Effects of intracutaneous injections of sterile water in patients with acute low back pain: a randomized, controlled, clinical trial

Intracutaneous sterile water injection (ISWI) is used for relief of low back pain during labor, acute attacks of urolithiasis, chronic neck and shoulder pain following whiplash injuries, and chronic myofascial pain syndrome. We conducted a randomized, double-blinded, placebo-controlled trial to evaluate the effect of ISWI for relief of acute low back pain (aLBP). A total of 68 patients (41 females and 27 males) between 18 and 55 years old experiencing aLBP with moderate to severe pain (scores ≥5 on an 11-point visual analogue scale [VAS]) were recruited and randomly assigned to receive either ISWIs (n=34) or intracutaneous isotonic saline injections (placebo treatment; n=34). The primary outcome was improvement in pain intensity using the VAS at 10, 45, and 90 min and 1 day after treatment. The secondary outcome was functional improvement, which was assessed using the Patient-Specific Functional Scale (PSFS) 1 day after treatment. The mean VAS score was significantly lower in the ISWI group than in the control group at 10, 45, and 90 min, and 1 day after injection (P<0.05, t-test). The mean increment in PSFS score of the ISWI group was 2.9±2.2 1 day after treatment, while that in the control group was 0.9±2.2. Our study showed that ISWI was effective for relieving pain and improving function in aLBP patients at short-term follow-up. ISWI might be an alternative treatment for aLBP patients, especially in areas where medications are not available, as well as in specific patients (e.g., those who are pregnant or have asthma), who are unable to receive medications or other forms of analgesia because of side effects.

Contact force-guided catheter ablation for the treatment of atrial fibrillation: a meta-analysis of randomized, controlled trials

Contact force (CF) sensing technology allows real-time monitoring during catheter ablation for atrial fibrillation (AF). However, the effect of CF sensing technology on procedural parameters and clinical outcomes still needs clarification. Because of the inconsistent results thus far in this area, we performed a meta-analysis to determine whether CF sensing technology can improve procedural parameters and clinical outcomes for the treatment of AF. Studies examining the benefits of CF sensing technology were identified in English-language articles by searching the MEDLINE, Web of Science, and Cochrane Library databases (inception to May 2015). Ten randomized, controlled trials involving 1834 patients (1263 males, 571 females) were included in the meta-analysis (681 in the CF group, 1153 in the control group). Overall, the ablation time was significantly decreased by 7.34 min (95%CI=-12.21 to -2.46; P=0.003, Z test) in the CF group compared with the control group. CF sensing technology was associated with significantly improved freedom from AF after 12 months (OR=1.55, 95%CI=1.20 to 1.99; P=0.0007) and complications were significantly lower in the CF group than in the control group (OR=0.50, 95%CI=0.29 to 0.87; P=0.01). However, fluoroscopy time analysis showed no significantly decreased trend associated with CF-guided catheter ablation (weighted mean difference: -2.59; 95%CI=-9.06 to 3.88; P=0.43). The present meta-analysis shows improvement in ablation time and freedom from AF after 12 months in AF patients treated with CF-guided catheter ablation. However, CF-guided catheter ablation does not decrease fluoroscopy time.

Random-start controlled ovarian stimulation for emergency fertility preservation in a patient with myelodysplastic syndrome: a case report

This study reports a case of a gonadotropin-releasing hormone agonist trigger in a young female with myelodysplastic syndrome (MDS) who underwent fertility preservation using random-start controlled ovarian stimulation. This method involves the stimulation of the ovary regardless of a patient's menstrual-cycle phase. A review of the related literature is also provided. A 17-year-old patient was diagnosed with MDS and required initiation of peripheral blood stem cell transplantation within a maximum of 3 weeks and was in the luteal phase of the menstrual cycle when the possibility of attempting preservation of fertility was presented to her. She opted for a random-start controlled ovarian stimulation with gonadotropins. With successful hemorrhagic prophylaxis, 17 oocytes were retrieved including 10 mature and 7 immature oocytes. Of the immature oocytes, 3 were successfully matured in vitro and a vitrification protocol was used to freeze the 13 mature oocytes.

Randomized controlled trials of serotonin-norepinephrine reuptake inhibitor in treating major depressive disorder in children and adolescents: a meta-analysis of efficacy and acceptability

New generation antidepressant therapies, including serotonin-norepinephrine reuptake inhibitor (SNRIs), were introduced in the late 1980s; however, few comprehensive studies have compared the benefits and risks of various contemporary treatments for major depressive disorder (MDD) in young patients. A comprehensive literature search of PubMed, Cochrane, Embase, Web of Science, and PsycINFO databases was conducted from 1970 to January 2015. Only clinical trials that randomly assigned one SNRI or placebo to patients aged 7 to 18 years who met the diagnostic criteria for major depressive disorder were included. Treatment success, dropout rate, and suicidal ideation/attempt outcomes were measured. Primary efficacy was determined by pooling the risk ratios (RRs) of treatment response and remission. Acceptability was determined by pooling the RRs of dropouts for all reasons and for adverse effects as well as suicide-risk outcomes. Five trials with a total of 973 patients were included. SNRIs were not significantly more effective than placebo for treatment response but were for remission. The comparison of patients taking SNRIs that dropped out for all reasons and those taking placebo did not reach statistical significance. Significantly more patients taking SNRIs dropped out for adverse effects than those taking placebo. No significant difference was found in suicide-related risk outcomes. SNRI therapy does not display a superior efficacy and is not better tolerated compared to placebo in these young patients. However, duloxetine has a potential beneficial effect for depression in young populations, showing a need for further research.

Quality evaluation of fresh-cut ‘Pérola’ pineapple stored in controlled atmosphere

The purpose of this research was to determine the best gas mixture in controlled atmosphere conditions to store fresh-cut ‘Pérola’ pineapple, particularly in relation to the maintenance of visual quality and reduction of microbial growth. After sanitation, fruit was manually peeled, sliced and dipped in 20 mg.L-1 NaOCl solution for 30 seconds. Then, the excess liquid was drained and the slices were placed in sealed glass jars connected to a flowboard installed in a cold room (5 ± 1 °C). Desired gas mixtures were supplied continuously for 12 days from cylinders connected to the flowboard. Controlled atmospheres of 2:5, 2:10, 2:15, 5:5, 5:10, 5:15, 8:5, 8:10 and 8:15 (O2:CO2, %) and air were used. The product was evaluated for pulp color, total and fecal coliforms, mesophilic and psychrotrophic aerobic, mold and yeast counts. Total and fecal coliforms were not detected. The fresh-cut ‘Pérola’ pineapple was not very sensitive to storage in controlled atmosphere, considering that the slices had little browning and were free of contamination, that would affect the food safety at the end of the storage period

Networking Notch : regulation of Notch traffic and signaling crosstalk

Utvecklingen av flercelliga organismer är en mångfacetterad process som kräver kommunikation celler emellan. Under utvecklingen av en organism måste cellerna göra vissa val, vilket bestämmer riktningen för deras fortsatta utveckling. Utgående från dessa val erhåller cellerna egenskaper som är karaktäristiska för olika celltyper. Notch-signalräckan är en viktig reglerare av valet mellan olika cellöden. Notch-signalräckan aktiveras när Notch-receptorer som uttrycks på ytan av en cell binder till Notch-ligander som uttrycks på ytan av en annan närliggande cell. Denna avhandling belyser mekanismerna som reglerar omsättningen av såväl Notch-receptorer som -ligander till och från cellmembranen, samt ökar förståelsen för hur dessa mekanismer påverkar Notch-medierade cellöden i stamceller. Internalisering av Notch receptorer anses nödvändigt för fullständig aktivering av Notch-signalvägen. De bakomliggande molekylära mekanismerna är dock fortfarande oklara. Vi har upptäckt att atypiskt protein kinas Cζ (aPKCζ) reglerar internaliseringen av Notch-receptorer. aPKCζ fosforylerar Notch, vilket leder till receptorns internalisering, men effekten är beroende av receptorns signaleringsstatus. Vi visar att aPKCζ reglerar Notch-signaleringen och styr både neuroners och muskelcellers differentiering. Ytterligare har vi analyserat samspelet mellan cellskelettet och Notch-signalvägen. Våra resultat visar att intermediärfilamenten, en del av cellskelettet, är viktiga reglerare av Notch-signaleringen både under neuronal och vaskulär utveckling. Intermediärfilamenten vimentin och GFAP reglerar uttrycket av Notch-ligander vid cellmembranen i hjärnans stödceller, astrocyterna, och påverkar därmed neuronala stamcellers cellödesbeslut. Vimentin är även viktigt reglerare av Notch-signalräckan vid angiogenesen. Celler som saknar vimentin uppvisar avvikande Notch-signalering emedan möss som saknar vimentin påvisar en fördröjd utveckling av vaskulaturen under embryonalstadiet. ------------------------------------------------- Monisoluisten organismien kehittyminen on monimutkainen prosessi, joka vaatii viestintää solujen välillä. Kehittymisen aikana solut joutuvat tiettyjen valintojen eteen, mitkä tulevat määrittämään niiden erilaistumisen suunnan. Solut omaksuvat solutyypille ominaisia ominaisuuksia näihin valintoihin perustuen Notch-signalointireitti säätelee solujen erilaistumista eri suuntiin. Notch-signalointireitti aktivoituu, kun Notch-reseptori yhden solun pinnalla sitoo Notch-ligandin toisen, viereisen solun solukalvolla. Tutkimukseni lisää tuntemusta Notch-reseptoreiden ja ligandien solun sisäisestä liikennöinnistä ja sitä säätelevistä mekanismeista, sekä tämän säätelyn vaikutuksista kantasulojen erilaistumiseen. Notch-signalointireitin aktivoituminen vaatii reseptoreiden ja ligandien sisäistämisen solukalvolta, mutta taustalla olevat ja sisäistymistä säätelevät mekanismit ovat vielä epäselviä. Tutkimukseni osoittaa, että atyyppinen proteiinikinaasi Cζ (aPKCζ) säätelee Notch-reseptoreiden endosytoosia. Endosytoosin lopputulos riippuu siitä onko reseptori aktivoitunut ligandin välityksellä vai ei. Tuloksemme osoittavat aPKCζ säätelevän Notch-signalointia ja kontrolloivan sekä hermosolujen, että lihassolujen erilaistumista. Analysoimme myös Notch-signaloinnin ja solun tukirangan vuorovaikutuksia. Välikokoiset filamentit, jotka ovat osa tukirankaa, säätelevät Notch-signalointia neuronaalisen erilaistumisen sekä verisuonten uudismuodostumisen aikana. Vimentiini ja GFAP ovat välikokoisia säikeitä, jotka säätelevät Notch-ligandien ekspressiota astrosyyttien, eli aivojen hermotukisolujen solukalvolla. Vimentiini säätelee myös Notch-signalointireittiä angiogeneesin aikana. Vimentiiniä vailla olevilla soluilla ilmenee heikentynyttä Notch-signalointia, joka voidaan liittää hiirillä ilmenevään vimenttiinin puutteesta johtuvaan viivästyneeseen verisuonien kehitykseen.

Effect of controlled atmosphere on postharvest quality of 'Douradão' peaches

This study was carried out with one of the most important cultivar grown in the State of Sao Paulo, Brazil, which has gained the preference of consumers, due to its sweet taste, intense skin color and large size; however, these fruits are susceptible to chilling injury when cold stored for long periods. The use of controlled atmosphere (CA) with elevated CO2 and reduced O2 concentrations prevent the onset of the chilling symptom. Thus, the effect of three different conditions of controlled atmosphere (CA1, CA2, CA3 and Control) was evaluated in order to extend the storage life of 'Douradão' peaches. After 14, 21 and 28 days, samples were withdrawn from CA and kept in fresh air at 25 ± 1 °C and 90 ± 5% RH to complete ripening. On the day of removal and after 4 days, were the peaches quality characteristics were evaluated. The results showed that the use of CA during cold storage reduced weight loss and prevented postharvest decay. CA2 and CA3 treatments were effective in keeping good quality of 'Douradão' peaches during 28 days of cold storage, the ripe fruits showed reduced incidence of woolliness, adequate juiciness and flesh firmness. CA1 and Control treatments did not present marketable conditions after 14 days of cold storage.

Sensory profile of 'Douradão' peaches cold stored under controlled atmosphere

The sensory quality of 'Douradão' peaches cold stored in three different conditions of controlled atmosphere (CA1, CA2, CA3 and Control) was studied. After 14, 21 and 28 days of cold storage, samples were withdrawn from CA and kept for 4 days in ambient air for ripening. The sensory profile of the peaches and the descriptive terminology were developed by methodology based on the Quantitative Descriptive Analysis (QDA). The panelists consensually defined the sensory descriptors, their respective reference materials and the descriptive evaluation ballot. Fourteen panelists were selected based on their discrimination capacity and reproducibility. Seven descriptors were generated showing similarities and differences between samples. The data were analyzed by ANOVA, Tukey test and Principal Component Analysis (PCA). Results showed significant differences in the sensory profiles of the peaches. The PCA showed that CA2 and CA3 treatments were more characterized by the fresh peach flavor, fresh peach appearance, juiciness and flesh firmness, and were effective in keeping the good quality of the 'Douradão' peaches during the 28 days of cold storage. The Control and CA1 treatments were characterized by the mealiness and were ineffective for quality maintenance of the fruits during cold storage.

Quality of yellow passion fruit stored under refrigeration and controlled atmosphere

In this study, it was evaluated the quality of yellow passion fruits stored under refrigeration and controlled atmospheres of different composition aiming to extend the postharvest life of the fruits. The characteristics of skin color, appearance, mass loss, as well as the chemical quality of the juice of yellow passion fruits stored at: 21% O2 plus 0.03% CO2; 1% O2 plus 0.03% CO2; 5% O2 plus 0.03% CO2; 12% O2 plus 5% CO2; and 5% O2 plus 15% CO2, with 1 control treatment (refrigeration at 13 ºC and 90% UR) were determined. The analyses were performed before and after 30 days of storage and after removing the controlled atmospheres and storage for 9 days under refrigeration at ambient atmosphere. The data were interpreted by simple statistical analysis using the test by confidence intervals with 95% of probability. It was concluded that the application of atmospheres with low oxygen concentration and high carbon dioxide level minimized quality losses. At atmosphere with 5% O2 and 15% CO2, it was observed the lowest color change indexes and mass loss, and also the smallest decrease in acidity, soluble solids content, vitamin C, reducing sugars, and total soluble sugars.

Utilizing hemicelluloses – the first step : controlled extraction with hot water

Människor utnyttjar ofta kemi mångsidigt i sitt vardagliga liv utan att närmare tänka på detaljerna. Nuförtiden kan man framställa en ökande mängd av produkter ur förnybara råmaterial och en av de mest mångsidiga nybara råmaterialet i Norden är barrträd. Den lyriska lägerelden eller spiselden och möbler av ved samt papper är en väsentlig del av vardagen. Också livsmedel och läkemedel kan innehålla föreningar ur ved. Ved som råmaterial består av tre huvudkomponenten: cellulosa, som är uppbyggd av druvsockermolekyler är en långkedjad, oförgrenad polymer; lignin, som sammanhåller fibrerna i vedmaterialet som lim samt hemicellulosor, som ofta är uppbyggda av olika sockerarter och är en förgrenad polymer. Följaktligen består vedmaterialet av 70 % socker. I detta arbete har vi koncentrerat på i hemicellulosa och dess extraktion ur gran, samt bestämning av hemicellulosans egenskaper. Den slutliga målsättningen i forskningen var att skapa nya produkter ur gran. Forskning i extraktionens hemligheter eller hur hemicellulosa kan effektivt extraheras i den önskade formen kräver nya typers experimentellasanläggningar och experiment samt matematisk modellering. Den långkedjade hemicellulosan är lämplig för att användas t.ex. i skyddshinnor eller i livsmedel. Medel- och småmolekylär hemicellulosa kan användas som utgångsämne för framställning av bränslen, smörjmedel, sockersyror och alkoholer, av vilka xylitol är mest känd för alla pga hälsobefrämjande effekter. Det är utomordentligt viktigt ur miljöns och energiekonomins synvinkel att sträva efter effektivering av utnyttjandet av den värdefullaste och största naturtillgången, skogen i vårt land, med alla möjliga sätt. Resultaten av denna forskning utnyttjar avsevärt den växande, nya, på skogen baserande biobaseradeindustrin, som framställer nya spetsprodukter samt skapar nya arbetsplatser. ----------------------------------------------------- Ihmiset hyödyntävät usein huomaamattaan kemiaa monipuolisesti jokapäiväisessä elämässä. Nykyään kasvava määrä tuotteista kyetään valmistamaan uusiutuvista raaka-aineista ja yksi monipuolisimmista uusiutuvista luonnonvaroistamme pohjolassa ovat havupuut. Tunnelmallinen nuotio tai takkatuli ja puiset huonekalut sekä paperi ovat olennainen osa arkea. Myös elintarvikkeet ja lääkkeet voivat sisältää puusta peräisin olevia yhdisteitä. Puu materiaalina koostuu rakenteeltaan pääosin kolmesta osasta; selluloosasta, joka on rypälesokerista koostuva pitkäketjuinen haaroittumaton polymeeri, ligniinistä, joka toimii puun koossa pitävänä liima-aineena ja hemiselluloosasta, joka on useista eri sokereista rakentunut haaroittunut polymeeri. Näin ollen puusta 70 % on sokeria. Tässä työssä olemme keskittyneet hemiselluloosaan ja sen uuttamiseen kuusesta, sekä ominaisuuksien kartoittamiseen. Tutkimusaiheen lopullinen tavoite on luoda uusia tuotteita kuusesta. Uuton salojen tutkiminen eli miten hemiselluloosa saadaan tehokkaasti uutettua halutunlaisena vaatii uudenlaisia koelaitteistoja ja kokeita, sekä matemaattista mallintamista. Suurikokoinen hemiselluloosa on sopivaa käytettäväksi esimerkiksi suojakalvoissa tai elintarvikkeissa. Keskikokoista ja pienimolekyylistä hemiselluloosaa voidaan käyttää lähtöaineena valmistettaessa polttoaineita, voiteluaineita, sokerihappoja ja sokerialkoholeja, joista xylitoli on terveysvaikutustensa vuoksi kaikille tuttu. Niin ympäristömme kuin myös energiataloutemme kannalta on ensiarvoisen tärkeää pyrkiä kaikin keinoin tehostamaan maallemme arvokkaan, sekä luonnonvaroistamme yhden suurimman, metsän, vastuullista hyödyntämistä. Tämän tutkimuksen tulokset hyödyntävät merkittävästi maahamme nousevaa uutta metsään pohjautuvaa biojalostusteollisuutta, joka valmistaa uusia huipputuotteita sekä luo työpaikkoja.

Evaluation of lignin content of soybean seed coat stored in a controlled environment

Breeding soybean for high seed quality is an important approach for developing cultivars for tropical regions, and the lignin content in the seed coat is one of the screening parameters for this trait. Considering that many breeding lines are evaluated in each growing season using the presently recommended method for lignin determination, a long period is required for the evaluation of the whole breeding program. This time limitation may influence lignin content assessment, if lignin is degraded during storage. This research reported was designed to determine whether lignin was degraded in the seed coat of soybean seed cultivars stored for one year in a controlled environment (10°C temperature and 50% air relative humidity). Seeds of 12 selected soybean cultivars that had a range in seed coat lignin content were evaluated. Seeds were hand harvested just after physiological maturity and evaluated for seed coat lignin content at harvest and after one year of storage in a cold room (10°C and 50% RH). The lignin content in seed coats differed significantly among cultivars in both analyses, but for both results the sequence of cultivar classification and the lignin content values of each cultivar did not change. A regression analysis of lignin content at harvest and after one year of storage indicated a direct relationship between both lignin determinations suggesting no differences between the lignin content of each cultivar due to prolonged storage (r² = 0.98***). This indicates that the lignin determination in the soybean seed coat can be performed over a long time period without any bias due to change in its content.

Accelerated aging of ipê seeds under controlled conditions of storage

This research was aimed at studying effects of storage and accelerated aging on germination and profile of storage proteins in Handroanthus albus seeds. These were stored into a cold chamber (± 8 ºC; RH ± 40%) and after periods of 0, 3, 6, 9, and 12 months of storage, were subjected to accelerated aging for 0, 24, 48, 72, and 96 hours. Relationships between germination and proteins profile were assessed. Germination test was performed at 25 ºC, under constant light. For protein extraction, 125 mg of seeds were macerated in 2 mL of extraction buffer (1M Tris-HCl; pH 8.8) and applied to SDS-PAGE polyacrylamide gel at 80 V .15 h-1. Twelve month storage, combined with 72 hours accelerated aging have increased germination in approximately 65% when compared to non-aged seeds or to seeds with 24 h of accelerated aging. Besides beneficial effects, degradation and synthesis of different proteins were observed. It was concluded that germination of Handroanthus albus seeds, when not subjected to accelerated aging, is favored by storage in cold chamber during three to six months, or from nine to 12 months when subjected to accelerated aging process. Storage proteins may be associated to those increases, and hence further studies are needed.

Helsinki hub – new traffic flows and business networks

This thesis is the Logistics Development Forum's assignment and the work dealing with the development of the Port of Helsinki as part of Helsinki hub. The Forum aims to develop logistics efficiency through public-private co-operation and development of the port is clearly dependent on both factors. Freight volumes in the Port of Helsinki are the biggest single factor in hub and, therefore, the role of the port of the entire hub development is strong. The aim is to look at how the port will develop as a result of changes in the foreign trade of Finland and the Northern European logistics trends in 25 years time period. Work includes the current state analysis and scenario work. The analyses are intended to find out, which trends are the most important in the port volume development. The change and effect of trends is examined through scenarios based on current state. Based on the work, the structure of Finnish export industry and international demand are in the key role in the port volume development. There is significant difference between demands of Finnish exporting products in different export markets and the development between the markets has different impacts on the port volumes by mass and cargo type. On the other hand, the Finnish economy is stuck in a prolonged recession and competition between ports has become a significant factor in the individual port's volume development. Ecological valuesand regulations have changed the competitive landscape and maritime transport emissions reductions has become an important competitive factor for short routes in the Baltic Sea, such as in the link between Helsinki and Tallinn.