An exploration of the disease burden due to Cryptosporidium in consumed surface water for sub-Saharan Africa

The protozoan pathogen Cryptosporidium is an important cause of diarrhoeal disease, but in many contexts its burden remains uncertain. The Global Waterborne Pathogen model for Cryptosporidium (GloWPa-Crypto) predicts oocyst concentrations in surface water at 0.5 by 0.5° (longitude by latitude) resolution, allowing us to assess the burden specifically associated with the consumption of contaminated surface water at a large scale. In this study, data produced by the GloWPa-Crypto model were used in a quantitative microbial risk assessment (QMRA) for sub-Saharan Africa, one of the regions most severely affected by diarrhoeal disease. We first estimated the number of people consuming surface water in this region and assessed both direct consumption and consumption from a piped (treated) supply. The disease burden was expressed in disability adjusted life years (DALYs). We estimate an annual number of 4.3 × 10⁷ (95% uncertainty interval [UI] 7.4 × 10⁶–5.4 × 10⁷) cases which represent 1.6 × 10⁶ (95% UI 3.2 × 10⁵–2.3 × 10⁶) DALYs. Relative disease burden (DALYs per 100,000 persons) varies widely, ranging between 1.3 (95% UI 0.1–5.7) for Senegal and 1.0 × 10³ (95% UI 4.2 × 10²–1.4 × 10³) for Eswatini. Countries that carry the highest relative disease burden are primarily located in south and south-east sub-Saharan Africa and are characterised by a relatively high HIV/AIDS prevalence. Direct surface water consumption accounts for the vast majority of cases, but the results also point towards the importance of stable drinking water treatment performance. This is, to our knowledge, the first study to utilise modelled data on pathogen concentrations in a large scale QMRA. It demonstrates the potential value of such data in epidemiological research, particularly regarding disease aetiology.     

摩擦化学法硅涂层对氧化锆陶瓷粘接强度的影响

目的： 评估摩擦化学法硅涂层对氧化锆陶瓷粘接强度的影响。方法： 将切割烧结后的Lava氧化锆瓷块60件分为6组，每2组分别经喷砂/硅烷偶联剂、喷砂/CoJet Sand/硅烷偶联剂、无处理3种表面处理后，相同表面处理的2组中，每组分别用RelyX Unicem或Panavia F2.0与牙釉质粘接。各组随机抽取5件共30件进行24 h水浴，其余30件进行5000周水热循环，然后进行剪切粘接强度测试。采用SPSS 23.0软件包对数据进行双因素方差分析、Tukey HSD多重比较法及t检验。结果： 喷砂/CoJet/硅烷组的剪切强度均显著高于其他2组（P<0.001）；经老化试验后，喷砂/CoJet/硅烷组使用RelyX Unicem仍保持较高的剪切强度[(21.374±4.433)MPa]，与其他各组相比有显著差异（P<0.001）。结论： 摩擦化学法硅涂层能够有效提高氧化锆的粘接强度及耐久性，表面处理方式与粘接剂之间的相互作用需得到临床关注。     

Functional outcomes and complications after treatment of distal radius fracture in patients sixty years and over: A systematic review and network meta-analysis

AimThis network meta-analysis aims to compare functional outcomes and complications between conservative treatment and surgery for distal radius fractures in patients aged 60 years and over.MethodsWe searched the PubMed, EMBASE, and Web of Science databases for randomized controlled trials (RCTs) assessing the effect of conservative treatment and surgery for distal radius fractures in patients aged 60 years and over. Primary outcomes included grip strength and overall complications. Secondary outcomes included Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Patient-Rated Wrist Evaluation (PRWE) scores, wrist range of motion and forearm rotation, and radiographic assessment. All continuous outcomes were assessed using standardized mean differences (SMDs) with 95% confidence intervals (CIs), and binary outcomes were assessed using odds ratio (OR) with 95% CIs. The surface under the cumulative ranking curve (SUCRA) was used to determine a hierarchy of treatments. Cluster analysis was performed for grouping treatments based on the SUCRA values of primary outcomes.ResultsFourteen RCTs were included to compare conservative treatment, volar lockedplate (VLP), K-wires fixation, and external-fixation. VLP outperformed conservative treatment for 1-year and minimum 2-year grip strength (SMD; 0.28 [0.07 to 0.48] and 0.27 [0.02 to 0.53], respectively). VLP yielded the optimal grip strength at 1-year and minimum 2-year follow-up (SUCRA; 89.8% and 86.7%, respectively). In a subgroup analysis of patients aged 60 to 80 years old, VLP outperformed conservative treatment in DASH and PRWE scores (SMD, 0.33 [0.10, 0.56] and 0.23 [0.01, 0.45], respectively). In addition, VLP had the fewest complications (SUCRA = 84.3%). Cluster analysis suggested that VLP and K-wire fixation were more effective treatment groups.ConclusionEvidence to date demonstrates that VLP provides measurable benefits in grip strength and fewer complications to those 60 years of age and over, and that benefit is not reflected in current practice guidelines. There is a subgroup of patients where K-wire fixation outcomes are similar to those of VLP; defining this subgroup may yield substantial societal benefits.     

Biomolecular modification of p(AAm-co-EG/AA) IPNs supports osteoblast adhesion and phenotypic expression

Interpenetrating polymer networks (IPNs) were designed to resist materials fouling caused by non-specific protein adsorption, and indiscriminate cell or bacterial adhesion. These IPNs were thin adherent films ( ~ 20 nm) comprised of acrylamide (AAm), ethylene glycol (EG), and acrylic acid (AA) grafted to either silicon waters or quartz substrates via photoinitiated free radical polymerization. These networks were further modified to promote specific cell adhesion by tethering bioactive groups such as peptides that mimic cell-binding domains found on extracellular matrix molecules. As a specific example of biomolecular surface engineering, peptides from the cell-binding domain of bone sialoprotein were tethered to a p(AAm-co-EG/AA) IPN to control cell behavior at the surface. The networks were characterized by contact angle measurements, spectroscopic ellipsometry, and X-ray photoelectron spectroscopy to convey information on IPN wettability, thickness, and chemistry. The surface characterization data supported the theory that the PEG/AA layer formed an IPN with the underlying p(AAm) network, and after graft modification of this IPN with diamino PEG (PEG(NH₂)₂), the PEG(NH₂)₂ chains were enriched at the surface. Rat calvarial osteoblasts attached to Arg-Gly-Asp (RGD) modified IPNs at levels significantly greater than on clean quartz, Arg-Gly-Glu (RGE) modified, or the PEG(NH₂)₂ modified IPN, with or without serum in the media. Cells maintained in media containing 15% fetal bovine serum (FBS) proliferated, exhibited nodule formation, and generated sheets of mineralized extracellular matrix (ECM) with the addition on β-glycerophosphate to the media. Cell adhesion and mineralized ECM formation were specifically dependent on the peptide sequence present at the surface.     

Electromyographic evaluation of synergist muscles of the pelvic floor muscle depending on the pelvis setting in menopausal women: A prospective observational study

BackgroundPelvic floor muscle (PFM) training is recommended to increase their strength and endurance. Muscles which act synergistically with PFM are taken into consideration in the therapeutic management of weakened PFM.Research questionhow does electromyography activity of the synergists muscle to PFM change concerning pelvis position and does the greater bioelectric activity of synergist muscles affect PFM function?MethodsA prospective, observational study evaluating the surface electromyography (sEMG) activity of selected synergist muscles of the PFM depending on the orientation of the pelvis. One hundred thirty-one menopausal women registered for the study were screened for inclusion and exclusion criteria, and by the results, eighty-two participants were enrolled for measurements. The comparisons of results between the values obtained in different positions of the pelvis (anterior pelvic tilt – P1, posterior pelvic tilt – P2 and neutral pelvic tilt – P3) were performed using Kruskal–Wallis test. A multivariate linear regression analysis was used to assess relationships between the bioelectrical activity of PFM and activity of all tested muscles – rectus abdominis (RA), gluteus maximus (GM), and adductor magnus (AM).ResultsHigher RA, GM, AM bioelectrical activity was observed in the P2 as compared to P3 (during resting and functional PFM activity)(p < 0.05). Multivariate linear regression did not find the association between the bioelectrical activity of PFM and the activity of all synergist muscles in each position.SignificancesEMG activity of selected muscles acting synergistically with PFM differ depending on the pelvis position and is the highest in the posterior pelvic tilt. Greater activity of the synergists, resulting from the pelvic position, does not affect the myoelectric activity of PFM. It seems that muscles that act synergistically with PFM may not play such a significant role in the therapeutic management of PFM.     

The role of the prefrontal cortex in the development of muscle fatigue in Charcot–Marie–Tooth 1A patients

This study aimed at comparing both peripheral and central mechanisms of muscle fatigue between Charcot–Marie–Tooth 1A patients and healthy individuals during a fatiguing voluntary task by simultaneous electromyographic and electroencephalographic recordings. Six Charcot–Marie–Tooth 1A patients (3 females, 40 ± 11 years) and 6-matched healthy individuals performed four blocks of sub-maximal isometric knee extensions. At the beginning of the session and after each block, electrically-evoked maximal single-twitch, maximal voluntary contraction and surface-electromyography of the vastus lateralis muscle were measured. The movement-related-cortical potentials were averaged in early (block 1–2) and late (block 3–4) stages of fatigue. The effect of fatigue was demonstrated at peripheral level by the decline of maximal voluntary contraction, maximal twitch and surface electromyography amplitude and at central level by the larger amplitude of movement-related-cortical-potentials during late than early stage of fatiguing sub-maximal contractions. Charcot–Marie–Tooth 1A patients showed lower motor cortex activity during motor planning, with earlier onset and larger prefrontal cortex activity during the late stage of the fatiguing task than healthy controls. These data demonstrate the key role of the prefrontal cortex in the development of fatigue in Charcot–Marie–Tooth 1A patients, which may be activated as a compensatory mechanism for the low motor cortex activation, thus reflecting high awareness of movement complexity.     

Detection of progressive idiopathic scoliosis during growth using back surface topography: A prospective study of 100 patients

The progression of adolescent idiopathic scoliosis is typically monitored via regular radiographic follow-up. The Cobb angle (as measured on whole-spine radiographs) is considered as the gold standard in scoliosis monitoring.ObjectiveTo determine the sensitivity and specificity of back surface topography parameters, with a view to detecting changes in the Cobb angle.Patient and methodOne hundred patients (mean age: 13.3) with Cobb angles greater than 10 degrees were included. Topographic parameters were measured in a standard position and in a position with hunched shoulders. Gibbosities and spinal curvatures were evaluated.ResultsAn increase of more than 2 degrees in any one gibbosity or in the sum of the gibbosities (in either of the two examination positions) enabled the detection of a five-degree increase in the Cobb angle with a sensitivity of 86% and a specificity of 50%.ConclusionIf the present results are confirmed by other studies, analysis with back surface topography parameters may reduce the number of X-ray examinations required to detect increases in the Cobb angle.     

Surface topography and chemistry shape cellular behavior on wide band-gap semiconductors

The chemical stability and electrical properties of gallium nitride make it a promising material for the development of biocompatible electronics, a range of devices including biosensors as well as interfaces for probing and controlling cellular growth and signaling. To improve the interface formed between the probe material and the cell or biosystem, surface topography and chemistry can be applied to modify the ways in which the device interacts with its environment. PC12 cells are cultured on as-grown planar, unidirectionally polished, etched nanoporous and nanowire GaN surfaces with and without a physisorbed peptide sequence that promotes cell adhesion. While cells demonstrate preferential adhesion to roughened surfaces over as-grown flat surfaces, the topography of that roughness also influences the morphology of cellular adhesion and differentiation in neurotypic cells. Addition of the peptide sequence generally contributes further to cellular adhesion and promotes development of stereotypic long, thin neurite outgrowths over alternate morphologies. The dependence of cell behavior on both the topographic morphology and surface chemistry is thus demonstrated, providing further evidence for the importance of surface modification for modulating bio-inorganic interfaces.