Traffic-related air pollution, chronic stress, and changes in exhaled nitric oxide and lung function among a panel of children with asthma living in an underresourced community.

We examined associations between short-term exposure to traffic-related air pollutants (TRAP) and airway inflammation and lung function in children with asthma, and whether these associations are modified by chronic psychological stress. Residents of underresourced port-adjacent communities in New Jersey were concerned about the cumulative impacts of exposure to TRAP, particularly diesel-engine truck emissions, and stress on exacerbation of asthma among children. Children with asthma aged 9-14 (n = 35) were recruited from non-smoking households. We measured each participant's (1) continuous personal exposure to black carbon (BC, a surrogate of TRAP) at 1-min intervals, (2) 24-h integrated personal exposure to nitrogen dioxide (NO2), (3) daily fractional exhaled nitric oxide (FeNO), and (4) lung function for up to 30 consecutive days. Personal BC was recorded by micro-aethalometers. We measured daily FeNO using the NIOX MINO, forced expiratory volume in one second (FEV1), and forced vital capacity (FVC) using Easy One Frontline spirometers. Chronic stress was measured with the UCLA Life Stress Interview for Children. The association was examined using linear mixed-effect models. In the fully adjusted model, an interquartile range (IQR) increase in BC at lag 0-6 h before the FeNO measurement was associated with 8 % (95 % CI: 3 % - 12 %) increase in FeNO, whereas an IQR increase in BC at lag 7-12 h and lag 0-24 h were associated with 6 % (95 % CI: 2 % - 11 %) and 7 % (2 % - 12 %) FeNO increases, respectively. There were no significant lung function changes per IQR increase in BC. No interactions were observed between chronic stress and BC on FeNO. Chronic stress was negatively associated with individual average FeNO levels. Our findings suggest that higher levels of BC exposure within the prior 24 h increased airway inflammation levels in children with asthma, with the strongest effect observed within the first 6 h.

Accuracy and safety of 3D printed surgical guides combined with monitored guidewires for placement of cervicothoracic pedicle screws: Technical note.

Subaxial cervical pedicle screws provide rigid fixation, but their placement poses an important neurovascular injury risk. 3D printed guides have successfully been used to place pedicle screws, but experience in the subaxial cervical spine is limited. We present a case of cervicothoracic dissociation after a pathological fracture due to tumour involvement of the upper thoracic spine, causing paraparesis and intense pain. The cervicothoracic junction is of difficult visualization on fluoroscopy and the patients' severe instability made navigation unreliable. 3D printed individualized guidewire guides were used to help place canulated pedicle screws from C4 to T6. We successfully report the use of impedance guidewire monitoring to prevent pedicle violation and improve procedure safety.

Exposure to traffic-related air pollution and changes in exhaled nitric oxide and DNA methylation in arginase and nitric oxide synthase in children with asthma.

BACKGROUND: Traffic-related air pollution (TRAP) has been associated with increased risk of airway inflammation in children with asthma. While epigenetic changes could potentially modulate TRAP-induced inflammatory responses, few studies have assessed the temporal pattern of exposure to TRAP, epigenetic changes and inflammation in children with asthma. Our goal was to test the time-lag patterns of personal exposure to TRAP, airway inflammation (measured as fractional exhaled nitric oxide, FeNO), and DNA methylation in the promoter regions of genes involved in nitric oxide synthesis among children with asthma. METHODS: We measured personal exposure to black carbon (BC) and FeNO for up to 30 days in a panel of children with asthma. We collected 90 buccal cell samples for DNA methylation analysis from 18 children (5 per child). Methylation in promoter regions of nitric oxide synthase (NOS1, NOS2A, NOS3) and arginase (ARG1, ARG2) was assessed by bisulfite pyrosequencing. Linear-mixed effect models were used to test the associations of BC at different lag periods, percent DNA methylation at each site and FeNO level. RESULTS: Exposure to BC was positively associated with FeNO, and negatively associated with DNA methylation in NOS3. We found strongest association between FeNO and BC at lag 0-6 h while strongest associations between methylation at positions 1 and 2 in NOS3 and BC were at lag 13-24 h and lag 0-24 h, respectively. The strengths of associations were attenuated at longer lag periods. No significant associations between exposure to TRAP and methylation levels in other NOS and ARG isoforms were observed. CONCLUSIONS: Exposure to TRAP was associated with higher levels of FeNO and lower levels of DNA methylation in the promoter regions of the NOS3 gene, indicating that DNA methylation of the NOS3 gene could be an important epigenetic mechanism in physiological responses to TRAP in children with asthma.

Neuropathic pain in rheumatoid arthritis and its association with Afro-descendant ethnicity: a hierarchical analysis.

BACKGROUND: nociceptive pain from joint damage caused by autoimmune inflammatory disease is expected in rheumatoid arthritis. However, neuropathic pain also occurs and persists even with the disease under control. This study aimed to investigate factors associated with neuropathic pain in rheumatoid arthritis by considering sociodemographic and behavioral data as well as lifestyle and clinical aspects in a self-referenced afro-descendant ethnicity sample. METHODS: In a cross-sectional study, the Douleur Neuropathique 4, Health Assessment Questionnaire, the Hospital Anxiety and Depression Scale and sociodemographic characteristics were used. Additionally, a Bivariate analysis was performed, followed by hierarchical multiple logistic regression, with results expressed as odds ratio and 95% confidence intervals. RESULTS: the frequency of NP was at a proximal level consisting of clinical characteristics related to anxiety (p=0.03) and depression (p=0.04). When a hierarchical multiple logistic regression analysis was conducted, an independent association was identified between neuropathic pain and black race. At the third and fourth stages, when the clinical variables were adjusted by race, an association was found with moderate functionality (p=0.04) and anxiety (p=0.04). CONCLUSION: neuropathic pain in rheumatoid arthritis is related to the Afro-descendant ethnicity that affects functionality and anxiety levels.

Spinal cord glioblastoma during pregnancy: Case report.

Spinal Cord Glioblastoma Multiforme (SCGBM) is a very rare, debilitating and often fatal tumor. Cases of intracranial GBM during pregnancy have been reported, and as other tumor occurring in this setting, it harbors a great dilemma to attending physicians and families. We report the first case of a SCGBM diagnosed during pregnancy and discuss its management and treatment.

Synthesis of thermoelectric magnesium-silicide pastes for 3D printing, electrospinning and low-pressure spray.

In this work, eco-friendly magnesium-silicide (Mg2Si) semiconducting (n-type) thermoelectric pastes for building components concerning energy-harvesting devices through 3D printing, spray and electrospinning were synthetized and tested for the first time. The Mg2Si fine powders were obtained through the combination of ball milling and thermal annealing under Ar atmosphere. While the latter process was crucial for obtaining the desired Mg2Si phase, the ball milling was indispensable for homogenizing and reducing the grain size of the powders. The synthetized Mg2Si powders exhibited a large Seebeck coefficient of ~ 487 µV/K and were blended with a polymeric solution in different mass ratios to adjust the paste viscosity to the different requirements of 3D printing, electrospinning and low-pressure spray. The materials produced in every single stage of the paste synthesis were characterized by a variety of techniques that unequivocally prove their viability for producing thermoelectric parts and components. These can certainly trigger further research and development in green thermoelectric generators (TEGs) capable of adopting any form or shape with enhanced thermoelectric properties. These green TEGs are meant to compete with common toxic materials such as Bi2Te3, PbTe and CoSb that have Seebeck coefficients in the range of ~ 290-700 µV/K, similar to that of the produced Mg2Si powders and lower than that of 3D printed bulk Mg2Si pieces, measured to be ~ 4866 µV/K. Also, their measured thermal conductivities proved to be significantly lower (~ 0.2 W/mK) than that reported for Mg2Si (≥ 4 W/mK). However, it is herein demonstrated that such thermoelectric properties are not stable over time. Pressureless sintering proved to be indispensable, but difficultly achievable by long thermal annealing (even above 32 h) in inert atmosphere at 400 °C, at least for bulk Mg2Si pieces constituted by a mean grain size of 2-3 µm. Hence, for overcoming this sintering challenge and become the silicide's extrusion viable in the production of bulk thermoelectric parts, alternative pressureless sintering methods will have to be further explored.

Treating low back pain with combined cerebral and peripheral electrical stimulation: A randomized, double-blind, factorial clinical trial.

BACKGROUND: Recent evidence suggests that chronic low back pain is associated with plastic changes in the brain that can be modified by neuromodulation strategies. This study investigated the efficacy of transcranial direct current stimulation (tDCS) combined simultaneously with peripheral electrical stimulation (PES) for pain relief, disability and global perception in patients with chronic low back pain (CLBP). METHODS: Ninety-two patients with CLBP were randomized to receive 12 sessions on nonconsecutive days of anodal tDCS (primary motor cortex, M1), 100 Hz sensory PES (lumbar spine), tDCS + PES or sham tDCS + PES. Pain intensity (11-point numerical rating scale), disability and global perception were applied before treatment and four weeks, three months and six months post randomization. RESULTS: A two points reduction was achieved only by the tDCS + PES (mean reduction [MR] = -2.6, CI95% = -4.4 to -0.9) and PES alone (MR = -2.2, CI95% = -3.9 to -0.4) compared with the sham group, but not of tDCS alone (MR = -1.7, CI95% = -3.4 to -0.0). In addition to maintaining the analgesic effect for up to three months, tDCS + PES had a higher proportion of respondents in different cutoff points. Global perception was improved at four weeks and maintained three months after treatment only with tDCS + PES. None of the treatments improved disability and the affective aspect of pain consistently with pain reduction. CONCLUSION: The results suggest that tDCS + PES and PES alone are effective in relieving CLBP in the short term. However, only tDCS + PES induced a long-lasting analgesic effect. tDCS alone showed no clinical meaningful pain relief. SIGNIFICANCE: Transcranial direct current stimulation combined simultaneously with PES leads to a significant and clinical pain relief that can last up to three months in chronic low back pain patients. For this article, a commentary is available at the Wiley Online Library.

Effect of fixation time on breast biomarker expression: a controlled study using cell line-derived xenografted (CDX) tumours.

AIMS: Altering the length of time specimens are placed in fixative without compromising analytical testing accuracy is a continuous challenge in the anatomical pathology lab. The aim of this study was to determine under controlled conditions the effects of variable fixation time on breast biomarker expression in human breast cancer cell line-derived xenografted (CDX) tumours. METHODS: CDX tumours using strong oestrogen receptor (ER)-positive, Her2-negative (MCF7) and weak ER-positive, Her2 equivocal (T47D) breast cancer cell lines were fixed for various times ranging from 1 to 336 hours in 10% neutral buffered formalin. CDX tumours were processed according to routine biomarker testing protocols and stained for ER and Her2 immunohistochemistry (IHC) and processed for HER2 fluorescence in situ hybridisation (FISH). The tumours were evaluated using Allred scoring for ER and current ASCO/CAP guidelines for Her2, and by objective cell counting methodology. RESULTS: No differences were found in expression of ER in either MCF7 or T47D CDX tumours under variable fixation. T47D tumours displayed equivocal Her2 staining when fixed for 24 hours, but fixation for ≤8 hours resulted in consistently negative staining while tumours fixed for >72 hours demonstrated consistent equivocal staining (p<0.01). Cell counting assays revealed only a significant increase in sensitivity in tumours fixed for >72 hours (p<0.01). As expected, FISH results were unaffected by variable fixation. CONCLUSIONS: Neither shortened nor prolonged fixation affects ER expression, consistent with previous findings. In equivocal Her2-expressing tumours, however, increasing fixation increased the sensitivity of Her2 IHC reporting while not affecting FISH.

[Psychometric approach of metacognition: Pilot study in clinical population]. / Approche psychométrique de la métacognition : étude pilote en population clinique.

BACKGROUND: Metacognition describes the process of thinking about one's own thought processes. This concept was introduced by Flavell in 1979 and has since been widely developed in the cognitive approach to mood and anxiety disorders. As it happens, many recent studies have underlined the links between metacognition and anxio-depressive symptoms, pointing out the interest of assessing its various dimensions. The short form of the Metacognitions Questionnaire is a brief multidimensional measure of a range of metacognitive processes and metacognitive beliefs about worry and cognition relevant to the vulnerability to and the maintenance of emotional disorders. The aim of this study was twofold: firstly to adapt and validate a French version of the short form of the Metacognitions Questionnaire (MCQ-30) and to assess its psychometric properties in a clinical sample, and secondly to investigate metacognitive predictors of anxiety and depression in this sample. METHOD: The sample included 55 clinical participants (24 men, 31 women, mean age=51.33±14.62) with DSM-IV-TR psychiatric disorders (major depression, bipolar disorder and obsessive-compulsive disorder). Instrument reliability (internal consistency), construct validity (confirmatory factor analysis), and convergent validity were measured. The total score and the five subscale scores were also compared with previous results in non-clinical samples. RESULTS: Reliability analyses indicated that the French version of the MCQ-30 possessed satisfactory internal consistency (Cronbach α=0.84), and confirmatory factor analysis supported the MCQ's original five-factor structure. Correlation with measurements of depression, anxiety and pathological worry demonstrated convergent validity (r=0.62, P<0.01 for anxiety; r=0.47, P<0.01 for rumination; r=0.33, P<0.05 for depression). Moreover, our clinical sample scored higher on the global scale when compared to previous non-clinical samples (mean score=71.85±13.57 while previous studies global scores ranged from 48.41±13.31 to 65.89±17.17). Consistent with others studies, negative beliefs about worry concerning uncontrollability and danger, as well as beliefs about the need to control thoughts were the strongest predictors of pathological worry (respectively r=0.68, P<0.01 and r=0.48, P<0.01) and depression (respectively r=0.45, P<0.01 and r=0.39, P<0.01), providing further support for the validity of the measure. CONCLUSION: These findings provide general support for the internal consistency of the French version of the MCQ-30, as well as its five-factor structure and its good concurrent validity in a clinical sample. They also confirm that this version is a valuable tool for the assessment of various dimensions of metacognition, in relation to the anxio-depressive symptomatology and the subsequent management of patients.

Effects of 5-hydroxytryptophan and m-hydroxybenzylhydrazine associated to Lactobacillus spp. on the humoral response of broilers challenged with Salmonella Enteritidis.

This study investigates the effects of different doses of serotonin, its precursor 5-hydroxytry-ptophan (5HTP), and m-hydroxybenzylhydrazine inhibitor (NSD1015), administered via intraperitoneal for 5 consecutive days, on behavior and average body weight of broilers. We also measured the humoral immune response and quantification of Salmonella Enteritidis in broilers chickens that received the drugs evaluated and a Lactobacillus pool. The study was divided into 3 experiments: Experiment 1--administration of pharmaceuticals with choice of dosage; Experiment 2--administration of pharmaceuticals and a Lactobacillus pool in birds that were not challenged with S. Enteritidis, and Experiment 3--administration of pharmaceuticals and a Lactobacillus pool in birds challenged with S. Enteritidis. The ELISA was used to scan dosages of intestinal IgA and serum IgY. We used colony-forming units to quantify S. Enteritidis. The concentrations of IgA and IgY did not show significant differences (P>0.05) in Experiment 2. In Experiment 3, NSD1015 associated with Lactobacillus determined higher IgA concentrations, promoting greater stimulus to the immune system than 5HTP. Regarding quantification of S. Enteritidis in the cecal content of birds, 5HTP associated to Lactobacillus determined the smallest number of bacteria, showing possible interaction of 5-hydroxytryptophan and Lactobacillus spp. with the immune system of broiler chickens.

Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomised-controlled trial.

To evaluate the effect of adding transcranial direct current stimulation (tDCS) to exercises for chronic pain, dysfunction and quality of life in subjects with temporomandibular disorders (TMD). Participants were selected based on the RDC/TMD criteria and assessed for pain intensity, pressure pain threshold over temporomandibular joint and cervical muscles and quality of life. After initial assessment, all individuals underwent a 4-week protocol of exercises and manual therapy, together with active or sham primary motor cortex tDCS. Stimulation was delivered through sponge electrodes, with 2 mA amplitude, for 20 min daily, over the first 5 days of the trial. A total of 32 subjects (mean age 24.7 ± 6.8 years) participated in the evaluations and treatment protocol. Mean pain intensity pre-treatment was 5.5 ± 1.4 for active tDCS group, and 6.3 ± 1.2 for sham tDCS. Both groups showed a decrease in pain intensity scores during the trial period (time factor--F(4.5,137.5) = 28.7, P < 0.001; group factor--F(1.0,30.0 = 7.7), P < 0.05). However, there were no differences between the groups regarding change in pain intensity (time*group interaction--F(4.5,137.5) = 1.5, P = 0.137). This result remained the same after 5 months (t-test t = 0.29, P > 0.05). Pressure pain thresholds decrease and improvement in quality of life were also noticeable in both groups, but again without significant differences between them. Absolute benefit increase was 37.5% (CI 95%: -15.9% to 90.9%), and number needed to treat was 2.66. This study suggests that there is no additional benefit in adding tDCS to exercises for the treatment of chronic TMD in young adults.

Outcomes in obese kidney transplant recipients.

BACKGROUND: Kidney transplantation (KT) in obese patients is controversial. The present study aimed to evaluate patient and graft survival and post-transplantation complications between obese and nonobese recipients. METHODS: Patients (n = 3,054) receiving a KT from 1998 to 2008 were divided according to body mass index (BMI) into 3 groups for analysis: group I: BMI <30 kg/m(2) (nonobese); group II: ≥30-34.9 kg/m(2) (class I obese); and group III: ≥35 kg/m(2) (class II and III obese). RESULTS: Mean BMIs were: group I (n = 2,822): 22.6 ± 3.3 kg/m(2); group II (n = 185): 31.9 ± 1.3 kg/m(2); and group III (n = 47): 36.8 ± 1.7 kg/m(2). There were no differences among the 3 groups in patient demographic variables regarding race, sex, or organ source. One-year (I, 98%; II, 98%; III, 95%) and 5-year (I, 90%; II, 92%; III, 89%) patient survival rates were similar among groups. Graft survival rates at 1 year were 96% for groups I and II and 91.5% for group III. Five-year graft survivals were: I, 81%; II, 96%; and III, 79%. The most common cause of graft loss was death, and the main cause of death was infection in all groups. Obese patients were more likely to experience wound dehiscence (I, 1.9%; II, 7.6%; III, 19.1%; P < .001), develop new-onset diabetes after transplantation (NODAT; I, 16.2%; II, 27%; III, 36%; P < .001), and have a prolonged length of hospital stay (I, 11.3 ± 11.4 d; II, 14.5 ± 14.3 d; III, 15.9 ± 16.7 d; P < .001). CONCLUSIONS: Obese recipients demonstrated outcomes similar to nonobese patients regarding patient and graft survival. However, they had higher rates of prolonged length of hospital stay, wound dehiscence, and NODAT.

Interaction of bone-dental implant with new ultra low modulus alloy using a numerical approach.

Although mechanical stress is known as being a significant factor in bone remodeling, most implants are still made using materials that have a higher elastic stiffness than that of bones. Load transfer between the implant and the surrounding bones is much detrimental, and osteoporosis is often a consequence of such mechanical mismatch. The concept of mechanical biocompatibility has now been considered for more than a decade. However, it is limited by the choice of materials, mainly Ti-based alloys whose elastic properties are still too far from cortical bone. We have suggested using a bulk material in relation with the development of a new beta titanium-based alloy. Titanium is a much suitable biocompatible metal, and beta-titanium alloys such as metastable TiNb exhibit a very low apparent elastic modulus related to the presence of an orthorhombic martensite. The purpose of the present work has been to investigate the interaction that occurs between the dental implants and the cortical bone. 3D finite element models have been adopted to analyze the behavior of the bone-implant system depending on the elastic properties of the implant, different types of implant geometry, friction force, and loading condition. The geometry of the bone has been adopted from a mandibular incisor and the surrounding bone. Occlusal static forces have been applied to the implants, and their effects on the bone-metal implant interface region have been assessed and compared with a cortical bone/bone implant configuration. This work has shown that the low modulus implant induces a stress distribution closer to the actual physiological phenomenon, together with a better stress jump along the bone implant interface, regardless of the implant design.

Immune response of broiler chickens immunized orally with the recombinant proteins flagellin and the subunit B of cholera toxin associated with Lactobacillus spp.

This study investigated the immune response of broiler chickens with oral treatment of a Lactobacillus spp. pool (PL) associated with microencapsulated recombinant proteins flagellin (FliC) and the subunit B of cholera toxin (CTB). Immune responses were evaluated by measuring IgA from intestinal fluid, serum IgY, and immunostaining of CD8(+) T lymphocytes present in the cecum. The evaluations were performed on d 0, 7, 14, 21, and 28 posttreatment. A significant increase (P < 0.05) was observed in IgA levels in all immunized groups, especially 3 wk after immunization. Treatments 2 (recombinant CTB) and 3 (recombinant FliC+CTB) showed the highest concentrations. Similarly, serum concentrations IgY (µg/mL) increased along the experiment, and the means for treatments 2 and 3 showed significant differences (P < 0.05) compared with controls, reaching concentrations of 533 and 540 µg/mL, respectively. The number of CD8(+) T lymphocytes in all treatments greatly differed (P < 0.05) compared with the negative control at 21 d posttreatment. However, only treatment 2 (recombinant CTB), 4 (PL), and 5 (recombinant FliC+ recombinant CTB + PL) remained significantly (P < 0.05) different from the control at 28 d posttreatment. Thus, it is concluded that the microencapsulated recombinant proteins administered orally to broiler chickens are capable of stimulating humoral and cellular immune response, and the combinations of these antigens with Lactobacillus spp. can influence the population of CD8(+) T cells residing in the cecum.

Colonic patch and colonic SILT development are independent and differentially regulated events.

Intestinal lymphoid tissues have to simultaneously ensure protection against pathogens and tolerance toward commensals. Despite such vital functions, their development in the colon is poorly understood. Here, we show that the two distinct lymphoid tissues of the colon-colonic patches and colonic solitary intestinal lymphoid tissues (SILTs)-can easily be distinguished based on anatomical location, developmental timeframe, and cellular organization. Furthermore, whereas colonic patch development depended on CXCL13-mediated lymphoid tissue inducer (LTi) cell clustering followed by LTα-mediated consolidation, early LTi clustering at SILT anlagen did not require CXCL13, CCR6, or CXCR3. Subsequent dendritic cell recruitment to and gp38(+)VCAM-1(+) lymphoid stromal cell differentiation within SILTs required LTα; B-cell recruitment and follicular dendritic cell differentiation depended on MyD88-mediated signaling, but not the microflora. In conclusion, our data demonstrate that different mechanisms, mediated mainly by programmed stimuli, induce the formation of distinct colonic lymphoid tissues, therefore suggesting that these tissues may have different functions.