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Aim: Cancers lacking standard screening (LSS) options account for approximately 70% of cancer-related deaths due to late-stage diagnosis. Circulating tumor DNA (ctDNA) is a promising biomarker for multi-cancer early detection. We previously developed SPOT-MAS, a multimodal ctDNA-based assay analyzing methylation and fragmentomic profiles, effective in detecting common cancers (breast, colorectal, liver, lung and gastric). This study extends the analysis to five LSS cancers: endometrial, esophageal, head and neck, ovarian and pancreatic. Methods: SPOT-MAS was applied to profile cfDNA methylation and fragmentomic patterns in 739 healthy individuals and 135 LSS cancer patients. Results: We identified 347 differentially methylated regions and observed genome-wide hypomethylation across all five LSS cancers. Esophageal and head and neck cancers showed an enrichment of short cfDNA fragments (<150 bp). Eleven 4-mer end motifs were consistently altered in cfDNA fragments across all LSS cancers. Many significant signatures were consistent with previous observations in common cancers. Notably, SPOT-MAS achieved 96.2% specificity and 74.8% overall sensitivity, with a lower sensitivity of 60.7% in early-stage cancers. Conclusion: This proof-of-concept study demonstrates that SPOT-MAS a non-invasive test trained on five common cancer types, could detect a number of LSS cancer cases, potentially complementing existing screening programs.

Postural sway has been demonstrated to increase following exposure to different types of motion. However, limited prior studies have investigated the relationship between exposure to normative on-road driving conditions and standing balance following the exposure. The purpose of this on-road study was to quantify the effect of vehicle motion and task performance on passengers' post-drive standing balance performance. In this study, trunk-based kinematic data were captured while participants performed a series of balance exercises before and after an on-road driving session in real-time traffic. Postural sway for all balance exercises increased following the driving session. Performing a series of ecologically relevant visual-based tasks led to increases in most post-drive balance metrics such as sway position and velocity. However, the post-drive changes following the driving session with a task were not significantly different compared to changes observed following the driving session without a task. The post-drive standing balance performance changes observed in this study may increase vulnerable users' risk of falling. Wearable sensors offer an opportunity to monitor postural sway following in-vehicle exposures.

Low- and middle-income countries urgently need to improve emergency medical services (EMSs) as a component of their healthcare systems. Here, we detailed EMS resources and their provision in Hanoi, Vietnam, and discussed necessary policies to upgrade EMSs. Between 2013 and 2018, EMS resources, measured as provider-to-population and ambulance-to-population ratios, decreased, whereas service provision, measured as the number of patients transported by ambulance per population, increased. EMS resources and their provision in Hanoi are far below the standards of high-income countries or figures in neighboring Asian countries. Therefore, it is imperative to upgrade health policies for the appropriate allocation of healthcare resources to EMSs and hospital services., Competing Interests: None, (Copyright © Japan Medical Association.)

Dehydration beyond 2% bodyweight loss should be monitored to reduce the risk of heat-related injuries during exercise. However, assessments of hydration in athletic settings can be limited in their accuracy and accessibility. In this study, we sought to develop a data-driven noninvasive approach to measure hydration status, leveraging wearable sensors and normal orthostatic movements. Twenty participants (10 males, 25.0 ± 6.6 years; 10 females, 27.8 ± 4.3 years) completed two exercise sessions in a heated environment: one session was completed without fluid replacement. Before and after exercise, participants performed 12 postural movements that varied in length (up to 2 min). Logistic regression models were trained to estimate dehydration status given their heart rate responses to these postural movements. The area under the receiver operating characteristic curve (AUROC) was used to parameterize the model's discriminative ability. Models achieved an AUROC of 0.79 (IQR: 0.75, 0.91) when discriminating 2% bodyweight loss. The AUROC for the longer supine-to-stand postural movements and shorter toe-touches were similar (0.89, IQR: 0.89, 1.00). Shorter orthostatic tests achieved similar accuracy to clinical tests. The findings suggest that data from wearable sensors can be used to accurately estimate mild dehydration in athletes. In practice, this method may provide an additional measurement for early intervention of severe dehydration.

Objective: To describe the outcomes of patients with out-of-hospital cardiac arrest (OHCA) transported to hospital in Hanoi, Vietnam., Methods: This was a multi-centre observational study of patients presenting with OHCA to one of five tertiary care hospital EDs in Hanoi from 2017 to 2019., Results: We analysed data from 239 OHCA cases of which 70.7% were witnessed, and 8.4% received bystander cardiopulmonary resuscitation (CPR). The emergency medical services (EMS) transported 20.5% of cases to hospital with the remaining being transported by private vehicle. No patients received external defibrillation before arriving to hospital. Return of spontaneous circulation in hospital was 33.1%, with 3.8% of patients survived to hospital discharge and only one patient (0.4%) discharged from hospital with a favourable neurological outcome., Conclusions: In cases of OHCA in Hanoi, both the proportion of cases receiving bystander CPR and EMS transportation were small. Urgent investments in pre-hospital capacity, training and capabilities are required to improve outcomes for OHCA in Hanoi., (© 2021 Australasian College for Emergency Medicine.)

We present a patient with severe middle cerebral artery occlusion who received an intra-arterial infusion of autologous bone marrow stem cells combined with Cerebrolysin IV. The patient was evaluated before and after treatment using the National Institutes of Health Stroke Scale, the Medical Research Council Muscle Scale, Modified Brunnstrom Classification, Barthel Index and modified Rankin Scale. After the therapy, the patient showed good outcome with functional as well as neurological improvements especially in terms of functional motor recovery without any side effects. Further controlled studies are needed to find possible side effects and establish net efficacy., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Starting from eugenol (4-allyl-2-methoxyphenol) three new quinoline derivatives, namely 5-bromo-7-(carboxymethoxy)-6-hydroxy-1-methylquinolin-1-ium-3-sulfonate (Q2, C 12 H 10 BrNO 7 S), 5-amino-7-(carboxymethoxy)-6-hydroxyquinolin-1-ium-3-sulfonate (Q4, C 11 H 10 N 2 O 7 S) and 7-(carboxymethoxy)-5,6-dihydroxylquinolin-1-ium-3-sulfonate (Q6, C 11 H 9 NO 8 ), have been synthesized and crystallised as dihydrate. The best planes through the quinoline ring and the carboxymethoxy substituent is 6.60 (14), 7.28 (6) and 4.73 (7)° for Q2, Q4 and Q6, respectively. The crystal packing of Q2 is characterised by O-H…O, π …π and Br …pyridine interactions. The two water molecules bridge three sulphate groups. Infinite chains of Q4 running in the direction [021] are formed by O/N-H …O hydrogen bonds at both ends of the molecule. Parallel chains interact by O/N-H…O hydrogen bonds and π…π and C=O…phenyl stacking. The -NH 2 substituent bridges two sulphate groups, while the two water molecules bridge the other functional groups. The packing of Q6 consists of sheets of molecules interaction through O/N-H…O hydrogen bonds while the two water molecules bridge all function groups present. Parallel sheets interact through π…π and C=O…pyridine stacking. An aqueous solution of Q2 and its precursor 7-(carboxymethoxy)-6-hydroxyquinolin-1-ium-3-sulfonate (Q) exhibits fluorescence which is pH dependent. The fluorescence intensity of a 10 μM solution of Q containing Zn 2+ reaches its maximum for a [Zn 2+ ]:[Q] ratio of 1:1. The fluorescence properties of Q, Q2, Q4 and Q6 were further investigated by DFT calculation methods.

Subarachnoid hemorrhage (SAH) due to a solitary spinal aneurysm is extremely rare. Early diagnosis of spinal SAH is challenging, particularly when the spinal cord has not been compressed. We report a case of a 45-year-old male who presented with sudden onset of abdominal pain, followed by severe headache, vomiting, and generalized seizure. Three days after admission to the hospital, he developed progressive paraparesis. Magnetic resonance imaging (MRI) revealed spinal SAH with hematoma resulting in cord compression at the level of T9. Diagnostic spinal angiography identified a ruptured aneurysm of a radiculomedullary artery. In conclusion, rupture of a spinal aneurysm should be considered a possible cause of SAH in appropriate clinical settings, and clinicians must be aware of the possibility of cord compression., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2020 by S. Karger AG, Basel.)

Background: Motion platforms and driving simulators have been shown to contribute to motion sickness and a short-term increase in standing postural sway. However, no studies to date have investigated how the motion of a passenger vehicle and the performance of a task during a drive on a closed test track affects post-drive standing balance., Research Questions: What are the effects of (1) a continuous, scripted drive on a closed test track, and (2) the performance of a handheld tablet-based task during the scripted drive, on post-drive standing balance?, Methods: Fifty adults (23 males, 27 females; 40.0 ± 20.6 yr) rode in the front passenger seat of a midsized sedan on a scripted drive. Participants were assigned to one of the acceleration levels (Low, Moderate) and completed both Task and No-Task test conditions, involving a visual-based task on a handheld tablet device. Before and after each scripted drive, participants completed two standing balance exercises: 1) feet tandem, eyes open, on firm support, and 2) feet together, eyes closed, on foam support. An inertial measurement unit (IMU) captured estimates of postural trunk sway. Root-mean-square (RMS) of angular position and velocity in the anteroposterior (A/P) and mediolateral (M/L) directions, and elliptical fit and path length of sway trajectory were computed. A nonparametric analysis was performed on the balance metrics., Results: Exposure to a scripted drive in a vehicle affected participants' postural sway, especially after using a handheld device during the drive. M/L RMS sway velocity and path length increased for both exercises following the scripted drive with task. Additionally, M/L RMS sway increased for the more challenging balance exercise, during which participants stood with feet together on foam support with eyes closed., Significance: This study is the first to explore balance following a scripted drive on a closed test track. Changes in post-drive balance introduces potential risks to vehicle passengers; concurrent performance of a task on a handheld device further increases the likelihood that post-drive balance will be negatively affected., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: External quality assessment (EQA) provides evidence of reliable, accurate, and precise results for customers using the diagnostic test for Toxocara canis. Objective . To establish a procedure for producing standard Toxocara canis serum samples for serodiagnostic testing in EQA., Methods: The collected serum samples to contain anti- Toxocara canis serum samples for serodiagnostic testing in EQA. F -test and a T -test were applied to evaluate their homogeneity and stability., Results: Among eleven samples positive by ELISA, ten of them were confirmed via Western blotting by positive reaction with 5 specific Toxocara canis serum samples for serodiagnostic testing in EQA. Toxocara canis serum samples for serodiagnostic testing in EQA. p > 0.05). Samples produced by both methods were stable for 7 days at 30°C ( p > 0.05). Samples produced by both methods were stable for 7 days at 30°C (., Conclusion: Specific serodiagnosis samples of anti- Toxocara canis antibodies for EQA could be produced that possessed homogeneity and stability lasting for 3 months and 6 months by the freeze-drying and freezing methods, respectively. At 30°C, the samples produced by both methods were stable for 7 days, suitable for delivery to remote laboratories. Toxocara canis serum samples for serodiagnostic testing in EQA., Competing Interests: The authors declare no conflict of interest, financial, or otherwise., (Copyright © 2020 Quang Huy Vu et al.)

As automation transforms drivers into passengers, the deployment of automated vehicles (AVs) has the potential to greatly increase the incidence of motion sickness. A study was conducted to quantify motion sickness response of front-seat passengers performing ecologically relevant passenger activities during conditions consistent with driving on public roadways. Fifty-two adults with a large range of self-reported levels of motion sickness susceptibility and age participated in data collection on a closed test track in a passenger sedan. Motion sickness ratings increased with task vs . no-task and moderate vs . low acceleration test conditions. Increased motion sickness susceptibility was associated with higher motion sickness ratings. In comparison to older participants (age > 60), younger participants (age < 60) experienced increased motion sickness. This is the first in-vehicle study that systematically compared normative passenger activities and acceleration magnitudes typical of normative driving conditions on motion sickness response for a large, diverse sample of passengers, enabling the exploration of the effects of covariates. Practitioner summary: The data demonstrate that a relatively large range of motion sickness response can be expected to result from passengers performing visual tasks in passenger vehicles. Measurement and modelling efforts should seek to elucidate relationships among the factors contributing to motion sickness for the purpose of informing and prioritising future countermeasures for automated vehicles (AVs). Abbreviations: AV(S): automated vehicles; BMI: body mass index; BVP: blood volume pulse; EDA: electrodermal activity; FMS: fast motion sickness scale; GPS: global positioning system; IMU: inertial measurement unit; ISO: International Organization for Standardization; MISC: misery scale; MSDV: motion sickness dose value; NDS: naturalistic driving study; SAE: Society of Automotive Engineers International; UMTRI: The University of Michigan Transportation Research Institute Key Aspect of Research: Motion sickness may be an important barrier to widespread adoption of automated vehicles @UMTRI.

Effective incorporation of multiple types of ligands in a given coordination structure provides structural complexity and functional diversity to the resultant coordination-driven assembly. One of the most widely used synthetic approaches is the utilization of the molecular symmetry principle to combine multiple ligands and specific metallic centers in a preferred manner. The variation of metal ions can be helpful to understand the importance of symmetry for the generation of structurally hierarchical supramolecular platforms. We describe the synthesis and characterization of isostructural supramolecular helicates, [M 8 (PDA) 6 (AIP) 3 (DMF) 6-x (H 2 O) x ] (M=Ni (1), Co (2), and Mn (3); PDA=2,6-pyridinedicarboxylate; AIP=5-aminoisophthalate; x=0 for 1, and x=4 for 2 and 3). The effect of metal variation on the formation of supramolecular helicates and their solid-state crystal packing are discussed. Despite the disparity in the ionic radii and distinct coordination-geometry preferences of Co 2+ , Ni 2+ , and Mn 2+ , all metal centers engaged in the assembly with the heteroleptic ligands in the same manner to form isostructural supramolecular helicates., (© 2019 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Activated Sludge Models (ASMs) assume an unbiodegradable organic particulate fraction in the activated sludge, which is derived from the decay of active microorganisms in the sludge and/or introduced from wastewater. In this study, a seasonal change of such activated sludge constituents in a municipal wastewater treatment plant was monitored for 1.5 years. The chemical oxygen demand ratio of the unbiodegradable particulates to the sludge showed a sinusoidal pattern ranging from 40 to 65% along with the change of water temperature in the plant that affected the decay rate. The biogas production in a laboratory-scale anaerobic digestion (AD) process was also affected by the unbiodegradable fraction in the activated sludge fed. Based on the results a chemical pre-treatment using H2O2 was conducted on the digestate to convert the unbiodegradable fraction to a biodegradable one. Once the pre-treated digestate was returned to the digester, the methane conversion increased up to 80% which was about 2.4 times as much as that of the conventional AD process, whilst 96% of volatile solids in the activated sludge was digested. From the experiment, the additional route of the organic conversion processes for the inert fraction at the pre-treatment stage was modelled on the ASM platform with reasonable simulation accuracy.

Purpose: We investigated correlations of coronary plaque composition determined by virtual histology (VH) intravascular ultrasound (IVUS) and blood levels of biomarkers that represent the vulnerability of coronary plaques., Materials and Methods: Pre- and postprocedural blood levels of high sensitivity C-reactive protein, soluble CD40 ligand (sCD40L), matrix metalloproteinase-9, and neopterin were measured in 70 patients with stable angina (SA) or unstable angina (UA) who were undergoing percutaneous coronary intervention (PCI) for single lesions. We evaluated the data for correlations between these biomarkers and necrotic core contents in PCI target lesions analyzed by VH., Results: Clinical characteristics, IVUS, VH, and biomarker blood levels were not different between the SA and the UA group except for more frequent previous statin use (52.3% vs. 23.1%, p=0.017) and lower remodeling index in the SA group (0.98±0.09 vs. 1.10±0.070, p<0.001). Among the biomarkers evaluated, only pre-PCI neopterin level showed a weakly significant correlation with the absolute volume of the necrotic core (r=0.320, p=0.008). Pre- and post-PCI blood levels of sCD40L (r=0.220, p=0.072; r=0.231, p=0.062) and post-PCI blood level of neopterin (r=0.238, p=0.051) showed trends toward weakly positive correlations with the absolute volume of necrotic core., Conclusion: We found a weakly positive correlation between the pre-PCI neopterin level and necrotic core volume in the PCI-target lesion. The clinical implications of our findings need to be investigated in further studies.

Kinetics and mechanisms of As(III) oxidation by free available chlorine (FAC-the sum of HOCl and OCl-), ozone (O3), and monochloramine (NH2Cl) were investigated in buffered reagent solutions. Each reaction was found to be first order in oxidant and in As(III), with 1:1 stoichiometry. FAC-As(III) and O3-As(III) reactions were extremely fast, with pH-dependent, apparent second-order rate constants, k''app, of 2.6 (+/- 0.1) x 10(5) M(-1) s(-1) and 1.5 (+/- 0.1) x 10(6) M(-1) s(-1) at pH 7, whereas the NH2Cl-As(III) reaction was relatively slow (k''app = 4.3 (+/- 1.7) x 10(-1) M(-1) s(-1) at pH 7). Experiments conducted in real water samples spiked with 50 microg/L As(III) (6.7 x 10(-7) M) showed that a 0.1 mg/L Cl2 (1.4 x 10-6 M) dose as FAC was sufficient to achieve depletion of As(III) to <1 microg/L As(III) within 10 s of oxidant addition to waters containing negligible NH3 concentrations and DOC concentrations <2 mg-C/L. Even in a water containing 1 mg-N/L (7.1 x 10(-5) M) as NH3, >75% As(III) oxidation could be achieved within 10 s of dosing 1-2 mg/L Cl2 (1.4-2.8 x 10(-5) M) as FAC. As(III) residuals remaining in NH3-containing waters 10 s after dosing FAC were slowly oxidized (t1/2 > or = 4 h) in the presence of NH2Cl formed by the FAC-NH3 reaction. Ozonation was sufficient to yield >99% depletion of 50 microg/L As(III) within 10 s of dosing 0.25 mg/L O3 (5.2 x 10(-6) M) to real waters containing <2 mg-C/L of DOC, while 0.8 mg/L O3 (1.7 x 10(-5) M) was sufficientfor a water containing 5.4 mg-C/L of DOC. NH3 had negligible effect on the efficiency of As(III) oxidation by O3, due to the slow kinetics of the O3-NH3 reaction at circumneutral pH. Time-resolved measurements of As(III) loss during chlorination and ozonation of real waters were accurately modeled using the rate constants determined in this investigation.