Development of a core outcome domain set for clinical research on capillary malformations (the COSCAM project).

BACKGROUND: Due to a large variety in treatment outcomes reported in therapeutic trials and lacking patient-relevant outcomes, it is hard to adequately compare and improve current therapies for patients with capillary malformations (CMs). The Core Outcome Set for Capillary Malformations (COSCAM) project aims to develop a core outcome set (COS) for use in future CM trials, in which we will first develop a core outcome (sub)domain set (CDS). Here, we describe the methods for the development of a CDS and present the results of the first development stage. METHODS: The COSCAM project is carried out according to the recommendations of the Cochrane Skin Core OUtcomes Set INitiative (CS-COUSIN) and the Core Outcome Measures in Effectiveness Trials (COMET) initiative. During the first stage, we identified all potentially relevant outcome subdomains based on a systematic review, two focus group sessions and input from patient representatives of Dutch patient organizations and the COSCAM-founding group. In stage two, we will present the subdomains in a three-round e-Delphi study and online consensus meeting, in which CM patients, parents/caregivers and CM experts worldwide rate the importance of the proposed subdomains, hereby finalizing the core outcome (sub)domains of the CDS. RESULTS: A total of 67 potential outcome subdomains were included; sixteen were previously used in the literature, 20 were proposed by Dutch patients and their parents/caregivers (n = 13) in focus group sessions and 38 were suggested by the experts of the COSCAM-founding group. Seven were excluded because of overlap. CONCLUSION: The final CDS may serve as a minimum standard in future CM trials, thereby facilitating adequate comparison of treatment outcomes. After this CDS development, we will select appropriate outcome measurement instruments to measure the core outcome subdomains.

Fenugreek seed extract attenuates cisplatin-induced testicular damage in Wistar rats.

Cisplatin (CIS) provides oxidative stress and inflammations in testicular tissues. Fenugreek seed extract (FSE) is a widely used herbal medicine with potent antioxidant and anti-inflammation properties. The purpose of this study was to investigate the protective effects and the possible mechanisms of FSE against CIS-induced testicular damage in rats. Adult male Wistar rats were given vehicle, single dose of CIS alone (10 mg kg(-1)), single dose of FSE alone or single dose of CIS followed by FSE (50, 100 or 200 mg kg(-1)) every day for 5 days. On day 6, oxidative stress and apoptotic testicular toxicity were evaluated. FSE attenuated both germ cell degenerations and apoptosis in seminiferous tubules in CIS-treated rats. Furthermore, FSE counteracted CIS-induced oxidative stress in rats as assessed by the restoration of superoxide dismutase and catalase activities and reduction in the myeloperoxidase activity and malondialdehyde levels in testes. CIS increased expressions of inducible nitric oxide synthase and nuclear factor-kappa B in testicular tissues. Importantly, treatment with FSE at all doses effectively alleviated all of these inflammatory parameters in testes. Based on these results, we concluded that FSE reduces CIS-induced reproductive toxicity in rats by the suppression of testicular oxidative stress, apoptosis and inflammations.

Extending the working pH of nitrobenzene degradation using ultrasonic/heterogeneous Fenton to the alkaline range via amino acid modification.

Oxides of iron, α-Fe2O3 (I), and copper, CuO (II) prepared by usual precipitation method without surfactant were used at room temperature in the process of nitrobenzene (10mgL(-1)) degradation at different pH values with ultrasonic at 20kHz. The degradation was complete in 20 and 30min for (I) and (II), respectively in the pH range 2-7 using1.0gL(-1) of solids and 10mM of H2O2. A remarkable decrease in degradation efficiency was recorded on increasing the pH to values higher than the neutral range. This loss in efficiency was cancelled to a great extent through modifying the used oxides with amino acids. Arginine showed higher improving effect to (II) (1:1 weight ration) than glycine or glutamic acid. Modification of both oxides with increasing amounts of arginine increased the degradation efficiency of (I) in a more regular way than in case of (II). However, the extent of improvement due to amino acid modification was higher in case of (II) because of its originally low degradation efficiency in strongly alkaline media.

Ultrasonic assisted-Fenton-like degradation of nitrobenzene at neutral pH using nanosized oxides of Fe and Cu.

Ultrasonic-assisted heterogeneous Fenton reaction was used for degradation of nitrobenzene (NB) at neutral pH conditions. Nano-sized oxides of α-Fe2O3 and CuO were prepared, characterized and tested in degradation of NB (10 mg L(-1)) under sonication of 20 kHz at 25 °C. Complete degradation of NB was effected at pH 7 in presence of 10 mM H2O2 after 10 min of sonication in presence of α-Fe2O3 (1.0 g L(-1)), (k=0.58 min(-1)) and after 25 min in case of CuO (k=0.126 min(-1)). α-Fe2O3 showed also effective degradation under the conditions of 0.1 g L(-1) oxide and 5.0 mM of H2O2, even though with a lower rate constant (0.346 min(-1)). Sonication plays a major role in enhancing the production of hydroxyl radicals in presence of solid oxides. Hydroxyl radicals-degradation pathway is suggested and adopted to explain the differences noted in rate constants recorded on using different oxides.

Enhancement of ethanol production by simultaneous saccharification and fermentation (SSF) of rice straw using ethoxylated span 20.

In this work, four nonionic surfactants based on sorbitan monolaurate (Span 20) were synthesized by introducing ethylene oxide gas (n = 20, 40, 60, 80 ethylene oxide units) into Span 20 to give four new surfactants with different hydrophilic-lipophilic balance (HLB), namely, E(20), E(40), E(60), and E(80). The structures of the prepared nonionic surfactants were elucidated using Fourier-transform infrared (FT-IR) and (1)H-nuclear magnetic resonance (NMR) spectroscopy. The surface-tension measurements were recorded. The effects of the prepared nonionic surfactants on the simultaneous saccharification and fermentation (SSF) of microwave/alkali-pretreated rice straw to produce ethanol were investigated. From the obtained data, it was found that the addition of the nonionic surfactants at 2.5 g/L had a positive effect on SSF. The maximum ethanol yield (76 and 55%) was obtained after 72 hr for rice straw using Kluyveromyces marxianus and Saccharomyces cerevisiae, respectively. Also, it was found that the ethanol yield increases with increasing HLB of the prepared nonionic surfactants by increasing ethylene oxide units. The adsorption of nonionic surfactants on lignocelluloses is proposed to be due to hydrophobic and hydrogen bonding interactions between nonionic surfactants and the lignin part in the lignocelulose. It can be concluded that additions of surface-active compounds, such as nonionic surfactants, increase enzymatic conversion of rice straw for bioethanol purposes.

The effect of different ethoxylations for sorbitan monolaurate on enhancing simultaneous saccharification and fermentation (SSF) of wheat straw to ethanol.

In this paper, four nonionic surfactants with different hydrophilic-lipophilic balance (HLB) based on sorbitan monolaurate were synthesized by introducing ethylene oxide gas (n = 20, 40, 60, and 80 ethylene oxide units). The chemical structure of the prepared ethoxylated surfactants was confirmed using Fourier transform-infrared and (1)H NMR spectroscopes. The surface tension and thermodynamic properties of the prepared surfactants have been studied. The simultaneous saccharification and fermentation (SSF) process for ethanol production from microwave/alkali pretreated wheat straw has been assayed using nonionic surfactants have different ethylene oxide units. Ethanol yield was 82% and 61% for Kluyveromyces marxianus and Saccharomyces cerevisiae, respectively, with the addition of 2.5 g/l of the prepared nonionic surfactant (HLB = 18.2). Results show that the production of ethanol from microwave/alkali pretreated wheat straw increased with increasing the (HLB) value of the nonionic surfactant.

Surface and antitumor activity of some novel metal-based cationic surfactants.

The development of anticancer metal-based drugs was attempted by reacting dodecyl amine with selenious acid to produce a quaternary ammonium salt which was then converted to copper and cobalt cationic complexes via complexing the first compounds with copper (II) or cobalt (II) ions. The surface properties of these surfactants were investigated. The surface properties studied included critical micelle concentration (CMC), maximum surface excess (Gamma max ), and minimum surface area (A min ). Free energy of micellization (Delta G degree mic ) and adsorption (Delta G degree ads ) were calculated. Antitumor activity was tested by using Ehrlich ascites carcinoma (EAC) as a model system of mice cell tumor. The compounds were also tested in vitro on five human monolayer tumor cell lines: MCF 7 (breast carcinoma), HEPG 2 (liver carcinoma), U 251 (brain tumor), HCT 116 (colon carcinoma), and H 460 (lung carcinoma). FTIR spectra, elemental analysis, and H 1 NMR spectra were performed to insure the purity of the prepared compounds.

Surface and biocidal activity of some synthesized metallo azobenzene isothiouronium salts.

A novel series of azobenzene isothiouronium salts of different alkyl chains (propyl, hexyl and dodecyl) were synthesized by reaction of 4-((4-methylphenyl)azo)phenol with 1,3-dibromopropane, 1,6-dibromohexane and 1,12-dibromododecane, respectively. These salts were reacted with copper (II) halide to give their corresponding metallo complexes. The surface tension measurements for the synthesized compounds show that the metallo complexes have adsorption and micellization better than that of the parent azobenzene isothiouronium salts. The pathogenic Gram-negative bacteria, Gram-positive bacteria, fungi and yeast were used to determine the biocidal activity of these compounds using gradient plate technique. The results indicate that the copper complexes of the synthesized azobenzene isothiouronium salts have a relatively better biocidal activity than the parent salts.

Chemical destabilization of oil-in-water emulsion by novel polymerized diethanolamines.

The main objective of this study was to synthesize novel demulsifiers for resolving oil-in-water emulsions. Diethanolamine polyethers are considered as a cationic polymer type. The study describes an improved synthesis of a series of diethanolamine polyethers via condensation of 3-7 or 9 mol of diethanolamine. The structure and the molecular weights of the major components in the reaction mixture were confirmed via IR and MS analyses. The demulsifiers were used for treatment of pollution in the refinery wastewater with or without FeCl3. The flocculation efficiency of the synthesized demulsifiers was determined by turbidity measurement of the treated and untreated O/W emulsion in the Cairo Oil Refinery Company. The critical flocculation concentration (CFC) and charge density of the synthesized demulsifiers were determined. Biodegradation of diethanolamine polyethers was measured in river water within 7-8 days.

The relationship of the International Prostate Symptom Score and objective parameters for diagnosing bladder outlet obstruction. Part II: the potential usefulness of artificial neural networks.

PURPOSE: The International Prostate Symptom Score (I-PSS) is used exclusively for evaluating patients with a prostate condition and following various treatment modalities. As previously demonstrated, there is poor or no correlation of bladder outlet obstruction diagnosed by pressure flow study with the symptoms projected by the I-PSS. Thus, we applied an artificial neural network model to assess patients with lower urinary tract symptoms. MATERIALS AND METHODS: Data on 460 patients enrolled in part 1 of our study were entered into a multilayer feed forward, back propagation network. RESULTS: In the training set of 305 patients the model predicted obstruction in 94% with 94% sensitivity and 68% specificity. In the test set of 155 patients it predicted obstruction in 87% with 87% sensitivity and 44% specificity. CONCLUSIONS: The accuracy of the model for diagnosing obstruction based on the I-PSS is acceptable, considering that statistical models failed to demonstrate a correlation of symptoms with objective obstruction.

Fuzzy logic algorithm for quantitative tissue characterization of diffuse liver diseases from ultrasound images.

Computerized ultrasound tissue characterization has become an objective means for diagnosis of liver diseases. It is difficult to differentiate diffuse liver diseases, namely cirrhotic and fatty liver by visual inspection from the ultrasound images. The visual criteria for differentiating diffused diseases are rather confusing and highly dependent upon the sonographer's experience. This often causes a bias effects in the diagnostic procedure and limits its objectivity and reproducibility. Computerized tissue characterization to assist quantitatively the sonographer for the accurate differentiation and to minimize the degree of risk is thus justified. Fuzzy logic has emerged as one of the most active area in classification. In this paper, we present an approach that employs Fuzzy reasoning techniques to automatically differentiate diffuse liver diseases using numerical quantitative features measured from the ultrasound images. Fuzzy rules were generated from over 140 cases consisting of normal, fatty, and cirrhotic livers. The input to the fuzzy system is an eight dimensional vector of feature values: the mean gray level (MGL), the percentile 10%, the contrast (CON), the angular second moment (ASM), the entropy (ENT), the correlation (COR), the attenuation (ATTEN) and the speckle separation. The output of the fuzzy system is one of the three categories: cirrhosis, fatty or normal. The steps done for differentiating the pathologies are data acquisition and feature extraction, dividing the input spaces of the measured quantitative data into fuzzy sets. Based on the expert knowledge, the fuzzy rules are generated and applied using the fuzzy inference procedures to determine the pathology. Different membership functions are developed for the input spaces. This approach has resulted in very good sensitivities and specificity for classifying diffused liver pathologies. This classification technique can be used in the diagnostic process, together with the history information, laboratory, clinical and pathological examinations.

Classification algorithms for quantitative tissue characterization of diffuse liver disease from ultrasound images.

Visual criteria for diagnosing diffused liver diseases from ultrasound images can be assisted by computerized tissue classification. Feature extraction algorithms are proposed in this paper to extract the tissue characterization parameters from liver images. The resulting parameter set is further processed to obtain the minimum number of parameters which represent the most discriminating pattern space for classification. This preprocessing step has been applied to over 120 distinct pathology-investigated cases to obtain the learning data for classification. The extracted features are divided into independent training and test sets, and are used to develop and compare both statistical and neural classifiers. The optimal criteria for these classifiers are set to have minimum classification error, ease of implementation and learning, and the flexibility for future modifications. Various algorithms of classification based on statistical and neural network methods are presented and tested. The authors show that very good diagnostic rates can be obtained using unconventional classifiers trained on actual patient data.

Synthesis of quaternary 8-hydroxyquinoline and 8-hydroxyquinaldine-carbamates structurally related to cholinesterase.

The quaternary carbamates were synthesized by reaction of 8-hydroxyquinoline and 8-hydroxyquinaldine with alkylisocyanates, then quaternizing the carbamates produced with alkylhalides, aralkylhalides or sulphate. The UV spectra of the compounds obtained showed lambdamax at 285 nm. The new quaternary carbamates were found to be of high toxicity and parasymapathomimetic activity in white mice.