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Context: No consensus has yet been formed on project development in lake-water conservancy on aspects such as lake quality, ecological environment, rural economy, social culture, leisure living environment and leisure aspirations due to the current lack of comprehensive discussion. Aims: This study mainly uses the case of Sun Moon Lake in Taiwan to verify the impact of lake-tourism optimisation and water-conservancy projects on the rural economy, water quality, ecology and sustainable development of tourism for local young people in the area around the lake. Methods: We employed open-sampling questionnaires and semistructured interviews to collect data and conducted multivariate analysis. Key results: The study investigated the hypothesis that optimising water-conservancy projects for lake tourism creates a stable leisure and tourism environment in rural areas, enhances visibility, and increases emotional exchanges and the preservation of historic sites. However, problems such as excessive tourism waste and a lack of public facilities negatively affect local young consumers' willingness to engage in tourism activities. Conclusions: Improving problems in the villages, ecology and natural environment surrounding lakes that are being conserved can increase young local individuals' willingness to engage in and share experiences of tourism activities. Implications: If the local government can improve the issues of protected villages, ecology and the natural environment around the lake, it can increase the willingness of local young people to participate in and share their experiences in tourism activities. Lake tourism-optimisation water-conservancy projects are indeed conducive to creating a safe leisure and tourism environment, thereby enhancing human interaction, historical monument protection and local visibility. However, problems such as shortage of basic public facilities and excessive tourism waste will still affect people's perception of the local environment and willingness to consume. This article belongs to the collection Ecological Monitoring and Assessment of Freshwater Ecosystems: New Trends and Future Challenges. [ABSTRACT FROM AUTHOR]

The study provided a qualitative investigation into problematic mobile phone use among the youth athlete population. The study aimed to identify the factors which contributed to problematic use, the effects of problematic use, and suggestions on how to help youth athletes overcome problematic use. Four focus groups sessions were conducted with a total of 21 Singaporean youth athletes (aged 12–18 years old) from four different sports. The data was analysed using reflexive thematic analysis. The findings indicated various factors which contributed to problematic use, namely personal attributes, needs fulfilment, and external influences. Effects of problematic use included areas such as shrinkage of time, performance deficits, and undesirable behaviours. There were various suggestions on how to overcome problematic use, which included strengthening internal resources and tapping into sources of external help. Future research should seek to use the knowledge derived from this study to create interventions to help youth athletes deal with their problematic mobile phone use. [ABSTRACT FROM AUTHOR]

This study presents a repetitive group sampling plan and a multiple dependent state sampling plan based on the EWMA (exponentially weighted moving average) yield index for product acceptance. The proposed plans utilize the current and previous information through EWMA statistic to reach a decision of lot sentencing. A non-linear optimization model is developed to determine the plan parameters of the proposed plans for various specified conditions. The performance of the proposed plans over several existing sampling plans is analyzed, showing that the proposed plans are efficient in reducing the sample size for lot sentencing. For industrial application, a real example is given to demonstrate the implementation of the proposed plans. [ABSTRACT FROM AUTHOR]

With the usage of gas ferrocene Fe(C5H5)2 as a reactant, which is different from the traditional thin Fe film, to grow the high-quality carbon nanotubes (CNTs) in the high aspect ratio (AR) trench structure, it has many advantages to be the through-silicon vias (TSVs) material for the three-dimensional (3-D) stacking technology. In this work, we successfully demonstrate the full process flow, including CNT growing, chemical–mechanical planarization (CMP), and wafer temporary bonding for CNTs as TSVs in the 3-D stacking connection. The flexibility for this demonstrated process flow makes the integration of real high dense devices and CNTs as TSVs for the 3-D connection more easily. [ABSTRACT FROM AUTHOR]

Key points: Several distinct strategies produce and conserve heat to maintain the body temperature of mammals, each associated with unique physiologies, with consequences for wellness and disease susceptibilityHighly regulated properties of skin offset the total requirement for heat production We hypothesize that the adipose component of skin is primarily responsible for modulating heat flux; here we evaluate the relative regulation of adipose depots in mouse and human, to test their recruitment to heat production and conservationWe found that insulating mouse dermal white adipose tissue accumulates in response to environmentally and genetically induced cool stress; this layer is one of two adipose depots closely apposed to mouse skin, where the subcutaneous mammary gland fat pads are actively recruited to heat productionIn contrast, the body‐wide adipose depot associated with human skin produces heat directly, potentially creating an alternative to the centrally regulated brown adipose tissue Mammalian skin impacts metabolic efficiency system‐wide, controlling the rate of heat loss and consequent heat production. Here we compare the unique fat depots associated with mouse and human skin, to determine whether they have corresponding functions and regulation. For humans, we assay a skin‐associated fat (SAF) body‐wide depot to distinguish it from the subcutaneous fat pads characteristic of the abdomen and upper limbs. We show that the thickness of SAF is not related to general adiposity; it is much thicker (1.6‐fold) in women than men, and highly subject‐specific. We used molecular and cellular assays of β‐adrenergic‐induced lipolysis and found that dermal white adipose tissue (dWAT) in mice is resistant to lipolysis; in contrast, the body‐wide human SAF depot becomes lipolytic, generating heat in response to β‐adrenergic stimulation. In mice challenged to make more heat to maintain body temperature (either environmentally or genetically), there is a compensatory increase in thickness of dWAT: a corresponding β‐adrenergic stimulation of human skin adipose (in vivo or in explant) depletes adipocyte lipid content. We summarize the regulation of skin‐associated adipocytes by age, sex and adiposity, for both species. We conclude that the body‐wide dWAT depot of mice shows unique regulation that enables it to be deployed for heat preservation; combined with the actively lipolytic subcutaneous mammary fat pads they enable thermal defence. The adipose tissue that covers human subjects produces heat directly, providing an alternative to the brown adipose tissues. [ABSTRACT FROM AUTHOR]

Summary: Previous studies have demonstrated the heritability of alopecia areata (AA). However, whether the heritability of AA is sex‐specific has not been examined. A nationwide population‐based retrospective cohort study was performed using the Taiwan Maternal and Child Health Database from 2004 to 2017. We examined the heritability of AA in offspring of parents with and without AA, and determined whether the transmission of AA from parents to the next generation may occur in opposite directions depending on sex. We found that the risk ratio (RR) for heritability of AA between parents with and without AA was approximately two‐fold. In addition, for fathers with AA, the risk of AA in offspring tended to be higher in girls than in boys (RR: 2.97; 95% confidence interval: 0.94, 9.31). Therefore, the present study confirms the heritability of AA, and further studies examining the sex‐specific heritability of AA with a larger sample are warranted. [ABSTRACT FROM AUTHOR]

Aims To study the risk factors associated with blindness after treatment of acute primary angle closure (APAC), and to identify the critical time window to decrease rate of blindness. Methods In this multicentre retrospective case series, 1030 consecutive subjects (1164 eyes) with APAC in China were recruited. The rates of blindness were analysed up to 3 months after treatment of APAC. A logistic regression was used to identify the risk factors associated with blindness, including age, gender, distance to hospital, rural or urban settings, treatment method, education level, time from symptom to treatment (TST, hours) and presenting intraocular pressure (IOP). The critical time window associated with a blindness rate of =1% was calculated based on a cubic function by fitting TST to the rate of blindness at each time point. Results The rate of blindness after APAC was 12.54% after treatment. In multivariate regression, education level, TST and presenting IOP were risk factors for blindness (p=0.022, 0.004 and 0.001, respectively). The critical time window associated with a blindness rate of =1% was 4.6?hours. Conclusions and relevance Education level, TST and presenting IOP were risk factors for blindness after APAC. Timely medical treatment is key in reducing blindness after APAC. [ABSTRACT FROM AUTHOR]

This study aimed to develop biodegradable calcium alginate microcarriers with uniform particle size and spherical integrity for sustained-release targeting transarterial chemoembolization. To determine related parameters including the ratio of cross-linking volume (sodium alginate: CaCl2), concentrations of sodium alginate and CaCl2 solutions, collection distance, flow rate, stirring speed, syringe needle diameter and hardening time to fabricate the microcarriers, the Taguchi method was applied. Using different conditions, a total of 18 groups were prepared. The average size of microspheres from different groups was estimated as ~ 2 mm (range 1.1 to 1.6 mm). Signal-to-noise ratio analysis showed the optimal spherical integrity (F1) achieved when the above parameters were designed as 0.1, 2.5 wt%, 6 wt%, 8 cm, 30 mL/h, 150 rpm, 0.25 mm and 2 h, respectively. The best (F1), middle (F2) and worst (F3) groups were used for further experiments. Fourier-transform infrared spectroscopy spectrum showed that F1, F2 and F3 conformations were distinct from original sodium alginate. Drug-loaded calcium alginate microcarriers demonstrated rougher surfaces compared to microspheres without drug under transmission electron microscopy. Compared to pH 7.4, swelling rates in PBS were decreased at pH 6.5. Encapsulation and loaded efficiencies of the Dox-loaded microcarriers were estimated as ~ 40.617% and ~ 3.517%. In vitro experiments indicated that the F1 Dox-loaded microcarriers provide a well sustained-release efficacy for about two weeks at 37 °C in PBS. Treatments of calcium alginate microcarriers without the Dox in two distinct hepatocellular carcinoma-derived cell lines, Huh-7 and Hep-3B, indicated that these microcarriers were non-toxic. The Dox-loaded microcarriers displayed sustained-release capacity and reduced cell viabilities to ~ 30% in both cell lines on Day 12. [ABSTRACT FROM AUTHOR]

This paper presented a multi-axis synchronous motion-sensing platform with virtual reality (VR) to enhance the depth of immersion. Multidisciplinary technologies have been integrated in this system, such as interactive technology, spatial position, tactile stimulation, and scenario sensing, to build a complete system of multi-axis VR sensing mechanism. This platform was consisted of servo motors with precision planetary gear reducer, drivers, and three crank linkages under 3 degrees of freedom (DoF) for working on a larger range of motion and able to support higher loading with lower folding height. A servo motor with reducer was connected to each linkage to control and drive the platform directly. The kinematic analysis of motion types on a heave, roll, and pitch was applied to validate the motion of this platform. The target speeds of step response experiments were 1000 rpm, 800 rpm, and 600 rpm, respectively. The rising time was upgraded by 15–18% in the experiment of the position loop. The results show that Cascade design can improve the response of this system. In addition, Visual Studio C# and EtherCAT communication transmission with the motion control card were utilized to establish the motion control system and human machine interface (HMI) to check the system status immediately. Finally, the platform was combined with VR image content that we designed. The motion-sensing platform could receive fast dynamic response. The simulation and control feedback of the synchronous bi-directional control can be realized the immersion of the virtual image and real world motion interactively. This system could highly enhance the immersion experience. [ABSTRACT FROM AUTHOR]

An emerging problem-finding and problem-solving approach suggests that management's ability to discover problems to solve, opportunities to seize, and challenges to respond to is vital to organizations. This paper explores the extent to which the problem-finding and problem-solving approach can provide a foundation for joining the capabilities, dynamic capabilities, and governance perspectives as a way to help scholars and practitioners to coherently design organizations from the perspective of design science. The problem-finding and problem-solving approach offers a unit of analysis and a set of behavioral assumptions that enable us to address open questions within the extant literature and to propose new questions in management research. [ABSTRACT FROM AUTHOR]

Process yield is an important criterion used in the manufacturing industry for measuring process performance. Methods for measuring yield for processes with single characteristic have been investigated extensively. However, methods for measuring yield for processes with multiple characteristics have been comparatively neglected. In this paper, we develop a generalized yield index, called TSpk,PC, based on the index Spk introduced by Boyles (Journal of Quality Technology, 23, 17–26, 1991) using the principal component analysis (PCA) technique. We obtained a lower confidence bound (LCB) for the true process yield. The proposed method can be used to determine whether a process meets the preset yield requirement, and make reliable decisions. Examples are provided to demonstrate the proposed methodology. [ABSTRACT FROM AUTHOR]

Confining water in lab synthesized nanoporous silica matrices MCM-41-S with pore diameters of 18 and 14 Å, we have been able to study the molecular dynamics of water in deeply supercooled states, down to 200 K. Using quasielastic neutron scattering and analyzing the data with the relaxing cage model, we determined the temperature variation of the average translational relaxation time and its Q-dependence. We find a clear evidence of an abrupt change of the relaxation time behavior at T≈225 K, which we interpreted as the predicted fragile-to-strong liquid–liquid transition.© 2004 American Institute of Physics. [ABSTRACT FROM AUTHOR]

The extent of inter-material mixing and the formation of intermetallic compounds play a critical role in the structural integrity and mechanical properties of the joints in the case of dissimilar metal friction stir welding. In general, there is a critical volume fraction of the intermetallic compounds in the mix zone of the friction stir welding-joint at which the mechanical properties of the joint are maximized. That is, insufficient inter-material mixing and the accompanying sub-critical volume fraction of the intermetallic compounds results in insufficient inter-material bonding and inferior joint strength. Conversely, super-critical volume fraction of the intermetallic compounds typically gives rise to the joint embrittlement. To address the problem of the effect of the friction stir welding process parameters on the extent of intermetallic compound formation, a multi-physics computational framework has been developed and applied to the case of dissimilar metal friction stir welding involving commercially pure (CP) aluminum and AISI 1005 low-carbon steel. The multi-physics framework comprises the following main modules: (a) finite-element-based friction stir welding-process modeling; (b) quantum-mechanics, atomistic and CALPHAD-type continuum material thermodynamics analyses of the intermetallic compound-nucleation process; (c) a continuum-type analysis of multi-component diffusion-controlled growth of the intermetallic compounds; and (d) Kolmogorov–Johnson–Mehl–Avrami type analysis of the evolution of the intermetallic compound volume fraction within the friction stir welding joint as a function of the friction stir welding process parameters. The results obtained revealed that: (i) the extent and the spatial distribution of the intermetallic compounds is a sensitive function of the friction stir welding-process parameters; and (ii) among the six potential Al-Fe intermetallic compounds, FeAl and Fe3Al are associated with the largest volume fractions and, hence, play a key role in both attaining the required joint strength and in the potential loss of the joint fracture toughness. [ABSTRACT FROM AUTHOR]

Background: The number and calibre of myelinated and unmyelinated fibres of the sacrococcygeal dorsal roots innervating the tail of rats were studied by means of light and electron microscopy.Materials and Methods: There were an estimated total of 12,500 myelinated and 25,500 unmyelinated dorsal root fibres innervating the tail of a rat.Results: The results showed that from the second sacral (S2) to the fourth sacral (S4) segment, the fibre diameter spectrum of myelinated fibres within each dorsal root was bimodal with two peaks at 5 microns and 10 microns, respectively. The first sacral (S1) segment was composed of numerous smaller-size myelinated fibres, thus forming a right-skewed distribution. The coccygeal (Co) segments showed a unimodal distribution peaking at 10 microns for the first (Co1) segment and gradually shifting to 7 microns for the third (Co3) segment. Overall, there was a continuous relative increase of the larger vs. the smaller myelinated fibres from the sacral to coccygeal segments. The fibre diameter of unmyelinated fibres of all these roots was unimodal with a single peak at 0.5 microns. The ratio of unmy- elinated to myelinated fibre numbers was on average 2.83 for the S1-S2 roots, 1.66 for the S3-S4 roots, and 1.24 for the coccygeal roots.Conclusions: The comparison of the left- and right-side nerve fibres show that there was no significant difference, thus implying a symmetrical sensory innervation of the rat's tail. [ABSTRACT FROM AUTHOR]

Purpose: This prospective study used anterior segment optical coherence tomography (AS-OCT) to determine how phacoemulsification (phaco) changes iris parameters in eyes with glaucoma or glaucoma suspect status. Methods: Using Visante AS-OCT (Carl Zeiss Meditec AG), the following pre- and post-phaco parameters were measured: IT750 = iris thickness at 750 μm from the scleral spur; IT2000 = iris thickness 2000 μm from the scleral spur; ITCM = the maximum iris thickness at the middle one third of the iris; ICURV = iris curvature; IAREA = iris area; and pupil size = pupil diameter (mm). Only high-quality images with an identifiable scleral spur were included, and only the nasal quadrant was analyzed. A single glaucoma specialist analyzed the parameters according to the Zhongshan Angle Assessment Program (ZAAP, Guangzhou, China). Multivariate analysis was performed using mixed effects regression correcting for age, gender, and ethnicity. Results: 89 subjects and 110 eyes were included in this study. The mean age of subjects was 74.83 {+/-} 8.69 years old. Most common diagnoses were POAG and glaucoma suspect (23% and 52%, respectively), and 16% of subjects had an LPI. In multivariate analysis of AS-OCT parameters, decreases in IT750, IT2000, ITCM, ICURV, and pupil size were statistically significant (p<0.05). Conclusions: After phacoemulsification, eyes with glaucoma as well as glaucoma suspect eyes have thinner irises and smaller pupils. This may lead to less iris-mediated aqueous outflow obstruction, providing support for early phacoemulsification glaucoma treatment. Translational relevance: Our AS-OCT imaging findings may guide clinical practice as iris parameters become increasingly relevant in preoperative phaco planning. [ABSTRACT FROM AUTHOR]

Objectives: To compare treatment duration in skeletal Class III malocclusion patients managed with a 2-step treatment (surgery-first approach, SFA) and conventional 3-step treatment, and to compare stability of surgical outcomes between segmentation and non-segmentation in the 2-step treatment group.Setting and Sample Population: The sample population consisted of 37 patients who completed orthognathic surgery (OGS) and orthodontic correction at the Charm Aesthetic Surgery Clinic (Taipei, Taiwan) between 2012 and 2015. Of these, 26 received 2-step treatment and 11 received 3-step treatment.Materials and Methods: To compare treatment efficiency and stability, three time points were analysed: T0 , before treatment (before OGS in the 2-step group and before orthodontic treatment in the 3-step group); T1 , after OGS but before orthodontic correction (cone beam computed tomography (CBCT) was obtained within 2 weeks of OGS); and T2 , after orthodontic correction (CBCT was obtained on the day of bracket removal). The post-OGS (T1 ) CBCT items were individually superimposed on the pre-treatment (T0 ) CBCT items to determine the distance of B point migration.Results: A significant difference was found in treatment times between 2-step treatment and conventional 3-step treatment. In addition, no significant difference was found when comparing B-X (mm) and B-Y (mm) at T2 -T1 for the segmentation and non-segmentation groups.Conclusions: Using SFA for skeletal Class III malocclusions saves approximately 6 months of treatment time over 3-step treatment; the stability of the segmentation group was comparable to that of the non-segmentation group, a result that is possibly associated with the fixation of 2 miniplates. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance defecography (MRD) allows for dynamic visualisation of the pelvic floor compartments when assessing for pelvic floor dysfunction. Additional benefits over traditional techniques are largely unknown. The aim of this study was to compare detection and miss rates of pelvic floor abnormalities with MRD versus clinical examination and traditional fluoroscopic techniques. Methods: A systematic review and meta-analysis was conducted in accordance with recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. MEDLINE, Embase and the Cochrane Central Register of Controlled Trials were accessed. Studies were included if they reported detection rates of at least one outcome of interest with MRD versus EITHER clinical examination AND/OR fluoroscopic techniques within the same cohort of patients. Results: Twenty-eight studies were included: 14 studies compared clinical examination to MRD, and 16 compared fluoroscopic techniques to MRD. Detection and miss rates with MRD were not significantly different from clinical examination findings for any outcome except enterocele, where MRD had a higher detection rate (37.16% with MRD vs 25.08%; OR 2.23, 95% CI 1.21-4.11, p = 0.010) and lower miss rates (1.20 vs 37.35%; OR 0.05, 95% CI 0.01-0.20, p = 0.0001) compared to clinical examination. However, compared to fluoroscopy, MRD had a lower detection rate for rectoceles (61.84 vs 73.68%; OR 0.48 95% CI 0.30-0.76, p = 0.002) rectoanal intussusception (37.91 vs 57.14%; OR 0.32, 95% CI 0.16-0.66, p = 0.002) and perineal descent (52.29 vs 74.51%; OR 0.36, 95% CI 0.17-0.74, p = 0.006). Miss rates of MRD were also higher compared to fluoroscopy for rectoceles (15.96 vs 0%; OR 15.74, 95% CI 5.34-46.40, p < 0.00001), intussusception (36.11 vs 3.70%; OR 10.52, 95% CI 3.25-34.03, p = 0.0001) and perineal descent (32.11 vs 0.92%; OR 12.30, 95% CI 3.38-44.76, p = 0.0001). Conclusions: MRD has a role in the assessment of pelvic floor dysfunction. However, clinicians need to be mindful of the risk of underdiagnosis and consider the use of additional imaging. [ABSTRACT FROM AUTHOR]

Background: Smad4 is a critical effector of TGF-ß signaling that regulates a variety of cellular functions. However, its role in the brain has rarely been studied. Here, we examined the molecular mechanisms underlying the posttranslational regulation of Smad4 function by SUMOylation, and its role in spatial memory formation. Results: In the hippocampus, Smad4 is SUMOylated by the E3 ligase PIAS1 at Lys-113 and Lys-159. Both spatial training and NMDA injection enhanced Smad4 SUMOylation. Inhibition of Smad4 SUMOylation impaired spatial learning and memory in rats by downregulating TPM2, a gene associated with skeletal myopathies. Similarly, knockdown of TPM2 expression impaired spatial learning and memory, while TPM2 mRNA and protein expression increased after spatial training. Among the TPM2 mutations associated with skeletal myopathies, the TPM2E122K mutation was found to reduce TPM2 expression and impair spatial learning and memory in rats. Conclusions: We have identified a novel role of Smad4 SUMOylation and TPM2 in learning and memory formation. These results suggest that patients with skeletal myopathies who carry the TPM2E122K mutation may also have deficits in learning and memory functions. [ABSTRACT FROM AUTHOR]

In this paper, we examine the performance of several popular hydraulic computer models in predicting the magnitude and location of a hydraulic jump. The computer programs considered include the standard HEC-RAS one-dimensional (1-D) models, as well as computational fluid dynamics models. Other computer programs considered include one-, two-, and three-dimensional (2-D and 3-D) models of both the steady and unsteady flow types. The computational model results are compared with experimental data from two different laboratories. It is shown that a few of these commonly used computer models miss the prediction of the hydraulic jump entirely and produce water surface profiles that are not proper estimates. Although the laboratory tests are one-dimensional steady-state scenarios, the failure of some of the multi-dimensional computer models to predict the likely occurrence of the hydraulic jump, or even provide an indication that the flow conditions are favorable for a jump to occur, indicates that care should be taken both while choosing the model for the application of interest and in interpreting the end results. [ABSTRACT FROM PUBLISHER]

Background Hepatocellular carcinoma ( HCC) is the sixth most common cancer worldwide and has high mortality despite treatment. While sorafenib has a survival benefit for patients with advanced HCC, clinical response is highly variable. Aim To determine whether development of sorafenib toxicity is a prognostic marker of survival in HCC. Methods In this prospective multicentre cohort study, patients with advanced-stage HCC receiving sorafenib were recruited from five international specialist centres. Demographic and clinical data including development and grade of sorafenib toxicity during treatment, radiological response to sorafenib and survival time (months) were recorded prospectively. Results A total of 634 patients with advanced-stage HCC receiving sorafenib were recruited to the study, with a median follow-up of 6692.3 person-months at risk. The majority of patients were male (81%) with Child-Pugh A stage liver disease (74%) and Barcelona Clinic Liver Cancer stage C HCC (64%). Median survival time was 8.1 months ( IQR 3.8-18.6 months). 94% experienced at least one sorafenib-related toxicity: 34% diarrhoea, 16% hypertension and 37% hand-foot syndrome ( HFS). Twenty-one per cent ceased sorafenib due to toxicity and 59% ceased treatment due to progressive disease or death. On multivariate analysis, sorafenib-related diarrhoea ( HR 0.76, 95% CI 0.61-0.95, P = 0.017), hypertension ( HR 0.531, 95% CI 0.37-0.76, P < 0.0001) and HFS ( HR 0.65, 95% CI 0.51-0.81, P < 0.0001) were all significant independent predictors of overall survival after adjusting for age, severity of liver disease, tumour stage and sorafenib dose. Conclusion Development of sorafenib-related toxicity including diarrhoea, hypertension and hand-foot syndrome is associated with prolonged overall survival in patients with advanced-stage HCC on sorafenib. [ABSTRACT FROM AUTHOR]

Background To examine the effect of mitomycin c and 5-flurouracil on treatment outcomes following Ahmed glaucoma valve implantation. Design Retrospective consecutive case series. Participants Fifty patients who received Ahmed glaucoma valve implantation from 1999 to 2013 in the San Francisco Veterans Administration Hospital. Methods The +INJECTION group received intraoperative mitomycin c followed by postoperative mitomycin c and/or 5-flurouracil, whereas the −INJECTION group did not. Main Outcome Measures Primary outcome was treatment success at 1 year post-implantation. Intraocular pressure, hypertensive phase, and the number of glaucoma medications were also examined. Results Twenty-six patients/eyes in the +INJECTION group and 24 patients/eyes in the −INJECTION group were included. Treatment success was higher in the +INJECTION compared with the −INJECTION group (86 vs. 58%; P = 0.04). Intraocular pressure was lower in the +INJECTION compared with the −INJECTION group at 1, 3, 6 and 12 months ( P ≪ 0.00001, P = 0.00003, 0.0008 and 0.024). Hypertensive phase occurred less often in the +INJECTION compared with the −INJECTION group (3.8 vs. 54%; P = 0.021). The +INJECTION group required fewer medications compared with the −INJECTION group ( P = 0.02, 0.002, 0.003 and 0.008 at 1, 3, 6 and 12 months). Complication rates were comparable between groups (46.2 and 54.2%; P = 0.63). Conclusions Adjuvant treatment with antifibrotics following Ahmed glaucoma valve implantation decreased the hypertensive phase and improved surgical outcomes without impacting complication rates at 1 year. This study postulates a role for antifibrotics in the postoperative management of Ahmed glaucoma valves. [ABSTRACT FROM AUTHOR]

Background Drug development in hepatocellular carcinoma ( HCC) is limited by disease heterogeneity, with hepatic reserve being a major source of variation in survival outcomes. The albumin-bilirubin ( ALBI) grade is a validated index of liver function in patients with HCC. Aim To test the accuracy of the ALBI grade in predicting post-sorafenib overall survival ( PSOS) in patients who permanently discontinued treatment. Methods From a prospectively maintained international database of 447 consecutive referrals, we derived 386 eligible patients treated with sorafenib within Barcelona Clinic Liver Cancer C stage (62%), 75% of whom were of Child class A at initiation. Clinical variables at sorafenib discontinuation were analysed for their impact on post-sorafenib overall survival using uni- and multivariable analyses. Results Median post-sorafenib overall survival of the 386 eligible patients was 3.4 months and median sorafenib duration was 2.9 months, with commonest causes of cessation being disease progression (68%) and toxicity (24%). At discontinuation, 92 patients (24%) progressed to terminal stage, due to worsening Child class to C in 40 (10%). Median post-sorafenib overall survival in patients eligible for second-line therapies ( n = 294) was 17.5, 7.5 and 1.9 months according respectively to ALBI grade 1, 2 and 3 ( P < 0.001). Conclusions The ALBI grade at sorafenib discontinuation identifies a subset of patients with prolonged stability of hepatic reserve and superior survival. This may allow improved patient selection for second-line therapies in advanced HCC. [ABSTRACT FROM AUTHOR]

Objective The clinical feasibility of passive immunotherapy has not been demonstrated in dogs naturally infected with canine distemper. In this study, porcine anti-canine distemper virus IgG and F(ab′)2 antibody fragments were used to treat infected puppies. Methods A total of 41 naturally infected puppies (age Äsix months) exhibiting severe respiratory signs, but lacking neurological signs, were enrolled in the study. Twenty-five puppies were treated with a combination of IgG or F(ab′)2 antibody fragments (Group 1) and supportive therapy and 16 puppies received routine supportive care only (Group 2). Results The survival rate of dogs in Group 1 (19/25; 76%) was significantly higher than that in Group 2 (5/16; 31·3%) (P<0·05). During the therapy, 8 of the 25 dogs (32%) in Group 1 developed neurological signs versus 12 of the 16 dogs (75%) in Group 2 (P<0·05). Adverse reactions were limited to elevated body temperature in dogs that received IgG antibodies. Clinical Significance Porcine anti-canine distemper virus antibodies improved survival in puppies affected with canine distemper with minimal adverse effects. Therefore, this therapy could be considered for treatment of endangered animal species infected with canine distemper virus. [ABSTRACT FROM AUTHOR]

Combined experimental and computational investigations are carried out of the mechanical properties of materials residing in different weld zones of friction stir-welded (FSW) joints of thick plates of AA2139-T8. The experimental portion of the work comprised (a) identification of the weld zones within the FSW joints, through the use of optical-microscopy characterization of a transverse section; (b) validation of the weld zones identified in (a) via the generation of a micro-hardness field over the same transverse section; (c) extracting and subsequently testing miniature tensile specimens from different weld zones; and (d) extracting and testing a larger-size tensile specimen spanning transversely the FSW weld. The computational portion of the work comprised (i) validation of the mechanical properties, as determined experimentally using the miniature tensile specimens, of the material residing within different zones of the FSW joint; and (ii) clarification of the benefits yielded by the knowledge of the local material properties within the FSW joint. These benefits arise from the fact that (a) joint mechanical properties are generally inferior to those of the base metal; (b) the width of the weld in thick metallic-armor is often comparable to the armor thickness, and therefore may represent a significant portion of the armor exposed-surface area; and (c) modeling of the weld-material structural response under loading requires the availability of high-fidelity/validated material constitutive models, and the development of such models requires knowledge of the local weld-material mechanical properties. [ABSTRACT FROM AUTHOR]

The effects of spinal cord injury ( SCI) on esophageal motility are largely unknown. Furthermore, due to the complete or partial loss of sensory innervation to the upper gastrointestinal tract, a symptom-based diagnosis of esophageal dysmotility is problematic in the SCI population. To determine the prevalence and characterize the type of motility disorders observed in persons with chronic SCI compared with that of able-bodied ( AB) controls based on esophageal pressure topography isometrics acquired by high-resolution manometry and categorized by application of the Chicago Classification. High-resolution manometry of the esophagus was performed in 39 individuals: 14 AB, 12 with paraplegia (level of injury between T4- T12) and 13 with tetraplegia (level of injury between C5- C7). A catheter containing multiple pressure sensors arranged at 360° was introduced into the esophagi of subjects at a distance that allowed visualization of both the upper esophageal sphincters ( UES) and lower esophageal sphincters ( LES). After a period to acquire pressures at baseline, subjects were asked to perform 10 wet swallows with 5-mL boluses of isotonic saline while esophageal pressure and impedance were being recorded. No significant differences were noted for gender, age, or body mass index between AB and SCI groups. Twenty-one of 25 (84%) subjects with SCI had at least one motility abnormality: 12% with Type II achalasia, 4% with Type III achalasia, 20% with esophagogastric junction outflow obstruction, 4% with the hypercontractile esophagus, and 48% with peristaltic abnormalities (weak peristalsis with small or large defects or frequent failed peristalsis). In contrast, only 7% (1 out of 14) of the AB subjects had any type of esophageal motility disorder. Despite the lack of subjective complaints and clinical awareness, esophageal dysmotility appears to be a highly prevalent condition in persons with SCI. The use of new and improved techniques, as well as a more stringent classification system, permitted the identification of the presence of nonspecific motility disorders in almost all SCI subjects, including four individuals who were previously undiagnosed with achalasia. Future work in persons with SCI is required to clarify the clinical impact of this observation and to study potential associations between esophageal dysmotility, gastroesophageal reflux disease, and pulmonary function. An increased awareness of esophageal dysfunction in the SCI population may lead to the development of new clinical guidelines for the diagnosis, prevention, and treatment of these largely unrecognized disorders. [ABSTRACT FROM AUTHOR]

Objective Previous studies examining the association between genetic variations in prostaglandin pathway and risk of head and neck cancer ( HNC) have only included polymorphisms in the PTGS2 ( COX2) gene. This study investigated the association between genetic polymorphisms of six prostaglandin pathway genes ( PGDS, PTGDS, PTGES, PTGIS, PTGS1 and PTGS2), and risk of HNC. Methods Interviews regarding the consumption of alcohol, betel quid, and cigarette were conducted with 222 HNC cases and 214 controls. Genotyping was performed for 48 tag and functional single-nucleotide polymorphisms ( SNPs). Results Two tag SNPs of PTGIS showed a significant association with HNC risk [rs522962: log-additive odds ratio ( OR) = 1.42, 95% confidence interval ( CI): 1.01-1.99 and dominant OR = 1.58, 95% CI: 1.02-2.47; rs6125671: log-additive OR = 1.49, 95% CI: 1.08-2.05 and dominant OR = 1.96, 95% CI: 1.16-3.32]. In addition, a region in PTGIS tagged by rs927068 and rs6019902 was significantly associated with risk of HNC (global P = 0.007). Finally, several SNPs interacted with betel quid and cigarette to influence the risk of HNC. Conclusions Genetic variations in prostaglandin pathway genes are associated with risk of HNC and may modify the relationship between use of betel quid or cigarette and development of HNC. [ABSTRACT FROM AUTHOR]

Background: Obesity is a severe health problem worldwide, which leads to multiple comorbidities including type 2 diabetes mellitus and cardiovascular diseases. Inflammation has been found to be an important characteristic of adipose tissue in obese subjects. However, obesity is also associated with compromised immune responses to infections and the impact of obesity on immune function has not been fully understood.Subjects/methods: To clarify the role of obesity in the immune responses, we investigated the Toll-like receptor (TLR)-induced cytokine secretion by leukocytes from obese and lean subjects. We also investigated the relationship between insulin-induced intracellular signaling and cytokine production using peripheral blood mononuclear cells (PBMCs) and a monocytic cell line THP-1.Results: We found decreased TLR-induced interferon-γ, interleukin-6 (IL-6) and tumor necrosis factor-α secretions and elevated IL-10 secretion by leukocytes from obese subjects when compared with lean controls. PBMCs from obese subjects showed enhanced basal Akt and glycogen synthase kinase-3β (GSK-3β) phosphorylation, which did not further increase with insulin and lipopolysaccharide (LPS) stimulation. We also found that LPS-induced IκBα degradation was inhibited in PBMCs from obese subjects. By using THP-1 cells with GSK-3β knockdown or cells treated with hyperinsulinemic and high-fatty acid conditions, we found that LPS-induced nuclear factor κB (NF-κB) activation was inhibited and cyclic adenosine monophosphate response element-binding protein (CREB) activation was enhanced.Conclusions: These findings indicate that GSK-3β is important in the regulation of NF-κB and CREB activation in leukocytes under the metabolic condition of obesity. Our study revealed a key mechanism through which metabolic abnormalities compromise leukocyte functions in people with obesity. [ABSTRACT FROM AUTHOR]

Background:Obesity is a severe health problem worldwide, which leads to multiple comorbidities including type 2 diabetes mellitus and cardiovascular diseases. Inflammation has been found to be an important characteristic of adipose tissue in obese subjects. However, obesity is also associated with compromised immune responses to infections and the impact of obesity on immune function has not been fully understood.Subjects/Methods:To clarify the role of obesity in the immune responses, we investigated the Toll-like receptor (TLR)-induced cytokine secretion by leukocytes from obese and lean subjects. We also investigated the relationship between insulin-induced intracellular signaling and cytokine production using peripheral blood mononuclear cells (PBMCs) and a monocytic cell line THP-1.Results:We found decreased TLR-induced interferon-γ, interleukin-6 (IL-6) and tumor necrosis factor-α secretions and elevated IL-10 secretion by leukocytes from obese subjects when compared with lean controls. PBMCs from obese subjects showed enhanced basal Akt and glycogen synthase kinase-3β (GSK-3β) phosphorylation, which did not further increase with insulin and lipopolysaccharide (LPS) stimulation. We also found that LPS-induced IκBα degradation was inhibited in PBMCs from obese subjects. By using THP-1 cells with GSK-3β knockdown or cells treated with hyperinsulinemic and high-fatty acid conditions, we found that LPS-induced nuclear factor κB (NF-κB) activation was inhibited and cyclic adenosine monophosphate response element-binding protein (CREB) activation was enhanced.Conclusions:These findings indicate that GSK-3β is important in the regulation of NF-κB and CREB activation in leukocytes under the metabolic condition of obesity. Our study revealed a key mechanism through which metabolic abnormalities compromise leukocyte functions in people with obesity. [ABSTRACT FROM AUTHOR]

Our recently developed multi-physics computational model for the conventional gas metal arc welding (GMAW) joining process has been upgraded with respect to its predictive capabilities regarding the process optimization for the attainment of maximum ballistic limit within the weld. The original model consists of six modules, each dedicated to handling a specific aspect of the GMAW process, i.e., (a) electro-dynamics of the welding gun; (b) radiation-/convection-controlled heat transfer from the electric arc to the workpiece and mass transfer from the filler metal consumable electrode to the weld; (c) prediction of the temporal evolution and the spatial distribution of thermal and mechanical fields within the weld region during the GMAW joining process; (d) the resulting temporal evolution and spatial distribution of the material microstructure throughout the weld region; (e) spatial distribution of the as-welded material mechanical properties; and (f) spatial distribution of the material ballistic limit. In the present work, the model is upgraded through the introduction of the seventh module in recognition of the fact that identification of the optimum GMAW process parameters relative to the attainment of the maximum ballistic limit within the weld region entails the use of advanced optimization and statistical sensitivity analysis methods and tools. The upgraded GMAW process model is next applied to the case of butt welding of MIL A46100 (a prototypical high-hardness armor-grade martensitic steel) workpieces using filler metal electrodes made of the same material. The predictions of the upgraded GMAW process model pertaining to the spatial distribution of the material microstructure and ballistic limit-controlling mechanical properties within the MIL A46100 butt weld are found to be consistent with general expectations and prior observations. [ABSTRACT FROM AUTHOR]

Coarse-grained molecular statics/dynamics methods are first used to investigate degradation in the PPTA fiber/yarn tensile strength, as a result of the prior compressive or tensile loading. PPTA fibers/yarns experience this type of loading in the course of a plain-weaving process, the process which is used in the fabrication of ballistic fabric and flexible armor. The more common all-atom molecular simulations were not used to assess strength degradation for two reasons: (a) the size of the associated computational domain rendering reasonable run-times would be too small and (b) modeling of the mechanical response of multi-fibril PPTA fibers could not be carried out (again due to the limited size of the computational domain). However, all-atom simulations were used to (a) define the coarse-grained particles (referred to as 'beads') and (b) parameterize various components of the bead/bead force-field functions. In the second portion of the work, a simplified finite-element analysis of the plain-weaving process is carried out in order to assess the extent of tensile-strength degradation in warp and weft yarns during the weaving process. In this analysis, a new material model is used for the PPTA fibers/yarns. Specifically, PPTA is considered to be a linearly elastic, transversely isotropic material with degradable longitudinal-tensile strength and the longitudinal Young's modulus. Equations governing damage and strength/stiffness degradation in this material model are derived and parameterized using the coarse-grained simulation results. Lastly, the finite-element results are compared with their experimental counterparts, yielding a decent agreement. [ABSTRACT FROM AUTHOR]

ABSTRACT The strain rate-dependent response of Al2O3/Al composite is examined using a split-Hopkinson pressure bar apparatus. High-speed photography is used to establish that the strain develops inhomogeneously in the specimen due to the onset and propagation of a kink band. The power balance equation is exploited in order to determine the dissipation at the kink band. The mechanism of kink band is shown to be essentially unaltered, with only the amount of fibre fracture being influenced by the dynamic loading process. [ABSTRACT FROM AUTHOR]