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An Amendment to this paper has been published and can be accessed via a link at the top of the paper.
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The electrochemical synthesis of ammonia from nitrogen under mild conditions using renewable electricity is an attractive alternative1-4 to the energy-intensive Haber-Bosch process, which dominates industrial ammonia production. However, there are considerable scientific and technical challenges5,6 facing the electrochemical alternative, and most experimental studies reported so far have achieved only low selectivities and conversions. The amount of ammonia produced is usually so small that it cannot be firmly attributed to electrochemical nitrogen fixation7-9 rather than contamination from ammonia that is either present in air, human breath or ion-conducting membranes9, or generated from labile nitrogen-containing compounds (for example, nitrates, amines, nitrites and nitrogen oxides) that are typically present in the nitrogen gas stream10, in the atmosphere or even in the catalyst itself. Although these sources of experimental artefacts are beginning to be recognized and managed11,12, concerted efforts to develop effective electrochemical nitrogen reduction processes would benefit from benchmarking protocols for the reaction and from a standardized set of control experiments designed to identify and then eliminate or quantify the sources of contamination. Here we propose a rigorous procedure using 15N2 that enables us to reliably detect and quantify the electrochemical reduction of nitrogen to ammonia. We demonstrate experimentally the importance of various sources of contamination, and show how to remove labile nitrogen-containing compounds from the nitrogen gas as well as how to perform quantitative isotope measurements with cycling of 15N2 gas to reduce both contamination and the cost of isotope measurements. Following this protocol, we find that no ammonia is produced when using the most promising pure-metal catalysts for this reaction in aqueous media, and we successfully confirm and quantify ammonia synthesis using lithium electrodeposition in tetrahydrofuran13. The use of this rigorous protocol should help to prevent false positives from appearing in the literature, thus enabling the field to focus on viable pathways towards the practical electrochemical reduction of nitrogen to ammonia.
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Green ammonia is an efficient, carbon-free energy carrier and storage medium. The ammonia synthesis using green hydrogen requires an active catalyst that operates under mild conditions. The catalytic activity can be promoted by controlling the geometry and electronic structure of the active species. An exsolution process is implemented to improve catalytic activity by modulating the geometry and electronic structure of Ru. Ru nanoparticles exsolved on a BaCe0.9 Y0.1 O3-δ support exhibit uniform size distribution, 5.03 ± 0.91 nm, and exhibited one of the highest activities, 387.31 mmolNH3 gRu -1 h-1 (0.1 MPa and 450 °C). The role of the exsolution and BaCe0.9 Y0.1 O3-δ support is studied by comparing the catalyst with control samples and in-depth characterizations. The optimal nanoparticle size is maintained during the reaction, as the Ru nanoparticles prepared by exsolution are well-anchored to the support with in-plane epitaxy. The electronic structure of Ru is modified by unexpected in situ Ba promoter accumulation around the base of the Ru nanoparticles.
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OBJECTIVE: Cervical cancer screening is as important in female-to-male transgender (FTMT) patients as it is in cisgender female patients. The aim of this study was to examine the impact of clinical information regarding gender identity and testosterone therapy on the cytological interpretations. METHODS: A list of FTMT patients and cisgender female patients who had received a cervical Papanicolaou (Pap) test for cancer screening was obtained. The cytological diagnoses, rendered at the time of collection, were recorded. A retrospective slide review with knowledge of the pertinent clinical information, including testosterone therapy status, was performed. The data sets were statistically compared. RESULTS: Of 122 cervical Pap tests in 111 FTMT individuals, 23 (19%) had surgical follow-ups; 73 (60%) had HPV testing, of which 12 (16%) were positive for high-risk strains; and 79 (65%) were known to be receiving testosterone. On the "original" review, 12 (9.8%) tests were diagnosed as unsatisfactory. Seventy-one (58%) Pap tests were initially diagnosed as negative for intraepithelial lesion or malignancy (NILM) without atrophy and 32 (26%) with atrophy. Seven (5.7%) of the tests were initially diagnosed as abnormal. On the "retrospective" review, the rate of unsatisfactory tests remained the same, and atrophy was observed in 76 (62%) tests. The number of abnormal tests was reduced to 4 (3.3%) after the retrospective review. Almost all comparative studies returned a P-value of ≤0.05. CONCLUSION: Our findings indicate that clinical information regarding whether a subject is transgender and/or is receiving testosterone therapy is crucial to avoiding Pap test overcalls.
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Infecções por Papillomavirus , Pessoas Transgênero , Displasia do Colo do Útero , Neoplasias do Colo do Útero , Humanos , Feminino , Masculino , Teste de Papanicolaou , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal , Displasia do Colo do Útero/patologia , Detecção Precoce de Câncer , Identidade de Gênero , Testosterona , Infecções por Papillomavirus/patologia , PapillomaviridaeRESUMO
BACKGROUND: This article reports an evaluation of the Immunization Training Challenge Hackathons (ITCH), invented by The Geneva Learning Foundation (TGLF) for national and sub-national immunization staff who strive to develop the knowledge and capacity of others to improve immunization program performance. ITCH, a fully-digital program focused on networked collaborative problem-solving between peers, provided an "opt-in" activity for learners in the Teach to Reach (T2R) Accelerator Program designed to improve training effectiveness in the immunization sphere. METHODS: Conducted by a team from the University of Georgia, this mixed method evaluation consisted of thematic analysis of recorded sessions and open-ended comments; and statistical analyses of application and follow-up survey data. The evaluation focused on what was learned and how ITCH participants implemented what they learned. Key stakeholder interviews provided supplemental data about program intent and results. ITCH consisted of 17 30-min sessions held in 2020, in English and French, with 581 participating at least once out of 1,454 enrolled in the overall program. Challenge owners and respondents came from 15 African and Asian countries and spanned different roles with differing scope. RESULTS: Over 85% [n = 154] of survey respondents [n = 181, a 31% response rate] indicated they were able to implement what they learned from the ITCH sessions. A majority [n = 139, 76.7%] reported finding the sessions useful. Issues with poor connectivity and the timing of the live meetings impeded some in their ability to participate, a problem compounded by consequences of the pandemic. The ITCH process constituted of learning or coming to consciousness simultaneously of four types of learning - participants realizing how much they could learn from each other (peer learning), experiencing the power of defying distance to solve problems together (remote learning), and feeling a growing sense of belonging to a community (social learning), emergent across country borders and health system levels (networked learning). CONCLUSIONS: Based on evaluation findings, it was concluded that ITCH demonstrated an effective scalable, informal, non-didactic, experience-led, fast-paced, peer learning design. A focus on community engagement and developing brokering skills was recommended.
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Imunização , Saúde Pública , Humanos , Programas de Imunização , Grupo Associado , Resolução de ProblemasRESUMO
Background and Objectives: The purpose of the present study was to investigate the anti-bacterial efficacy of passive ultrasonic irrigation (PUI) and a 980-nm-gallium-aluminum-arsenide (GaAlAs) laser using a real-time DNA-based quantitative polymerase chain reaction (qPCR) assay and scanning electron microscopy (SEM). Materials and Methods: Eighty-six extracted single- and double-rooted human teeth were used in the experiment. The following four experimental groups were evaluated, as well as a control group: group 1: single root + PUI (n = 20); group 2: single root + laser application (n = 20); group 3: double roots + PUI (n = 20); group 4: double roots + laser application (n =20); control group (n = 6): 3 single roots, 3 double roots. The qPCR assay was performed in three stages to evaluate the efficacy of the adjunctive method against Enterococcus faecalis. SEM analysis was also used to examine the microstructure of root canal surfaces. The data were statistically analyzed using the Friedman test and the Kruskal-Wallis test with Bonferroni adjustment. Results: The decrease in the DNA levels from S1 (before preparation) to S2 (just after preparation) was highly significant in all groups, and decreases in DNA levels from S2 to S3 (after incubation for 1 week) were found in all experimental groups except group 1. An inter-group analysis showed that PUI was significantly more effective in terms of antibacterial efficacy than GaAlAs laser irradiation in single root (p < 0.05). However, in double roots, experimental groups did not show significantly lower DNA levels than the control group (p > 0.05). SEM images showed that cleaning of the root canal surface and reduction of dentin debris were achieved only in single-rooted teeth when using PUI application. Conclusions: Two adjunctive methods were effective in reducing E. faecalis in single rooted tooth.
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Irrigantes do Canal Radicular , Hipoclorito de Sódio , Humanos , Lasers Semicondutores/uso terapêutico , Irrigação Terapêutica , UltrassomRESUMO
This study aimed to investigate the effects of the luting methods on the amount of cement remnants in implant restorations and to determine the restoration surface with the maximum amount of residual cement. Forty abutments and crowns were divided into 4 groups as follows: TB group, luting with zinc oxide-eugenol cement; TBV group, luting with zinc oxide-eugenol cement after application of a separating agent over the transmucosal area of the abutment; PI group, luting with methacrylate cement; and PIV group, luting with methacrylate cement after application of a separating agent. After cementation, all the quadrants of the specimens were photographed, and the amount and location of the cement remnants were statistically analyzed (P ≤ .05). The amount of cement remnants was significantly smaller in the groups with a separating agent. The type of luting material did not significantly affect the results. Cement remnants were more abundant on the mesial and distal sides than on the buccal and lingual sides of the restoration.
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Dente Suporte , Cimentos Dentários , Cimentação , Coroas , Prótese Dentária Fixada por ImplanteAssuntos
Neoplasias dos Ductos Biliares/diagnóstico , Ductos Biliares/patologia , Carcinoma Papilar/diagnóstico , Colangite Esclerosante/complicações , Colestase/diagnóstico , Neoplasias dos Ductos Biliares/etiologia , Neoplasias dos Ductos Biliares/patologia , Ductos Biliares/diagnóstico por imagem , Carcinoma Papilar/etiologia , Carcinoma Papilar/patologia , Colangiopancreatografia Retrógrada Endoscópica , Colangite Esclerosante/patologia , Colestase/etiologia , Colestase/patologia , Endossonografia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The purpose of this study was to analyze the characteristics of cracked teeth and to evaluate pulp status according to periodontal probing depth (PPD). METHODS: A total of 182 cracked teeth were included. The location and type of the cracked teeth, age and gender of the patients, restoration type, pulp status, PPD, and radiographic findings were analyzed. RESULTS: Mandibular second molars (25.3%) were the most frequently involved teeth, followed by mandibular first molars (22.5%), maxillary first molars (22.0%), and maxillary second molars (17.6%). The patient age was most frequently 50-59 years. Cracks occurred mainly in nonbonded restorations, such as gold (26.9%), and were usually found in intact teeth (37.9%). A total of 103 teeth (56.6%) had an initial PPD of less than 3 mm, while 40 (22.0%) had a PPD of 4-6 mm, and 39 (21.4%) had PPD of 7 mm or more. A total of 33 cracked teeth (18.1%) were diagnosed with pulp necrosis, 40 (22.0%) with irreversible pulpitis, and 97 (53.3%) with reversible pulpitis. The incidence of pulp necrosis was 31.8% among cracked teeth with a PPD of 4-6 mm, and 28.6% among those with a PPD of 7 mm or more. CONCLUSIONS: Cracks occurred mainly in molar teeth, and were commonly found in intact teeth with no restoration. Patients with cracked teeth were most frequently aged 50-59 years. Cracked teeth showing a PPD of more than 4 mm were more likely to show pulp necrosis.
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Síndrome de Dente Quebrado/epidemiologia , Necrose da Polpa Dentária/diagnóstico , Pulpite/diagnóstico , Adulto , Distribuição por Idade , Idoso , Síndrome de Dente Quebrado/diagnóstico , Polpa Dentária/diagnóstico por imagem , Restauração Dentária Permanente/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Radiografia Dentária , Adulto JovemRESUMO
By employing the phenomenographic approach, the present study explored children's cognitive understanding of and emotional responses to death and bereavement. Participants included 52 Korean, 16 Chinese, and 16 Chinese American children ages 5-6. Thematic analysis of children's drawings and open-ended interviews revealed that most children associated death with negative emotions such as fear, anxiety, and sadness. The majority of children used realistic expressions to narrate death. The core themes from their drawings included causes for death, attempts to stop the dying, and situations after death. This study contributes to the literature by targeting young children who have been relatively excluded in death studies and provides evidence in the usefulness of drawings as a developmentally appropriate data collection tool. The findings also enrich our knowledge about children's understanding of death and bereavement, rooted in the inductive analysis of empirical data with children from culturally diverse backgrounds.
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Atitude Frente a Morte , Luto , Comparação Transcultural , Arte , Asiático/psicologia , Asiático/estatística & dados numéricos , Criança , Pré-Escolar , China/etnologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , República da Coreia/etnologia , Estados UnidosRESUMO
High levels of stress, anxiety and depression have been reported in patients with orofacial pain. Dental pain has the potential to reduce quality of life (QOL), and pain relief is important aspect of QOL. The purpose of this study was to assess the relationships of dental pain with QOL and mental health using a nationally representative, population-based study. This study analyzed data from the 2012 Korea National Health and Nutrition Examination Survey (N = 5469). Oral health status was assessed using the oral health questionnaire, and oral examination was performed by trained dentists. Health-related QOL (HRQOL) was evaluated using EQ-5D and EQ-VAS, and mental health was evaluated by questionnaires. Logistic regression was applied to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI). Among 5469 adults, 1992 (36.42%) presented self-reported dental pain. Participants with anxiety/depression or pain/discomfort, and participants with stress, melancholy, suicidal thought or depression showed significantly higher prevalence of dental pain. After adjusting for covariates, five aspects of QOL and five aspects of mental health were related with dental pain. The AORs (95% CI) for dental pain were 1.39 (1.06-1.81) for mobility, 1.77 (1.19-2.63) for self-care, 1.38 (1.02-1.85) for usual activities, 1.73 (1.43-2.09) for pain/discomfort and 1.50 (1.13-1.98) for anxiety/depression. For mental health status factors, the AORs (95% CI) for dental pain were 1.29 (1.11-1.51) for stress, 1.37 (1.09-1.74) for melancholy, 1.26 (1.01-1.58) for suicidal thoughts, 1.43 (.93-2.19) for consultation to psychiatrist and 1.53 (1.07-2.19) for depression. This study showed that dental pain has an association with lower HRQOL and worse mental health status in South Korean adults.
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Transtornos Mentais/epidemiologia , Qualidade de Vida , Odontalgia/epidemiologia , Adulto , Idoso , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologiaRESUMO
As a catalyst, single-atom platinum may provide an ideal structure for platinum minimization. Herein, a single-atom catalyst of platinum supported on titanium nitride nanoparticles were successfully prepared with the aid of chlorine ligands. Unlike platinum nanoparticles, the single-atom active sites predominantly produced hydrogen peroxide in the electrochemical oxygen reduction with the highest mass activity reported so far. The electrocatalytic oxidation of small organic molecules, such as formic acid and methanol, also exhibited unique selectivity on the single-atom platinum catalyst. A lack of platinum ensemble sites changed the reaction pathway for the oxygen-reduction reaction toward a two-electron pathway and formic acid oxidation toward direct dehydrogenation, and also induced no activity for the methanol oxidation. This work demonstrates that single-atom platinum can be an efficient electrocatalyst with high mass activity and unique selectivity.
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OBJECTIVE: The aim of this study was to compare the degree of dentinal penetration between an epoxy resin-based sealer applied by using two different filling methods and an ultrasonically activated calcium silicate-based sealer via confocal laser scanning microscopy (CLSM). MATERIALS AND METHODS: Forty-five extracted permanent maxillary premolars with type II canals (Vertucci's classification) were subjected to the experiment. The root canals were instrumented and distributed randomly into the following three groups: AH Plus + continuous wave technique (AHC group); AH Plus + single cone technique (AHS group); and Endoseal MTA + single cone technique with ultrasonic activation (EMS) group. Each sealer was labeled with rhodamine B dye to allow visualization under CLSM. The sealer penetration depth in each sample was observed at 2 mm and 5 mm from the apex by using CLSM. The data were statistically analyzed by using analysis of variance or Kruskal-Wallis H test according to normality of variable (α = 0.05). RESULTS: In all groups, the maximum sealer penetration depth, mean fluorescence intensity, and sum fluorescence intensity values were higher at the 5-mm level than at the 2-mm level. At the 5-mm level, the EMS group showed the lowest value (p = 0.02). At the 2-mm level, there were no statistically significant differences among any of the groups. The AHC group showed higher values than the other groups, but there was no statistically significant difference in the apical area where access of instruments was difficult. CONCLUSION: The AHC group showed the highest dentinal tubule penetration, but had questionable filing efficacy in the apical area, which is of particular importance for the success of root canal treatment. Therefore, in areas such as the apical 2 mm of premolars with type II canals, which are difficult to access by using instruments such as heat carriers, other appropriate approaches may be required accordingly.
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This study investigated the retreatability of EndoSeal MTA (Maruch, Wonju, Korea) according to the presence or absence of a canal isthmus and the additional use of passive ultrasonic irrigation (PUI) through microcomputed tomography (micro-CT) imaging. An epoxy resin sealer (AH Plus (Dentsply DeTrey, Konstanz, Germany)) was used as a reference for comparison. Forty-five artificial mandibular molars (TRUETOOTH #19, DELABS, Santa Barbara, CA) with a mesial canal with an isthmus and a distal canal without an isthmus were obturated using gutta-percha and one of the following sealers (n = 15 each): AH Plus, EndoSeal MTA, and EndoSeal MTA + PUI. Micro-CT scanning was performed to assess the void volume (as a percentage) at three root levels. After the root fillings were removed, second micro-CT scanning was conducted to evaluate the amount of remaining root filling material. The Kruskal-Wallis H test and post hoc analysis were used for between-group comparisons. The Mann-Whitney U test was used for comparisons between canals with and without an isthmus (p < 0.05). In the EndoSeal MTA group, the void volume and remaining filling materials were higher irrespective of the presence or absence of an isthmus. In apical lesions in the EndoSeal MTA group, the void ratio was significantly lower, and there was a significantly higher amount of remaining filling material. Regardless of the presence of an isthmus, the amount of remaining filling material of the EndoSeal + PUI group was reduced to a similar degree as the AH plus group. When performing retreatment for root canals filled with EndoSeal MTA, removal of the filling material can be more difficult in the apical region. The additional use of PUI can improve the efficacy of removal.
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Materiais Restauradores do Canal Radicular , Compostos de Cálcio , Cavidade Pulpar , Resinas Epóxi , Guta-Percha , Retratamento , Obturação do Canal Radicular , Preparo de Canal Radicular , Silicatos , Ultrassom , Microtomografia por Raio-XRESUMO
Ammonia is a promising carbon-free hydrogen carrier. Owing to their nickel-rich anodes and high operating temperatures, solid oxide fuel cells (SOFCs) can directly utilize NH3 fuel-direct-ammonia SOFCs (DA-SOFCs). Lowering the operating temperature can diversify application areas of DA-SOFCs. We tested direct-ammonia operation using two types of thin-film SOFCs (TF-SOFCs) under 500 to 650°C and compared these with a conventional SOFC. The TF-SOFC with a nickel oxide gadolinium-doped ceria anode achieved a peak power density of 1330 mW cm-2 (NH3 fuel under 650°C), which is the best performance reported to date. However, the performance difference between the NH3 and H2 operations was significant. Electrochemical impedance analyses, ammonia conversion quantification, and two-dimensional multi-physics modeling suggested that reduced ammonia conversion at low temperatures is the main cause of the performance gap. A comparative study with previously reported DA-SOFCs clarified that incorporating a more active ammonia decomposition catalyst will further improve low-temperature DA-SOFCs.
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We report a case of atypical de Quervain's thyroiditis diagnosed as atypia of undetermined significance by cytology and suspicious for cancer by Afirma Genomic Sequencing Classifier. A 71-year-old male underwent thyroid ultrasound for goiter and was found to have two American Thyroid Association (ATA) 2015 high-suspicion nodules. The larger, 2.2-cm nodule was biopsied and the cytology showed atypical follicular cells and histiocytes. The Afirma Genomic Sequencing Classifier (detecting mRNA expression profile) result was ''suspicious'' (risk of malignancy ~50%) but Afirma Xpression Atlas (detecting specific mutations) did not find mutations in BRAF V600E, RET/PTC1, or RET/PTC3. The patient saw two endocrine surgeons and two endocrinologists who each recommended hemithyroidectomy. The patient chose to monitor the nodules. A new diagnostic ultrasound performed 3 months after the first one showed that the thyroid was significantly smaller and the previously seen nodules were no longer found. Re-examination of the cellular smears confirmed that the cytological findings were also compatible with de Quervain's thyroiditis. This case illustrates that atypical de Quervain's thyroiditis should be in the differential diagnosis of thyroid nodules for cytologists, radiologists, and clinicians. Furthermore, this case demonstrates that atypical de Quervain's thyroiditis can generate false positive results of molecular tests for indeterminate thyroid nodules.
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Diagnóstico Diferencial , Neoplasias da Glândula Tireoide , Tireoidite , Idoso , Citodiagnóstico/métodos , Perfilação da Expressão Gênica , Humanos , Masculino , Mutação , Oncogenes , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Tireoidite/diagnóstico , Tireoidite/genética , Tireoidite/patologiaRESUMO
Solid oxide cells (SOCs) are promising sustainable and efficient electrochemical energy conversion devices. The application of a bilayer electrolyte comprising wide electrolytic oxide and highly conductive oxide is essential to lower the operating temperatures while maintaining high performance. However, a structurally and chemically ideal bilayer has been unattainable through cost-effective conventional ceramic processes. Here, we describe a strategy of naturally diffused sintering aid allowing the fabrication of defect-free doped-zirconia/doped-ceria bilayer electrolyte with full density and reduced interdiffusion layer at lower sintering temperature owing to the supply of small but appropriate amount of sintering aid from doped zirconia to doped ceria that makes the thermal shrinkages of both layers perfectly congruent. The resulting SOCs exhibit a minimal ohmic loss of 0.09 ohm cm2 and remarkable performances in both fuel cell (power density exceeding 1.3 W cm−2) and electrolysis (current density of −1.27 A cm−2 at 1.3 V) operations at 700°C.
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BACKGROUND: Melastatin (TRPM1), a.k.a. transient receptor potential cation channel, subfamily M, member 1 (TRPM-1) regulates melanocyte differentiation and proliferation. TRPM1 is transcriptionally regulated by the essential melanocyte transcription factor MITF (microphthalmia-associated transcription factor). For the most part, MITF expression is preserved during melanoma progression, while TRPM1 mRNA expression decreases or is completely lost. The loss of TRPM1 is associated with melanomas that are more aggressive. OBJECTIVE: To assess the relationship between TRPM1 mRNA expression and the expression of MITF and nine other markers of melanocytes and melanin-related proteins by immunohistochemistry in normal skin, scars, hair follicles and ordinary melanocytic nevi. METHODS: Samples of normal skin (n = 102; from tumor excisions and plastic procedures), scars (n = 5; from re-excision specimens) and compound melanocytic nevi (n = 4) were evaluated for the presence of TRPM1 mRNA transcripts as detected by chromogenic in situ hybridization (CISH). Immunohistochemical techniques were used to detect melanin-related proteins including: MITF, S100 protein, Mart-1, tyrosinase, Mel5, HMB45, tyrosinase-related protein-1 (TRP1), TRP2 and alpha-melanocyte stimulating hormone (alphaMSH). The labeling index (LI) was defined as the number of intraepidermal cells expressing mRNA or protein per one hundred basal keratinocytes. RESULTS: A wide range of LI was found for all markers (0-33 positive cells/100 keratinocytes). When these LI were compared, no significant differences in the expression of MITF, S100, Mart1, tyrosinase proteins and TRPM1 mRNA were identified. The LI for TRPM1 mRNA expression ranged from 74% of that for MITF to 86% for tyrosinase. The LI for TRP-1, TRP-2 and Mel5 was similar to that of TRPM1, while HMB-45 had a significantly lower LI than all other markers. TRPM1 mRNA correlated most tightly with MITF and tyrosinase expression (r = 0.81 and 0.68, respectively, both p = 0.0001). Likewise, the strongest correlation among all the melanin-related proteins existed between tyrosinase and MITF (r = 0.79, p = 0.0001). There was variable expression of melanin-related proteins when LI were analyzed by anatomic site, patient age, extent of sun-damage and proximity to a melanocytic tumor. Anogenital skin showed the highest and acral skin the lowest LI for TRPM1, MITF, S100 protein, Tyrosinase, Mel5 and HMB45. Advanced age (> 60 years) was associated with decreased TRPM1 expression. Sun-damaged skin exhibited significantly increased LI as measured by MITF, S100 protein, Mart1, tyrosinase and HMB-45, but no differences for TRPM1. However, the MITF-TRPM1 differential (i.e. MITF LI-TRPM1 LI = MITF+TRPM1--melanocytes) was significantly increased in site-matched skin (4.6 +/- 4.4 vs. 1.5 +/- 2.5, p = 0.01). There was a suggestion of reduced LI in normal skin in the proximity of melanoma (from melanoma re-excision specimens) for S100, HMB45 and TRPM1 mRNA. TRPM1 LI was significantly decreased in scars compared to normal skin (5.6 +/- 1.4 vs. 9.7 +/- 4.3, p = 0.02), this was reflected in an increase in the MITF-TRPM1 differential (9.6 +/- 7.5 vs. 3.2 +/- 3.1, p = 0.0001). MITF LI were consistently higher than MSLN LI at all levels of the hair follicle; notably, MITF was expressed by isthmic-bulge cells. In ordinary melanocytic nevi, MITF and TRPM1 expression decreased with melanocyte descent: there was more signal for both markers in superficial epithelioid type A melanocytes than deeper type C melanocytes. CONCLUSIONS: By CISH, TRPM1 mRNA expression is specific for melanocytes and strongly associated with MITF and tyrosinase expression, the latter implicating a mature melanocyte phenotype. However, in normal skin, TRPM1 mRNA expression appears to be dynamic, labeling most but not all melanocytes, with variable expression ostensibly related to local environmental factors.
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Folículo Piloso/fisiologia , Fator de Transcrição Associado à Microftalmia/genética , Nevo Pigmentado/fisiopatologia , Neoplasias Cutâneas/fisiopatologia , Canais de Cátion TRPM/genética , Adulto , Idoso , Biomarcadores/metabolismo , Diferenciação Celular/fisiologia , Cicatriz/metabolismo , Cicatriz/patologia , Cicatriz/fisiopatologia , Epiderme/metabolismo , Epiderme/patologia , Epiderme/fisiologia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Imuno-Histoquímica , Hibridização In Situ , Queratinócitos/citologia , Queratinócitos/fisiologia , Masculino , Melanócitos/citologia , Melanócitos/fisiologia , Mesotelina , Fator de Transcrição Associado à Microftalmia/metabolismo , Pessoa de Meia-Idade , Nevo Pigmentado/metabolismo , Nevo Pigmentado/patologia , RNA Mensageiro/metabolismo , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia , Canais de Cátion TRPM/metabolismo , Adulto Jovem , alfa-MSH/genética , alfa-MSH/metabolismoRESUMO
The objective of this study was to evaluate the association between overweight, obesity and the incidence of advanced dental caries in South Korean adults, using alternate measures. The participants included 376,077 people aged 20 years and older who had health examination at least one time between 2005 and 2008. This evaluation is based on a change of body mass index (BMI) category, for 10 years, using a nationally representative data resource available from the National Health Insurance System. Instead of using decayed, missing, and filled teeth (DMFT), the diagnostic codes which indicate dental caries, pulpal disease and visiting frequency at dental health professionals were used in this case. A multivariate adjusted Cox regression analysis was performed to examine the association between advanced dental caries and BMI. In addition to the BMI, a multivariate analysis of gender, age, lifestyle behaviors and systemic disease information was included. To this end, the hazard ratio (HR) and 95% confidence interval (CI) were calculated. Chiefly, it is noted that the overweight and obese people were more likely to develop advanced dental caries independent of the noted variables. The positive association between high BMI and incidence of advanced dental caries was more prominent in the population's characteristic of people who were in a classification of the elderly and women. Among the health and lifecycle behaviors, smoking or not was found to be one of the factors affecting the results. The alternate method used in this study showed that being overweight and obesity had a direct association with the incidence of advanced dental caries in Korean adults.
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Cárie Dentária/complicações , Cárie Dentária/epidemiologia , Obesidade/complicações , Sobrepeso/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , República da Coreia , Fumar/efeitos adversos , Adulto JovemRESUMO
Background: The surgical management of nodular thyroid disease has been influenced by the advent of molecular diagnostics and recent guidelines recommending a more conservative approach to low-risk thyroid tumors. The purpose of this study was to assess practice changes arising from the early adoption of current literature within a single high-volume center. Methods: A retrospective cohort study of all patients evaluated or surgically treated for known or suspected thyroid cancer at a single institution was performed (2010-2018). We analyzed the yield of diagnostic thyroidectomy for indeterminate (Bethesda III and IV) nodules, the choice of initial operation for likely malignant (Bethesda V and VI) nodules, and the rate of completion thyroidectomy. The Cochran-Armitage test was used to assess the significance of any observed trends. Results: Of 2497 patients who underwent initial thyroidectomy from 2010 to 2018, 1791 patients had a tissue diagnosis of suspected or known thyroid cancer by cytopathology (Bethesda III-VI) or surgical pathology (differentiated thyroid cancer). In patients with likely malignant nodules but no clinical evidence of invasive or metastatic disease, the proportion managed with total thyroidectomy plus prophylactic neck dissection fell from 50% to 10% (p = 0.007). The proportion with likely malignant nodules managed definitively with thyroid lobectomy rose from 2% to 19% (p < 0.001). The rate of completion thyroidectomy for thyroid cancer found in the initial lobectomy specimen declined from 73% to 26% (p < 0.001). Among all patients with cytologically indeterminate nodules (n = 1036), we observed a decrease in the rate of diagnostic thyroidectomy from 67% to 35% over the study period (p = 0.015). Conclusions: The early adoption of new diagnostic technology and management guidelines has manifested in a less aggressive surgical approach to known or suspected thyroid cancer. Long-term follow-up will be required to assess oncologic and patient-centered outcomes arising from this modern strategy.