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The records of 2,277 patients referred to the Colposcopy Clinic at Cook County Hospital were reviewed, and those of 1,328 black patients who had a histological diagnosis of dysplasia or carcinoma in situ of the cervix were chosen for this study.Treatment modalities of intraepithelial cervical neoplasia are discussed and the conservative management of young patients is emphasized. Because of the effectiveness of outpatient management in cervical preinvasive lesions, health providers should make every attempt to motivate people particularly those at high risk, ie, black women, to undertake preventive measures.

Background: Osteoporosis, or porous bone, is a disease characterized by low bone mass density (BMD) and structural deterioration of bone tissue, leading to bone fragility and increased risk of hip, spine, and wrist fractures. There are numerous risk factors for osteoporosis. While many of these factors are non-genetic in nature, there is a definite genetic component responsible for this condition. The main aim of this study was to evaluate the association between VDR (Vitamin D receptor gene) polymorphisms (Fok1) A>G (rs2228570) and bone mineral density in an Iranian defined population. Methods: The study participants comprised of 1032 Iranians recruited from the city of Sanandaj during IMOS (Iranian Multi Center Osteoporosis Study). Bone mineral density measurement was performed in all the participants with and without osteoporosis. All samples were genotyped for VDR genes (Fok1) polymorphism with polymerase chain reaction, using a predesigned TaqMan allele discrimination assay. Results: There was a significant association between Fok1 polymorphism and osteoporosis in postmenopausal women, 0.138 (0.025-0.768). Conclusion: It seems that cohort studies, which are more powerful than case-control studies, can be useful in evaluating the roles of genetic variants as risk or protective factors for osteoporosis.

An opportunistic and local choice of raw materials is typically attested in the Lower and Middle Paleolithic industries throughout Italy. The quality of the raw material usually affected the flaking technology and quality of the products. In the Upper Paleolithic and the Mesolithic, raw material procurement strategies were more complex. Flint was exploited both locally, in areas where abundant outcrops of raw materials were available (such as the Lessini mountains), and in distant localities, after which it was transported or exchanged over medium/long distances. Different routes of exchange were thus followed in the various periods; good reconstruction of these routes have been provided by a study of the Garfagnana sites in Northern Tuscany, and the Mesolithic deposit of Mondeval de Sora (Dolomites). An interesting example of a Late Upper Paleolithic flint quarry and workshop were found in Abruzzo, in the San Bartolomeo shelter. The extended trade of obsidian from Lipari, Palmarola and Sardinia to the Italian Peninsula is attested in the Neolithic, with some differences concerning the age and different areas.

In this paper we introduce a complete system architecture of a textile-based rectenna loaded by a novel power management platform able to be autonomously activated by ambient RF energy harvesters. An integral design approach of the system blocks is carried out to provide the actual nonlinear behavior of the rectenna output, which is a function of the operating frequencies and power levels, as the DC-DC converter input. The RF properties of the textile rectenna are computed by nonlinear techniques with textile materials and antenna layout numerically characterized by means of EM simulations. A novel integrated power converter is adopted. It is equipped with a start-up circuit and an energy storage unit and it is designed by microelectronic technology. Energy autonomy of the entire system, including a battery-less activation is expected for RF available power levels as low as -15 dBm. The system operation is computed with the wearable rectenna recovering RF energy upon user request from GSM 900, GSM 1800 and WiFi sources

Objectives: Despite the large amount of literature examining the potential influence of subthalamic nucleus deep brain stimulation (STN-DBS) on psychiatric symptoms and cognitive disorders, only a few studies have focused on its effect on personality. We investigated the correlation between total electrical energy delivered (TEED) and the occurrence of depressive traits in patients with Parkinson disease (PD) after one year of DBS. Materials and Methods: Our study involved 20 patients with PD (12 women, mean [±SD] age 57.60 ± 7.63 years) who underwent bilateral STN-DBS, whose personality characteristics were assessed using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), according to the core assessment program for surgical interventional therapies in Parkinson's disease (CAPSIT-PD) procedure. Results: We found that despite a marked improvement in motor functions and quality of life after 12 months, patients showed a significant increase in MMPI-2 subscales for depression (D scale and Depression scale) and in other content component scales (low self-esteem, work interference, and negative treatment indicators). Interestingly, only the TEED on the right side was inversely correlated with the changes in scale D (rs = −0.681, p = 0.007), whereas depressive traits did not correlate with disease duration, levodopa equivalent daily dose (LEDD) reduction, patient's age, or severity of motor symptoms. Conclusions: Our preliminary observations indicate that despite the excellent motor outcome and general improvement in quality of life, DBS treatment can result in patients poorly adjusting to their personal, familiar, and socio-professional life. Different influences and multiple factors (such as TEED, intra/postsurgical procedure, coping mechanisms, and outcome expectations) may affect depressive traits. Further advances are expected to improve stimulation methods.

The common bed bug, Cimex lectularius L, has been a persistent pest of humans. Conventional pyrethroid-formulation insecticides are known to be ineffective for controlling modern bed bug populations. This study evaluates alternative treatment methods such as whole-home heat, a biological control agent (Beauveria bassiana), and the fumigant sulfuryl fluoride for control of insecticide-resistant bed bugs. Three heat systems with different energy sources (propane, electric, and glycol) were evaluated to determine attributes contributing to heat treatment efficacy. The glycol system produced the most mortality of the three systems, killing all nymphs, eggs, and most adults. Heat treatment duration and achieving lethal temperatures in complex environments were found to be the most important factors for treatment efficacy. These factors were directly correlated with technician diligence, specifically regarding monitoring surface temperatures and repositioning equipment. A formulation of B. bassiana was evaluated in the laboratory to determine its ability to infect bed bugs under varying conditions of temperature (15°C, 21°C, and 32°C) and humidity (30%, 50%, and 70%). It was found that humidity conditions (30%-50%) at ≈21°C produced the greatest bed bug mortality and the shortest bed bug median survival time. The fumigant sulfuryl fluoride was evaluated for its ability to eliminate bed bugs from motor vehicles and cargo trailers filled to 85% capacity. This study was the first to document that sulfuryl fluoride fumigation at the 1.9X dosage factor can kill all pyrethroid-resistant bed bug life stages (including eggs) in motor vehicles as well as in chambers filled with personal items. Master of Science in Life Sciences Since the world-wide bed bug (Cimex lectularius L.) resurgence began in the late 1990s, populations of the common bed bug have been evaluated, but most have been found to be highly resistant to pyrethroid insecticides. This resistance has been particularly troublesome due to the fact that the 1996 US Food Quality Protection Act has eliminated the use of many existing chemistries from indoor use and has inadvertently limited the development of new active ingredients for indoor use due to the cost of the required animal testing to document the No Observable Effects Level (NOEL). Due to the lack of novel chemistry for addressing modern bed bug infestations, pest management professionals have had to identify new methods for applying existing products (chemical and non-chemical) for bed bug control. This study evaluated gaseous, mechanical, and biological control methods for bed bug elimination to determine which factors contribute the most to their efficacy, as well as how these methods might be applied in novel ways for control of bed bugs in homes, personal belongings, and even vehicles. At the turn of the 20th century heat treatments were used for controlling bed bug infestations in homes and other structures. Today, mechanical heating systems are again being used to control bed bug infestations in homes and apartments. This study investigated the utility of three commercial heating systems for their ability to control existing infestations in apartment units. The three heat systems utilized different energy sources, different types of delivery equipment, and required different set up and take down procedures in apartments of different cubic footage and clutter levels. Overall, the Assault glycol heating system was found to be the most effective in its ability to get (almost) all of our hidden (in hard to heat locations) temperature sensors up to bed bug lethal temperature. Interestingly, our statistical analysis determined that getting the hard to heat locations up to lethal temperature was directly correlated with heat technician activity. The more times that the technician entered the home to monitor the treatment and adjust the equipment positions, the greater the chance of getting the hidden sensors up to bed bug lethal temperature (and killing the bed bugs). However, it was also found that none of the heat systems tested killed all of the sentinel bed bugs in every replicate. Therefore, we learned heat treatments cannot be expected to eliminate each and every bed bug in a home, and that supplemental control products such as desiccants dusts should be applied after every heat treatment. When attempting to determine which heat system was the most effective for killing bed bugs, it was determined that regardless of which heat systems was being used, the attention and activity (monitoring temperatures and adjusting equipment) of the heat treatment technician was the most important factor contributing to bed bug mortality as well as the achievement of bed bug lethal temperatures in cracks and crevices for all three systems. Our second study examined the environmental factors that influenced fungal growth after bed bug exposure to the insecticidal product Aprehend® (active ingredient Beauveria bassiana). Over the last several decades, this fungus has been widely used to control multiple insect pests. Recently, it has been labelled for bed bug control in indoor environments. This second study was intended to determine the atmospheric conditions (temperature and humidity) under which Aprehend sporulation was most effective for killing bed bugs. It was found that humidity conditions of 30-50% combined with temperatures of ~21°C produced the highest frequency of fungal infection and the shortest median bed bug survival time. This result was surprising because it was originally hypothesized that the 70% humidity condition would be equally effective for promoting fungal growth. However, at all of the temperatures tested, bed bug fungal infection rates at 70% humidity were not as high as those observed when the humidity was within the 30-50% range. Therefore, this study was able to document that the temperatures and humidity combinations that would typically be found within human homes (21oC at 30-50% humidity) were the most effective for producing fungal infections when bed bugs were exposed to the Aprehend product. The final study addressing novel methods for controlling insecticide resistant bed bugs investigated the efficacy of using Vikane gas fumigant (sulfuryl fluoride) at the 1.9× dosage rate for eliminating bed bugs in two challenging infestation situations: personal vehicles, and confined spaces densely packed with personal belongings. The vehicles used in this study were large minivans with seating that folded into the floor. The confined spaces were cargo trailers filled to 85% capacity with books, furniture, and other household items. Each van and trailer was equipped with ~90 sentinel bed bugs consisting of three groups of 9-11 bed bug eggs, 10 nymphs, and 10 adults. The Vikane Fumiguide calculator was used to determine the target dosage (g-h/m3) to apply in each replicate (e.g., one van or trailer). Sulfuryl fluoride concentrations were measured throughout the fumigation process using a Spectros SF-ReportIR. Concentration readings were input into the Fumiguide to determine when the accumulated dosage (g-h/m3) was achieved, and when aeration should be initiated. After aeration was complete, the sentinel bed bugs were removed from the replicates and bed bug nymph and adult mortality was recorded. Bed bug eggs were monitored for 23 d to determine latent mortality. Fumigated bed bug mortality for each replication was 100% regardless of life stage. Latent mortality was observed in a single bed bug egg, where the nymph never fully hatched. This study determined that fumigation with sulfuryl fluoride at the 1.9× dosage factor is an effective method for eliminating insecticide resistant bed bugs from vehicles and personal belongings in densely packed situations. Overall, it was found that the Beauveria bassiana product was most effective when applied under atmospheric conditions that are typically found in indoor home environments. This discovery was very reassuring, because the Aprehend product is one of very few that actually have residual activity with regard to bed bug control. This study also found that whole home heat treatments require rigorous pest technician attention and monitoring to achieve the best results. It was also determined that heat treatments cannot be assumed to be 100% effective on their own, and that they should be supplemented with additional (residual) treatment applications. Not surprisingly, fumigation with sulfuryl fluoride was determined to be 100% effective for eliminating bed bugs in personal belongings that had been packed into treatment chambers. The fumigation process also proved to be 100% effective for eliminating bed bug infestations in transport vehicles which cannot not be adequately treated and are at risk for having electronic components damaged if treated with heat.

Summary Background Elevated proinflammatory cytokines are associated with greater COVID-19 severity. We aimed to assess safety and efficacy of sarilumab, an interleukin-6 receptor inhibitor, in patients with severe (requiring supplemental oxygen by nasal cannula or face mask) or critical (requiring greater supplemental oxygen, mechanical ventilation, or extracorporeal support) COVID-19. Methods We did a 60-day, randomised, double-blind, placebo-controlled, multinational phase 3 trial at 45 hospitals in Argentina, Brazil, Canada, Chile, France, Germany, Israel, Italy, Japan, Russia, and Spain. We included adults (≥18 years) admitted to hospital with laboratory-confirmed SARS-CoV-2 infection and pneumonia, who required oxygen supplementation or intensive care. Patients were randomly assigned (2:2:1 with permuted blocks of five) to receive intravenous sarilumab 400 mg, sarilumab 200 mg, or placebo. Patients, care providers, outcome assessors, and investigators remained masked to assigned intervention throughout the course of the study. The primary endpoint was time to clinical improvement of two or more points (seven point scale ranging from 1 [death] to 7 [discharged from hospital]) in the modified intention-to-treat population. The key secondary endpoint was proportion of patients alive at day 29. Safety outcomes included adverse events and laboratory assessments. This study is registered with ClinicalTrials.gov, NCT04327388; EudraCT, 2020-001162-12; and WHO, U1111-1249-6021. Findings Between March 28 and July 3, 2020, of 431 patients who were screened, 420 patients were randomly assigned and 416 received placebo (n=84 [20%]), sarilumab 200 mg (n=159 [38%]), or sarilumab 400 mg (n=173 [42%]). At day 29, no significant differences were seen in median time to an improvement of two or more points between placebo (12·0 days [95% CI 9·0 to 15·0]) and sarilumab 200 mg (10·0 days [9·0 to 12·0]; hazard ratio [HR] 1·03 [95% CI 0·75 to 1·40]; log-rank p=0·96) or sarilumab 400 mg (10·0 days [9·0 to 13·0]; HR 1·14 [95% CI 0·84 to 1·54]; log-rank p=0·34), or in proportions of patients alive (77 [92%] of 84 patients in the placebo group; 143 [90%] of 159 patients in the sarilumab 200 mg group; difference −1·7 [−9·3 to 5·8]; p=0·63 vs placebo; and 159 [92%] of 173 patients in the sarilumab 400 mg group; difference 0·2 [−6·9 to 7·4]; p=0·85 vs placebo). At day 29, there were numerical, non-significant survival differences between sarilumab 400 mg (88%) and placebo (79%; difference +8·9% [95% CI −7·7 to 25·5]; p=0·25) for patients who had critical disease. No unexpected safety signals were seen. The rates of treatment-emergent adverse events were 65% (55 of 84) in the placebo group, 65% (103 of 159) in the sarilumab 200 mg group, and 70% (121 of 173) in the sarilumab 400 mg group, and of those leading to death 11% (nine of 84) were in the placebo group, 11% (17 of 159) were in the sarilumab 200 mg group, and 10% (18 of 173) were in the sarilumab 400 mg group. Interpretation This trial did not show efficacy of sarilumab in patients admitted to hospital with COVID-19 and receiving supplemental oxygen. Adequately powered trials of targeted immunomodulatory therapies assessing survival as a primary endpoint are suggested in patients with critical COVID-19. Funding Sanofi and Regeneron Pharmaceuticals.

Deep brain stimulation is an established technique for the treatment of movement disorders related to neurodegenerative diseases such as Parkinson's disease (PD) and essential tremor (ET). Its application seems also feasible for the treatment of neuropsychiatric disorders such as treatment resistant depression (TRD) and Tourette's syndrome (TS). In a typical deep brain stimulation system, the amount of current delivered to the patients is constant and regulated by the physician. Conversely, an adaptive deep brain stimulation system (aDBS) is a closed loop system that adjusts the stimulation parameters according to biomarkers which reflect the patient's clinical state. In this chapter, we examined the main issues related to aDBS systems, which are both clinical and technological in nature. From a clinical point of view, we have reported the major findings related to symptoms management using aDBS and principal findings in animal models, showing that the implementation of closed loop adaptive deep brain stimulation can ameliorate symptom management in neurodegenerative disorders. From the technological point of view, we reported the major advances related to aDBS system design and implementation, such as noise filtering methods, biomarkers recording and processing to adjust pulse delivery. To date, aDBS systems represent a major evolution in brain stimulation, further developments are needed to maximize the efficacy of this technique and to expand its use in a wide range of neuropsychiatric disorders.

Tondiite, with the simplified formula Cu3Mg(OH)6Cl2, occurs as a rare supergene mineral in a phonolitic tephrite from the type locality, Vesuvius volcano, Italy, as well as associated with haydeeite in the Santo Domingo Mine, Arica Province, Chile. It is emerald green to bright green in colour and occurs in irregularly shaped crystals, often with stepped faces. Its calculated density is 3.503 g cm−3. Tondiite crystallizes with the herbertsmithite structure type, space group Rm. Lattice parameters are a = 6.8377(7) Å and c = 14.088(2)Å for the holotype material. The c parameter may vary with Mg/Cu ratio and the presence of impurity atoms. The five strongest lines in the calculated powder diffraction pattern are [d in Å(I)(hkil)]: 5.459(88)(101), 3.419(22)(110), 2.764(100)(112 3), 2.266(54)(024), 1.706(26)(220). Several tondiite crystals have been examined by single-crystal X-ray diffraction and by electron microprobe analysis. The observed Mg content ranges between 0.6 and 0.7 atoms per formula unit. The structural role of Mg is discussed.

This paper presents the nanopower design of an integrated 1 μW-to-5 mW power management circuit. The circuit integrates a boost converter with maximum power point tracking, a low drop-out voltage regulator (LDO), and a start-up circuit for battery-less activation from discharged states. The IC implements a dynamic two-way power routing policy that ensures a fast start-up from discharged states even with very large energy storage capacitors. In order to reduce the intrinsic power, asynchronous control logic was adopted. The circuit was implemented in a STMicroelectronics 0.32 μm microelectronic technology. The power conversion section and the LDO draw respectively stand-by currents of 121 nA and 414 nA in the active modes. The circuit achieves a peak conversion efficiency of 77.1% and a minimum start-up voltage of 223 mV.

The increasing interest on pervasive sensor networks and the steady development of electronic devices with low power consumption motivates the research on electronic systems capable of harvesting energy from the surrounding environment. The use of microelectronic technologies allows a series of circuit optimizations paving the way toward the exploitation of sub‐microwatt power regimes, thanks to the significant reduction of parasitics and to the efficiency of custom designed circuit topologies. This chapter reviews some of the most promising integrated circuits (ICs) for power harvesting, conversion, and management, achieved either by industry or academia, intended for exploiting several different types of energy transducers. The chapter reviews a specific case study consisting in a nanopower IC for harvesting power from multiple energy sources. It focuses on the advantages conferred by nanoelectronic ICs in this specific field. The chapter highlights recent achievements presented in scientific literature, with a special focus on nanopower‐integrated solutions.

The Common bed bug, Cimex lectularius L., suddenly reappeared in developed countries in the past 15 years. The factor contributing to the sudden resurgence of the bed bugs is insecticide resistance. In this study, we investigated the mechanisms of reduced cuticular penetration type insecticide resistance in bed bugs. First, we determined and compared the lethal dosage (LD50) of a pyrethroid insecticide using topical and injection application. The resistant strain not only had significantly greater resistance ratios, but also demonstrated significantly greater penetration resistance ratios. This provided the evidence of the reduced cuticular penetration in bed bugs. Second, we determined the levels of gene transcription (CPR-type cuticle protein genes) using real-time quantitative polymerase chain reaction (qRT-PCR). We identified 62 putative bed bug cuticle protein-encoding contigs based on the presence of the Chitin-binding 4 (CB4) domain. Based on the qRT-PCR analysis of the mRNAs, we found many of the genes were up-regulated in the resistant strain suggesting thickening of the cuticle or increasing the cuticular proteins might be involved in the reduced cuticular penetration. Third, we identified and described the cuticular proteins using the matrix-assisted laser desorption/ionization (MALDI) time-of-flight/time-of-flight (TOF/TOF) high-resolution tandem mass spectrometry (MALDI-TOF/TOF). The total of 265 peptides were identified, among which 206 belonged to one of 50 confidently identified proteins. We identified the CPRL, CPF, CPFL, TWDL, and CPAP1 family proteins. The profile of the cuticular proteins between the resistant and the susceptible strains bed bugs were almost identical. Fourth, we determined and compared the cuticular thickness using Scanning Electron Microscopy (SEM). We found statistical differences of the cuticular thickness among different strains (populations), however, correlation between the levels of insecticide resistance and cuticular thickness were not found. Finally, we identified and described bed bug cuticular hydrocarbon profiles using Gas-Chromatography and Mass-Spectrometry (GC-MS). The total of 87 compounds in addition to n-alkanes were extracted and identified. There were no correlation found with the concentration and the levels of insecticide resistance. However, several additional compounds exhibited the correlation between the concentration of the compounds and the levels of insecticide resistance. Overall, we found three lines of evidence to support reduced cuticular penetration as a mechanism of insecticide resistance in some bed bug populations. This study provides additional evidence of the reduced cuticular penetration type resistance in bed bugs. Ph. D.

Although bed bug eggs are a difficult life stage to control with our currently labeled insecticides, few studies have examined how bed bug egg morphology and physiology is potentially related to pesticide resistance in bed bug eggs. Bed bug egg morphological features were examined using scanning electron microscopy (SEM) and the chorion and respiration structures were identified. Scanning electron microscopy photographs and bed bug egg measurements indicated there were no morphological differences between different bed bug egg strains (susceptible and resistant). Bed bug egg respiration rates measured by the amount of oxygen consumed (standard metabolic rate; SMR) also indicated there was no difference in SMR between different bed bug egg strains. Water conservation during respiration is vital to terrestrial insects. Therefore, similar patterns would be expected between egg water loss and respiration rates. However, susceptible strain eggs lost more water than one resistant strain of bed bug eggs, which was dissimilar from the respiration results, indicating that bed bug egg water loss and respiration are not directly related. Dose- response bioassays using two insecticide formulations (Temprid; imidacloprid/β-cyfluthrin, and Transport; acetamiprid/bifenthrin) indicated that bed bug eggs collected from pyrethroid resistant adult bed bug strains are also highly resistant. RNA sequencing of bed bug eggs from two resistant strains indicated that egg resistance may be directly related to the overexpression of multiple genes associated with insecticide resistance. Master of Science in Life Sciences