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Objective: This study investigates the impact of maxillary advancement (Le Fort I osteotomy) on consonant proficiency in patients with cleft lip and palate (CLP) and explores how these patients and lay people perceive their speech 1 year post Le Fort I osteotomy.Design: Retrospective group study before and after treatment.Participants: All patients with CLP who had undergone Le Fort I osteotomy for maxillary retrognathia between 2007 and 2010 at Karolinska University Hospital, Sweden (n = 21). Six patients were excluded due to additional malformations and missing data. Two experienced speech and language pathologists assessed consonant proficiency, and speech accuracy was determined by lay listeners from pre- and postoperative standardized audio recordings. The patients’ satisfaction with speech postoperatively was collected from medical records.Main Outcome Measures: Percentage of oral consonants correct and acoustic analysis of /s/, lay listeners’ opinion, and patients’ satisfaction with speech.Results: One year postoperation, 11 of the 15 patients had improved articulation, especially on the /s/-sound, without speech intervention. The mean percentage of oral consonants correct before treatment (82%) was significantly improved later (95%; P> .01). This assessment was supported by the patients’ satisfaction with speech. However, lay listeners’ opinion on accuracy was inconsistent. Length of maxillary advancement or change in occlusion did not correlate with change in articulation.Conclusion: Maxillary advancement performed to normalize occlusion and facial profile improved consonant proficiency in patients with CLP 1 year postoperation. Lay listeners’ and patients’ perceptions of speech need further exploration.

Psychopathic traits vary dimensionally in the population and are associated with multiple negative outcomes. The impaired integration theory (IIT) proposes that psychopathic traits are associated with abnormal neural network topology, such that disturbed integration of neural networks results in a self-perpetuating impairment in rapid integration and learning from multiple components of information. The IIT is based on findings from male offenders presenting high scores on all psychopathic traits. The present study investigated whether IIT predictions of topology abnormalities were associated with psychopathic traits, measured dimensionally, in young adult women with subsyndromal scores.

High prevalence of behavioral risk factors for cardiovascular disease (CVD) warrants a life course approach for efficient prevention. Our previous HARDIC trial in semi-urban Nepal shows conventional CVD educational interventions for mothers improved knowledge, attitude, and practice (KAP). Digital cardiovascular health promotion provides opportunities to efficiently reach adolescents. Our aim was therefore to develop such digital health promotion through a serious game that is educational and entertaining, as an innovative way to reach adolescents. We conducted a mixed-method study to assess adolescents’ KAP and perception regarding CVD, explored opportunities for digital cardiovascular health promotion, and developed a concept for a serious game prototype. In total, 649 adolescents grades 8-10 in two government and seven private schools in a semi-urban community of Nepal were surveyed cross-sectionally following parental consent. A self-administered questionnaire assessed KAP of CVD, mobile phone use, internet availability at home and gaming behaviors. For deeper understanding of adolescents’ perception on CVD, we conducted eight focus group discussions (FGDs) separately among boys and girls (n=76). The health belief model and the technology acceptance model guided FGD development and analysis. Eighty percent of adolescents were aged 13-15 years, 49% were girls and 40.4% studied in government schools. The median (IQR) percent scores for KAP were 70.6 (10.59), 78.5 (8.46) and 69.5 (11.59), respectively. Good KAP (median percent scores >75%) was found in 27.7%, 69% and 27.8% adolescents, respectively. Knowledge (p<0.001), attitude (p=0.025) and practice (p<0.001) was higher among adolescents in private than government schools. Girls had better attitude than boys (<0.001). Furthermore, 98% adolescents had smartphone access and 91.6% had internet access.Preliminary FGD analyses show that adolescents mentioned physical, nutritional, mental, environmental, and hereditary causes for CVD. Financial and work-related burdens, as well as psychological, mental and family-related issues were perceived to influence CVD severity. Temptations for junk food and physical inactivity were barriers to follow heart-healthy behavior. Adolescents perceived serious games as beneficial and easy to use for creating CVD awareness. The game should offer challenge and exhibit increased levels of difficulty to remain stimulating throughout its intended use.We conclude that the existing gaps in knowledge and practice, with good attitude and excellent mobile and internet prerequisites, provide great opportunity for serious games in Nepal.The prototype of “Happy Heart” is being pilot-tested among adolescents, suggesting a promising way forward for digital cardiovascular health promotion.

AbstractFibromyalgia (FM) is a syndrome characterized by chronic pain without known peripheral causes. Previously, we have reported dysfunctional pain inhibitory mechanisms for FM patients during pain administration. In this study we employed a seed correlation analysis, independent component analysis (ICA), and an analysis of fractional amplitude of low frequency fluctuations (fALFF) to study differences between a cohort of female FM patients and an age- and sex-matched healthy control group during a resting-state condition. FM patients showed decreased connectivity between thalamus and premotor areas, between the right insula and primary sensorimotor areas, and between supramarginal and prefrontal areas. Individual sensitivity to painful pressure was associated with increased connectivity between pain-related regions (e.g., insula and thalamus) and midline regions of the default mode network (including posterior cingulate cortex and medial prefrontal cortex) among patients and controls. However, neither ICA nor fALFF revealed any group differences. Our findings suggest that abnormal connectivity patterns between pain-related regions and the remaining brain during rest reflect an impaired central mechanism of pain modulation in FM. Weaker coupling between pain regions and prefrontal- and sensorimotor areas might indicate a less efficient system level control of pain circuits. Moreover, our results show that multiple, complementary analytical approaches are valuable for obtaining a more comprehensive characterization of deviant resting-state activity. In conclusion, our findings show that FM primarily is associated with decreased connectivity, for example, between several pain-related areas and sensorimotor regions, which could reflect a deficiency in pain regulation.

AbstractPharmacological functional brain imaging has traditionally focused on neuropharmacological modulations of event-related responses. The current study is a randomized, cross-sectional resting-state functional magnetic resonance imaging study where a single dose of commonly prescribed amounts of either benzodiazepine (oxazepam), L-dopa, or placebo was given to 81 healthy subjects. It was hypothesized that the connectivity in resting-state networks would be altered, and that the strength of connectivity in areas rich in target receptors would be particularly affected. Additionally, based on known anxiolytic mechanisms of benzodiazepines, modulated amygdala (Am) connectivity was predicted. To test this, seed region-based correlational analysis was performed using seven seeds placed in well-characterized resting-state networks, in regions with above-average densities of GABA-A or dopamine receptors and in Am. To alleviate the anatomical bias introduced by the a prioriselected seed regions, whole-brain exploratory analysis of regional homogeneity and fractional amplitude of low-frequency fluctuations (fALFF) was also carried out. Oxazepam increased functional connectivity between midline regions of the default-mode network (DMN) and the prefrontal, parietal, and cerebellar areas, but decreased connectivity between, for example, the Am and temporal cortex. L-dopa mainly decreased connectivity between the Am and bilateral inferior frontal gyri and between midline regions of the DMN. The fALFF analysis revealed that L-dopa decreased low-frequency fluctuations in the cerebellum. It was concluded that the overall effects of single administrations of oxazepam and L-dopa on resting-state connectivity were small both in strength and in spatial extent, and were on par with placebo effects as revealed by comparing the two placebo groups.

To investigate visual function and ocular morphology in children born after intracytoplasmic sperm injection (ICSI) and compare them with visual function and ocular morphology in matched children born after spontaneous conception.

In the present study we describe the synthesis, wet spinning, mechanical testing, and degradation of poly(urethane urea)s (PUURs) intended for clinical use in anterior cruciate ligament (ACL) reconstruction. The effects of soft segment chemical composition and molar mass and the kind of diamine chain extender on the material properties were investigated. It was found that the fibers made of PUUR with polycaprolactone diol (PCL530) as soft segment and MDI/1,3-DAP as hard segment (PCL530-3) have high tensile strength and high modulus and when degraded keep their tensile strength for the time demanded for the application. In conclusion, from a chemical and mechanical point of view PUUR fibers of PCL530-3, ARTELON, are suitable for designing a degradable ACL device.

Large osteoclast-like cells, labeled by using monoclonal antibodies directed against macrophages, are participating in a bone remodeling process in the rat bullar bone after induced experimental acute otitis media, leading to tympanosclerosis.

AbstractThe etiology of multiple sclerosis (MS) may involve exposure to infectious, chemical or physical agents damaging the blood-brain barrier and an autoimmune reaction against myelin breakdown products. Here we report a pooled analysis of 174 MS cases and 815 population controls from two case-control studies with regard to such a potentially damaging exposure, namely X-ray examinations, radiological work and treatment with ionizing radiation. Exposure was assessed by questionnaires to the subjects. We obtained odds ratios of 4.4 (95% confidence interval, CI, 1.6–11.6) and 1.8 (95% CI 1.2–2.6) for radiological work and X-ray examinations, respectively; 5 cases, but no controls, in one of the studies had been treated with ionizing radiation. Our data and some other observations reported in the literature suggest a contributory role for ionizing radiation to the development of MS in some cases.Copyright © 2001 S. Karger AG, Basel

That NK cell receptors engage fast-evolving MHC class I ligands suggests that they, too, evolve rapidly. To test this hypothesis, the structure and class I specificity of chimpanzee KIR and CD94:NKG2 receptors were determined and compared to their human counterparts. The KIR families are divergent, with only three KIR conserved between chimpanzees and humans. By contrast, CD94:NKG2 receptors are conserved. Whereas receptors for polymorphic class I are divergent, those for nonpolymorphic class I are conserved. Although chimpanzee and human NK cells exhibit identical receptor specificities for MHC-C, they are mediated by nonorthologous KIR. These results demonstrate the rapid evolution of NK cell receptor systems and imply that “catching up” with class I is not the only force driving this evolution.

Background and aims:The predictive value of body mass and functional capacity for 1 year mortality was examined retrospectively in 552 consecutive geriatric patients categorized in 14 diagnosis groups.

ABSTRACTLigand screening was utilized to isolate a human cDNA that encodes a novel CpG binding protein, human CpG binding protein (hCGBP). This factor contains three cysteine-rich domains, two of which exhibit homology to the plant homeodomain finger domain. A third cysteine-rich domain conforms to the CXXC motif identified in DNA methyltransferase, human trithorax, and methyl-CpG binding domain protein 1. A fragment of hCGBP that contains the CXXC domain binds to an oligonucleotide probe containing a single CpG site, and this complex is disrupted by distinct oligonucleotide competitors that also contain a CpG motif(s). However, hCGBP fails to bind oligonucleotides in which the CpG motif is either mutated or methylated, and it does not bind to single-stranded DNA or RNA probes. Furthermore, the introduction of a CpG dinucleotide into an unrelated oligonucleotide sequence is sufficient to produce a binding site for hCGBP. Native hCGBP is detected as an 88-kDa protein by Western analysis and is ubiquitously expressed. The DNA-binding activity of native hCGBP is apparent in electrophoretic mobility shift assays, and hCGBP trans-activates promoters that contain CpG motifs but not promoters in which the CpG is ablated. These data indicate that hCGBP is a transcriptional activator that recognizes unmethylated CpG dinucleotides, suggesting a role in modulating the expression of genes located within CpG islands.

The red marine alga Polysiphonia sphaerocarpawas extracted by a simultaneous steam distillation-solvent extraction technique and several brominated compounds were identified by gas chromatography–mass spectrometry. The compounds detected were 2,4-dibromoanisole, 2,4,6-tribromoanisole, 3-bromocresol, 3,5-dibromocresol, 3-bromo-4- hydroxybenzaldehyde, 3,5-dibromo-4-hydroxybenzaldehyde, 2-bromophenol, 4-bromophenol, 2,4-dibromophenol, 2,6-dibromophenol and 2,4,6-tribromophenol. This is the first time brominated anisoles and cresols have been detected in marine algae.

The neurosteroid allopregnanolone modulates oxytocin expression in the brain, and its effects arise from its action on the GABAAreceptor. Whether neurosteroid levels and the function of the GABAAreceptor are involved in the risk of preterm labour in pregnant women is unknown. Pregnant women with (n= 16) or without (n= 20) threatened preterm labour (TPL) in gestational week 33 + 6 days to 37 + 0 days were studied prospectively with procedures including foetal heart rate monitoring, vaginal examination, ultrasound examination and blood tests to determine allopregnanolone, progesterone and oxytocin levels. The GABAAreceptor function in both groups was measured with a saccadic eye velocity test (SEVT). Plasma oxytocin levels were higher in the TPL group than in the control group (41.5 vs. 37.0 pmol/L, respectively, p= .021). Although the allopregnanolone and progesterone levels in both groups did not differ, there was a negative association between blood oxytocin and allopregnanolone (as predictor) levels in the TPL group (B: −3.2, 95% confidence interval (CI): −5.5 to −0.9, p= .012). As a predictor of TPL, progesterone was associated with cervix maturity (odds ratio: 1.02, 95% CI: 1.00–1.04, p= .038). SEVT showed that the women in both groups had similar GABAAreceptor functions. In both groups, body mass index correlated with peak saccadic eye velocity (r= .34, p= .044) and negatively with allopregnanolone (r= −.41, p= .013). Neurosteroid levels were unchanged in the peripheral blood of women with TPL, despite the increase in available oxytocin. Although the function of the GABAAreceptor was unchanged in women with TPL, to ensure reliable results, saccadic eye velocity should be investigated during a challenge test with a GABAAreceptor agonist. The GABAergic neurosteroid allopregnanolone inhibits oxytocin synthesis during pregnancy, and in women with threatened preterm labour, the levels of the allopregnanolone and progesterone in the peripheral blood and GABAA receptor function were unchanged, despite the increase in available oxytocin, but an association between allopregnanolone and oxytocin levels may suggest a central mechanism in which allopregnanolone controls the peripheral oxytocin levels.

Clinical experience of cases of fatty liver disease (FLD) with exposure to organic solvents suggested a possible risk. Thirty male cases of FLD, ages 20–59 years, with biopsy records at departments of pathology in southeast Sweden were compared to 120 male controls randomly drawn from the study area population. Questionnaire information was obtained about job titles and specific occupational exposures; exposure level categories were then assessed blindly for both cases and controls. Medical records for cases were scrutinized to elucidate possible confounding and/or interacting effects from alcohol, the use of drugs, and other diseases. Moderately intense and mixed solvent exposure for more than 1 year within the last 15 years prior to diagnosis resulted in an age-adjusted Mantel-Haenszel odds ratio of 4.3 (95% confidence interval (CI), 1.2–15); for intense exposure, the odds ratio was 7.7 (95% CI 1.7–48). Confounding from alcohol, use of drugs, other diseases, and overweight could be ruled out with reasonable confidence. This study indicates that occupational exposure to organic solvents may play a role in the development of FLD, as indicated earlier in case reports and in one small case-control study. Am. J. Ind. Med. 35:132–136, 1999. © 1999 Wiley-Liss, Inc.

From previous investigations of the alkaline dehydrochlorination of PVC it is well known that polyene sequences are formed. In this paper the true overall kinetics of the dehydrochlorination reaction between PVC and alcoholic KOH in tetrahydrofuran solution was studied at 9.5°C by measuring the rate of disappearance of KOH. Titrations of the hydroxide ions consumed and the chloride ions evolved showed close agreement. IR spectra of the samples did not show any evidence of substitution by hydroxide ions. Small amounts of DMSO present in the solvent were found to increase the reaction rate markedly. The kinetic scheme was discussed and the first rate constant was determined. Preliminary results of reactions of the polyene sequences with various reagents are presented. These reactions were made in order to introduce new functional groups into the PVC chains.

To evaluate the possible relation between exposure to organic solvents and the development of multiple sclerosis, we carried out a bestevidence synthesis of the available information. We found 13 studies with varying methodology that included information on solvent exposure. In 10 of the studies, there were indications of an increased risk of multiple sclerosis in relation to solvent exposure. We made three selections of studies for both pooled analyses and metaanalyses. The relative risk point estimates that we obtained varied from 1.7 to 2.6. Our evaluation is consistent with the hypothesis that organic solvents may be a cause of multiple sclerosis.