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Objective: Compare the efficacy and safety of daily versus fortnightly oral vitamin D3 in treating symptomatic vitamin D deficiency in children aged 1−10 years. Design: Open labelled randomized controlled trial. Patients: Eighty children with symptomatic vitamin D deficiency were randomized into group daily (D) and group bolus (B) [40 in each group] to receive oral vitamin D3, 4000 IU daily or 60,000 IU fortnightly for 12 weeks respectively. Both groups received daily oral calcium of 500 mg/day. Measurements: Serum calcium (Ca), phosphate (P), alkaline phosphatase (ALP), 25‐hydroxy cholecalciferol (25(OH)D), parathyroid hormone (PTH) levels, urine calcium: creatinine ratio and radiological score were assessed at baseline, 4 weeks and 12 weeks. At the end of 12 weeks, 74 children were available for evaluation of the efficacy and safety of both regimens. Results: Both regimens led to a significant increase in Ca and P levels and a fall in ALP and PTH levels from baseline to 4 and 12 weeks of therapy, with no intergroup difference. At 4‐ and 12‐week assessments, all children in both treatment arms achieved 25(OH)D level in sufficiency range, with no significant difference in their geometric mean. Both regimens were associated with asymptomatic transient hypercalcemia [group D—51.4% vs. group B—34.3%; p −0.14] and hypercalciuria (5.7%) in group D that resolved spontaneously on follow‐up. Conclusions: Daily and fortnightly oral vitamin D3 in similar cumulative doses are efficacious for treating symptomatic vitamin D deficiency in children (1−10 years). Treated children should be monitored for serum 25(OH)D, Ca and urinary calcium creatinine ratio. [ABSTRACT FROM AUTHOR]

This paper unveils the simulation and optimum design of five models based on photovoltaic (PV), diesel generator (DG), and battery energy systems for rural area farmhouse load demand (agriculture and household). The choice for designing an optimal energy system is constructed on minimum technical considerations like loss of load probability (LOLP), economic (cost of electricity [COE] with net present cost [NPC]), environmental (CO2 aspects) using a novel flamingo swarm intelligence algorithm (FSIA). The optimization results are compared by particle swarm intelligence algorithm, improved particle swarm intelligence algorithm, genetic algorithms, and hybrid optimization of multiple energy resources (HOMER‐Pro). FSIA shows PV/DG/battery energy system to be an optimal system as regards NPC (Rs. 8 056 734), COE (12.14 Rs./kWh), CO2 (13 784 kg/y), and LOLP (0.00000501 per year). The saving of the fuel cost and CO2 emission from PV/DG/battery to DG only system is 66.10% and 61.26%, respectively. [ABSTRACT FROM AUTHOR]

Aim: To compare the demographic, clinical, laboratory and radiological parameters of patients with different clinical outcomes (death or discharge) and analyse them to find out the potential predictors for mortality in children hospitalised with SARS‐CoV‐2 infection. Methods: Retrospective chart review of all patients less than 18 years of age with laboratory‐confirmed SARS‐CoV‐2 infection and requiring hospital admission between 16 April 2020 and 31 October 2020. Results: Of 255 children with SARS‐CoV‐2 infection, 100 patients (median age 62.5 months, 59% males, 70% with moderate to severe disease) were hospitalised, of whom 27 died (median age 72 months, 59% males and 30% severely underweight). The subgroup with comorbidities (n = 14) was older (median age 126 months) and had longer duration of stay (median 10 days). Fever and respiratory symptoms were comparable while gastrointestinal symptoms were more common among non‐survivors. Hypoxia at admission (odds ratio (OR) 5.48, P = 0.001), multiorgan dysfunction (OR 75.42, P = 0.001), presence of acute kidney injury (OR 11.66, P = 0.001), thrombocytopenia (OR 4.40, P = 0.003) and raised serum C‐reactive protein (CRP) (OR 4.69, P = 0.02) were independently associated with mortality. The median time from hospitalisation to death was 3 days. The deceased group had significantly higher median levels of inflammatory parameters and a higher incidence of complications (myocarditis, encephalitis, acute respiratory distress syndrome and shock). Conclusions: Hypoxia at admission, involvement of three or more organ systems, presence of acute kidney injury, thrombocytopenia and raised serum C‐reactive protein were found to be independently associated with increased odds of in‐hospital mortality in children admitted with SARS‐CoV‐2 infection. [ABSTRACT FROM AUTHOR]

We previously generated Brassica juncea lines overexpressing either glyoxalase I (gly I) or γ-tocopherol methyltransferase (γ-TMT) involved in the glyoxalase system and tocopherol biosynthesis, respectively. These transgenic plants showed tolerance to multiple abiotic stresses. As tolerance is a complex trait that can be improved by pyramiding of several characteristics in a single genotype, we generated in this study B. juncea plants coexpressing gly I and γ-TMT by crossing the previously generated stable transgenic lines. The performance of the newly generated B. juncea lines coexpressing gly I and γ-TMT was compared with that of wild-type and the single transgenic lines under non-stressed and NaCl and mannitol stress conditions. Our results show a more robust antioxidant response of B. juncea plants coexpressing gly I and γ-TMT compared to the other lines in terms of higher chlorophyll retention, relative water content, antioxidant enzyme and proline levels, and photosynthetic efficiency and lower oxidative damage. The differences in response to the stress of the different lines were reflected in their yield parameters. Overall, we demonstrate that the pyramiding of multiple genes involved in antioxidant pathways could be a viable and useful approach for achieving higher abiotic stress tolerance in crop plants. [ABSTRACT FROM AUTHOR]

Pseudosections generated using the correctly estimated effective bulk composition (EBC), that is, the bulk of the closed metamorphic system that stays in chemical equilibrium are crucial in deciphering the PT history of a metamorphic terrain. A variety of tools are used by metamorphic petrologists to calculate the effective bulk of a sample, such as XRF bulk data, average bulk using point count analysis, and using X‐ray maps areal analysis, each with its own limitations. In this work, we demonstrate a scanning electron microscopy (SEM) based method to generate EBC, by analysing multiple grids of a thin section using area spectrum analysis tool and energy dispersive spectrometry (EDS) acquisition function of electron microscopes. The pseudosections generated using EBC estimated by SEM based method are tested over two pelitic granulites of east Antarctic shield and a medium‐grade metapelite from North Delhi Fold Belt of the Indian shield. The results are validated through thermobarometric estimations and are compared with pseudosections produced by using other bulk determination methods, such as XRF data and average bulk combining modal percentage with the mineral compositions. We propose that this method of calculating EBC is better compared to the other methods, as it allows the user to define the localized bulk of a particular domain, besides being a simpler and faster approach than other commonly used methods. [ABSTRACT FROM AUTHOR]

This paper presents a new wideband inductorless CMOS transimpedance amplifier (TIA) for 10Gb/s applications. In this proposed TIA, inverter‐based common‐drain active feedback topology is modified by introducing a cascode transistor to reduce input impedance. Furthermore, capacitive degeneration and negative capacitance techniques are employed by using a single capacitor. Both techniques extend the bandwidth. Mathematical analysis of the proposed TIA has been done using the small signal model to describe bandwidth extension. To verify the theoretical description, the proposed TIA is simulated using TSMC 0.18 μm CMOS technology at 1.8 V power supply with 4.3 mW power consumption. The input photodiode capacitance is 0.25 pF. Simulation results show the transimpedance gain of 51.4 dBΩ and 7.6 GHz bandwidth. The input noise current spectral density is 27 pA/√Hz. [ABSTRACT FROM AUTHOR]

Objective: We sought to assess factors associated with the frequency of self‐reported prescription opioid use in persons with migraine, including demographic variables, comorbidities, headache characteristics, and patterns of consultation. Background: Despite the dose‐dependent effect of opioids on migraine progression and the association with negative outcomes, migraine treatment often includes opioids. The Migraine in America Symptoms and Treatment Study focuses on individuals with migraine who receive prescription acute medications, including those receiving and those not receiving opioids. Methods: This web‐based panel survey identified people in the United States with migraine using a validated screener. This analysis stratified people with migraine into 4 groups based on days of monthly opioid use: non‐opioid users, ≤3 days, 4‒9 days, and ≥10 days per month. Results: Of 15,133 respondents with migraine, 4701 (31%) reported acute prescription medication use for headache/migraine in the previous 3 months (mean age 45 years, 71.6% [3367/4701] female), of whom 32.5% (1528/4701) reported opioid use. About one‐third of respondents with primary care or neurology consults in the prior 6 months reported receiving an opioid, and more than half of respondents (209/391, 53.5%) with a pain clinic consultation did so. Models compared those using opioids ≤3 days/month (879/4701, 18.7%), 4‒9 days/month (304/4701, 6.5%), ≥10 days/month (345/4701, 7.3%) to non‐opioid users (3173/4701, 67.5%). Compared to non‐opioid users, infrequent users (≤3 days/month) were more likely to be male and less likely to have chronic migraine or to screen positive for anxiety and depression; and frequent opioid users (the 4‒9 days/month and the ≥10 days/month groups) were more likely to be male, to smoke, to be obese, to report greater pain interference, to have moderate to severe disability, to have symptoms of anxiety and depression, to use fewer triptans and nonsteroidal anti‐inflammatory drugs, and to have poor acute treatment optimization. Conclusion: Among prescription medication users, this cross‐sectional analysis shows that increasing use of prescription opioids is associated with male gender, chronic migraine, more severe disability, anxiety and depression, poor acute treatment optimization, and treatment in a pain clinic. [ABSTRACT FROM AUTHOR]

Age‐associated mitochondrial dysfunction and oxidative damage are primary causes for multiple health problems including sarcopenia and cardiovascular disease (CVD). Though the role of Nrf2, a transcription factor that regulates cytoprotective gene expression, in myopathy remains poorly defined, it has shown beneficial properties in both sarcopenia and CVD. Sulforaphane (SFN), a natural compound Nrf2‐related activator of cytoprotective genes, provides protection in several disease states including CVD and is in various stages of clinical trials, from cancer prevention to reducing insulin resistance. This study aimed to determine whether SFN may prevent age‐related loss of function in the heart and skeletal muscle. Cohorts of 2‐month‐old and 21‐ to 22‐month‐old mice were administered regular rodent diet or diet supplemented with SFN for 12 weeks. At the completion of the study, skeletal muscle and heart function, mitochondrial function, and Nrf2 activity were measured. Our studies revealed a significant drop in Nrf2 activity and mitochondrial functions, together with a loss of skeletal muscle and cardiac function in the old control mice compared to the younger age group. In the old mice, SFN restored Nrf2 activity, mitochondrial function, cardiac function, exercise capacity, glucose tolerance, and activation/differentiation of skeletal muscle satellite cells. Our results suggest that the age‐associated decline in Nrf2 signaling activity and the associated mitochondrial dysfunction might be implicated in the development of age‐related disease processes. Therefore, the restoration of Nrf2 activity and endogenous cytoprotective mechanisms by SFN may be a safe and effective strategy to protect against muscle and heart dysfunction due to aging. [ABSTRACT FROM AUTHOR]

Background: The objective of the current study was to provide insight into the effect of coronavirus disease 2019 (COVID‐19) on breast cancer screening, breast surgery, and genetics consultations. Methods: User data from a risk assessment company were collected from February 2 to April 11, 2020. The use of risk assessment was used as a proxy for the use of 3 breast cancer services, namely, breast imaging, breast surgery, and genetics consultation. Changes in the use of these services during the study period were analyzed. Results: All 3 services experienced significant declines after the COVID‐19 outbreak. The decline in breast surgery began during the week of March 8, followed by breast imaging and genetics consultation (both of which began during the week of March 15). Breast imaging experienced the most significant reduction, with an average weekly decline of 61.7% and a maximum decline of 94.6%. Breast surgery demonstrated an average weekly decline of 20.5%. When surgical consultation was stratified as breast cancer versus no breast cancer, the decrease among in non–breast cancer patients was more significant than that of patients with breast cancer (a decline of 66.8% vs 11.5% from the pre‐COVID average weekly volume for non–breast cancer patients and patients with breast cancer, respectively). During the week of April 5, use of genetics consultations dropped to 39.9% of the average weekly volumes before COVID‐19. Conclusions: COVID‐19 has had a significant impact on the number of patients undergoing breast cancer prevention, screening, diagnosis, and treatment. Coronavirus disease 2019 (COVID‐19) has had a significant impact on the number of patients undergoing breast cancer prevention, screening, diagnosis, and treatment in the United States. In the current study, user data from a risk assessment company were collected from February 2 to April 11, 2020, with the use of risk assessment used as a proxy to analyze changes in the use of 3 breast cancer services: breast imaging, breast surgery, and genetics consultation. [ABSTRACT FROM AUTHOR]

A composite film of nickel hexacyanoferrate (NiHCF) and bentonite (Bt) clay (abbreviated as NiHCF−Bt) is synthesized by an in situ electrochemical method. For this synthesis, nickel ions are immobilized on Bt clay by an ion‐exchange process, equilibrating Bt clay with nickel nitrate. On a glassy carbon electrode (GCE), the nickel ion‐exchanged Bt clay (Ni2+−Bt) is coated to get the modified electrode which is represented as GCE/Ni2+−Bt. The NiHCF−Bt composite film is prepared on the GCE surface using the GCE/Ni2+−Bt and scanning the electrode potentials between −0.10 to 1.00 V continuously in an aqueous solution containing potassium hexacyanoferrate and potassium chloride. This NiHCF−Bt modified GCE (GCE/NiHCF−Bt) exhibits redox peaks due to the oxidation and reduction of the central metal ion, Fe2+. The electro‐generated Fe3+ present in the GCE/NiHCF−Bt, electrocatalytically oxidizes a range of drugs like acetaminophen (AC), dopamine (DA), and tyrosine (TY) at decreased overpotentials with high current. This property is advantageously used for the precise quantification of AC, DA, and TY. Sensitivity, limit of detection, and linear calibration range for the determination of AC are found to be 0.20 μA μM−1 cm−2, 1.5 μM, and 25.0–1000.0 μM, respectively. Further, the amount of AC present in pharmaceutical products is satisfactorily quantified which demonstrated the use of the NiHCF−Bt composite film in electroanalysis. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to determine the rates of nausea, phonophobia, and photophobia reported overall and as the most bothersome symptom (MBS) in individuals with migraine and to identify individual characteristics associated with each of the 3 candidate MBSs. Background: The MBS has emerged as an important coprimary efficacy endpoint in clinical trials of acute treatments for migraine, as recommended by the Food and Drug Administration. The current understanding of how persons with migraine designate an associated symptom as the most bothersome has been assessed primarily in the context of randomized trials. Methods: Respondents (n = 95,821) in the cross‐sectional, observational Migraine in America Symptoms and Treatment (MAST) study were adults (aged ≥18 years) recruited from a US nationwide online research panel. A validated diagnostic screener identified 15,133 individuals who met modified International Classification of Headache Disorders (ICHD)‐3 beta criteria for migraine and reported at least 1 monthly headache day (MHD) over the previous 3 months. The survey ascertained sociodemographic variables, headache‐related disability, MHDs, cutaneous allodynia, medication overuse, a migraine symptom severity score, pain interference, noncephalic pain, anxiety and depression symptoms, visual aura over the previous year, and acute treatment optimization. The current analysis is based on respondents who also completed a 6‐month follow‐up assessment that included questions about their most bothersome headache symptom. Results: A total of 7518 respondents completed the 6‐month follow‐up, and 6045 met inclusion criteria and were included in the analysis. The mean age of respondents was 47 (SD 13.4) years, 76.0% (4596/6045) were women, and 84.8% (5103/6017) were white. Among all respondents, 64.9% reported all 3 migraine symptoms. The MBS was photophobia in 49.1% (2967/6045), nausea in 28.1% (1697/6045), and phonophobia in 22.8% (1381/6045). Respondents reporting photophobia as the MBS were more likely to be men, to be obese, and to report visual aura. Those reporting nausea as the MBS were more likely to be women, to have lower incomes, and to report lower levels of treatment optimization. Respondents reporting phonophobia as the MBS were more likely to have cutaneous allodynia and less likely to have visual aura. Conclusion: Most people with migraine in the MAST observational study reported all 3 cardinal symptoms of nausea, photophobia, and phonophobia. As in clinical trials, the most common MBS was photophobia. Patient profiles differed among the groups defined by their MBS. [ABSTRACT FROM AUTHOR]

We present a single‐inlet paper‐pencil based microfluidic fuel cell which works on the capillary driven fluid flow of a mixture of fuel (formic acid) and electrolyte (dilute sulfuric acid) solutions as a single entity. Different types of pencils are used to prepare the graphite electrodes to observe their effect on the fuel cell performance. The graphite electrodes are porous and act as a gas diffusion electrode which breaths in oxygen directly from the quiescent air and out CO2 from the cell. The paper fuel cell also fabricated in different dimensions and connected as cell‐stacks to enhance its performance. The paper‐pencil device generates maximum open circuit potential of ∼2.5 V in series combination and maximum current density of ∼ 82 mA cm−2 and power density of ∼ 100 mW cm−2 in parallel combination. Later, rGO−Cu/CuO nanocomposite embedded electrodes are used to observe their effect on the device performance. A single‐inlet paper‐based microfluidic fuel cell demonstrated which works on capillary action of a fluid that consists of a mixture of fuel (formic acid) and electrolyte (diluted sulfuric acid) solutions. Different grades of pencils are used to fabricate the graphite electrodes to study the performance of the fuel cell. Finally, the miniaturized fuel cells stacked to draw more energy for potential applications. [ABSTRACT FROM AUTHOR]

Prader–Willi syndrome (PWS), is a complex genetic disease affecting 1/15,000 individuals, characterized by lack of expression of genes on the paternal chromosome 15q11‐q13 region. Clinical features include central hypotonia, poor suck, learning and behavior problems, growth hormone deficiency with short stature, hyperphagia, and morbid obesity. Despite significant advances in genetic testing, the mean age for diagnosis in PWS continues to lag behind. Our goal was to perform a pilot feasibility study to confirm the diagnosis utilizing different genetic technologies in a cohort of 34 individuals with genetically confirmed PWS and 16 healthy controls from blood samples spotted and stored on newborn screening (NBS) filter paper cards. DNA was isolated from NBS cards, and PWS testing performed using DNA methylation‐specific PCR (mPCR) and the methylation specific‐multiplex ligation dependent probe amplification (MS‐MLPA) chromosome 15 probe kit followed by DNA fragment analysis for methylation and copy number status. DNA extraction was successful in 30 of 34 PWS patients and 16 controls. PWS methylation testing was able to correctly identify all PWS patients and MS‐MLPA was able to differentiate between 15q11‐q13 deletion and non‐deletion status and correctly identify deletion subtype (i.e., larger Type I or smaller Type II). mPCR can be used to diagnose PWS and MS‐MLPA testing to determine both methylation status as well as the type of deletion or non‐deletion status from DNA extracted from NBS filter paper. We propose that PWS testing in newborns is possible and could be included in the Recommended Uniform Screening Panel after establishing a validated cost‐effective method. [ABSTRACT FROM AUTHOR]

The main aim of this study was to investigate the oxidative stress, genotoxicity and cytotoxicity of erythromycin ( EMC) in pups of treated dams in gestation as well as the lactation period ( LP). The two doses of EMC were compared using intraperitoneal ( i.p.) route in two different periods, that is , in gestation period and in the LP. The rationale behind selection of i.p. route is because of the fact that EMC gets degrades in acidic pH of the stomach. The doses of EMC used were clinically equivalent dose ( CED; EMC 14.2 mg/kg, i.p.) and a lower dose ( EMC 10 mg/kg, i.p.) than CED. EMC toxicities in mice pups were evaluated using various parameters such as micronucleus ( MN) test in peripheral blood and bone marrow, malondialdehyde ( MDA) assay, glutathione ( GSH reduced) assay and histopathological assessment in liver tissue. The CED of EMC led to a significant increase in MDA and decreased in GSH concentration in pups' liver tissue in both gestation and LPs and also to a significant increase in MN frequency in both peripheral blood and bone marrow cells of pups. There were no significant toxicities at a lower dose than CED. There were also some chronic findings with liver histopathological examination at CED. It is thus concluded that EMC accentuates the oxidative stress, cytotoxicity and DNA damage in pups of their postnatal life; hence, EMC should be avoided in the pregnancy and also in the LP. [ABSTRACT FROM AUTHOR]

Compositional analyses of seeds from two cultivars (Mateera and Sugar baby) was performed to evaluate their suitability as oilseeds. Watermelon seeds and kernels contained 21.9-25.5 % and 38.9-46.9 % oil of exceptionally high quality. The crude oil was expelled with a screw press and then refined to obtain a odor free and colorless oil. The moisture content, unsaponifiable matter content, refractive index, and specific gravity were within the narrow ranges. Refining influenced the color, acid value, saponification value, peroxide value, and free fatty acid contents. Linoleic acid (C18:2) was the principal fatty acid constituting 64.5-67.2 % of the total fatty acids. Oxidative stability increased with the addition of tocopherols, butylated hydroxyl anisole (BHA), and tert-butyl hydroxyl quinine (TBHQ). The high amount of polyunsaturated fatty acids (PUFA) along with physicochemical properties were similar to soybeans, sunflower and other common vegetable oils, suggesting the suitabilty of watermelon seed oil for industrial production. [ABSTRACT FROM AUTHOR]

Signal Transducer and Activator of Transcription (STATs) regulate various target genes such as cyclin D1, MYC, and BCL2 in nonneuronal cells which contribute towards progression as well as prevention of apoptosis and are involved in differentiation and cell survival. However, in neuronal cells, the role of STATs in the activation and regulation of these target genes and their signaling pathways are still not well established. In this study, a robust cyclin D1 expression was observed following IGF-1 stimulation in SY5Y cells as well as neurospheres. JAK/STAT pathway was shown to be involved in this upregulation. A detailed promoter analysis revealed that the specific STAT involved was STAT5, which acted as a positive regulatory element for cyclin D1 expression. Overexpression studies confirmed increase in cyclin D1 expression in response to STAT5a and STAT5b constructs when compared to dominant-negative STAT5. siRNA targeting STAT5, diminished the cyclin D1 expression, further confirming that STAT5 specifically regulated cyclin D1 in neuronal cells. Together, these findings shed new light on the mechanism of IGF-1 mediated upregulation of cyclin D1 expression in neural cell lines as well as in neural stem cells via the JAK/STAT5 signaling cascade. © 2013 IUBMB Life, 65(5):462-471, 2013. [ABSTRACT FROM AUTHOR]

Rice starch is one of the major cereal starches with novel functional properties. Significant progress has been made in recent years on the characterization of rice starches separated from different rice cultivars. Studies have revealed that the molecular structure and functional properties are affected by rice germplasm, isolation procedure, climate, agronomic conditions, and grain development. Morphological studies (microscopy and particle size analysis) have reflected significant differences among rice starch granule shapes (polyhedral, irregular) and in granule size (2 to 7 μm). Nonwaxy and long-grain rice starches show greater variation in granular size than the waxy starches. Rice starch granules are smaller than other cereal starches with amylose contents varying from virtually amylose-free in waxy to about 35% in nonwaxy and long-grain rice starches. Amylose content appears to be the major factor controlling almost all physicochemical properties of rice starch due to its influence on pasting, gelatinization, retrogradation, syneresis, and other functional properties. Waxy rice starches have high swelling and solubility parameters, and larger relative crystallinity values than nonwaxy and long-grain starches. However, nonwaxy rice starches have a higher gelatinization temperature than the waxy and long-grain starches. The bland taste, nonallergenicity, and smooth, creamy, and spreadable characteristics of rice starch make it unique and valuable in food and pharmaceutical applications. This review provides recent information on the variation in the molecular structure and functional properties of different rice starches. [ABSTRACT FROM AUTHOR]

The upswing in consumer demand for fresh and high quality preservative-free foods has led to the development of modified atmosphere packaging (MAP). Increasingly, MAP is being used with high carbon dioxide (CO2) concentration as well as CO2/N2 gas mixes. Modified atmosphere packaging or 'gas flushing' as it is also known is an increasingly popular technique used to extend the shelf life (both quality and safety) of a number of dairy products. Carbon dioxide is an active constituent of MAP, naturally present in freshly drawn raw milk. Addition of CO2 to raw milk or flushing the package headspace has proved to be a simple and cost-effective method, depending upon the initial microbiological quality of the food product. Carbon dioxide addition through MAP or direct injection as an economically affordable shelf life extension strategy is used commercially worldwide for some dairy products. The development of food packaging machines with integrated gas flushing capabilities and the supply of 'food grade' gases allow dairy foods manufacturers to enhance the quality of their products. This review presents a broad spectrum of current research and the current trends with respect to CO2 as a natural microbial hurdle with special focus on its precise mechanism and its role in quality improvement of dairy products. [ABSTRACT FROM AUTHOR]

We describe a 77-year-old female with hypertrophic cardiomyopathy in whom live/real time three-dimensional transesophageal echocardiography (3DTEE) provided incremental value over two-dimensional transthoracic and transesophageal echocardiography (2DTTE, 2DTEE) and three-dimensional transthoracic echocardiography (3DTTE) in making a more comprehensive assessment and a more confident diagnosis of caseous mitral annular calcification. 3DTEE revealed a portion of the mass to consist of small, multiple, highly echogenic discrete band-like and punctate areas within a relatively much less echogenic stroma and surrounded by a well defined highly echogenic border. This appearance correlated with the pathological findings of calcific granules/strands located in a liquefied or semiliquefied interior providing a typical toothpaste like appearance. The highly echogenic outer border represented the residual outer portion or rim of the calcific mass which did not undergo liquefaction. These findings on 3DTEE which correlated with the toothpaste like appearance seen at surgery were not visualized on 2DTTE, 2DTEE, and 3DTTE. (Echocardiography 2010;27:1147-1150) [ABSTRACT FROM AUTHOR]

Live/real time three-dimensional transthoracic echocardiography provided incremental value over two-dimensional transthoracic echocardiography in an adult patient with complete atrioventricular (AV) septal defect by (1) making a confident diagnosis of Rastelli type A defect, (2) providing en face view of all the five leaflets of the common AV valve, (3) diagnosing left ventricle to right atrial shunt, and (4) permitting more accurate quantitative assessment of regurgitant lesions. (Echocardiography 2010;27:87-90) [ABSTRACT FROM AUTHOR]

We studied 31 patients with prosthetic valves (PVs) using two-dimensional and three-dimensional transthorathic echocardiography (2DTTE and 3DTTE, respectively) in order to determine whether 3DTTE provides an incremental value on top of 2DTTE in the evaluation of these patients. With 3DTTE both leaflets of the St. Jude mechanical PV can be visualized simultaneously, thereby increasing the diagnostic confidence in excluding valvular abnormalities and overcoming the well-known limitations of 2DTTE in the examination of PVs, which heavily relies on Doppler. Three-dimensional transthorathic echocardiography provides a more comprehensive evaluation of PV regurgitation than 2DTTE with its ability to more precisely quantify PV regurgitation, in determining the mechanism causing regurgitation, and in localizing the regurgitant defect. Furthermore, 3DTTE is superior in identifying, quantifying, and localizing PV thrombi and vegetations, in addition to the unique feature of providing a look inside mass lesions by serial sectioning. These preliminary results suggest the superiority of 3DTTE over 2DTTE in the evaluation of PVs and that it provides incremental knowledge to the echocardiographer. [ABSTRACT FROM AUTHOR]

We studied 19 patients with pericardial disease using two-dimensional and three-dimensional transthorathic echocardiography (2DTTE and 3DTTE, respectively) in order to determine whether 3DTTE provides incremental value on top of 2DTTE in the evaluation of these patients. With 3DTTE a more comprehensive assessment of pericardial effusion can be made and both the parietal and visceral layers of the pericardium can be visualized en face and examined for pathologies and fibrin deposits. In our series of patients, 3DTTE was superior to 2DTTE in uncovering mass lesions involving the pericardium such as tuberculous granulomas and metastatic disease. Furthermore, it provided a better assessment of the nature of pericardial lesions, such as pericardial and mediastinal hematomas, pericardial cysts, and metastatic disease to the pericardium by sequential cropping of the 3D data sets and visualizing the interior of the lesions in a manner not possible with 2DTTE. It was also valuable in determining the extent of pericardial calcification in pericardial constriction and in measuring the size of pericardial masses. These preliminary results suggest the superiority of 3DTTE over 2DTTE in the evaluation of pericardial diseases and that it provides incremental knowledge to the echocardiographer. [ABSTRACT FROM AUTHOR]

We studied 13 patients with valvular vegetations who underwent intraoperative live/real time three-dimensional transesophageal echocardiography (3DTEE) and real time two-dimensional transesophageal echocardiography (2DTEE). The 3DTEE provided incremental value on top of 2DTEE in its ability to accurately identify and localize vegetations and in identifying complications of infective endocarditis such as abscesses, perforations, and ruptured chordae. By using 3DTEE, we were able to measure vegetation volumes, perforation areas, and estimate the area of the valve that is involved in the infective process. These preliminary results suggest the superiority of 3DTEE over 2DTEE in the evaluation of valvular vegetations and provide incremental knowledge that is useful to the cardiac surgeons. [ABSTRACT FROM AUTHOR]

We studied 11 adult patients with dextro-transposition and 5 adult patients with levo-transposition (corrected transposition) of the great arteries with real time two-dimensional (2DTTE) and live/real time three-dimensional transthoracic echocardiography (3DTTE). All patients with dextro-transposition underwent a Mustard or Senning procedure during infancy. Incremental findings provided by 3DTTE and not delineated by 2DTTE were (a) comprehensive examination of all three leaflets of the tricuspid valve including the detection and measurement of anatomic defects in the leaflets and the assessment of systolic noncoaptation and segmental prolapse; (b) en face viewing and measurement of vena contracta areas of the valvular regurgitation jets and the assessment of regurgitant volumes; (c) en face viewing of the intra-atrial baffle and localization and measurement of baffle defects as well as the measurement of vena contractas of the baffle leaks; (d) recognition of a bicuspid pulmonary valve; and (e) the quantitative assessment of left ventricular outflow tract obstruction. 3DTTE appears to be a useful noninvasive modality which could supplement 2DTTE in the comprehensive assessment of adult patients with transposition of the great arteries. [ABSTRACT FROM AUTHOR]

Thirteen patients already scheduled for surgery for repair of prosthetic paravalvular regurgitation underwent intraoperative real time two-dimensional transesophageal echocardiography (2D TEE) and live/real time three-dimensional transesophageal echocardiography (3D TEE). In all patients, 3D TEE was able to provide more information regarding the location and size of the paravalvular defect as compared to 2D TEE. 3D TEE resulted in a more accurate localization of the defect and an estimation of the size of the defect that correlated much more closely with surgical findings when compared with 2D TEE. Our preliminary results demonstrate the superiority of 3D TEE over 2D TEE in the evaluation of paravalvular prosthetic regurgitation. 3D TEE not only provides an accurate assessment of the exact site of the leakage, but also gives a more accurate estimate of its size. This information could be valuable to surgeons who may encounter difficulty when localizing and estimating the size of paraprosthetic leaks while the heart is devoid of blood during surgery. [ABSTRACT FROM AUTHOR]

This case series demonstrates the incremental value of three-dimensional transthoracic echocardiography (3D TTE) over two-dimensional transthoracic echocardiography (2D TTE) in the assessment of 11 patients with right ventricular (RV) masses or mass-like lesions (three cases of RV thrombus, one myxoma, one fibroma, one lipoma, one chordoma, and one sarcoma and three cases of RV noncompaction, which are considered to be mass-like in nature). 3D TTE was of incremental value in the assessment of these masses in that 3D TTE has the capacity to section the mass and view it from multiple angles, giving the examiner a more comprehensive assessment of the mass. This was particularly helpful in the cases of thrombi, as the presence of echolucencies indicated clot lysis. In addition, certainty in the number of thrombi present was an advantage of 3D TTE. Also, sectioning of cardiac tumors allowed more confidence in narrowing the differential diagnosis of the etiology of the mass. In addition, 3D TTE allowed us to identify precise location of the attachments of the masses as well as to determine whether there were mobile components to the mass. Another noteworthy advantage of 3D TTE was that the volumes of the masses could be calculated. Additionally, the findings by 3D TTE correlated well with pathologic examination of RV tumors, and some of the masses measured larger by 3D TTE than by 2D TTE, which was also validated in one case by surgery. As in the case of RV fibroma, another advantage was that 3D TTE actually identified more masses than 2D TTE. RV noncompaction was also well studied, and the assessment with 3D TTE helped to give a more definitive diagnosis in these patients. [ABSTRACT FROM AUTHOR]

Lycopene is the principal pigment of the carotenoids naturally found in tomatoes and is important not only because of the color it imparts but also because of the recognized health benefits associated with its presence. Red tomatoes typically contain about 95% of their lycopene as the all -trans isomer, the most stable form. In tangerine tomatoes, on the other hand, the lycopene is present as tetra-cis-lycopene, a geometric isomer of all -trans lycopene. Lycopene is a major component found in blood serum. This carotenoid has been extensively studied for its antioxidant and cancer-preventing properties. Prevention of heart disease has been shown to be another antioxidant role played by lycopene because it reduces the accumulation of platelets that eventually lead to blood clots, heart attacks, and strokes. In contrast to many other food phytonutrients whose effects have only been studied in animals, lycopene from tomatoes has been repeatedly studied in humans and found to be protective against several cancers, which now include colorectal, prostate, breast, lung, and pancreatic cancers. This review outlines the background information dealing with lycopene and presents the most comprehensive and current understanding of its potential functional role in human health. [ABSTRACT FROM AUTHOR]

Consumers are becoming increasingly interested in healthful foods and are open to soy protein ingredients. Soybeans as food are very versatile and a rich source of essential nutrients. They are also an excellent source of good-quality protein, comparable to other protein foods, and suitable for all ages. Adverse nutritional and other undesirable effects followed by the consumption of raw soybean meal have been attributed to the presence of endogenous inhibitors of digestive enzymes and lectins, as well as poor digestibility. To improve the nutritional quality of soy foods, inhibitors and lectins are generally inactivated by heat or eliminated by fractionation during food processing. Soybeans provide an alternative source of protein for people who are allergic to milk protein. Soy protein is highly digestible (92% to 100%) and contains all essential amino acids. Although relatively low in methionine, it is a good source of lysine. Soy-protein products contain a high concentration of isoflavones, up to 1 g/kg. Increased acceptance of soy proteins is due to unmatched qualities like good functional properties in food applications, high nutritional quality, abundance, availability, and low cost. At present the various forms of soy proteins are primarily utilized for their functional effects rather than their nutritional properties. This article summarizes the integrated overview of the widely available, scattered information about the nutritional and functional uses of the soy proteins when applied in food systems and intends to present the most current knowledge with an interest to stimulate further research to optimize their beneficial effects. [ABSTRACT FROM AUTHOR]

Background: Fluoride and chlorhexidine (CHX) are state-of-the-art preventive measures for remineralizing teeth and for preventing plaque accumulation. The aim of this study was to examine the effects of fluoride and CHX varnishes on root caries and microbiota located on root surfaces. Methods: Thirty-three patients from a periodontal maintenance program, having at least one tooth with gingival recession in each quadrant, participated in this study. One tooth per quadrant was assigned randomly to the control group or to one of the test groups that were treated with fluoride varnish, 1% CHX, or 40% CHX. The varnish treatment and the tooth cleaning were repeated every 3 months. Clinical examinations were performed at baseline and once a year for 3 years. Caries status and oral hygiene indices were evaluated clinically. The total cultivable microbiota and percentage of Mutans streptococci (MS), Actinomyces (ACC), and lactobacilli (LB) were analyzed. Results: Oral hygiene was improved greatly during the course of the study. The percentage of MS, ACC, and LB of the total cultivable microbiota revealed a statistically significant reduction between baseline and final examination for each of the four groups. Conclusion: Professional tooth cleaning alone at 3-month intervals might be as effective in reducing MS, ACC, and LB as adjunctive treatment with fluoride or chlorhexidine. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions Islet antibody‐negative type 1 diabetes mellitus (T1DM) has not been well characterised. We determined the frequency of antibody‐negative T1DM and compared it with antibody‐positive T1DM in a cohort of north Indian children.In a multi‐centre, prospective, observational study, 176 Indian children (age 1–18 years) were assessed within 2 weeks of diagnosis of T1DM. Antibodies against GAD65 (GADA), islet antigen‐2 (IA‐2A) and zinc transporter 8 (ZnT8A), were estimated using validated ELISA. HLA‐DRB1, DQA1 and DQB1 alleles were studied by Luminex‐based typing. Monogenic diabetes was determined by targeted next‐generation sequencing using the Illumina platform.After excluding 12 children with monogenic diabetes, GADA, IA‐2A and ZnT8A were present in 124 (76%), 60 (37%) and 62 (38%) o children, respectively, while 24 (15%) were negative for all antibodies. A single antibody (most frequently GADA) was present in 68 (41%) of children, while all three antibodies were found in 34 (21%). Islet antibody‐negative T1DM (n = 24, 15%) did not differ from antibody‐positive children in their clinical features, HbA1c or plasma C‐peptide, both at onset or after 1 year follow‐up (available in 62 children). The frequency of other organ‐specific antibodies or high‐risk HLA‐DR and DQ alleles were also similar. Children with a single islet antibody did not differ from those with multiple antibodies.The frequency of various islet‐antibodies, in isolation and combination, differed considerably from studies among children of European descent with T1DM. Children with T1DM who were islet antibody‐negative were indistinguishable from those who were antibody‐positive. [ABSTRACT FROM AUTHOR]

We describe acute dysfunction of a bileaflet mechanical mitral valve prosthesis for the first time in a 57-year-old male. Unlike two-dimensional transesophageal echocardiography, three-dimensional imaging convincingly showed a large rounded echo density consistent with a papillary muscle in contact with one of the leaflets showing only partial opening during systole. (Echocardiography 2010;27:885-887) [ABSTRACT FROM AUTHOR]

We describe the value of live/real time three-dimensional transthoracic echocardiography (3DTTE) over two-dimensional transthoracic echocardiography (2DTTE) in the assessment of inferior vena cava (IVC) and hepatic vein (HV) obstruction in a patient with sickle cell disease. 3DTTE provided additional information when compared to 2DTTE by (1) identifying the obstructing lesion as a likely thrombus, (2) by providing assessment of anatomical severity of IVC lumen obstruction since the thrombus could be visualized en face also, and (3) identifying an area of increased mobility of a portion of the thrombus suggesting greater risk of embolization. (Echocardiography 2010;27:594-596) [ABSTRACT FROM AUTHOR]

We report a young patient with post traumatic acquired thoracic aortic coarctation in whom three-dimensional transthoracic echocardiography (3DTTE) demonstrated incremental value over two-dimensional transthoracic echocardiography (2DTTE). 3DTTE showed (1) en face views of the obstruction site that showed a markedly narrowed, roughly circular orifice measuring 0.33 cm2 in area, (2) echogenic tissue encroaching on the graft lumen consistent with fibrosis/thrombus, and (3) no graft protrusion into the aortic lumen, only hypermobility of the medial portion of the graft. These important findings were not detected by 2DTTE. (Echocardiography 2010;27:470-472) [ABSTRACT FROM AUTHOR]

We report a 3-year-old girl with autosomal dominant inherited Waardenburg syndrome type I showing circumscribed hypopigmentation of the skin, heterochromia iridis, sensorineural deafness, and dental aberrations. Clinical diagnosis was confirmed by the identification of an underlying missense mutation (C811T) in the PAX3 gene. Early diagnosis of Waardenburg syndrome among children with pigment anomalies enables a successful interdisciplinary medical care. [ABSTRACT FROM AUTHOR]

Real time two-dimensional transthoracic and transesophageal echocardiography demonstrated a mobile echolucent mass attached to the pulmonary valve in a 25-year-old adult, 20 years following balloon pulmonary valvuloplasty. The mass was surgically excised and pathology showed it to be a cyst. [ABSTRACT FROM AUTHOR]

We describe the usefulness of three-dimensional transthoracic echocardiography (3D TTE) in the assessment of bicuspid aortic valve morphology in an adult patient with no stenosis but severe aortic regurgitation. [ABSTRACT FROM AUTHOR]