Poly(lactic acid), PLA, is a biodegradable polymer, but its applications are limited by its high cost and relatively poorer properties when compared to petroleum-based plastics. The addition of starch powder into PLA is one of the most promising efforts because starch is an abundant and cheap biopolymer. However, the challenge is the major problem associated with poor interfacial adhesion between the hydrophilic starch granules and the hydrophobic PLA, leading to poorer mechanical properties. In this paper, soybean oil maleate (SOMA) was synthesized by grafting soybean oil with various weight percents of maleic anhydride (MA) using dicumyl peroxide (DCP) as an initiator. Then, SOMA was employed for the surface modifying of cassava starch powder, resulting in SOMA-g-STARCH. The obtained SOMA-g-STARCH was mixed with PLA in various weight ratios using twin-screw extruder, resulting in PLA/SOMA-g-STARCH. Finally, the obtained PLA/SOMA-g-STARCH composites were prepared by a compression molding machines. The compatibility, thermal properties, morphology properties, and mechanical properties were characterized and evaluated. The results showed that the compatibility, surface appearance, and mechanical properties at 90 : 10 and 80 : 20 ratios of PLA/SOMA-g-STARCH were the best. Tg, low crystallinity and low thermal stability. With respect to its chemistry, PLA is synthesized by direct condensation polymerization of the lactic acid monomers or by ring opening polymerization of lactide monomer. There have been several possibilities to modify its property such as the nucleating agent addition, polymer composites, and polymer blend preparation with natural fillers such as starch or cellulose and with natural rubber, respectively [The petroleum-derived plastics have been used extensively, causing tons of thousands of plastic waste. The improper disposal of petroleum-derived plastics leads to environmental pollution which has aroused much interest in searching for substitutes . Recentlectively –6.  The addition of starch into PLA is one of the most promising efforts due its abundant and cheap biopolymer particularly cassava starch since it is the fifth most abundant starch crop produced in the world and the third most important food source for inhabitants of tropical regions. As a result, starch has been used as filler for environmentally friendly plastics . However This research was focused on the effect of soybean oil maleate grafted cassava starch as a filler on the properties improvement of PLA. The soybean oil maleate grafted cassava starch was easily synthesized by the maleation of soybean oil with maleic anhydride . Thus, oTg) of 58–60°C and a density of 1.24 g/cm3, as reported by the manufacturer. Cassava starch flour was purchased from Thai Wah Food Products Public Company Limited . Soybean oil was supplied from Siam Chemical Industry (Thailand). Maleic anhydride (≥98% purity) produced by Sigma Aldrich, dicumyl peroxide (98% purity) manufactured by Sigma Aldrich, and acetone (AR grade) were purchased from the local distributor .PLA pellet (2003D grade) by NatureWorks was purchased from BC Polymers Marketing Co., Ltd. . It is transparent polymer with a glass transition temperature (Soybean oil (100 g) was charged into a 500 mL glass reactor. Then, 10 g or 20 g of MA powder  was added and continuously stirred. Following that, DCP (3 wt% of MA) was used as a free radical initiator. The reaction was allowed to continue at temperature of 170°C for 2 hrs. The viscous yellowish liquid of soybean oil maleate (SOMA) was obtained. SOMA10 and SOMA20 were assigned to soybean oil maleate having anhydride content of 10 wt% and 20 wt%, respectively. 50 g SOMA and 50 g starch powder at weight ratio of 1 : 1 were well mixed using a mechanical stirrer. After that, the mixture was put in the hot-air oven and the temperature was set at 120°C for 2 hours. It was anticipated that at this condition, SOMA underwent the ring opening reaction with starch hydroxyl group, yielding SOMA-g-STARCH. Then, the crude product was washed with acetone to remove unreacted SOMA. Two sorts of SOMA-g-STARCH were prepared which were assigned to SOMA10-g-STARCH and SOMA20-g-STARCH for SOMA-g-STARCHs prepared from SOMA10 and SOMA20, respectively. The obtained SOMA-g-STARCHs were dried in an oven at 50°C and ground prior to subsequent experiment. The obtained SOMA-g-STARCH (SOMA10-g-STRACH and SOMA20-g-STRACH) was mixed with PLA in various PLA : SOMA-g-STARCH weight ratios of 90 : 10, 80 : 20, 70 : 30, 60 : 40, and 50 : 50 using twin-screw extruder and the barrel zone temperature was set at 135, 160, 170, 180, and 180°C fore zone 1, zone 2, zone 3, and zone 4, respectively.−1. Proton NMR was recorded on Varian UNITYINOVA 500 Hz spectrometer using deuterated acetone as a medium. Morphology was observed by a JEOL, JSM-6480LV scanning electron microscope  using acceleration voltage of 22 kV. Colored Appearance was evaluated by dyeing 1 wt% red disperse dye using H24 Newave Lab Equipment (Taiwan). TGA analysis was conducted on Mettler Toledo TGA/SDTA851e thermalgravimetric analyzer  which was carried out under nitrogen atmosphere with the flow rate of 20 mL/min and heating from 25°C to 600°C at heating rate of 10°C/min. Impact strength was determined by izod impact tester (GOTECH) according to ASTM D256 standard, and tensile properties were determined by universal testing machine (LR 100 K) according to ASTM D638 standard and using load cell of 100 kN and crosshead speed at 50 mm/min.Fourier transform infrared spectroscopy was conducted using Nicolet FTIR spectrometer (Nicolet 6700) recorded in the range of 3500–1000 cm−1. From the spectra of SOMA10 and SOMA20, the additional absorption bands at 1775 cm−1 and 1850 cm−1 are observed, corresponding to the symmetric and asymmetric stretching of C=O in the pendent anhydride group. Their absorption intensities tend to increase with an increase in the amount of applied MA, indicating that the more the amount of added MA the more the amount of anhydride ring content. This anhydride ring remains intact since no absorption peaks related to –OH stretching in the region of 3,500 cm−1 due to the opening of the anhydride were observed [The graft reaction between soybean oil and maleic anhydride initiated by DCP to produce SOMA is proposed by observed . The pre1H-NMR technique was employed to confirm the structure of SOMA. The −1 and 1850 cm−1, corresponding the ester bonding formed by the ring opening relation between SOMA anhydride group and starch hydroxyl group. As a result, the starch powder surface becomes hydrophobic due to surface oil coverage. The starch hydroxyl groups are hindered, as indicated by the weak intensity of hydroxyl bands between 3000 and 3500 cm−1. Therefore, SOMA-g-STARCH exhibits hydrophobicity which is anticipated to exhibit good compatibility with PLA.SOMA-g-STARCH represents surface modified starch powder. The surface modification of starch powder was achieved by curing SOMA mixed cassava starch powder in an oven at 120°C for 2 hours. The SOMA-g-STARCH was washed with acetone to remove excess SOMA. FTIR analysis of SOMA-g-STARCH was carried out and FTIR spectra are presented in When considering TGA thermograms , it is fThe PLA/SOMA-g-STARCH composites with various PLA : SOMA-g-STARCH weight ratios were prepared. Distribution of SOMA-g-STARCH particles in PLA matrix was observed by disperse dye coloration and SEM analysis. PLA is considered as the brittle polymer derived from low thermal stability occurring during heat processing, leading to its application restriction. Therefore, an improvement of PLA impact strength is one of the challenging research topics. In this study, an effect of SOMA-g-STARCH on impact strength was evaluated and the results are shown in Tensile strength and percent elongation at break of PLA/SOMA-g-STARCH composites are shown in Figures 1H NMR was successfully prepared by grafting reaction of soybean oil with maleic anhydride using dicumyl peroxide as an initiator. Then, maleated soybean oil was employed for surface modification of cassava starch powder, producing soybean oil grafted starch powder (SOMA-g-STARCH). FTIR analysis and TGA analysis confirmed that SOMA-g-STARCH surface changed from hydrophilicity to hydrophobicity. The incorporation of SOMA-g-STARCH into polylactic acid by melt extrusion mixing using PLA : SOMA-g-STARCH weight ratios of 90 : 10, 80 : 20, 70 : 30, 60 : 40, and 50 : 50 was carried out. It was found that the loading of SOMA-g-STARCH into PLA resulted in a significant improvement of impact strength, in case of SOMA-g-STARCH contents which have below 30 wt% due to better interfacial adhesion and good particles distribution. However, PLA/SOMA-g-STARCH composites with SOMA-g-STARCH content higher than 30 wt% exhibited a decrease in the impact strength, arising from the problem of particle agglomeration. In a similar manner, polymer composites of PLA filled with cassava starch-g-soybean oil maleate exhibited higher mechanical properties than polymer composites of PLA filled with unmodified starch powder. It was thought that soybean oil on the particle surface might play a key role in improving the compatibility as well as performing the plasticity-like behavior. Maleated soybean oil whose functional group and chemical structure were confirmed by FTIR and


We are currently in an era where the international scientific publication is highly valued, acting as a strong parameter for evaluation mechanism in ranking universities in the competitive scientific world. In this context, writing the editorial of this special issue gives us a great responsibility. After a cautious revision of the several articles submitted for publication in this special issue by the Editorial Board of this journal, the accepted papers translate the commitment of the authors to the scientific research. This special issue is a sample of the current research efforts addressing issues related to the interaction between the light and the oral tissues, highlighting subjects such as the treatment of pathologies associated with high intensity laser for better healing and welding, the use of high intensity laser treatment for cosmetic dentistry, evaluation of adhesive systems and dentin hypersensitivity, the detection and treatment decision of caries lesions with laser fluorescence, the treatment of root perforation using high intensity laser, and also the low level laser therapy for improving wound healing.We hope that the readers can enjoy this special issue and improve their knowledge about the light interaction with the hard and soft oral tissues.S. Nammour S. Nammour H. S. LohH. S. LohR. De MoorR. De MoorC. P. EduardoC. P. Eduardo


There is a perception that kidney transplant recipients transferred from pediatric centers to adult care have an increased risk of graft loss. It is not clear whether young adults transplanted in adult centers also suffer from high graft loss rates.We examined death censored graft survival in 3 cohorts of young patients transplanted at a single center. Pediatric (PED) patients transplanted at the pediatric center were compared to a cohort of young adults  and a cohort of adults .In a multivariate Cox model for death-censored graft survival, PED survival was statistically similar to the YAD , however the ADL cohort  demonstrated better survival. Admitted non-adherence rates were not different among cohorts. Patients were transferred within a narrow age window (18.6 ± 1.0 age in years) but at a wide range of times from the date of transplantation (5.1 ± 3.5 years) and with a wide range of graft function (serum creatinine 182 ± 81 μmol/L).The perception that pediatric transfers do poorly reflects advanced graft dysfunction in some at the time of transfer. The evidence also suggests that it is not the transfer of care that is the critical issue but rather recipients, somewhere between the ages of 11-14 and 25, are a unique and vulnerable cohort. Effective strategies to improve outcomes across this age group need to be identified and applied consistently. The transfer from pediatric to adult care is a challenging area of medicine for adolescents with chronic diseases and especially after kidney transplantation . A high The purpose of this report was to compare graft survival in young adults transplanted in the pediatric hospital to older adults transplanted in the adult hospital. The null hypothesis was there would be no difference in graft survival. However we anticipated that survival in the pediatric cohort would be inferior. If this was true we would be compelled to change our transfer process.This is a single center program retrospective chart review of consecutive solitary kidney recipients transplanted between January 1990 and December 2009. All recipients who were age ≤35 at the time of transplantation and were from Nova Scotia or Prince Edward Island are included in the analysis. Permission for the study was obtained from our institution ethics review board. Data was abstracted from the program's database and individual patient charts and flow sheets.Pediatric kidney transplants were performed at the IWK Health Center and adults at the QEII Health Sciences Center . However the surgery is performed by the same surgeons. Medical care is provided by pediatric and adult nephrologists at the respective sites. Care is transferred from pediatric to adult medicine at approximately age 18 years. A transfer letter is sent by the pediatric nephrologist to the adult transplant nephrologist along with all relevant records. The pediatric clinic nurse contacts the adult nurse to review the important issues and set the date of transfer. A visit is scheduled within 3 months in the adult clinic.To test the above hypothesis three cohorts were determined based on age at transplantation and place of transplant. All pediatric (PED) were transplanted in the pediatric hospital. This cohort was compared to 2 older cohorts, who were transplanted in the adult hospital, consisting of young adults  and older adults ,The status of the patients at transfer was defined at first visit to the adult center. The study examined age at transfer, graft function (serum creatinine), blood pressure, phosphate control, and immunosuppressive therapy. The number of laboratory tests performed was also examined in the year pre and post transfer. We examined the causes of graft loss and defined non-adherence as a contributor to graft loss only if the patient admitted discontinuation of an immunosuppressive medication to an attending physician.Descriptive statistics are presented as mean and standard deviation or percentages. Differences between groups for variables of interest were performed using parametric and non-parametric tests, where appropriate. To exclude potential differences in technical  and survival bias (patients with early graft loss less likely to transfer with a functioning transplant) death censored graft survival was examined in patients with functioning kidney transplant at 1 year. Pediatric (PED) graft survival was compared to YAD and ADL using Kaplan-Meier survival tested by log-rank starting at year 1 as time zero. Other covariates were examined for associations with graft survival and these included gender, acute rejection within the first year, donor age, organ source, delayed graft function , diabetes mellitus at time of transplant, HLA mismatch, peak PRA (%), immunosuppression at transplantation , and recipient and donor CMV status. Cold ischemia time could not be examined given the large amount of missing data. Pre transplant PRA was only examined in deceased donation as this test was not performed on live donor recipients. The Kaplan-Meier method was used to test for significant univariate associations with graft survival. Donor age and peak PRA were also tested by examining tertiles for donor age and 0% versus > 0% for PRA (deceased organ source only). Covariates with a level of significance of < 0.10 were included into the final multivariate Cox model. Significance was tested at the 5% level. Statistical analyses were performed using SPSS 15.0 software .There were 247 transplants performed in 224 recipients between January 1990 and December 2009. Only 7 (3.1%) were not Caucasian. Table Twenty six transplants were lost within 1 year (PED- 7 (12.5%); YAD-6 (11.1%); ADL-13 (9.5%)) and these graft outcomes were excluded. All 7 of the pediatric graft losses occurred at the pediatric center. The remaining were distributed to the PED (n = 49), YAD (n = 48) and ADL (n = 124) cohorts. Figure In a multivariate Cox model for death censored graft survival, pre-emptive transplantation , CMV D+R- status  and male gender  were associated with much better outcomes whereas acute rejection was associated with an inferior outcome . In comparison to the PED group the YAD was statistically similar . However the older age category demonstrated better survival . HLA mismatch, diabetes mellitus, PRA, immunosuppressive therapy, organ source, and donor age were not significant.Of the 49 PED cohort 24 transferred to the adult program with a functioning transplant. Of these 24, 18 were followed at this center and the remaining 6 were followed elsewhere. Table In the PED group, 4 (21%) of the 19 graft failures were admitted non-adherers whereas the number in the YAD cohort was 3 (19%) of 18 graft losses and in the ADL group was 6 (20%) of 30 graft losses.The major finding is that there does not appear to be any difference in graft survival for young recipients transplanted at the pediatric center and those young adults transplanted at the adult center. Both groups appear to do worse than a slightly older cohort. This study does not provide any evidence that the transfer from pediatric to adult care is responsible for any increase in graft failure. The perception of early graft loss after transfer likely reflects advanced graft dysfunction in some patients. The more important implication of this report is our conception of the issue which might identify appropriate areas of study. Conceptually, it is not the transfer of care that is the critical issue but rather recipients, somewhere between the ages of 11-14 and 25, are a unique and vulnerable cohort. Effective strategies across this age group need to be identified and applied consistently.The findings of this study appear to be at odds with a Government of Accountability Office (GAO-07-1117) report of US kidney transplant recipients. In an analysis of the USRDS database of kidney transplant recipients transplanted between 1997 and 2000, researchers also created 3 cohorts of patients  and examined survival . At 5 yeThe literature on transfer to adult care in kidney transplantation is limited. There is a concern that adolescents feel disenfranchised and alienated in the process . Some haThe study did not find a greater rate of admitted non-adherence as a cause of graft failure despite our initial perception that this might explain observed differences. It is difficult to know the extent of the non-adherence in the entire group since often the admission is only detected at graft failure. No measures of non-adherence have high sensitivities or specificities . We utilPart of the perception that patients do worse after transfer is that some are transferred with failing allografts leading to dialysis within a short time period. Of the cohort transferred almost half have lost their transplant. Age was the reason for transfer, not graft function. Patients were transferred within a narrow age window but at a wide range of times from the date of transplantation and with a wide range of graft function. Many of the patients transferred have significant 'mileage' on their grafts and this is the more likely explanation for the perception of inferior outcomes. Overall the care of the patients at transfer was excellent with well controlled blood pressure and serum phosphate. It is interesting to note that the number of laboratory tests in the year after transfer was about half of the number in the year before transfer. Although there were significant differences in the types of initial immunosuppression between cohorts this did not explain the differences detected. Whether the differences in outcomes could be related to greater immune activity or greater non-immunologic  stress in younger recipients remain a distinct possibility and should not be discounted.The study has limitations. To test the hypothesis adequately that transfer of care is the critical event there would need to be a control trial randomizing pediatric kidney recipients at age 18 to continued follow up at the pediatric center compared to transfer and follow up to an adult center. As analyzed in this study a significant difference between the pediatric and young adults could have been missed. A sample size of nearly 700 patients would be required to detect a hazard ratio of 0.80 with a power of 80%. This is a single center Canadian study in a predominately white population with universal health care. Other centers might experience different outcomes. A prospective comprehensive standardized non-adherence study would better detect this as a cause of differences in survival between cohorts than this retrospective analysis. We suspect that non-adherence remains a major explanation but cannot prove it.Immunosuppression was significantly different between groups at baseline but was not a significant predictor of outcomes. This may have been the small sample size or the fact that many pediatric patients had medication changes, as demonstrated in the composition of drug therapies at transfer Table . The morWhat this study identifies is that both pediatric patients prior to transfer and adolescents transplanted in the adult center are vulnerable and likely need similar interventions. These might include relatively more immunosuppression, better non-immunosuppressive renal protection strategies, effective education with regards to adherence, and better coping strategies. A large randomized controlled intervention trial would be needed to establish benefit. At present there are likely multiple strategies that might be beneficial and the preferred strategy would need to be established. The study does not negate the fact that adolescents transferring to adult medicine require special attention and expertise, but rather the date of transfer is an artificial time point and focusing at this point may miss opportunities to improve outcomes. Further research in this vulnerable cohort deserves our greater attention.The authors declare that they have no competing interests.All authors participated in the research design, collected data, and data interpretation. All authors read and approved the final manuscript. BK performed the statistical analysis.The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2369/12/54/prepub


The main aim of this research was to assess the relevance and impact of wellness recovery action planning (WRAP) as a tool for self-management and wellness planning by individuals with mental health problems from pre-existing and newly formed groups, where the possibilities for continued mutual support in the development of WRAPs could be explored. Interviews and focus groups were conducted and pre-post recovery outcome measures completed . 21 WRAP group participants took part in the research. The WRAP approach, used in groups and delivered by trained facilitators who could also share their lived experience, was very relevant and appeared to have a positive impact on many of the participants. The impact on participants varied from learning more about recovery and developing improved self-awareness to integrating a WRAP approach into daily life. The apparent positive impact of WRAP delivered in the context of mutual support groups indicates that it should be given serious consideration as a unique and worthwhile option for improving mental health. WRAP groups could make a significant contribution to the range of self-management options that are available for improving mental health and well-being. There has been a growing commitment to a recovery approach in mental health in the recent years in many countries . This haThere are a range of self-management approaches available for people to enhance well-being, from guided self-help, such as computerized CBT , 15, minWRAP explores key values of recovery, such as hope, personal responsibility, education, self-advocacy, and support, and provides a structured process for developing individualized WRAP plans . These iWRAP is reported in the research to be perceived positively by those who have used it. The findings from the research on WRAP that have been conducted tend to elicit very positive feedback from those that attend a WRAP group –26. WRAPWRAP has also been shown to have a positive impact on mental health outcomes. Two studies with much larger sample sizes found that following the use of WRAP, there were significant decreases in global symptom severity, a statistically significant decrease in symptoms, and a significant increase in the scores for recovery , 28. A sThe benefits of WRAP extend to how individuals might also interact with others around them, such as carers or professionals. Research that focused on self-reports showed that participants reported an increase in more positive thinking , greaterWRAP has been used in a number of settings and cultures, such as with Chinese mental health consumers in New Zealand  Somali wThe Scottish Recovery Network supported four organizations throughout Scotland to train people with lived experience of mental health problems as WRAP facilitators, who would go on to run WRAP groups in their own organisations for people who were having mental health difficulties. Each organization identified two facilitators who were given advanced level training as WRAP facilitators and who then went on to deliver WRAP groups. This research followed the delivery of WRAP for the first two groups  undertaken by the newly trained facilitators. WRAP can be delivered in a variety of formats, but for this intervention, all were delivered in groups. During the first and second deliveries of WRAP, two of these organisations convened the WRAP training over two days whereas the other two organisations spread the WRAP training over 4 days. Both groups who conducted the training over 4 days ran the sessions a week apart over 4 weeks. One group that ran two sessions did so a week apart for both the first and second deliveries of training, and the other ran the first training delivery one week apart and the second delivery on two consecutive days over a weekend.The main aim of this research was to assess the relevance and impact of wellness recovery action planning (WRAP) as a tool for self-management and wellness planning by individuals with mental health problems in mutual support group settings.An assessment of the extent to which participants who received training benefited in terms of recovery and wellness and the extent to which they used their own WRAP to help them do so.An examination of the role of self-help and mutual support groups in supporting recovery and wellness planning.The specific objectives of the research we report on here are as follows.In this paper we report on the aims as they relate to the groups' participants. Data describing the experience of the facilitators has been reported elsewhere . The experience of those taking part in the WRAP training groups was explored in different ways, through focus groups, individual face-to-face interviews, by collecting pre-post test outcome measures, and by the use of session-by-session evaluation forms. Qualitative data was only collected on a sample of participants taking part in the first round of WRAP training, and quantitative data was collected in both rounds of delivering WRAP training. The participants who took part in the first WRAP training sessions were invited to attend a focus group at the end of their training. Four focus groups with group participants were conducted in each of the 4 sites between December 2009 and February 2010. In total, 21 people participated in the focus groups. Group participants were also asked to complete brief session-by-session evaluation forms although these were mostly used by the facilitators themselves to gauge the usefulness of their individual training sessions and/or topics covered in the groups, and those are not reported on here.Follow-up individual face-to-face interviews were conducted with 11 people who took part in the baseline participant focus groups. Participants across all four focus groups, from the four different organizations, were interviewed. These interviews were conducted 3-4 months after the baseline focus group had taken place, in order to explore their experience of developing their own WRAP and whether participants were still using the WRAP approach. The use of scales that measure outcomes has increasingly been used to establish the effectiveness of self-management approaches in mental health. This project used two different outcome measures: one that focuses on recovery, the Recovery Assessment Scale, and one that focuses on well-being, the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Participants completed the short version of RAS and WEMWBS before and after their WRAP training, and these have been used to show any improvements in self-rated mental health following attendance of the WRAP training sessions. All focus group and interview data were recorded, transcribed, and analyzed in NVivo8 (QSR). A thematic analysis was conducted, following the principles of the social constructivist version of grounded theory . Themes The ethical subcommittee of the Scottish Centre for Social Research's parent organization, the National Centre for Social Research, reviewed the study and gave it ethical clearance in July 2009. No National Health Service sites were included in this research and as such an ethical opinion was not required from the NHS. First we describe the qualitative findings from the WRAP group participants, and then we describe the recovery and well-being measures collected.Many of the participants described attending the WRAP group as a process to learn about themselves and reflect on the various aspects of their mental health. The benefit of going through that process of reflection was viewed as having the potential to increase self-awareness and acceptance. One of the key benefits for many participants was learning about a recovery approach. For many participants this was a new and different way of looking at their lives, which was transformative for some. Here we describe the reported benefits of WRAP, the impact of the group setting, the levels of integration of WRAP into daily life, and the challenges encountered.Um…it's for me, I think its mine, its nobody else's and I wrote it, I think…that's how I see me. And I think that's probably how a lot of other people see me so it's not something that somebody else has wrote and I need to follow it. It's just…mine I think. Yeah. (Follow-up interview)The consensus was that there were lasting benefits from undertaking WRAP. These included being able to challenge your own behaviors, identifying alternative responses, and evaluating what constitutes a priority. Participants reported a reduction in anxiety, a reduction in panic attacks, and an increased identification of their own triggers for negative mental health. The perceived benefits of WRAP led to feelings of increased confidence and self-esteem for many. Participants gained insight into triggers for poor mental health and the benefits of identifying wellness-promoting activities. The sense of achievement was evident from being able to find different, useful approaches to dealing with stressful situations. One participant said that she had put her Christmas tree up for the first time in three years and attributed this action to having undertaken the WRAP course. Seeing strategies written out offered confidence and guidance, as participants described they could check back on their own ideas and get clear feedback or reinforcement from their WRAP. These strategies were ones that were tailor made, by the participants, for the participants. This led to a sense of ownership of the WRAP plan.Well I feel…I mean I don't talk to strangers about ma condition. It's like I live a secret life, like nobody knows I've got this condition, but when I come here I can talk to people that.. that understand what I've went through and stuff, you know?, and they might come up wi' suggestions aboot maybe medicine they've been o.. You know? You just pick up different ideas. (Focus group)Some respondents reflected that they felt undertaking WRAP in a group, compared with undertaking WRAP one to one, would be more supportive, less intense, and had the potential to offer mutuality and the ability to learn together. Participants described a range of benefits to this, including increased confidence, challenging stigma, increased self-esteem, and a feeling that they were not alone. Participants valued having the opportunity to both offer and receive support. Whereas on a one-to-one, for a start you'd be embarrassed to ask any questions. You'd just go, “Oh, right you are. Thanks very much”, you know?:… and you would… you wouldn't want to sort o' say, “Well, look. I don't really understand that”. But it was so easy, so everything that anyone has said here, the (facilitators), the charts where all our thoughts went up. (Focus group)Many of the participants had experienced a range of interventions, and some reflected that the collective setting was much more interactive for participants, and that was seen to increase the likelihood of engaging with the approach.The vast majority of the participants, both in the focus groups and the follow-up interviews, had drawn on WRAP in their daily lives. In the follow-up interviews, the majority had used their WRAPs and intended to continue to do so. The ways in which participants integrated WRAP into their lives varied at times, and the many different ways in which people utilised their WRAP and the related activities and resultant benefits can be broadly characterised as having drawn on the concept and ideas, engaging in the WRAP process itself, integrating the WRAP into daily life, and fully integrating WRAP into activities and outlook. Not all participants went on to develop their own WRAP. Some comments suggested that undertaking a WRAP was challenging, and actively using the components contained within it required a certain level of commitment and motivation. Some felt that they were not in the right place in their life or feeling well enough to explore the WRAP process further. However, many reflected that the process of systematically working through a process of self-awareness was very helpful, even if they did not develop a WRAP as such. This process alone appeared to offer useful insights into one's own experience of living with a mental illness. -up interview)And I feel that um…in the WRAP training it's almost along those lines of quite fundamental in…um…it's almost a seismic shift in thinking. Um…where there was no thinking, only confusion and mystery before there was great mystery why is this happening to me? One challenge was that crisis planning aspect could be quite difficult for participants to complete, both because respondents thought that they had either not experienced a genuine “crisis” or because of the sensitivities of thinking back to a time of crisis. Where participants had experienced a crisis that resulted in admission to a health care facility, this part of WRAP was seen as being vital at communicating the individual's wishes to friends, family, and health care staff. This research found that the WRAP approach used in groups and delivered by trained facilitators who could also share their lived experience was very relevant and appeared to have a positive impact on many of the participants. The group-based format and facilitators offering mutual support through sharing their lived experience with group members appeared to be important aspects of the impact of this approach. The level of impact varied among the participants, and ranged from increased awareness gained from the concept and ideas of recovery, increased self-awareness, integrating WRAP tools and self-management into daily life, and fully integrating it into their thinking about well-being. All of these levels of impact offered substantial benefits for participants even if participants did not go on to complete their own written version of their WRAP. This is an important point to note in ongoing work researching WRAP completed WRAP plans may not be an indicator of how much the intervention might impact participants.Most participants had not come across the concept of recovery before this experience and found that this offered a useful, and for some, powerful new perspective on their experience. Participants described feeling they could take ownership over their well-being and were able to challenge stigma to the point where they could talk about their experiences, sometimes for the first time. As put by one participant, WRAP offers a reminder of what you are like when you are well, and that offered hope and uncovered strategies for overcoming challenges when encountering an episode of illness. These findings are consistent with the growing literature on the positive benefits of undertaking WRAP , 26, 27.The group setting appeared to provide optimal conditions for the delivery of WRAP. The provision of mutual support appeared to enhance the recovery-orientated principles of WRAP. Mutuality offered a supportive, caring environment, and it was viewed as being particularly positive that facilitators were also able to share their experiences. The group aspect of the WRAP intervention itself was clearly an important factor to the success of the WRAP groups, and research on other group recovery orientated approaches based in group settings have also demonstrated positive benefits for participants –21. It wThere are limitations that should be considered in relation to this research. It may have been the case that the individuals taking part in the study were a fairly self-selecting group, both in terms of participating in the interviews and in the intervention itself. The WRAP program and evaluation only focused on four organizations, and it is possible that other organizations and groups would not have had such a favorable response to WRAP. As the sample size of the study was relatively small, the limited quantitative results should be viewed with some caution, even if they tended to support the positive perceptions elicited during the qualitative research phase. Similarly, whilst there were attempts to collect control group data in this research, and RAS and WEMWBS scales were distributed to those attending self-help groups not using the WRAP approach, there were insufficient returns to include as a comparison. Future research should consider including control group data. Although there was very little indication of negative impact, the potential for a negative impact should continue to be monitored in future work.The apparent positive impact of WRAP delivered in the context of mutual support groups indicates that it should be given serious consideration as a unique and worthwhile option for improving mental health. WRAP groups could make a significant contribution to improving mental health and well-being, and further research that established and compares its effectiveness with other modalities may be worthwhile. WRAP is a self-management tool that is underpinned by mutuality and empathy, not by a professionally-applied treatment or therapy, and therefore offers a unique alternative to professionally-driven approaches, yet with much consistency with the patient-led emphasis of self-management. The results of the research indicate that WRAP has the potential to offer a unique and useful approach that could play an important role in the development of interventions for improving mental health.


For starch digestion to glucose, two luminal α-amylases and four gut mucosal α-glucosidase subunits are employed. The aim of this research was to investigate, for the first time, direct digestion capability of individual mucosal α-glucosidases on cooked (gelatinized) starch. Gelatinized normal maize starch was digested with N- and C-terminal subunits of recombinant mammalian maltase-glucoamylase (MGAM) and sucrase-isomaltase (SI) of varying amounts and digestion periods. Without the aid of α-amylase, Ct-MGAM demonstrated an unexpected rapid and high digestion degree near 80%, while other subunits showed 20 to 30% digestion. These findings suggest that Ct-MGAM assists α-amylase in digesting starch molecules and potentially may compensate for developmental or pathological amylase deficiencies. Starch is the major dietary carbohydrate for humans. It consists of two glucans, amylose and amylopectin. Amylose is composed of long linear chains of D-glucose units linked by α-1,4-glycosidic linkages with few branches; while amylopectin has higher molecular weight with shorter linear glucans linked by α-1,4-linkages and is highly branched by α-1,6-linkages The four mucosal α-glucosidase activities are associated with the two membrane-bound MGAM (EC 3.2.1.20 and 3.2.1.3) and SI (EC 3.2.148 and 3.2.10) complexes. Each protein complex contains two catalytic subunits: an N-terminal subunit that is anchored to the enterocyte membrane and a C-terminal luminal subunit in vitro digestibility methods are based on the susceptibility of starch to porcine pancreatic α-amylase A confusing issue regarding starch digestion is lack of consideration of the role of the mucosal α-glucosidases in regulating digestion rate. Conventional in vitro system In vivo, α-amylase amplified both wild type and MGAM null mice mucosal glucogenesis in vitro and in vivo systems indicate a considerable contribution of mucosal α-glucosidases in starch digestion at various structural levels. Here our objective was to investigate whether gut mucosal α-glucosidases are capable to digest gelatinized starch without the aid of α-amylase. In this study, gelatinized normal maize was incubated with individual recombinant mucosal α-glucosidase subunits of varying amounts and digestion periods for the purpose of exploring their potentially larger role in starch digestion than previously thought.Here we ask the question whether gut mucosal α-glucosidases participate and contribute to digestion of gelatinized starch molecules. Our research group has investigated gut mucosal α-glucosidase digestion at various starch structural levels. Recombinant human Nt-MGAM was found to be capable, albeit at a very low rate, to digest intact starch granules to glucose Recombinant human Nt-MGAM, Ct-MGAM and Nt-SI and recombinant mouse Ct-Mgam and Ct-Si were employed in this research. The production of recombinant human Nt-MGAM and Nt-SI was performed as described previously Normal maize  was dispersed in a 10 mmol/L phosphate buffer , and then cooked in a boiling water bath with stirring at about 200 rpm for 30 min. Phosphate buffer was chosen to maintain the constant pH environment. Gelatinized starch was cooled down to 37°C before adding individual mucosal α-glucosidases. An aliquot of cooked starch (10 µL) was transferred to microcentrifuge tubes and incubated with individual mucosal α-glucosidases  for different time intervals  at a water bath set at 37°C and 80 rpm. Glucosidases were inactivated by heating in a boiling water bath for 10 min. The released glucose amount was determined by the glucose oxidase-peroxidase (GOPOD) assay To test the digestion capability on large starch molecules, recombinant α-glucosidases activities were normalized based on amounts required to hydrolyze 50 mmol/L maltose in 10 mmol/L phosphate buffer. Assays were done in triplicate. One unit of activity was defined as the amount of glucose (µg) that is released from 10 µL of 50 mmol/L maltose at 37°C in 5 min. The released glucose amount was determined by the GOPOD assay. Statistical analysis was performed using one-way ANOVA and Tukey’s multiple comparision test. Significance was considered at P <0.05. To compare the starch digestive capability of each enzyme subunits, the applied enzymes (30 units) were further converted to specific activity, the released glucose amount (mg) per pmol protein in the enzyme preparation.Mucosal α-glucosidases were incubated at 37°C water bath, and aliquot (1 or 2 µL) was taken at different time intervals to react with 10 µL malotse (50 mmol/L) for activity assay described above.The production of glucose from cooked normal maize starch digested with the four individual mucosal α-glucosidases, human Nt-MGAM, human Nt-SI, mouse Ct-Mgam, and mouse Ct-Si, is shown in Mouse Ct-Mgam was comparably much more active in directly digesting cooked starch, even at low enzyme units (5 units), than other subunits. In To test the upper limitation of mucosal α-glucosidase digestion of cooked starch, 100 enzyme units were added of each subunit and digested for a prolonged period. In this test, recombinant human Ct-MGAM was included. All four subunits increased digestion extent, and both mouse and human Ct-MGAM reached a plateau level after 6 h with a small increase to 81 and 76% digestion after 24 h, respectively . The othin vitro system used in this study. The other two subunits maintained stable activity in this system over a 6 h period.The glucosidase activity was determined by using maltose as a substrate, and the stability of maltase activity during the digestion progress was determined in . Mouse Cin vitro digestion in the first hour and later reaching nearly 80%. Why does Ct-MGAM have such high digestion capability on gelatinized starch molecules? One explanation may be the broad activity shown in pig MGAM studies. The MGAM complex isolated from intestinal mucosa was shown to have wide ranging activity on various α-glycosidic linkages including α-1,2 of kojibiose, α-1,3 of nigerose, α-1,4 of maltooligosaccharides, α-1,5 of leucrose, and α-1,6 of isomaltose This research reveals, notably, that the each subunit of the gut mucosal α-glucosidases directly digests gelatinized starch to some degree without α-amylase pre-hydrolysis. Unexpected was the considerable hydrolysis of gelatinized starch molecules by mucosal Ct-MGAM with about 50% In further understanding Ct-MGAM’s high starch degrading activity, a review of the current knowledge of its hydrolysis mechanism is useful. Ct-MGAM is a well known exo-hydrolytic enzyme while α-amylase has endo-hydrolytic activity with a role to quickly break down starch molecules. In light of such high activity on gelatinized starch, it is reasonable to speculate that Ct-MGAM has endo-activity contributing to the high digestion, but this is not supported by digestion mechanism studies. Based on the subsite theory The other three recombinant subunits to a lower degree digested gelatinized starch molecules without α-amylase pre-hydrolysis. For Nt-MGAM, this is related to its ability to digest only linear oligomers in vitro system, Nt-SI hydrolyzed gelatinized starch around 20% without aid of other enzymes. Thus, apparently Nt-SI hydrolytic activities at α-1,4 and α-1,6 linkages digest starch to some degree.Regarding debranching activity, Nt-SI is the subunit responsible for isomaltase activity and, as well, hydrolyzes maltose The current study brings forth the issue of the different as well as similar roles of α-amylase and mucosal α-glucosidases in starch digestion, and in particular how α-amylase and Ct-MGAM act on gelatinized starch molecules. The initial stage of starch hydrolysis occurs in the oral cavity, and the final stages of digestion is at the small intestine membrane, and one must reconsider the long held view of the sequential relationship of α-amylase first digesting starch molecules and mucosal α-glucosidases reducing only those products to glucose. It is interesting to note that α-amylase has been reported to participate in starch digestion when in contact with the luminal surface Appendix S1The appendix presents the method of producing recombinant human Ct-MGAM and mouse Ct-Mgam.(DOCX)Click here for additional data file.


International Journal of Radiation Biology 2009;85:421–431.Radioresistance of Stat1 over-expressing tumour cells is associated with suppressed apoptotic response to cytotoxic agents and increased IL6-IL8 signalling. International Journal of Radiation Biology hereby notifies its readers that one word was erroneously omitted from the Abstract. The article published online with this error and consequently its PubMed record must be considered incorrect. The error is highlighted in bold type below.Conclusion: Nu61, which over-expresses Stat1 pathway, is deficient in apoptotic response to ionising radiation and cytotoxic ligands. This resistance to apoptosis is associated with Stat1-dependent production of IL6 and IL8 and suppression of caspases 8, 9 and 3.


Bacteria play an essential role in the initiation, progression, and persistence of dental infections. Therefore endodontic therapy aims to eliminate bacteria from the infected root canal and prevent reinfection.Enterococcus faecalis, Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, Acinetobacter baumani, Candida albicans, Klebsiella pneumonia. The antibacterial activities were assessed in vitro by 1) Agar diffusion test (ADT) 2) MIC by spectroscopic method 3) efficacy assessment using dentinal tubule model at depths of 200 μm and 400 μm in extracted single rooted teeth.Silver nanoparticles have gained more attention owing to their broad spectrum of antibacterial activity and low cost of manufacturing. In the present study, starch coated silver nanoparticle were synthesized and characterized by SEM/EDX and UV/Vis spectroscopy. Starch coated nanosilver was tested for their antibacterial activity against various microorganisms that are commonly found in endodontic failures such as Enterococcus faecalis to nanoparticulates-treated dentin.The results indicated that the synthesized starch coated nanosilver showed good bactericidal effect against a wide range of organisms. The efficacy study using human tooth model shows that there was a significant reduction in the adherence of These experimental results highlighted the potential advantage of silver suspension in root canal disinfection and thereby reduces bacterial invasion into dentin. Hence this eco friendly starch coated silver nanoparticle could be developed as a potent antibacterial agent against a wide range of microorganisms to control and prevent the spreading and persistence of endodontic infections.


Journal of Clinical InvestigationSouth African Medical Journal in 1977. Furthermore, it gave rise to several articles by other authors, on the extent of the diseaseA recent publication on the identification of the gene for progressive familial heart block (PFHB) type 1 in the The disease affects the electrical system of the heart as opposed to diseases that affect the blood vessels, such as coronary artery disease. Heart block causes palpitations, light-headedness, fainting and sudden, unexpected death. This condition can present at any age and, as in the original proband first studied, even in utero. Management depends on the insertion of a pacemaker at the appropriate time.In 1986, the probable locus for the condition was narrowed down to an area encompassing about 80 genes on chromosome 19, which contains just over 1 500 genes.About the same time, Prof Olaf Pongs of Hamburg University’s Centre for Molecular Neurobiology was researching a link between the gene TRPM4 on the 19th chromosome and PFHB type 1. The subjects of his study were all Afrikaans-speaking South Africans. The two research groups decided to join hands and this joint effort eventually led to the discovery of the gene for PFHB type 1.It became clear that the product of this gene was playing a role in the way heart cells handle sodium and potassium, which underlies the electrical signals of the heart. The discovery was a breakthrough for South African medical science as it gave hope to sufferers who can now get advance warning of their condition and receive the necessary treatment.Persistent research over a 35-year period spanning two generations of researchers (father and son: Andries and Paul Brink), and making use of new opportunities and international co-operation has contributed to breaking new ground and advancing the field of medicine.


Spinal manipulative therapy (SMT) is a common intervention used to treat low-back pain. Some prior investigations report decreased spinal stiffness following SMT; others report no effect. Given that the efficacy of many therapies  depend on choice of application site and outcome metric (e.g. fasting vs non-fasting blood sugar), potential explanations for mixed SMT results include variability in SMT application site and the method of computing stiffness. Based on these considerations, our goal was to determine the influence of SMT application site and stiffness computation on SMT-induced changes in spinal stiffness.6 spinous process, left L6 lamina, left L6 mammillary process, and L7 spinous process. To obtain stiffness data, the apparatus slowly displaced the L6 spinous process to 16N; force and displacement were recorded continuously. Three metrics were calculated from the resulting force-displacement curve: Terminal Instantaneous Stiffness , k (average stiffness), and Regional Stiffness . SMT-induced changes in each metric were determined for each application site using an ANOVA model controlling for SMT presentation order.In an anesthetized cat preparation (n=8), simulated SMT was delivered by a validated mechanical apparatus to the intact lumbar spine at 4 sites: L6 spinous decreased TIS . SMT applied at the L6 lamina also decreased TIS . SMT applied to the L6 spinous increased k . SMT applied at L6 spinous process and L6 lamina decreased RS during some, but not all intervals.SMT applied at the LThese results suggest that previous reports on SMT’s effect on spinal stiffness may be influenced by the choice of SMT application site and stiffness metric.


Journal of Cellular and Molecular Medicine , ‘Caveolin and MAP kinase interaction in angiotensin II preconditioning of the myocardium' by Manika Das, Samarjit Das and Dipak K Das, published online on 24th June 2007 in Wiley Online Library (http://onlinelibrary.wiley.com), has been retracted by agreement between the authors, the journal Editor-in-Chief, Professor LM Popescu, and Blackwell Publishing Ltd. The retraction has been agreed due to findings of data fabrication in the western blot data in Figure 2a in an investigation into the work of Dipak K. Das by the University of Connecticut Health Center.The following article from


Despite significant reductions in acute-rejection rates with the introduction of calcineurin inhibitor (CNI)-based immunosuppressive therapy, improvements in long-term graft survival in renal transplantation have been mixed. Improving long-term graft survival continues to present a major challenge in the management of kidney-transplant patients. CNIs are a key component of immunosuppressive therapy, and chronic CNI toxicity has been widely thought to be a major factor in late graft failure. However, recent studies examining the causes of late graft failure in detail have challenged this view, highlighting the importance of antibody-mediated rejection and other factors. In addition, the diagnosis of CNI nephrotoxicity represents a challenge to clinicians, with the potential for over-diagnosis and an inappropriate reduction in immunosuppressive therapy. When graft function is deteriorating, accurately determining the cause of the kidney disease is essential for effective long-term management of the patient. Diagnosis requires a thorough clinical investigation, and in the majority of cases a specific cause can be identified. Despite significant reductions in acute-rejection rates seen with the introduction of tacrolimus, mycophenolate mofetil (MMF) and interleukin-2 receptor antibody induction in the 1990s, improvements in long-term graft survival in renal transplantation have been mixed. In Europe, data from the Collaborative Transplant Study show substantial improvements in graft survival half-life , and eduEven with the gains seen in Europe, long-term graft loss is still a significant problem in renal transplantation. Improving long-term graft survival represents a major challenge in the management of kidney-transplant patients, as a wide range of factors can contribute to transplant loss .Providing immunosuppressive therapy that is effective for the individual patient is an important part of transplant management. Calcineurin inhibitors (CNIs) are a key component of immunosuppressive regimens, yet chronic CNI toxicity has also been widely thought to be a major factor in late graft failure. Recent studies, however, have challenged this view. Findings from the Long-term Deterioration of Kidney Allograft Function (DeKAF) and the Genome Canada studies showed that antibody-mediated injury was a predictor of graft loss, whereas a biopsy diagnosis of ‘CNI nephrotoxicity’ was not –7. AccurA large number of nonimmunological and immunological factors can potentially contribute to deteriorating function and graft loss following renal transplantation ,9. Both Risk-factor analyses of graft failure are after-the-fact evaluations performed in a defined cohort of patients. Although such analyses are valuable in identifying those at risk of graft failure, this is quite different from defining the cause of graft function deterioration in an individual patient. In these cases, the first, and often late, sign of a negative development is an increase in serum creatinine. The first, but sometimes insufficient, step in determining causality is to perform a graft biopsy.de novo or recurrent), chronic hypertension and obstruction can all be identified from biopsies. Chronic CNI nephrotoxicity may be suggested by a number of histological lesions, although these are not specific, so diagnosis relies on elimination of other potential causes [Transplant biopsies may be helpful in determining the potential causes of deteriorating graft function . Early bl causes –15. ChroDetermining the cause of late graft failure presents a considerable challenge, given the interactions between the factors that can affect graft function, and the difficulty of making definitive diagnoses from graft biopsies. Consequently, many cases of late graft failure are classified using the nonspecific term ‘interstitial fibrosis and tubular atrophy (IF/TA), not otherwise specified’, previously known as chronic allograft nephropathy (CAN) . The recThe slow decline in renal function coupled with absence of evidence of acute rejection has led to the view that nonimmunological factors, such as CNI nephrotoxicity, are the most important causes in late graft failure. However, given concerns that the actual causes of late kidney allograft dysfunction and failure may be being overlooked, a number of recent studies set out to examine these causes in detail .et al. showed that most cases of kidney allograft failure could be attributed to a specific cause [n = 153), glomerular diseases were the most common cause (37%), whereas around 30% of cases were described as IF/TA; however, most of these could be attributed to a specific cause  from CNI- (ciclosporin-) treated and CNI-free kidney-transplant patients . AlthougChronic renal failure is a serious problem in nonrenal transplant recipients, raising concerns about the potential effects of CNI therapy on renal function in these patients. An analysis of over 69 000 nonrenal solid organ transplants showed that 16.5% of patients developed chronic renal failure during follow-up (median 36 months), with the 5-year cumulative incidence ranging from 7% to 21%, depending on the type of transplant . MultivaIn a retrospective analysis of renal biopsies in 101 patients following nonrenal transplantation, histological changes characteristic of hypertension, CNI toxicity, primary glomerular disease and thrombotic microangiopathy were observed . Other sOver-diagnosis of CNI nephrotoxicity could lead to an inappropriate reduction in immunosuppressive therapy, putting the patient at risk of increased immunological activity . This haEvidence from clinical trials shows that CNI-based regimens provide similar renal function and equivalent or superior graft survival to alternative regimens. The CAESAR study showed that patients receiving a ciclosporin withdrawal regimen showed similar renal function to low- or standard-dose ciclosporin therapy, but had a higher incidence of biopsy-confirmed acute rejection (BCAR) . In the Evidence shows that under-immunosuppression is associated with increased injury and graft loss. Some studies have shown that reduced immunosuppression therapy is associated with increased IF/TA progression , while aPreventative measures aimed at minimizing the risk of renal dysfunction are an important aspect of patient management following kidney transplantation. Hence, the impact of comorbidities such as diabetes, hypertension and hyperlipidaemia on graft function and overall patient health needs to be considered. For example, hypertension is widespread in kidney-transplant recipients, and treatment with calcium channel blockers has been shown to be well tolerated, reduce graft loss and improve GFR . Other mWhen graft function is deteriorating, accurately determining the cause of the kidney disease is essential for the effective management of the patient. Diagnosis requires a thorough clinical investigation, with nothing taken for granted; as discussed above, a specific cause can be identified in the majority of cases, based on a combination of biopsy diagnosis, antibody testing and clinical information.Investigations should include clinical assessments for dehydration, uncontrolled hypertension and infection, which can all affect renal function, whereas ultrasound should be used to assess outflow obstruction and renal circulation . ProteinBiopsy assessments are a key part of the diagnostic process, with characteristic histological changes allowing the identification of a range of specific causes of graft loss. Studies show that in most cases, a specific cause of late graft failure can be identified ,19. DiagOnce a diagnosis has been made, the treatment approach should be individualized for each patient. For those with evidence of chronic AMR from biopsy or the presence of DSA, for example, immunosuppression should be increased, either by raising the dose of tacrolimus or MMF therapy or adding an mTOR  inhibitor, such as everolimus. Specific measures to reduce DSA levels may also be considered, such as the administration of bortezomib or eculizumab, although these treatment modalities should still be regarded as largely experimental –47. AsseEditorial services of iS Health involved in the preparation of this manuscript were supported by Astellas Pharma Europe Ltd. No honoraria were received by the authors for the preparation of the manuscript.


Trauma Monthly (TM) formerly known as the Kowsar Medical Journal (KMJ). KMJ was a persian medical journal targeting GPs as the primary readers and was not international; it failed to provide a worldwide forum to address issues of a specific field. In accord with the new policy adopted by our ministry of health, KMJ was upgraded to TM. This necessitated a total revamp of the journal with new editors, consultants and an international editorial board. This process was a time-taking, pain-staking undertaking by which the new English Medical journal TM evolved.Rapid advancements and research in the fields of medicine and the growing number of specialists are narrowing the spectrum of healthcare that general practitioners (GPs) can provide. In order to provide patients with an accurate diagnosis and proper treatment care, GPs have to refer their patients to the relevant specialist. This is why more and more GPs are inclined to pursue a specialty and more specialists are inclined to pursue a subspecialty. This trend as well as the daily increase of medical doctors is why fewer patients refer to GPs. This is the primary basis for upgrading journals of general medicine to more specialized ones. Having said that, it is with great pride that I introduce the initiation of the journal TM meets the high expectations of our readers and remains up to par in upholding international standards.TM seeks to provide scientists, specialists and traumatologists a medium to publish contemporary research in the fields of Trauma, Surgery and Emergency Medicine. It is an international peer-reviewed medical journal indexed in Scopus and Embase. TM aims to publish high-impact papers within a short time frame both in print and online. As the field of trauma is a vast one, submissions in the form of Original Articles, Reviews, Case Reports, Short Communications, Technical Reports, Iatrogenic Trauma, Surgical Pathology and Letters-to-the-Editor are accepted. All submissions are reviewed by the relevant section editor and peer reviewers. In order to expedite the publication process we have expanded the number of our reviewers. Because publication time is an important factor for contributing authors accepted manuscripts are immediately slated for publication. There are no fees of any sort for authors or institutions and all articles are permanently available online free of charge. I would like to take the opportunity here to thank the journal team for their endeavors. I hope


Although large panels of synthetic overlapping peptides spanning the entire length of the polyproteins of a virus facilitate the detection of cytotoxic T lymphocyte (CTL) epitopes, it is an exceedingly costly and cumbersome approach. Alternatively, computational predictions have been proven to be of satisfactory accuracy and are easily performed. Such a method enables the systematic identification of genome-wide CTL epitopes by incorporating epitope prediction tools in analyzing large numbers of viral sequences. In this study, we have implemented an integrated bioinformatics pipeline for the identification of CTL epitopes of swine viruses including the CSF virus (CSFV), FMD virus (FMDV) and PRRS virus (PRRSV) and assembled these epitopes on a web resource to facilitate vaccine design. Identification of epitopes for cross protections to different subtypes of virus are also reported in this study and may be useful for the development of a universal vaccine against such viral infections among the swine population. The CTL epitopes identified in this study have been evaluated in silico and possibly provide more and wider protection in compared to traditional single-reference vaccine design. The web resource is free and open to all users through http://sb.nhri.org.tw/ICES. Classical swine fever (CSF), foot-and-mouth disease (FMD) and porcine reproductive and respiratory syndrome (PRRS) are the primary diseases affecting the pig industry globally. Vaccine induced CD8 Classical swine fever virus (CSFV), foot-and-mouth disease virus (FMDV) and porcine reproductive and respiratory syndrome virus (PRRSV) are debilitating pathogens in the swine industry, resulting in serious economic losses year-after-year. The development of effective vaccines against these pathogens is therefore of practical significance in the swine industry. Although neutralizing antibodies induced upon vaccination are highly effective in controlling disease and viral transmission, they do not confer cross-subtype protection and might become ineffective due to antigenic changes . Current A systematic approach based on the synthesis and evaluation of large sets of overlapping peptides has been proposed and used in screening CTL epitopes of viral proteins -12, howehttp://sb.nhri.org.tw/ICES for genome-wide scan and epitope search for potential CTL epitopes of swine viruses. In addition, we have demonstrated that experimentally-validated epitopes can be found in support the predictions of ICES. Taken together, ICES is a valuable resource for the design of effective peptide vaccines for swine viruses. In this study, we have integrated a bioinformatics pipeline to analyze swine viral sequences in order to resolve the above-mentioned challenges: (1) genetic variation, (2) incomplete screening from particular surface proteins, and (3) inappropriate prediction based on non-swine leukocyte antigens. We thus have designed and constructed a web resource, called identification of cytotoxic T lymphocyte epitopes for swine viruses (ICES) for the identification of CTL epitopes of swine viruses such as CSFV, FMDV and PRRSV. Predictions of proteasomal cleavage sites and binding affinity to SLA as well as calculations of sequence conservation were implemented in ICES. Users are able to freely access ICES online via  The coding sequences of swine viruses including CSFV, FMDV and PRRSV were retrieved from NCBI GenBank . For eac We have performed the viral sequence analyses, including the predictions of proteasomal cleavage sites and binding affinity as well as the calculation of sequence conservation for peptides, and have stored all data in MySQL database. We have constructed ICES with JSP and JavaScript and constructed it on a Linux machine. The server is free and open to all users via http://sb.nhri.org.tw/ICES. Four schemes: genome-wide scan, epitope search, literature support, and vaccine design & evaluation were implemented in ICES for the identification and evaluation of CTL epitopes of swine viruses.in silico evaluation. We hypothesized that a tailored viral vector expressing specific CTL epitopes is able to induce T-cell immunity, and the pre-existing immunity could be activated when exposed to the corresponding antigens. We therefore assumed that the as-designed memory T-cell immunity could recognize and clean viruses containing the specific epitopes. We evaluated vaccine efficacy by means of counting the number of peptides in an examined virus correspond with the as-designed epitopes. Viruses of whole genome sequence (≥ 10) were tested. 41 Type Asia 1, 81 Type A, 16 Type C and 138 Type O FMDV viral sequences were thus used for evaluation. We firstly segmented the genome polyproteins into peptides using NetChop prediction [ We have identified genome-wide CTL epitopes for CSFV, FMDV and PRRSV  located in the nineteen positions across the reference genome of FMDV type-O virus  higher than that obtained from a single-reference design by NetChop+NetMHCpan, in testing type A and type O viruses. Although, in testing type A viruses, the numbers of peptides and alleles obtained from internal peptides are close to that from ICES, they are only 80% of the numbers obtained from ICES in testing type O viruses. In order to design cross-subtypic vaccine for FMDV viruses, we have identified 36 CTL epitopes from ICES based on all collected viral sequences and 38 internal CTL epitopes based on the 7 single reference strains (FMDV viruses in -5). On the whole, ICES is a valuable resource of potential CTL epitopes for swine vaccine design.The aim of this study is to assist in vaccine design. Since multiple CTL epitopes can be incorporated in a non-disease-causing viral vector for development of universal T cell vaccine, we have identified 47, 36 and 77 CTL epitopes for heterosubtypic CSFV, FMDV and PRRSV, respectively .  of ICES , we sepain silico prediction of T-cell epitopes of PRRSV, they neither searched for the whole protein nor utilized alleles of SLA, which might lead to incomplete and/or false positive identification of CTL epitopes. The established integrated bioinformatics pipeline was hence designed to facilitate the genome-wide identification of CTL epitopes for swine viruses. CSF, FMD and PRRS are considered key challenges in the swine industry. A number of studies have been investigated for the identification of CTL epitopes of CSFV ,12,25-27 Many CTL epitope prediction tools are publicly available -33. Neve+ T cell-mediated immune responses might be long-lived and cross-serotype and thus deserves further attention [ We have analyzed all the viral sequences of CSFV, FMDV and PRRSV that were downloaded from GenBank in order to generate a genome-wide list of potential CTL epitopes in the ICES. As shown in ttention . ICES wa In summary, a systematic bioinformatics pipeline has been designed to identify potential CTL epitopes of CSFV, FMDV and PRRSV; the as-predicted CTL epitopes were subsequently integrated into ICES. Therefore, ICES has been demonstrated as a valuable resource for swine vaccine design. In addition, the framework of ICES can easily be adapted for use among other emerging human pathogens, such as dengue virus and HIV, and thus making a great impact on the control of infectious diseases.


To date, there has been little agreement on the use of ultrasonographic parameters in predicting the long-term outcome after transplantation. This study evaluates whether ultrasonography of the graft performed in the early stage after transplantation is a valuable predictor for long-term-outcome.The aim of this study was to evaluate the association of ultrasonographic parameters  measured within the first week after transplantation with 6 months graft function.A cross-sectional study was performed on 91  living renal transplants between April 2011 and February 2013. All patients underwent an ultrasonography at the first week after transplantation. Intrarenal Doppler indices including RI, PI and EDV were measured at the interlobar artery level and the graft length and parenchymal volume were defined with gray scale ultrasonography. Graft function was estimated at 6months by glomerular filtration rate (GFR). Unpaired t-test and multivariate-linear and logistic regression analysis were used to estimate the relationship between ultrasonographic parameters and GFR.Fourteen patients (15.4%) had impaired graft function after 6 months (GFR less than 60 ml/min/1.73m2). Multivariate linear regression analysis showed significant correlation between GFR at 6 months and RI, PI and EDV with a P value of 0.026, 0.016 and 0.015, respectively. Logistic regression analysis showed that GFR<60 ml/min/1.73 m2 at 6 months was significantly associated with RI>0.7  and PI>1.3  and EDV<9 cm/Sec .In this study, kidney transplant recipients with a lower RI and PI and a higher EDV at 1week showed better graft function at 6 months after transplantation. Ultrasound is a noninvasive and relatively inexpensive diagnostic tool providing information about renal location, contour and size. Doppler ultrasonography shows kidney morphology and hemodynamics . It is wResistive index (RI) has been shown as the best ultrasonographic parameter to determine renal dysfunction , 5. It iIntrarenal diastolic blood flow has no association with systolic components; therefore, the end diastolic velocity (EDV) obtained with Doppler wave tracing illustrates pathologic changes at kidney graft more reliably than RI , 9.PI is another Doppler parameter more emphasized on Doppler wave pattern and has a significant value in graft function prediction. On the other hand, some gray scale parameters such as graft size are often used to predict long-term graft function .The aim of this study was to evaluate the association of ultrasonographic parameters  measured within the first week after transplantation with 6 months graft function.Between April 2011 and February 2013, a total of 100 patients who underwent renal transplantation in Afzalipour university hospital were enrolled and a single investigator performed all ultrasonographies by MEDISON V10 device  with a curved probe of 3.5-5 MHz (C3-7IM) in the supine position. We consulted the local ethics committee regarding this study. No formal ethical committee approval was required.Three patients died and six patients were excluded from the study owing to factors that influenced the Doppler parameters; three patients due to hydronephrosis, two patients due to arterial stenosis and one patient due to perirenal collection , 2. The RI and PI were calculated by system software at an interlobar artery level  accordinV max is the maximum systolic velocity, V min is the minimum diastolic velocity, and V mean is the time-averaged mean velocity .EDV was calculated by system software. The renal function was evaluated by measurement of serum creatinine (Cr) and estimation of the gloumerular filtration rate (GFR) according to the 2 and EDV in cm/Sec.Age was measured in year, body weight in Kg, creatinine in mg/dl, GFR in ml/min/per 1.73 mPatients were classified as display decreased graft function when GFR was <60 and normal graft function when GFR was ≥60. Continuous variables were expressed as a mean value±standard deviation. The differences between patient groups were assessed with unpaired standard t-test. The degree of correlation between ultrasonographic parameters and GFR were estimated by multi linear regression models. Logistic regression analysis was used to estimate the potential association between ultrasound parameters and decreased graft function versus near normal graft function at 6 months post transplantation. All statistical tests were interpreted as two tailed. P values lower than 0.05 were considered as statistically significant. Analyses were performed using SPSS .2). The median of RI and PI at the first week after grafting was 0.71 and 1.2, respectively. Mean RIs were 0.68±0.07 and 0.79±0.07 in patients with normal graft function and graft dysfunction at 6 months after transplantation, respectively , 46 (50.6%) were male and 45 (49.4%) were female. They were followed up for 6 months after transplantation. Fourteen patients (15.4%) had impaired graft function after 6 months (GFR less than 60 ml/min/1.73 mectively . On the ectively . This meectively . Multivaectively . Ultrasonographic parameters are widely used to evaluate not only the present graft function, but also as predictive factors of long term outcome of the renal transplant. These parameters have been shown to correlate with short-term renal transplant function determined by serum creatinine or GFR. However, their relationship with long-term function is more controversial, with conflicting results in the literature .The results of this study indicate that RI, PI and EDV in the early phase after transplantation are significantly associated with renal dysfunction 6 months after transplantation. Intrarenal RI is influenced by not only arterial resistance but also various extararenal factors such as the systemic blood pressure. Therefore, RI parameter as a sole element in distinguishing various causes of graft dysfunction has a limited value. On the other hand, an increase in RI can be induced by any interarenal condition such as acute renal failure or urinary tract obstruction that induces a reduction in diastolic renal perfusion , 11. PI Radermacher et al.  showed tButurovic-Ponikvar et al.  demonstrOn the other hand, some researchers did not support this correlation. Loock et al.  and GarcIn recent years, management of renal transplant recipients has progressively improved. Moreover, it is necessary to use available short-term tools to predict long-term graft function. Applying these factors make better management of the transplants. In spite of the controversies regarding ultrasound assessment in kidney transplants, it is considered as a prognostic marker for long-term graft survival. This study focused on evaluating whether ultrasonography performed in the early period after transplantation would be a valuable predictor of long-term-outcomes.Our findings demonstrate that out of the different ultrasonographic parameters that were measured within the first week after renal transplantation, only the early evaluation of RI, PI and EDV were effective in the estimation of long-term graft function.


One α-amylase was isolated from whole larval midguts of T. molitor using non-denaturing SDS-PAGE, while two other α-amylase fractions were isolated from whole larval midguts of Z. subfasciatus using hydrophobic interaction chromatography., Digested starch granules from larvae fed on maize, potato or wheat were isolated from midgut contents. Combinations of starch granules with isolated α-amylases from both species showed similar patterns of granule degradation. In vitro enzymatic degradation of maize starch granules by the three different α-amylase fractions began by creating small holes and crater-like areas on the surface of the granules. Over time, these holes increased in number and area resulting in extensive degradation of the granule structure. Granules from potato did not show formation of pits and craters on their surface, but presented extensive erosion in their interior. For all types of starch, as soon as the interior of the starch granule was reached, the inner layers of amylose and amylopectin were differentially hydrolyzed, resulting in a striated pattern. These data support the hypothesis that the pattern of starch degradation depends more on the granule type than on the α-amylase involved.Scanning electron microscopy images were taken of starch granules from different sources following exposure  Starch is a major constituent of seeds and grains that is used as a source of fuel and carbon for germinating seeds but it is also used as nutrient source by granivorous insects. In order to understand the adaptability of insect pests to their food sources, qualitative and quantitative determination of digestive parameters must be carried out. A complete description of the digestive process of starch granules involves the quantification and spatial distribution of enzymes involved in digestion of carbohydrates (endo- and exocarbohydrases). However, starch granules present a special difficulty in terms of digestion, when compared to other nutrients such as proteins  because Bemisia tabaci (Gennadius) (Homoptera: Aleyrodidae)  and the Mexican bean weevil, Zabrotes subfasciatus Boheman (Coleoptera: Bruchidae), both of which are serious pests of stored grains and pulses. The results showed that the overall patterns of starch granule digestion depends more on granule type than on the α-amylasess involved in the process.In spite of the importance of starch utilization by insects, the process of starch granule digestion has received relatively little attention, compared to the greater number of studies that used refined starch, rather than “unaltered” or granular starch. Raw starch granules are natural substrates, and two articles from the beginning of the last decade are the pivotal works that utilized starch granules to assay for α-amylase activity  followedrodidae) . These arodidae) . For mosrodidae) . To bettZ. subfasciatus was supplied originally by Prof. F.M. Wiendl of the Centro de Energia Nuclear na Agricultura, Piracicaba, São Paulo, Brazil. A stock culture of this species has been maintained since 1994. The insects were reared on black-eye pea, Vigna unguiculata (L.) Walp. , seeds in darkness and maintained at 29 ± 1° C and 65 ± 5 % RH. To have a source of inducible α-amylasess, seeds of the common bean, Phaseolus vulgaris L.  were also used to feed Z. subfasciatus  of maize (Zea mays), potato (Solanum tuberosum) or wheat (Triticum vulgaris). To feed Z. subfasciatus larvae, starch granule flour was inserted and compacted inside gelatin capsules. Two fourth instar larvae were transferred into a cavity made in the compacted mass of flour in one half of a gelatin capsule. Feeding larvae were maintained in the capsules for 48 h . Both T. molitor and Z. subfasciatus have high amylase activity at pH 5.5. The assay was terminated by the addition of 200 µl 3,5-dinitrosalicylic acid. The solution was heated in a boiling water bath for 5 min, cooled, and after the addition of 200 µl of distilled water, the absorbance was read at 550 nm. All assays were performed at 30°C. Incubations were carried out for at least four different periods of time, unless otherwise stated, and the initial rates of hydrolysis were calculated. One enzyme unit was expressed as the quantity of enzyme that produces 1 µmol of maltose equivalent per minute.α-Amylase activity was determined, unless otherwise stated, by using a 3,5-dinitrosalicylic acid reagent prepared according to Noelting and Bernfeld . In the In vitro digestion of starch granules was performed by incubating 200 µl of 2 % (w/v) granule suspensions with an equal volume of the enzyme sources (0.3 U α-amylases) in a reaction mixture containing 50 mM acetate buffer (pH 5.5), 0.2% NaN3, 10 µM E-64, 5 µg/ml pepstatin A, 20 mM NaCl and 2 mM CaCl2. The reactions were conducted at 30° C for different periods of time. The suspensions were centrifuged at 7000 g for 5 min and divided into supernatants and packed starch granules. The granules were suspended and washed twice in 2.0 ml of water and finally suspended in 95% ethanol for scanning electron microscopy.www.biorad.com) Mini Protean 3 apparatus. Proteins were separated on 7.5% (samples from Z. subfasciatus) or 12% (samples from T. molitor) acrylamide resolving gel and 6% acrylamide stacking gel. The runs were carried out at 4°C and 150 V using pre-cooled buffers. After the runs, gels were transferred to 2.5% Triton X-100 (w/v) for 20 min at room temperature, and then transferred to a substrate/buffer solution  and incubated at 30°C for 30 min. After briefly rinsing the gel in water, amylolytic activity was stopped by transferring the gels to the staining solution . After staining, light bands against the dark background indicated the presence of active α-amylases.Midgut a—amylases were detected using in-gel assays following non-denaturing SDS-PAGE . ChromatT. molitor was obtained by elution following semi-denaturing electrophoresis as described above. Induced and constitutive α-amylases from larval Z. subfasciatus were obtained by hydrophobic interaction chromatography on a phenyl-agarose column essentially as described by Silva et al.  equilibrated with 10 mM imidazole buffer, pH 6.0 containing 1 M ammonium sulfate, using an Econo System (BioRad). The column was washed with 10 ml of equilibration buffer and eluted with a 40 ml linear gradient decreasing to 0 M ammonium sulfate in imidazole buffer, followed by a 10 ml isocratic elution using imidazole buffer without ammonium sulfate. The flow rate was 1.0 ml/min and 1.0 ml fractions were collected and placed on ice immediately.Samples of 50 larval The broad α-amylases activity peak that eluted between 300 mM—0 M ammonium sulfate was collected and pooled and then subjected to another chromatographic step on the same column, but using a stepwise elution procedure. The column was equilibrated with 10 mM imidazole buffer, pH 6.0 containing 1 M ammonium sulfate. The enzyme fraction was adjusted to 1 M with ammonium sulfate, it was applied to the column and washed with 5 ml of equilibration buffer, followed by 20 ml of a linear gradient of 1 M - 300 mM ammonium sulfate in imidazole buffer, followed by 20 ml of 300 mM ammonium sulfate in imidazole buffer, followed by a linear gradient of 5 ml of 300 mM - 0 M ammonium sulfate in imidazole buffer, and finally 25 ml of imidazole buffer only. The flow rate was 1.0 ml/min and fractions of 1.0 ml were collected and placed on ice immediately. Runs were performed at room temperature. Recovery of enzyme activity was 80–100%.www.zeiss.com) at 15 kV.Scanning electron microscopy images were obtained of starch granules subjected to hydrolysis by the different amylase fractions and of starch granules obtained from insect intestinal lumens. Starch granule preparations were suspended in 95% ethanol and applied to a specimen stub. Samples were then coated with gold and observed using a Zeiss 964 Scanning Electron Microscope (T. molitor following non-denaturing electrophoresis (Z. subfasciatus fed on P. vulgaris using two sequential hydrophobic interaction chromatography steps (in vivo within the gut, and in vitro with different α-amylase fractions. All combinations of starch granules with different enzyme sources resulted in similar patterns of granule degradation (in vivo digestion seemed to have greater erosion in the inner core, leaving external parts with holes, when the larvae had been fed maize and wheat starch granules, and an apparently undamaged surface when they were fed potato starch granules (One α-amylase fraction was isolated from whole midgut of larval phoresis . Two α-ahy steps . Scanninradation  and 4. Tgranules  and 4. MIn vivo degradation of maize, potato, and wheat starch granules was similar irrespective of the insect (In vitro enzymatic degradation of maize starch granules by the three different insect α-amylases began by creating small holes and crater-like areas on the surface of the granules (in vitro and in vivo digestion of wheat starch granules by larval Tribolium castaneum α-amylases (V. unguiculata and P. vulgaris, also showed that different α-amylases produced the same pattern of granule degradation, but with liberation of different dextrins (in vitro degradation by plant amylases, characterized by the “Swiss cheese” pattern of the digested starch granules (Analysis of the images showed that the patterns of digestion of the different starch granules were similar, even when digested by different α-amylases  and 4. Ie insect . In vitrgranules . Over tigranules . Similargranules . This saamylases . A compadextrins . For alldextrins . Starch granules .in vitro digestion is very much slower than the in vivo process. Therefore, exposure of the internal parts by the mastication process is crucial for digestion of starch granules that have a resistant surface, as is the case for potato starch granules.Undamaged raw starch granules can be very resistant to digestion . Therefo


The Society for Microbial Ecology's (SOMED) 36th International Conference is now history. As stated by President Andy Onderdonk in the last SOMED newsletter, the meeting was a success. The Organizing Committee, headed by Professor Alojz Bomba, had done a marvellous job. The programme was well balanced with a many good lectures highly relevant for our society. We would, however, have liked to see even more participants and/or SOMED members, something that was discussed at the General Assembly meeting. The discussion resulted in a proposal from one of our councillors, Sandrine Claus, who a few days after the meeting came up with an excellent proposal:If they have not started already, I am quite sure that the SOMED Board will work hard to substantiate the excellent ideas that are outlined in Sandrine Claus’ proposal. I look forward to reading the winner's manuscript!MEHD and how the journal is developing. As the journal is now indexed in PubMed Central/PubMed, she encouraged all members of SOMED to support their society's own journal by submitting their best work to it, and also to have abstracts and/or proceedings from SOMED meetings published in MEHD.At the recent SOMED meeting in Kosice, Senior Publisher Anne Bindslev from Co-Action Publishing presented interesting information about At the meeting, four new members for the Editorial Board were recruited:N.V. Boyko, Uzhhorod National University, Ukraine. Her last article in Journal of the Science of Food and Agriculture clearly demonstrates that some plant extracts can modulate platelet functions in humans.S.P. Claus, University of Reading, UK. In Cell Host Microbe, she recently had an exciting article entitled “Fighting undernutrition: don't forget the bugs”!R.N. Fichorova, Harvard Medical School, USA. Readers of Microbial Ecology in Health and Disease will already be familiar with her article in the 2013 volume: “Effect of feminine hygiene products on the vaginal mucosa.”K. Venema, TNO, Netherlands. His recent article in Best Practice & Research in Clinical Gastroenterology, entitled “Experimental models of the gut microbiome,” is a “must” for young scientists entering that field.These four names will now be added to the current editorial board: J. Artega, Columbia; A. Berstad, Norway; E. Bezirtzuglou, Greece; P. Carter, USA; P. Conway, Australia; M. Fons, France; W. Garrett, USA; E. Houpt, USA; K.A. Krogfelt, Denmark; V. Lazar, Romania; P. Mastrantoni, Italy; M. Mikelsaar, Estonia; I. Rowland, UK; and B. Shenderov, Russia.MEHD. Several board members took up the challenge given in my Editorial from November 2012 and submitted excellent manuscripts for publication in MEHD. With the strengthened editorial board and an increasing number of readers around the world, in addition to PubMed indexing, I am confident that an increasing number of articles will be submitted to the journal from now on.Thus, the journal now has “ambassadors” all over the world, and in addition, they represent all the fields that are covered by With a slight travesty of a statement given in the Editorial mentioned above, I will end by underlining:MEHD!Only together can we make 2014 the best year ever for SOMED and Tore MidtvedtEditor-in-Chief