Measuring the Rheological and Textural Properties of Thick Purees Used to Manage Patients with Swallowing Disorders.

Texture-modified diets are the first-line compensatory strategy for older patients with swallowing and mastication disorders. However, the absence of a common protocol to assess textural properties inhibits their standardization and quality control and, thus, patient safety. This study aimed to (a) assess the rheological and textural properties of ten thick purees (Texture C, British Dietetic Association), (b) understand the effect of oral processing, and (c) measure the properties of the ready-to-swallow bolus after oral processing in healthy adults. Shear viscosity at 50 s-1 and 300 s-1 and textural properties (maximum force, cohesiveness, and adhesiveness) of boluses of ten thick purees were analyzed with a rheometer and a texture analyzer before and after oral processing (ready-to-swallow) in five healthy volunteers. Viscosity varied by 81.78% at 50 s-1 (900-4800 mPa·s) among purees before oral processing. Maximum force varied by 60% (0.47-1.2 N); cohesiveness, 18% (0.66-0.82), and adhesiveness, 32% (0.74-1.1 N·s). The high variability of viscosity was also present in ready-to-swallow boluses, 70.32% among purees. Oral processing significantly reduced viscosity in most purees (French omelet, zucchini omelet, turkey stew, red lentils, noodles, and hake fish) and also significantly reduced maximum force (7-36%) and adhesiveness (17-51%) but hardly affected cohesiveness (<5%). All thick purees met the qualitative textural descriptors for Level C texture. However, all ten purees showed significant differences in all parameters measured instrumentally and were affected differently by oral processing. This study demonstrates the need to use instrumental quality control using standardized protocols and SI units to narrow the variability and provide the optimal values for patients with dysphagia who require texture-modified diets.

Graphitic carbon nitride (g-C3N4)-assisted materials for the detection and remediation of hazardous gases and VOCs.

Graphitic carbon nitride (g-C3N4)-based materials are attracting attention for their unique properties, such as low-cost, chemical stability, facile synthesis, adjustable electronic structure, and optical properties. These facilitate the use of g-C3N4 to design better photocatalytic and sensing materials. Environmental pollution by hazardous gases and volatile organic compounds (VOCs) can be monitored and controlled using eco-friendly g-C3N4- photocatalysts. Firstly, this review introduces the structure, optical and electronic properties of C3N4 and C3N4 assisted materials, followed by various synthesis strategies. In continuation, binary and ternary nanocomposites of C3N4 with metal oxides, sulfides, noble metals, and graphene are elaborated. g-C3N4/metal oxide composites exhibited better charge separation that leads to enhancement in photocatalytic properties. g-C3N4/noble metal composites possess higher photocatalytic activities due to the surface plasmon effects of metals. Ternary composites by the presence of dual heterojunctions improve properties of g-C3N4 for enhanced photocatalytic application. In the later part, we have summarised the application of g-C3N4 and its assisted materials for sensing toxic gases and VOCs and decontaminating NOx and VOCs by photocatalysis. Composites of g-C3N4 with metal and metal oxide give comparatively better results. This review is expected to bring a new sketch for developing g-C3N4-based photocatalysts and sensors with practical applications.

Characterization of Dysphagia Thickeners Using Texture Analysis-What Information Can Be Useful?

Besides shear viscosity, other texture parameters (adhesiveness or cohesiveness) might be relevant for safe swallowing in people suffering from oropharyngeal dysphagia. Shear viscosity is assessed through protocols developed using a viscometer or a rheometer. In contrast, protocols and instruments (capillary break-up rheometer) to assess adhesiveness and cohesiveness are less common and much less developed. Other equipment such as texture analyzers can provide useful information on food properties. Here, we aimed to explore different texture analyzer settings (type of test, probe, and protocol) to characterize four commercial dysphagia thickeners at the shear viscosity levels recommended by manufacturers. Among the tests used (extrusion or penetration) with the different probes (disc, cone and shape holder, sphere, or cylinder), cone extrusion provided information about adhesivity, disc extrusion about sample cohesiveness, and sphere about penetration and sample elasticity. The test speeds used influenced the results, but only one speed is needed as the different speeds provided the same fluid information; for easiness, it is proposed to use 1 mm/s. Comparing the texture analyzer results with viscosity values obtained at different shears, the texture analyzer parameters reflected information that differ from shear viscosity. This information could be relevant for the therapeutic effect of thickening products and food characterization.

HOX and PBX gene dysregulation as a therapeutic target in glioblastoma multiforme.

BACKGROUND: Glioblastoma multiforme (GBM) is the most common high-grade malignant brain tumour in adults and arises from the glial cells in the brain. The prognosis of treated GBM remains very poor with 5-year survival rates of 5%, a figure which has not improved over the last few decades. Currently, there is a modest 14-month overall median survival in patients undergoing maximum safe resection plus adjuvant chemoradiotherapy. HOX gene dysregulation is now a widely recognised feature of many malignancies. METHODS: In this study we have focused on HOX gene dysregulation in GBM as a potential therapeutic target in a disease with high unmet need. RESULTS: We show significant dysregulation of these developmentally crucial genes and specifically that HOX genes A9, A10, C4 and D9 are strong candidates for biomarkers and treatment targets for GBM and GBM cancer stem cells. We evaluated a next generation therapeutic peptide, HTL-001, capable of targeting HOX gene over-expression in GBM by disrupting the interaction between HOX proteins and their co-factor, PBX. HTL-001 induced both caspase-dependent and -independent apoptosis in GBM cell lines. CONCLUSION: In vivo biodistribution studies confirmed that the peptide was able to cross the blood brain barrier. Systemic delivery of HTL-001 resulted in improved control of subcutaneous murine and human xenograft tumours and improved survival in a murine orthotopic model.

A Hybrid Algorithm to Enhance Colour Retinal Fundus Images Using a Wiener Filter and CLAHE.

Digital images used in the field of ophthalmology are among the most important methods for automatic detection of certain eye diseases. These processes include image enhancement as a primary step to assist optometrists in identifying diseases. Therefore, many algorithms and methods have been developed for the enhancement of retinal fundus images, which may experience challenges that typically accompany enhancement processes, such as artificial borders and dim lighting that mask image details. To eliminate these problems, a new algorithm is proposed in this paper based on separating colour images into three channels (red, green, and blue). The green channel is passed through a Wiener filter and reinforced using the CLAHE technique before merging with the original red and blue channels. Reducing the green channel noise with this approach is proven effective over the other colour channels. Results from the Contrast Improvement Index (CII) and linear index of fuzziness (r) test indicate the success of the proposed algorithm compared with alternate algorithms in the application of improving blood vessel imagery and other details within ten test fundus images selected from the DRIVER database.

Surgical repair of large pulmonary artery to left atrium fistula.

We report a successful surgical closure of a rught pulmonary artery to left atrium fistula (RPALAF) with secondary atrial septal defect (ASD) in a 3.5 years old girl. These fistulae are rare cause of cyanosis and require early diagnosis and treatment to prevent the serious complications of them.

The Targeting of RNA Polymerase I Transcription Using CX-5461 in Combination with Radiation Enhances Tumour Cell Killing Effects in Human Solid Cancers.

An increased rate of cellular proliferation is a hallmark of cancer and may be accompanied by an increase in ribosome biogenesis and dysregulation in rRNA synthesis. In this regard, CX-5461 has been developed as a novel RNA polymerase I inhibitor and is currently in Phase I/II clinical trials for solid and hematological malignancies. In the present study, interactions between CX-5461 and single-dose X-ray exposure were assessed using isobologram analysis using MTS assay and drug-induced cell death was assessed using flow cytometric, confocal microscopy and Western blot analysis. Combination treatments involving CX-5461 and single-dose X-ray exposure highlighted increased effectiveness compared to individual treatment alone in the CaSki cervical cancer line, with marked synergistic interaction occurring within the low-drug (50 nM) and low-dose radiation range (2-6 Gy). Cell lines challenged with CX-5461 demonstrated the presence of DNA damage, induction of apoptosis, autophagy and senescence alongside high percentages of G2/M cell cycle arrest. In addition, we report preferential sensitivity of ovarian cancer cells with BRCA2 mutation to this novel agent. Taken together, CX-5461 displayed a broad spectrum of activity in a panel of solid cancer cell lines with IC50 values ranging from 35 nM to >1 µM. The work described herein identifies the synergistic effects of CX-5461 in combination with X-rays in solid cancers and may also aid in the design of clinical trials involving this novel agent.

Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging in prediction of response to neoadjuvant chemotherapy in pediatric osteosarcoma.

The aim of our study was to evaluate the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) in prediction of response to neoadjuvant chemotherapy (NAC) in pediatric osteosarcoma (OS) patients compared to percentage of tumor necrosis after surgical excision of the tumor. Forty-six pediatric OS patients treated with neoadjuvant chemotherapy and surgery were underwent PET/CT and MRI before, after 3 cycles, and after the completion of neoadjuvant chemotherapy. Imaging parameters include maximum standardized uptake value (SUVmax1, 2, and 3), tumor liver ratio (TLR 1, 2, and 3), and MRI tumor volume (MRTV 1, 2, and 3) at initial assessment before starting NAC, after finishing three cycles and after finishing 6 cycles before tumor excision, respectively. Cutoff values of the PET/CT and MRI parameters were determined using receiver operating characteristic (ROC) curve analysis and percentage of tumor necrosis of postsurgical specimen. Fourteen patients were good responders (30.4%), with more than 90% tumor necrosis, while 31 patients were poor responders (67.4%). The results of one patient were missed. We noticed that higher sensitivity for detecting poor responders was detected by SUVmax3/1, TLR3/1, and MRTV2/1 ratio cutoff values, while higher specificity was detected by TRL2 and SUVmax3 cutoff values. ROC curve analysis of MRTV2/1 and MRTV3/1 ratio was fair in predicting poor responders. PET/CT parameters are capable of predicting histological response to NAC in OS patients with overall sensitivity and specificity higher than MRI parameters.

Evaluation of the Role of Displacement Surgery in the Management of Congenital Nystagmus.

INTRODUCTION: The aim of this study was to assess the effectiveness of displacement surgery in damping of ocular oscillation and management of compensatory head posture in patients of congenital nystagmus. METHODS: This study was carried out in 2014. The participants were 50 patients with congenital nystagmus that dampens in a certain direction of gaze with or without abnormal head posture and with or without strabismus. Patients underwent the augmented modified Kestenbaum (augmented parks) procedure. Data were analyzed by SPSS version 15, using Chi-square text, exact test, and Mann Whitney U test. RESULTS: In this study, 12 patients (80%) were noticed clinically to have damping of nystagmus while 3 patients (20%) had no damping of nystagmus. Twelve patients (80.0%) had no post-operative abnormal head position, while 3 patients (20.0%) had residual abnormal head position. There was a statistically significant difference between the pre-operative BCVA in primary position and post-operative BCVA in primary position (p = 0.001 for both right and left eyes). CONCLUSION: The displacement surgeries (e.g. Kestenbaum procedure) for the treatment of patients with congenital nystagmus is an effective procedure for correction of abnormal head posture, improving the visual acuity in the primary position and damping of nystagmus in patients with congenital nystagmus who have null points away from the primary position.

Process review of a departmental change from conventional coronary artery bypass grafting to totally arterial coronary artery bypass and its effects on the incidence and severity of postoperative stroke.

BACKGROUND: We evaluated the process of changing from conventional coronary artery bypass grafting (CABG) to totally arterial off-pump coronary artery bypass (TOPCAB) at a single heart center in Germany. METHODS: We (1) used multivariate statistical methods to assess real-time monitoring of OPCAB effects, (2) conducted a case review to assess preventable deaths and identify areas of improvement, (3) conducted a team survey, and (4) evaluated benchmarking results. RESULTS: All surgeons and assistants (n = 18) at this center were involved and were guided by the department head and one of the consultants, who was trained in this procedure in 2004 at the Leuven OPCAB school. The frequency of OPCAB operations increased abruptly in 2005 from 5% to 43% and then increased gradually to 67% (n = 546) by 2008 (total, 1781 OPCAB cases and 1563 on-pump cases). The in-hospital and 30-day mortality rates for OPCAB surgeries (n = 10 [0.6%] and 21 [1.2%], respectively) were lower than for on-pump surgeries (n = 27 [1.7%] and 26 [1.7%], respectively). Stroke rates were also lower for OPCAB surgeries (7 cases [0.4%] versus 15 cases [1%]). The lower risk of stroke in the OPCAB group was significant (P < .05) after risk adjustment. Monitoring curves and case reviews demonstrated a preventable death percentage of at least 30%. The attitude of the team was mostly positive because of the promising results (eg, fewer strokes, increasing TOPCAB popularity, and a top national rank). CONCLUSIONS: The change from conventional CABG to TOPCAB was effective in decreasing the incidence and severity of stroke, in developing a team routine and a positive team attitude, and in producing excellent benchmarking results. The presence of a training and communication deficiency at the beginning of the study suggested an area for further improvement. After 6 years TOPCAB had largely replaced conventional CABG.