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In this report, we present a series of two unusual cases of elapid snakebite with acute neuroparalysis, that after initial response to standard anti-snake venom therapy, developed recurrence of disabling quadriparesis with dysautonomia, that on detailed evaluation turned out to be immune-mediated polyradiculoneuropathy (GB syndrome). Both the cases then responded to therapy with intravenous immunoglobulins. These cases bring out the rare immune-mediated late complication of snake venom, which if recognized and treated in time, can significantly reduce the morbidity and mortality.

Soils should supply nutrients to the plants in accessible forms, in the right level as well as in the absence of toxic substances. The ability of soils to provide nutrients in these required forms is known as soil fertility. It is very crucial to know a way to estimate the soil fertility and so soil fertility plays a vital role in sustainable agriculture. Soil analysis is used for evaluating the availability of nutrients present in a soil sample. Soil analysis helps the farmers or agricultural producers to identify the needed fertilizers and its quantity that should be supplied to the plant for a profitable crop production. The most commonly used method for soil analysis is chemical analysis but it is time consuming, laborious, high costs processes. With the evolution of applied science, several methods have been discovered for the analysis of soil traits. Spectroscopic methods had shown to be a cost-effective, fast, eco-friendly, nondestructive, and repeatable analytical technique for soil analysis. Our project is to develop a cost effective technique and instrument for the analysis of soils in situ to detect nutrients excess and deficient in the sample. The equipment under development is expected to be a useful addition to increase the profit and reduce the risk of small and medium scale farmers across the world. Infrared spectroscopy (IR) has already developed as a popular as well as rapid method to evaluate the fertility of soil. It is precise to organic as well as inorganic materials present in the soil sample. IR spectrum provides significant information about all chemicals present in the soil sample including macro and micro nutrients. In the agriculture and food industry, spot identification of elements are very important. This can be done using nanomaterials based on optical sensors. We apply spectroscopic methods along with the latest commercially available sensors and computational facilities to develop an economical, user convenient, IT enabled appliance for rapid and effortless soil sample analysis.

Nanotechnology in association with herbal medicine can lead to enhanced therapeutic and diminished adverse effects of medication. In turn, it can lead to synergistic effects of administered compound overcoming its demerits. Nowadays, the trend of herbal compounds to treat even a small illness is gaining momentum. Gone are the days when the ineffectiveness of a compound was impossible to be dealt with. Nevertheless, in this competitive era of science and innovative technology, it has become possible to maximize the usefulness of ineffective yet potent herbal compounds. The demand for herbal compounds is getting amplified because of their ability to treat a myriad of diseases, including COVID-19, showing fewer side effects. The merger of nanotechnology with traditional medicine augments the potential of herbal drugs for devastating dangerous and chronic diseases like cancer. In this review article, we have tried to assimilate the complete information regarding the use of different nanocarriers to overcome the drawbacks of herbal compounds. In addition, all the recent advancements in the herbal field, as well as the future exploration to be emphasized, have been discussed.

Torrefaction is a pretreatment method that converts biomass to a fuel-like substance that can replace coal for sustainable power generation. In this work, a thermodynamic-based process simulation model was developed to simulate the gasification of empty fruit bunch (EFB), with torrefaction as pretreatment, to determine the optimum conditions; equivalence ratio, reactor temperature, torrefaction medium concentration, steam-to-biomass (S/B) ratio and system configuration were studied to determine their influence on hydrogen concentration, higher heating value (HHV), syngas ratio and cold gas efficiency (CGE). The highest hydrogen yield was obtained at an S/B ratio of 1.3 at 800 °C, with a syngas ratio of 2.5 and a CGE of 84%. Concentration of torrefaction medium showed no effect on hydrogen concentration due to the simplicity of the model used, but work is in progress in this direction. Therefore, steam gasification is more suitable than air gasification in hydrogen production.

Air pollution is a rapidly growing major health concern around the world. Atmospheric particulate matter that has a diameter of less than 2.5 µm (PM2.5) refers to an air pollutant composed of particles and chemical compounds that originate from various sources. While epidemiological studies have established the association between PM2.5 exposure and cardiovascular diseases, the precise cellular and molecular mechanisms by which PM2.5 promotes cardiovascular complications are yet to be fully elucidated. In this review, we summarize the various sources of PM2.5, its components, and the concentrations of ambient PM2.5 in various settings. We discuss the experimental findings to date that evaluate the potential adverse effects of PM2.5 on cardiovascular homeostasis and function, and the possible therapeutic options that may alleviate PM2.5-driven cardiovascular damage.

Background Total Ankle Arthroplasty (TAA) is increasingly undertaken for the treatment of end-stage ankle arthritis. For each TAA procedure informed consent is required. The consent process should include discussion of the relevant complications, both systemic and regional. There is a lack of data regarding the systemic complications of TAA. This might cause problems in obtaining valid informed consent. Methods We reviewed and summarised the literature regarding the systemic complications and mortality rate of TAA. Results The average rate of systemic medical complications after TAA was 3% (range: 0–7%). The average mortality rate following TAA was 0.3% (range: 0–0.72%). The following were risk factors for systemic medical complications: obesity, diabetes, systemic co-morbidities, preoperative blood transfusion, revision procedures, and long anaesthetic duration. Conclusions When obtaining informed consent for TAA a systemic complication rate of 3% and a mortality rate of 0.3% ought to be included and documented.

Hydrogels are widely used materials due to their biocompatibility, their ability to mimic the hydrated and porous extracellular microenvironment, as well as their ability to tune both mechanical an...

Pain is a complex phenomenon that is usually unpleasant and aversive. It can range widely in intensity, quality, and duration and has diverse pathophysiologic mechanisms and meanings. Voltage-gated sodium and calcium channels are essential to transmitting painful stimuli from the periphery until the dorsal horn of the spinal cord. Thus, blocking voltage-gated calcium channels (VGCCs) can effectively control pain refractory to treatments currently used in the clinic, such as cancer and neuropathic pain. VGCCs blockers isolated of cobra Naja naja kaouthia (α-cobratoxin), spider Agelenopsis aperta (ω-Agatoxin IVA), spider Phoneutria nigriventer (PhTx3.3, PhTx3.4, PhTx3.5, PhTx3.6), spider Hysterocrates gigas (SNX-482), cone snails Conus geographus (GVIA), Conus magus (MVIIA or ziconotide), Conus catus (CVID, CVIE and CVIF), Conus striatus (SO- 3), Conus fulmen (FVIA), Conus moncuri (MoVIA and MoVIB), Conus regularis (RsXXIVA), Conus eburneus (Eu1.6), Conus victoriae (Vc1.1.), Conus regius (RgIA), and spider Ornithoctonus huwena (huwentoxin-I and huwentoxin-XVI) venoms caused antinociceptive effects in different acute and chronic pain models. Currently, ziconotide is the only clinical used N-type VGCCs blocker peptide for chronic intractable pain. However, ziconotide causes different adverse effects, and the intrathecal route of administration also impairs its use in a more significant number of patients. In this sense, peptides isolated from animal venoms or their synthetic forms that act by modulating or blocking VGCCs channels seem to be a relevant prototype for developing new analgesics efficacious and well tolerated by patients.

Rare earth elements (lanthanide and yttrium, abbreviated as REY) provide important support for national security, energy production, environmental protection and economic growth. In recent years, many studies have shown that the content of REY in some coal or coal by-products is close to or even higher than that in traditional REY ore, which makes coal a potential source of REY. This study took the No. 17 coal of Panzhou mining area in Liupanshui coal field as the research object, and the content and occurrence modes of REY in raw coal and 7 density fraction samples were studied. The results show that the content of REY in the raw coal reaches 220.67 μg/g, which is significantly higher than the average REY in the World coal and Chinese coal as reported in the literature. Gravity separation has a certain pre-enrichment effect on REY and the fraction sample ＞1.8 g/cm3 has the highest REY of 426.27 μg/g (equal to rare earth oxide 0.1%). Study on correlation between REY and ash yields reveals that the organic affinity of the light rare earth is higher than the medium rare earth and the heavy rare earth. As shown by XRD and XRF, the major minerals in coal are kaolinite, quartz and calcite, and the content of REY in coal is significantly related to Al and Si and kaolinite, which implies that REY occur mainly in kaolinite. LA-ICP-MS was adopted to determine chemical composition of micro-zone in kaolinite in coal and the results show that there is no obvious correlation between REY and the content of Al and Si. This indicates that the REY occurred probably in the form of adsorption. The research results provide a scientific reference for the potential extraction of the associated REY in the coal.

Air pollution is associated with cardiopulmonary disease and death in the general population. Fine particulate matter (PM2.5) is particularly harmful due to its ability to penetrate into areas of gas exchange within the lungs. Persons with advanced lung disease are believed to be particularly susceptible to PM2.5 exposure, but only a few studies have examined the effect of exposure on this population. Here we investigate the association between PM2.5 exposure and adverse waitlist events among lung transplant (LT) candidates.US registry data were used to identify LT candidates listed between January 1, 2010 and December 31, 2016. Annual PM2.5 concentration at year of listing was estimated for each candidate's ZIP Code using National Aeronautics and Space Administration's (NASA) Socioeconomic Data and Applications Center Global Annual PM2.5 Grids. We estimated crude and adjusted hazard ratios for adverse waitlist events, defined as death or removal, using Cox proportional hazards regression.Of the 15 075 included candidates, median age at listing was 60, 43.8% were female individuals, and 81.7% were non-Hispanic White. Median ZIP Code PM2.5 concentration was 9.06 µg/m3. When compared with those living in ZIP Codes with lower PM2.5 exposure (PM2.510.53 µg/m3), candidates in ZIP Codes in the highest quartile of PM2.5 exposure (≥10.53 µg/m3) had 1.14-fold (95% confidence interval, 1.04-1.25) risk of adverse waitlist events. The result remained significant after adjusting for demographics, education, insurance, smoking, lung allocation score, body mass index, and blood type (hazard ratio, 1.17; 95% confidence interval, 1.07-1.29).Elevated ambient PM2.5 concentration was associated with adverse waitlist events among LT candidates. These findings highlight the impact of air pollution on clinical outcomes in this critically ill population.

Cannabis is one of the most frequently used psychoactive substances in the world. The most common route of administration for cannabis and cannabinoid constituents such as Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) is via smoking or vapor inhalation. Preclinical vapor models have been developed, although the vaporization devices and delivery methods vary widely across laboratories. This review examines the emerging field of preclinical vapor models with a focus on cannabinoid exposure in order to (1) summarize vapor exposure parameters and other methodological details across studies; (2) discuss the pharmacological and behavioral effects produced by exposure to vaporized cannabinoids; and (3) compare behavioral effects of cannabinoid vapor administration with those of other routes of administration. This review will serve as a guide for past and current vapor delivery methods in animals, synergize findings across studies, and propose future directions for this area of research.

The use of antidepressants is widespread in modern times. Thus, they present a potential risk for ecosystems due to occurrence in domestic sewage containing unaltered metabolites and structures, even after the treatment plants have processed the sewage. The current research investigated the sorption and desorption of antidepressants (citalopram, venlafaxine, fluoxetine, sertraline, and amitriptyline) and caffeine from freshwater sediment and sewage sludge. The samples of freshwater sediment were collected in a river spring in an area with few anthropogenic sources of pollution and samples of sewage sludge were taken from stabilization ponds of a sewage treatment. The matrices were mainly composed of organic fractions, sediment of humic nature, and aliphatic biomolecules in sludges. The presence of silt and clay in the sediment proved to be important for the sorption process when compared to the flocs and colloidal structure of the sludge. The kinetic study indicated pseudo-first order behavior. The Freundlich isotherm was satisfactorily used in the interpretation of sorption and desorption for all analytes and matrices. The high percentages obtained for desorption suggest analyte mobility, which is more intense in the sludge than in the sediment since each matrix has a different composition. It can be considered that the information obtained here reinforces the ecotoxicological concern with respect to pharmacological residues in the environment, as processes of retention by sorption in the sludge and the sediment have been confirmed, as well as the preferential partition of some analytes by the aqueous phase.

The mining of extra-thick coal seams features severe deformation of the stoping roadway and section coal pillars due to the large mining thickness of the coal seams and the intense movement of the overlying strata. The adjacent goaf and secondary mining disturbance in the current working face further challenge the roadway deformation control. This study explores the effect of the overlying strata structural evolution in the fully mechanized caving face of the extra-thick seam on the failure of section roadway and coal pillars. Physical analog modeling was carried out. A MatchID non-contact full-field displacement- and strain-measuring system was used to determine the evolutionary characteristics of the overlying strata breakage in the extra-thick coal seam, including the displacement variation pattern and stress/strain distribution in coal pillars. The results indicated that following the primary mining disturbance in the adjacent working face, the section roadway and coal pillars underwent initial deformation due to the primary mining-induced stress. As the mining of the current working face continued, the section roadway and coal pillars were subjected to secondary mining disturbance to the effect that the structure of the broken overlying strata gradually formed a triangular support structure. Thus, the overlying strata tilted downwards and subsided, forming a layered hanging roof structure. The additional load was then imposed on the stoping roadway and upper part of the section coal pillars. Meanwhile, the overlying strata failure caused a significant increase in the stress within the section coal pillars. Following the secondary mining disturbance, the peak stress reached a maximum of 33.62 KPa, leading to deformation and instability failure of the section roadway and coal pillars. Finally, distinctive evolutionary features of the overlying strata structure in the extra-thick and ordinary coal seams were identified, and their effect on the deformation and failure of the section roadway and coal pillars were analyzed in detail. These findings are considered instrumental in substantiating the deformation control of the stoping roadway and coal pillars in the extra-thick coal seams.

Shearer is an indispensable and important equipment for coal mining and the mining efficiency of shearer depends on the performance of pick to a great extent. In this paper, we conducted a series experiments of single pick cutting on the coal and rock cutting testbed. Simultaneously, we built the single pick cutting coal seam model, based on which, considering the strength condition of coal seam and coal–rock interface, the rotary cutting mechanical model of pick cutting coal seam with coal–rock interface is established. According to the crushing theory of coal and rock interface, this paper analyzed stress strain and strength condition of the area surround the interface, which ensured the basics for the further research. The data of picking force in the cutting process under different experimental conditions was collected by the sensor installed on the drum, a phenomenon appeared in the amplitude domain analysis of the data that the bigger force arising along with the greater compressive strength difference between coal seam and coal–rock interface, which means the force is positively correlated with the compressive strength. The results of time domain analysis shown that some basic properties of the cutting load changes over times.

Rationale: Epidemiological evidence indicates ambient exposure to PM2.5 have adverse effects on lung function growth in children, but it is not actually clear whether exposure to low level PM2.5 re...

Considering the failure mechanism of pick cutting coal & rock, combined with the cutting load test, the single pick load of cutting coal & rock is obtained and analyzed,​ based on the load of single coal & rock caving load change process in time domain analysis, establish the fold catastrophe theory model of cutting load, qualitative analysis, the change rule of cutting load and provide theoretical basis for the further study of cutting load. The single fracture load equation in cutting was obtained by numerical fitting, the load characteristics and change rule were analyzed by catastrophe theory, the coal–rock cutting system dynamics model was established. The mutation characteristics of coal and rock breaking process for pick pressing into the coal and rock until spallation are revealed, and the mutation mechanical model taking the load as disturbance factor is established. The stiffness of the cutting system plays an important role in cutting. The dynamic crushing load change process of coal–rock cutting mechanical system can be well described by catastrophe theory.

In this work, we investigated leaching of lanthanide and yttrium (REY) from a Central Appalachian coal and its ashes obtained at 550–950 °C with the main purpose of understanding the impact of ashing temperature on REY leachability in water, ammonium sulfate, and hydrochloric acid. It is found that the coal contains a negligible amount of water-soluble REY, less than 1% ion-exchangeable REY, and about 28% of HCl-soluble REY. Ashing leads to dramatic changes in REY leachability in both ammonium sulfate and hydrochloric acid solutions, which is believed to be related to transformation and redistribution of organically-associated REY in coal during the ashing process. Ashing temperature significantly affects REY leaching from coal ashes; higher ashing temperature results in lower REY leachability in both solutions. Clay minerals may play a significant role in changing the leachability of REY after ashing. In addition, the results also suggest that the organic matter in the coal is relatively enriched in heavy REY.

BACKGROUND Omega-3 fatty acids have been proposed to be useful in the prevention of cardiac events. High-risk plaque (HRP) and plaque progression on serial coronary computed tomography angiography (CTA) have been suggested to be the predecessor of acute coronary syndrome (ACS). The purpose of this study was to investigate whether addition of omega-3 fatty acids to statin therapy for secondary prevention would lead to change in plaque characteristics detected by using serial CTA.Methods and Results:This study enrolled 210 patients with ACS: no eicosapentaenoic acid (EPA)/ docosahexaenoic acid (DHA; EPA/DHA), low-dose EPA+DHA, high-dose EPA+DHA, and high-dose EPA alone. HRP was significantly more frequent in patients with plaque progression (P=0.0001). There was a significant interaction between plaque progression and EPA dose regardless of the DHA dose; 20.3% in EPA-none (no EPA/DHA), 15.7% in EPA-low (low-dose EPA+DHA), and 5.6% in EPA-high (high-dose EPA+DHA and high-dose EPA alone). On multivariate logistic regression analysis, HRP (OR 6.44, P

Objective: The goal of this study was to compare patient-reported efficacy of suburothelial versus intradetrusor onabotulinumtoxin A (BTX-A) in patients with refractory overactive bladder (OAB). Ma...

The global population continues to grow and unfortunately in a response to this, the food environment has changed dramatically. This change has primarily brought about an increase in the affordabil...

This chapter discusses current developments and latest applied solid–liquid separation technologies and equipment used for coal. It commences with a classification of the different solid–liquid separation technologies used and pre-treatment applied, such as thickening, coagulation and flocculation. It then describes all types of commonly used filters, including vacuum and pressure types, centrifuges such as vibrating basket, screen scroll, screen bowl and solid bowl types with their applications for different coal size fraction or coal tailings. An overview of non-mechanical technologies such as coal drying is given before the chapter closes with a discussion on the emerging and future trends in solid–liquid separation within the coal industry.

Background Wood represents the majority of the biomass on land and constitutes a renewable source of biofuels and other bioproducts. However, wood is recalcitrant to bioconversion, raising a need for feedstock improvement in production of, for instance, biofuels. We investigated the properties of wood that affect bioconversion, as well as the underlying genetics, to help identify superior tree feedstocks for biorefining. Results We recorded 65 wood-related and growth traits in a population of 113 natural aspen genotypes from Sweden (https://doi.org/10.5061/dryad.gtht76hrd). These traits included three growth and field performance traits, 20 traits for wood chemical composition, 17 traits for wood anatomy and structure, and 25 wood saccharification traits as indicators of bioconversion potential. Glucose release after saccharification with acidic pretreatment correlated positively with tree stem height and diameter and the carbohydrate content of the wood, and negatively with the content of lignin and the hemicellulose sugar units. Most of these traits displayed extensive natural variation within the aspen population and high broad-sense heritability, supporting their potential in genetic improvement of feedstocks towards improved bioconversion. Finally, a genome-wide association study (GWAS) revealed 13 genetic loci for saccharification yield (on a whole-tree-biomass basis), with six of them intersecting with associations for either height or stem diameter of the trees. Conclusions The simple growth traits of stem height and diameter were identified as good predictors of wood saccharification yield in aspen trees. GWAS elucidated the underlying genetics, revealing putative genetic markers for bioconversion of bioenergy tree feedstocks.

Polycyclic aromatic hydrocarbons are lipophilic chemicals that are normally formed as by-products of fossil fuel combustion and residues of coal processing. They are ubiquitous as contaminants from petroleum and coal utilization and are of environmental and occupational health concern because of their toxic, mutagenic, and carcinogenic properties.

Steam is the most energy efficient, reliable and flexible way to transfer heat within most food processing operations. This chapter discusses the differences between plant, filtered and clean steam and the various issues that affect their quality and purity. It summarises the best practices in steam system design, operation and maintenance that will help prevent contamination problems affecting food quality in the future. Food manufacturers should take pains to identify and control potential steam system contamination.

In order to operate in a safe manner, nuclear reactors should operate such that when small naturally occurring random power perturbations occur during operation, the reactor passively responds with corresponding reactivity changes that act to suppress the growth of the perturbations. While it is possible to control reactors, where this is not the case, quite a robust active control system is required to operate safely. Such reactor configurations are generally not desirable and should be avoided if possible. In a nuclear rocket engine, power perturbations manifest themselves through temperature changes in various portions of the reactor. It is possible that some portions of the reactor act to add reactivity when the temperature increases and other portions of the reactor act to decrease the reactivity when the temperature increases. As long as the overall reactivity change is such that the power decreases with increases in temperature, the reactor should be stable during operation.

We hypothesized that combining adoptively transferred autologous T cells with a cancer vaccine strategy would enhance therapeutic efficacy by adding antimyeloma idiotype (Id)–keyhole limpet hemocyanin (KLH) vaccine to vaccine-specific costimulated T cells. In this randomized phase 2 trial, patients received either control (KLH only) or Id-KLH vaccine, autologous transplantation, vaccine-specific costimulated T cells expanded ex vivo, and 2 booster doses of assigned vaccine. In 36 patients (KLH, n = 20; Id-KLH, n = 16), no dose-limiting toxicity was seen. At last evaluation, 6 (30%) and 8 patients (50%) had achieved complete remission in KLH-only and Id-KLH arms, respectively (P = .22), and no difference in 3-year progression-free survival was observed (59% and 56%, respectively; P = .32). In a 594 Nanostring nCounter gene panel analyzed for immune reconstitution (IR), compared with patients receiving KLH only, there was a greater change in IR genes in T cells in those receiving Id-KLH relative to baseline. Specifically, upregulation of genes associated with activation, effector function induction, and memory CD8+ T-cell generation after Id-KLH but not after KLH control vaccination was observed. Similarly, in responding patients across both arms, upregulation of genes associated with T-cell activation was seen. At baseline, all patients had greater expression of CD8+ T-cell exhaustion markers. These changes were associated with functional Id-specific immune responses in a subset of patients receiving Id-KLH. In conclusion, in this combination immunotherapy approach, we observed significantly more robust IR in CD4+ and CD8+ T cells in the Id-KLH arm, supporting further investigation of vaccine and adoptive immunotherapy strategies. This trial was registered at www.clinicaltrials.gov as #NCT01426828.

BACKGROUND/PURPOSE Salmonella Panama was considered an invasive non-typhoidal Salmonella (iNTS) serovar. Comprehensive clinical, microbiological, and genomic studies on S. Panama are scarce. We aimed to characterize the clinical and microbiological characteristics of S. Panama infection. Virulence mechanism of S. Panama and other iNTS serovars were also examined. METHODS Based on data from the longitudinal surveillance system for Salmonella deployed in Taiwan since 2004, a case-control study was undertaken to evaluate clinical characteristics of S. Panama infection during an outbreak in 2015-2016. Cellular experiments were conducted to compare pathogenicity of S. Panama and other iNTS with S. Typhimurium. RESULTS Most patients (41/44, 93.2%) infected by S. Panama were

In order to study the propagation laws of acoustic wave of coal samples from the Upper Permian Xuanwei Formation in the east of Yunnan Province, China, under saturated water and dry conditions, the basic physical parameters, acoustic parameters and anisotropic parameters were obtained through the experiments. Based on FFT and wavelet analysis theory, the spectral characteristics of coal samples under different conditions were studied. The results show that physical parameters of coal samples in different directions have different values, that is, the anisotropy of coal samples is obvious. When the coal samples are saturated with water, the acoustic velocities and the attenuation coefficient increase, whereas the dominant frequency decreases. The signal amplitude of the frequency domain significantly decreases, that is, the internal structure of coal samples is damaged. The P-wave velocity and S-wave velocity increase with the increase of the confining pressure, whereas the anisotropy parameters decrease with the increase of the confining pressure. Overall, this study provides the basis to understand basic acoustic information and anisotropy characteristics of coal samples.

Snakebite in India is often attributed to the "big 4," for which polyvalent anti-snake venom is effective. Also significant and less known is the burden of other venomous snakes, one of which is Trimeresurus malabaricus. We report a bite to the face of a tree climber by Trimeresurus malabaricus in the Western Ghats of India, which caused severe local envenomation in the form of facial edema and systemic signs of envenomation, including coagulopathy and hypotension. We discuss the role of thromboelastogram, infrared thermography, and routine diagnostics in this case, which led to the administration of Indian-made polyvalent anti-snake venom. The patient recovered and was discharged without any clinically evident physiological or physical dysfunction.

Immunohistochemistry (IHC) and/or MSI-PCR (microsatellite instability-polymerase chain reaction) tests are performed routinely to detect mismatch repair deficiency (MMR-D). Classical MMR-D tumors present a loss of MLH1/PMS2 or MSH2/MSH6 with MSI-High. Other profiles of MMR-D tumors have been described but have been rarely studied. In this study, we established a classification of unusual MMR-D tumors and determined their frequency and clinical impact. All MMR-D tumors identified between 2007 and 2017 were selected. Any profile besides the classical MMR-D phenotype was defined as unusual. For patients with unusual MMR-D tumors, IHC, and PCR data were reviewed, the tumor mutation burden (TMB) was evaluated and clinical and genetic features were collected. Of the 4948 cases of MMR testing, 3800 had both the available IHC and MSI-PCR results and 585 of these had MMR-D. After reviewing the IHC and PCR, 21% of the cases initially identified as unusual MMR-D were reclassified, which resulted in a final identification of 89 unusual MMR-D tumors (15%). Unusual MMR-D tumors were more often associated with non-CRC than classical MMR-D tumors. Unusual MMR-D tumors were classified into four sub-groups: i) isolated loss of PMS2 or MSH6, ii) classical loss of MLH1/PMS2 or MSH2/MSH6 without MSI, iii) four MMR proteins retained with MSI and, iv) complex loss of MMR proteins, with clinical characteristics for each sub-group. TMB-high or -intermediate was shown in 96% of the cancers studied (24/25), which confirmed MMR deficiency. Genetic syndromes were identified in 44.9% (40/89) and 21.4% (106/496) of patients with unusual and classical MMR-D tumors, respectively (P

In this study, we investigated the action of varespladib (VPL) alone or in combination with a coral snake antivenom (CAV) on the local and systemic effects induced by Micrurus corallinus venom in rats. Adult male Wistar rats were exposed to venom (1.5 mg/kg – i.m.) and immediately treated with CAV (antivenom:venom ratio 1:1.5 ‘v/w’ – i.p.), VPL (0.5 mg/kg – i.p.), or both of these treatments. The animals were monitored for 120 min and then anesthetized to collect blood samples used for haematological and serum biochemical analysis; after euthanasia, skeletal muscle, renal and hepatic tissue samples were collected for histopathological analysis. M. corallinus venom caused local oedema without subcutaneous haemorrhage or apparent necrosis formation, although there was accentuated muscle morphological damage; none of the treatments prevented oedema formation but the combination of CAV and VPL reduced venom-induced myonecrosis. Venom caused neuromuscular paralysis and respiratory impairment in approximately 60 min following envenomation; CAV alone did not prevent the neurotoxic action, whereas VPL alone prevented neurotoxic symptoms developing as did the combination of CAV and VPL. Venom induced significant increase of serum CK and AST release, mostly due to local and systemic myotoxicity, which was partially prevented by the combination of CAV and VPL. The release of hepatotoxic serum biomarkers (LDH and ALP) induced by M. corallinus venom was not prevented by CAV and VPL when individually administered; their combination effectively prevented ALP release. The venom-induced nephrotoxicity (increase in serum creatinine concentration) was prevented by all the treatments. VPL alone or in combination with CAV significantly prevented the venom-induced lymphocytosis. In conclusion, VPL shows to be effective at preventing the neurotoxic, nephrotoxic, and inflammatory activities of M. corallinus venom. In addition, VPL acts synergistically with antivenom to prevent a number of systemic effects caused by M. corallinus venom. Fundação de Amparo à Pesquisa do Estado de São Paulo/[No.2020/04287-6]/FAPESP/Brasil Fundação de Amparo à Pesquisa do Estado de São Paulo/[No.2020/14191-6]/FAPESP/Brasil Conselho Nacional de Desenvolvimento Científico e Tecnológico/[No.309320/2016-0]/CNPq/Brasil University of the West of São Paulo/[No.2020/04287-6]/UNOESTE/Brasil UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto Clodomiro Picado (ICP) UCR::Vicerrectoría de Docencia::Salud::Facultad de Microbiología

Globally, the availability and delivery of cognitive pharmaceutical services (CPS) by pharmacists has expanded over time. Australia has been no exception to this trend, with government funding to support the provision of certain CPS significantly increasing over the last two decades. Whilst medication management services have been consistently funded by the government for more than 15 years, fluctuations in the funding of other CPS have been observed; for example, certain disease state management CPS and introduction of funded MedsChecks. Furthermore, legislative changes have broadened pharmacists’ scope of practice and the CPS provided, contributing to an increase in user-pay services. Although the literature to date has highlighted positive impacts associated with CPS on economic, clinical and/or humanistic outcomes, context-specific, real world evidence for the benefits of CPS is much needed to ensure the profession engages in evidence-based practice. The aim of this commentary is to outline the changes in CPS provision and funding within the Australian context, the existing evidence for CPS, and highlight the implications for future research.

Panax ginseng is a medicinal plant is a material with various pharmacological activities and research suggests that it is particularly effective in representative metabolic diseases such as hyperglycemia, hypertension, and hyperlipidemia. Therefore, in this study, systematic review and meta-analysis were performed to investigate the comprehensive effect of P. ginseng on metabolic parameters representing these metabolic diseases. A total of 23 papers were collected for inclusion in the study, from which 27 datasets were collected. The investigational products included P. ginseng and Korean Red ginseng. Across the included studies, the dose ranged from 200 mg to 8 g and the supplementation period lasted from four to 24 weeks. The study subjects varied from healthy adults to those with diabetes, hypertension, obesity, and/or hyperlipidemia. As a result of the analysis, the levels of glucose and insulin area under the curves, % body fat, systolic and diastolic blood pressures, total cholesterol, triglycerides, and low-density lipoprotein cholesterol were significantly reduced in the P. ginseng group as compared with in the placebo group. In conclusion, P. ginseng supplementation may act as an adjuvant to prevent the development of metabolic diseases by improving markers related to blood glucose, blood pressure, and blood lipids.

Rationale: Indoor particulate matter is associated with worse COPD outcomes. It remains unknown whether reductions of indoor pollutants improve respiratory morbidity. Methods: Eligible former smoke...

Abstract: The immune system involves both active and passive immunization. The antibodies are developed against the antigens during active immunization and are permanently stored. But, in the case of passive immunization, the antibodies are exposed to the same antigens in every person who is already infected. In order to enhance the immune systems i.e. innate and adaptive immune responses, herbal plants are used as an immune booster. Some of the herbal plants have been proven clinically to enhance immunity that includes Morniga oleifera (Drumstick), Azadirachta indica (Neem), Ocimum sanctum (Tulsi), Withania somnifera (Aswagandha), Zingiber officinale (Ginger), Allium sativum (Garlic), Curcuma longa (Turmeric), Emblica officinalis (Amla) etc. Compared to synthetic drugs, herbal drugs have fewer side effects and stimulate the immune system to defend against various foreign pathogens. Even though herbal medicines are usually considered as safe and effective therapy, it is clinically proven that if a drug is effective, it would have some side effects. But, sometimes, the antioxidant property of herbal medicines is helpful in reducing the toxicities produced by any toxic substances or any drugs. This review aims to encourage the study of various herbal constituents and their role in the treatment of different types of viral infections.

The article presents the results of mathematical modeling of the initial stage of the combustion of wood and coal particles in conditions corresponding to the combustion chambers of boiler units of thermal power plants. A hypothesis is formulated that describes the sequestration of anthropogenic sulfur oxides (SOx) under the conditions of combustion of mixed fuels based on coal and wood as a result of the interaction of water vapors (formed during the evaporation of interporeal and adsorbed biomass moisture) with SOx with the formation of sulfuric (H2SO4) acid vapors. When these vapors of sulfuric acid H2SO4 interact with iron oxides of the mineral part of the coal. To test the formulated hypothesis, a new mathematical model has been developed for the processes of co-ignition and combustion of wood and coal particles under high-temperature heating conditions. The mathematical model of the ignition process developed by the authors differs from the known ones (published in leading international scientific periodicals on the combustion of solid fuels) by a detailed description of a complex of gas-phase and heterogeneous thermochemical reactions occurring both in the boundary layer of fuel particles and in their porous structure. The mathematical model of the combustion process of wood-coal fuel particles developed by the authors is currently the most detailed in describing the thermophysical, thermochemical and aeromechanical processes occurring both in the fuel particles and in their small vicinity. Multistage kinetic schemes for the oxidation of the main volatile components (methane ‒ CH4, carbon monoxide ‒ CO, hydrogen ‒ H2), as well as the formation of sulfur oxides by means of oxidation of hydrogen sulphide (H2S), released as a result of pyrolysis of the organic part of coal, have been adopted. Based on the results of numerical modeling, the possibility of intensifying the processes of sequestration of sulfur oxides by moistening the wood component of the fuel mixture has been established. It is shown that water vapor can act as an agent adsorbing anthropogenic sulfur oxides, transforming the latter into sulfuric acid vapor, respectively. In turn, the vapors H2SO4 and HNO- 3 can be relatively easily captured by means of condensation. It has been established that for effective SOx capture during co-combustion of coal and biomass, the moisture content of the latter must be at least 5% by weight. The research provides grounds for the conclusion about the possibility of environmentally efficient combustion of coal in the composition of wood-coal fuel composites.

Engineering microbes to produce value-added chemicals from C6/C5 sugars sometimes requires long biosynthetic pathways, which causes carbon loss due to involving multiple metabolic branch nodes, leading to a lower product yield. Using C2 feedstocks derived from gaseous, cellulosic, and plastic wastes could establish shorter biosynthetic pathways to produce some target chemicals, for example, acetyl-CoA-derived natural products. Utilizing these waste-derived feedstocks would also contribute to reducing the carbon footprint of the chemical industry. In this review, we highlighted the promising waste-processing technologies that could provide C2 feedstocks that are compatible with microbial fermentation. We also analyzed the recent metabolic engineering works in which the microorganisms/fermentation processes were modified/optimized to utilize acetate, ethanol, or ethylene glycol more efficiently.

Co-firing with coal is a promising technology for alleviating the ash-related issues during biomass combustion. This paper examines the effects of co-firing coal and straw on deposition characteristics under various biomass fractions and illustrates the mechanism of deposition formation during co-firing. Deposition experiments were conducted on a drop tube furnace with an air-cooled probe simulating the surface of the superheater. To clarify the detailed formation process of deposition, the micromorphology of deposits collected at different depths along the perpendicular direction to the deposition probe, as well as the elemental composition and mineralogy were characterized by SEM/EDS, XRF and XRD. Results showed that co-firing with coal reduced the serious slagging observed during biomass combustion, whereas resulted in higher deposition efficiency than that occurred in unblended coal/biomass combustion. As biomass fractions increased, the deposition efficiency exhibited a non-monotonic downward trend, whereas the sintering degree intensified remarkably. The formation of Ca sulfates and Fe-AAEMs aluminosilicates during co-firing led to the enrichment of Ca, S, Al, and Fe in deposits, and thus promoted melt-induced agglomeration. Viscous particles and adhesive films rich in alkali sulfates adhered closely to the probe surface were believed to be the initial layer, which triggered the deposition formation during co-firing. The inner layer composed of low-melting particles accelerated the formation and growth of deposition. Meanwhile, the fusion characteristics of coarse particles in the outer layer dominated the sintering degree. Co-firing with coal greatly alleviated the slagging tendency compared with biomass combustion, but we should be aware of the negative glue effect of AAEMs sulfates.

Background The endothelium regulates vascular tonus by releasing nitric oxide (endothelium-derived nitric oxide, EDNO) and hyperpolarizing factor (endothelium-derived hyperpolarizing factor, EDHF). In vein grafts with poor runoff, lack of function of these factors causes severe intimal hyperplasia. This study evaluated how the functions of EDNO and EDHF are altered in artery grafts under poor runoff conditions. Materials and methods The right common carotid arteries of rabbits were excised and implanted in their original positions as autogenous grafts under normal runoff conditions ("nonoccluded grafts") or poor runoff conditions ("poor runoff grafts"). Histochemical changes, acetylcholine (ACh)-induced effects on endothelium-dependent relaxation and smooth muscle cell (SMC) hyperpolarization were examined. Results Both artery graft types displayed negligible intimal hyperplasia. In the absence and presence of an EDNO synthase inhibitor, ACh-induced relaxation was lower in grafts with poor runoff than in nonoccluded grafts. Furthermore, ACh-induced but not nonreceptor agonist A23187-induced SMC hyperpolarization was lower in the poor runoff graft group than in the nonoccluded graft group. Conclusions Unlike in those in vein grafts, the functions of EDNO and EDHF in autogenous carotid artery grafts under poor runoff conditions were reduced but partly maintained. In such artery grafts, intimal hyperplasia caused by surgical operation was not present. These results may explain some of the mechanisms underlying the improved patency of artery grafts compared with vein grafts.

Light aromatic hydrocarbons are an important by-product of the coal chemical industry. The structure and properties of low molecular compounds (LMCs) embedded in coal are different from those of coal macromolecular skeleton structure, they have important effects on the coal pyrolysis. In this paper, the roles of LMCs on the formation of light aromatics during coal pyrolysis are investigated. The results show that LMCs have little effect on the thermal weight loss behavior of the three coals, but they can influence the carbon structure distribution of coals. The main source of light aromatics from coal pyrolysis is derived from thermal cracking of the coal macromolecular framework. And also the LMCs will be pyrolyzed to generate light aromatics. The total amount of BTEXN from extracts of Shengli coal (SL), Pingshuo coal (PS) and Hexi coal (HX) pyrolysis was 15%, 91%, and 12% of that of raw coal. The alkylbenzenes, naphthalene series, and PAHs can be cracked to form light aromatics. The long chain and cyclic aliphatic compounds can not only provide hydrogen for the free radical fragment of aromatics but also generate light aromatics. And the content of these compounds in the extracts of PS is higher than that of the other two coals. Due to the complexity of the combination between LMCs and coal structure, the extracts are easier to generate light aromatics than LMCs embedded in coal during pyrolysis. Because the composition and content of low molecules in coal with different metamorphic degrees are different, the effects of LMCs on the pyrolysis of low rank coal are more obvious compared with high rank coal.

Introduction: Manual lymphatic drainage (MLD), one of the components of complex decongestive physiotherapy, which is accepted as the gold standard in the treatment of lymphedema, is used for therapeutic purposes in many diseases. The most well-known feature of MLD is that it helps to reduce edema. In addition to reducing edema, MLD has many effects, such as increasing venous flow, reducing fatigue, and raising the pain threshold. To the best of our knowledge, there is no study examining the effects of MLD other than its effects on edema in detail. The aim of this study is to compile effects of MLD and to provide a better understanding of the effects of MLD.

Contains fulltext : 249993.pdf (Publisher’s version ) (Open Access) Our purpose was to perform a systematic review to assess the prevalence of microvascular angina (MVA) among patients with stable symptoms in the absence of obstructive coronary artery disease (CAD). We performed a systematic review of the literature to group the prevalence of MVA, based on diagnostic pathways and modalities. We defined MVA using three definitions: (i) suspected MVA using non-invasive ischaemia tests; proportion of patients with non-obstructive CAD among patients with symptoms and a positive non-invasive ischaemia test result, (ii) suspected MVA using specific modalities for MVA; proportion of patients with evidence of impaired microvascular function among patients with symptoms and non-obstructive CAD, and (iii) definitive MVA; proportion of patients with positive ischaemia test results among patients with an objectified impaired microvascular dysfunction. We further examined the ratio of women-to-men for the different groups. Of the 4547 abstracts, 20 studies reported data on MVA prevalence. The median prevalence was 43% for suspected MVA using non-invasive ischaemia test, 28% for suspected MVA using specific modalities for MVA, and 30% for definitive MVA. Overall, more women were included in the studies reporting sex-specific data. The women-to-men ratio for included participants was 1.29. However, the average women-to-men ratio for the MVA cases was 2.50. In patients with stable symptoms of ischaemia in the absence of CAD, the prevalences of suspected and definitive MVA are substantial. The results of this study should warrant cardiologists to support, promote and facilitate the comprehensive evaluation of the coronary microcirculation for all patients with symptoms and non-obstructive CAD.

The impact of PM2.5 on epithelial cells is a pivotal process leading to many lung pathological changes and pulmonary diseases. In addition to PM2.5 direct interaction with epithelia, macrophages that engulf PM2.5 may also influence the function of epithelial cells. However, among the toxic researches of PM2.5, there is a lack of evaluation of direct or indirect exposure model on human bronchial epithelial cell against PM2.5. In this present research, PM2.5-exposed human bronchial epithelial cell line (BEAS-2B) serves as the direct interaction model, while the contrast is to indirect stimulation model, which takes advantage of transwell co-culture system to carry out that PM2.5 is promptly contacted with macrophages rather than BEAS-2B. By comparing these two modes of interaction, we determined the viability of BEAS-2B and mRNA and/or protein expression profile of transcription factors Nrf2,NF-kB and according inflammatory indicators, with a view to evaluating the effects of different interaction modes of PM2.5 on epithelial cell damage in vitro. We have found that macrophage involvement may protect epithelia from PM2.5 cytotoxic effect, while strengthen the inflammation response.

Inhalation of fine particulate matter (PM2.5), produced by the combustion of fossil fuels, is an important risk factor for cardiovascular disease. Exposure to PM2.5 has been linked to increases in blood pressure, thrombosis, and insulin resistance. It also induces vascular injury and accelerates atherogenesis. Results from animal models corroborate epidemiological evidence and suggest that the cardiovascular effects of PM2.5 may be attributable, in part, to oxidative stress, inflammation, and the activation of the autonomic nervous system. Although the underlying mechanisms remain unclear, there is robust evidence that long-term exposure to PM2.5 is associated with premature mortality due to heart failure, stoke, and ischemic heart disease. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The article presents an overview of current data on the epidemiology, pathogenesis, clinical picture, intensive care of tetanus. It is noted that the largest prevalence of tetanus disease is in wartime. However, even in peacetime, tetanus often kills about 160000 people in the world daily. In developed countries, tetanus is rare as a result of the introduction of effective immunization programs. The part of the etiology, pathogenesis presents the data on the biochemistry of tetanolisin and tetanospasmin, gives the definition of autonomic dysfunction. The paper considers the classification of tetanus severity (Ablett), tetanus diagnostic tests (Tetanus Outbreak Control Guidelines February 2014) as follows: 1) the level of serum tetanus antibodies is determined prior to the introduction of tetanus toxoid or immunoglobulin, but the disease can develop at the ‘protective’ level of antibodies (‘protection’ titre); 2) the diagnosis of tetanus is exposed on the basis of clinical and epidemiological data; 3) human immunoglobulin contains tetanus antitoxin and can be used if tetanus immunoglobulin is not available. The article shows recommendations for intensive therapy of tetanus, which is graded as severe (grade 1) and mild (grade 2) by the GRADE system. Grade 1 includes the following items: 1) patients with tetanus moderate to severe are recommended to be hospitalized and treated in the Intensive Care Unit; 2) early passive immunization with human tetanus immunoglobulin (or PPP); 3) administration of antibiotics active against Slostridium tetani. Grade 2 includes the following as: 1) do not use the advisability peritraumatic and intrathecal immunoglobulin; 2) debridement within 1–6 hours after immunoglobulin; 3) imposition of tracheostomy within the first 24 hours after intubation in patients requiring restrictive support; 4) control AVL mode in volume and pressure; 5) the use of muscle relaxants with the ineffectiveness of other anticonvulsants; 6) the use of opioids with a central α-agoistami and/or propofol; 7) monitoring of creatinine phosphokinase levels to assess the effectiveness of anticonvulsant therapy. The prediction of disease outcome is consistent with a Control Guideline for Public Health Units in 2012 and is based on the epidemic parameters, the incubation period duration, prodromal period duration.

At present, the situation of coal mine safety production is still grim. The key to solve the problem is to analyze the risk of management activities in the process of coal mine safety production. This paper takes the management activities in the process of coal mine safety production as the research object. Firstly, according to the coal mine safety production standardization management system, the safety production management activities are carried out layer by layer. Then, the Failure Mode and Effect Analysis (FMEA) is used to identify the human errors that lead to the failure of management activities at all levels of coal mine. Furthermore, the Fuzzy Set Theory is used to determine the evaluation results of experts on the risk level of coal mine safety production management activities. Combined with Bayesian network (BN), the risk assessment model of coal mine safety production management activities is established. Through the model, the risk probability of coal mine enterprise management activities is accurately calculated. According to the evaluation results, the risk of management activities in coal mine safety production is analyzed.

Inhalations (inhalation of medicinal substances) are one of the effective ways to treat upper respiratory tract diseases and colds. Inhalation therapy is used to treat rhinitis, sinusitis, tonsillitis, pharyngitis, laryngitis, bronchitis and pneumonia, which can be complications of acute respiratory viral infections. The main rules of inhalation are as follows to conduct the procedure better after 1.5 hours after eating; clothes should not impede breathing; the procedure can be carried out only while sitting or standing; solution for the inhaler for treatment of bronchitis should be fresh; it is necessary to strictly keep the prescribed dosage; the time of the procedure should also be respected — usually it is from 1 to 4 minutes, sometimes for adults up to 10 minutes, for children the inhalation period is shorter — 1–2 minutes. Contraindications to inhalation are body temperature above 37.5 degrees; propensity to nasal blee­ding in a patient; propensity to increased arterial pressure, with cardiovascular failure; purulent inflammation of the tonsils; respiratory failure. The procedure should be stopped immediately in case of appearance of adverse symptoms such as shortness of breath, dizziness, difficulty in breathing. Therefore, inhalations must be prescribed by a doctor after examination of a patient. During inhalations in rhinitis, you should try to inhale the vapor through the nose. For effective treatment of rhinitis, inhalations from conife­rous plants are very suitable: fir, pine, juniper, larch, from steamed dried chamomile flowers, mint, and blackberry leaves. Honey inhalations can be used for the treatment of acute and chronic diseases of the upper respiratory tract (tonsillitis, pharyngitis, laryngitis and tracheitis). Medical herbal inhalation for children should be carried out from the age of two years. This must be done under the constant supervision of an adult. Leaves of coniferous trees: pine, fir, if or juniper, cedar are recommended for the treatment of children. Dried leaves of eucalyptus, lime, black currant, chamomile, mint and sage are also useful. During pregnancy, inhalations are one of the least risk ways to treat colds. It is necessary to keep precautions and correctly select herbs. For example, the use of medical herb farfara for inhalations is not recommended during pregnancy as well as the medical herbs that can cause allergies. In case of a cold, it is useful for pregnant women to use raspberry leaves, marigold flowers, flax flowers, as well as flowers and herb thyme for inhalations. Optimal herbs for inhalation during pregnancy will become chamomile, herb St. John's wort, thyme, althea and plantain if you need to cure a dry cough. In case of a moist cough, doctors recommend breat­hing a couple of herbs of yarrow decoction, rosemary or eucalyptus.

In order to effectively purify the diesel particulate matter (DPM) emitted by the trackless rubber wheel car in coal mining under the premise of dust control. This paper comprehensively investigated the laws of dust and DPM diffusion under forced ventilation and mixed ventilation and under different air intake volumes of the dust removal fan Q and different distances between the extractive air duct outlet and the head L by means of CFD numerical simulation. The following conclusions were drawn. Under mixed ventilation (Q=450 m3/min) dominated by forced ventilation, when L=5 m, the overall control effects on low-concentration dust, high-concentration dust and DPM are the best, with the diffusion distances being 46 m, 62 m and 54 m. Under mixed ventilation (Q=750 m3/min) dominated by exhaust ventilation, when L=5 m, the overall control effects on low-concentration dust, high-concentration dust and DPM are the best, with the diffusion distances being 23 m, 24 m and 39 m, respectively. Therefore, under the above two air volumes, when L=5 m, the best control effects can be achieved on dust and DPM in the working face.

Frothers are added in coal and mineral flotation to assist the formation of small air bubbles and stable froth. However, we have found that frothers can also adsorb on hydrophobic and hydrophilic sites of coal particles in flotation. In the current study, the interaction of two widely used frothers with coal particles in NaCl solution was investigated. While focused beam reflectance monitor was applied to measure the aggregation of coal particles, surface tension was measured to understand the aggregation of frother molecules. It was found that the adsorption of frothers on coal particles in NaCl solution was influenced by the NaCl-modified properties of frother molecules and coal particles. The presence of NaCl enhanced the intermolecular interaction between frothers and water and also facilitated the aggregation of coal particles. On hydrophobic sites, the hydrophobic interaction (CH/ π) between frothers and coal particles could be easily replaced by the stronger π/π interaction between coal particles, while on hydrophilic sites, the hydrophilic interaction between frothers and coal particles could be enhanced through ion-dipole attraction. Whether the hydrophobic interaction or the hydrophilic interaction played a dominant role in frother adsorption depended on the ratio of hydrophobic to hydrophilic sites and the formation of hemimicelles of frother molecules.

Fluorinated hydrocarbons have transformed inhalational anaesthesia, and vaporizers are essential for safe and accurate delivery of these agents. The modern day vaporizers have evolved considerably since the ether inhaler invented by John Snow in 1847 and are robust, precise and efficient. For an anaesthetist to administer safe inhalational anaesthetic, it is important to understand the physical principles of the various inhalational anaesthetic agents along with the working principles of the vaporizers. Almost all modern vaporizers are located outside the circle system and the have multiple safety mechanisms in place.