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The aim of this study was to evaluate nutritional care and outcomes in a medical intensive care unit (ICU) following multidisciplinary nutritional team (MNT) involvement. The authors retrospectively reviewed the data of all patients admitted to a medical ICU from April to October 2013 (pre-MNT period) and from April to October 2014 (post-MNT period). In total, 140 patients were included and allocated to the pre-MNT group (n=70) or the post-MNT group (n=70). The post-MNT group was more likely to use enteral nutrition (61.4 vs 37.1%, P=0.002). In terms of total calories and protein provided, the number of nutritional goal-achieved days during stays in ICU was significantly greater in the post-MNT group than in the pre-MNT group (63.7% vs 47.6%, P<0.05 and 44.3% vs 29.9%, respectively, P<0.05). The MNT activities resulted in significant improvements in terms of nutritional provision and adequacy in a medical ICU.

A cooperative regenerative braking control algorithm is proposed for a six-speed automatic-transmission-based parallel hybrid electric vehicle (HEV) during a downshift that satisfies the requirements for braking force and driving comfort. First, a downshift strategy during braking is suggested by considering the re-acceleration performance. To maintain driving comfort, a cooperative regenerative braking control algorithm is developed that considers the response characteristics of the electrohydraulic brake. Using the electrohydraulic brake’s hardware and an HEV simulator, a hardware-in-the-loop simulation (HILS) is performed. From the HILS results, it is found that the proposed cooperative regenerative braking control algorithm satisfies the demanded braking force and driving comfort during the downshift with regenerative braking.

A series of natural product analogues based on helioxanthin (2), with particular attention to modification of the lactone ring and methylenedioxy group, were synthesized and evaluated for their antiviral activities. Among them, lactam derivative 18 and helioxanthin cyclic hydrazide 28 exhibited significant in vitro antiviral activity against hepatitis B virus (EC50 = 0.08 and 0.03 μM, respectively). Compound 18 showed the most potent antiviral activity against hepatitis C virus (55% inhibition at 1.0 μM). Compound 12, an acid-hydrolyzed product of helioxanthin cyclic imide derivative 9, was found to exhibit broad-spectrum antiviral activity against hepatitis B virus (EC50 = 0.8 μM), herpes simplex virus type 1 (EC50 = 0.15 μM) and type 2 (EC50 &lt; 0.1 μM), Epstein−Barr virus (EC50 = 9.0 μM), and cytomegalovirus (EC50 = 0.45 μM). Helioxanthin lactam derivative 18 also showed marked inhibition of herpes simplex virus type 1 (EC50 = 0.29 μM) and type 2 (EC50 = 0.16 μM). The cyclic hydrazide derivative of helioxanthin 28 and its brominated product 42 exhibited moderately potent activities against human immunodeficiency virus (EC50 = 2.7 and 2.5 μM, respectively). Collectively, these molecules represent a novel set of antiviral compounds with unique structural features.

The aqueous extract of Scutellariae baicalensis Georgi has inhibitory activity against P-gp 170, a multiple drug resistant gene product. Baicalein, one of the major flavones, was found to be responsible for this activity. The hydroxyl groups of the A ring of baicalein were systematically alkylated in order to assess the effect of such modifications on the activity against P-gp 170. The impact of the baicalein modifications on activity against the growth of a human nasopharyngeal cancer cell line KB and its P-gp 170 overexpressing cell line KB/MDR were also examined. The results indicate that alkylation of R5 of baicalein does not have a major impact on the interaction with P-gp 170, whereas alkylation of R6 or R7 alone or both, could enhance the interaction of baicalein with P-gp 170 as well as the amount of intracellular accumulation of vinblastine, a surrogate marker for the activity of P-gp 170 pump of KB/MDR cells. In this case, the optimal linear alkyl functionality is a propyl side chain. These modifications could also alter the activity of compounds inhibiting cell growth. Among the different compounds synthesized, the most potent molecule against P-gp 170 is 5-methoxy-6,7-dipropyloxyflavone (23). Its inhibitory activity against P-gp 170 is approximately 40 times better, based on EC50 (concentration of the compound enhancing 50% of the intracellular vinblastine accumulation in the KB/MDR cells) and 3 times higher, based on Amax (the intracellular vinblastine accumulation of the KB/MDR cells caused by the compound) as compared to baicalein. Compound 23 is also a more selective inhibitor than baicalein against P-gp 170, because its cytotoxicity is less than that observed for baicalein. The growth inhibitory IC50 of compound 23 against KB and KB/MDR cells are about the same, suggesting that compound 23 is unlikely to be a substrate of P-gp 170 pump. Acetylation of R6, R7 or both could also decrease EC50 and increase Amax. Acetylated compounds are more toxic than baicalein, and their potency against cell growth is compromised by the presence of P-gp 170, suggesting that these compounds are substrates of P-gp 170. Benzylation of R6 or R7 but not both also enhanced anti-P-gp170 activity and potency against cell growth; however, the presence of P-gp 170 in cells did not have an impact on their sensitivity to these molecules, suggesting that the benzylated compounds are inhibitors but not substrates of P-gp 170, and perhaps have a different mechanism of action. In conclusion, the substitutions of R6 and R7 hydroxyl groups by alkoxy groups, acetoxy groups, or benzyloxy groups could yield compounds with different modes of action against P-gp 170 with different mechanisms of action against cell growth.

We compared the radiological appearances and survival of four methods of fixation of a femoral stem in 538 hips after follow-up for five or ten years. The fixation groups were: 1) press-fit shot-blasted smooth Ti-Al-V stem; 2) press-fit shot-blasted proximally ridged stem; 3) proximal hydroxyapatite (HA) coating; and 4) cementing.Survival analysis at five to ten years showed better results in the HA-coated (100% at five to six years) and cemented stems (100% at 5 to 6 years) than in the two press-fit groups. There was a higher mean rate of migration in the smooth and ridged Ti-Al-V shot-blasted press-fit groups (0.8 mm/year and 0.6 mm/year, respectively) when compared with the HA-coated and cemented prostheses (both 0.3 mm/year). More radiolucent lines and osteolytic lesions were seen in the press-fit groups than in either the HA-coated or cemented implants, with a trend for a lower incidence of both in the HA compared with the cemented group. Proximal osteopenia increased in the press-fit and cemented prostheses with time, but did not do so in the HA group. There was a higher incidence of resorption of the femoral neck with time in the cemented group than in the other three.We conclude that the HA and the cemented interfaces both provide secure fixation with a trend in favour of HA. The cemented prosthesis meets the suggested National Institutes of Health definition of ‘efficacious’ at ten years.

The infrared and Raman spectra of 9,9‘-spirobifluorene (SBFL), bis(2,2‘-biphenylene)silane (BBPS), and bis(2,2‘-biphenylene)germane (BBPG) are measured, and the vibrational frequencies and modes for these molecules are assigned by ab initio Hartree−Fock and Becke 3-Lee−Yang−Parr (B3LYP) density functional theory (DFT) calculations using the 4-31G and 3-21G basis sets for SBFL and for BBPS and BBPG, respectively. Assignment of some of the vibrational modes of SBFL is also confirmed by solution Raman spectroscopy with the depolarization method. Comparison of the calculated and experimental vibrational spectra reveals that the DFT calculations are quite accurate in predicting the vibrational frequencies, intensities, and modes. It is found that the central Si and Ge atoms dominantly enhance some of the IR intensities of the vibrations involving only the M−C4 (M = Si, Ge) antisymmetric stretching motion. The enhancement of some of the infrared intensities is accounted for by the increase of the electric dipole moment involving the M−C4 vibrations due to the presence of the small electronegative Si and Ge atoms in the central position.

The preparation of ethyl 4-ethoxy-2-methylcyclohexa-1,3-diene-1-carboxyate, ethyl 4-isopropoxy- 2-methylcyclohexa-1,3-diene-1-carboxylate, t-butyl 4-isopropoxy-2-methylcyclohexa-1,3-diene-1- carboxylate, ethyl 4-(t-butylcarbonyloxy)-2-methylcyclohexa-1,3-diene-1-carboxylate, and t-butyI 4-(t-butylcarbonyloxy)-2-methylcyclohexa-1,3-diene-1-carboxylate from Hagemann's ester and its t-butyl analogue in the presence of diethyl or diisopropyl sulfates and sodium hydride in dimethyl sulfoxide, or pivaloyl chloride and N,N,N',N'-tetramethylethylenediamine in tetrahydrofuran is described. The foregoing dienol ethers and esters are smoothly deprotonated by lithium diisopropyl- amide in tetrahydrofuran at -78" to give the corresponding ester dienolates, which react regio- specifically with a number of electrophiles, either a or y to the alkoxycarbonyl group of the dienol ether or ester. A number of the products, which are generally obtained in good yields, have been hydrolysed to Hagemann's ester derivatives substituted exclusively at C1.

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