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People with substance use disorder (SUD) face barriers to prevention and treatment services, increasing risk for hospitalization and death. Injection drug use (IDU) can lead to an increased risk of overdose and infections. However, identifying people who inject drugs (PWID) within healthcare systems is challenging. International Classification of Disease (ICD-10) codes are used for billing and tracking healthcare utilization. In this commentary, experts in the field weigh the benefits and risks of creating an IDU-specific ICD-10 code. Potential benefits include earlier identification, better access to health services, and improved systems of resource allocation. Potential risks include further stigmatization of PWID and, if not tied to financial reimbursement, low rates of code utilization. As the current systems of identifying PWID are lacking, we feel that a guided operationalization of an ICD code to identify PWID could improve quantitative and epidemiological research accuracy and, therefore, support the health and well-being of PWID. [ABSTRACT FROM AUTHOR]

Down syndrome is associated with several comorbidities, including intellectual disability, growth restriction, and congenital heart defects. The prevalence of Down syndrome–associated comorbidities is highly variable, and intellectual disability, although fully penetrant, ranges from mild to severe. Understanding the basis of this interindividual variability might identify predictive biomarkers of in utero and postnatal outcomes that could be used as endpoints to test the efficacy of future therapeutic interventions. The main objective of this study was to examine if antenatal interindividual variability exists in mouse models of Down syndrome and whether applying statistical approaches to clinically relevant measurements (ie, the weights of the embryo, placenta, and brain) could define cutoffs that discriminate between subgroups of trisomic embryos. Three commonly used mouse models of Down syndrome (Dp(16)1/Yey, Ts65Dn, and Ts1Cje) and a new model (Ts66Yah) were used in this study. Trisomic and euploid littermate embryos were used from each model with total numbers of 102 for Ts66Yah, 118 for Dp(16)1/Yey, 92 for Ts65Dn, and 126 for Ts1Cje. Placental, embryonic, and brain weights and volumes at embryonic day 18.5 were compared between genotypes in each model. K-mean clustering analysis was applied to embryonic and brain weights to identify severity classes in trisomic embryos, and brain and placental volumetric measurements were compared between genotypes and classes for each strain. In addition, Ts66Yah embryos were examined for malformations because embryonic phenotypes have never been examined in this model. Reduced body and brain weights were present in Ts66Yah, Dp(16)1/Yey, and Ts65Dn embyos. Cluster analysis identified 2 severity classes in trisomic embryos—mild and severe—in all 4 models that were distinguishable using a putative embryonic weight cutoff of <0.5 standard deviation below the mean. Ts66Yah trisomic embryos develop congenital anomalies that are also found in humans with Down syndrome, including congenital heart defects and renal pelvis dilation. Statistical approaches applied to clinically relevant measurements revealed 2 classes of phenotypic severity in trisomic mouse models of Down syndrome. Analysis of severely affected trisomic animals may facilitate the identification of biomarkers and endpoints that can be used to prenatally predict outcomes and the efficacy of treatments. [ABSTRACT FROM AUTHOR]

Highlights • We studied candidate genetic alterations associated with recurrent miscarriage. • Twenty-nine Japanese women with recurrent miscarriages were enrolled. • We identified 26 copy-number variations (CNV) using single nucleotide polymorphism (SNP)-array data from 15 diploid cases. • We identified one novel CNV that caused deletion of a microRNA cluster region. • Regulation of gene expression may contribute to the pathogenesis of miscarriages. Abstract Research question The causes of almost half of all miscarriages are unknown. Genetic alterations undetectable by conventional methods may cause some cases of recurrent miscarriage. The study aimed to identify candidate genetic alterations associated with recurrent miscarriage. Design Twenty-nine Japanese women with a history of recurrent miscarriage without any known underlying anatomical or medical causes were recruited. The products of conception were collected after miscarriage and showed either a normal karyotype or a failure of complete chromosomal Giemsa banding. Genomic DNA from the chorionic villi of the conception products was analysed using genome-wide single-nucleotide polymorphism (SNP) arrays. Results In four cases, the products could not be analysed because of contaminating maternal-origin DNA, and chromosomal aneuploidies were observed in 10 cases. Thirty-three copy-number variations (CNV) were identified from the array data of 15 diploid cases. Causative CNV were identified by comparison with CNV observed in healthy, parous Japanese women. Twenty-four chromosomal regions with 26 CNV were identified as strong candidates for causing recurrent miscarriage, and these were all too small to detect by conventional chromosome analysis banding. Moreover, one novel CNV that caused complete deletion of a microRNA cluster region was detected. Conclusions High-resolution genome-wide SNP arrays are effective for detecting novel genetic factors causing recurrent miscarriage. A more appropriate reference CNV list may be necessary to more effectively enrich for CNV likely to cause recurrent miscarriage. The findings confirmed one non-coding RNA cluster as a strong candidate that may contribute to unexplained miscarriages. Gene expression-regulatory mechanisms may play important roles in the pathogenesis of miscarriages. [ABSTRACT FROM AUTHOR]

• Pressure drops for surfactant solutions of rod-like micelles were investigated for small-slit flows. • Surfactant solutions of rod-like micelles exhibited higher pressure drops than water. • To investigate the anomalous pressure drop, the phase difference was observed via a high-speed polarization camera. • The correlation between the pressure drop and the phase difference is discussed. Pressure drops in flows through a small slit were experimentally measured at constant flow rates to investigate flows with an abrupt contraction and expansion. The flow properties of water, 50 wt% glycerol solution, and two types of surfactant solutions (Lipoquad and Lipothoquad) with a counterion (NaSal) were examined. The slit heights used were 480 µm, 222 µm, and 129 µm, with estimated hydraulic diameters of 938 µm, 439 µm, and 256 µm, respectively. Viscosity was measured using a capillary-type viscosity meter. Water and the 50 wt% glycerol solution exhibited Newtonian viscosity, with the viscosity of the glycerol solution being 10 times that of water. By contrast, the surfactant solutions, which contained rod-like micelles, exhibited non-Newtonian viscosity. A power law model was therefore applied for the relationship between shear viscosity and shear rate on the wall. The observed flow properties of water (and the 50 wt% glycerol solution) and the numerical predictions of the Navier–Stokes equations were found to agree to within the experimental errors. In plots of the dimensionless pressure drop against the generalized Reynolds number, however, anomalous flow properties of the surfactant solutions were observed. The pressure drops of Lipoquad/NaSal agreed with those of water (and the 50 wt% glycerol solution) at low apparent strain rate (Reynolds number) but were larger at high apparent strain rate (Reynolds number). Furthermore, the pressure drops of Lipothoquad/NaSal were greater than those of water in the investigated range of the generalized Reynolds number. To examine these experimental results further, flows in a planar channel with an abrupt contraction and expansion were observed using a polarization measurement system based on a high-speed polarization camera. In contrast to polymer solutions (in which polymer chains were oriented along the flow direction), the phase difference for Lipoquad/NaSal before and in the slit region was high in regions with a strong elongational component. In addition, it was high along the centerline after the slit region. These results also differ from those of simple shear flows. Furthermore, the phase difference of Lipothoquad/NaSal was very unstable. In addition, the relationship between the resultant pressure drop and the measured phase differences was investigated, and a dependence was found on the apparent strain rate (Weissenberg number). [ABSTRACT FROM AUTHOR]

We present a case with discordant results in three prenatal screening methods, with additional genetic analyses. Non-invasive prenatal testing (NIPT) was performed on a 41-year-old Japanese woman at 10 weeks of gestation, and the result was positive for trisomy 18 with high accuracy. Amniocentesis was performed at 16 weeks of gestation. However, the result showed 47,XX,+mar[16]/47,XX,+18[2]. Fetal examination by ultrasound revealed no malformations. After termination of the pregnancy, we performed additional genetic analyses, and confirmed the presence of confined placental mosaicism (CPM). Furthermore, a small supernumerary marker chromosome (sSMC) was detected in fetal cells, which was derived de novo from the centromere of chromosome 18. Single nucleotide polymorphism array analysis revealed that fetal chromosome 18 was inherited with maternal uniparental disomy, with a relatively large copy-neutral loss of heterozygosity, including its centromere. Our genetic analyses strongly indicated the cause of result discrepancy in prenatal testing as incomplete trisomy 18 rescue leading to atypical CPM with a sSMC. These findings also offer insight into the mechanisms by which chromosomal aberrations form during human oogenesis and embryogenesis. [ABSTRACT FROM AUTHOR]

The ToggleLoc with ZipLoop is an adjustable suspensory device for anterior cruciate ligament reconstruction. However, there is no string to flip the button in the device because it has only one hole and one string. Therefore, the surgeon cannot use the button flip technique. The purpose of this article is to present the pearls and pitfalls of using ToggleLoc with ZipLoop. While preparing the ACL graft, we draw a 15- to 20-mm-width marking in the adjustable loop at the same length as the femoral tunnel depth. While passing of the graft, the tensioning sutures are placed at the anterior side to make sure they pass through the medial portal smoothly. The proximal passing suture and distal adjustable loop is pulled to the opposite direction by one surgeon's hands while passing the button. We stop pulling the sutures just at the marking while feeling the button being passed over the lateral femoral cortex. The distal artificial ligament is held distally with moderate tension while passing the graft. Although there are some pitfalls and knacks, the present technique is easy and certainly helps surgeons achieve appropriate positioning of the button. [ABSTRACT FROM AUTHOR]

A solution of hydrogen bromide (HBr) in 1,4-dioxane was prepared and investigated for its ability to brominate alcohols, and hydrobrominate alkenes. This study revealed that the brominating ability of this HBr/1,4-dioxane solution is equal or superior to that of hydrobromic acid or HBr in acetic acid. The solution of HBr in 1,4-dioxane is robust, exhibiting no decomposition of the solvent, and retaining 97% of its original concentration, when kept at −25 °C for 30 days. This solution is a liquid alternative to HBr gas without protic solvents. [ABSTRACT FROM AUTHOR]

Highlights • Pressure drop of steady-state-flow dilute polymer solutions in narrow pipe is measured. • Aqueous solutions of polyethylene oxide, polyacrylamide, and xanthan gum are used. • Flow properties of water and silicone oil agree with predictions. • Pseudo-laminarization effect is seen with dilute/ultra-dilute polymer solutions. • Elasticity is discussed for understanding the phenomena. Abstract The properties of dilute and ultra-dilute polymer solutions flowing in a narrow pipe (inner diameter: 680, 400, and 125 μ m) were evaluated experimentally by measuring the pressure drop at constant flow rate. Deionized water, silicone oil, and several aqueous solutions of polyacrylamide (PAA), polyethylene oxide (PEO), and xanthan gum (X-Gum) were used. In viscosity measurements, 100- and 10-ppm solutions exhibited non-Newtonian viscosities whereas 1-ppm solutions exhibited Newtonian viscosities. We applied a power-law model to the non-Newtonian viscosities and estimated a generalized Reynolds number. Moreover, we focused on the transition and turbulent regions because the flows being observed were through narrow pipes. For water and silicone oil, good agreement was obtained between the resultant pressure drop and the predicted value. Furthermore, the critical Reynolds number for water and silicone oil was approximately 1.8 × 10 3 . In contrast, laminar flow was maintained in the transition region for the dilute and ultra-dilute polymer solutions. In the 125- μ m capillary flows, the maximum critical Reynolds numbers for the ultra-dilute polymer solutions were 2.4 × 10 3 (PAA), 3.9 × 10 3 (PEO), and 3.0 × 10 3 (X-Gum). Even though ultra-dilute solutions were used, pseudo-laminarization was obtained. To understand the experimental results, we estimated the first normal stress difference. All such values were correlated with the wall shear rate. We conclude that the pseudo-laminarization can be associated with the elasticity of the polymer solutions and is typified by the appearance of strong elastic properties in small-scale flows. [ABSTRACT FROM AUTHOR]

The consumption of fresh vegetables has been increasing in part owing to an increase in awareness of their health benefits. Chemicals are used for washing fresh vegetables in washing fresh vegetables to remove surface micro-organisms. However, the effect of these chemicals on human health must be considered, and the chemical concentrations used should be minimal. Previous studies have examined washing fresh vegetables with electrolyzed water, fine bubbles, and ultra-fine bubbles with strong mechanical action. A technique using fine and ultra-fine bubbles containing ozone and chlorine has also been developed. Although the efficiency of these techniques for washing fresh vegetable was high, the observations of fine and ultra-fine bubbles were limited. In the present study, the effect of fine and ultra-fine bubbles on the washing rate of fresh vegetables in an alternating flow, which has a stronger mechanical action for washing, was investigated. Although all results in no mechanical action were the almost same ( ≒ 6.1 log cfu/g), the difference between the washing result (5.9 log cfu/g) for deionized water and those (5.3 log cfu/g) for ultra-fine bubble was obtained in an alternating flow. Moreover, the resultant viable bacterial count (3.7 log cfu/g) for ultra-fine ozone-rich bubble was less than that (4.6 log cfu/g) for sodium hypochlorite alone. There were substantial differences between washing with deionized water alone and with ultra-fine (ozone-rich) bubble mixtures. Stronger washing effects were obtained when ultra-fine (ozone-rich) bubble mixtures were combined with an alternating flow. Furthermore, surface tension, free radicals, mechanical action, and limitation of the effect was discussed for understanding the experimental results. [ABSTRACT FROM AUTHOR]

The flow properties of complex fluids, such as aqueous solutions of polymers and surfactants, have been investigated in many studies, which revealed interesting and anomalous tendencies for several types of complex fluids in abrupt contraction and expansion flows, such as flows passing through small-sized orifices and slits. In the study, the jet thrust and excess pressure drop (net differential pressure) for experimentally observing their flow properties of water and aqueous solutions of several types of surfactants with spherical micelles in slit flows were measured. Different properties were observed for various surfactant solutions depending on the charge of the solute. The resultant jet thrust and excess pressure drop of cationic and non-ionic surfactant solutions were lower than the experimental values of water. For anionic surfactant solutions, the experimental results were similar to those of water. The types can be arranged as cationic > non-ionic > anionic in order of diminishing the jet thrust and excess pressure drop. Moreover, the effect of strong strain, boundary slip, contraction ratio, size effect, concentration, and interface phenomena was discussed. [ABSTRACT FROM AUTHOR]