Contributors: Habelitz, Stefan, Marshall, Grayson, Nurrohman, Hamid
... Abstract Mineralized and sound dentin matrices contain inactive preforms of proteolytic enzymes that may be activated during the demineralization cycle. In this study, we tested the hypothesis that protease inhibitors (PI) preserve demineralized collagen fibrils and other constituents of the dentin matrix and thereby affect the potential for remineralization. Artificial carious lesions with lesion depths of 140 µm were created with acetate buffer (pH=5.0, 66 hours), and remineralized using a polymer-induced-liquid-precursor (PILP) process (pH=7.4, 14 days) containing poly(aspartic acid) (pAsp) as the process-directing agent. De- and remineralizing procedures were performed in the presence or absence of PI. Ultrastructure and mechanical recovery of demineralized dentin following PILP remineralization were examined and measured in water with atomic force microscopy (AFM) and nanoindentation. Nanomechanical properties of hydrated artificial lesions had a low elastic modulus (ER <0.4 GPa) extending about 100 µm into the lesion, followed by a sloped region of about 140 µm depth where values reached those of normal dentin (18.0–20.0 GPa). Mapping of mineral content by both micro-FTIR and micro x-ray computed tomography correlated well with modulus profiles obtained by nanoindentation. Tissue demineralized in the presence of PI exhibited higher elastic moduli (average 2.8 GPa) across the lesion and comprised a narrow zone in the outer lesion with strongly increased modulus (up to 8 GPa; p < 0.05), which might be related to the preservation of non-collagenous proteins that appear to induce calcium phosphate mineral formation even under demineralizing physical-chemical conditions. However, mechanical aspects of remineralization through the elastic modulus change, and the micromorphological aspects with SEM and TEM observation were almost identical with PILP treatments being conducted in the presence or absence of PI. Thus, the application of the protease inhibitors (PI) seemed to be less effective in promoting the remineralization of demineralized dentin.
Contributors: Upadhyay, Ushma, Kimport, Katrina, Belusa, Elise, Johns, Nicole, Laube, Douglas, Roberts, Sarah
... Abstract Background Since mid-2013, Wisconsin abortion providers have been legally required to display and describe pre-abortion ultrasound images. We aimed to understand the impact of this law. Methods We used a mixed-methods study design at an abortion facility in Wisconsin. We abstracted data from medical charts one year before the law to one year after and used multivariable models, mediation/moderation analysis, and interrupted time series to assess the impact of the law, viewing, and decision certainty on likelihood of continuing the pregnancy. We conducted in-depth interviews with women in the post-law period about their ultrasound experience and analyzed them using elaborative and modified grounded theory. Results A total of 5342 charts were abstracted; 8.7% continued their pregnancies pre-law and 11.2% post-law (p=0.002). A multivariable model confirmed the law was associated with a higher odds of continuing pregnancy (aOR=1.23, 95% CI: 1.01-1.50). Decision certainty (aOR=6.39, 95% CI: 4.72-8.64) and having to pay fully out of pocket (aOR=4.98, 95% CI: 3.86-6.41) were most strongly associated with continuing pregnancy. Viewing fully mediated the relationship between the law and continuing pregnancy. Interrupted time series analyses found no significant effect of the law but may have been underpowered to detect such a small effect. Nineteen of twenty-three women interviewed viewed their ultrasound image. Most reported no impact on their abortion decision; five reported a temporary emotional impact or increased certainty about choosing abortion. Two women reported viewing helped them decide to continue the pregnancy; both also described preexisting decision uncertainty. Conclusions This law caused an increase in viewing rates and a statistically significant but small increase in continuing pregnancy rates. However, the majority of women were certain of their abortion decision and the law did not change their decision. Other factors were more significant in women’s decision-making, suggesting evaluations of restrictive laws should take account of the broader social environment.
Contributors: Rodriguez, Robert, Mower, William
... Abstract Background Clinicians, afraid of missing intracranial injuries, liberally obtain computed tomographic (CT) head imaging in blunt trauma patients. Prior work suggests that clinical criteria (NEXUS Head CT decision instrument) can reliably identify patients with important injuries, while excluding injury, and the need for imaging in many patients. Methods We conducted a prospective observational study of the NEXUS Head CT decision instrument (DI) that requires patients to meet eight criteria to achieve “low-risk” classification. We examined the instrument’s performance in identifying patients requiring neurological intervention from among a cohort of 11,770 blunt head injury patients. Results The NEXUS Head CT DI assigned high-risk status to 420 of 420 patients requiring neurological intervention (sensitivity, 100.0% [95% confidence interval [CI]: 99.1% – 100.0%]). The instrument assigned low-risk status to 2,823 of 11,350 patients who did not require neurological intervention (specificity, 24.9% [95% CI: 24.1% - 25.7%]). None of the 2,823 low-risk patients required neurological intervention (NPV, 100.0% [95% CI: 99.9% - 100.0%]). The DI assigned high-risk status to 759 of 767 patients with significant intracranial injuries (sensitivity, 99.0% [95% CI: 98.0% - 99.6%]). The instrument assigned low-risk status to 2,815 of 11,003 patients who did not have significant injuries (specificity, 25.6% [95% CI: 24.8% - 26.4%]). Significant injuries were absent in 2,815 of the 2,823 patients assigned low-risk status (NPV, 99.7% [95% CI: 99.4% - 99.9%]). Conclusions The NEXUS Head CT DI reliably identifies blunt trauma patients who require head CT imaging, and could significantly reducing the use of CT imaging. Methods Prospective multicenter
Contributors: Smith, Jennifer, Sturrock, Hugh
... Abstract Data from a prospective case-control study conducted between January 2013 and August 2014 in Ohangwena and Omusati regions in north central Namibia. Patients attending health facilities who tested positive by malaria rapid diagnostic test (RDT) (index cases) were traced back to their home. All occupants of index case households (n = 116 households) and surrounding households (n = 225) were screened for Plasmodium infection with a rapid diagnostic test (RDT) and loop mediated isothermal amplification (LAMP) and interviewed. A comparison group of 286 randomly-selected control households was also screened, to compare infection levels of RACD and non-RACD households and their neighbours.
Gut Microbiota from Multiple Sclerosis patients triggers spontaneous autoimmune encephalomyelitis in mice --16S data--
Contributors: Wekerle, Hartmut, Berer, Kerstin, Gerdes, Lisa Ann, Cekanaviciute, Egle, Jia, Sherman, Xiao, Liang, Xia, Zhongkui, Liu, Chuan, Klotz, Luisa, Stauffer, Uta
... Abstract The commensal microbiota has emerged as a key factor influencing human health and has been associated with several diseases, including those of the central nervous system (CNS). To investigate the role of the microbiome in multiple sclerosis (MS), a complex autoimmune disorder shaped by a multitude of genetic and environmental factors, we recruited a cohort of 34 monozygotic twin pairs discordant for MS, and compared their gut microbial composition by 16S ribosomal RNA sequencing of stool samples. While no major differences in the microbial profiles between MS-affected twins and their healthy co-twins were detected, a significant increase in some taxa (including Akkermansia) was seen in affected untreated subjects. To search for possible functional differences, we used a transgenic mouse model, in which spontaneous anti-CNS autoimmunity is dependent on the commensal gut flora. Germ-free mice colonized with microbiota from MS-affected twins, developed the MS-like disease with a significantly higher incidence than mice colonized with healthy twin-derived microbiota. Although alpha diversity was reduced compared to human donors, the microbial profiles of the colonized mice showed high intraindividual, remarkable temporal stability and a high transfer rate,. Analysis of the transplanted mou