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The study presented hereby investigates experimentally and with CFD simulations the gas distribution effect on the hydrodynamic of a Geldart Group A turbulent fluidized bed. Experiments were carried out on a cold flow fluidized bed column with an even and uneven gas distribution. Local solid volume fraction profiles were measured using optical probes at different bed heights and along two radial directions. Optical probe measurements allow catching a clear hydrodynamic difference between both even and uneven gas distributions. These results were then used to assess CFD simulations with the code Barracuda™ (MP-PIC approach). It is noteworthy that the choice of drag correlation and boundary conditions strongly influences the agreement between the experimental and CFD results. Once the correct parameters are chosen, CFD simulations captured the effect of gas distribution changes.

Transportation infrastructure plays a significant role in the economic growth of developing countries where heavy vehicles act as the backbone in transporting goods and people via highways. However, presence of heavy vehicles in traffic stream lowers the overall operating speed and flow in rural highways especially at the vicinity of intersections. This research aims at developing an empirical model for estimating and predicting capacity of highway roundabouts considering both geometric and traffic parameters. Based on data collected from six roundabouts along the national highways in Bangladesh, multivariate regression method has been used to develop an empirical model as a function of entry width, rotary lane width, distance between entry and nearest exit, central island diameter, and circulating traffic flow to estimate and predict the capacity of rural highway roundabouts. For incorporating the presence of heavy vehicles in the model, all vehicle types are converted to passenger car equivalent units. A comparative study with established methods (i.e., HCM 2016, TRRL, IRC and German method) proves the superiority of the developed model in terms of predictive capacity. Furthermore, a Python based program called PyNomo, has been executed with the help of several add-on packages (e.g., numpy, scipy, pyx) to generate a compound parallel scale nomograph consisting of multiple variables using the developed empirical model. Considering the impact of heavy vehicles in the socio-economic development of a country, the nomograph will aid the practitioners and engineers as a quick and easily interpretable graphical tool for planning and designing roundabouts in rural highways.

Counterions are important constituents for the structure and function of nucleic acids. Using

To further explore the damage characteristics and impact response of the shaped charge to the solid rocket engine (SRE) in storage or transportation, protective armor was designed and the shelled charges model (SCM)/SRE with protective armor impacting by shaped charge tests were conducted. Air overpressures at 5 locations and axial acceleration caused by the explosion were measured, and the experimental results were compared with two air overpressure curves of propellant detonation obtained by related scholars. Afterwards, the finite element software AUTODYN was used to simulate the SCM impacted process and SRE detonation results. The penetration process and the formation cause of damage were analyzed. The detonation performance of TNT, reference propellant, and the propellant used in this experiment was compared. The axial acceleration caused by the explosion was also analyzed. By comprehensive comparison, the energy released by the detonation of this propellant is larger, and the HMX or Al particles contained in this propellant are more than the reference propellant, with a TNT equivalent of 1.168–1.196. Finally, advanced protection armor suggestions were proposed based on the theory of woven fabric rubber composite armor (WFRCA).

High efficiency, environmental protection and sustainability have become the main theme of the development of the protection engineering, requiring that the components not only meet the basic functions, but also have chemical properties such as acid and alkali corrosion resistance and aging resistance. Polyisocyanate-oxazodone (POZD) polymer has the above characteristics, it also has the advantages of strong toughness, high strength and high elongation. The concrete slab sprayed with POZD material has excellent anti-blast performance. In order to explore the damage characteristics of POZD sprayed concrete slabs under the action of contact explosion thoroughly, the contact explosion test of POZD concrete slabs with different charges were carried out. On the basis of experimental verification, numerical simulation were used to study the influence of the thickness of the POZD on the blast resistance of the concrete slab. According to the test and numerical simulation results that as the thickness of the coating increases, the anti-blast performance of the concrete slab gradually increases, and the TNT equivalent required for critical failure is larger. Based on the above analysis, empirical expressions on normalized crater diameter, the normalized spall diameter and normalized spall diameter are obtained.

Formation of claudin-10 based tight junctions (TJs) is paramount to paracellular Na+ transport in multiple epithelia. Sequence variants in CLDN10 have been linked to HELIX syndrome, a salt-losing tubulopathy with altered handling of divalent cations accompanied by dysfunctional salivary, sweat, and lacrimal glands. Here, we investigate molecular basis and phenotypic consequences of a newly identified homozygous CLDN10 variant that translates into a single amino acid substitution within the fourth transmembrane helix of claudin-10. In addition to hypohidrosis (H), electrolyte (E) imbalance with impaired urine concentrating ability, and hypolacrimia (L), phenotypic findings include altered salivary electrolyte composition and amelogenesis imperfecta but neither ichthyosis (I) nor xerostomia (X). Employing cellular TJ reconstitution assays, we demonstrate perturbation of cis- and trans-interactions between mutant claudin-10 proteins. Ultrastructures of reconstituted TJ strands show disturbed continuity and reduced abundance in the mutant case. Throughout, both major isoforms, claudin-10a and claudin-10b, are differentially affected with claudin-10b showing more severe molecular alterations. However, expression of the mutant in renal epithelial cells with endogenous TJs results in wild-type-like ion selectivity and conductivity, indicating that aberrant claudin-10 is generally capable of forming functional paracellular channels. Thus, mutant proteins prove pathogenic by compromising claudin-10 TJ strand assembly. Additional ex vivo investigations indicate their insertion into TJs to occur in a tissue-specific manner.

Polyalkenoate cement (PAC) is a promising material for regenerative hard tissue therapy. The ionically rich glass component of PAC encourages bioactive interaction via. the release of essential ions. However, PAC bioactivity is restricted owing to (i) structurally inherent cationic network formers and (ii) surface bacterial biofilm formation. These two factors cause a deficiency in ion release, further complicated by secondary infections and premature therapeutic failure. Here, a multivalent zwitterionic network modifier (mZM) is presented for upregulation of ionic exchange and bioactivity enhancement. By introducing a non-zero charged mZM into PACs, an increase in the proportion of non-bridging oxygen occurs. The network modification promotes ion channel formation, causing a multiple-fold increase in ion release and surface deposition of hydroxy-carbonate apatite (ca. 74%). Experiments ex vivo and animal models also demonstrate the efficient remineralization ability of the mZM. Furthermore, divalent cationic interaction results in bacterial biofilm reduction (ca. 68%) while also influencing a shift in the biofilm species composition, which favors commensal growth. Therefore, PAC modification with mZM offers a promising solution for upregulation of bioactivity, even aiding in customization by targeting site-specific regenerative therapy in future applications.

Long-standing research in animal models and humans with stroke or incomplete spinal cord injury (iSCI) indicate that specific physical training variables, such as the specificity and amount of practice, may influence neurologic recovery and locomotor function. More recent data highlight the contributions of exercise intensity, as estimated indirectly by cardiovascular exertion, as potentially more important than previously considered. The effects of exercise intensity are well described in neurologically intact individuals, although confusion regarding the definitions of intensity and safety concerns have limited its implementation during physical rehabilitation of patients with neurologic injury. The purpose of this review is to delineate some of the evidence regarding the effects of exercise intensity during locomotor training in patients with stroke and iSCI. We provide specific definitions of exercise intensity used within the literature, describe methods used to ensure appropriate levels of exertion, and discuss potential adverse events and safety concerns during its application. Further details on the effects of locomotor training intensity on clinical outcomes, and on neuromuscular and cardiovascular function will be addressed as available. Existing literature across multiple studies and meta-analyses reveals that exercise training intensity is likely a major factor that can influence locomotor function after neurologic injury. To extend these findings, we describe previous attempts to implement moderate to high intensity interventions during physical rehabilitation of patients with neurologic injury, including the utility of specific strategies to facilitate implementation, and to navigate potential barriers that may arise during implementation efforts.

In intermodal transportation, it is essential to balance the trade-off between the cost and duration of a route. The duration of a path is inherently stochastic because of delays and the possibility of overbooking. We study a problem faced by a company that supports shippers with advice for the route selection. The challenge is to find Pareto-optimal solutions regarding the route's costs and the probability of arriving before a specific deadline. We show how this probability can be calculated in a network with scheduled departure times and the possibility of overbookings. To solve this problem, we give an optimal algorithm, but as its running time becomes too long for larger networks, we also develop a heuristic. The idea of this heuristic is to replace the stochastic variables by deterministic risk measures and solve the resulting deterministic optimization problem. The heuristic produces, in a fraction of the optimal algorithm's running time, solutions of which the costs are only a few percent higher than the optimal costs.

Background Endoscopic screening and adherence to a healthy lifestyle are major avenues for colorectal cancer (CRC) prevention. We investigated changes in lifestyles after endoscopic screening. Methods We drew data from 76,303 pairs of time- and age-matched individuals who had and had not, respectively, reported first time endoscopic screening, in the 3 cohorts (Nurses’ Health Study I and II and the Health Professionals Follow-up Study). Detailed information was collected every 2–4 years on endoscopy screening, 12 lifestyle factors (including smoking, physical activity, regular use of aspirin/nonsteroidal anti-inflammatory drugs, body weight, and 8 dietary factors), and adherence to a healthy lifestyle based on a score defined by 5 major lifestyle factors (smoking, alcohol, body weight, physical activity, and diet). We assessed changes in lifestyle from pre- to post-screening periods for the matched pairs. We also conducted subgroup analysis according to screening findings (negative, low- and high-risk polyps, and CRC). Results Endoscopic screening was associated with higher prevalence of adherence to a healthy lifestyle (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.04–1.16). The association strengthened with the severity of the screening findings, with an OR of 1.09 (95% CI, 1.03–1.15) for negative screening, 1.19 (95% CI, 1.07–1.33) for low-risk polyps, 1.42 (95% CI, 1.14–1.77) for high-risk polyps, and 1.55 (95% CI, 1.17–2.05) for CRC. The individual lifestyle factors and diet showed modest change. Conclusions Endoscopic screening was associated with a modest improvement in healthy lifestyles, particularly in individuals with more severe endoscopic findings. Further efforts of integrating lifestyle medicine into the screening setting are needed, to better leverage the teachable moment in improving CRC prevention.

Introduction The topic of healthcare human resource planning for diagnostic radiographers has received limited research attention to date. This research is concerned with developing a framework that can be used to determine diagnostic radiographer staffing requirements at a unit- or department level (i.e. at the micro-level). Methods An inductive approach is applied to formulate requirement specifications that inform the development of the framework. A number of verification and validation activities are performed, including theoretical verification and a case study application. Results The diagnostic radiographer staffing framework consists of seven steps that comprise a workload-based approach to determining the number of full time equivalent diagnostic radiographers that are required for each modality, or group of modalities. Both clinical and non-clinical activities are considered, and guidance is provided on calculating staffing requirements to cover leave allowances. A number of potential approaches to determining activity times are also discussed. Conclusion The framework represents a holistic approach to determining the required number of diagnostic radiographers at a practice-level, that is designed to remain relevant as technological advances are made in the field of diagnostic radiography. Implications for practice By providing a practical guideline, with accompanying examples, the framework is expected to hold value for individuals involved in the management of diagnostic radiography practices. The framework proposes an approach to a topic that affects every radiography practice in operation yet has received limited attention in literature to date.

Signals from the peripheral retina are important for myopia development. Unlike temporal vision, deficits in peripheral spatial visual functions of myopes have been investigated previously. This study investigated temporal contrast thresholds in emmetropes and myopes at different retinal eccentricities.Forty-four young adults (mean age 23 ± 3 years) including 21 emmetropes (Spherical Equivalent (SE): +0.01 ± 0.30D) and 23 myopes (SE: -3.98 ± 2.41D) participated in this prospective study. Flicker modulation thresholds (FMT) were determined monocularly (right eye) for 15 Hz flicker stimulus at 0°, nasal (23°, 10°) and temporal (-23°, -10°) retinal eccentricities along the horizontal meridian. FMTs were measured psychophysically using 5-adaptive interleaved staircases and threshold was taken as the average of the last 6 reversals.In both the groups (emmetropes and myopes), there was a naso-temporal asymmetry in FMTs with higher thresholds in the far temporal retina (Median; Interquartile range: 40.97%; 17.06) than the nasal retina (28.07%; 9.36) (p0.001). Flicker modulation thresholds were significantly higher in myopes (30.58%; 12.15) compared to emmetropes (26.77%; 7.74; p = 0.04) at far nasal retina (23°), while at other eccentricities there was no effect (p0.05). Further sub-analysis revealed only high myopes (34.48 %, 21.9) showed significantly higher FMT compared to emmetropes (26.77%; 7.74; p = 0.04).Greater FMTs were seen in high myopes than that of emmetropes in the nasal retina. Further studies exploring the structural aspects of the myopic eye with FMT would provide a better understanding of role of flicker sensitivity in myopiogenesis.

Background and Aims We explored the associations among fruit consumption, physical activity and their dose-response relationship with all-cause and cardiovascular disease (CVD) mortality in type 2 diabetic patients. Methods and Results We prospectively followed 20,340 community-dwelling type 2 diabetic patients aged 21-94 years. Information on diets and physical activity was collected using standardized questionnaires. All-cause and CVD mortality were assessed. Hazard ratios (HRs) for all-cause mortality were estimated with Cox regression models, and HRs for CVD mortality were derived from a competing risk model. Restricted cubic spline regression was used to analyse dose-response relationships. We identified 1,362 deaths during 79,844 person-years. Compared to non-consumption, fruit consumption >42.9 g/d was inversely associated with all-cause mortality (HR 0.76; 95% CI 0.64-0.88), CVD mortality (HR 0.69, 0.51-0.94) and stroke mortality (HR 0.57, 0.36-0.89), but not with heart disease mortality (HR 0.93, 0.56-1.52). The HRs comparing the top vs bottom physical activity quartiles were 0.44 (0.37-0.53) for all-cause mortality, 0.46 (0.33-0.64) for CVD mortality, 0.46 (0.29-0.74) for stroke mortality and 0.51 (0.29-0.88) for heart disease mortality. Lower fruit consumption combined with a lower physical activity level was associated with a greater mortality risk. A nonlinear threshold of 80 g fruit/day was identified, all-cause mortality risk was reduced by approximately 24% at this value. A physical activity threshold of 8 metabolic equivalents (MET) h/day was also identified, after which the risk of mortality did not decrease. Conclusions Fruit consumption and physical activity may reduce all-cause, CVD and stroke mortality in type 2 diabetic patients.

Purpose To retrospectively investigate the clinical and functional outcomes of patients who underwent knotted medial-row rotator cuff repair (KT-RCR) compared with patients who underwent knotless medial-row rotator cuff repair (KL-RCR). Methods A retrospective chart review of patients who underwent double-row transosseous-equivalent rotator cuff repair in 2016 was performed at a single institution with 2-year follow-up. Information regarding demographic characteristics, preoperative tear size (magnetic resonance imaging), surgical variables (including method of suture stabilization), preoperative and postoperative American Shoulder and Elbow Surgeons (ASES) scores, and all complications (e.g., cuff failure, adhesive capsulitis, and persistent pain) was compiled. Results A total of 189 patients met the inclusion criteria: 72 in the KL-RCR group and 117 in the KT-RCR group. No significant difference in preoperative ASES scores was found between the KL-RCR and KT-RCR groups (48.3 vs 45.4, P = .327). Postoperative ASES scores did not differ between the groups (82.4 for KL-RCR vs 78.8 for KT-RCR, P = .579). We found no significant difference in cuff failure rates after 2 years, determined by magnetic resonance imaging (5.6% for KL-RCR vs 6.1% for KT-RCR, P > .999), or complication rates (11.1% for KL-RCR vs 8.6% for KT-RCR, P = .743). Conclusions The knotted approach and knotless approach to double-row rotator cuff repair showed similar outcome scores, cuff failure rates, and complication rates at minimum 2-year follow-up. Level of Evidence Level III, retrospective therapeutic comparative trial.

In this study, natural radioactivity concentration and dosimetric values of fly ash samples were collected and evaluated from the landfill area of the coal-fired power plant (CFPP) complex at Binh Thuan, Vietnam. The average activity concentration of 238U, 226Ra, 232Th and 40K were 93, 77, 92 and 938 Bq kg−1, respectively. The average results of for radon dose, indoor external, internal, and total effective dose equivalent (TEDE) were 5.27, 1.22, 0.16, and 6.65 mSv y−1, respectively. The average emanation faction for fly ash were 0.028. The excess lifetime cancer risks (ELCR) were recorded as 20.30 × 10−3, 4.26 × 10−3, 0.62 × 10−3, and 25.61 × 10−3 for radon, indoor, outdoor exposures, and total ELCR, respectively. The results indicated that the cover of shielding materials above the landfill area significantly decreased the gamma radiation from the ash and slag in the ascending order: Geoline

PURPOSE To compare the biomechanical properties of the knotted versus knotless transosseous-equivalent (TOE) techniques for rotator cuff repair (RCR). METHODS A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using PubMed, Embase, and the Cochrane Library to identify studies that compared the biomechanical properties of knotted and knotless TOE RCR techniques. The search phrase used was as follows: (Double Row) AND (rotator cuff) AND (repair) AND (biomechanical). Evaluated properties included ultimate load to failure, cyclic displacement, stiffness, footprint characteristics, and failure mode. RESULTS Eight studies met the inclusion criteria, including a total of 67 specimens in each group. Of 6 studies reporting on ultimate load to failure, 4 found tendons repaired with the knotted TOE technique to experience significantly higher ultimate load to failure compared with knotless TOE repairs (knotted range, 323.5-549.0 N; knotless range, 166.0-416.8 N; P < .05). Of 6 studies reporting on failure stiffness, 2 found knotted TOE repairs to have significantly higher failure stiffness compared with knotless TOE repairs (knotted range, 30.0-241.8 N/mm; knotless range, 28.0-182.5 N/mm; P < .05), whereas 1 study found significantly higher failure stiffness in knotless TOE repairs compared with knotted TOE repairs (P = .039). Cyclic gap formation favored the knotted TOE group in 2 of 3 studies (knotted range, 0.6-5.2 mm; knotless range, 0.4-9.1 mm; P < .05). The most common mode of failure in both groups was suture tendon tear. CONCLUSIONS On the basis of the included cadaveric studies, rotator cuff tendons repaired via the knotted TOE technique display superior time-zero biomechanical properties, including greater ultimate load to failure, compared with rotator cuffs repaired via the knotless TOE technique. Suture tearing through the tendon remains a common failure method for both techniques. CLINICAL RELEVANCE The results of this systematic review provide helpful insight into the biomechanical differences between 2 popular techniques for RCR. Although these results should be carefully considered by surgeons who are using either of these techniques in the operating room, they should not be mistaken for direct clinical applicability because cadaveric studies may not directly correlate to clinical outcomes.

PURPOSE To elucidate clinical factors related to the presence of loculation of fluid (LOF) in the posterior choroid in central serous chorioretinopathy (CSC). DESIGN Retrospective, cross-sectional study. METHODS This single-center study included 158 eyes from 158 patients with CSC who were classified into LOF and non-LOF groups. The groups were compared for age, sex, spherical equivalent, axial length, subfoveal choroidal thickness (SCT), and scleral thickness. Using swept-source optical coherence tomography (OCT), we determined the presence of LOF based on B-scan and en face images. Scleral thickness was measured 6 mm posterior to the scleral spur in four directions using anterior segment OCT. RESULTS The 158 eyes were classified into 98 eyes in the LOF group and 60 eyes in the non-LOF group. In univariable analyses, the LOF group was younger (P = .01) and had a higher male ratio (P = .03) and greater SCT (P < .001) than the non-LOF group. All scleral thicknesses at the superior, temporal, inferior, and nasal points were greater in the LOF group than in the non-LOF group (426.2 μm vs. 395.1 μm, 445.7 μm vs. 414.9 μm, 459.2 μm vs. 428.8 μm, 445.4 μm vs. 414.3 μm, all P < .05). Multivariable analyses found that SCT (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01-1.02, P < .001) and mean scleral thickness (OR: 1.02, 95% CI: 1.02-1.03, P = .002) were significantly associated with the presence of LOF. CONCLUSION A thick choroid and thick sclera appeared to be related to the presence of LOF in CSC.

This research was supported by the project MAT2017-82182-R funded by the State Research Agency (SRA) of Spain and European Regional Development Fund (ERDF). Funding for open access charge: Universidad de Granada / CBUA, Hypothesis: Ice adhesion to rigid materials is reduced with low energy surfaces of high receding contact angles. However, their adhesion strength values are above the threshold value to be considered as icephobic materials. Surface deformability is a promising route to further reduce ice adhesion. Experiments: In this work, we prepared elastomer surfaces with a wide range of elastic moduli and hydrophobicity degree and we measured their ice adhesion strength. Moreover, we also explored the deicing performance of oil-infused elastomeric surfaces. The ice adhesion was characterized by two detachment modes: tensile and shear. Findings: The variety of elastomeric surfaces allowed us to simultaneously analyze the ice adhesion dependence with deformability and contact angle hysteresis. We found that the impact of these properties depends on the detachment mode, being deformability more important in shear mode and hydrophobicity more relevant in tensile mode. In addition, oil infusion further reduces ice adhesion due to the interfacial slippage. From an optimal balance between deformability and hydrophobicity, we were able to identify surfaces with super-low ice adhesion., MAT2017-82182-R State Research Agency (SRA), European Regional Development Fund (ERDF), Universidad de Granada / CBUA

To compare the long-term results of Descemet's stripping automated endothelial keratoplasty (DSAEK) and Descemet's membrane endothelial keratoplasty (DMEK) in fellow eyes for treatment of Fuchs endothelial corneal dystrophy.This study is a 2-centered, retrospective case series of 64 patients (128 eyes) with DSAEK followed by DMEK. The main outcomes measured were best spectacle-corrected visual acuity (BSCVA) and duration of time to achieve BSCVA as well as eye preference.Preoperative median logarithm of the minimum angle of resolution (logMAR) BSCVA was similar in eyes receiving DMEK 0.36 ± 0.26 and DSAEK 0.42 ± 0.34 (P = .266). The average follow-up time needed for the DMEK eyes to achieve BSCVA was faster than that of DSAEK (277 days vs 490 days, P = .0014). With long-term follow-up, the BSCVA of the DMEK eyes [0.09 ± 0.10 logMAR] and DSAEK eyes [0.11 ± 0.16 logMAR] did not show a statistically significant difference (P = .069). Twenty-two of the 64 preferred the DMEK eye, 17 patients preferred the DSAEK eye (P = .423), and 25 patients did not have a preference. In the DMEK group, the average spherical equivalent was -0.08 compared with the DSAEK group at 0.06 (P = .2854).In our fellow eye study with long-term follow-up, DMEK and DSAEK had comparable levels of BSCVA and patient satisfaction. The DMEK eyes reached their BSCVA sooner, whereas the DSAEK eyes improved over a longer time frame. A greater number of patients had 20/25 and 20/20 vision in the DMEK group; however, the difference was not statistically significant. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

Background Rotator cuff injuries have traditionally been managed by either single-row or double-row arthroscopic repair techniques. Complex single-row techniques have recently been proposed as a biomechanically stronger alternative treatment option. However, no rigorous meta-analysis has evaluated the effectiveness of complex single-row against double-row repair. This meta-analysis aims to evaluate clinical outcomes in patients with full-thickness rotator cuff injuries treated with both simple and complex single-row, as well as transosseous-equivalent (TOE) double-row procedures. Methods An up-to-date literature search was performed using the pre-defined search strategy. All studies that met the inclusion criteria were assessed for methodological quality and included in the meta-analysis. Pain, functional scores, range-of-motion and re-tear rate were all considered in the study. Conclusion The results of our meta-analysis suggest that there is no significant difference between complex single-row and TOE double-row in any of the observed outcomes. At this point in time, the available comparative data between simple single row and transosseous equivalent double row repair techniques is limited. Further high-quality studies are required in order to assess the clinical outcomes and cost-effectiveness of these different techniques.

Summary Objective To investigate the differences between the amblyopic eye and the fellow eye in adults with anisometropic amblyopia. Materials and methods Measurements of the central macular thickness [CMT], subfoveal choroidal thickness [SFCT], and retinal nerve fiber layer [RNFL] in patients with anisometropic amblyopia were obtained using optical coherence tomography [OCT]. Axial length [AL], anterior chamber depth [ACD], and central corneal thickness [CCT] were measured with optical biometry. All 12 parameters were compared between the amblyopic eye [Group 1] and the fellow eye [Group 2]. Results A total of 110 eyes of 55 patients [9 myopic, 46 hypermetropic] were analyzed retrospectively. The ages of the patients ranged from 17 to 55 years, with a mean of 30.8 ± 10.7 years. 56.4% [n = 31] of the patients were female, and 43.6% [n = 24] were male. The mean spherical equivalent [SE] was 1.96 ± 3.79 in Group 1 and 1.28 ± 2.45 in Group 2. SFCT was 312.00 ± 53.03 in Group 1 and 283.47 ± 51.91 in Group 2. AL was 22.53 ± 1.40 in Group 1 and 22.79 ± 1.18 in Group 2. SE, SFCT, and AL were statistically significantly different between the two groups. There was no difference between the two groups in terms of CMT, RNFL , ACD and CCT values. Conclusion In adults with anisometric amblyopia, the SFCT of the amblyopic eye is greater than that of the fellow eye. The choroid plays an important role in the nutrition of the retinal layers, the development of ocular function and refractive error, and its development may be affected by the refractive error. Since the majority of our patients were hyperopic, the AL was found to be shorter in the amblyopic eye. CMT, RNFL, ACD and CCT values were the similar in both groups. There was no clinically significant relationship between biometric parameters and OCT parameters.

Among different modes for municipal solid waste separate collection (SC), there is a lack of scientifically based methods for their selection available for decision-makers. This study develops and applies a methodology based on Multi-Criteria Decision Analysis (MCDA) aiming to assess and compare the sustainability of different waste management schemes. Considering the city of Bari (Southern Italy) as a supporting case study, 3 systems/visions of city waste management options are considered: (i) bring points systems with about 35% SC rate (S1, status quo); (ii) door-to-door system with an excellent (>80%) SC rate (S2); (iii) combined bring point and door-to-door system (S3, with about 70% SC rate). Scenarios differed mainly on the management of the residual fraction from SC through mechanical-biological treatment (S1 and S2) or recovery of recyclables at material recovery facility (S3). Sustainability is assessed in environmental, economic, and socio-technical terms by means of MCDA and Life Cycle Assessment (LCA). Results showed that S2 is the best solution in global, environmental, and socio-technical terms, while the weak point is the cost (65.76 € per capita). Even more interesting is the limited deviation between S3 and S2 indicators, amounting to 5.4% and 9.4% in terms of environmental and socio-technical criteria respectively, suggesting a strong competitiveness of the mixed collection mode. Methodologically, the approach proved to be robust and easy to apply by local authority decision-makers.

Two-dimensional material membranes with fast transport channels and versatile chemical functionality are promising for molecular separation. Herein, for the first time, we reported design and engineering of two-dimensional Ti3C2Tx MXene (called transition metal carbides and nitrides) membranes supported on asymmetric polymeric hollow fiber substrate for water desalination. The membrane morphology, physicochemical properties and ions exclusion performance were systematically investigated. The results demonstrated that surface hydrophilicity and electrostatic repulsion and size sieving effect of interlayer channels synergistically endowed the MXene hollow fiber membrane with fast water permeation and efficient rejection of divalent ions during nanofiltration process.

Lectins from plants of the Diocleinae subtribe often exhibit specificity towards mannose/glucose and derived sugars, with some plants also displaying a second lectin specific to lactose/GalNAc. Here, we present a novel lectin from Collaea speciosa, named CsL, that displays specificity for GlcNAc/glucose. The lectin was extracted from Collaea speciosa seeds and purified by a single chromatographic step on a Sephadex G-50 matrix. In solution, the lectin appears as a dimeric protein composed of 25 kDa monomers. The protein is stable at pH 7–8 and dependent on divalent cations. CsL maintained its agglutination activity after heating to 90 °C for 1 h. Glycan array studies revealed that CsL binds to N-glycans with terminal GlcNAc residues, chitobiose and chitotriose moieties. The partial amino acid sequence of the lectin is similar to that of some lactose-specific lectins from the same subtribe. In contrast to other ConA-like lectins, CsL is not toxic to Artemia. Because of its remarkably different properties and specificity, this lectin could be the first member of a new group inside the Diocleinae lectins.

Objective: To analyze opioid intake interference with psychological, well-being, and functional outcomes and medication tapering in patients with fibromyalgia admitted to the Mayo Clinic Pain Rehabilitation Program (MCPRP) in Florida. Patients and Methods: A retrospective study on MCPRP outcomes was conducted. We reviewed the health records of 150 patients with fibromyalgia who participated in the program from May 1, 2014, to May 1, 2015. All patients were asked to fill out a survey at admission to and dismissal from the program. Surveys contained questions from the numeric pain score, Multidimensional Pain Inventory (perceived life control and interference of pain subscales), Center for Epidemiological Studies–Depression Scale, Pain Catastrophizing Scale, 36-Item Short-Form Health Status Survey (general health perceptions subscale), and Pain Self-Efficacy Questionnaire. A medical record review identified categories and number of medications at program admission and dismissal. Patients were divided in 2 groups: those whose concomitant medication did not include opioids at admission (no opioids group) and those whose concomitant medication included opioids at admission (opioids group). Results: By dismissal from the MCPRP, patients with fibromyalgia in the no opioids group had a significant (P

Purpose To investigate the association between smartphone use and refractive error in teenagers using the Myopia app. Design Cross-sectional population-based study. Participants A total of 525 teenagers 12 to 16 years of age from 6 secondary schools and from the birth cohort study Generation R participated. Methods A smartphone application (Myopia app; Innovattic) was designed to measure smartphone use and face-to-screen distance objectively and to pose questions about outdoor exposure. Participants underwent cycloplegic refractive error and ocular biometry measurements. Mean daily smartphone use was calculated in hours per day and continuous use as the number of episodes of 20 minutes on screen without breaks. Linear mixed models were conducted with smartphone use, continuous use, and face-to-screen distance as determinants and spherical equivalent of refraction (SER) and axial length-to-corneal radius (AL:CR) ratio as outcome measures stratified by median outdoor exposure. Main Outcome Measures Spherical equivalent of refraction in diopters and AL:CR ratio. Results The teenagers on average were 13.7 ± 0.85 years of age, and myopia prevalence was 18.9%. During school days, total smartphone use on average was 3.71 ± 1.70 hours/day and was associated only borderline significantly with AL:CR ratio (β = 0.008; 95% confidence interval [CI], –0.001 to 0.017) and not with SER. Continuous use on average was 6.42 ± 4.36 episodes of 20-minute use without breaks per day and was associated significantly with SER and AL:CR ratio (β = –0.07 [95% CI, –0.13 to –0.01] and β = 0.004 [95% CI, 0.001–0.008], respectively). When stratifying for outdoor exposure, continuous use remained significant only for teenagers with low exposure (β = –0.10 [95% CI, –0.20 to –0.01] and β = 0.007 [95% CI, 0.001–0.013] for SER and AL:CR ratio, respectively). Smartphone use during weekends was not associated significantly with SER and AL:CR ratio, nor was face-to-screen distance. Conclusions Dutch teenagers spent almost 4 hours per day on their smartphones. Episodes of 20 minutes of continuous use were associated with more myopic refractive errors, particularly in those with low outdoor exposure. This study suggested that frequent breaks should become a recommendation for smartphone use in teenagers. Future large longitudinal studies will allow more detailed information on safe screen use in youth.

Inorganic pyrophosphatase catalyzes the conversion of pyrophosphate to phosphate and is often critical for driving reactions forward in cellular processes such as nucleic acid and protein synthesis. Commonly used methods for quantifying pyrophosphatase enzyme activity employ reacting liberated phosphate with a second molecule to produce absorbance changes or employing a second enzyme in coupled reactions to produce a product with a detectable absorbance. In this investigation, a novel [31P]-NMR spectroscopy-based assay was used to quantitatively measure the formation of phosphate and evaluate the activity of inorganic pyrophosphatase from the thermoacidophilic Crenarchaeota Sulfolobus islandicus. The enzymatic activity was directly measured via integration of the [31P] resonance associated with the phosphate product (δ = 2.1 ppm). Sulfolobus islandicus inorganic pyrophosphatase preferentially utilized Mg2+ as divalent cation and had pH and temperature optimums of 6.0 of 50 °C, respectively. The Vmax value was 850 μmol/min/mg and the Km for pyrophosphate was 1.02 mM. Sequence analysis indicates the enzyme is a Family I pyrophosphatase. Sulfolobus islandicus inorganic pyrophosphatase was shown to be inhibited by sodium fluoride with a IC50 of 2.26 mM, compared to a IC50 of 0.066 mM for yeast inorganic pyrophosphatase. These studies reveal that a [31P]-NMR spectroscopy-based assay is an effective method for analyzing catalysis by phosphate-producing enzymes.

Numerous incidents have illustrated that lithium-ion batteries are flammable and thermally unstable when used improperly or at high temperature. Decomposition reactions further increase the possibility of fire and explosion. Polymer electrolytes have been partially applied to commercial lithium-ion polymer batteries (LIPBs) and determined to improve their thermal stability at high temperature. To determine the degree of thermal stability conferred by a polymer electrolyte and enable its future application to various battery types under different combination modes, this study conducted adiabatic thermal tests to simulate and analyse the thermal runaway curves of LIPBs under various states of charge (SOC) by conducting thermodynamic evaluations. Combining the simulation kinetic model, the pseudo-first-order model was fitted to the self-heating reaction of the polymer electrolyte. In a typical explosion, the LIPB had a TNT equivalent mass of 0.028 g in a nitrogen atmosphere and 0.023 g under ambient conditions. Moreover, under a limited overpressure (2068.4 Pa; 0.3 psig), the safety distance of the LIPBs was 1.66 m in a nitrogen atmosphere and 5.79 m in an air atmosphere. In addition, the value of pressure increased from 2.90 to 22,476.9 Pa within 0.2 m in the case of an SOC change from 30% to 100 % in a nitrogen atmosphere. In the same distance, the blast pressure of an LIPB in the nitrogen atmosphere was 43% higher than that in ambient air. Combined with the thermal analysis data and kinetic model, the thermal stability results for the various SOCs of the polymer electrolyte were confirmed in calculating the reaction kinetics and key safety parameters in nitrogen and air environments.

Thiamine hydrochloride (TH) was thought to exert a good insect repellent activity. The purpose of this work was to develop a formulation that releases TH in sustained regimen on human skin. Long lasting protection against mosquito bites was achieved. Pullulan acetate (PA) was used to prepare TH nanospheres. Optimal system was incorporated in Pluronic® hydrogel. Formulae were tested for in-vitro release and ex-vivo permeation. Complete protection time (CPT) was done adopting Kaplan-Meier survival function for the synthetic repellent (DEET), TH solution and nanospheres in hydrogel. Release profile of TH solution, nanospheres and nanosphere-loaded hydrogel (DG) demonstrated an added effect of DG, where t 1/2 was 11.2 ± 1.4 h. SEM for DG showed homogenous dispersion of nanospheres inside the matrix of the gel. Ex-vivo permeation showed only 0.761 ± 0.04% of TH in hydrogel permeated the skin after 12 h, while 44.98 ± 3.2% permeated when TH solution was applied. Clinical study revealed a significant difference in CPT between TH solution with either DEET or (DG) (p 0.05). The high efficacy of TH-loaded hydrogel rendered it a successful alternative for DEET, offering long protection against mosquito bites.

Protein quality is an important component of protein intake to support growth, development, and maintenance of essential body tissues and functions. Therefore, protein quality should be emphasized as a key characteristic during protein food selection within the larger context of healthy dietary patterns, especially when considering the wide variance of protein quality across animal- and plant-based foods. However, the USDA Dietary Guidelines for Americans (DGA) do not address specific protein quality recommendations within their protein foods ounce equivalents guidance or as a component of Healthy U.S. Style, Healthy Vegetarian, and Healthy Mediterranean Style dietary patterns. In addition, the protein foods ounce equivalents within the DGA are not established on any obvious metabolic equivalency characteristic [i.e., energy, protein, or essential amino acid (EAA) content], which creates misleading messaging of equivalent functional and metabolic benefit across protein foods. EAA content is a key characteristic of protein quality and can be a practical focal point for protein intake recommendations and achieving healthy dietary patterns. This review discusses the importance of protein quality, the state of messaging within DGA recommendations, and proposes EAA density (i.e., EAA content relative to total energy) as one practical approach to improve current dietary recommendations. Two recent publications that evaluated the DGA protein foods ounce equivalents based on metabolic effect and their application within DGA recommended dietary patterns are discussed.

Dengue fever is a common mosquito-borne viral infectious disease in the world and is widely spread, especially in tropical and subtropical regions. At this moment, one of the best ways to fight the disease is to prevent mosquito bites. In this study, we present a mathematical model that carefully considers personal protection for humans. It is an epidemiological model that translates the dengue disease through a system of differential ordinary equations which takes in consideration the dynamics of the disease between human and mosquito populations. This model incorporates a parameter that simulates personal protection measures, namely insect repellent, special clothes, or bed nets, and a parameter that asserts the effectiveness of public awareness to the importance of using personal protective equipment. In 2012 there was a dengue disease outbreak in Madeira Island, in Portugal, and this study not only tries to predict what could happen if a second outbreak occurs, where it is considered that there are two serotypes of Dengue disease, but also tries to predict the effects and the importance of taking personal protection measures. The results show that the level of personal measures and the time that people are compelled to use them have a significant impact to prevent dengue disease.

Background: Mediated by outcomes such as improved exercise capacity, cardiac rehabilitation (CR) reduces morbidity and mortality. For accuracy, an individual CR patient's change must be measured reliably, an issue not typically considered in practice. Drawing from psychometric theory, we calculated reliable change indices (RCIs), to measure individual CR patients’ true clinical change, apart from that from error and test practice/exposure, in exercise capacity, anxiety, and depression. Methods: Indirectly calculated exercise capacity (peak metabolic equivalents [METs]) and psychological symptoms were each measured twice, 1 week apart, by administering treadmill tests or the Hospital Anxiety and Depression Scale (HADS) to separate samples of 35 (mean age: 59.0 years; 6 women) and 96 (mean age: 64.4 years; 32 women) CR patients, respectively. Using test-retest reliability and mean difference scores from these samples to estimate error and practice/exposure effects, we calculated RCIs for a separate cohort (n = 2066; mean age: 62.0 years; 533 women) who completed 6-month CR, and compared change distributions (worsened/unchanged/improved) based on critical RCIs, mean and percent changes, cut-off scores, and standard deviations. Results: Practice/exposure effects were nonsignificant, except the mean HADS anxiety score decreased significantly (P ≤ 0.013; d = 0.17, small effect). Test-retest reliabilities were high (METs r = 0.934; HADS anxiety score r = 0.912; HADS depression score r = 0.90; P < 0.001). Among 2066 CR patients, RCI distributions differed (P < 0.001) from those of most other change criteria. Conclusions: Change ascertainment depends on criterion choice. A Canadian Cardiovascular Society CR quality indicator of increase by 0.5 MET may be too small to assess individuals’ functional capacity change. RCIs offer a pragmatic approach to benchmarking reliable change frequency, and pending further validation, could be used for feedback to individual patients. Résumé: Contexte: Grâce à des résultats tels que l'amélioration de la capacité d'exercice, la réadaptation cardiaque (RC) réduit la morbidité et la mortalité. Pour être précis, le changement de RC d'un patient doit être mesuré de manière fiable, un aspect qui n'est généralement pas pris en compte dans la pratique. En nous inspirant de la théorie psychométrique, nous avons déterminé des indices de changement fiables afin de mesurer le véritable changement clinique individuel des patients en RC en lien avec la capacité d'entraînement, l'anxiété et la dépression et indépendamment des erreurs et de la pratique du test/l'exposition au test. Méthodologie: La capacité d'entraînement calculée indirectement (l’équivalent métabolique maximum [MET]) et les symptômes psychologiques ont été mesurés deux fois, à une semaine d'intervalle, par le biais de tests sur tapis roulant ou de l’échelle de l’évaluation de l'anxiété et de la dépression en milieu hospitalier (HADS), auxquels ont respectivement été soumis des échantillons de 35 personnes en RC (âge moyen : 59,0 ans; 6 femmes) et de 96 personnes en RC (âge moyen : 64,4 ans; 32 femmes). En recourant à la fiabilité test-retest et aux écarts moyens dans les scores de ces échantillons pour faire une approximation des effets d'erreur et de pratique/exposition, nous avons déterminé des indices de changement fiables pour une cohorte distincte (n = 2 066; âge moyen : 62,0 ans; 533 femmes) qui a terminé une RC de six mois, et comparé la répartition des changements (aggravé/inchangé/amélioré) sur la base des indices de changement fiables critiques, des changements moyens et en pourcentage, des scores-seuils et des écarts types. Résultats: Les effets de la pratique/exposition étaient peu significatifs, sauf une diminution du score moyen de l'anxiété sur l’échelle HADS (p ≤ 0,013; d = 0,17, petit effet). La fiabilité test-retest était élevée (MET, r = 0,934; score de l'anxiété sur l’échelle HADS, r = 0,912; score de la dépression sur l’échelle HADS, r = 0,90; p < 0,001). Parmi les 2 066 patients en RC, la répartition des indices de changement fiables différait (p < 0,001) de celle de la plupart des autres critères de changement. Conclusions: Le constat du changement dépend du choix du critère. Une augmentation de 0,5 MET selon l'indicateur de qualité en RC de la Société canadienne de cardiologie est peut-être trop faible pour évaluer le changement de capacité fonctionnelle des individus. Les indices de changement fiables offrent une approche pragmatique pour comparer la fréquence du changement fiable et, en attendant une vérification plus poussée, ils pourraient être utilisés comme rétroaction fournie individuellement aux patients.

Objective To develop a score from cumulative dietary risk factors and examine its nonlinear associations with cardiovascular disease (CVD) and cancer incidence and mortality, as well as all-cause mortality. Patients and Methods There were 422,702 participants from UK Biobank included in this prospective study. Cumulative dietary risk factors were represented using a score ranging from 0 (healthiest) to 9 (least healthy). This was derived from 9 food items based on current UK guidelines using baseline data. Associations between the cumulative score and health outcomes were investigated using nonlinear penalized cubic splines fitted in Cox proportional hazard models. Follow-up was conducted until June 2020 for mortality, and for incidence, up to June 2020 in England and March 2017 in Wales and Scotland. Results The median follow-up period was 9.0 years for incidence outcomes and 9.3 years for mortality outcomes. Each 1-point increment in the cumulative dietary risk factors score was associated with higher risk for incidence and mortality of the outcomes studied. The highest risks were identified for mortality due to heart failure (8.0% higher), CVD, and ischemic heart disease (both 7.0% higher). In addition, a higher diet score accounted for 18.8% of all deaths, 4.47% of incident cases of CVD, 25.5% of CVD deaths, 7.7% of incident cancers, and 18.2% of all cancer deaths. Conclusion Our findings show that dietary risk factors contributed to a large proportion of CVD and cancer events, as well as deaths, among those who did not meet most dietary recommendations.

Hypothesis Self-similarity is a scale-invariant irregularity that can assist in designing a robust superhydrophobic material. A combinatorial design strategy involving self-similarity and dual-length scale can be employed to create a new library of a doubly re-entrant, disordered, and porous network of superhydrophobic materials. Asymmetric wettability can be engineered in nonwoven materials by rendering them with superhydrophobic characteristics on one side. Experiments A facile, scalable, and inexpensive spray-coating technique was used to decorate the weakly hydrophobic stearate-treated titanate nanowires (TiONWs) over the self-similar nonwoven material. Laser scanning confocal microscopy was employed to image the impalement dynamics in three dimensions. With the aid of X-ray microcomputed tomography analysis, the three-dimensional (3D) nonwoven structural parameters were obtained and analyzed. The underwater superhydrophobic behavior of the prepared samples was investigated. Findings A classic 'lotus effect' has been successfully endowed in self-similar nonwoven-titanate nanostructured materials (SS-Ti-NMs) from a nonwoven material that housed the air pockets in bulk and water repellent TiONWs on the surface. The finer fiber-based SS-Ti-NMs exhibited lower roll-off angles and a thinner layer of water on its surface. An asymmetric wettability and the unusual display of underwater superhydrophobic behavior of SS-Ti-NMs have been uncovered.

Zika, dengue, and Yellow fever are transmitted primarily by Aedes aegypti mosquitoes. Investigations to find more natural but highly effective pesticidal agents against Ae. aegypti have increased in the last few years. Plant-based compounds have been the source of several current pesticides and have provided models for creation of synthetic derivatives like the pyrethroids. Plants continue to be a rich source for potential new active ingredients. The aim of this study is to increase knowledge on V. dioscoridis and to present the results of the cytotoxic and insecticidal activities of various extracts of its roots and volatile compound compositions of roots. The hexane and chloroform extracts, HM1 and CM1 respectively, exhibited cytotoxicity with IC50 values of 128.4 and 86.93 mg/mL against the HepG2 cell line. Because CM1 had higher cytotoxicity across the studied concentration range, it was also tested against the HUVEC cell line. Extracts HM1 and CM1 were also tested for their insecticidal activities. CM1 was found to be the more active (mortality (\%) = 96.7\% +/- 5.8 at 5 mu g/mosquito), consistent with its cytotoxic activity. Since these active extracts were nonpolar, the chemical composition of the volatile compounds of the roots were analyzed by GC-MS analysis. About 87.7\% of the essential oil were characterized. The major compound was beta-eudesmol (9.2\%), following by camphene (8.9\%), bornyl acetate (8.2\%) and maaliol (7.6\%). This is the first study on the HepG2 and HUVEC cytotoxicity and insecticidal activity of V. dioscoridis. Further studies on the potential of this plant to define the spectrum of activity and examine potential therapeutic agents is warranted. (C) 2021 SAAB. Published by Elsevier B.V. All rights reserved.

BACKGROUND: Plant-rich diets are associated with lower cardiometabolic risks and longer survival in the general population, but their association with mortality in cancer survivors is still unclear. OBJECTIVES: We aimed to examine the associations of 3 postdiagnostic plant-based diet indices with all-cause mortality in omnivorous long-term colorectal cancer (CRC) survivors. METHODS: Diet was assessed with FFQs at a median of 6 years after diagnosis in 1404 CRC survivors (56% male; median age, 69 years) in a Northern German prospective cohort study. An overall, a healthful plant-based, and an unhealthful plant-based diet index were derived by scoring intakes of animal foods reversely and intakes of healthy (whole grains, vegetables, fruits, legumes, nuts, oils, tea/coffee) and less healthy plant foods (refined grains, fruit juices, sugar-sweetened beverages, potatoes, sweets/desserts) positively or reversely, depending on the index. Vital status follow-up was conducted via population registries. Cox proportional hazards regression was applied to estimate HRs for all-cause mortality according to plant-based diet adherence. RESULTS: Within 7 years (median) after diet assessment, 204 deaths occurred. The overall plant-based diet index displayed a significant, inverse association with all-cause mortality (HR per 10-point increase in diet index, 0.72; 95% CI, 0.57–0.91). Although not statistically significant, higher healthful plant-based diet scores showed a strong tendency towards lower mortality (HR, 0.82; 95% CI, 0.67–1.01). The unhealthful plant-based diet index was associated with higher mortality, but lost statistical significance after multivariable adjustment (HR, 1.19; 95% CI, 0.96–1.48). A subgroup analysis revealed that the tendency towards a positive association of the unhealthful plant-based diet with mortality was restricted to less physically active individuals (

Objective To evaluate physician perceptions and attitudes toward telemedicine use at a tertiary care academic institution in northeast Florida during the coronavirus disease 2019 pandemic. Patients and Methods An anonymous 38-question cross-sectional survey was developed using Qualtrics survey software (Qualtrics) and e-mailed to all staff physicians from all specialty disciplines at Mayo Clinic in Florida. The survey was open from August 17, 2020, through September 1, 2020. Collected data included general demographic characteristics and employment information, attitude and experience with telemedicine use before and during the coronavirus disease 2019 pandemic, perception of patients’ experience, and the effect of telemedicine on burnout. Results The survey was distributed to 529 eligible physicians at our institution, with 103 physicians responding (20%). The distribution of specialties was 22% primary care specialties, 41% other internal medicine subspecialties, and 18% surgical specialties. Collectively, 63% found comparable quality of care when provided virtually (vs in-person) whereas 80% perceived telemedicine as cost-effective. A total of 76% of physicians felt that telemedicine increased flexibility and control over patient care activities, with 36% reporting improved work-life balance and 30% reporting improved burnout symptoms. Overall, 42% preferred using telemedicine over in-person visits when possible. Conclusion Physicians generally had positive attitudes regarding the adoption of telemedicine and perceived that the quality of health care delivery as generally comparable to in-person care. Future studies are needed to explore attitudes regarding telemedicine after the pandemic and how this virtual technology may be further used to improve physicians’ professional and personal well-being.

In this paper eight successive experimental blast tests with an increasing TNT equivalent charge weights ranging from 0.56 kg to 17.78 kg were conducted on unreinforced, ferrocemented overlay masonry and confined masonry walls. The pressure-time history caused by the blast was recorded by pressure sensors installed on the test specimen. The resulting damage pattern was observed during each test. Weak zones in the three systems of masonry were identified. Scaled distances for different damage levels in the three masonry systems were experimentally obtained. The results provide a basis for determining the response of each masonry system against blast loading. Consequently, efficiency of ferrocemented overlay masonry and confined masonry was found established in mitigation against blast loads.

Hypertension increases healthcare costs, but the impact of cardiorespiratory fitness (CRF) on these costs is unknown. This study explored the association between healthcare costs and CRF among hypertensive and normotensive men.We studied 9794 male subjects aged 58.5 ± 11.3 years from the Palo Alto Veterans Affairs Medical Center, including 6413 with and 3381 without hypertension. CRF was classified into four age-stratified categories according to metabolic equivalents (METs) derived from exercise testing: low fit (4.6 ± 1.2 METs; n = 2481), moderate fit (6.6 ± 1.2 METs; n = 2412), fit (8.0 ± 1.3 METs; n = 2505), and high fit (10.8 ± 2.1 METs; n = 2396). Annual costs per subject were quantified over eight years.Total annual healthcare costs were higher in subjects with hypertension ($34,794, 95% CI, 32,828 to 36,761) in comparison to non-hypertensive subjects ($30,221, 95% CI, 26,104 to 32,450) (p 0.01). In hypertensive subjects, a graded reduction in annual healthcare costs was observed as CRF was higher; costs were $40,346 for low fit, $35,939 for moderate fit, $32,312 for fit, and $29,277 for high fit subjects (p 0.001). For each 1-MET increase in CRF, annual costs per subject (USD) were $1752 (95% CI, -2476 to -1,027, p 0.001) lower among those with hypertension and $1025 (95% CI, -2047 to -2, p 0.05) lower in those without hypertension.Higher CRF is associated with lower healthcare costs in men with and without hypertension. The impact of CRF on healthcare costs is more striking in those with hypertension.

To assess the cardiorespiratory fitness (CRF) impact on the association between exercise blood pressure (BP) and mortality risk.We assessed CRF in 15,004 US Veterans (mean age 57.5 ± 11.2 years) who completed a standardized treadmill test between January 1, 1988 and July 28, 2017 and had no evidence of ischemia. They were classified as Unfit or Fit according to the age-specific metabolic equivalents (METs) achieved50% (6.2 ± 1.6 METs; n = 8440) or ≥ 50% (10.5 ± 2.4 METs; n = 6264). To account for the impact of resting systolic BP (SBP) on outcomes, we calculated the difference (Peak SBP-Resting SBP) and termed it SBP-Reserve. We noted a significant increase in mortality associated with SBP-Reserve ≤52 mmHg and stratified the cohort accordingly (SBP-Reserve ≤52 mmHg and 52 mmHg). We applied multivariable Cox models to estimate hazard ratios (HR) and 95% confidence interval (CIs) for outcomes.Mortality risk was significantly elevated only in Unfit individuals with SBP-Reserve ≤52 mmHg compared to those with SBP-Reserve52 mmHg (HR = 1.35; CI: 1.24-1.46; P 0.001). We then assessed the CRF and SBP-Reserve interaction on mortality risk with Fit individuals with SBP-Reserve52 mmHg serving as the referent. Mortality risk was 92% higher (HR = 1.92%; 95% CI: 1.77-2.09; P 0.001) in Unfit individuals with SBP-Reserve ≤52 mmHg and 47% higher (HR = 1.47; 95% CI: 1.33-1.62; P 0.001) in those with SBP-Reserve52 mmHg.Low CRF was associated with increased mortality risk regardless of peak exercise SBP. The risk was substantially higher in individuals unable to augment their exercise SBP52 mmHg beyond resting levels.

A large body of research has well established that changes in net balances between labor supply and demand can drive competition for human capital. We propose that AI-enabled recruiting tools constitute a force that will intensify the war for talent above and beyond episodic changes in net balances. We also propose that three seismic shifts will further intensify the war for talent by increasing the value of human capital and lowering its switching costs. Lastly, we bridge human resource management and military escalation literatures and examine how three key onset conditions relative to the use of AI-enabled recruiting tools have the potential to spark an arms race for those tools. Finally, we examine the managerial implications of these dynamics so that managers prevail not just in short-term skirmishes but also in the long-term war for talent.

1,3-PDO (1,3-propanediol) is a high value-added platform chemical used widely in adhesives, laminates, and food additives. For the efficient production of 1,3-PDO, the sustainable and non-toxic regeneration of NADH is of great importance. ZVI (Zero-Valent Iron) can provide a reducing equivalent for 1,3-PDO synthesis from glycerol as an electron donor. Klebsiella pneumoniae has a 1,3-PDO conversion pathway from glycerol and has been studied as an electrochemically active strain that can exchange respiratory electrons through the cell membrane. In this study, 1,3-PDO was produced using an electrochemically active strain, K. pneumoniae L17, and ZVI as an electron donor. The production of 1,3-PDO with ZVI increased significantly to 24.2 ± 1.3 mM compared to the control (12.0 ± 0.1 mM). These results suggest that an external reducing agent, such as ZVI, can regulate the bioconversion of K. pneumoniae L17, and improve the conversion of glycerol to value-added platform chemicals.

Plant monovalent cation/proton antiporters (CPAs), types of transmembrane transporters, play important roles in resistance to salt stress. In this study, 37 CPA genes from moso bamboo (Phyllostachys edulis) were identified and characterised. The expression profiles of 10 CPA1 genes (PheNHXs) of moso bamboo were detected by qRT-PCR, which showed that they were specifically expressed in six tissues. In addition, the expression of 10 PheNHXs in leaves and roots changed significantly under 150/200 mM NaCl and 100 μM ABA treatments. In particular, the expression of PheNHX2 in leaves and roots was significantly upregulated under NaCl treatment, thus, we cloned PheNHX2 and analysed its function. Subcellular localisation analysis showed that PheNHX2 was located on the vacuolar membrane. Overexpression of PheNHX2 reduced seed germination and root growth of Arabidopsis thaliana under salt stress, as well as severely affecting cellular Na+ and K+ content, which in turn reduced the salt tolerance of transgenic Arabidopsis. Measurements of physiological indicators, including chlorophyll content, malondialdehyde content, peroxidase and catalase enzyme activities and relative electrical conductivity, all supported this conclusion. Under salt stress, PheNHX2 also inhibited the expression of some stress-related and ion transport-related genes in transgenic Arabidopsis. Overall, these results indicate that overexpression of PheNHX2 reduces the salt tolerance of transgenic Arabidopsis. This investigation establishes a foundation for subsequent functional studies of moso bamboo CPA genes, and it provides a deeper understanding of PheNHX2 regulation in relation to the salt tolerance of moso bamboo.

Most studies on SO2 capture using ionic liquids (ILs) have been carried out under mild conditions (e.g., about 1 bar of SO2 and 20–40 °C). However, these ILs only exhibit a fraction of their original SO2 uptake under harsher conditions, i.e., much lower SO2 partial pressure and evidently higher temperature (e.g., ≤0.2 mbar of SO2 and ≥110 °C). In this work, we screen 127 reported ILs for multi-molar SO2 absorption under the harsher conditions, covering nearly all the chemical space explored of the SO2 capturing IL. A unique cooperative anion-SO2 interaction mode with two forms (the insertion adduct and the ringed adduct) has been identified for branched anions, where SO2 acts as both acid and base to attack different reactive sites on anions. The simulated Langmuir isotherms further help screen out potential sorbents (amino-based branched singly charged anions with an Al atom as the center and carboxyl-based divalent anions) with both high overall capacity and high per-cycle absorption capacity. The energies of the reacting orbitals of the anions are linearly correlated to their SO2 binding energies. This work provides new insights for the design of task-specific ILs under harsh conditions.

Hyaluronan (HA) is the major glycosaminoglycan in the extracellular matrix of most mammalian tissues, including the epidermis. It is synthesized in epidermis, and mainly metabolized after transfer to the liver via lymphatic vessels in the dermis following its passage through the basement membrane (BM) at the dermal-epidermal junction. The aim of the present study was to investigate the influence of BM integrity on the level of HA in the epidermis. Epidermal HA content was decreased in sun-exposed skin of older subjects, whose BM structure was impaired, compared with sun-exposed young skin and sun-protected skin, in which BM integrity was well maintained. In an organotypic culture model of sun-exposed facial skin, epidermal HA was increased in the presence of inhibitors of BM-degrading matrix metalloproteinases and heparanase. In a skin equivalent model treated with these inhibitors, HA content was increased in the epidermis, but decreased in conditioned medium. These findings suggest that the BM at the dermal-epidermal junction plays an important role in maintaining epidermal HA levels.

Intracorneal ring segments (ICRS), used in the management of keratoconus since the 2000s, have enjoyed significant technological development. Various types of ICRS exist, whose arc length, thickness, and diameter can be chosen according to the desired effect on the spherical equivalent, keratometry and asphericity. Individualized implantation strategies, based on each patient's topographic and tomographic pattern, are constantly evolving. The surgical procedure is standardized, and complications remain very rare. Combined procedures (corneal collagen cross-linking and refractive photokeratectomy±topo-guided, phakic and pseudophakic intraocular lenses) are increasingly used and require a good knowledge of the effect of ICRS alone on the keratoconic cornea. The objective of this review is to summarize clinical practices used in the visual rehabilitation of keratoconic patients using the ICRS+- combined procedures.

Summary Objectives To study corneal haze following myopic photorefractive keratectomy (PRK) in a high-risk population and to assess methods for minimizing the risk. Methods The medical records of 150 patients who underwent PRK were reviewed. A total of 300 eyes were included. All patients underwent myopic PRK using the Allegretto Wave Concerto 500 Hz (Wavelight AG, Erlangen, Germany)excimer laser platform with intraoperative mitomycin-C (MMC) application. Demographic data including age, gender and ethnicity in addition to preoperative and postoperative subjective manifest refraction, spherical equivalent, best-corrected distance visual acuity, uncorrected distance visual acuity (UDVA), postoperative corneal haze grade and other possible postoperative complications were retrieved. Hanna grading (0–4+) was used to evaluate corneal haze. Results The patients were comprised of 74 men (49.3%) and 76 women (50.7%). The mean age at the time of surgery was 26.5 ± 6.0 (range, 17–46) years. All patients were Saudis with brown irides. UDVA improved to 20/25 in 93.8% at 3 months. The mean and standard deviation of preoperative spherical equivalent was −3.02 ± 1.63 (range, −7.63 – −0.13). At 3 months, postoperative spherical equivalent improved to 0.05 ± 0.50 (−1.00 – +1.00). At 6 months, 13.6% exhibited corneal haze of grade 1, and none exhibited grades 2 or 3. Conclusions The results of this study confirmed that patients with brown irides can achieve favorable outcomes after PRK. MMC, postoperative topical steroids and ultraviolet protection evidently play a major role in preventing corneal haze in high-risk populations.

A comparative study on CaO–MgO–Al2O3–SiO2 slag and CaO–MgO–Al2O3–SiO2–Cr2O3 slag was conducted to investigate the distribution of the elements at the gas-slag interface. The effect of redox states of chromium on the distribution of sulfur and oxygen at the interface was revealed by gas-slag equilibrium method using X-ray photoelectron spectroscopy at 1873K. From the analysis of the S2p core-level spectra, the negative divalent sulfur(S2−) was detected at the interface in the Cr-bearing slag, which directly proved that sulfur exists in the form of S2− in the slag for the first time. However, the S2− peak is very weak at the interface of Cr-free slag. The reason for the difference between the two slags may be due to chromium changing the interface structure. According to the O1s and Cr2p core-level spectra, non-bridged oxygen(O−) increased, while bridged oxygen(O0) decreased with the etching depth deepened. The increase of NBO/BO and Cr2+/Cr3+ elucidates that Cr3+ can modify the structure of the slag as basicity substance, but its effect is weaker than that of Cr2+. Meanwhile, due to the affinity of sulfur and chromium, the addition of chromium may also lead to the enhancement of the S2− peak at the gas-slag interface. Gradient change of elements at the interface proved the existence of the boundary layer.

Exercise testing represents the preferred stress modality for individuals undergoing evaluation of suspected myocardial ischemia. Patients with limited functional status may be unable to achieve an adequate exercise stress, thus influencing the diagnostic sensitivity of the results. The Duke Activity Status Index (DASI) is a clinically applicable tool to estimate exercise capacity. The purpose of the current study was to assess the utility of the DASI to identify patients unable to achieve an adequate exercise stress result. Patients referred for exercise stress testing were administered the DASI pre-exercise. Baseline characteristics and exercise variables were evaluated including DASI-metabolic equivalents (DASI-METs), peak METs, exercise time (ET), and %-predicted maximal heart rate (%PMHR). Criteria for determining adequate exercise stress was defined as ≥85%PMHR or ≥ 5-METs at peak exercise. In 608 cardiovascular stress tests performed during the study period; 314 were exercise stress. The median DASI-METs (8.4 [interquartile range; 6.7 to 9.9]) was associated with estimated peak exercise METs (R=0.50, p0.001), ET (R=0.29, p0.001), and %PMHR (R=0.19, p = 0.003). DASI-METs were different between those withor ≥85%PMHR (7.9 [6.6-9.0] vs. 8.9 [7.1-9.9], P=0.025) and those withor ≥5-METs (5.8 [4.6 to 6.6] versus 8.9 [7.3-9.9], p0.001). Receiver operating characteristic curve analysis identified a DASI-MET threshold of ≤/7.4 to optimally predict adequate exercise stress (sensitivity=93%, specificity=71%). In conclusion, the DASI correlates with peak METs, ET, and %PMHR among patients referred for exercise testing and can be used to identify patients with an increased likelihood of an inadequate stress test result.