randomized controlled trials,RCTs)(spontaneous preterm birth,SPTB)17α-(intramuscular 17α-hydroxyprogesterone caproate,17-OHPC)SPTB。metaSPTB17-OHPCSPTB。 : ,SPTBRCTs,RCTs()17-OHPC()。。34SPTB。37、32、2824SPTB,。(relative risk,RR)95%CI。。 : 3RCTs(680)。16。,36。,90 mg,100 mg,200 mg。,RCTs250 mg 17-OHPC。17-OHPC,34 [17.5%25.0%;RR,0.71(95% CI,0.53 ~ 0.95);]32[8.9%14.5%;RR,0.62(95% CI,0.40 ~ 0.94);]SPTB。37、2824SPTB。17-OHPC,[7.1%13.2%;RR,0.53(95% CI,0.31 ~ 0.91);]。,17-OHPC,[18.7%23.5%;RR,0.63(95% CI,0.47 ~ 0.83);]。17-OHPC,(),()。 : SPTBSPTB,16()17-OHPC,。,GRADE,,。.

Upper Bounds on Spontaneous Wave-Function Collapse Models Using Millikelvin-Cooled Nanocantilevers.

Collapse models predict a tiny violation of energy conservation, as a consequence of the spontaneous collapse of the wave function. This property allows us to set experimental bounds on their parameters. We consider an ultrasoft magnetically tipped nanocantilever cooled to millikelvin temperature. The thermal noise of the cantilever fundamental mode has been accurately estimated in the range 0.03-1 K, and any other excess noise is found to be negligible within the experimental uncertainty. From the measured data and the cantilever geometry, we estimate the upper bound on the continuous spontaneous localization collapse rate in a wide range of the correlation length r_{C}. Our upper bound improves significantly previous constraints for r_{C}>10^{-6} m, and partially excludes the enhanced collapse rate suggested by Adler. We discuss future improvements.

Adipose derived mesenchymal stem cells express keratinocyte lineage markers in a co-culture model.

Cutaneous wound healing is a complex type of biological event involving proliferation, differentiation, reprograming, trans/de-differentiation, recruitment, migration, and apoptosis of a number of cells (keratinocytes, fibroblasts, endothelial cells, nerve cells and stem cells) to regenerate a multi-layered tissue that is damaged by either internal or external factors. The exact regeneration mechanism of damaged skin is still unknown but the epithelial and other kinds of stem cells located in skin play crucial roles in the healing process. In this work, a co-culture model composed of adipose derived mesenchymal stem cells and keratinocytes was developed to understand the cellular differentiation behaviour in wound healing. Human mesenchymal stem cells were isolated from waste lipoaspirates. Keratinocytes were isolated from neonatal rats skin as well from human adult skin. Both types of cells were cultured and their culturing behaviour was observed microscopically under regular intervals of time. The identity of both cells was confirmed by flow cytometry and qRT-PCR. Cells were co-cultured under the proposed co-culturing model and the model was observed for 7, 14 and 21 days. The cellular behaviour was studied based on change in morphology, colonization, stratification, migration and expression of molecular markers. Expression of molecular markers was studied at transcriptional level and change in cellular morphology and migration capabilities was observed under the invert microscope regularly. Successfully isolated and characterized mesenchymal stem cells were found to express keratinocyte lineage markers i.e. K5, K10, K14, K18, K19 and Involucrin when co-cultured with keratinocytes after 14 and 21 days. Their expression was found to increase by increasing the time span of cell culturing. The keratinocyte colonies started to disappear after 10 days of culturing which might be due to stratification process initiated by possibly transdifferentiated stem cells. It can be concluded that mesenchymal stem cells can regenerate the damaged skin if transplanted to damaged area but for their successful differentiation and enhanced regeneration, they need a population of keratinocytes in situ which need further experiments for validation of co-culture model and its potential for being used in clinics.

Why do the [PhSiO(1.5)](8,10,12) cages self-brominate primarily in the ortho position? Modeling reveals a strong cage influence on the mechanism.

(PhSiO1.5)8,10,12 cages are bulky, electron withdrawing like CF3; yet self-brominate (60 °C), favoring ortho substitution: PhT8 (≈85%), PhT10 (≈75%) and PhT12 (60%). First-principles calculations suggest bromination initiates when Br2 is "trapped" via H-bonding to ortho-H's, followed by polarization via strong interactions with cage faces, possibly cage LUMOs.

Investigation of subwavelength grating structure for enhanced surface plasmon resonance detection.

A metallic subwavelength grating structure built on a thin gold film is studied for surface plasmon resonance (SPR) detection of refractive index variations of biological buffer solutions. By employing finite element analysis as a numerical method, characteristics of the angle interrogated SPR sensor were calculated and discussed in a broad operating wavelength varying from visible to near-infrared (NIR). The effects of grating structural parameters such as grating depth, grating period, and grating fill factor in different operating wavelengths have been evaluated on the sensor performance parameters of sensitivity, full width at half-minimum, minimum reflectance at resonance, and resonance angle. Numerical results indicate that adjusting grating geometrical parameters can enhance the performance parameters of the sensor especially in the NIR wavelengths. The enhanced sensor performance parameters for optimizing grating geometry have been explored in detail for visible and NIR wavelengths of 633 and 984 nm, respectively. These findings are important for developing localized surface plasmon sensors with enhanced performance.

Design study of nanograting-based surface plasmon resonance biosensor in the near-infrared wavelength.

A key issue with surface plasmon resonance (SPR) biosensors, which are the focus of many researchers, is improving their sensitivity to detect lower amounts of analyte in a solution. Most SPR developments have focused on the grating-based sensitivity-enhancement approach. In addition to sensitivity, a substantial enhancement of other sensor characteristics such as resolution and signal-to-noise ratio (SNR) is desired for designing a practical sensor. So, in this paper, the characteristics of surface plasmon polaritons sustained by 1D subwavelength metallic gratings on a thin metal slab (under the Krestchmann configuration) have been investigated numerically for the analyte-ligand interactions detection. Effects of different structural parameters, such as grating period, grating depth, metal film thickness, and fill factor have been evaluated on the sensor sensitivity as well as resolution and SNR. Numerical results indicate that the sensor working in the near-infrared wavelength has a better performance than that in the visible one. The result of numerical investigation has been used to design an optimized sensor with the best figure of merit.

Effect of neurofeedback and electromyographic-biofeedback therapy on improving hand function in stroke patients.

PURPOSE: The aim of the present study was to evaluate the effect of applying electroencephalogram (EEG) biofeedback (neurobiofeedback) or electromyographic (EMG) biofeedback to conventional occupational therapy (OT) on improving hand function in stroke patients. METHODS: This study was designed as a preliminary clinical trial. Thirty patients with stroke were entered the study. Hand function was evaluated by Jebsen Hand Function Test pre and post intervention. Patients were allocated to 3 intervention cohorts: (1) OT, (2) OT plus EMG-biofeedback therapy, and (3) OT plus neurofeedback therapy. All patients received 10 sessions of conventional OT. Patients in cohorts 2 and 3 also received EMG-biofeedback and neurofeedback therapy, respectively. EMG-biofeedback therapy was performed to strengthen the abductor pollicis brevis (APB) muscle. Neurofeedback training was aimed at enhancing sensorimotor rhythm after mental motor imagery. RESULTS: Hand function was improved significantly in the 3 groups. The spectral power density of the sensorimotor rhythm band in the neurofeedback group increased after mental motor imagery. Maximum and mean contraction values of electrical activities of the APB muscle during voluntary contraction increased significantly after EMG-biofeedback training. CONCLUSION: Patients in the neurofeedback and EMG-biofeedback groups showed hand improvement similar to conventional OT. Further studies are suggested to assign the best protocol for neurofeedback and EMG-biofeedback therapy.

Decoherence effects on superpositions of chiral states in a chiral molecule.

The superposition of chiral states of chiral molecules, as delocalized quantum states of a many-particle system, can be used for the experimental investigations of decoherence theory. In this regard, a great challenge is the precise quantification of the robustness of these superpositions against environmental effects. The methods so far proposed need the detailed specification of the internal states of the molecule, usually requiring heavy numerical calculations. Here, by using the linearized quantum Boltzmann equation and by borrowing ideas employed for analyzing other quantum systems, we present a general and simple approach, of wide applicability, which can be used to compute the dominant contribution to the decoherence rate for the superpositions of chiral states of chiral molecules, due to environmental scattering.

Evaluating Dose-response of Cataract Induction in Radiotherapy of Head and Neck Cancers Patients.

BACKGROUND: Head and neck cancers are currently the most common types of cancers. 3D-conformal radiation therapy is the most common dose delivery technique for head and neck cancers. Eye Lens is a radio sensitive structure and cataract formation as a visual disorder associated with exposure to ionizing radiation which is documented. OBJECTIVE: Determining the radiation dose to eye lens during head and neck radiography and estimating the probability of cataract induction are essential. MATERIAL AND METHODS: This experimental study was performed on 14 patients with head and neck cancers through experimental study analysis. The maximum opacity of the eyes lens were measured by pentacamTM before radiation therapy. CT data of patients were transmitted to Isogray treatment planning Software, and dose calculations for each patient was performed. At the end of radiation treatment, 3 and 6 months after radiotherapy, the eye lens opacity of the patients was assessed. RESULTS: Overall, 28 lenses were studied. Statistical one sample K- S test proved normality of obtained data. Using repeated measures test, the relation before and 3 months after radiotherapy, as well as the relationship before and 6 months after radiotherapy proved a significant relationship. CONCLUSION: The opacity caused by radiation in eyes is a non-statistical and linear-quadratic response curve with no threshold. This opacity can also appear within 3 months after completion of radiation therapy.

Computational modeling of a carbon nanotube-based DNA nanosensor.

During the last decade the design of biosensors, based on quantum transport in one-dimensional nanostructures, has developed as an active area of research. Here we investigate the sensing capabilities of a DNA nanosensor, designed as a semiconductor single walled carbon nanotube (SWCNT) connected to two gold electrodes and functionalized with a DNA strand acting as a bio-receptor probe. In particular, we have considered both covalent and non-covalent bonding between the DNA probe and the SWCNT. The optimized atomic structure of the sensor is computed both before and after the receptor attaches itself to the target, which consists of another DNA strand. The sensor's electrical conductance and transmission coefficients are calculated at the equilibrium geometries via the non-equilibrium Green's function scheme combined with the density functional theory in the linear response limit. We demonstrate a sensing efficiency of 70% for the covalently bonded bio-receptor probe, which drops to about 19% for the non-covalently bonded one. These results suggest that a SWCNT may be a promising candidate for a bio-molecular FET sensor.

Study of interpolation method in diagnosis of carpal tunnel syndrome and comparison with midpalm antideromic sensory method.

Carpal tunnel syndrome (CTS) is the most common focal compression neuropathy. There are a significant number of different methods available to evaluate a patient for median nerve compromise at the carpal tunnel. One of them is interpolation method created by Dr E.B. Bodofski. In our study Sensitivity of interpolation method was 85.5%, Specificity was 85%, Positive predictive value was 94.6% and Negative predictive value was 65.4%. These results are lower than Dr Bodofski results. Also in our study sensitivity of midpalm antidromic sensory method was 95.1%, Specificity was 95%, Positive predictive value was 98.3% and Negative predictive value was 86.4%, these results are higher than results of interpolation method. These show interpolation method is a good method (with high sensitivity & specificity) for diagnosis of mild CTS, but it's sensitivity & specificity are lower than antideromic sensory stimulation method at wrist & midpalm.

Empowerment of women and mental health improvement with a Preventive approach.

AIM AND BACKGROUND: Mental health and empowerment are two of the women's essential needs. These two related concepts play an important role in women's lives. Therefore, this study aimed to investigate empowerment of women and its relation with mental health problem prevention during difficult situations. METHODS: This qualitative study was conducted through semi-structured interviews with 33 experts in the fields of psychology, social sciences, women studies, medicine and crisis management specialists using snowball sampling in cities of Tehran, Isfahan, Tabriz, and Mashhad during the year 1395 (March 2016-March 2017). Samples were selected heterogeneously. The interview transcripts and codes were presented to the participants, and structural analysis was used for data evaluation. RESULTS: The factors related to empowerment of women with consideration to their mental health were determined based on Longew theory and interviews and include: welfare (primary needs (biological and security) and developmental needs (social needs and dignity), access (facilities and values), knowledge (about inequalities and rights), participation (in politics, decision-making and society), and control (implementation and institutionalization of the above-mentioned needs). CONCLUSIONS: The indicators determined in this study show that empowerment has an important role in determining women's real position in society. Since women make up half of the population and affect society as a whole, the advantages of empowerment of women will be felt in the entire society.

An efficient size-dependent shear deformable shell model and molecular dynamics simulation for axial instability analysis of silicon nanoshells.

Understanding the size-dependent behavior of structures at nanoscale is essential in order to have an effective design of nanosystems. In the current investigation, the surface elasticity theory is extended to study the nonlinear buckling and postbuckling response of axially loaded silicon cylindrical naoshells. Thereby, an efficient size-dependent shear deformable shell model is developed including the size effect of surface free energy. A boundary layer theory of shell buckling in conjunction with a perturbation-based solution methodology is employed to predict the size dependency in the buckling loads and postbuckling behavior of silicon nanoshells having various thicknesses. After that, on the basis of the Tersoff empirical potential, a molecular dynamics (MD) simulation is performed for a silicon cylindrical nanoshell with thickness of four times of silicon lattice constant, the critical buckling load and critical shortening of which are extracted and compared with those of the developed non-classical shell model. It is demonstrated that by taking the effects of surface free energy into account, a very good agreement is achieved between the results of the developed size-dependent continuum shell model and those of MD simulation.

Comparing distal and proximal techniques of saphenous nerve conduction study in healthy subjects.

For comparing distal and proximal techniques. To obtain saphenous nerve sensory response, 102 healthy subjects with mean age 43.1 years and mean Body Mass Index (BMI) 25.3 were studied. Both techniques performed by using surface electrodes. In distal technique recording site was anterior to medial malleolus and stimulator 14 cm proximal to it. In proximal technique stimulation performed on the medial aspect of the knee and response recorded from the leg, 14 cm distal to the cathode. In 204 studied nerves, response obtained in 145 nerves (71%) by distal technique, in 125 nerves (61%) by proximal technique and in 94 nerves (46%) by both techniques. In 176 nerves (86%) response obtained at least by one of two techniques. In men, response obtaining rate by proximal technique (90.5%) was higher than distal one (57%) (P < 0.0001) but in women this rate was 81% by distal technique and 41% by proximal technique (P < 0.0001). Distal technique was more successful than proximal in subjects with higher age (P < 0.05) and higher BMI (P < 0.001). In conclusion, for saphenous nerve conduction study in men, it is better to perform proximal technique primarily but in women distal technique is preferred. Performing the second technique when the first one is failed is suggested.

Prevalence and severity of carpal tunnel syndrome (CTS) during pregnancy.

Carpal Tunnel Syndrome (CTS) is the entrapment of Median nerve at wrist. Pregnancy can affect prevalence and severity of CTS. In this study frequency and severity of CTS in pregnancy was evaluated. In this study 100 pregnant women were evaluated by Hand symptoms, CTS provocation tests (Tinel and Phalen) and for definite diagnosis of CTS standard EDX studies were used. For this purpose sensory and motor distal latency of Median were measured and compared with ulnar nerve. 17% of pregnant women had CTS with 23.5% bilateral involvement and 17.5% severe CTS. Prevalence of hand symptom and clinical sign of CTS (phalen and tinel sign) were 36% and 26% respectively. Results indicated that prevalence of CTS in pregnant women was significant. Although hand signs and symptoms are useful, EDX study is more reliable.

Palmar cutaneous branch of the median nerve conduction study.

The study of the palmar cutaneous branch of median nerve (PCBMN) was down in the Shohada hospital from september 1st 2002 to june 1st 2004. One hundred fifty healthy adult, 65 men and 85 women, with mean age of 36 year were studied by antidromic stimulation of median nerve 10 cm from the surface recording over the midthenar eminence. The nerve maybe injured by direct trauma or during surgery at the wrist. The latency was 2.07+/-0.22 (range 1.50 to 2.80) and the Amplitude of SNAP was 14.36+/-0.86 (range 12 to 16.2). the study is useful in evaluating lesions of the PCBMN

The effect of nanobioceramic reinforcement on mechanical and biological properties of Co-base alloy/hydroxyapatite nanocomposite.

The goal of the present research was to fabricate, characterize, and evaluate mechanical and biological properties of Co-base alloy composites with different amounts of hydroxyapatite (HA) nanopowder reinforcement. The powder of Co-Cr-Mo alloy was mixed with different amounts of HA by ball milling and it was then cold pressed and sintered. X-ray diffraction (XRD) and scanning electron microscopy (SEM) techniques were used. Microhardness measurement and compressive tests were also carried out. Bioactivity behavior was evaluated in simulated body fluid (SBF). A significant decrease in modulus elasticity and an increase in microhardness of the sintered composites were observed. Apatite formation on the surface of the composites showed that it could successfully convert bioinert Co-Cr-Mo alloy to bioactive type by adding 10, 15, and 20wt.% HA which have lower modulus elasticity and higher microhardness.

Effectiveness of strategies to disseminate and implement clinical guidelines for the management of impacted and unerupted third molars in primary dental care, a cluster randomised controlled trial.

OBJECTIVE: To investigate the effectiveness and cost-effectiveness of different guideline implementation strategies, using the Scottish Intercollegiate Guidelines Network (SIGN) Guideline 42 "Management of unerupted and impacted third molar teeth" (published 2000) as a model. DESIGN: A pragmatic, cluster RCT (2x2 factorial design). SUBJECTS: Sixty-three dental practices across Scotland. Clinical records of all 16-24-year-old patients over two, four-month periods in 1999 (pre-intervention) and 2000 (post-intervention) were searched by a clinical researcher blind to the intervention group. Data were also gathered on the costs of the interventions. INTERVENTIONS: Group 1 received a copy of SIGN 42 Guideline and had an opportunity to attend a postgraduate education course (PGEC). In addition to this, group 2 received audit and feedback (A and F). Group 3 received a computer aided learning (CAL) package. Group 4 received A and F and CAL. PRINCIPAL OUTCOME MEASUREMENT: The proportion of patients whose treatment complied with the guideline. RESULTS: The weighted t-test for A and F versus no A and F (P=0.62) and CAL versus no CAL (P=0.76) were not statistically significant. Given the effectiveness results (no difference) the cost effectiveness calculation became a cost-minimisation calculation. The minimum cost intervention in the trial consisted of providing general dental practitioners (GDPs) with guidelines and the option of attending PGEC courses. Routine data which subsequently became available showed a Scotland-wide fall in extractions prior to data collection. CONCLUSION: In an environment in which pre-intervention compliance was unexpectedly high, neither CAL nor A and F increased the dentists' compliance with the SIGN guideline compared with mailing of the guideline and the opportunity to attend a postgraduate course. The cost of the CAL arm of the trial was greater than the A and F arm. Further work is required to understand dental professionals' behaviour in response to guideline implementation strategies.