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Objectives: We assessed preoperative factors predicting the poor therapeutic efficacy of holmium laser enucleation of the prostate (HoLEP) in benign prostatic hyperplasia (BPH) patients. Methods: The present study included 159 patients who underwent HoLEP between August 2015 and June 2021 at our institution. Overall therapeutic efficacy was divided into good and poor therapeutic efficacies according to changes in the international prostate symptom score (IPSS), IPSS quality of life (IPSS‐QOL), and the maximum urinary flow rate. Patients were divided into good and poor therapeutic efficacy groups based on findings obtained 3 months after HoLEP, and comparative assessments were performed between the two groups. Results: The therapeutic efficacy of HoLEP was poor in 53 (33.3%) out of 159 patients. Intravesical prostatic protrusion (IPP), IPSS, IPSS‐QOL, post‐void residual volume (PVR), and the presence of overactive bladder (OAB) were significantly higher in the poor therapeutic efficacy group than in the good therapeutic efficacy group. A multivariable analysis of several factors identified the preoperative presence of OAB and short IPP as independent risk factors for the poor therapeutic efficacy of HoLEP. When treatment efficacy was divided according to risk factors, poor therapeutic efficacy was observed in only 14% of patients with prolonged IPP and the absence of OAB. Conclusions: The therapeutic efficacy of HoLEP may be poor in patients with OAB and short IPP, resulting in the significant deterioration of lower urinary tract symptoms. Accordingly, it is important to consider the presence or absence of OAB and IPP measurements when selecting indications for HoLEP. [ABSTRACT FROM AUTHOR]

Proton pump inhibitors (PPIs) are one of the most commonly used drug groups in clinical practice. Despite the high prevalence of their use, symptoms of hypersensitivity to IPPs are rare and few cases of the occurrence of allergies to drugs from this group have been documented in the available literature. The most often allergic symptoms include urticaria, angioedema and near fatal anaphylaxis. Between the individual drugs of this group there are cross-reactivity reactions. Knowledge- about crossreactivity in this group allow the safe administration of the drugs to patients who require their use. [ABSTRACT FROM AUTHOR]

The characterization of compatibility is the key research content of polymer blending modification. The commonly used rheological characterization methods are mainly based on dynamic frequency scanning tests, while the tests in the low frequency region usually take long experimental time. Isotactic polypropylene (iPP)/acrylonitrilebutadiene- styrene graft copolymer (ABS) blends were investigated. The shear creep recovery mode of rotary rheometer was utilized to evaluate the compatibility of polymer blends. The obtained conclusions were further verified by using scanning electron microscopy. The results show that for incompatible iPP/ABS blends with different phase morphology, creep recoverable compliance ( Jr) exhibits different phenomena. The blends with co-continuous morphology show the highest creep recoverable compliance, while the Jr values of the blends with sea-island morphology are between those of the blends with co-continuous morphology and the pure components. When maleic anhydride grafted polypropylene (PP-g-MAH) and styrene-ethylene-butylene-styrene block copolymer (SEBS) were selected as compatibilizers, respectively, the Jr values of the compatibilized iPP/ABS blends are significantly lower than those of the pure components. This test is relatively short in time and could replace the common characterization methods to quickly evaluate the compatibility of polymer blends. [ABSTRACT FROM AUTHOR]

Background: Plaque excision and grafting (PEG) has been recommended for patients with Peyronie's disease (PD) with >60° curvature and/or hinge effect and strong preoperative erections, while placement of an inflatable penile prosthesis (IPP) is recommended when rigidity is suboptimal. Nevertheless, many patients counseled to undergo an IPP decline and insist on proceeding with PEG due to personal preference or desire to avoid an implant. Aim: We aim to review long-term outcomes in patients who underwent PEG for PD at our institution and investigate whether there is any difference in long-term outcomes in patients who undergo PEG despite a recommendation to undergo IPP. Methods: We conducted a retrospective chart review from 2007 to 2021 on PEG surgery performed at a single tertiary care institution in patients ≥18 years old who had >3 months of follow-up. Outcomes: Postoperative information was gathered from the electronic medical record, including postoperative erectile function, patient satisfaction, and the ability to engage in penetrative sexual intercourse. Results: An overall 251 patients underwent PEG with a median follow-up of 12 months (IQR, 6-54). Among these, 54 (22%) were initially advised to undergo IPP but elected for PEG. Patients who underwent PEG despite counseling to undergo IPP reported lower postoperative ability to engage in intercourse (51% vs 76%). Seven (13%) patients initially advised to undergo IPP eventually received an IPP, relative to 7 (4%) initially advised to undergo PEG. Clinical Implications: Thorough preoperative assessment of erectile function and penile deformity can guide clinician counseling and manage patient expectations during decision making between PEG surgery and IPP implantation for PD. Strengths and Limitations: Limitations of this study include its retrospective nature, high attrition to follow-up, and risk of recall and selection bias. This is a large study with a median follow-up of 12 months, with a high-volume single surgeon who treats patients in a specialized population of complex cases. Conclusion: Patients who were initially counseled to undergo IPP due to suboptimal erectile rigidity but elected for PEG had worse postoperative ability to engage in penetrative intercourse, and a higher proportion of these patients eventually received an IPP. [ABSTRACT FROM AUTHOR]

TMB-5, an aryl amide-based compound, was treated with various solvents and employed as a β-nucleating agent (β-NA) to tailor the structure and properties of iPP. The crystalline structures and morphological evolution of different iPP/TMB-5 specimens were investigated via wide-angle X-ray diffraction (WAXD) and the Olympus BX51 optical microscope equipped with the Linkam CSS-450 hot stage, respectively. The results indicated that reducing the polarity of the solvent employed in the treatment of TMB-5 was conducive to deceasing the particle size and increasing the specific surface area of the initial TMB-5 particles. It facilitated the formation of needle-like/shish-like self-assembled TMB-5 in iPP melt, and promoted the formation of β-iPP crystal. These findings provide an alternative approach for tailoring the β-crystal inducing efficiency of TMB-5, which can modulate the β-crystal content and thus enhance the performance of iPP products. A proposed mechanism for the crystallization of β-iPP induced by NA is presented, taking into account the influence of solvent-dependent NA morphology. [ABSTRACT FROM AUTHOR]

Background: Penile prosthesis (PP)–induced impending erosion is a rare complication that has not been well characterized. Aim: This study evaluates the role of prosthesis sizing and of the safety of xenograft windsock repair (AlloDerm, Tutoplast, ArthroFLEX) of impending erosion. Methods: This was a retrospective review of xenograft use during inflatable penile prosthesis (IPP) replacement. Patient demographics, prior PP characteristics, and xenograft-augmented IPP characteristics were obtained. Paired-samples t tests were used to compare the PP cylinder size, rear tip extender size, and calculated PP length between the most recent prior PP and the xenograft-augmented IPP. Complications and follow-up data were obtained. Outcomes: The primary outcome was comparing the corporal body and device measurements between the PP presenting with impending erosion and the implanted xenograft-augmented IPP. The secondary outcome was evaluating the incidence of subsequent explantation. Results: A total of 24 patients underwent xenograft repair with simultaneous IPP replacement from 2012 to 2022. The median number of prior PP was 1 (interquartile range, 1-2.75). The median time between the most recent prior PP and xenograft-augmented IPP placement was 21 (interquartile range, 14-79) months. The prior PP was significantly longer at the time of explantation compared with the measured corporal body length in both the left (21.4 cm vs 20.1 cm; P <.01) and right (21.4 cm vs 20.1 cm; P <.01) sides. However, there was no significant difference in length between the xenograft-augmented IPP length at the time of implantation and measured corporal body length in both the left (20.1 cm vs 20.0 cm; P =.67) and right (20.2 cm vs 20.1 cm; P =.56) sides. A total of 16 (66.7%) cases required bilateral xenograft corporal body use. Only 1 (4.2%) patient had an IPP infection requiring explantation within 90 days of xenograft-augmented IPP placement. A total of 2 (8.3%) patients had device malfunction and 1 (4.2%) patient had impending erosion recurrence requiring removal/replacement of their initial xenograft-augmented IPP in a median time of 56 months from placement. Clinical Implications: PP oversizing may increase risk of PP-induced impending erosion, which is a delayed process. Strengths and Limitations: This is the largest retrospective study of xenograft use during IPP replacement for impending erosion but does not have a control cohort. This study is limited by its retrospective nature, limited follow-up, and absence of a treatment comparison. Conclusion: PP-induced impending erosion may be due to PP oversizing but can be successfully repaired with xenograft windsock during simultaneous IPP replacement. [ABSTRACT FROM AUTHOR]

In this video we present our technique for mini jupette sling (MJS) placement during the placement of an inflatable penile prosthesis (IPP). MJS could be considered in patients who are experiencing incontinence or climacturia, common complications of radical prostatectomy and prostate cancer treatment. The technique is initially described by Dr Andrianne, and our technique is modified from the mini-jupette as employed by Dr Yafi. The standard dissection and exposure is done using a typical penoscrotal or subcoronal approach. The corporotomies and dilation are done in the typical fashion. However, instead of placing stay sutures on either side of the corporotomies, we only place them on the lateral sides. When the mini jupette is placed it is secured with a running suture, and a loop is tied in the middle and divided to create four free ends, after the start and end of the running suture are completed. These four free ends match up with the four stay sutures placed lateral to the corporotomies. The pairs are tied together once the cylinders are placed, closing the corporotomies and securing the mini-jupette at the same time. The corporotomies are eventually closed by tying the stay sutures across the incision. This technique allows for a secure sling placement, without bunching of the sling. Since the corporotomies can be tied closed, there is no risk of needle injury to the cylinders. Operative time is not significantly increased when adding this procedure. We have encountered no complications related to the mini-jupette with this method.

Background: Penile prosthesis implantation offers a durable, safe, and effective treatment option for male erectile dysfunction; however, many urologists feel apprehensive and uncomfortable placing penile prostheses due to limited training, low surgical experience, and intra- and postoperative complication management. Aim: To compare a previously validated hydrogel inflatable penile prosthesis (IPP) training model with cadaver simulations across 4 main categories: anatomic replication and realism, procedural replication and realism, educational effectiveness, and efficacy and safety. Methods: An overall 88 participants (15 attendings, 18 fellows, and 55 residents) performed guided IPP placements on a cadaver and a hydrogel model. Based on a 5-point Likert scale, postsurveys were used to assess the participants' opinions regarding anatomic replication and realism, procedural replication and realism, educational effectiveness, and safety between the hydrogel model and cadavers. Outcomes: A direct head-to-head scenario was created, allowing participants to fully utilize the hydrogel model and cadaver, which ensured the most accurate comparison possible. Results: A total of 84% agreed that the hydrogel model replicates the relevant human cadaveric anatomy for the procedure, whereas 69% agreed that the hydrogel tissue resembles the appearance of cadaveric tissue. Regarding the pubic bone, outer skin, corporal bodies, dartos layer, and scrotum, 79%, 74%, 82%, 46%, and 30% respectively agreed that the hydrogel tissue resembled the texture/behavior of cadavers. Furthermore, 66% of participants agreed that the hydrogel model replicates all the procedural steps. Specifically, participants agreed that the model replicates the skin incision/dartos dissection (74%), placement of stay suture and corporotomy (92%), corporal dilation (81%), measurement of prosthetic size (98%), reservoir placement (43%), IPP placement (91%), scrotal pump placement (48%), and skin closure (51%). Finally, 86%, 93%, and 78% agreed that the hydrogel model is useful for improving technical skills, as a teaching/practicing tool, and as an evaluation tool, respectively. To conclude, 81% of participants stated that they would include the hydrogel model platform in their current training. Clinical Implications: By replicating the IPP procedure, the hydrogel model offers an additional high-fidelity training opportunity for urologists, allowing them to improve their skills and confidence in placing penile prostheses, with the goal of improving patient surgical outcomes. Strengths and Limitations: The hydrogel training model allows users to perform the entire IPP placement procedure with high anatomic realism and educational effectiveness, maintaining many of the high-fidelity benefits seen in cadavers while improving safety and accessibility. Conclusion: Ultimately, this high-fidelity nonbiohazardous training model can be used to supplement and bolster current IPP training curriculums. [ABSTRACT FROM AUTHOR]

Intel integrated performance primitives is a high-performance multimedia acceleration library for signal and image processing.However,as of now,there is no high-performance IPP library based on the ARM architecture.This paper implements a high-performance algorithm library PerfIPP based on the ARM computing platform for basic image geometric transformation algorithms such as mirror,remap,and affine/perspective transformation.The PerfIPP,optimized through SIMD assembly,memory alignment,data pre-calculation,high-performance matrix optimization techniques,has significantly improved the performance of the above algorithms.At the same time,This paper summarizes the key technologies for the realization and optimization of image geometric transformation algorithms on the ARM computing platform by comparing the performance differences brought about by different instruction combinations,different instruction arrangements,and different access and storage methods.Experimental results show that,on the Huawei Kunpeng 920 platform,thePerfIPP proposed in this paper can achieve 108.08%~435.5% performance improvement in image transformation compared with the open source computer vision library while meeting accuracy.It also achieves 83.79% of the average performance of Intel IPP library on Intel Xeon E5-2640 processor.

The Internet Printing Protocol (IPP) is a bridge between hosts and printers, and is supported by more than 98 percent of printers today. In addition to supporting local use, the IPP protocol also supports online use. Although this can expand the scope of its application, it has also introduced potential risks to user data. IPP has security components that should be able to guarantee confidentiality, integrity, and non-repudiation. In order to verify whether its security components can achieve this goal, this study modeled the 0-RTT authentication process of the IPP protocol based on Petri net theory and CPN Tools, introducing the improved Dolev–Yao adversary model to perform security evaluation on the protocol model. The result showed that the server could not resist the adversary's replay attacks on early data. Accordingly, we proposed an improved authentication scheme that introduced a random number signature to enhance the server's anti-replay capability. Using the same attack model to verify, the result proved that the new scheme was feasible and effective. The method used in this article could easily observe the movement of the security protocol message flow and the specific actions of each participant (including the adversary), which ensured researchers could easily locate the protocol defects and make improvements. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Gastroesophageal reflux disease (GERD) is a very common digestive disease worldwide. About half of all adults will report symptoms of reflux at some point in their lives. The symptoms of the disease are non-specific, which is why doctors of many specializations face the problem both in doctor's offices and hospital rooms. GERD is a disorder with troublesome symptoms and complications resulting from the regurgitation of gastric contents into the esophagus, causing subjective symptoms and related complications, negatively affecting the quality of life. Symptoms negatively affect the quality of life of patients, lowering well-being, physical activity, and social functioning. Diagnosis is based in most cases on the observation of symptoms, which is why this paper presents the symptoms that should be taken into account when diagnosing patients. Therapeutic procedures, selection of the appropriate form of treatment: conservative, pharmacological and surgical, were discussed. Materials and methods: The review was based on the analysis of materials collected in the "Pubmed" database, books and other scientific articles. Summary: Gastroesophageal reflux disease is an important health problem because it is associated with impaired daily functioning and morbidity. Proper management of GERD symptoms can result in significant improvements in patients' well-being, including reduction in physical pain, increase in vitality, physical and social functioning, and improvement in emotional well-being. In some patients, only lifestyle modification and a change in habits are enough to reduce the occurrence of symptoms. First-line drugs are proton pump inhibitors. Endoscopic examination should be performed when pharmacological therapy is ineffective or in the event of alarm symptoms, i.e. dysphagia, weight loss, anemia, bleeding and recurrent vomiting. Surgical treatment is used as a last resort when pharmacological treatment fails.

TMB-5 nucleating agent (NA) treated by different solvents were used as the β-NA of iPP. The effects of temperature on the crystalline structure of different iPP/TMB-5, as well as the crystallization and melting behaviors were investigated. It was found that strong polar solvent treated TMB-5 (TMB-5DMSO and TMB-5DMF) could induce more β-crystal at high Tc = 140 °C than the other TMB-5 NAs, while the β-crystal inducing efficiency of untreated TMB-5 (TMB-5UT) and non-polar solvent treated TMB-5 (TMB-5LP) is seriously reduced at high Tc = 140 °C. TMB-5DMSO can induce a high and stable content of β-crystal with Kβ = 83–94% within Tc = 90–140 °C, and TMB-5ODCB can induce a high content of β-crystal with Kβ > 91.3% within Tc = 90–130 °C. TMB-5DMF is the most temperature-sensitive one, but can induce a high fraction of β-crystal with Kβ > 92% both at low Tc = 90 °C and high Tc = 140 °C. High temperature pre-crystallization at Tpc = 150 °C tremendously reduces the β-crystal inducing efficiency of all TMB-5 NAs. TMB-5UT and TMB-5LP exhibit higher nucleating efficiency than TMB-5DMSO, TMB-5DMF and TMB-5ODCB. During the non-isothermal crystallization process, TMB-5UT induced β-crystal possesses higher structural perfection and stability, while TMB-5LP is more likely to induce α-crystal with considerable quantity and stability. The structural perfection and stability of TMB-5 induced β-crystal can be enhanced with appropriate increasing of Tc. [ABSTRACT FROM AUTHOR]

To study FIC on the laboratory scale, we used a parallel plate rheometer (PPR), which imparts shear rates of some order of magnitude. Applying shear in undercooling temperature (151 °C) conditions to induced crystallization, which was monitored by the increase in viscosity in the PPR following an established protocol that was stetted up to assess the conditions of the experiments. After annealing samples at 230 °C for 10 min to remove the melt memory effect, it was cooled to crystallization temperature (1510C) at the rate of -1.5 °C/min to undertake FIC and finally the sample was quenched by a cryo-freezer aerosol below 0 °C before being removed for characterization study. FIC involves the formation of the time and temperature-dependent relative crystallinity of a series of isotactic polypropylene (iPP) homopolymers. In this study, I selected iPP as a typical sample due to its simple formation conditions of polymorphic crystals and its unique properties of melting curves and crystalline morphology. In this research, the influence of some nucleating agents on the crystallization behavior of (iPP) Homopolymer has been investigated by OM (Optical Microscopy) and Transmission Electron Microscope (TEM) after undergoing FIC crystallization. The study of crystallization kinetics of iPP Homopolymer nucleated with (Talc, Na-Benzoate) and neat melt (Not nucleated-used as control) helped us to control the final morphologies and mechanical properties of semi-crystalline polymers. From the measured onset time of crystallization, it was possible to conclude that iPP containing Na- Benzoate as the nucleating agent was faster in crystallization.

Alluvial-diluvial deposit (ADSRM) is a special soil-rock mixture, which is composed of gravels, boulders, pebbles, and fine-grained soils carried by rivers or temporary floods. Its mechanical properties are quite different from regular soils and rocks. Based on the investigation results of alluvial-diluvial deposits in Luonan, Shaanxi Province, China, and the theory of the N-method, the shear mechanical properties of ADSRM samples with different N-values were analyzed using large-scale direct shear tests and image processing technology (IPP). Investigation results show that alluvial-diluvial deposits in the Luonan area are widely distributed, and most of complex origins and structures. The fractal dimension values of ADSRM samples only have one scale range of particle size and decrease with the increasing n value. The equivalent cohesion, internal friction angle, shear strength, and dilation value of the ADSRM sample with n = 0.55 are higher than those of other samples. The proportion of pore area, pore abundance, total crushing area, the fractal dimension of rock block contour, and equivalent diameter and abundance of rock blocks were used to characterize the pores and rock block morphology on the shear plane. The shape of most pores on the shear plane is oblate, secondly near-equiaxed, and the least long-strip. The crushing area of rock blocks on the shear plane of n = 0.55 sample is the highest, and the shape of most rock blocks is oblate and tends to develop to near-equiaxed. In summary, the macro-meso shear properties and engineering characteristics of the n = 0.55 sample are better than those of other samples designed by the N-method.

Least-squares parameterization of retrieved Vertical Total Electron Content (VTEC) from permanent dual-frequency GPS stations in terms of Time Varying Spherical Radial Basis Functions (TV-SRBFs) with optimal shape parameter leads to proper regional VTEC reconstruction at Ionospheric Pierce Points (IPPs). However, in the area where there is no observation, the modeling result is not satisfactory. This feature is especially tangible when the number of IPPs in the study area is low with poor geometric distribution, which leads to a rank deficient problem. Whereas, if the global ionospheric maps (GIMs) are used as a background in estimating the optimal shape parameter of TV-SRBFs and coefficients of the expansion, the stated obstacle to produce accurate regional ionospheric maps will be removed. For this purpose, an objective function is defined and optimized. The objective function consists of three terms. First, L-2 norm of the differences between the reproduced VTECs and values obtained from the receivers' observations. Second, L-2 norm of the differences between the reproduced values on a regular grid with the values obtained from the spatial interpolation of GIM at a specific moment in the modeling interval. Third, the discrete smoothing norm of the coefficients of TV-SRBFs. Since the obtained VTECs from GPS receivers are more accurate than the resulted VTECs from interpolation of GIMs and also a regularization parameter is needed due to the ill-posedness, the three objectives cannot be considered with the same weights in the multi-objective optimization. Hence the weighted sum method with the preference-based solution is applied to obtain the optimal relative weight of GIMs, the regularization parameter and the coefficients. Moreover, utilizing the least-squares collocation (LSC) can also improve the modeling accuracy to some extent. The proposed method is applied for hourly regional VTEC modeling over Iran from 3 May to 9 May 2016, which had both low and very high geomagnetic activities. A portion of the retrieved VTECs which is excluded from the modeling dataset, is considered as test data. The Root Mean Square (RMS) of the differences between obtained VTECs from regional constructed model and test data is 0.94 TECU in the study period. RMS of the differences between obtained VTECs from the regional model and VTECs of two control stations which are not involved in the modeling are 1.12 TECU and 1.24 TECU. Also, the regional model performs well in ionospheric delay estimation and the accuracy of single-frequency positioning at control stations in the study period is better than 0.7 m. [ABSTRACT FROM AUTHOR]

A novel nucleating agent (NA) 1-N',3-N'-dibenzoylbenzene-1,4-dicarbohydrazide (PTADH-Ph-3) for isotactic polypropylene (iPP) was synthesized and the structure of the synthesized product was characterized by fourier transform infrared spectroscopy (FT-IR), proton nuclear magnetic resonance spectroscopy (1H-NMR) and high resolution mass spectrometry (HRMS). The results showed that the target compound was successfully synthesized. Differential scanning calorimeter (DSC) was used to study the influence of the addition concentration of PTADH-Ph-3 and the final heating temperature (Tf) on the crystallization behavior of iPP. The results showed that the crystallization behavior of nucleated iPP had no relationship with Tf no matter how much PTADH-Ph-3 was added. This shows that PTADH-Ph-3 is not a solution-type NA, so its nucleation mechanism belongs to the traditional heterogeneous crystallization. The nucleation mechanism of PTADH-Ph-3 in iPP was explored through Materials Studio (MS) simulation. Firstly, the molecular dynamics (MD) of PTADH-Ph-3 and iPP were calculated mainly by MS. The calculation results showed that the interaction force between PTADH-Ph-3 and iPP molecules was 14.447 kcal mol−1, indicating that PTADH-Ph-3 has a better adsorption effect on the iPP surface, which can promote the epitaxial crystallization of iPP. Then the unit cell parameters of PTADH-Ph-3 and the mismatch ratio between PTADH-Ph-3 and iPP were calculated by MS. The calculated results show that the lattice mismatch between PTADH-Ph-3 and iPP is only 0.03% and 2.28%, which is far lower than the strict upper limit of 10–15% geometric mismatch in the crystal lattice matching theory. This can reasonably explain the nucleation mechanism of PTADH-Ph-3 nucleated iPP by epitaxial growth. [ABSTRACT FROM AUTHOR]

we prepared a series of aromatic dihydrazide compounds which were used as nucleating agents (NAs) in isotactic polypropylene (iPP). Differential scanning calorimetry (DSC) was used to study the influence of aromatic dihydrazide compounds with different structures on the crystallization behavior of iPP. The optimum concentration and mechanical properties of 1-N′,3-N′-dibenzoylbenzene-1,4-dicarbohydrazide (PTADH-Ph-3) with the best nucleation effect were investigated. The results of DSC demonstrate that all synthesized compounds have strong α-nucleating ability for iPP. When the para position of phenylenedihydrazide is substituted by phenyl, the crystallization peak temperature (Tc) of nucleated iPP is 14.4 °C higher than that of pure iPP. The Tc of iPP nucleated by dihydrazide compounds first raises sharply and then reduces slowly with increasing the number of carbon atoms in straight chain alkyl. When the number of carbon atoms in straight chain alkyl is two, the nucleation effect of nucleated iPP is the best, and the Tc of iPP nucleated with PTADH-CH-1 is higher 11.2 °C than that of pure iPP. While the addition amount of PTADH-Ph-3 is 0.2 mass%, the Tc of nucleated iPP can reach the maximum at 130.6 °C. The rigidity of iPP nucleated with PTADH-Ph-3 is improved. Compared with pure iPP, the impact and tensile strength of iPP nucleated with 0.2 mass% PTADH-Ph-3 have little change, but the flexural modulus and flexural strength increased significantly. [ABSTRACT FROM AUTHOR]

The Internet Printing Protocol (IPP) is a bridge between hosts and printers, and is supported by more than 98 percent of printers today. In addition to supporting local use, the IPP protocol also supports online use. Although this can expand the scope of its application, it has also introduced potential risks to user data. IPP has security components that should be able to guarantee confidentiality, integrity, and non-repudiation. In order to verify whether its security components can achieve this goal, this study modeled the 0-RTT authentication process of the IPP protocol based on Petri net theory and CPN Tools, introducing the improved Dolev–Yao adversary model to perform security evaluation on the protocol model. The result showed that the server could not resist the adversary’s replay attacks on early data. Accordingly, we proposed an improved authentication scheme that introduced a random number signature to enhance the server’s anti-replay capability. Using the same attack model to verify, the result proved that the new scheme was feasible and effective. The method used in this article could easily observe the movement of the security protocol message flow and the specific actions of each participant (including the adversary), which ensured researchers could easily locate the protocol defects and make improvements.

Incompatible polypropylene (PP) and polyethylene (PE) are difficult to separate in mixed recycling streams such as waste plastic packaging, which makes polyolefin mixtures unsuitable for high-quality products. In this work, based on the free radical branching reaction, a co-branching reaction of isotactic polypropylene (iPP) and high-density polyethylene (HDPE) blends was carried out in the presence of the peroxide, free radical regulator and multifunctional acrylate monomer, and a star-like long-chain branching (LCB) copolymer was obtained. The effect of in situ compatibilization on the structures and mechanical properties of iPP/HDPE was investigated, and the compatibilization mechanism was discussed. Results showed that the mechanical properties of the modified blends were largely improved, and efficient in-situ compatibilization of iPP and HDPE could be taken place in a wide process window. Moreover, the sizes of the dispersed phase in the modified blends were clearly decreased, and the interfacial thickness increased. Compared with the pure iPP/HDPE blend, the initial crystallization temperature of iPP in the modified iPP/HDPE blend was increased, and long branched chains of the LCB copolymers were physically entangled with the chemical identical homopolymers or even participated in the crystallization of iPP and HDPE. Thanks to the in situ compatibilization strategy, the compatibility of iPP/HDPE was significantly improved. [ABSTRACT FROM AUTHOR]

Branched C5 alcohols are promising biofuels with favorable combustion properties. A mevalonate (MVA)-based isoprenoid biosynthetic pathway for C5 alcohols was constructed in Escherichia coli using genes from several organisms, and the pathway was optimized to achieve over 50% theoretical yield. Although the MVA pathway is energetically less efficient than the native methylerythritol 4-phosphate (MEP) pathway, implementing the MVA pathway in bacterial hosts such as E. coli is advantageous due to its lack of endogenous regulation. The MVA and MEP pathways intersect at isopentenyl diphosphate (IPP), the direct precursor to isoprenoid-derived C5 alcohols and initial precursor to longer chain terpenes, which makes independent regulation of the pathways difficult. In pursuit of the complete "decoupling" of the MVA pathway from native cellular regulation, we designed novel IPP-bypass MVA pathways for C5 alcohol production by utilizing promiscuous activities of two enzymes, phosphomevalonate decarboxylase (PMD) and an E. coli-endogenous phosphatase (AphA). These bypass pathways have reduced energetic requirements, are further decoupled from intrinsic regulation, and are free from IPP-related toxicity. In addition to these benefits, we demonstrate that reduced aeration rate has less impact on the bypass pathway than the original MVA pathway. Finally, we showed that performance of the bypass pathway was primarily determined by the activity of PMD. We designed PMD mutants with improved activity and demonstrated titer increases in the mutant strains. These modified pathways would be a good platform for industrial production of isopentenol and related chemicals such as isoprene.

Résumé: La néoplasie endocrinienne multiple de type 1 (NEM1) est une maladie héréditaire rare, de transmission autosomique dominante prédisposant au développement d'une hyperplasie ou de tumeurs neuroendocrines (TNE) dans différents organes. Les atteintes les plus fréquentes, appelées atteintes majeures, sont l'hyperparathyroïdie, les TNE duodéno-pancréatiques, thymiques et bronchiques, ainsi que les adénomes hypophysaires et surrénaliens. Les TNE duodéno-pancréatiques sont fréquentes et représentent 60 % des causes de décès de la NEM1. Elles peuvent être fonctionnelles ou non fonctionnelles, bénignes ou malignes. Les TNE fonctionnelles duodéno-pancréatiques les plus fréquentes sont les gastrinomes et les insulinomes. Les patients atteints de NEM1 nécessitent une prise en charge pluridisciplinaire (gastroentérologue, endocrinologue, anatomopathologiste, radiologue, médecin nucléaire, chirurgien, généticien) en centre expert et un suivi à vie. La méconnaissance du diagnostic de NEM1 est une perte de chances pour le patient et sa famille. Cette revue fait le point sur les TNE duodéno-pancréatiques de la NEM1, notamment la prise en charge diagnostique et thérapeutique. Multiple endocrine neoplasia type 1 (MEN1) is a rare, hereditary, autosomal dominant disease. It is characterized by the presence of cell hyperplasia or tumors of the endocrine system : parathyroid, duodenopancreatic, thymic, and bronchial neuroendocrine tumors (NETs), and pituitary and adrenal adenomas. Duodenopancreatic involvement is common and accounts for 60% of the causes of death in MEN1. Duodenopancreatic NETs can be functional or non-functional, benign or malignant. The most common functional duodenopancreatic NETs are gastrinomas and insulinomas. Patients with MEN1 require multidisciplinary management (gastroenterologist, endocrinologist, pathologist, radiologist, nuclear physician, surgeon) in an expert center and lifelong follow-up. Failure to diagnose MEN1 is a loss of opportunity for the patient and his family. This review is centered on duodenopancreatic NETs in MEN1, specifically diagnostic and therapeutic management. [ABSTRACT FROM AUTHOR]

هدف: این پژوهش با هدف شناسایی تفاوت شاخص ضریب تأثیر (IF) در معرفی مجلات علمی برتر حوزه‌های علمی نسبت به شاخص‌های SJR، SNIP و IPP انجام شده است. روش‌شناسی: پژوهش از نظر نوع، کاربردی و از نظر روش اجرا از نوع مطالعه علم‌سنجی-‌تطبیقی، با رویکرد تحلیلی است. جامعه این مقاله مجلات علمی برتری است که در چارک اول (Q1) گزارش استنادی نشریات قرار دارند که شامل ۱۰۹۳ عنوان در حوزه‌های پزشکی، مهندسی و علوم اجتماعی است. داده‌های مورد نیاز از طریق جستجوی برخط در گزارش استنادی نشریات، پایگاه استنادی اسکوپوس و سایمگو جمع‌آوری شده است. در بخش تجزیه و تحلیل داده‌ها، برای سنجش نرمال‌بودن داده‌ها از آزمون‌های آماری کلموگروف اسمیرنف و برای پاسخ به ‌سؤالات از تحلیل عاملی اکتشافی مبتنی بر نرم‌افزار «اس پی اس اس، ویرایش 23» استفاده شد. یافته‌ها: نتایج نشان دادند در حوزه‌های مهندسی و علوم اجتماعی، اختلاف میانگین دو شاخص IF و SJR معنی‌دار و در حوزه پزشکی اختلاف میانگین این دو شاخص معنی‌دار نبوده است. در هر سه حوزه اختلاف میانگین دو شاخص IF و SNIP معنی‌دار است. در حوزه‌های پزشکی و علوم اجتماعی، اختلاف میانگین دو شاخص IF و IPP معنی‌دار و در حوزه مهندسی معنی‌دار نبوده است. در حوزه علوم اجتماعی شاخص­های SJR ،SNIP و IPP دارای هم‌بستگی بالا و شاخص IF با سایر شاخص‌ها هم‌بستگی بالایی ندارد. در حوزه مهندسی و علوم پزشکی شاخص‌های IF، SNIP و IPP دارای هم‌بستگی بالا و شاخص SJR با سایر شاخص‌ها هم‌بستگی بالایی ندارد. نتیجه‌گیری: بر اساس نتایج، استفاده از شاخص‌های مختلف در موضوعات گوناگون، نتایج متفاوتی ارائه می‌دهد و انتخاب شاخص دقیق‌تر در هر حوزه، با توجه به میزان نزدیکی و اختلاف این تفاوت‌ها باید صورت گیرد. در حوزه علوم اجتماعی به‌ترتیب شاخص‌های SJR، SNIP و IPP و در حوزه مهندسی و علوم پزشکی به‌ترتیب شاخص‌های IF، SNIP و IPP به دلیل بیشترین شباهت در رتبه‌بندی مجلات این حوزه‌ها، شاخص‌های مناسب‌تری برای استناد و تصمیم‌گیری هستند. استفاده از شاخص IF در حوزه علوم اجتماعی و شاخص SJR در حوزه‌های مهندسی و علوم پزشکی به دلیل نبود هم‌بستگی با سایر شاخص‌ها چندان مناسب به نظر نمی‌رسد و به‌طور کلی به‌کارگیری دو شاخص IPP و SNIP در تمام حوزه‌های موضوعی، شاخص‌های بهتر و قابل اعتمادتری هستند.

TMB-5 nucleating agent (NA) treated by different solvents were used as the β-NA of iPP. The effects of temperature on the crystalline structure of different iPP/TMB-5, as well as the crystallization and melting behaviors were investigated. It was found that strong polar solvent treated TMB-5 (TMB-5DMSO and TMB-5DMF) could induce more β-crystal at high Tc = 140 °C than the other TMB-5 NAs, while the β-crystal inducing efficiency of untreated TMB-5 (TMB-5UT) and non-polar solvent treated TMB-5 (TMB-5LP) is seriously reduced at high Tc = 140 °C. TMB-5DMSO can induce a high and stable content of β-crystal with Kβ = 83–94% within Tc = 90–140 °C, and TMB-5ODCB can induce a high content of β-crystal with Kβ > 91.3% within Tc = 90–130 °C. TMB-5DMF is the most temperature-sensitive one, but can induce a high fraction of β-crystal with Kβ > 92% both at low Tc = 90 °C and high Tc = 140 °C. High temperature pre-crystallization at Tpc = 150 °C tremendously reduces the β-crystal inducing efficiency of all TMB-5 NAs. TMB-5UT and TMB-5LP exhibit higher nucleating efficiency than TMB-5DMSO, TMB-5DMF and TMB-5ODCB. During the non-isothermal crystallization process, TMB-5UT induced β-crystal possesses higher structural perfection and stability, while TMB-5LP is more likely to induce α-crystal with considerable quantity and stability. The structural perfection and stability of TMB-5 induced β-crystal can be enhanced with appropriate increasing of Tc.

Résumé: Les inhibiteurs de la pompe à protons (IPP) sont une des classes thérapeutiques les plus prescrites. Le respect des indications est au centre d'un enjeu de santé publique, les taux de prescription inappropriée variant de 25 à 70 % selon les données de la littérature. La problématique de sécurité d'usage des IPP a récemment attiré l'attention des médias et des profanes. Les gastro-entérologues sont fréquemment sollicités sur la pertinence et l'innocuité du traitement par IPP. Afin d'éviter des arrêts intempestifs et inappropriés d'un traitement indiqué, les prescripteurs doivent évaluer objectivement les preuves permettant de retenir une éventuelle relation de cause à effet entre un effet indésirable et la prise d'IPP. Malgré la longue liste d'effets secondaires potentiels rapportée dans de nombreuses publications au cours de ces dernières années, la qualité des preuves apportées dans la littérature est souvent insuffisante pour établir une relation causale entre l'IPP et bon nombre d'effets indésirables signalés. Ainsi, de nombreux effets secondaires rapportés pourraient résulter de biais méthodologiques observés dans les études observationnelles, souvent rétrospectives. Le bon usage des IPP est le premier temps de prévention des effets secondaires ; il regroupe le respect des indications, l'adaptation de la posologie à la dose minimale efficace, la reconsidération du traitement à chaque nouvelle prescription et fait partie de notre responsabilité médicale permettant de limiter la survenue d'effets indésirables. La connaissance de ces effets et de leur risque de survenue peut permettre de les prévenir, de les détecter et de les prendre en charge précocement de façon adaptée. En cas d'indication avérée du traitement par IPP, il n'y a aucune preuve scientifique suffisante pour imposer un arrêt du traitement afin de limiter la survenue et l'intensité d'effets indésirables potentiels. Le but de ce travail est de passer en revue les principaux effets secondaires attribués aux IPP rapportés dans la littérature. Proton pump inhibitor's (PPI) are one of the most prescribed therapeutic classes. The respect of the indications is at the center of a public health issue, the rates of inappropriate prescription ranging from 25 to 70% according to the data in the literature. The problem of security in the use of PPIs has recently attracted the attention of the media and lay people. Gastroenterologists are frequently asked about the suitability and safety of treatment with PPI. In order to avoid untimely and inappropriate discontinuation of an indicated treatment, prescribers should objectively assess the evidence to support a possible cause-and-effect relationship between an adverse reaction and taking PPIs. Despite the long list of potential side effects of PPIs reported in numerous publications in recent years, the quality of the evidence provided in the literature is often insufficient to establish a causal relationship between treatment with PPIs and many of the effects unwanted reported. Thus, many reported side effects could be the result of methodological biases observed in observational studies, often retrospective. The correct use of PPIs is the first step in preventing side effects; it includes compliance with the indications, adjusting the dosage to the minimum effective dose, reconsidering the treatment with each new prescription and is part of our medical responsibility to limit the occurrence of adverse effects. The knowledge of these effects and their risk of occurrence can help prevent, detect and treat them early appropriately. In the event of a proven indication for treatment with PPI, there is currently no sufficient scientific evidence to impose treatment to be discontinued in order to limit the occurrence and intensity of potential side effects. The aim of this work is to review the main side effects attributed to PPIs reported in the literature. [ABSTRACT FROM AUTHOR]

Basalt powder (BP) is a promising eco-friendly filler for polymeric composites. Due to its chemical composition, it can alter the effectiveness of various modifying agents used in the polymer industry. In this study, the influence of simultaneous addition of 5 wt% of basalt powder and 0.5 or 1 wt% of a sorbitol-based nucleating agent (NA) on the structure and properties of isotactic polypropylene (iPP) composites was analyzed. The potential chemical reactions of BP and NA were evaluated by Fourier transform infrared spectroscopy. The influence of the additives on the crystallization of the polymer was studied by differential scanning calorimetry, optical microscopy in polarized light, and rheological measurements. The kinetics of crystallization was analyzed using Mo and Friedman methods. The structure of the composites was observed by scanning electron microscopy. The mechanical properties were also evaluated. It was found that the BP reacts with the NA, which limits its ability to form the microfibrillated network in the melt. As a result, the crystallization behavior of the nucleated basalt-filled iPP is almost the same as in the case of the composite without the NA. However, the samples containing both NA and BP present good mechanical properties and adhesion between the polymer and the filler.

Objective: To determine the relationship between total cholesterol, prostate volume, and intravesical prostatic protrusion in patients with benign prostatic hyperplasia. Material & Methods: This study used a cross-sectional method, carried out at the Paru and Bina Sehat Hospital in Jember. The sample in this study was BPH patients who met the inclusion criteria taken through medical record data from October 2019 to January 2020 Results: Samples on this study amounted to 33 patients. In this study, there was a difference between normal and high cholesterol with prostate volume in BPH patients (p = 0.00) and there was a significant relationship between cholesterol and prostate volume with strong correlation strength (p = 0.00 and r = 0.751) while the difference between high and normal cholesterol with IPP obtained insignificant results (p = 0.211) and the correlation between cholesterol and IPP obtained an insignificant relation with weak correlation strength (p = 0.217 and r = 0.221). Conclusion: There is a significant relationship between total cholesterol and prostate volume and a significant difference in prostate volume between normal and high total cholesterol in BPH patients, while there is no significant result between total cholesterol and intravesical prostatic protrusion in BPH patients.

Gamma delta (γδ) T cells, especially the Vγ9Vδ2 subtype, have been implicated in cancer therapy and thus have earned the spotlight in the past decade. Although one of the most important properties of γδ T cells is their activation by phosphoantigens, which are intermediates of the Mevalonate and Rohmer pathway of isoprenoid biosynthesis, such as IPP and HDMAPP, respectively, the global effects of such treatments on Vγ9Vδ2 T cells remain elusive. Here, we used the high-throughput transcriptomics approach to elucidate the transcriptional changes in human Vγ9Vδ2 T cells upon HDMAPP, IPP, and anti-CD3 treatments in combination with interleukin 2 (IL2) cytokine stimulation. These activation treatments exhibited a dramatic surge in transcription with distinctly enriched pathways. We further assessed the transcriptional dynamics upon inhibition of Notch signaling coupled with activation treatments. We observed that the metabolic processes are most affected upon Notch inhibition via GSI-X. The key effector genes involved in gamma–delta cytotoxic function were downregulated upon Notch blockade even in combination with activation treatment, suggesting a transcriptional crosstalk between T-cell receptor (TCR) signaling and Notch signaling in Vγ9Vδ2 T cells. Collectively, we demonstrate the effect of the activation of TCR signaling by phosphoantigens or anti-CD3 on the transcriptional status of Vγ9Vδ2 T cells along with IL2 stimulation. We further show that the blockade of Notch signaling antagonistically affects this activation. [ABSTRACT FROM AUTHOR]

La prescription des inhibiteurs de la pompe à protons (IPP) apparaît excessive. Pris au long cours, les IPP peuvent provoquer des effets indésirables graves. Il s'avère donc justifié de suspendre les traitements dont le bénéfice attendu semble trop faible par rapport aux risques encourus : c'est la dé-prescription. L'objectif de cette étude est d'évaluer un processus de dé-prescription des IPP à l'aide d'un algorithme dans un service hospitalier de médecine interne. Après une délibération collégiale, un algorithme d'aide à la dé-prescription des IPP a été validé. Le cas échéant, l'arrêt de l'IPP était progressif sur 1 mois. Un suivi téléphonique à 1, 2 et 3 mois a été réalisé afin d'évaluer le maintien de la dé-prescription et la survenue de symptômes digestifs. Les critères d'évaluation étaient les taux de dé-prescription et de maintien de la dé-prescription à 3 mois suivant les déclarations des patients, de leurs soignants ou d'un membre de leur famille. Cent cinq patients d'âge moyen 72 ans, ont été inclus sur une période de 21 semaines, et dans 31 cas (29 %), une dé-prescription a été réalisée. Après 3 mois de suivi, on constate 71 % de maintien de la dé-prescription. Trois patients ont été perdus de vue et 6 patients ont repris un IPP. La démarche entreprise a permis de suspendre une prise d'IPP dans près de 3 cas sur 10. L'effet persiste à 3 mois pour une grande majorité des patients. Il sera intéressant de poursuivre ce processus et d'étendre le suivi sur des périodes plus longues, afin de s'assurer du maintien à long terme de la dé-prescription des IPP. The prescription of proton pump inhibitors (PPIs) seems excessive. Taken over the long term, PPIs can cause serious side effects. It therefore turns out to be justified to suspend treatments whose expected benefit seems too low compared to the risks involved : it is deprescription. The objective of this study is to assess a process for the deprescription of PPIs in a hospital internal medicine department. After collegial deliberation, an algorithm for assisting in the deprescription of PPIs was validated. If necessary, the PPI was phased out over 1 month. A telephone follow-up at 1, 2 and 3 months was carried out in order to assess the maintenance of deprescription and the occurrence of digestive symptoms. The evaluation criteria were the rate of deprescription and the rate of maintenance of deprescription at 3 months following reports from patients, their caregivers or a family member. 105 patients with a mean age of 72 years were included over a period of 21 weeks, and in 31 cases (29%), deprescription was performed. After 3 months of follow-up, there was 71% maintenance of deprescription. Three patients were lost to follow-up and 6 patients resumed PPI. The approach undertaken resulted in the suspension of PPI intake in almost 3 out of 10 cases. This result was maintained at least three months for a large majority of patients. It will be interesting to continue this process and extend the monitoring over longer periods, in order to ensure that PPI de-prescription is maintained in the long term. [ABSTRACT FROM AUTHOR]

Benign prostate hyperplasia is common condition among elderly men, but giant intravesical prostatic protrusion is rare and may be confused with bladder carcinoma. We report an unusual case of giant intravesical prostatic protrusion mimicking bladder carcinoma. A diagnosis of giant intravesical prostatic protrusion was confirmed with the assistance of cystoscopy and patient was managed by transvesical simple open prostatectomy where he had uneventfully recovery. Both bladder carcinoma and benign prostate hyperplasia are more prevalent in elderly men and they all present with lower urinary tract symptoms. Ultrasound and computer tomography may all suggest bladder carcinoma. The two conditions are treated differently, and therefore having correct diagnosis is mandatory. Cystoscopy is an important investigation that can act as a tiebreaker in differentiating giant intravesical prostatic protrusion from bladder carcinoma. Transvesical simple open prostatectomy is the preferred surgical approach with good postoperative outcome. This case report reminds urology surgeons on the possibility of having giant intravesical prostate mimicking bladder carcinoma and the importance of cystoscopy in differentiating the two. Transvesical simple open prostatectomy has promising result. • Benign prostate enlargement is a common cause of lower urinary tract symptoms among elderly men. • Large intravesical prostatic protrusion is a rare condition, mimicking bladder tumour. • Cystoscopy plays an important role in differentiating IPP from bladder tumour. • Transvesical simple open prostatectomy for large intravesical prostatic protrusion and has good post operative results. [ABSTRACT FROM AUTHOR]

Isotactic polybutene-1 (iPB-1) possesses excellent physical and mechanical properties, but its applications are limited owing to the slow II-I transition after melt processing. The concerned II-I transition mechanism is a long-lasting hot topic. After an isotactic polypropylene (iPP) was melt-blended into iPB-1, a good model system for II-I transition study to discuss on roles of amorphous phase was consequently obtained with amorphous phase tuned but form II crystalline structures almost kept fixed according to the affected crystallization and melting behaviors of iPB-1 in iPB-1/iPP blends. Both DSC and FTIR results revealed the enhanced II-I transition behaviors of iPB-1 in the blends and FTIR results especially confirmed form I direct crystallization from amorphous phase of iPB-1/iPP blends prior to form II consumption due to II-I transition. The earlier the direct form I crystallization, the faster II-I transition of iPB-1 in the iPB-1/iPP blends. It was proposed that form I direct crystallization of the iPB-1 chain segments which have ability to crystallize but remained in the amorphous phase lowered the energy barrier of transition from adjacent form II crystals to packed-mesophases due to the local volume contract resulting in a stretch to iPB-1 chains with parts contained in the adjacent form II crystals. Consequently, the II-I transition of adjacent form II crystals were triggered to start and it generated a ripple effect on the entire II-I transition process. The results are of great significance on understanding of iPB-1 II-I transition process and also of importance for iPB-1 industrial applications. [Display omitted] • Minor iPP incorporation inhibits iPB-1 melt crystallization without form II crystalline structure variations. • Minor iPP incorporation accelerates II-I transition of iPB-1 after both isothermal and non-isothermal crystallization. • Direct form I crystallization occurs in amorphous phase prior to form II consumption related to II-I transition of iPB-1. • The earlier or more direct form I crystallization, triggers the faster iPB-1 II-I transition in a ripple manner. [ABSTRACT FROM AUTHOR]

Abstract Background Bioinformatics methods are helpful to identify new molecules for diagnostic or therapeutic applications. For example, the use of peptides capable of mimicking binding sites has several benefits in replacing a protein which is difficult to produce, or toxic. Using peptides is less expensive. Peptides are easier to manipulate, and can be used as drugs. Continuous epitopes predicted by bioinformatics tools are commonly used and these sequential epitopes are used as is in further experiments. Numerous discontinuous epitope predictors have been developed but only two bioinformatics tools have been proposed so far to predict peptide sequences: Superficial and PEPOP 2.0. PEPOP 2.0 can generate series of peptide sequences that can replace continuous or discontinuous epitopes in their interaction with their cognate antibody. Results We have developed an improved version of PEPOP (PEPOP 2.0) dedicated to answer to experimentalists’ need for a tool able to handle proteins and to turn them into peptides. The PEPOP 2.0 web site has been reorganized by peptide prediction category and is therefore better formulated to experimental designs. Since the first version of PEPOP, 32 new methods of peptide design were developed. In total, PEPOP 2.0 proposes 35 methods in which 34 deal specifically with discontinuous epitopes, the most represented epitope type in nature. Conclusion Through the presentation of its user-friendly, well-structured new web site conceived in close proximity to experimentalists, we report original methods that show how PEPOP 2.0 can assist biologists in dealing with discontinuous epitopes.

Aims/objectives: Interprofessional case conferences support future team-based approaches to healthcare, and inevitably require targeted communication between the various participants. However, the success of communication during a case conference must be learnt explicitly. The subject of conversation is often the only outcome of the case conference that is discussed in plenary or small groups. Communication processes are hardly taken into account. However, integrating process orientation and making communication relevant to goal achievement is mandatory in order to teach in a competence-oriented fashion in this area. The aim of this article is to present an empirically sound framework for teaching case conferences, with the help of which conversation processes can be practiced, evaluated and analysed in interprofessional case conferences.Methodology: With the aid of literature analysis, insights from empirical conversation research and the International Classification of Functioning and Health (ICF), we have developed an empirically and theoretically sound framework for interprofessional case conferences. This is intended to support the training of communication skills and to serve as a basis for assessing them.Results: In practice, it has been shown that embedding case conferences in higher education curricula is feasible and effective for a group size of 200 students. The framework has proven itself in verbal training while aligning itself with concepts of sharing for the negotiation of leadership, goals and decisions. In addition, it could also be used as a theoretical construct for the “interprofessional objective structured clinical examination” (iOSCE) at graduation from the module “Interprofessional Case Conference” at the Hochschule für Gesundheit.Conclusion: The topics of interprofessional practice (IPP) and communication are now the subject of curricula in the health professions, both nationally and internationally. In addition, various competence settings are available that can support didactic orientation. However, the authors believe that there are no concrete imperatives for competence-oriented implementation in teaching and examination. In the area of communication teaching, one can integrate empirically sound concepts instead of induction into degree course for the health professions, in order to provide a basis for the further development of communicative competence in this field.

Background: The indeterminate sentence of Imprisonment for Public Protection (IPP), was created in England and Wales in 2003. After its abolition in 2012, many IPP‐prisoners have become stuck in the prison system, facing considerable problems of sentence progression. The extant literature makes clear that the uncertainty and hopelessness caused by the indeterminacy of the IPP sentence are compounded by the negative impacts experienced by families and others providing support to people serving these sentences. Aims: The mental strains caused for family members by the IPP sentence were examined. Of particular interest is the role and weight of the parole process experience, and its potential mental and physiological health impact on families. Methods: This article draws on findings from two qualitative research projects conducted with families of prisoners serving the IPP sentence in England and Wales. Their experiences will be examined by reference to literature on the mental health impact of indeterminate sentences on prisoners and their families and the wider literature on the symbiotic harms of imprisonment for families. The aim was to add to this by focusing on families' experiences of cumulative stress caused by the sentence. Findings: We demonstrate that the IPP parole process exerts specific weight and mental strains on family members occupying the negative end of the stress spectrum. Drawing on a body of neuroscientific, neuroendocrinological and criminological literature, we argue that these mental health impacts on families may represent a public health risk in need of practical and policy mitigation. Implications: There is a pressing need for recognition of what are often hidden symbiotic harms experienced by families of people sentenced to IPP. Families require more information as well as considerably greater practical and emotional support on an institutional and communal level. [ABSTRACT FROM AUTHOR]

Background: Despite its abolition in 2012, the indeterminate sentence of Imprisonment for Public Protection (IPP) still casts a long shadow over the justice system. Recall is a growing problem: In June 2020, there were 1,359 recalled IPP prisoners. Research documents the negative mental health implications of initial imprisonment under an IPP sentence; however, little is known about experiences on licence, or post-recall.Aims: To explain how recalled IPP prisoners perceive being on licence, and in prison post-recall, to affect their mental wellbeing.Methods: We draw on 31 interviews with recalled IPP prisoners, conducted for a wider project exploring the high rates of IPP recall.Results: Three themes emerged: a perpetual state of anxiety about recall and spending additional years behind bars; self-imposed social isolation, both in the community and in prison; and a profound sense of hopelessness. People often feel trapped in an unjust and inevitable cycle of imprisonment, with little faith in a positive future.Conclusions: The government must make structural changes to stop the revolving door of IPP recall. In the short term, confidential mental health support should be available to people serving IPPs in prison and the community. [ABSTRACT FROM AUTHOR]

To understand the influence of freeze-thaw on the carbonization performance of concrete in severe cold areas, this paper conducted experiments to explore the carbonization law of fly ash concrete under freeze-thaw cycles. First, carbonization tests were conducted under different freeze-thaw cycles and fly ash contents; then PS (Photoshop) and IPP (Image-Pro Plus) were adopted to measure the carbonized area and calculate the ratio of carbonized area (RCA). The experimental results showed that, when the fly ash content was between 10% and 30%, RCA increased slowly; when the fly ash content was 20%, the convergence point showed up; when the fly ash content was 0, the air-entrained fly ash concrete had the best resistance to carbonation. With the help of PS and IPP, this paper calculated the RCA more accurately and found that, the freeze-thaw cycles can aggravate carbonization, and there is a linear relationship between carbonization depth and RCA. The research findings in this paper can provide a reference for the durability evaluation and design of concrete structures in severe cold areas. [ABSTRACT FROM AUTHOR]

Since 1999, when Takuzo Aida proposed the preparation of high density polyethylene (HDPE) crystalline nanofibers through polymerization of ethylene by a Cp2 TiCl2 /MCM-41 catalyst, many researchers have published various papers on different aspects of the idea. The published researches show that the endeavors to polymerize other types of alpha olefins, especially propylene, to obtain polyolefins with crystalline nanofiberous morphology have not been successful and no one has reported such morphology for them. In the present article, a possible reason behind these observations is proposed. Comparing the direction of the growth of HDPE chains and isotactic polypropylene (iPP) helices to become appropriate for making polymer crystals shows that HDPE chains are able to form crystal unit cells without concerning upward or downward chain growth direction, while the growth direction of adjacent iPP chains might be responsible for unsuccessful synthesis of crystalline iPP nanofibers in confined channels of the mesoporous catalysts. iPP helices can crystallize beside each other only in the form of anticline isochiral helices.

Severe problems of climate change, inequality, poverty, and unemployment have compelled the South African government to pass legislation that introduced programmes aimed at achieving energy security, promoting economic development, and realising environmental protection. The Renewable Energy Independent Power Producers Procurement Programme objective is to increase the share of renewable sources in the national energy mix, deliver jobs and economic empowerment for black communities (Africans, Coloureds, and Indians) and cut harmful greenhouse gas emissions. Independent power producers (IPPs) must demonstrate that their projects contribute to job creation and broad-based black economic empowerment during the bidding process. To date, studies suggest that IPPs are missing this government target. This study investigated this phenomenon through face-to-face interviews with key informants involved in the IPP process at two solar parks in Limpopo province. Qualitative content analysis was used to analyse and interpret the field notes. Findings reveal that the process of involving local communities in the governance of the IPP process is highly fragmented, leaving room for powerful stakeholders to thrive over vulnerable community members. The lack of monitoring by the government IPP office enables a prominent not-for-profit organisation to abscond from its responsibility of setting up a community trust for the benefit of local residents. Also, limited skills in the local communities mean that young people are employed in low-paying construction jobs that end after project commissioning. Lack of awareness and knowledge about IPP commitments made during the bidding process are responsible for the ‘wait and see’ approach of local leaders and community members. In the short-term, awareness and capacity-building interventions for local leaders and community members are urgently required to conscientise beneficiaries. It is imperative to create a participatory governance framework that prioritises vulnerable stakeholders as a long-term solution.

Résumé: L'endoscopie d'urgence s'adresse à des maladies graves à toute heure de prise en charge. Les indications sont essentiellement le traitement de l'hémorragie digestive et l'extraction des corps étrangers supérieurs. Mais elle peut aussi être nécessaire en cas de volvulus du sigmoïde et de syndrome d'Ogilvie résistant au traitement médical. La plupart des indications urgentes doivent conduire à une endoscopie dans les 24 heures mais, dans de rares cas, le délai doit être de moins de 12 heures voire de moins de 2 heures. Elle est souvent réalisée en dehors des heures ouvrables, la nuit, le week-end et les jours fériés. Elle doit cependant être réalisée dans de bonnes conditions avec une équipe entraînée. La bonne connaissance des indications des endoscopies d'urgence, ainsi que du délai et de ses modalités de réalisation est nécessaire à tout hépato-gastroentérologue pour prendre les bonnes décisions avec les correspondants urgentistes, réanimateurs, radiologues et chirurgiens et conduire à une prise en charge optimale du patient. Emergency endoscopy is mandatory at all times for critically ill patients. Emergency endoscopy is mainly performed for the management of digestive bleeding and for the extraction of foreign bodies. But it may also be necessary in case of sigmoid volvulus and Ogilvie syndrome resistant to medical treatment. Most urgent indications must lead to an endoscopy within 24 hours, and in rare cases within 12 hours or even less than 2 hours. It is therefore often be carried out outside working hours; at night, weekends and holidays. However, it should be performed by a properly trained team in an adequate environment. A knowledge of validated indications for emergency endoscopies, appropriate timing and procedures should therefore be mastered by any hepatogastroenterologist on duty, in order to take the appropriate decisions with emergency intensivists, radiologists and surgeons, and to obtain an optimal care for patients. [ABSTRACT FROM AUTHOR]

Despite recent progress in the understanding of γδ T cells' roles and functions, their interaction with αβ T cells still remains to be elucidated. In this study, we sought to clarify what precisely endows peripheral Vδ2+ T cells with immunosuppressive function on autologous αβ T cells. We found that negatively freshly isolated Vδ2+ T cells do not exhibit suppressive behavior, even after stimulation with IL-12/IL-18/IL-15 or the sheer contact with butyrophilin-3A1-expressing tumor cell lines (U251 or SK-Mel-28). On the other hand, Vδ2+ T cells positively isolated through TCR crosslinking or after prolonged stimulation with isopentenyl pyrophosphate (IPP) mediate strong inhibitory effects on αβ T cell proliferation. Stimulation with IPP in the presence of IL-15 induces the most robust suppressive phenotype of Vδ2+ T cells. This indicates that Vδ2+ T cells' suppressive activity is dependent on a TCR signal and that the degree of suppression correlates with its strength. Vδ2+ T cell immunosuppression does not correlate with their Foxp3 expression but rather with their PD-L1 protein expression, evidenced by the massive reduction of suppressive activity when using a blocking antibody. In conclusion, pharmacologic stimulation of Vδ2+ T cells via the Vδ2 TCR for activation and expansion induces Vδ2+ T cells' potent killer activity while simultaneously licensing them to suppress αβ T cell responses. Taken together, the study is a further step to understand—in more detail—the suppressive activity of Vδ2+ γδ T cells. [ABSTRACT FROM AUTHOR]

BACKGROUND: We sought to evaluate the effect of an integrated prospective payment program (IPP) on knowledge of hospice care and willingness to participate in hospice care among family members of patients on prolonged mechanical ventilation (PMV). METHODS: Between November 2013 and April 2014, we used paper-based survey questionnaires from 64 institutions to evaluate knowledge, willingness, and related factors among the main caregivers of patients on PMV regarding hospice care and to determine whether their decisions for the patients were affected by the IPP. RESULTS: The average ages of the respondents and patients on PMV were 51.9 y and 70.8 y respectively; 70.6% of the respondents knew about the Hospice Palliative Care Act (HPCA), and 42.3% of the medical staff had introduced hospice care-related information to patients and caregivers in Taiwan. Among the caregiver respondents, 67.6% agreed to write a letter of intent regarding the choice of hospice care or limited life-sustaining treatment. In total, 66.2% (16.1 = 50.1%) of the respondents agreed to hospice care for their family members (ie, the patients on PMV) when the condition was terminal. The factors of greater HPCA knowledge among the patients on PMV were IPP participation, female sex, and coma status. Factors leading to higher levels of HPCA knowledge included age > 65 y being married, higher income, awareness of the law, and being introduced to hospice care by medical staff. CONCLUSIONS: High levels of hospice care knowledge were unrelated to willingness to participate. HPCA knowledge was greater in the IPP group than in the non-IPP group; however, there was no significant difference in the willingness to agree to hospice care. It is recommended that individuals be encouraged to express their medical decisions. [ABSTRACT FROM AUTHOR]

To assess the impact of an interprofessional objective structured clinical examination (iOSCE) on attitudes/perceptions regarding interprofessional practice (IPP) and to determine if patient (simulated) outcomes improved with interprofessional collaboration (pharmacy and physician assistant (PA) students). A team of interprofessional faculty designed an iOSCE case and grading checklist containing key interventions. Students individually reviewed the case and were asked to document potential changes to the admission orders. Then they were given the opportunity to collaborate in an interprofessional team to discuss the case and orders. Finally, the team presented their recommendations to an interprofessional faculty panel. Individual and team scores were compared to determine the impact of interprofessional collaboration. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was administered pre- and post-iOSCE to assess changes in opinions about interprofessional learning. Individual and team iOSCE scores for 187 students were evaluated (86 PA and 101 pharmacy). A 21% absolute increase in the number of key interventions was found when comparing average individual scores to average team scores (2.11/5 vs. 3.18/5, p < 0.001). While in aggregate the students had a positive attitude towards IPE pre-iOSCE, RIPLS responses were strengthened post-iOSCE. Through iOSCEs, it appears students can learn from and with one another to improve patient care and gain perspective on the roles/skills of interprofessional colleagues. [ABSTRACT FROM AUTHOR]