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To evaluate the best option among orthoses for carpometacarpal (CMC) osteoarthritis (OA) of the thumb, using a network meta-analysis. Medline, Embase, Cochrane, and ClinicalTrials.gov registry databases were used. PubMed, Embase, Cochrane Controlled Trials Register, Cochrane, and other databases were used without language restrictions. We searched randomized controlled trials (RCTs) on adults with OA of the thumb by studying any orthosis from the beginning to March 10, 2020. Data were extracted and checked for accuracy and completeness by pairs of reviewers. Outcomes were pain and function. Comparative treatment effects were analyzed by random-effects model for direct pairwise comparisons and Bayesian network meta-analyses to integrate direct and indirect evidence. Eleven RCTs involving 619 patients were included. We evaluated 5 groups, for 4 different orthoses: short thermoplastic CMC splint (rigid CMC) (n=5), long thermoplastic carpometacarpal-metacarpophalangeal splint (rigid CMC-MCP) (n=7), short neoprene CMC splint (soft CMC) (n=1), long neoprene CMC-MCP splint (soft CMC-MCP) (n=5), and one as a control group (n=5). Our results show that all splints were superior to placebo to reduce pain intensity and the top-ranked intervention was the rigid CMC-MCP (surface under the cumulative ranking curve analysis [SUCRA], score: 65.4). In function evaluation, we report a 71.6 SUCRA for rigid CMC. Although the current evidence is unclear on the use of the splint in OA of the thumb, it is not known which orthosis is more effective and whether the orthosis is more effective than other interventions. The network meta-analysis shows that a long thermoplastic splint it is the best choice for pain relief and the short thermoplastic CMC splint is the best treatment to increase function. These results may suggest initial treatment with a long rigid orthosis and then a short rigid orthosis. [ABSTRACT FROM AUTHOR]

Hypereosinophilic syndromes are characterized by an increased number of blood eosinophils (usually more than 1.5 × 109) infiltrating tissues and causing organ damage through over-production of pro-inflammatory cytokines with heterogeneous clinical presentation. Here we present a case of a 47 years old male, with an unremarkable previous medical history, with a sudden onset of subungual hemorrhage and low back pain. Admitted for right arm weakness and vomiting, was raised the suspicion of acute cerebrovascular syndrome, but a brain CT scan with angiogram and perfusion sequences did not show any signs of early ischaemic lesions; conversely, lab tests revealed an increased peripheral eosinophil blood count. Clinical conditions rapidly worsened and a brain MRI showed multiple sub-acute ischaemic lesions compatible with vasculitis while EEG was in favor of widespread cortical distress. Diagnosis of the hypereosinophilic syndrome was made through peripheral blood smear and osteo-medullar biopsy, which showed a rich prevalence of eosinophils. The molecular biology testing showed FIP1L1-PDGRA gene mutation. Despite the prompt therapy beginning with intravenous corticosteroids and tyrosine-kinase inhibitors with normalization of cell blood count in a few days, the patient remained in minimal consciousness. When facing unusual symptoms onset (low back pain with weakness in one limb) and a highly impaired WBC not consistent with other courses (such as infections, vasculitis, allergies, and other diseases involving the immune system) clinicians should take into account the possibility of a hematological disorder and treat it as soon as possible to avoid a poor prognosis. [ABSTRACT FROM AUTHOR]

In recent years the international community has acknowledged the importance of gender perspectives in Disaster Risk Reduction (DRR), arguing that social constructs of gender lead to structural inequalities, prejudices and biases that articulate people's disaster vulnerabilities and capabilities in all disaster phases. Studies showed that especially women are prone to gender-based disaster risks, and it is the responsibility of national governments not only to identify these vulnerabilities but also to develop disaster education and preparedness strategies to address them. To better understand gender-based disaster vulnerability in Japan, this study identifies factors of disaster vulnerabilities of women within a complex set of social and community norms and values, stressing the impact of public discourses of gender. Then, this paper addresses the questions: "What are the disaster vulnerabilities of women in Japan?" and "What is the impact of discourses of gender on disaster vulnerabilities of women in disaster preparedness Japan?". To address the first question, factors of vulnerability were identified through Grounded Theory based on data collected from participant observations and stakeholder interviews. Then, the impact of discourses around gender was extracted from the literature on gender and DRR using Critical Discourse Analysis. The study results show that the main factors of gendered disaster vulnerability are inadequate disaster education, a lack of protection measures, and cultural issues. Moreover, public discourses of gender are shown to not only shape these factors but to be deeply embedded in Japan's disaster preparedness strategies at large affecting both the quality and quantity of disaster information available. [ABSTRACT FROM AUTHOR]

Background: Histamine modulates several functions in human monocytes, macrophages, and dendritic cells. However, responses elicited by histamine differ depending on cell type, suggesting variable expression of histamine receptors in the monocyte/macrophage lineage. Objective: We sought to examine whether the expression of H1 receptors was regulated by cell differentiation of human monocytes into macrophages or dendritic cells. Methods: Expression of H1 receptor was evaluated by RT-PCR and western blot in monocytes, monocyte-derived macrophages (MDMs), monocyte-derived dendritic cells (DCs) and human lung macrophages (HLMs). Results: Expression of H1 receptor mRNA and protein was higher in HLMs and DCs than in monocytes. H1 expression was approximately 15-fold and 4-fold higher in MDMs and HLMs, respectively, as compared with that seen in monocytes. H1 receptor protein was undetectable in monocytes, whereas it was conspicuous in MDMs. Simultaneous analysis of H2 and H1 mRNA expression indicated that the H2/H1 ratio decreased from 202.7 ± 14.8 in monocytes to 2.2 ± 0.4 in MDM and 39.5 ± 5.0 in DCs. Incubation of monocytes with histamine neither affected intracellular Ca2+ concentrations nor influenced IL-8 production. In contrast, histamine rapidly induced a Ca2+ signal and stimulated IL-8 production in MDMs. Both effects were inhibited by H1 blockade with levocetirizine, but not by H2 blockade with ranitidine. Conclusions: Differentiation of monocytes into macrophages or dendritic cells is associated with profound changes of histamine receptor expression. Upregulation of H1 receptors confers on macrophages the capacity of being activated by histamine. Clinical implications: Regulation of H1 and H2 receptor expression in the monocyte/macrophage lineage can be relevant to the pathogenesis of allergic inflammation. [Copyright &y& Elsevier]

This study aims to determine the best choice of breathing exercises (BE) for patients with chronic obstructive pulmonary disease (COPD) via a network meta-analysis. We searched randomized controlled trials (RCTs) of adults with COPD investigating any BEs in MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov databases. The effects of comparative treatment on the St. George Respiratory Questionnaire as the outcome were analysed and ranked according to a surface under the cumulative classification curve (SUCRA) analysis. The network meta-analysis included six RCTs involving 280 patients with four intervention groups, comprising control, diaphragmatic breathing training (DBT), yoga, and singing course. Performing SUCRA, we reported that yoga is 75% likely to be the best treatment available as DBT with 66%, instead of 35% for singing and 21% for control. DBT and yoga seem to be the best choices for breathing exercises in people with COPD. • To assess best breathing exercise in chronic obstructive pulmonary disease among yoga, diaphragmatic breathing, and singing. • Trials with pursed-lip breathing and St. George's respiratory questionnaire as outcome are needed for further investigation. • The best breathing exercises for chronic obstructive pulmonary disease seem to be diaphragmatic breathing and yoga. [ABSTRACT FROM AUTHOR]

In this paper is presented consolidation of nanometer-sized molybdenum powders to form bulk samples by the technique of Plasma Pressure Compaction (P2C). The nanocrystalline powders, consolidated at a temperature of 1400 °C and pressure of 48 MPa for a time period of 3 min, had a theoretical density of 97%. The presence of distributed agglomerates in the nanocrystalline powders has an influence on density and microstructure of the bulk metal sample. To facilitate comparison micrometer-sized powders of molybdenum were also consolidated, at a temperature of 1650 °C, and had a theoretical density of 98.5%. The bulk sample obtained by consolidating nanocrystalline powders had a higher microhardness (2.95 GPa) than the sample obtained by consolidating from micron-sized powders (2.16 GPa). [Copyright &y& Elsevier]

In this paper, the quasi-static and cyclic fatigue fracture behavior of aluminum alloy 6061 discontinuously-reinforced with fine particulates of silicon carbide are presented and discussed. The discontinuous particulate-reinforced 6061 aluminum alloy was cyclically deformed to failure at ambient temperature under stress-amplitude controlled conditions. The influence of volume fraction of particulate reinforcement on high cycle fatigue response is presented. The underlying mechanisms governing the fracture behavior during quasi-static and cyclic fatigue deformation are discussed and rationalized in light of concurrent and mutually interactive influences of composite microstructural features, deformation characteristics of the metal matrix and reinforcement particulate, nature of loading and ductility of the microstructure. [Copyright &y& Elsevier]

Type 2 diabetes is a metabolic disorder that may cause major problems to several physiological systems. Exercise has proven to be very effective in the prevention, management and improvement of this pathology in patients. Muscle metabolism is often studied with near-infrared spectroscopy (NIRS), a noninvasive technique that can measure changes in the concentration of oxygenated (O2Hb) and reduced hemoglobin (HHb) of tissues. These NIRS signals are highly non-stationary, non-Gaussian and nonlinear in nature. The empirical mode decomposition (EMD) is used as a nonlinear adaptive model to extract information present in the NIRS signals. NIRS signals acquired from the tibialis anterior muscle of controls and type 2 diabetic patients are processed by EMD to yield three intrinsic mode functions (IMF). The sample entropy (SE), fractal dimension (FD), and Hurst exponent (HE) are computed from these IMFs. Subjects are monitored at the beginning of the study and after one year of a physical training programme. Following the exercise programme, we observed an increase in the SE and FD and a decrease in the HE in all diabetic subjects. Our results show the influence of physical exercise program in improving muscle performance and muscle drive by the central nervous system in the patients. A multivariate analysis of variance performed at the end of the training programme also indicated that the NIRS metabolic patterns of controls and diabetic subjects are more similar than at the beginning of the study. Hence, the proposed EMD technique applied to NIRS signals may be very useful to gain a noninvasive understanding of the neuromuscular and vascular impairment in diabetic subjects. [ABSTRACT FROM AUTHOR]

Abstract: Diabetes mellitus (DM) is a metabolic disorder that is widely rampant throughout the world population these days. The uncontrolled DM may lead to complications of eye, heart, kidney and nerves. The most common type of diabetes is the type 2 diabetes or insulin-resistant DM. Near-infrared spectroscopy (NIRS) technology is widely used in non-invasive monitoring of physiological signals. Three types of NIRS signals are used in this work: (i) variation in the oxygenated haemoglobin (O2Hb) concentration, (ii) deoxygenated haemoglobin (HHb), and (iii) ratio of oxygenated over the sum of the oxygenated and deoxygenated haemoglobin which is defined as: tissue oxygenation index (TOI) to analyze the effect of exercise on diabetes subjects. The NIRS signal has the characteristics of non-linearity and non-stationarity. Hence, the very small changes in this time series can be efficiently extracted using higher order statistics (HOS) method. Hence, in this work, we have used sample and HOS entropies to analyze these NIRS signals. These computer aided techniques will assist the clinicians to diagnose and monitor the health accurately and easily without any inter or intra observer variability. Results showed that after a one-year of physical exercise programme, all diabetic subjects increased the sample entropy of the NIRS signals, thus revealing a better muscle performance and an improved recruitment by the central nervous system. Moreover, after one year of physical therapy, diabetic subjects showed a NIRS muscular metabolic pattern that was not distinguished from that of controls. We believe that sample and bispectral entropy analysis is need when the aim is to compare the inner structure of the NIRS signals during muscle contraction, particularly when dealing with neuromuscular impairments. [Copyright &y& Elsevier]

Abstract: Secreted phospholipases A2 (sPLA2s) are molecules released in plasma and biological fluids of patients with systemic inflammatory, autoimmune and allergic diseases. These molecules exert proinflammatory effects by either enzymatic-mechanisms or through binding to surface molecules expressed on inflammatory cells. sPLA2s are released at low levels in the normal airways and tend to increase during respiratory allergies (e.g., rhinitis and bronchial asthma) as the result of local secretion. Several sPLA2 isoforms are expressed in the human lung and some of them (e.g., group IIA and group X) are released in the airways of patients with rhinitis or asthma. Mast cells play a major role in the pathogenesis of respiratory allergies and other chronic inflammatory lung diseases. Recent evidence indicates that mast cells purified from human lung express most of the sPLA2 isoforms so far described. IgE-mediated activation of these cells induce the release of sPLA2s suggesting that mast cells are a main source of extracellular sPLA2s during allergic reactions. Once released, sPLA2s may contribute to the generation of eicosanoids (e.g., PGD2 and LTC4) and to the release of preformed mediators (e.g., histamine) by an autocrine loop involving the interaction of sPLA2s with surface molecules such as heparan sulphate proteoglycans or the M-type receptor. Thus, mast cell-derived sPLA2s may play an important role in the initiation and amplification of the inflammatory reactions in patients with allergic rhinitis and bronchial asthma. [Copyright &y& Elsevier]

Abstract: In this study a ceramic powder mixture of titanium diboride (TiB2) and boron carbide (B4C) was consolidated to near theoretical density using the rapid consolidation technique of plasma pressure compaction. Rapid consolidation of the mixture of single phase ceramic powders is essential for purposes of achieving better microstructural control and mechanical properties in the consolidated end product. Influence of consolidation temperature on microstructural development and microhardness of the composite samples is examined. Microhardness measurements reveal an initial increase in hardness of the composite samples at 1700°C consolidation temperature and a subsequent decrease with further increase in the temperature of consolidation. The role of consolidation temperature in microstructural development, to include the presence, nature and distribution of artifacts, and hardness is discussed. [Copyright &y& Elsevier]

The objective was to identify any possible cases of variant Creutzfeldt-Jakob disease (CJD) in Italy, and to estimate the trends in mortality from sporadic CJD for 1993–2000. CJD cases were ascertained through direct notification to the Registry; 382 definite or probable sporadic CJD patients, but no cases of variant CJD were identified. The average yearly mortality rate was 1.04 cases per million inhabitants, with an increase in deaths in the 60–69 and ⩾70 year age groups. Survival was shorter in male respect to female and in patients with an age at onset ⩾65 years. CJD cases were uneven distributed among different regions in the period 1993–1995, but not herein after. The rise in mortality from sporadic CJD in Italy likely reflects increased awareness and better diagnosis during the years. However, continuous notification and postmortem examination of all suspected cases are recommended for optimal surveillance. [Copyright &y& Elsevier]

This paper describes the consolidation of copper powders by the technique of plasma pressure compaction. Microstructural observations and density measurements provide evidence of the presence of residual porosity even after consolidation at 820 °C. Vicker''s microhardness measurements revealed the sample consolidated at temperatures as high as 820 °C to have the maximum hardness of 0.79 GPa. The influence of processing variables on microstructure, including the presence and distribution of processing-related artifacts, density and microhardness are presented and discussed. [Copyright &y& Elsevier]

Facial nerve paralysis (FNP) has a significant effect on a person's quality of life. In individuals with FNP undergoing facial rehabilitation, methods to analyze the loss of function are useful in diagnosis, treatment and follow up. To propose a protocol with kinematic analysis coupled with sEMG to evaluate the outcomes of FNP, quantifying the excursion degrees of the facial muscles and symmetry of voluntary movements. 10 patients (Group A) were followed by diagnosis until the end of the rehabilitation program. Kinematic analysis of 20 healthy adults (group B) was performed as a starting point to have a normality range and to test intra-subject and inter- intra rater reliability. An optoelectronic system and sEMG wireless electrodes were used. In Group A, a significant improvement in the movement of frontalis muscle (P = 0.0118) after 4-week treatment from the beginning (T0) 9.8 ± 4.5 mm to the end of rehabilitation (T1) 16.3 ± 5.8 mm and orbicularis oris (P = 0.0143) from T0 14.8 ± 5.5 mm to T1 20.3 ± 3.3 mm and, a reduction of % of maximum voluntary contractions (MVC) at T1 for frontalis and orbicularis compared to T0. This protocol provides meaningful data in a simple, reliable and objective way for the functional assessment of patients with PNF. [ABSTRACT FROM AUTHOR]