Search

This study aimed to identify plasma lipoproteins and small metabolites associated with high risk of malnutrition during intensive care unit (ICU) stay in patients with severe injuries.

Background: Necrotizing soft-tissue infections (NSTIs) present a surgical emergency of increasing incidence, which is often misdiagnosed and associated with substantial mortality and morbidity. A retrospective multicenter (11 hospitals) cohort study was initiated to identify the early predictors of misdiagnosis, mortality, and morbidity (skin defect size and amputation). Methods: Patients of all ages who presented with symptoms and were admitted for acute treatment of NSTIs between January 2013 and December 2017 were included. Generalized estimating equation analysis was used to identify early predictors (available before or during the first debridement surgery), with a significance level of P< 0.05. Results: The median age of the cohort (N = 216) was 59.5 (interquartile range = 23.6) years, of which 138 patients (63.9%) were male. Necrotizing soft-tissue infections most frequently originated in the legs (31.0%) and anogenital area (30.5%). More than half of the patients (n = 114, 54.3%) were initially misdiagnosed. Thirty-day mortality was 22.9%. Amputation of an extremity was performed in 26 patients (12.5%). Misdiagnosis was more likely in patients with a higher Charlson Comorbidity Index (β = 0.20, P= 0.001), and less likely when symptoms started in the anogenital area (β = −1.20, P= 0.003). Besides the established risk factors for mortality (septic shock and age), misdiagnosis was identified as an independent predictor of 30-day mortality (β = 1.03, P= 0.01). The strongest predictors of the final skin defect size were septic shock (β = 2.88, P< 0.001) and a skin-sparing approach to debridement (β = −1.79, P= 0.002). Conclusion: Recognition of the disease is essential for the survival of patients affected by NSTI, as is adequate treatment of septic shock. The application of a skin-sparing approach to surgical debridement may decrease morbidity.

The mechanism of action of bronchial thermoplasty (BT) treatment for patients with severe asthma is incompletely understood. This study investigated the 2.5-year impact of BT on airway smooth muscle (ASM) mass and clinical parameters by paired data analysis in 22 patients. Our findings demonstrate the persistence of ASM mass reduction of >50% after 2.5 years. Furthermore, sustained improvement in asthma control, quality of life and exacerbation rates was found, which is in line with previous reports. An association was found between the remaining ASM and both the exacerbation rate (r=0.61, p=0.04 for desmin, r=0.85, p<0.01 for alpha smooth muscle actin (SMA)) and post-bronchodilator forced expiratory volume in 1 s predicted percentage (r=−0.69, p=0.03 for desmin, r=−0.58, p=0.08 for alpha SMA). This study provides new insight into the long-term impact of BT.

Poor nutrition during pregnancy can lead to adverse birth outcomes including low birth weight (LBW).

Maternal infections during pregnancy have been linked to increased risk of adverse birth outcomes, including low birth weight (LBW), preterm birth (PTB), small for gestational age (SGA), and stillbirth (SB).

Low birth weight (LBW) increases the risk of short- and long-term morbidity and mortality from early life to adulthood. Despite research effort to improve birth outcomes the progress has been slow.

Low birth weight (LBW) is associated with neonatal mortality and sequelae of lifelong health problems; prioritizing the most promising antenatal interventions may guide resource allocation and improve health outcomes.

Risk factors related to the harmful behaviors, psychosocial wellbeing, and socio-economic circumstances in the lives of pregnant women can lead to adverse birth outcomes, including low birth weight (LBW).

A package of care for all pregnant women within eight scheduled antenatal care contacts is recommended by WHO. Some interventions for reducing and managing the outcomes for small vulnerable newborns (SVNs) exist within the WHO package and need to be more fully implemented, but additional effective measures are needed. We summarise evidence-based antenatal and intrapartum interventions (up to and including clamping the umbilical cord) to prevent vulnerable births or improve outcomes, informed by systematic reviews. We estimate, using the Lives Saved Tool, that eight proven preventive interventions (multiple micronutrient supplementation, balanced protein and energy supplementation, low-dose aspirin, progesterone provided vaginally, education for smoking cessation, malaria prevention, treatment of asymptomatic bacteriuria, and treatment of syphilis), if fully implemented in 81 low-income and middle-income countries, could prevent 5·202 million SVN births (sensitivity bounds 2·398–7·903) and 0·566 million stillbirths (0·208–0·754) per year. These interventions, along with two that can reduce the complications of preterm (<37 weeks' gestation) births (antenatal corticosteroids and delayed cord clamping), could avert 0·476 million neonatal deaths (0·181–0·676) per year. If further research substantiates the preventive effect of three additional interventions (supplementation with omega-3 fatty acids, calcium, and zinc) on SVN births, about 8·369 million SVN births (2·398–13·857) and 0·652 million neonatal deaths (0·181–0·917) could be avoided per year. Scaling up the eight proven interventions and two intrapartum interventions would cost about US$1·1 billion in 2030 and the potential interventions would cost an additional $3·0 billion. Implementation of antenatal care recommendations is urgent and should include all interventions that have proven effects on SVN babies, within the context of access to family planning services and addressing social determinants of health. Attaining high effective coverage with these interventions will be necessary to achieve global targets for the reduction of low birthweight births and neonatal mortality, and long-term benefits on growth and human capital.

CO2methanation is a very promising technology for the production of alternative fuels with the simultaneous use of greenhouse gases. Therefore, intensive research is carried out on the optimization of catalysts with excellent properties for operation in the area of low temperatures. Here, we present research on a catalyst composed of 19 wt % NiO supported on alumina/calcium aluminate. The catalyst was modified with V2O5in order to be suited for extrusion and scale-up in the frame of power to gas technology. Samples with various vanadium contents (Ni–xV, where xrepresents the amount of vanadium) were prepared in the form of ground granules obtained from 0.5 mm diameter spherical grains. X-ray diffraction (XRD), transmission electron microscopy (TEM), skeletal infrared (IR), diffuse reflectance ultraviolet–visible-near-infrared (DR-UV–vis-NIR), and X-ray photoelectron (XPS) spectroscopies, as well as H2temperature-programmed reduction (H2-TPR), were used to characterize the samples. Catalytic performances of the catalyst samples were tested in CO2hydrogenation at 1 atm. Among the many supported Ni catalysts tested in our laboratories, the catalysts of 0.5 and 1 wt % V showed very high activity, with the highest CH4yield of 97% at 623 K. These catalysts exhibited 100% CH4selectivity up to 673 K. The excellent performances of the studied catalysts are attributed to the possible formation of Ni–V solid solution alloy nanoparticles.

This study aimed to carry out the physical–chemical characterization, assess the functional potential and sensory analysis of bread made with 2.10, 5, 7.1 and 10% of cajá-manga peel flour (Spondias cythereaSonn.; CMPF), using a mixture experimental design. CMPF showed high antioxidant activity and content of phenolic compounds (PCs). Breads showed a reduction in PC content due to the baking process; however, it still maintained a fraction of them, in greater quantity in breads containing CMPF. In general, the formulations showed good scores for sensory acceptability, with emphasis on formulations with lower addition of CMPF, being flavor and texture the most influential attributes. Formulations containing from 5 to 10% of CMPF (presented higher correlation for physical–chemical variables and PCs) differed from those containing from 0.0 to 2.10% of CMPF (presented higher correlation for texture variables), through principal component (PCA) and hierarchical cluster analysis (HCA). Therefore, the addition of CMPF in breads, especially to a concentration of 5%, is an effective alternative for using fruit residue, obtaining a product with antioxidant potential, which contributes to the popularization of cajá-manga consumption.

Background: Prior to treatment decisions concerning isolated Weber type B ankle fractures, assessment of the stability of the ankle joint is mandatory. The gravity stress (GS) radiograph is a radiographic tool to determine stability. We hypothesized that this additional GS radiograph would lead to fewer operative treatments by applying the criterion of operative treatment when medial clear space (MCS) > superior clear space (SCS) + 2 mm on the GS radiograph, compared with the nonstressed mortise view criteria of advising operative treatment in case of MCS > SCS + 1 mm.Methods: This retrospective comparative cohort study analyzed 343 patients aged between 18 and 70 years with an isolated Weber type B ankle fracture diagnosed at the emergency department between January 2014 and December 2019. The cohort was divided into 2 groups based on whether an additional GS radiograph was performed. Group I consisted of 151 patients in whom a regular mortise and lateral radiograph were performed. Group II comprised 192 patients, with an additional GS radiograph. Primary outcome was type of treatment (conservative vs operative). Secondary outcomes were patient-reported functional outcomes and pain.Results: Baseline characteristics of both groups did not differ. In group I, surgery was performed in 60 patients (39.7%) compared with 108 patients (56.3%) in group II (P= .002). In the operatively treated patients, the mean MCS on regular mortise view was significantly smaller in patients in whom an additional GS radiograph was performed compared to patients without an additional GS radiograph (4.1 mm vs 5.2 mm, P< .001). Mean Olerud-Molander Ankle Score and mean visual analog scale (VAS) for pain did not differ significantly between groups I and II.Conclusions: Contrary to what was hypothesized, the introduction of an additional gravity stress radiograph, by which operative treatment was indicated if the MCS was wider than the SCS + 2 mm, did not result in reduced operative treatment of Weber type B ankle fractures when operative treatment was indicated for MCS > SCS + 1 mm on non-gravity stress radiographs.Level of Evidence: Level III: retrospective comparative study.

Amyloid β, Aβ(1–42), is a component of senile plaques present in the brain of Alzheimer’s disease patients and one of the main suspects responsible for pathological consequences of the disease. Herein, we directly visualize the Aβ activity toward a brain-like model membrane and demonstrate that this activity strongly depends on the Aβ oligomer size. PeakForce quantitative nanomechanical mapping mode of atomic force microscopy imaging revealed that the interaction of large-size (LS) Aβ oligomers, corresponding to high-molecular-weight Aβ oligomers, with the brain total lipid extract (BTLE) membrane resulted in accelerated Aβ fibrillogenesis on the membrane surface. Importantly, the fibrillogenesis did not affect integrity of the membrane. In contrast, small-size (SS) Aβ oligomers, corresponding to low-molecular-weight Aβ oligomers, created pores and then disintegrated the BTLE membrane. Both forms of the Aβ oligomers changed nanomechanical properties of the membrane by decreasing its Young’s modulus by ∼45%. Our results demonstrated that both forms of Aβ oligomers induce the neurotoxic effect on the brain cells but their action toward the membrane differs significantly.

The prenatal identification of complex obstetric anomalies can present issues for expectant parents, sonographers and departments of obstetric ultrasound. The limitations of imaging technologies, ongoing fetal development and various interpretations of anomalies and prognosis create ambiguity. Complexity is further heightened by a lack of policies and training related to the communication of unexpected findings and support for sonographers who work with expectant parents during or after times of significant distress and trauma. This case report details challenges presented upon a third‐trimester diagnosis of a complex obstetric anomaly agenesis of the corpus callosum and offers recommendations to reduce the negative psychosocial consequences of complex obstetric anomaly diagnosis.

Fully ion-exchanged Pd/SSZ-13 model passive NOx adsorbers (PNA) exhibit significant NOx storage capability, achieving NOx-to-Pd ratios of 1, and NOx desorption at higher temperatures, where downstream NOx reduction catalysts are active, under simulated exhaust conditions. However, CO has been found to induce PNA degradation, which limits the potential for practical application. In this study, in an attempt to understand the consequences of limiting CO exposure, we integrated a model Pt/Al2O3diesel oxidation catalyst (DOC) with a Pd/SSZ-13 PNA and performed NOx adsorption and temperature-programmed desorption (TPD) cycles with the PNA, the DOC, and the DOC+PNA integrated system. Despite the high initial NOx-to-Pd ratio, Pd/SSZ-13 experienced significant degradation over 15 adsorption and desorption cycles when including CO, with the NOx-to-Pd ratio dropping from 0.98 to 0.75. CO oxidation over the DOC+PNA integrated system lights off at significantly lower temperature compared to the PNA, limiting the PNA CO exposure at temperatures above 200 °C. As a result, the durability of the DOC+PNA integrated system is enhanced, and only a 0.02 decrease in NOx-to-Pd ratio was observed over the 15 test cycles. A further benefit with integration of the PNA with the DOC was a lower temperature NOx release, within a more practical temperature window. This is due to the enhanced oxidation activity of the DOC+PNA integrated system and consequently an early onset of NO2formation, which was found to trigger the low temperature NOx release. Low temperature NOx adsorption and TPD experiments with controlled exposure of CO and NO2reveal two types of NOx storage mechanisms, one of which is destabilized by the presence of NO2, leading to the evolution of a lower temperature NOx release. Overall, integrating the PNA with a highly active low temperature CO oxidation catalyst was beneficial by lowering the NOx release temperature window and leading to significantly less NOx capacity loss.

Indigenous Māori youth struggle to connect with science delivered in a Eurocentric model of education in Aotearoa, New Zealand. In transforming conservation biology through Indigenous perspectives, we asked whether Māori knowledge-based resources and traditional schooling (wānanga) methodologies increased the connection of Māori youth (rangatahi) to conservation science. We collaborated with a Māori environmental science body to run a culturally based environmental program (noho taiao) attended by 70 youth from three Māori-centric schools. We undertook surveys to assess baseline scientific understanding and to gauge how their understanding of the Māori-based conservation principles we introduced shifted over the course of the program. We developed a bilingual gaming app to introduce basic environmental concepts from both cultural perspectives, measuring its impact on knowledge retention for these students, and others at a Eurocentric school. Indigenous contexts for conservation learning markedly increased uptake of knowledge content, and enthusiasm for conservation concepts. After the program, Māori students reported that science was more accessible and relevant. Gaming as an educational medium was successful in engaging youth generally, but students primed by experiential learning from Indigenous perspectives had increased knowledge gained. Enabling rangatahi to explore place-based learning within a relevant cultural context allowed them to understand their duty of care to the environment (te taiao). Utilising Māori engagement mediums and mentors that resonate with youth are key to encouraging more Māori youth into conservation science. Therefore, empowering youth to draw from Indigenous ways of knowing, being and doing can create a step-change in science participation and leadership.

We introduce a new latent fingermark (LFM) development method, where compounds showing long lifetime luminescence are generated in situ by the reactions of Eu(TTA)3(H2O)2with LFM components. Until now, time-gated imaging could not be used to develop LFM on porous surfaces due to the difficulties with selective binding of the developing agents to the fingermark ridges. The nature of the interactions of Eu(TTA)3(H2O)2with the LFM material has been investigated for three model compounds commonly found in the LFM composition—oleic acid, l-serine, and squalene. The LFMs developed with the europium β-diketonate complex have been successfully photographed using a time-gated imaging scheme. The presented new approach has been demonstrated to give similar or better results than developing agents commonly used for paper samples (ninhydrin and 1,2-indanedione). Moreover, contrary to the methods mentioned above, the new approach allows for the development of amino acid-poor LFM on paper.

Background Studies indicate there is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations.Aims To develop consensus guidelines for unexpected news delivery in Early Pregnancy Unit and Fetal Anomaly Screening Programme NHS settings.Methods A workshop was conducted to identify priorities and reach consensus on areas of contention. Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers (n= 28). Written and verbal feedback was used to draft initial guidance which was then circulated amongst the wider writing group (n= 39). Revisions were undertaken until consensus was reached.Results Consensus guidelines were developed outlining the behaviours and phrases which should be used during scans where unexpected findings are identified. Specific recommendations included that: honest and clear communication should be prioritised, even with uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g. ‘foetus’), the term ‘baby’ should be used as a default, even in early pregnancy; at the initial news disclosure, communication should focus on information provision. Expectant parents should not be asked to make decisions during the scan.Conclusions These recommendations can be used to develop and improve news delivery interventions in obstetric ultrasound settings. The full guidelines can be accessed online as supplemental material and at https://doi.org/10.5518/100/24.

SCLC accounts for approximately 250,000 deaths worldwide each year. Acquisition of adequate tumor biopsy samples is challenging, and liquid biopsies present an alternative option for patient stratification and response monitoring.

Background/AimsSpastic paresis is the most common motor disorder in stroke survivors and can cause various types of muscle overactivity. This can lead to the development of spastic equinovarus foot, producing an inadequate base of support that limits locomotion and weight transfers. Physical therapists require better knowledge of the effects of spastic equinovarus foot in order to administer effective clinical treatment. Therefore, the aim of the present review was to describe changes in the muscle morphology and force production of stroke survivors with spastic equinovarus foot in relation to gait performance.MethodsA narrative review of research into the effects of spastic paresis and equinovarus foot in stroke survivors was undertaken.ResultsThere were a total of 20 identified studies that observed muscle-tendon morphology and force production in stroke survivors. All studies included in the present review reported several changes in muscle and tendon biomechanical properties as results of the spastic muscle overactivity.ConclusionsStroke survivors with spastic equinovarus foot experience muscle and tendon morphology that result in decreased force production, muscle power and gait performance.

Supplemental digital content is available in the text.

Background: Polytrauma patients are at risk of considerable harm from malnutrition due to the metabolic response to trauma. However, there is little knowledge of (the risk of) malnutrition and its consequences in these patients. Recognition of sub-optimally nourished polytrauma patients and their nutritional needs is crucial to prevent complications and optimize their clinical outcomes.Aim: The primary objective is to investigate whether polytrauma patients admitted to the Intensive Care Unit (ICU) who have or develop malnutrition have a higher complication rate than patients who are and remain well nourished. Secondary objectives are to determine the prevalence of pre-existent and in-hospital acquired malnutrition in these patients, to assess the association between malnutrition and long-term outcomes, and to determine the association between serum biomarkers (albumin and pre-albumin) and malnutrition.Methods: This international observational prospective cohort study will be performed at three Level-1 trauma centers in the United States and two Level-1 centers in the Netherlands. Adult polytrauma patients (Injury Severity Score ≥16) admitted to the ICU of one of the participating centers directly from the Emergency Department are eligible for inclusion. Nutritional status and risk of malnutrition will be assessed using the Subjective Global Assessment (SGA) scale and Nutritional Risk in Critically Ill (NUTRIC) score, respectively. Nutritional intake, biomarkers and complications will be collected daily. Patients will be followed up to one year after discharge for long-term outcomes.Conclusions: This international prospective cohort study aims to gain more insight into the effect and consequences of malnutrition in polytrauma patients admitted to the ICU.

Maximal expiratory airflow peaks early in the third decade of life, then gradually declines with age. The pattern of airflow through adulthood for individuals born very preterm (at <32 weeks' gestation) or with very low birthweight (<1501 g) is unknown. We aimed to compare maximal expiratory airflow in these individuals during late adolescence and early adulthood with that of control individuals born with normal birthweight (>2499 g) or at term.

This column examines the trajectory and current state of augmented and virtual reality in libraries and education with a focus on recently released virtual reality (VR) headsets. The author discusses a variety of VR headsets that can be purchased as an entry point for virtual reality experiences in libraries and education. The author also considers various headsets that can be used as a classroom educational tool and provides perspective on circulation or use in media labs and makerspaces for libraries. [ABSTRACT FROM AUTHOR]

Background and Aims This exploratory observational prospective study aimed to evaluate fat-soluble vitamin plasma levels during hospital admission and its relation with the development of malnutrition and complications in polytrauma patients, considering the protocolized multivitamin supplementation during intensive care unit (ICU) admission.Methods In 49 well-nourished polytrauma (injury severity score ≥ 16) patients admitted to the ICU of two level-1 trauma centers, vitamin A, D, and E levels were assessed weekly during hospital stay. All patients received multivitamin supplementation during ICU stay. Linear mixed-effect models were used to assess a trend in vitamin levels over time during hospital stay. Mixed-effects logistic regression analysis was performed to relate vitamin concentrations with malnutrition, defined as a subjective global assessment score ≤5, and complications.Results Vitamin A levels increased 0.17 µmol/L per week (95% confidence interval 0.12–0.22, p < 0.001), vitamin D levels increased 1.49 nmol/L per week (95% confidence interval 0.64–2.33, p < 0.01), vitamin E levels increased 1.17 µmol/L per week (95% confidence interval 0.61–1.73, p < 0.001) during hospital stay (29 ± 17 days). Vitamin levels were not related to malnutrition or complications during hospital stay.Conclusion Vitamin A, D, and E levels increased due to supplementation during hospital admission. Plasma levels of vitamins A, D, and E do not seem to be useful as biomarkers for the nutritional status of polytrauma patients during hospital stay. No correlation with complications could be demonstrated.

The paper presents the case of a 23-year-old man with multiple venous anomalies. The abnormalities were asymptomatic, and they were detected accidentally on routine abdominal ultrasound examination. The anomalies were found in the inferior vena cava, right testicular vein, left renal vein, and hepatic veins. Familiarity with different developmental variants within the inferior vena cava and other venous vessels plays a crucial role in ultrasound imaging. Vascular anomalies, although rare, should be taken into account in the differential diagnosis of focal lesions within the abdominal cavity. Also, variation in vascular anatomy may be a precipitating factor for blood flow disorders, and hence predispose patients to deep vein thrombosis and other pathological conditions. The reported case serves as a valuable addition to the knowledge of the vascular system that radiologists use in their everyday practice when performing diagnostic ultrasound examinations.

Uit de tuin komt het geluid van kakelende kippen en fluitende vogeltjes, uit de grote zaal klinken pianoklanken. De geur van lavendelolie verspreidt zich door de gang na een uitwendige therapie. De verse bloemen op tafel kleuren de therapieruimte waar we in een comfortabele stoel een kop warme thee drinken. Volgens de auteurs is Lievegoed GGZ een feest voor de zintuigen, een helende plek voor ieder mens. Een introductie in de antroposofische ggz.

For thousands of years the Eurasian steppes have been a centre of human migrations and cultural change. Here we sequence the genomes of 137 ancient humans (about 1× average coverage), covering a period of 4,000 years, to understand the population history of the Eurasian steppes after the Bronze Age migrations. We find that the genetics of the Scythian groups that dominated the Eurasian steppes throughout the Iron Age were highly structured, with diverse origins comprising Late Bronze Age herders, European farmers and southern Siberian hunter-gatherers. Later, Scythians admixed with the eastern steppe nomads who formed the Xiongnu confederations, and moved westward in about the second or third century bc, forming the Hun traditions in the fourth–fifth century ad, and carrying with them plague that was basal to the Justinian plague. These nomads were further admixed with East Asian groups during several short-term khanates in the Medieval period. These historical events transformed the Eurasian steppes from being inhabited by Indo-European speakers of largely West Eurasian ancestry to the mostly Turkic-speaking groups of the present day, who are primarily of East Asian ancestry.

Throughout their lifetime, cells are subject to extrinsic and intrinsic mutational processes leaving behind characteristic signatures in the genome. DNA mismatch repair (MMR) deficiency leads to hypermutation and is found in different cancer types. Although it is possible to associate mutational signatures extracted from human cancers with possible mutational processes, the exact causation is often unknown. Here, we use C. elegansgenome sequencing of pms-2and mlh-1knockouts to reveal the mutational patterns linked to C. elegansMMR deficiency and their dependency on endogenous replication errors and errors caused by deletion of the polymerase ε subunit pole-4. Signature extraction from 215 human colorectal and 289 gastric adenocarcinomas revealed three MMR-associated signatures, one of which closely resembles the C. elegansMMR spectrum and strongly discriminates microsatellite stable and unstable tumors (AUC = 98%). A characteristic difference between human and C. elegansMMR deficiency is the lack of elevated levels of NCG > NTG mutations in C. elegans,likely caused by the absence of cytosine (CpG) methylation in worms.The other two human MMR signatures may reflect the interaction between MMR deficiency and other mutagenic processes, but their exact cause remains unknown. In summary, combining information from genetically defined models and cancer samples allows for better aligning mutational signatures to causal mutagenic processes.

A new redox conducting polymer, viz. poly[meso-N,N′-bis(salicylidene)-2,3-butanediaminonickel(II)], poly[meso-Ni(II)-SaldMe], belonging to the Schiff base polymer family, was electrochemically synthesized. The charge transfer and polymerization mechanism were unraveled by simultaneous cyclic voltammetry (CV) and in situ UV–vis, FTIR-ATR, and ex situ low-temperature ESR spectroscopy. With the latter, a short-living paramagnetic transient form of electro-oxidized poly[meso-Ni(II)-SaldMe] was detected. This form was identified as the bisphenolic radical cation. In situ UV–vis and FTIR-ATR spectroelectrochemistry measurements revealed that the charge transfer of the polymer involved bisphenolic radical cation formation at the potential lower than 0.80 V vs Ag/Ag+and then dication formation at the potential exceeding 0.80 V. The proposed mechanism of electropolymerization of meso-N,N′-bis(salicylidene)-2,3-butanediaminonickel(II), meso-Ni(II)-SaldMe, involves two steps. First, electro-oxidation of the monomer results in bisphenolic radical cation generation, and then mutual binding of these radicals at the parapositions of aromatic rings is activated by electron-donating phenol moieties. In this electropolymerization, the Ni(II) metal center played the role of a template providing planarity to the monomer molecule. Structures responsible for the charge transfer in the polymer and formed during electropolymerization were modeled with quantum chemistry calculations using the DFT method at the PBE level. The resulting polymer film was highly conducting and stable with respect to potential multicycling under cyclic voltammetry conditions, from 0 to 1.3 V vs Ag/Ag+. Under these conditions, it changes color from yellow through orange to russet for its neutral, bisphenolic radical cation, and bisphenolic dication form, respectively. High electrochemical stability and a wide potential range of electroactivity (0.40–1.30 V vs Ag/Ag+) of the polymer are very promising for its application as a new electrochromic electrode material for supercapacitors. That is, an anode composed of poly[meso-Ni(II)-SaldMe] can serve as an internal charging–discharging indicator in these supercapacitors.

This column examines the free Unpaywall Chrome/Firefox browser extension, which can be used to locate and read legally uploaded full text articles, and related Open Access resources that Libraries, librarians, and scholars may find useful. Unpaywall is from Impactstory, a nonprofit interested in providing scholars and scientists with a platform to share and exchange scholarly information online using a variety of Open Access resources. [ABSTRACT FROM AUTHOR]

This column examines the Adobe Spark cloud-based creation dashboard and corresponding iOS apps. Spark is a potentially useful tool for library professionals, especially in terms of library marketing, education, and events. Spark allows for the quick and easy creation of template-driven pages, posts, and video projects. Media can be input directly by the user, or from a variety of online accounts such as Dropbox, YouTube, Vimeo, Google Photos, and Adobe's own Creative Cloud account or Lightroom app. [ABSTRACT FROM AUTHOR]

This column examines the Delve Deep app from Mic-Apps. Delve Deep promises deeper searching for academics, including real time results from user-specified sites or predefined groups of resources. The app's interface is presented and explained. Test search results across various sources are examined for comparison to the stated capabilities of the search application. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text.The antidepressant mirtazapine is an alternative to classical hypnotics, and this study investigated the efficacy and safety of esmirtazapine (Org 50081, the maleic acid salt of S-mirtazapine) in patients given a diagnosis of primary insomnia after acute (2-day) treatment. Patients aged 18 to 65 years with primary insomnia were randomized to receive placebo or 1.5-, 3.0-, or 4.5-mg esmirtazapine in a balanced 4-way crossover study; 2 sleep laboratory nights with polysomnography were separated by 5-day, single-blind placebo washout periods. Polysomnography-determined total sleep time (primary end point) and patient-reported total sleep time improved by at least 25 minutes with all 3 doses of esmirtazapine (P≤ 0.001 vs placebo). Polysomnography-measured wake time after sleep onset (P≤ 0.0001) and latency to persistent sleep also improved vs placebo (P≤ 0.01, 3.0 and 4.5 mg). Patient-reported sleep quality improved with 3.0- and 4.5-mg esmirtazapine (P≤ 0.01 and P≤ 0.05, respectively, vs placebo). Morning alertness and contentment were not altered after esmirtazapine, and calmness increased with 4.5-mg esmirtazapine vs placebo. Evening questionnaires showed no difference in duration of daytime naps but reduced energy and ability to work/function after esmirtazapine treatment periods vs placebo (P< 0.05), although this effect was limited to the first night of each 2-night period. There were few adverse events, no serious adverse events, or clinically relevant treatment differences in vital signs, laboratory values, or electrocardiogram. Esmirtazapine doses of 1.5 to 4.5 mg/day significantly improved quantity and quality of sleep and were generally well tolerated, with no evidence of safety concerns or consistent pattern of residual effects.

We describe and review recent research on potential biomass-derived fuels consisting of methanol, ethanol, butanol, and carboxylic acids. These fuels possess a volumetric energy densities of 15.6–22.7, 20.9–26.8, and 24.6 (levulinic acid) MJ?L-, respectively. We recognize biomass as a valuable, sustainable, and economic fuel source in comparison to fossil fuels. First, we discuss, characterize, and compare all mentioned fuels. Second, we review recent research developments in the continuous pre-processing for syngas production for biofuels production, specifically concentrating on dry reforming and the catalytic effects on the effluent and process efficiency. Finally, we discuss the future prospects and research needs to realize this technology on a global scale. Future perspectives: Imagine a world where two wastes (lignocellulosic biomass and CO2) will be the sources of fuels, chemicals, and commodities thanks to the use of less-expensive transition-metal-based catalysts in a low-temperature dry reforming process. A critical vision of this kind of world is presented in this Review.

The aim of this study was to explore possible environmental factors behind the regional differences in the incidence of pediatric inflammatory bowel disease (IBD). All of the patients diagnosed with IBD who were aged 0 to 14 years in Finland between 1987 and 2003 were identified from the Social Insurance Institution database. Finland was divided into squares of 250?×?250 m, and spatial variations of incidence rates were evaluated accordingly. The role of the environmental determinants (pediatric population density, agricultural industry, chemical contaminants of tap water and proximity to the sea or paper mills) in the geographic variations of the incidence rates was evaluated. During the study period, the overall incidence of pediatric IBD was 6.5 of 100,000 (95% confidence interval [CI] 6.1–6.9). The incidence in very sparsely populated areas (=10 person-years per 250?×?250 m2) was 9.2 of 100,000 (95% CI 6.3–13.1) and 5.6 of 100,000 (95% CI 4.8–6.4) in the districts with the highest population density (>800 person-years per 250?×?250 m2). A nonsignificant trend toward the same direction was also seen for ulcerative colitis (trend P?=?0.09). Chemical contaminant concentrations of tap water, residence near the seaside, or proximity to paper mills were not associated with the incidence of pediatric IBD. Our findings suggest higher incidence rates of pediatric IBD in the districts with low compared with high density of child population, but the differences cannot be explained by variations in the environmental exposures evaluated here.

Supplemental Digital Content is available in the text

The toxicity of sediments is often closely bound to the labile toxic elements contents. In porewaters, metal concentrations are generally measured after separation from the solid material by means of pressure or centrifugation. The recent developments of in situmetal measurements by microsensors do not require any pretreatment of the sediment and hence avoid some possible artefacts like oxygen penetration in anoxic sediment and/or temperature modification. Our work describes firstly the preparation of microelectrodes based on a thin solid Silver (diameter: 30 μm) or Iridium (diameter: 75 μm) wire, covered at the tip with a fine layer of mercury. Secondly, an analytical procedure (based on cathodic voltammetry) is presented to measure Mn(II), Fe(II) and S(-II) concentrations, which play a relevant role in the metal pollutant cycle in sediments. By anodic stripping voltammetry, such microsensors are able to detect trace heavy metals such as Cd(II) or Pb(II) at relatively low concentration levels (~1 μg.dm-3) with 5 minutes accumulation time. Finally, the most important challenge is to install the microelectrodes in natural media and to follow up metal pollution over a long time period.

This column explores Blippar for Education, an app for viewing and creating augmented reality (AR) and interactive print. Blippar for Education is free for educators and cultural institutions and provides an easy to use and intuitive app and Web interface for creating, publishing, and viewing AR elements. The online creation tool allows educators to create user accounts, and is feature rich. Blippar for Education provides educators with a seamless interface for incorporating augmented reality in the classroom. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is available in the text.

Aims and methodThe aims of the study were to develop a scale sensitive enough to measure the interpersonal processes within a therapeutic environment, and to explore whether the new scale was sensitive enough to detect differences between settings, including a community based on compassionate mind and contextual behaviourism. The Therapeutic Environment Scales (TESS) were validated with 81 participants in three different settings: a specialist service for anxiety disorders, a specialist in-patient ward and a psychodynamic therapeutic community.ResultsTESS was found to be reliable and valid. Significant differences were seen between the services on the dimensions of compassion, belongingness, feeling safe, positive reinforcement of members' acts of courage, extinction and accommodation of unhelpful behaviours, inconsistency and high expressed emotion. These processes were over time associated with improved outcomes on a specialist service for anxiety disorders.Clinical implicationsThe TESS offers a first step in exploring important interpersonal relationships in therapeutic environments and communities. An environment based on a compassionate mind and contextual behaviourism offers promise for the running of a therapeutic community.