Is there a relationship between low back pain and ligamentum flavum hypertrophy?

OBJECTIVE: A condition known as ligamentum flavum (LF) hypertrophy occurs when the ligamentum flavum (LF) swells as a result of pressures applied to the spine. Among the elderly population, lumbar spinal stenosis is a major cause of pain and disabilities. Numerous studies indicate that lumbar spinal stenosis etiology involves the ligamentum flavum in a major way. This study looks into the relationship between low back pain and ligamentum flavum thickening. PATIENTS AND METHODS: The imaging tests and case histories of all patients with low back pain who had consecutive magnetic resonance imaging exams performed at the Prince Sattam University and King Khalid hospitals in Al Kharj City will serve as the basis for this retrospective observational study. A radiologist utilized the Pfirrmann grading system, which is based on spinal levels starting from the first lumbar to the first sacral vertebrae, to measure the thickness of the ligamentum flavum in all cases who underwent magnetic resonance imaging (MRI). A correlation between age, hypertrophy of LF, and low back pain was investigated. RESULTS: There were 79 participants in the study, ages ranging from 21 to 82, 49 of which were men. The patients' average age was 54 years, and 62% of them were men. We found no appreciable variations in LF thickness according to gender. At the L4-L5 and L5-S1 levels, the left LF was noticeably thicker than the right. Moreover, there was a significant difference (p < 0.05) in the bilateral LF thicknesses at L5-S1 compared to the comparable sides at L4-L5. CONCLUSIONS: By evaluating the thickness of LF on magnetic resonance images, we discovered that it may be closely associated with the etiology of pain processes in the spine.

Association between COVID-19 exposure and autonomic nervous system dysfunction in apparently healthy adults: an observational study.

OBJECTIVE: Coronavirus disease (COVID-19) is a respiratory disease caused by SARS-CoV-2, which complicates the functioning of multiple systems, including the autonomic nervous system (ANS), causing dysautonomia. Investigation of dysautonomia and its association with exposure to COVID-19 is limited in healthy people. Therefore, the study aimed to investigate the relationship between ANS dysautonomia and coronavirus exposure and compare the ANS function between exposed and non-exposed to COVID-19. SUBJECTS AND METHODS: The study involved 141 participants, with a mean age of 18-24.5 years, 83% male (49.6% exposed to COVID-19). The ANS was measured using a composite autonomic symptom scale (COMPASS-31) questionnaire and heart rate variability (HRV) using photoplethysmography. Exposure to COVID-19 was investigated using two national health-status tracking and COVID-19 exposure applications, "Sehhaty" and "Twakkalna". RESULTS: A significantly inverse weak correlation between COMPASS-31 scores and COVID-19 exposure (r=-0.2, p=0.04). No significant association was found between HRV and COVID-19 exposure. COMPASS-31 scores for the exposed group (median=15, n=70) were significantly higher than those for the non-exposed group (median=12, n=71), U=1,913.5, p=0.03. Height (r=-0.4, p=0.002) and gender (r=0.3, p=0.001) were moderately correlated with COMPASS-31 among the exposed group. CONCLUSIONS: These findings indicated that exposure to COVID-19 was associated with poorer ANS scores measured via COMPASS-31. Additionally, exposure to COVID-19 resulted in higher dysautonomia symptoms than non-exposed. Height and gender differences contribute to the severity of dysautonomia among exposed people.

Protective effect of sterubin against neurochemical and behavioral impairments in rotenone-induced Parkinson's disease

This study was conducted to evaluate how sterubin affects rotenone-induced Parkinson's disease (PD) in rats. A total of 24 rats were distributed into 4 equal groups: normal saline control and rotenone control were administered saline or rotenone (ROT), respectively, orally; sterubin 10 received ROT + sterubin 10 mg/kg po; and sterubin alone was administered to the test group (10 mg/kg). Rats of the normal saline and sterubin alone groups received sunflower oil injection (sc) daily, 1 h after receiving the treatments cited above, while rats of the other groups received rotenone injection (0.5 mg/kg, sc). The treatment was continued over the course of 28 days daily. On the 29th day, catalepsy and akinesia were assessed. The rats were then euthanized, and the brain was extracted for estimation of endogenous antioxidants (MDA: malondialdehyde, GSH: reduced glutathione, CAT: catalase, SOD: superoxide dismutase), nitrative (nitrite) stress markers, neuroinflammatory cytokines, and neurotransmitter levels and their metabolites (3,4-dihydroxyphenylacetic acid (DOPAC), dopamine (DA), norepinephrine (NE), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA)). Akinesia and catatonia caused by ROT reduced the levels of endogenous antioxidants (GSH, CAT, and SOD), elevated the MDA level, and altered the levels of nitrites, neurotransmitters, and their metabolites. Sterubin restored the neurobehavioral deficits, oxidative stress, and metabolites of altered neurotransmitters caused by ROT. Results demonstrated the anti-Parkinson's activities of sterubin in ROT-treated rats.

Protective effect of sterubin against neurochemical and behavioral impairments in rotenone-induced Parkinson's disease.

This study was conducted to evaluate how sterubin affects rotenone-induced Parkinson's disease (PD) in rats. A total of 24 rats were distributed into 4 equal groups: normal saline control and rotenone control were administered saline or rotenone (ROT), respectively, orally; sterubin 10 received ROT + sterubin 10 mg/kg po; and sterubin alone was administered to the test group (10 mg/kg). Rats of the normal saline and sterubin alone groups received sunflower oil injection (sc) daily, 1 h after receiving the treatments cited above, while rats of the other groups received rotenone injection (0.5 mg/kg, sc). The treatment was continued over the course of 28 days daily. On the 29th day, catalepsy and akinesia were assessed. The rats were then euthanized, and the brain was extracted for estimation of endogenous antioxidants (MDA: malondialdehyde, GSH: reduced glutathione, CAT: catalase, SOD: superoxide dismutase), nitrative (nitrite) stress markers, neuroinflammatory cytokines, and neurotransmitter levels and their metabolites (3,4-dihydroxyphenylacetic acid (DOPAC), dopamine (DA), norepinephrine (NE), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA)). Akinesia and catatonia caused by ROT reduced the levels of endogenous antioxidants (GSH, CAT, and SOD), elevated the MDA level, and altered the levels of nitrites, neurotransmitters, and their metabolites. Sterubin restored the neurobehavioral deficits, oxidative stress, and metabolites of altered neurotransmitters caused by ROT. Results demonstrated the anti-Parkinson's activities of sterubin in ROT-treated rats.

Fustin alleviates lipopolysaccharide-induced anxiety-depression-like performances by modulation of oxidative stress/neuroinflammatory markers/ NF-κB/caspase-3/BDNF expression in rodents.

OBJECTIVE: Anxiety and depression are common psychiatric disorders that affect millions of people worldwide. Lipopolysaccharide (LPS) is a bacterial endotoxin that has been demonstrated to cause depression and anxiety-like behaviors in animal models. Fustin is a flavonoid found in various plant species that have been reported to have neuroprotective effects. The study proposed the evaluation of fustin's impact on anxiety and depression in LPS-injected rats. MATERIALS AND METHODS: The efficacy of fustin in higher and lower doses was studied by administering a single dose of LPS-injected anxiety/depression in rodents. Behavioral models like the elevated plus maze test, open field test, marble burying test, force swimming test, tail suspension test, and hyperemotionality behavior were performed to evaluate anxiety/depression in rodents. The neuroinflammatory markers such as interleukin-6 (IL-6), interleukin-1ß (IL-1ß), nuclear factor-κB (NF-κB), tumor necrosis factor-α (TNF-α), apoptosis marker caspase-3, and brain-derived neurotrophic factor (BDNF) were also measured as a part of the study. Additionally, biochemical markers of oxidative stress, such as malonaldehyde (MDA) and antioxidants, including superoxide dismutase (SOD), glutathione (GSH), catalase (CAT), and nitric oxide (NO), were also evaluated. RESULTS: LPS administration resulted in significant (p<0.001) changes in behavior tests and biochemical markers including IL-1ß, IL-6, NF-κB, TNF-α, NO, caspase-3, BDNF, MDA, CAT, SOD, and GSH. In contrast, treating the rats with fustin significantly improved the behavior tests and restored the changes in biochemical markers. CONCLUSIONS: The current work established the efficacy of fustin with its therapeutic impact on depression and anxiety-like behaviors in rodent experimental models through its modulation of apoptosis markers, oxidative stress, and neuroinflammation.

AWARENESS AND KNOWLEDGE OF OBSTRUCTIVE SLEEP APNEA AMONG THE POPULATION OF THE AL-BAHA REGION OF SAUDI ARABIA: A CROSS-SECTIONAL STUDY.

Obstructive sleep apnea (OSA) is a known sleep-disordered breathing, with known morbidity and mortality, that affects a lot of people worldwide. In Saudi Arabia, the prevalence of OSA is estimated to be around 8.8% among adult males and 5.1% among adult females. The research is a cross-sectional study design conducted in the Al-Baha region; Saudi Arabia in 385 participants. To evaluate the knowledge and awareness of OSA, the study utilized a validated and reliable adapted Arabic version of the OSA questionnaire. The degree of consciousness and understanding regarding OSA demonstrated a noteworthy connection with varying levels of education and a favorable family history of OSAS (p<0.05). The regression analyses unveiled that people with a familial OSA background had a 2.565-fold increased likelihood of identifying daytime fatigue as a symptom of OSA (p<0.05). The study reported an insufficient level of awareness and knowledge of OSA among the Saudi Arabian population. Various factors, including gender, education, and family history of OSA, may affect the awareness and knowledge of this condition.

Push out bond strength of fiber post to radicular dentin using Q-mix, lemon/garlic extract, and riboflavin activated by photodynamic therapy as a final canal irrigant.

OBJECTIVE: The aim of this study was to assess the extrusion bond values of fiber post to radicular dentin when disinfected using different final irrigants lemon garlic extract (LGE), riboflavin (RFP) activated by PDT (photodynamic therapy), and Q-mix 2-in-1. MATERIALS AND METHODS: Forty single-rooted mandibular premolar teeth were decoronated. Endodontic treatment was performed, and the canals were continually irrigated with normal saline, dried with paper points, and obturated. Post space was prepared by removing gutta-percha using peso-reamers. All specimens were randomly allocated into four groups based on the final irrigant used. Specimens in Group 1 irrigated with: 5.25% NaOCl+17% EDTA, group 2: 5.25% NaOCl+Q-mix 2-in-1, group 3: 5.25% NaOCl+RFP, and group 4: 5.25% NaOCl+LGE. Following final irrigation, a fiber post was placed in the canal space and luted. Samples were sectioned and each section was placed in a universal testing machine to assess bond values. Debonded samples were assessed for failure modes, EBS and modes of failure. For comparisons among groups, the one-way analysis of variance (ANOVA) test and the Post-Hoc Tukey HSD test were used keeping the level of significance at p=0.05. RESULTS: The cervical section of samples in group 2 (NaOCL+Qmix) (7.11±0.81 MPa) exhibited the maximum value of EBS. However, the apical section of samples in group 3 (5.25% NaOCl+RFP) (3.33±0.26 MPa) displayed minimum extrusion bond values. Group 3 specimens in which final irrigation was performed with RFP established significantly lower bond integrity values than all the other investigated groups coronal (3.77±0.13 MPa), middle (3.60±0.41 MPa), and apical (3.33±0.26 MPa) (p<0.05). Intragroup comparison analysis, the coronal and middle root sections of all the experimental groups displayed comparable outcomes of EBS (p>0.05). However, near the apical section of the root, the bond strength of all the groups declined considerably. CONCLUSIONS: Q-mix 2-in-1 as the final irrigant displayed the highest extrusion bond strength of fiber-reinforced composite to canal dentin at all three levels coronal, middle and apical. Lemon garlic extract has the potential to be used alternative to ethylene diamine tetra acetic acid as a final irrigant.

Assessment of prevalence and measurement of mandibular lingual concavities using Cone-Beam Computerized Tomography (CBCT) among patients in Jeddah: a cross-sectional study.

OBJECTIVE: Dental implant procedure is the most common way to restore missing teeth but also comes with several complications. Success rates for dental implants are expected to be good when proper diagnosis and planning, study of bone morphology and closeness of implant with vital structures, such as nerves and blood vessels, are made pre-surgery. PATIENTS AND METHODS: This cross-sectional study involved 636 adult patients, aged 18-80 years old, that came for dental implants in screening clinics or referred to specialty clinics in Jeddah, Saudi Arabia for the year 2019 to 2020. Instead of conventional Computed Tomography (CT), Cone Beam Computed Tomography (CBCT) X-Rays have been used to evaluate mandibular lingual concavities. RESULTS: Prevalence and measurement of lingual concavities were determined. Type U mandibles with a lingual concavity, were found to have a higher chance of lingual cortical plate but this may still vary on factors such as type of population and ethnicity. The typical finding in the mandibular posterior region is the lingual undercut. CONCLUSIONS: CBCT is a great tool used to study mandibular lingual concavities and it is essential prior the installation of dental implant to prevent life-threatening complications.

Protective effect of barbigerone against ethanol-induced ulcers via the interleukins/ICAM-1/Bcl-2 pathway.

OBJECTIVE: The objective of the study was to assess the protective effects of barbigerone in ethanol-induced gastric ulcers in rats. MATERIALS AND METHODS: Male Wistar rats (180±20 g) were used in the study (n=06). The rats were randomly divided into different groups, i.e., the normal group, ethanol control, and barbigerone 10 and 20 mg/kg group. Various biochemical parameters were assessed - total acidity and pH values, oxidative stress biomarkers such as superoxide dismutase (SOD), glutathione (GSH), malondialdehyde (MDA), and catalase (CAT) along with markers, i.e., tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1ß, intercellular adhesion molecule-1 (ICAM-1) and expression of B-Cell Leukemia/Lymphoma 2 (Bcl-2). Also, histopathology was performed. RESULTS: Treatment with barbigerone in the ethanol-induced-ulcer rats restored the levels of biochemical parameters such as SOD, GSH, MDA, CAT, and markers expression, including TNF-α, IL-6, IL-1ß, ICAM-1, and Bcl-2 with protected against cellular necrosis. CONCLUSIONS: Barbigerone protective effects can be attributed to its ability to reduce oxidative stress and inflammation, as well as promote gastroprotection against ethanol-induced ulcers in rats.

Infection-Control knowledge, attitude, practice and risk perception of occupational exposure to COVID-19 among dentists: A cross-sectional survey.

Background: COVID-19 is a potentially fatal disease that was announced as a global pandemic at the beginning of the year 2020. Aim: The purpose of our cross-sectional study was to evaluate the infection-control knowledge, attitude, practice, and risk perception of occupational exposure to COVID-19 among multinational dentists. Patients and Methods: A self-designed, 33-item, English questionnaire was created and distributed through social media and digital communication platforms. The questionnaire covered the demographic data, knowledge and perception of the occupational risk of the COVID-19 infections, and compared some infection control measures taken before and after this global pandemic. The results were analyzed, and four scores were used to assess the aforementioned parameters. Results: A total of 300 multinational dentists answered our survey, with the majority being females (59%) and aging from 25 to 44 years old (68%). We found that a statistically significant relationship exists between attitude and nationality, country of practice, medical condition, and the practicing specialty (P < 0.05). In addition, risk perception had a statistically significant correlation with nationality, smoking habits, education level, and specialty (P < 0.05). Furthermore, there was a statistically significant correlation between the practice score and the gender, age, smoking habits, education level, nature of the practice (private or governmental), and academia affiliation (P < 0.05). Conclusions: The study sample had good compliance with the instructions and guidelines of the World Health Organization (WHO) and the Centre for Disease Control (CDC), with most of them improving their infection control precautions after the virus's emergence according to the said guidelines. Furthermore, our participants were fearful of the COVID-19 virus and the fact of being potential transmitters. Despite saying that, the significant majority of them reported being confident in treating COVID-19-positive patients.

Knowledge attitude and practices of university students to Vitamin D and Vitamin D supplements during times of low sun exposure and post lockdown.

OBJECTIVE: Vitamin D deficiency is prevalent in Saudi Arabia. Inability to get sun exposure greatly influences Vitamin D levels. Getting enough Vitamin D during childhood and young adulthood can prevent possible future diseases. We aim to estimate the level of knowledge of Saudi University students about Vitamin D and Vitamin D supplements, to correlate it with their attitudes and practices to sun exposure and Vitamin D supplements and to compare between males and females. MATERIALS AND METHODS: This is an epidemiological cross-sectional KAP study conducted at King Saud University in Riyadh. A stratified random sampling technique was used where students were randomly selected from 3 colleges and stratified to males and females. N= 767 students completed the online survey used to assess the knowledge, attitudes, and practices of the students. RESULTS: We found that the level of knowledge of university students was moderate to low (mean equivalent to 40%) whereas females had better knowledge. Also, their practices are not sufficient to maintain healthy Vitamin D levels as only 8.2% stay in the sun for more than an hour during weekdays. Only 10.2% of students take regular Vitamin D supplements, where females are the more likely users. 99.1% of students stay indoors during work. CONCLUSIONS: The knowledge about Vitamin D is low among university students but slightly higher in females and medical students. Almost all participants work indoors and most of them wear a mask whenever going out. Few students take regular Vitamin D supplements. Females agreed more they have Vitamin D deficiency and take supplements more than males.

Assessment of genetic variation in Apis mellifera jemenitica (Hymenoptera: Apidae) using Cytochrome Oxidase I gene sequences.

The Arabian Honeybee Apis mellifera jemenitica is endemic to the Arabian Peninsula. It is highly adapted to temperature extremes and drought dominating the region. In this study, the mitochondrial Cytochrome Oxidase I (COI) was analyzed in 133 specimens of A. m. jemenitica from eight localities along the Red Sea cost of Saudi Arabia. Results revealed 33 synonymous, and 6 non-synonymous mutations within the COI sequences, resulting in change of 4 amino acids. Phylogenetic analysis based on either type of mutations revealed two main haplogroups accounting for 94% of the samples. In total Eighteen new haplotypes were identified and uploaded in the genebank, Fourteen of them are restricted to one/both haplogroups. All haplotypes identified in this study clustered with reference COI sequences of the sub-lineag Z (African Lineage). However one Haplotype (MW428270) represents high COI variability compared to other haplotypes and may resemble different evolutionary sub-lineage. Tajima's Neutrality Test (Ps = 0.025; D = -1.5) indicated population size expansion that took place after selective sweep and/or purifying selection.

Surfactant-Free Synthesis of Nb2O5 Nanoparticles Anchored Graphene Nanocomposites with Enhanced Electrochemical Performance for Supercapacitor Electrodes.

Nb2O5/graphene nanocomposites without any surfactant are synthesized by an in situ microwave irradiation technique. Structural and morphological studies revealed that the prepared composites were composed of Nb2O5 nanoparticles intercalated into the graphene sheet. The thermal stability of graphene oxide, Nb2O5, and Nb2O5/graphene nanocomposite was studied by the TGA. The electrochemical properties are assessed by cyclic voltammetry, chronopotentiometry and electrochemical impedance spectroscopy analyses. The specific capacitance of Nb2O5/graphene nanocomposites is greater (633 Fg-1) than pure Nb2O5 nanoparticles (221 Fg-1) and graphene (290 Fg-1) at a current density of 1 Ag-1. The long-term cyclic measurement confirms higher cyclic stability of the nanocomposite with capacitance retention of 99.3% after 5000 cycles without performance degradation. The composites exhibit higher electrochemical conductivity and allow effective ions and charge transport over the entire electrode surface with aqueous electrolyte. The electrochemical study suggests that Nb2O5/graphene nanocomposites have the potential to be an effective electrode for superior performance supercapacitor applications.

Enhanced electrochemical performance of α-MoO3/graphene nanocomposites prepared by an in situ microwave irradiation technique for energy storage applications.

Nanoparticles of α-molybdenum oxide (α-MoO3) are directly grown on graphene sheets using a surfactant-free facile one step ultrafast in situ microwave irradiation method. The prepared α-MoO3 and α-MoO3/G nanocomposites are analysed by different characterization techniques to study their structural, morphological and optical properties. Transmission electron microscope images reveal the intercalation of three dimensional (3D) α-MoO3 nanoparticles into 2D graphene sheets without any agglomeration. The electrochemical results exhibit improved performance for the α-MoO3/G composite electrode compared to pristine α-MoO3 owing to its structural superiority. The specific capacitance (C s) values of the α-MoO3/G composite and pristine α-MoO3 are measured to be 483 and 142 F g-1 respectively at a current density of 1 A g-1. The α-MoO3/G composite maintains a very strong cyclic performance after 5000 cycles. The capacitance retention of the composite electrode shows stable behavior without any degradation confirming its suitability as an enduring electrode material for high-performance supercapacitor applications.

Freestanding flexible, pure and composite form of reduced graphene oxide paper for ammonia vapor sensing.

Metal oxides based graphene nanocomposites were used for ammonia vapour sensing. The self-assembly process was adopted to prepare freestanding flexible pure rGO, CeO2-rGO and SnO2-rGO composite papers. The structural studies confirmed the formation of rGO composite papers. The ammonia vapor sensing was demonstrated using an impedance analyzer at different humidity levels as well as concentration. The CeO2-rGO composite paper achieved a sensitivity of 51.70 ± 1.2%, which was higher than that of pure rGO and SnO2-rGO composite paper. Both the surfaces (top and bottom) of the papers are active in efficiently sensing ammonia, which makes the present work unique. The results reveal that metal oxide/rGO papers can be effectively utilized in real time sensor application.

Viral Infections After Kidney Transplantation in a Cohort of Children: A Retrospective Single-Center Study.

BACKGROUND: Viral infections are known to be common complications after kidney transplant (KTx), causing significant numbers of mortality and morbidity. OBJECTIVES: We aimed to highlight the pattern of viral infections after KTx in children and its impact on allograft function. METHODS: We included children who underwent KTx between 2012 and 2017. Baseline demographics, immunosuppressive agents, episodes of viral infections with cytomegalovirus (CMV), BK virus, and Epstein-Barr virus (EBV), and serum creatinine were collected. All children received induction agent followed by maintenance immunosuppression. Oral valganciclovir was given to all high-risk patients for CMV for 180 days as prophylaxis. CMV and EBV polymerase chain reactions were monitored every 2 weeks initially until the ninth month, then monthly until the end of the second year, and then every 3 months. Urine BKV polymerase chain reactions were monitored monthly in the first year and then every 3 months. RESULTS: A total of 18 children received transplants. There was 1 episode of CMV infection (5.6%), 2 episodes (11.1%) of isolated BK viruria (1 of the 2 with an episode of BK viremia [5.6%] with no associated BK nephropathy [0%]), and no episodes of EBV or lymphoproliferative disease (0%). Allograft functions continued to be stable with mean serum creatinine of 52.2 µmol/L during the study period with 2 episodes (11.1%) of acute cellular rejection and 1 episode (5.6%) of early antibody-mediated rejection. CONCLUSION: Prolonged prophylaxis and strict viral monitoring protocol can be effective ways of controlling viral infections after KTx.

TBX18 overexpression enhances pacemaker function in a rat subsidiary atrial pacemaker model of sick sinus syndrome.

KEY POINTS: The sinoatrial node (SAN) is the primary pacemaker of the heart. SAN dysfunction, or 'sick sinus syndrome', can cause excessively slow heart rates and pauses, leading to exercise limitation and syncope, currently treated by implantation of an electronic pacemaker. 'Biopacemaking' utilises gene therapy to restore pacemaker activity by manipulating gene expression. Overexpressing the HCN pacemaker ion channel has been widely used with limited success. We utilised bradycardic rat subsidiary atrial pacemaker tissue to evaluate alternative gene targets: the Na+ /Ca2+ exchanger NCX1, and the transcription factors TBX3 and TBX18 known to be involved in SAN embryonic development. TBX18 overexpression restored normal SAN function, as assessed by increased rate, improved heart rate stability and restoration of isoprenaline response. TBX3 and NCX1 were not effective in accelerating the rate of subsidiary atrial pacemaker tissue. Gene therapy targeting TBX18 could therefore have the potential to restore pacemaker function in human sick sinus syndrome obviating electronic pacemakers. ABSTRACT: The sinoatrial node (SAN) is the primary pacemaker of the heart. Disease of the SAN, sick sinus syndrome, causes heart rate instability in the form of bradycardia and pauses, leading to exercise limitation and syncope. Biopacemaking aims to restore pacemaker activity by manipulating gene expression, and approaches utilising HCN channel overexpression have been widely used. We evaluated alternative gene targets for biopacemaking to restore normal SAN pacemaker physiology within bradycardic subsidiary atrial pacemaker (SAP) tissue, using the Na+ /Ca2+ exchanger NCX1, and the transcription factors TBX3 and TBX18. TBX18 expression in SAP tissue restored normal SAN function, as assessed by increased rate (SAN 267.5 ± 13.6 bpm, SAP 144.1 ± 8.6 bpm, SAP-TBX18 214.4 ± 14.4 bpm; P < 0.001), improved heart rate stability (standard deviation of RR intervals fell from 39.3 ± 7.2 ms to 6.9 ± 0.8 ms, P < 0.01; root mean square of successive differences of RR intervals fell from 41.7 ± 8.2 ms to 6.1 ± 1.2 ms, P < 0.01; standard deviation of points perpendicular to the line of identity of Poincaré plots (SD1) fell from 29.5 ± 5.8 ms to 7.9 ± 2.0 ms, P < 0.05) and restoration of isoprenaline response (increases in rates of SAN 65.5 ± 1.3%, SAP 28.4 ± 3.4% and SAP-TBX18 103.3 ± 10.2%; P < 0.001). These changes were driven by a TBX18-induced switch in the dominant HCN isoform in SAP tissue, with a significant upregulation of HCN2 (from 1.01 × 10-5  ± 2.2 × 10-6 to 2.8 × 10-5  ± 4.3 × 10-6 arbitrary units, P < 0.001). Biophysically detailed computer modelling incorporating isoform-specific HCN channel electrophysiology confirmed that the measured changes in HCN abundance could account for the observed changes in beating rates. TBX3 and NCX1 were not effective in accelerating the rate of SAP tissue.

The variation in quality and content of patient-focused health information on the Internet for otitis media.

BACKGROUND: When symptoms of otitis media appear, parents and patients often access the Internet for health information. We study the content and quality of health information in parent-patient-focused websites for otitis media. METHODS: We searched the 3 search engines (Google, Yahoo, and Bing) using "otitis media" and "middle ear infection" then reviewed the top 30 hits for each search. We included sites that were focused on providing patient-patient information about otitis media. A variety of instruments were used to assess website content and quality. RESULTS: In 35 included websites, there was considerable variation in content, with the average site having 11 out of 15 informational items potentially useful to parents and patients on otitis media (range 4-15). Across included websites, the mean DISCERN score was 47 out of 80 (low to medium quality), 16 (46%) were HONcode certified, and 8 (23%) fulfilled all the JAMA benchmark criteria. The average website was written at a 9th/10th-grade reading level. CONCLUSION: The content and quality of health information for otitis media in parent-and-patient-focused websites is highly variable. Although easy-to-read, high-quality websites with complete content are available, the average website sites is difficult to read without a high school education and is difficult to use. Consideration should be given to adopting a standard approach for presenting disease-specific information to parents and patients.

Detecting beta-amyloid aggregation from time-resolved emission spectra.

The aggregation of beta-amyloids is one of the key processes responsible for the development of Alzheimer's disease. Early molecular-level detection of beta-amyloid oligomers may help in early diagnosis and in the development of new intervention therapies. Our previous studies on the changes in beta-amyloid's single tyrosine intrinsic fluorescence response during aggregation demonstrated a four-exponential fluorescence intensity decay, and the ratio of the pre-exponential factors indicated the extent of the aggregation in the early stages of the process before the beta-sheets were formed. Here we present a complementary approach based on the time-resolved emission spectra (TRES) of amyloid's tyrosine excited at 279 nm and fluorescence in the window 240-450 nm. TRES have been used to demonstrate sturctural changes occuring on the nanosecond time scale after excitation which has significant advantages over using steady-state spectra. We demonstrate this by resolving the fluorescent species and revealing that beta-amyloid's monomers show very fast dielectric relaxation, and its oligomers display a substantial spectral shift due to dielectric relaxation, which gradually decreases when the oligomers become larger.

Traumatic bilateral dissection of cervical internal carotid artery in the wake of a car accident: A case report.

BACKGROUND: Bilateral carotid artery dissection secondary to severe trauma is rare and can be potentially life -threatening if not diagnosed and treated properly. CASE PRESENTATION: We report a 29-year-old female who was admitted to the emergency department after a car accident. The patient was conscious at the time of admission and presented with an initial Glasgow Coma Scale (GCS) of 15 presenting normal vital signs. The patient developed motor dysphasia with right upper limb paresis a few hours after the admission. Magnetic resonance imaging (MRI) revealed a bilateral cervical internal carotid artery (ICA) occlusion in addition to left frontal lobe infarct in a subacute phase. Medical management was successful and the patient was discharged from the hospital two weeks after the admission. DISCUSSION: Noninvasive vascular imagining modalities are merging as the gold standard in the early detection of carotid artery dissection (CAD). Typical pathognomonic findings on MRI include double lumen and intimal flap. The management with systemic anticoagulation or antiplatelet therapy is aimed to prevent the development of ischemic stroke. In case of medical therapy being ineffective or in case of complication or any disorders suffered by a patient, endovascular treatment is performed. CONCLUSION: With early detection and proper management, traumatic dissection of cervical carotid artery can have a benign outcome. As for the current patient, medical treatment with anticoagulation was sufficient and surgical management was therefore not required. Improvement in the patients' speech was observed; nevertheless the continuation of speech therapy was indicated.