Biocompatibility analysis and chemical characterization of Mn-doped hydroxyapatite.

The present work studies the effect of Mn doping on the crystalline structure of the Hap synthesized by the hydrothermal method at 200 °C for 24 h, from Ca(OH)2 and (NH4)2HPO4, incorporating MnCl2 to 0.1, 0.5, 1.0, 1.5 and 2.0 %wt of Mn concentrations. Samples were characterized by the X-Ray Diffraction technique, which revealed the diffraction peaks that corresponded to the hexagonal and monoclinic phase of the Hap; it was observed that the average size of crystallite decreased from 23.67 to 22.69 nm as the concentration of Mn increased. TEM shows that in all samples, there are two distributions of particle sizes; one corresponds to nanorods with several tens of nanometers in length, and the other in which the diameter and length are very close. FTIR analysis revealed absorption bands corresponding to the PO4-3 and OH- groups characteristic of the Hap. It was possible to establish a substitution mechanism between the Mn and the ions of Ca+2 of the Hap. From the Alamar blue test, a cell viability of 86.88% ± 5 corresponding to the sample of Hap at 1.5 %wt Mn was obtained, considered non-cytotoxic according to ISO 10993-5. It also evaluated and demonstrated the good osteoinductive properties of the materials, which were verified by histology and immunofluorescence expression of osteogenic markers. Adhesion, viability, biocompatibility and osteoinductive properties, make these materials candidates for future applications in bone tissue engineering with likely uses in regenerative medicine.

Service-Learning, Movies, and Infectious Diseases: Implementation of an Active Educational Program in Microbiology as a Tool for Engagement in Social Justice.

Service-Learning is an educational methodology that allows student learning while addressing community needs. A program in microbiology and infectious diseases was implemented in Universidad Complutense de Madrid, Spain. University lecturers, clinical microbiologists, doctorate students, and undergraduates from several Bachelor Degrees and courses worked in an interdisciplinary team along with social institutions that attend disadvantaged persons. Using commercial movies that deal with infectious diseases, the students learn clinical microbiology, prepare divulgation materials, visit social centers to accompany, and help others to know about illnesses and prevention. The program was developed through two academic years and involved 58 voluntary students, 13 teachers and tutors, and 4 social entities as community partners. Postsurvey evaluation of the program revealed a highly satisfactory achievement of goals: acquiring scientific and personal competencies by university students, including critical analysis and science diffusion, solving problems or collaborative team working, and contributing, together with the tutors, to the social responsibility of the university.

Dynamics in cortical activity revealed by resting-state MEG rhythms.

The brain is a biophysical system subject to information flows that may be thought of as a many-body architecture with a spatiotemporal dynamics described by its neuronal structures. The oscillatory nature of brain activity allows these structures (nodes) to be described as a set of coupled oscillators forming a network where the node dynamics and that of the network topology can be studied. Quantifying its dynamics at various scales is an issue that claims to be explored for several brain activities, e.g., activity at rest. The resting-state (RS) associates the underlying brain dynamics of healthy subjects that are not actively compromised with sensory or cognitive processes. Studying its dynamics is highly non-trivial but opens the door to understand the general principles of brain functioning, as well as to contrast a passive null condition vs the dynamics of pathologies or non-resting activities. Here, we hypothesize about how the spatiotemporal dynamics of cortical fluctuations could be for healthy subjects at RS. To do that, we retrieve the alphabet that reconstructs the dynamics (entropy-complexity) of magnetoencephalography (MEG) signals. We assemble the cortical connectivity to elicit the dynamics in the network topology. We depict an order relation between entropy and complexity for frequency bands that is ubiquitous for different temporal scales. We unveiled that the posterior cortex conglomerates nodes with both stronger dynamics and high clustering for α band. The existence of an order relation between dynamic properties suggests an emergent phenomenon characteristic of each band. Interestingly, we find the posterior cortex as a domain of dual character that plays a cardinal role in both the dynamics and structure regarding the activity at rest. To the best of our knowledge, this is the first study with MEG involving information theory and network science to better understand the dynamics and structure of brain activity at rest for different bands and scales.

Cost-effectiveness analysis of treatment sequences containing tofacitinib for the treatment of rheumatoid arthritis in Spain.

OBJECTIVE: To assess the cost-effectiveness of tofacitinib-containing treatment sequences versus sequences containing only standard biological therapies in patients with moderate-to-severe rheumatoid arthritis (RA) after the failure of conventional synthetic disease-modifying antirheumatic drugs (csDMARD-IR population) and in patients previously treated with methotrexate (MTX) who show an inadequate response to second-line therapy with any tumour necrosis factor inhibitor (TNFi-IR population). METHODS: A patient-level microsimulation model estimated, from the perspective of the Spanish Public NHS, lifetime costs and quality-adjusted life years (QALY) for treatment sequences starting with tofacitinib (5 mg twice daily) followed by biological therapies versus sequences of biological treatments only. Concomitant treatment with MTX was considered. Model's parameters comprised demographic and clinical inputs (initial Health Assessment Questionnaire [HAQ] score and clinical response to short- and long-term treatment). Efficacy was measured by means of HAQ score changes using mixed treatment comparisons and data from long-term extension (LTE) trials. Serious adverse events (SAEs) data were derived from the literature. Total cost estimation (€, 2018) included drug acquisition, parenteral administration, disease progression and SAE management. RESULTS: In the csDMARD-IR population, sequences starting with tofacitinib proved dominant options (more QALYs and lower costs) versus the corresponding sequences without tofacitinib. In the TNFi-IR population, first-line treatment with tofacitinib+MTX followed by scAbatacept+MTX➔rituximab+MTX➔certolizumab+MTX proved dominant versus scTocilizumab+MTX➔scAbatacept+MTX➔rituximab+MTX➔certolizumab+MTX; and tofacitinib+MTX➔scTocilizumab+MTX➔scAbatacept+MTX➔rituximab+MTX versus scTocilizumab+MTX➔scAbatacept+MTX➔rituximab+MTX➔certolizumab+MTX was less effective but remained a cost-saving option. CONCLUSIONS: Inclusion of tofacitinib seems a dominant strategy in moderate-to-severe RA patients after csDMARDs failure. Tofacitinib, as initial third-line therapy, proved a cost-saving strategy (€- 337,489/QALY foregone) in moderate-to-severe TNFi-IR RA patients. Key points • Therapeutical approach in rheumatoid arthritis (RA) consisted in sequences of several therapies during patient lifetime. • Treatment sequences initiating with tofacitinib followed by biological drugs provided higher health effects in csDMARDs-IR population, compared with sequences containing only biological drugs. • In both csDMARD-IR and TNFi-IR RA populations, initiating treatment with tofacitinib was associated to lower treatment costs for the Spanish National Health System.

Four-Body Scale in Universal Few-Boson Systems.

The role of an intrinsic four-body scale in universal few-boson systems is the subject of active debate. We study these systems within the framework of effective field theory. For systems of up to six bosons we establish that no four-body scale appears at leading order (LO). However, we find that at next-to-leading order (NLO) a four-body force is needed to obtain renormalized results for binding energies. With the associated parameter fixed to the binding energy of the four-boson system, this force is shown to renormalize the five- and six-body systems as well. We present an original ansatz for the short-distance limit of the bosonic A-body wave function from which we conjecture that new A-body scales appear at N^{A-3} LO. As a specific example, calculations are presented for clusters of helium atoms. Our results apply more generally to other few-body systems governed by a large scattering length, such as light nuclei and halo states, the low-energy properties of which are independent of the detailed internal structure of the constituents.

Influence of dentine debris and organic tissue on the properties of sodium hypochlorite solutions.

AIM: To determine the free available chlorine of 2.5% sodium hypochlorite (NaOCl) alone and combined with 9% etidronic acid (HEDP) in the presence of inhibitors, organic tissue and organic tissue plus dentine debris; to evaluate the influence of dentine debris on the tissue-dissolving capacity of both NaOCl solutions; and to determine the antimicrobial action of these solutions when in contact with organic tissue and organic tissue plus dentine debris. METHODOLOGY: The available chlorine of the solutions over time in the absence and presence of the inhibitors was measured using a titration method. The organic tissue dissolution by the solutions alone and in the presence of dentine powder was evaluated by weighing bovine tissue specimens before and after exposure to the solutions for 3 and 10 min. For the antimicrobial activity, biofilms of Enterococcus faecalis were exposed to the solutions for 3 min in the absence and presence of organic tissue and organic tissue + dentine debris. The biovolume and percentage of damaged membrane cells of the biofilm were measured by means of confocal microscopy and the live/dead technique. Nonparametric tests were used to determine statistical differences (P < 0.05). RESULTS: Both inhibitors consumed the free available chlorine of the solutions over time. The presence of dentine debris significantly reduced the tissue dissolution capacity of the NaOCl solutions (P < 0.05). The percentages of biovolume reduction were not affected by the presence of the inhibitors in the two NaOCl solutions, whereas the percentage of damaged membrane cells was significantly reduced (P < 0.001). Overall, a similar behaviour was observed in the NaOCl and NaOCl/HEDP groups. CONCLUSIONS: The presence of organic tissue and organic tissue + dentine debris favoured rapid consumption of the free chlorine of NaOCl and NaOCl/HEDP. This resulted in a decreased ability to dissolve organic tissue without affecting the short-term antimicrobial activity.

Efectos de la estimulación eléctrica habenular en la modulación de respuestas emocionales en ratas Wistar / Efeitos da estimulação elétrica habenular na modulação de respostas emocionais em ratos Wistar / Effects of electrical stimulation of the habenula on the modulation of emotional responses in Wistar rats

Resumen A pesar del amplio uso de la estimulación cerebral profunda para controlar patologías neurológicas y neuropsiquiátricas, su mecanismo de acción aún no es claramente conocido, y existen pocos estudios sistemáticos que relacionen la variación de parámetros de estimulación eléctrica (frecuencia, intensidad, duración del pulso) y la ejecución comportamental. La habénula es una estructura reguladora de respuestas emocionales diana en tratamientos para dolor crónico y depresión, pero la relación entre su estimulación crónica y el desempeño animal en pruebas conductuales no se ha establecido con claridad. Con el objetivo de evaluar el efecto emocional de la estimulación habenular crónica, en este estudio se utilizaron ratas Wistar que recibieron estimulación habenular a intensidad baja (10-80 pA) o alta (120-260 pA) y frecuencia baja (80-150 Hz) o alta (240380 Hz): BIBF-AIBF-BIAF-AIAF, durante 15 minutos a lo largo de tres días consecutivos. Al cuarto día, se hizo la evaluación en un laberinto elevado en cruz y en campo abierto. Los resultados indican un efecto de tipo ansiolítico en el tratamiento BIAF, en comparación con BIBF y AIBF (aumento del número de entradas, porcentaje de tiempo en brazos abiertos y de la distancia recorrida en ellos), efecto que no se explica por cambios en la locomotricidad (distancia recorrida en los brazos cerrados y la exploración en el campo abierto). Se concluye que el parámetro frecuencia posee mayor impacto sobre el efecto comportamental que la intensidad -lo que puede explicar algunos hallazgos paradójicos previos-, que los parámetros utilizados no poseen efecto ansiogénico, y que los efectos potencialmente ansiogénicos de la estimulación a baja frecuencia y el papel de los sistemas dopaminérgicos y serotoninérgicos encontrados deben ser estudiados en futuras investigaciones.

Resumo Apesar do amplo uso da estimulação cerebral profunda para controlar patologias neurológicas e neuropsiquiátricas, seu mecanismo de ação ainda não é claramente conhecido e existem poucos estudos sistemáticos que relacionem a variação de parâmetros de estimulação elétrica (frequência, intensidade, duração do pulso) e a execução comportamental. A habênula é uma estrutura reguladora de respostas emocionais específicas em tratamentos para dor crònica e depressão, mas a relação entre sua estimulação crònica e o desempenho animal em testes comportamentais não foi claramente estabelecida. Com o objetivo de avaliar o efeito emocional da estimulação habenular crònica, neste estudo foram utilizados ratos Wistar que receberam estimulação habenular de intensidade baixa (10-80 pA) ou alta (120-260 pA) e frequência baixa (80-150 Hz) ou alta (240-380 Hz): BIBF-AIBF-BIAF-AIAF, durante 15 minutos ao longo de três dias consecutivos. No quarto dia, foi feita a avaliação em um labirinto em cruz elevado e em campo aberto. Os resultados indicam um efeito de tipo ansiolítico no tratamento BIAF, em comparação com BIBF e AIBF (aumento do número de entradas, porcentagem de tempo em braços abertos e da distância percorrida neles), efeito que não se explica por mudanças na locomotividade (distância percorrida nos braços fechados e a exploração no campo aberto). Conclui-se que o parâmetro "frequência" tem mais impacto sobre o efeito comportamental do que a "intensidade" - o que pode explicar algumas descobertas paradoxais prévias -, que os parâmetros utilizados não tenham efeito ansiogênico, e que os efeitos potencialmente ansiogênicos da estimulação de baixa frequência e o papel dos sistemas dopaminérgicos e serotoninérgicos encontrados devem ser estudados em pesquisas futuras.

Abstract Deep brain stimulation is a widely-used approach to the treatment of neurologic and neuropsychiatric diseases. However, its mechanisms remain unclear. There are few systematic studies relating variations on electrical stimulation parameters (frequency, intensity, pulse duration) and behavioral outcome. The habenula relates to emotional behavior and is a main target for chronic pain and depression stimulation treatment. The relation between habenular electrical stimulation and performance in behavioral tests has not been clearly defined. In order to assess the emotional effects of chronic habenular electrical stimulation, Wistar male rats were unilaterally implanted with electrodes aimed to the lateral habenula and assigned to low (10-80 pA) or high (120-260 pA) intensity and low (80-150 Hz) or high (240-380 Hz) frequency conditions: BIBF-AIBF-BIAF-AIAF. They received electrical stimulation 15 minutes/day for three consecutive days and on the fourth day were tested in the elevated plus maze and the open field. The results of these study show that BIAF stimulation has a possible anxiolytic-like effect when compared to BIBF and AIBF (increase in the percentage of open-arms time, entries into the open-arms and total-distance-run in the open-arms). This is not due to any changes in locomotion (total-distance-run and open field exploration). It is concluded that frequency is more important than intensity for behavioral modification. This could explain some previous inconsistent results. The data also suggest that these parameters of stimulation have no anxiogenic effects. The role for dopaminergic and serotonergic systems must be subsequently evaluated as well as potential anxiogenic-like effects of low frequency stimulation.

Wet chemical synthesis of nanocrystalline hydroxyapatite flakes: effect of pH and sintering temperature on structural and morphological properties.

Wet chemical synthesis of hydroxyapatite (HAp) nanostructures was carried out with different solution pH values (9, 10 and 11) and sintering temperatures (300°C, 500°C, 700°C and 900°C). The effects of pH and sintering temperature on the structural and morphological properties of nanocrystalline HAp powders were presented. Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and scanning electron microscopy (SEM) analysis were performed to obtain the crystalline structure, chemical composition, morphology and particle size of the HAp powders. The TEM analysis is used in order to observe the rod- and flake-like HAp structures. XRD confirms the presence of both HAp hexagonal and monetite phases, although the monetite phase was less abundant in the resultant powders. Increase in pH reduced the monetite phase and enhanced Ca/P ratio from 1.7 to 1.83. Additionally, an increment in sintering temperature increased the crystallite size from 20 to 56 nm. The SEM analysis revealed the formation of semi-spherical and flake-like HAp structures with preferential flake morphology. An increase in pH and sintering temperature resulted in the growth and coalescence of crystals resulting in a porous capsular morphology. The FTIR analysis confirmed the reduction of carbonate stretching modes with an increase in pH and H-O-H antisymmetric stretching mode is eliminated for powders sintered at 900°C confirming the formation of stable and porous HAp powders.

A quality assessment of randomized controlled trial reports in endodontics.

AIM: To assess the quality of the randomized clinical trial (RCT) reports published in Endodontics between 1997 and 2012. METHODOLOGY: Retrieval of RCTs in Endodontics was based on a search of the Thomson Reuters Web of Science (WoS) database (March 2013). Quality evaluation was performed using a checklist based on the Jadad criteria, CONSORT (Consolidated Standards of Reporting Trials) statement and SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials). Descriptive statistics were used for frequency distribution of data. Student's t-test and Welch test were used to identify the influence of certain trial characteristics upon report quality (α = 0.05). RESULTS: A total of 89 RCTs were evaluated, and several methodological flaws were found: only 45% had random sequence generation at low risk of bias, 75% did not provide information on allocation concealment, and 19% were nonblinded designs. Regarding statistics, only 55% of the RCTs performed adequate sample size estimations, only 16% presented confidence intervals, and 25% did not provide the exact P-value. Also, 2% of the articles used no statistical tests, and in 87% of the RCTs, the information provided was insufficient to determine whether the statistical methodology applied was appropriate or not. Significantly higher scores were observed for multicentre trials (P = 0.023), RCTs signed by more than 5 authors (P = 0.03), articles belonging to journals ranked above the JCR median (P = 0.03), and articles complying with the CONSORT guidelines (P = 0.000). CONCLUSIONS: The quality of RCT reports in key areas for internal validity of the study was poor. Several measures, such as compliance with the CONSORT guidelines, are important in order to raise the quality of RCTs in Endodontics.

Caracterización de la enfermedad respiratoria baja en pacientes menores de 5 años, hospitalizados en un centro de 3º nivel / Characterization of low respiratory disease in patients under 5 years old, hospitalized in a center of 3º level / Caracterização da doença respiratória baixa em pacientes menores de 5 anos, hospitalizados em centro de 3 níveis

Introducción: Caracterizar la enfermedad respiratoria baja en pacientes hospitalizados basados en el panel viral, como parte del programa de vigilancia epidemiológica en Bogotá, Colombia. Población y métodos: Trabajo retrospectivo transversal entre enero de 2010 y junio de 2011 en un hospital de tercer nivel, involucrando menores de 5 años, mediante inmunofluorescencia indirecta en aspirado nasofaríngeo para virus sincitial respiratorio (VSR), parainfluenza 1, 2, 3, influenza A, B y adenovirus. Resultados: Se obtuvieron 1063 casos, encontrándose un mayor número en el primer semestre del segundo año (145%). Los meses de mayor afectación fueron abril y mayo, siendo los hombres los más afectados. El promedio de edad fue de 8,18 meses; los menores de 1 año representaron el 75% de los casos y los menores de 2 años el 93%. En el 67% de los eventos no se aisló ninguno de los virus estudiados y en el 28% el VSR. El promedio de estancia hospitalaria fue de 7,11 días, siendo mayor para el VSR que para los otros virus o resultado negativo. El 51% recibió antibióticos. Conclusiones: Resultados similares a los descritos en la literatura pero analizados a la altura de Bogotá y en una comunidad de condición socioeconómica baja.

Introduction: Characterization of lower respiratory disease in hospitalized patients based on the viral panel as part of epidemiological surveillance program in Bogota, Colombia. Population and methods: Transversal retrospective study between January 2010 and June 2011 from a tertiary level hospital was developed with children younger than 5 years old. Indirect immunofluorescence in nasopharyngeal aspirate for respiratory syncytial virus (RSV), parainfluenza 1, 2, 3; influenza A, B and adenoviruses were analyzed. Results: 1063 cases were obtained, finding a greater number of cases in the first half of year (145%). The months with higher affectation were April and May, men being the most affected. The average age was 8.18 months; children under 1 year old accounted for 75% of cases and children under 2 years old 93%. In 67% of the events none of the studied virus was isolated and in 28% RSV. The average hospital stay was 7.11 days, being greater for RSV than for other viruses or negative. 51% received antibiotics. Conclusion: The results were similar to those described in the literature but analyzed at the height of Bogota and in a community of low socio-economic status.

Introdução: Caracterização da doença respiratória inferior em pacientes hospitalizados com base no painel viral como parte do programa de vigilância epidemiológica em Bogotá, Colômbia. População e métodos: Estudo transversal retrospectivo entre jeiro de 2010 e junho de 2011 de um hospital de nível terciário foi desenvolvido com crianças menores de 5 anos. Imunofluorescência indireta em aspirado nasofaríngeo para o vírus respiratório sincitial (VSR), parainfluenza 1, 2, 3; Influenza A, B e adenovírus foram analisados. Resultados: Foram obtidos 1063 casos, encontrando-se um maior número de casos na primeira metade do ano (145%). Os meses com maior afetação foram abril e maio, sendo os homens os mais afetados. A média de idade foi de 8,18 meses; Crianças menores de 1 ano representaram 75% dos casos e crianças menores de 2 anos 93%. Em 67% dos eventos nenhum dos vírus estudados foi isolado e em 28% RSV. A média de internação hospitalar foi de 7,11 dias, sendo maior para RSV do que para outros vírus ou negativos. 51% receberam antibióticos. Conclusão: Os resultados foram semelhantes aos descritos na literatura, mas analisados na altura de Bogotá e em uma comunidade de baixo status socioeconômico.

Trasplante combinado hígado-riñón en la fundación valle del Lili, Cali, Colombia - Experiencia de un centro / The experience of the Fundacion Valle Del Lili in Cali, Colombia with Combined Liver and Kidney Transplantation

Introducción: el trasplante combinado de hígado y riñón (CLK) ha mostrado ser una buena alternativa para pacientes con diagnóstico concomitante de enfermedad renal crónica (ERC) y enfermedad hepática terminal. Algunos estudios han mostrado además un beneficio inmunológico del trasplante combinado, con disminución de la tasa de rechazo del injerto renal. Objetivo: describir las indicaciones y los resultados clínicos en receptores de trasplante CLK en un hospital de alta complejidad. Materiales y métodos: se seleccionaron los pacientes con trasplante CLK del registro institucional de trasplante (TRENAL) entre 2000 y 2011. Se describieron las características demográficas y clínicas y se estimó la sobrevida de los pacientes y de los injertos con el método Kaplan Meier. Resultados: en un período de 11 años, se realizaron 16 trasplantes CLK. Esto corresponde al 1.51% de los trasplantes de riñón y al 3.48% de los trasplantes de hígado hechos en la institución durante el mismo periodo de tiempo. La mayoría de los receptores fueron de sexo masculino (10/16). La mediana de la edad fue 56.5 años. La mediana del MELD fue de 17 (RIQ: 12.5-20.5, Rango 8-24). El diagnóstico hepático más frecuente fue cirrosis por NASH (4/16). Todos los pacientes tenían diagnóstico de ERC, en 4 casos secundaria a diabetes mellitus. Las indicaciones más comunes del trasplante fueron ascitis de difícil manejo, encefalopatía recurrente y desnutrición. El tiempo promedio de isquemia en frío del hígado fue de 7,3 horas, y del riñón 9,6 horas. La sobrevida de los pacientes y de los injertos hepático y renal fue de 87,5% al año y 67,3% a los 5 años. Cuatro pacientes murieron, 2 casos como consecuencia de sepsis y otros 2 por malignidad. Conclusión: el trasplante CLK en la Fundación Valle del Lili tiene resultados clínicos satisfactorios y comparables a los reportados en otros centros.

Introduction: Combined liver and kidney transplantation (CLK) has been shown to be a good alternative for patients with concomitant diagnosis of chronic kidney disease (CKD) and end-stage liver disease. Some studies have also shown immunological benefits from combined transplantation with decreased rates of kidney graft rejection. Objective: The objective of this study was to describe the indications and clinical outcomes of CLK transplant recipients in a highly complex hospital. Materials and Methods: CLK transplant patients were selected from the institutional transplant registry (Trenal) from 2000 to 2011. Demographic and clinical characteristics were described and survival of patients and grafts were estimated with the Kaplan-Meier method. Results: Over a period of 11 years, 16 CLK transplants were performed. This was 1.51% of kidney transplants and 3.48% of liver transplants done in the institution during this period. Most recipients were male (10/16). The median age was 56.5 years. The median MELD was 17 (IQR: 12.5 to 20.5, range: 8 to 24). The most frequent diagnosis was liver cirrhosis due to NASH (4/16). All patients had been diagnosed with CKD: four cases were secondary to diabetes mellitus. The most common indications for transplants were difficult to manage ascites, recurrent encephalopathy and malnutrition. The average liver cold ischemia time was 7.3 hours, and the average kidney cold ischemia time 9.6 hours. The five-year liver graft survival rate was 87.5%, and the five-year kidney graft survival rate was 67.3%. Four patients died: two as the result of sepsis and two as the result of malignancy. Conclusion: CLK transplantation results at the Fundación Valle del Lili have been satisfactory and comparable to those reported by other transplant centers.

Power counting of contact-range currents in effective field theory.

We analyze the power counting of two-body currents in nuclear effective field theories (EFTs). We find that the existence of nonperturbative physics at low energies, which is manifest in the existence of the deuteron and the ^{1}S_{0} NN virtual bound state, combined with the appearance of singular potentials in versions of nuclear EFT that incorporate chiral symmetry, modifies the renormalization-group flow of the couplings associated with contact operators that involve nucleon-nucleon pairs and external fields. The order of these couplings is thereby enhanced with respect to the naive-dimensional-analysis estimate. Consequently, short-range currents enter at a lower order in the chiral EFT than has been appreciated up until now, and their impact on low-energy observables is concomitantly larger. We illustrate the changes in the power counting with a few low-energy processes involving external probes and few-nucleon systems, including electron-deuteron elastic scattering and radiative neutron capture by protons.

Hemorragia alveolar difusa asociada a vasculitis ANCA positiva, manejo con plasmaféresis. reporte de un caso / ANCA vasculitis associated diffuse alveolar hemorrhage treated with plasmapheresis: a case report

Presentamos el caso de una paciente femenina de 43 años con vasculitis tipo ANCA con severo compromiso pulmonar por desarrollo de hemorragia alveolar difusa (HAD) e insuficiencia respiratoria. Debido al rápido deterioro clínico y pobre respuesta a inmunosupresores (ciclofosfamida y metilprednisolona) se le practicó plasmaféresis resultando en rápida mejoría, permitiendo la liberación en la ventilación mecánica y mejoría radiológica. En la actualidad se puede sugerir esta terapia en pacientes con diagnóstico de vasculitis tipo ANCA con compromiso pulmonar severo.

We describe a 43 years old woman who was diagnosed of ANCAassociated vasculitides (AAV) with onset of diffuse alveolarhemorrhage and poor pulmonary function. She developed a clinicaldeterioration in spite of cyclophosphamide and methylprednisolonetreatment, and plasmapheresis was performed. She was successfullytreated with timely plasma exchange and immunosuppressivetreatment. Early plasmapheresis with immunosuppressant therapycan rescue this fatal complication.

Slow modulations of high-frequency activity (40-140-Hz) discriminate preictal changes in human focal epilepsy.

Recent evidence suggests that some seizures are preceded by preictal changes that start from minutes to hours before an ictal event. Nevertheless an adequate statistical evaluation in a large database of continuous multiday recordings is still missing. Here, we investigated the existence of preictal changes in long-term intracranial recordings from 53 patients with intractable partial epilepsy (in total 531 days and 558 clinical seizures). We describe a measure of brain excitability based on the slow modulation of high-frequency gamma activities (40-140 Hz) in ensembles of intracranial contacts. In prospective tests, we found that this index identified preictal changes at levels above chance in 13.2% of the patients (7/53), suggesting that results may be significant for the whole group (p < 0.05). These results provide a demonstration that preictal states can be detected prospectively from EEG data. They advance understanding of the network dynamics leading to seizure and may help develop novel seizure prediction algorithms.

Potential errors and misuse of statistics in studies on leakage in endodontics.

AIM: To assess the quality of the statistical methodology used in studies of leakage in Endodontics, and to compare the results found using appropriate versus inappropriate inferential statistical methods. METHODOLOGY: The search strategy used the descriptors 'root filling' 'microleakage', 'dye penetration', 'dye leakage', 'polymicrobial leakage' and 'fluid filtration' for the time interval 2001-2010 in journals within the categories 'Dentistry, Oral Surgery and Medicine' and 'Materials Science, Biomaterials' of the Journal Citation Report. All retrieved articles were reviewed to find potential pitfalls in statistical methodology that may be encountered during study design, data management or data analysis. RESULTS: The database included 209 papers. In all the studies reviewed, the statistical methods used were appropriate for the category attributed to the outcome variable, but in 41% of the cases, the chi-square test or parametric methods were inappropriately selected subsequently. In 2% of the papers, no statistical test was used. In 99% of cases, a statistically 'significant' or 'not significant' effect was reported as a main finding, whilst only 1% also presented an estimation of the magnitude of the effect. When the appropriate statistical methods were applied in the studies with originally inappropriate data analysis, the conclusions changed in 19% of the cases. CONCLUSIONS: Statistical deficiencies in leakage studies may affect their results and interpretation and might be one of the reasons for the poor agreement amongst the reported findings. Therefore, more effort should be made to standardize statistical methodology.

EPILAB: a software package for studies on the prediction of epileptic seizures.

A Matlab®-based software package, EPILAB, was developed for supporting researchers in performing studies on the prediction of epileptic seizures. It provides an intuitive and convenient graphical user interface. Fundamental concepts that are crucial for epileptic seizure prediction studies were implemented. This includes, for example, the development and statistical validation of prediction methodologies in long-term continuous recordings. Seizure prediction is usually based on electroencephalography (EEG) and electrocardiography (ECG) signals. EPILAB is able to process both EEG and ECG data stored in different formats. More than 35 time and frequency domain measures (features) can be extracted based on univariate and multivariate data analysis. These features can be post-processed and used for prediction purposes. The predictions may be conducted based on optimized thresholds or by applying classifications methods such as artificial neural networks, cellular neuronal networks, and support vector machines. EPILAB proved to be an efficient tool for seizure prediction, and aims to be a way to communicate, evaluate, and compare results and data among the seizure prediction community.