Notes

Extra fat Embolism After Autologous Cosmetic Excess fat Grafting.
Data regarding the impact of psychological factors in patients with pemphigus is sparse. This study evaluated the correlation of demographic, clinical, and psychological parameters with quality of life in 58 patients with pemphigus. Illness perception showed a realistic view, with the highest scores for cyclical course (3.35 ± 0.09) and treatment control (3.08 ± 0.06). Mean scores for perceived social support were relatively high from family and significant others (5.89 ± 0.18 and 5.66 ± 0.23, accordingly), and relatively low from friends (4.55 ± 0.24). There were no correlations be-tween demographic, clinical parameters, perceived social support, and Dermatology Life Quality Index. Beliefs in cyclical course, emotional influence, psychological cause, and treatment control correlated significantly with quality of life. Stronger beliefs in self-control, chronicity, and accidental cause predicted higher quality of life, while stronger beliefs in cyclical course, psychological cause, and risk factors predicted lower quality of life. In order to enhance QoL, dermatologists should deliver the message to the patients that pemphigus is a chronic disease rather than cyclical and unexpected, and stress the patients' role in controlling it.
To evaluate the effects of a rehabilitation programme for lumbopelvic pain after childbirth.

Women with lumbopelvic pain 3 months postpartum were included in a randomized controlled trial. Patients in the intervention group (n = 48) received pelvic floor muscle training combined with neuromuscular electrical stimulation of the paraspinal muscles for 12 weeks, while patients in the control group (n = 48) received neuromuscular electrical stimulation for 12 weeks. Outcomes were measured with the Triple Numerical Pain Rating Scale (NPRS), Modified Oswestry Disability Questionnaire (MODQ) and Short-Form Health Survey-36 (SF-36).

The NPRS score was significantly better in the intervention group at 12 weeks compared with the control group (p = 0.000). The MODQ score was significantly better at 6 and 12 weeks compared with the control group (p = 0.009 and p = 0.015, respectively). The mean value of the Physical Components Summary of the SF-36, was significantly better in the intervention group at 6 weeks (p = 0.000) and 12 weeks (p = 0.000) compared with the control group, but there was no significant improvement in Mental Components Summary of the SF-36.

A postpartum programme for women with lumbopelvic pain is feasible and improves the physical domain of quality of life.
A postpartum programme for women with lumbopelvic pain is feasible and improves the physical domain of quality of life.Incomplete excisions of melanocytic lesions occur despite the intention of complete removal. The aim of this study was to determine the incomplete excision rates for benign and malignant melanocytic lesions and the associated risk factors. Demographic, clinical, and histo-pathological data possibly associated with incomplete excision were collected from 2,782 consecutive excisions between 2014 and 2015. Of these, 269 melanocytic lesions (9.7%) were incompletely excised. Multivariate analysis revealed the following risk factors for significantly higher incomplete excision rates lesions located in the head and neck area (odds ratio (OR) 3.95, 95% confidence interval (95% CI) 2.35-6.65), surgery performed by general practitioners (OR 3.01, 95% CI 2.16-4.19), the use of a punch excision technique (OR 2.83, 95% CI 1.96-4.08), and excision of non-dysplastic naevi (OR 1.58, 95% CI 1.11-2.23). In conclusion, more caution should be taken when excising melanocytic lesions in the head and neck area, general practitioners require more surgical training, and punch excisions of melanocytic lesions should be avoided.
The Molecular Environmental Monitoring Program (MEMP) Listeria Assay is a quick, reliable method for detecting Listeria species in environmental samples. The assay incorporates a real-time PCR approach to identifying Listeria cells expressed from the swab sample. The assay does not require an enrichment step, leading to much faster time to a negative result.

This report details the method validation study to validate the MEMP using environmental surface swabs for stainless steel, plastic, rubber, ceramic tile, and sealed concrete.

Matrix studies, inclusivity/exclusivity, product consistency and stability, and robustness testing were conducted to assess the method's performance. In the matrix studies, this method was compared to the U.S. Food and Drug Administration Bacteriological Analytical Manual (BAM) Chapter 10 (1) for environmental surface sponges and swabs.

Inclusivity and exclusivity testing showed that the MEMP Listeria Assay was able to detect all 75 Listeria strains tested while excluding the 30 non-Listeria species. There were no statistically significant differences found between the candidate and reference methods. Small variations in critical test parameters (volume of extraction reagent and volume of extracted DNA sample) did not adversely affect the assay's performance, and stability testing indicated consistent results for at least one year.

The data presented in this report show that the candidate method performed as well as the reference method and is therefore can be used in place of the reference method for detecting Listeria species.

The MEMP Listeria Assay requires no enrichment for detecting Listeria on environmental surfaces.
The MEMP Listeria Assay requires no enrichment for detecting Listeria on environmental surfaces.
This study aimed to compare the methodological quality and risk bias of orthodontic systematic reviews (SRs) using the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) and ROBIS (Risk of Bias in Systematic Review) tools.

A search of electronic databases (OVID and Medline) was undertaken to identify orthodontic SRs published in five primary orthodontic journals (January 2015 to December 2018) and the Cochrane Library of Systematic Reviews (January 2000 to January 2018). Full articles were reviewed by two assessors against the eligibility criteria. Methodological quality of each SR was gauged using the AMSTAR tool with a score of 0 or 1 given for each of the 11 items. Cumulative totals were calculated and scores between 4 and 8 represented poor to fair methodological quality and 9 or greater deemed to be good. As per the ROBIS tool, the risk of bias (ROB) for each domain was assessed and the overall ROB was classified as low, high, or unclear.

A total of 91 SRs were included. The median AMSTAR score was 8 (IQR = 3). The methodological quality of 47.3% SRs was rated good. SRs without protocol registration (Coef -3.00, 95% CI -3.72, -2.28, P < 0.001) and American continent SRs (Coef -1.00, 95% CI -1.72, -0.21, P = 0.007) were associated with lower AMSTAR scores. A total of 56.0% SRs were rated a low ROB, with a lower ROB apparent in multicentre SRs (OR 0.27, 95% CI 0.11, 0.64, P = 0.003) and a higher ROB evident in SRs without a registered protocol (OR 111.81, 95% CI 22.34, 559.62, P < 0.001). When adjusted for the effect of AMSTAR score on ROB, a higher ROB was associated with SRs without protocol registration (OR 32.24, 95% CI 6.03, 172.44, P ≤ 0.001). As the AMSTAR score (per unit) increased, the odds of having a high ROB rating decreased (OR 0.31, 95% CI 0.21, 0.45, P ≤ 0.001).

As the methodological quality rating of orthodontic SRs increases, a reduction in the ROB is evident.
As the methodological quality rating of orthodontic SRs increases, a reduction in the ROB is evident.
Chyle leakage is an uncommon but potentially life-threatening complication following esophageal resections. The optimal management strategy is not clear, with a limited evidence base.

Searches were conducted up to 31 December 2020 on MEDLINE, Embase, and Web of Science for randomized trials or retrospective studies that evaluated the management of chyle leakage following esophageal resection. Two authors independently screened studies, extracted data, and assessed for bias. The protocol was prospectively registered on PROSPERO (CRD 42021224895) and reported in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines.

A total of 530 citations were reviewed. Twenty-five studies, totaling 1016 patients met the inclusion criteria, including two low-quality clinical trials and 23 retrospective case series. Akt inhibitor Heterogeneity of study design and outcomes prevented meta-analysis. The overall incidence of chyle leak/fistula was 3.2%. Eighteen studies describe management of chyle ut lower efficacy compared with surgery. Further high-quality, prospective studies that compare interventions at different levels of severity are needed to determine the optimal approach to treatment.Technical performances of two optically stimulated luminescence readers including, a microStar reader and an Auto 200 reader both manufactured by Landauer, Inc. were studied by the National Radiation Protection Agency Dosimetry Laboratory using manufacturer and International Electrotechnical Commission requirements. The two reader tools demonstrated satisfactory results as they met all the requirements. The two readers showed similar performance for the overall uncertainty and the Coefficient of Variation tests. The microStar reader showed better performances for the linearity and quality control tests, whereas the Auto 200 reader has a lower limit of detection. Moreover, an average shift of 0.08 mSv exists when measuring the doses with the two readers.Malate dehydrogenase (MDH) catalyzes the reversible reduction of oxaloacetate (OAA) to L-malate using nicotinamide adenine dinucleotide hydrogen (NADH). MDH has two characteristic loops, the mobile loop and the catalytic loop, in the active site. On binding to the substrate, the enzyme undergoes a structural change from the open-form, with an open conformation of the mobile loop, to the closed-form, with the loop in a closed conformation. In this study, three crystals of MDH from a moderate thermophile, Geobacillus stearothermophilus (gs-MDH) were used to determine four different enzyme structures (resolutions, 1.95-2.20 Å), each of which was correspondingly assigned to its four catalytic states. Two OAA-unbound structures exhibited the open-form, while the other two OAA-bound structures exhibited both the open- and closed-form. The structural analysis suggested that the binding of OAA to the open-form gs-MDH promotes conformational change in the mobile loop and simultaneously activates the catalytic loop. The mutations on the key amino acid residues involving the proposed catalytic mechanism significantly affected the gs-MDH activity, supporting our hypothesis. These findings contribute to the elucidation of the detailed molecular mechanism underlying the substrate recognition and structural switching during the MDH catalytic cycle.
Previous literature shows systematic differences in health according to socioeconomic status (SES). However, there is no clear evidence that the SARS-CoV-2 infection might be different across SES in Portugal. This work identifies the COVID-19 worst-affected municipalities at four different time points in Portugal measured by prevalence of cases, and seeks to determine if these worst-affected areas are associated with SES.

The worst-affected areas were defined using the spatial scan statistic for the cumulative number of cases per municipality. The likelihood of being in a worst-affected area was then modelled using logistic regressions, as a function of area-based SES and health services supply. The analyses were repeated at four different time points of the COVID-19 pandemic 1st of April, 1st of May, 1st of June, and 1st of July, corresponding to two moments before and during the confinement period and two moments thereafter.

Twenty municipalities were identified as worst-affected areas in all four time points, most in the coastal area in the Northern part of the country.
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