Biomechanical comparison of bone staple fixation methods with suture material for median sternotomy closure using 3D-printed bone models

AIM

To compare the biomechanical properties of three different sternal closure techniques in a 3D-printed bone model of a sternum from a 30-kg dog.

METHODS

Median sternotomy was performed on a total of 90 three-dimensional (3D) copies of a polycarbonate (PC) model of a sternum, generated from the CT images of the sternum of a 30-kg German Shepherd dog. Three different methods were used to repair the sternotomies: polydioxanone suture (group PDS, n = 30), stainless steel bone staples (group SS, n = 30), and nitinol bone staples (group NS, n = 30). Each repair method was tested by applying tensile force in one of three ways (longitudinally, laterally, or torsionally) resulting in a sample size of n = 10 for each repair method-loading combination. In all experiments, the loads at 1-mm and 2-mm gap formation, failure, and the displacement at the failure point were measured.

RESULTS

In lateral distraction and longitudinal shear tests, NS and SS staple repairs required application of significantly greater force than PDS across all displacement criteria (1 and 2 mm). NS exhibited significantly greater failure load than PDS. In torsion tests, NS required significantly greater application of force compared to SS or PDS at all displacement criteria (1 and 2 mm) and exhibited a greater failure load than PDS. In terms of displacement at failure point, PDS suture showed more displacement than SS or NS across all experiments (laterally, longitudinally, torsionally).

CONCLUSIONS

In this study, bone staples were mechanically superior to PDS suture in median sternotomy closure using 3D-printed bone model in terms of 1-mm, 2-mm displacement loads, and displacement at failure. NS had a higher failure load than PDS under lateral, longitudinal, and torsional distraction.

CLINICAL RELEVANCE

These study results imply that bone staples can be considered as an alternative surgical method for median sternotomy closure in dogs.

Optical engineering of PbS colloidal quantum dot solar cells via Fabry-Perot resonance and distributed Bragg reflectors

A tradeoff between light absorption and charge transport is a well-known issue in PbS colloidal quantum dot (CQD) solar cells because the carrier diffusion length in PbS CQD films is comparable to the thickness of CQD film. We reduce the tradeoff between light absorption and charge transport by combining a Fabry-Perot (FP) resonator and a distributed Bragg reflector (DBR). A FP resonance is formed between the DBR and a dielectric-metal-dielectric film as a top transparent electrode. A SiO₂-TiO₂ multilayer is used to form a DBR. The FP resonance enhances light absorption near the resonant wavelength of the DBR without changing the CQD film thickness. The light absorption near the FP resonance wavelength is further boosted by coupling the FP resonance with the high reflectivity of the Ag-coated DBR. When the FP resonance and DBR are combined, the power conversion efficiency (PCE) of PbS CQD solar cells increases by 54%. Moreover, the DBR assisted FP resonance enables a very thin PbS layer to absorb near infrared light four times more. The overall PCE of the thin PbS CQD solar cell increases by 24% without sacrificing the average visible transmittance (AVT). Our results show how to overcome the inherence problem of the CQD and develop a semi-transparent solar cell where the wavelength-selective absorption and the transparency for visible light are important.

Fracture Liaison Service and Its Role in Secondary Fracture Prevention in Malaysia: A Scoping Review

Introduction

Fragility fractures, which occur after a low-trauma injury, increases with advancing age. Such fracture doubles the life-time risk of sustaining another fracture. This risk is highest in the immediate 18 months after the index fracture. However, most patients do not receive the appropriate risk assessment and intervention to reduce this risk. A coordinated model of care termed Fracture Liaison Service (FLS) has been reported to address this treatment gap.

Materials and methods

This scoping review aims to explore the potential role and delivery of FLS services in Malaysia. Scientific and non-scientific sources relevant to FLS were identified from electronic bibliographic databases, specialist journals and relevant websites. Findings were categorised into themes and presented narratively.

Results

FLS services remain concentrated in the Klang Valley. Even within FLS services, many do not have extensive coverage to risk assess all fracture patients. These services are multidisciplinary in nature where there are links between different departments, such as orthopaedics, osteoporosis expertise, bone densitometry, rehabilitation, falls services and primary care. FLS was able to increase the number of people undergoing fracture risk assessment and treatment. The importance of FLS was highlighted by local experts and stakeholders. Its implementation and delivery are supported by a number of national guidelines.

Conclusion

FLS is central to our national efforts to reduce the impending fragility fracture crisis in the coming years. Continued effort is needed to increase coverage within FLS services and across the country. Training, awareness of the problem, research, and policy change will support this endeavour.

Stabilization of Perovskite Solar Cells: Recent Developments and Future Perspectives

Exceptional power conversion efficiency (PCE) of 25.7% in perovskite solar cells (PSCs) has been achieved, which is comparable with their traditional rivals (Si-based solar cells). However, commercialization-worthy efficiency and long-term stability remain a challenge. In this regard, there are increasing studies focusing on the interface engineering in PSC devices to overcome their poor technical readiness. Herein, the roles of electrode materials and interfaces in PSCs are discussed in terms of their PCEs and perovskite stability. All the current knowledge on the factors responsible for the rapid intrinsic and external degradation of PSCs is presented. Then, the roles of carbonaceous materials as substitutes for noble metals are focused on, along with the recent research progress in carbon-based PSCs. Furthermore, a sub-category of PSCs, that is, flexible PSCs, is considered as a type of exceptional power source due to their high power-to-weight ratios and figures of merit for next-generation wearable electronics. Last, the future perspectives and directions for research in PSCs are discussed, with an emphasis on their commercialization.

Recovery from Cranial Nerve Symptoms after Flow Diversion without Coiling for Unruptured Very Large and Giant ICA Aneurysms

BACKGROUND AND PURPOSE

Cranial nerve symptoms, including visual impairment and ophthalmoplegia, are one of the most common presentations of very large and giant (≥15 mm) ICA aneurysms. In this study, we evaluated the treatment outcomes of flow diversion and conventional coiling in terms of recovery from cranial nerve symptoms and postoperative complications.

MATERIALS AND METHODS

Seventy-nine patients with unruptured ICA aneurysms of >15 mm who were treated with flow diversion or conventional coiling between December 2009 and December 2020 were retrospectively evaluated. We compared the radiologic and clinical outcomes, including recovery from cranial nerve symptoms, between the 2 groups.

RESULTS

Twenty-eight of 49 patients (57.1%) treated with flow diversion and 10 of 30 patients (33.3%) treated with conventional coiling initially presented with cranial nerve symptoms (P = .068). In the clinical follow-up, the symptom recovery rate was significantly higher in those treated with flow diversion (15 [50%] versus 3 [25%] with conventional coiling, P = .046). Multivariate logistic regression analysis demonstrated that flow diversion was significantly associated with symptom recovery (OR, 7.425; 95% CI, 1.091-50.546; P = .040). The overall postoperative complication rate was similar (flow diversion, 10 [20.4%]; conventional coiling, 6 [20.0%], P = .965), though fatal hemorrhagic complications occurred only in patients with intradurally located aneurysms treated with flow diversion (4 [8.2%] versus 0 [0.0%] with coiling, P = .108).

CONCLUSIONS

Flow diversion without coiling for very large and giant ICA aneurysms yielded a higher rate of recovery from cranial nerve symptoms, but it may be related to an increased hemorrhagic complication rate, especially for intradurally located aneurysms.

Immunoglobulin D Multiple Myeloma with a “Hidden” Lambda Light Chain

Introduction/Objective

In rare cases, the conventional immunofixation gel electrophoresis technique fails to detect the light chain of an M-protein. We report a case of immunoglobulin (Ig) D multiple myeloma with a hidden lambda (λ) light chain.

Methods/Case Report

Capillary electrophoresis (CE) (Sebia CAPILLARYS 2) was used to detect and quantify M- proteins in serum specimens. Immunosubtraction (IS) on the CAPILLARYS 2 systems was used to identify the classes of M-proteins. Conventional gel immunofixation electrophoresis (IFE) was performed, using monospecific antisera for IgD, IgE, kappa (κ) or λ in the Sebia HYDRASYS system, and IgG, IgA, IgM, κ or λ in the Helena SPIFE3000 system. Beta-mercaptoethanol (BME) with Fluidil were used as reduction agents.

Results (if a Case Study enter NA)

Results of serum CE showed two abnormal peaks in beta 2 and gamma regions, suspected to be positive for M-proteins. IS results showed subtraction for λ light chain only in both peaks, suggesting two monoclonal λ light chains. In contrary, no monoclonal λ light chain was detected in gamma region by IFE (Sebia). Epitope masking in the folded monoclonal protein was suspected to cause the “hidden λ light chain” and was further investigated by two laboratory approaches. IFE performed on the Helena SPIFE3000 system found two λ bands in beta 2 and gamma regions, which was consistent with the results from IS. The treatment of BME with Fluidil helped unmasking the hidden epitope and revealed the λ band in gamma region on IFE (Sebia).

Conclusion

The medical laboratories should be aware of the described scenario. The failure to detect light chains of certain intact M-proteins is most likely due to the structurally inaccessibility of light chains. It is recommended that treatment with reduction agents or use of an alternative methodology or IS might be helpful for investigating suspected heavy chain only cases, due to the limitation of conventional methodology.

The Variations of Insulin-like Growth Factor 1 Measured between Siemens Immulite, DiaSorin Liaison and IDS iSYS

Introduction/Objective

Insulin-like Growth Factor 1 (IGF-1) is a biomarker for the evaluation of growth hormone activity in the hypothalamic-pituitary axis. The current most common methodology for IGF-1 measurement is automated immunometric assays. In this study, we compared the IGF-1 on Siemens Immulite 2000, DiaSorin Liaison XL and IDS iSYS.

Methods/Case Report

Residual 30-110 serum specimens were randomly selected from routine hospital orders. IGF- 1 was measured on these three platforms and compared with Passing-Bablok regression. Bias was evaluated using the Bland-Altman method.

Results (if a Case Study enter NA)

Weighted Deming regression analysis showed approximately 80% and 56% positive bias on IDS iSYS and DiaSorin Liaison, compared with Siemens Immulite (iSYS=1.81*Immulite-117.65, r=0.91; Liaison=1.56*Immulite-4.58, r=0.98). There was approximately 8% positive bias on Liaison, compared with iSYS (Liaison=1.08*iSYS+0.56, r=0.99). The Passing-Bablok regression analysis revealed approximately 67% and 54% positive bias (iSYS=1.67*Immulite-75, r=0.91; Liaison=1.54*Immulite-3.44, r=0.91). Approximately 8% positive bias on Liaison was observed, compared with iSYS (Liaison=1.08*iSYS+5.65, r=0.99). The Bland-Altman plot showed the agreement between iSYS and Immulite IGF-1 was on average 129.6±123.3 ng/mL, 98.6±148.8 ng/mL between Liaison and Immulite and 37.0±46.5 ng/mL between Liaison and iSYS.

Conclusion

Immunoassays rely on the specificity of antibodies. There are wide variations between different immunoassay platforms for IGF-1 measurement. The standardization of IGF-1 assay is lack. It would be a challenge for clinicians to monitor IGF-1 or treat the patients with pituitary disorders, when switching to another platform. The potential impact of the variations in IGF-1 measurement between different immunoassay platforms should be aware.

Development of the Asia Pacific Consortium on Osteoporosis (APCO) Framework: clinical standards of care for the screening, diagnosis, and management of osteoporosis in the Asia-Pacific region

Guidelines for doctors managing osteoporosis in the Asia-Pacific region vary widely. We compared 18 guidelines for similarities and differences in five key areas. We then used a structured consensus process to develop clinical standards of care for the diagnosis and management of osteoporosis and for improving the quality of care.

PURPOSE

Minimum clinical standards for assessment and management of osteoporosis are needed in the Asia-Pacific (AP) region to inform clinical practice guidelines (CPGs) and to improve osteoporosis care. We present the framework of these clinical standards and describe its development.

METHODS

We conducted a structured comparative analysis of existing CPGs in the AP region using a "5IQ" model (identification, investigation, information, intervention, integration, and quality). One-hundred data elements were extracted from each guideline. We then employed a four-round Delphi consensus process to structure the framework, identify key components of guidance, and develop clinical care standards.

RESULTS

Eighteen guidelines were included. The 5IQ analysis demonstrated marked heterogeneity, notably in guidance on risk factors, the use of biochemical markers, self-care information for patients, indications for osteoporosis treatment, use of fracture risk assessment tools, and protocols for monitoring treatment. There was minimal guidance on long-term management plans or on strategies and systems for clinical quality improvement. Twenty-nine APCO members participated in the Delphi process, resulting in consensus on 16 clinical standards, with levels of attainment defined for those on identification and investigation of fragility fractures, vertebral fracture assessment, and inclusion of quality metrics in guidelines.

CONCLUSION

The 5IQ analysis confirmed previous anecdotal observations of marked heterogeneity of osteoporosis clinical guidelines in the AP region. The Framework provides practical, clear, and feasible recommendations for osteoporosis care and can be adapted for use in other such vastly diverse regions. Implementation of the standards is expected to significantly lessen the global burden of osteoporosis.

Asymmetric Bipolar Resistive Switching of Halide Perovskite Film in Contact with TiO2 Layer

Halide perovskite materials such as methylammonium lead iodide (CH₃NH₃PbI₃) have attracted considerable interest for the resistive random-access memory applications, which exploit a dramatic change in the resistance by an external electric bias. In many semiconductor films, the drift, accumulation, and chain formation of defects explain the change in the resistance by an external bias. This study demonstrates that the interface of CH₃NH₃PbI₃ with TiO₂ has a significant impact on the formation and rupture of defect chains and causes the asymmetric bipolar resistive switching in the Au/CH₃NH₃PbI₃/TiO₂/FTO device (FTO = fluorine-doped tin oxide). When a negative bias is applied to the Au electrode, iodine interstitials with the lowest migration activation energy move toward TiO₂ in the CH₃NH₃PbI₃ layer and pile up at the CH₃NH₃PbI₃-TiO₂ interface. Under the same condition, oxygen vacancies in the TiO₂ layer also travel to the CH₃NH₃PbI₃-TiO₂ interface and strongly attract iodine interstitials. As a result, a Schottky barrier appears at the CH₃NH₃PbI₃-TiO₂ interface, and the resistance of Au/CH₃NH₃PbI₃/TiO₂/FTO becomes much larger than that of Au/CH₃NH₃PbI₃/FTO in the high resistance state. The frequency dependence of the capacitance confirms the asymmetric appearance of a large space charge polarization at the CH₃NH₃PbI₃-TiO₂ interface, which causes the unique bipolar resistive switching behavior with the on/off ratio (10³) and retention time (>10⁴ seconds) at -0.85 V in Au/CH₃NH₃PbI₃/TiO₂/FTO film.

Blindness increases the risk for hip fracture and vertebral fracture but not the risk for distal radius fracture: a longitudinal follow-up study using a national sample cohort

The risks for hip fracture and vertebral fracture, but not the risk for distal radius fracture, were significantly higher in the blindness group than in the control group with a maximum 12-year follow-up.

PURPOSE

To evaluate the influence of visual impairment on the risk for osteoporotic fractures at common sites: hip, thoracic/lumbar vertebra, and distal radius.

METHODS

This longitudinal follow-up study used a database of a national sample cohort from 2002 to 2013 provided by the Korean National Health Insurance Service. Of a total of 1,125,691 subjects, 3918 patients with visual impairment and age ≥ 50 years were enrolled in a 1:4 ratio; 15,672 control participants were matched for age, sex, income, and region of residence. Stratified Cox proportional-hazards models were used to evaluate the crude and adjusted (for steroid medication, rheumatoid arthritis, depression, osteoporosis, diabetes mellitus, and stroke history) hazard ratios (HRs) for each fracture site. Fracture diagnoses were based on the ICD-10 codes: hip fracture (S720, S721, S722), vertebral fracture (S220, S320), and distal radius fracture (S525).

RESULTS

The HRs for hip and vertebral fracture were significantly higher in the blindness group (adjusted HR = 2.46, p < 0.001 for hip fracture; adjusted HR = 1.42, p = 0.020 for thoracic/lumbar vertebral fracture) than in the matched control group. However, the HR for distal radius fracture was not higher in the blindness group. The HRs for all three fracture sites were not significantly higher in the non-blindness visual impairment group after adjustment.

CONCLUSION

The risks for hip fracture and vertebral fracture were significantly higher in the blindness group. However, the risk for distal radius fracture was not related to visual impairment including blindness.

The Current and Future Challenges of Hip Fracture Management in Malaysia

By 2050, it is predicted that six million hip fractures will occur each year of which the majority will happen in Asia. Malaysia is not spared from this predicted rise and its rate of increase will be one of the highest in this region. Much of this is driven by our unprecedented growth in the number of older people. Characteristics of individuals with hip fractures in Malaysia mirror what has been reported in other countries. They will be older multimorbid people who were already at risk of falls and fractures. Outcomes were poor with at least a quarter do not survive beyond 12 months and in those that do survive have limitation in their mobility and activities of daily living. Reviewing how these fractures are managed and incorporating new models of care, such as orthogeriatric care, could address these poor outcomes. Experts have warned of the devastating impact of hip fracture in Malaysia and that prompt action is urgently required. Despite that, there remains no national agenda to highlight the need to improve musculoskeletal health in the country.

Effects of Surface Modifications to Single and Multilayer Graphene Temperature Coefficient of Resistance

Interfacial effects on single-layer graphene (SLG) or multilayer graphene (MLG) properties greatly affect device performance. Thus, the effect of the interface on the temperature coefficient of resistance (TCR) on SLG and MLG due to surface-deposited core-shell metallic nanoparticles (MNPs) and various substrates was experimentally investigated. Observed substrates included glass, SiO₂, and Si₃N₄. We show that these modifications can be used to strongly influence SLG interface effects, thus increasing the TCR up to a 0.456% per K resistance change when in contact with the SiO₂ substrate at the bottom surface and MNPs on the top surface. However, these surface interactions are muted in MLG due to the screening effect of nonsuperficial layers, only achieving a -0.0998% per K resistance change in contact with the bottom Si₃N₄ substrate and the top MNPs. We also demonstrate contrary thermal sensitivity responses between SLG and MLG after the addition of MNP to the surface.

An effective datasets describing antimicrobial peptide produced from Pediococcus acidilactici - purification and mode of action determined by molecular docking

Most of the probiotics Bacterial cells, express native antibacterial genes, resulting in the production of, antimicrobial peptides, which have various applications in biotechnology and drug development. But the identification of antibacterial peptide, structural characterization of antimicrobial peptide and prediction on mode of action. Regardless of the significance of protein manufacturing, three individual factors are required for the production method: gene expression, stabilization and specific peptide purification. Our protocol describes a straightforward technique of detecting and characterizing particular extracellular peptides and enhancing the antimicrobial peptide expression we optimized using low molecular weight peptides. This protocol can be used to improve peptide detection and expression. The following are the benefits of this method, (DOI – https://doi.org/10.1016/j.ijbiomac.2019.10.196 [1]).

The data briefly describe a simple method in detection identification, characterization of antimicrobial extracellular peptide, predicating the mode of action of peptide in targeting pathogens (In-silico method), brief method on profiling of antimicrobial peptide and its mode of action [1]. Further the protocol can be used to enhance the specific peptide expressions, detection of peptides. The advantages of this technique are presented below:•

Characterization protocol of specific antimicrobial peptide

•

The folded antimicrobial peptide expression were less expressed or non-expressed peptides.

•

Besides being low cost, less time-consuming, easy to handle, universal and fast to execute, the suggested technique can be used for multiple proteins expressed in probiotics (Lactobacillus species) expression system.

Secondary prevention of fragility fractures in Asia Pacific: an educational initiative

The Asia -Pacific Bone Academy (APBA) Fracture Liaison Service (FLS) Focus Group educational initiative has stimulated activity across the Asia -Pacific region with the intention of supporting widespread implementation of new FLS. In 2017, the APBA FLS Focus Group developed a suite of tools to support implementation of FLS across the Asia-Pacific region as a component of a multi-faceted educational initiative. This article puts this initiative into context with a narrative review describing the burden of fragility fractures in the region, the current secondary fracture prevention care gap and a summary of emerging best practice. The results of a survey to evaluate the impact of the APBA educational initiative is presented, in addition to commentary on recent activities intended to improve the care of individuals who sustain fragility fractures across the Asia -Pacific. A FLS Toolbox for Asia-Pacific was developed which included the following sections:1. The burden of fragility fractures in the Asia-Pacific region.2. A summary of evidence for FLS in the Asia-Pacific.3. A generic, fully referenced FLS business plan template.4. Potential cost savings accrued by each country, based on a country-specific FLS Benefits Calculator.5. How to start and expand FLS programmes in the Asia-Pacific context.6. A step-by-step guide to setting up FLS in countries in the Asia-Pacific region.7. Other practical tools to support FLS establishment.8. FLS online resources and publications.The FLS Toolbox was provided as a resource to support FLS workshops immediately following the 5th Scientific Meeting of the Asian Federation of Osteoporosis Societies (AFOS) held in Kuala Lumpur in October 2017. The FLS workshops addressed three key themes:• The FLS business case.• Planning the FLS patient pathway.• The role of the FLS coordinator in fragility fracture care management.A follow-up survey of 142 FLS workshop participants was conducted in August-September 2018. The survey included questions regarding how FLS were developed, funded, the scope of service provision and the support provided by the educational initiative. Almost one-third (30.3%) of FLS workshop participants completed the survey. Survey responses were reported for those who had established a FLS at the time the survey was conducted and, separately, for those who had not established a FLS. Findings for those who had established a FLS included:• 78.3% of respondents established a multidisciplinary team to develop the business case for their FLS.• 87.0% of respondents stated that a multidisciplinary team was established to design the patient pathway for their FLS.• 26.1% of respondents stated that their FLS has sustainable funding.• The primary source of funding for FLS was from public hospitals (83.3%) as compared with private hospitals (16.7%).Most hospitals that had not established a FLS at the time the survey was conducted were either in the process of setting-up a FLS (47%) or had plans in place to establish a FLS for which approval is being sought (29%). The primary barrier to establishing a new FLS was lack of sustainable funding. The APBA FLS Focus Group educational initiative has stimulated activity across the Asia-Pacific region with the intention of supporting widespread implementation of new FLS. A second edition of the FLS Toolbox is in development which is intended to complement ongoing efforts throughout the region to expedite widespread implementation of FLS.

Measurement of R(D) and R(D^{*}) with a Semileptonic Tagging Method

The experimental results on the ratios of branching fractions R(D)=B(B[over ¯]→Dτ^{-}ν[over ¯]_{τ})/B(B[over ¯]→Dℓ^{-}ν[over ¯]_{ℓ}) and R(D^{*})=B(B[over ¯]→D^{*}τ^{-}ν[over ¯]_{τ})/B(B[over ¯]→D^{*}ℓ^{-}ν[over ¯]_{ℓ}), where ℓ denotes an electron or a muon, show a long-standing discrepancy with the standard model predictions, and might hint at a violation of lepton flavor universality. We report a new simultaneous measurement of R(D) and R(D^{*}), based on a data sample containing 772×10^{6}  BB[over ¯] events recorded at the ϒ(4S) resonance with the Belle detector at the KEKB e^{+}e^{-} collider. In this analysis the tag-side B meson is reconstructed in a semileptonic decay mode and the signal-side τ is reconstructed in a purely leptonic decay. The measured values are R(D)=0.307±0.037±0.016 and R(D^{*})=0.283±0.018±0.014, where the first uncertainties are statistical and the second are systematic. These results are in agreement with the standard model predictions within 0.2, 1.1, and 0.8 standard deviations for R(D), R(D^{*}), and their combination, respectively. This work constitutes the most precise measurements of R(D) and R(D^{*}) performed to date as well as the first result for R(D) based on a semileptonic tagging method.

Correction to: Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures

The article 'Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures',written by J. A. Kanis, was originally published Online First without Open Access. After publication in volume [#], issue [#] and page [#-#], the author decided to opt for Open Choice and to make the article an Open Access publication.

Surgical treatment of nasolabial cysts in a single institute

OBJECTIVES

To analyse the results of treatment for nasolabial cysts according to whether an intraoral sublabial or endoscopic transnasal approach was used, and to determine the recent surgical trend in our hospital.

METHODS

Twenty-four patients with a histopathologically and radiologically confirmed nasolabial cyst between January 2010 and December 2017 were enrolled in this study.

RESULTS

Nasolabial cysts were predominant in females (91.7 per cent) and on the left side (54.2 per cent). Treatment involved an intraoral sublabial approach in 12 cases (48.0 per cent) and a transnasal endoscopic approach in 13 cases (52.0 per cent). In 13 cases (52.0 per cent) surgery was performed under local anaesthesia, while in 12 cases (48.0 per cent) it was conducted under general anaesthesia. The most common post-operative complications were numbness of the upper lip or teeth (n = 9, 36.0 per cent). Only one patient (4.0 per cent), who underwent a transnasal endoscopic approach, experienced a reoccurrence.

CONCLUSION

Surgical resection through an intraoral sublabial or transnasal endoscopic approach is the best treatment for a nasolabial cyst, showing very good results and a low recurrence rate. The recent surgical trend in our hospital is to treat nasolabial cysts using a transnasal endoscopic approach under local anaesthesia.

Role of the Interface between Ag and ZnO in the Electric Conductivity of Ag Nanoparticle-Embedded ZnO

The addition of Ag nanoparticles (Ag NPs) with an average size of 30 nm into ZnO increases the electric conductivity up to 1000 times. While a similar increase in the conductivity is observed in a mixture of Ag nanoparticles and Al-doped ZnO (AZO) films, a physical mechanism underlying the change in electric conductivity is not the same for Ag NP-added ZnO and Ag NP-added AZO. In Ag NP-added ZnO, an ohmic junction is formed at the ZnO-Ag interface, and electrons are accumulated in ZnO near the ZnO-Ag interface until electron-rich islands are connected. However, in Ag NP-added AZO, electrons in Ag NPs move to the AZO matrix via thermionic emission and travel through the AZO matrix. This change in electron transport at ZnO-Ag and AZO-Ag interfaces is due to the fact that the work function of ZnO (4.62 eV) is larger than those of Ag (4.24 eV) and AZO (4.15 eV). An increase in Ag NP content in the ZnO matrix leads to the overlap of the electron accumulation regions and forms a percolation path for the electron transport without deteriorating the electron mobility. Hence, the electron concentration increases to 2.4 × 10²⁰/cm³ in the 1.4 vol % Ag NP-added ZnO film. In addition, Ag NPs have a negligible effect on the transmittance, and the best Haacke figure of merit (Φ_H) values are 2.86 and 5.18 for ZnO:Ag NP and AZO:Ag NP, respectively.

Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures

Guidance is provided in an international setting on the assessment and specific treatment of postmenopausal women at low, high and very high risk of fragility fractures.

INTRODUCTION

The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2019. This manuscript seeks to apply this in an international setting, taking additional account of further categorisation of increased risk of fracture, which may inform choice of therapeutic approach.

METHODS

Clinical perspective and updated literature search.

RESULTS

The following areas are reviewed: categorisation of fracture risk and general pharmacological management of osteoporosis.

CONCLUSIONS

A platform is provided on which specific guidelines can be developed for national use to characterise fracture risk and direct interventions.

Outcomes of treatment of mammary analogue secretory carcinoma of the parotid gland

Mammary analogue secretory carcinoma (MASC) of the salivary gland is a newly-described, rare, malignant tumour. Few patients present with MASC of the parotid gland, so the exact characteristics, outcomes of treatment, and prognosis are unknown. The aim of this study was to analyse the clinical features and outcomes of treatment of MASC of the parotid gland in patients being treated at a single hospital. Five patients with histopathologically-confirmed MASC of the parotid gland between January 2015 and August 2018 were retrospectively enrolled. In all cases preoperative fine-needle aspiration cytology had failed to provide an accurate diagnosis. All patients underwent a macroscopically complete oncological resection. Two patients had postoperative radiotherapy (RT). On immunohistochemical examination all tumours stained for S-100 and mammaglobin but not for DOG1. There were no regional recurrences or distant metastases in any of the patients at their last follow-up. We obtained good results for patients with MASC of the parotid gland with surgical treatment and postoperative RT.

Unveiling the potentials of bacteriocin (Pediocin L50) from Pediococcus acidilactici with antagonist spectrum in a Caenorhabditis elegans model

Human-milk-based probiotics play a major role in the early colonization and protection of infants against gastrointestinal infection. We investigated potential probiotics in human milk. Among 41 Lactic acid bacteria (LAB) strains, four strains showed high antimicrobial activity against Escherichia coli 0157:H7, Listeria monocytogenes ATCC 15313, Bacillus cereus ATCC 14576, Staphylococcus aureus ATCC 19095, and Helicobacter pylori. The selected LAB strains were tested in simulated gastrointestinal conditions for their survival. Four LAB strains showed high resistance to pepsin (82%-99%), bile with pancreatine stability (96%-100%), and low pH (80%-94%). They showed moderate cell surface hydrophobicity (22%-46%), auto-aggregation abilities (12%-34%), and 70%-80% co-aggregation abilities against L. monocytogenes ATCC 15313, S. aureus ATCC 19095, B. cereus ATCC 14576, and E. coli 0157:H7. All four selected isolates were resistant to gentamicin, imipenem, novobiocin, tetracycline, clindamycin, meropenem, ampicillin, and penicillin. The results show that Pediococcus acidilatici is likely an efficient probiotic strain to produce < 3 Kda pediocin-based antimicrobial peptides, confirmed by applying amino acid sequences), using liquid chromatography mass spectrometry and HPLC with the corresponding sequences from class 2 bacteriocin, and based on the molecular docking, the mode of action of pediocin was determined on LipoX complex, further the ¹³C nuclear magnetic resonance structural analysis, which confirmed the antimicrobial peptide as pediocin.

Dental implant and fungus ball in the ethmoid sinus

Dental migration into the ethmoid sinus is extremely rare. Furthermore, it is very unusual that a displaced dental implant is associated with a concomitant fungus ball in the ethmoid sinus. Herein, we report an unusual case of the coexistence of a dental implant and fungus ball in the ethmoid sinus. It appears that this condition has not been reported previously.

C-band PAM-4 signal transmission using soft-output MLSE and LDPC code

We propose a DSP scheme with soft-output maximum likelihood sequence equalizer (sMLSE) and low-overhead (8.51%) low density parity check (LDPC) code for C-band PAM-4 transmission. In order to apply LDPC code in conjunction with MLSE, the conventional hard-output MLSE is modified to have a soft-output value by using the Max-log BCJR algorithm. The feasibility of this approach is experimentally investigated in a 56 Gb/s C-band PAM-4 system. In order to investigate the advantages of the proposed scheme, we compare the performance of the sMLSE-LDPC code to that of MLSE-RS code. Relatively, additional OSNR gain of 0.6 dB ~2.1 dB is achieved. The variation of the relative OSNR gain depends on the burst errors, which originate from the power fading effect. By using an interleaver that spreads burst errors in time, one can see that the relative OSNR gain is improved as 1.6 dB ~2.1 dB. Using the proposed scheme with the interleaver, one can see that the 30 km transmission of 56 Gb/s PAM-4 in the C-band was experimentally demonstrated.

Case reports of atrial and pericardial rupture from blunt cardiac trauma

Background

Blunt cardiac trauma is diagnosed in less than 10% of trauma patients and covers the range of severity from clinically insignificant myocardial contusions to lethal multi-chamber cardiac rupture. The most common mechanisms of injury include: motor vehicle collisions (MVC), pedestrians struck by motor vehicles and falls from significant heights. A severe complication from blunt cardiac trauma is cardiac chamber rupture with pericardial tear. It is an exceedingly rare diagnosis. A retrospective review identified only 0.002% of all trauma patients presented with this condition. Most patients with atrial rupture do not survive transport to the hospital and upon arrival diagnosis remains difficult.

Case presentation

We present two cases of atrial and pericardial rupture. The first case is a 33-year-old female involved in a MVC, who presented unresponsive, hypotensive and tachycardic. A left sided hemothorax was diagnosed and a chest tube placed with 1200 mL of bloody output. The patient was taken to the OR emergently. Intraoperatively, a laceration in the right pericardium and a 3 cm defect in the anterior, right atrium were identified. Despite measures to control hemorrhage and resuscitate the patient, the patient did not survive.

The second case is a 58-year-old male involved in a high-speed MVC. Similar to the first case, the patient presented unresponsive, hypotensive and tachycardic with a left sided hemothorax. A chest tube was placed with 900 mL of bloody output. Based on the output and ongoing resuscitation requirements, the patient was taken to the OR. Intraoperatively, a 15 cm anterior pericardial laceration was identified. Through the defect, there was brisk bleeding from a 1 cm laceration on the left atrial appendage. The injury was debrided and repaired using a running 3–0 polypropylene suture over a Satinsky clamp. The patient eventually recovered and was discharged home.

Conclusions

We present two cases of uncontained atrial and pericardial rupture from blunt cardiac trauma. Contained ruptures with an intact pericardium present as a cardiac tamponade while uncontained ruptures present with hemomediastinum or hemothorax. A high degree of suspicion is required to rapidly diagnose and perform the cardiorrhaphy to offer the best chance at survival.

Highly Bendable Flexible Perovskite Solar Cells on a Nanoscale Surface Oxide Layer of Titanium Metal Plates

We report highly bendable and efficient perovskite solar cells (PSCs) that use thermally oxidized layer of Ti metal plate as an electron transport layer (ETL). The power conversion efficiency (PCE) of flexible PSCs reaches 14.9% with a short-circuit current density (J_sc) of 17.9 mA/cm², open-circuit voltage (V_oc) of 1.09, and fill factor (ff) of 0.74. Moreover, the Ti metal-based PSCs exhibit a superior fatigue resistance over indium tin oxide/poly(ethylene terephthalate) substrate. Flexible PSCs maintain 100% of their initial PCE even after PSCs are bent 1000 times at a bending radius of 4 mm. This excellent performance of flexible PSCs is due to high crystalline quality and low oxygen vacancy concentration of TiO₂ layer. The concentration of oxygen vacancies in the oxidized Ti metal surface controls the electric function of TiO₂ as ETL of PSCs. A decrease in the oxygen vacancy concentration of the TiO₂ layer is critical to improving the electron collection efficiency of the ETL. Our results suggest that Ti metal-based PSCs possess excellent mechanical properties, which can be applied to the renewable energy source for flexible electronics.

Standardisation of defined approaches for skin sensitisation testing to support regulatory use and international adoption: position of the International Cooperation on Alternative Test Methods

Skin sensitisation is the regulatory endpoint that has been at the centre of concerted efforts to replace animal testing in recent years, as demonstrated by the Organisation for Economic Co-operation and Development (OECD) adoption of five non-animal methods addressing mechanisms under the first three key events of the skin sensitisation adverse outcome pathway. Nevertheless, the currently adopted methods, when used in isolation, are not sufficient to fulfil regulatory requirements on the skin sensitisation potential and potency of chemicals comparable to that provided by the regulatory animal tests. For this reason, a number of defined approaches integrating data from these methods with other relevant information have been proposed and documented by the OECD. With the aim to further enhance regulatory consideration and adoption of defined approaches, the European Union Reference Laboratory for Alternatives to Animal testing in collaboration with the International Cooperation on Alternative Test Methods hosted, on 4-5 October 2016, a workshop on the international regulatory applicability and acceptance of alternative non-animal approaches, i.e., defined approaches, to skin sensitisation assessment of chemicals used in a variety of sectors. The workshop convened representatives from more than 20 regulatory authorities from the European Union, United States, Canada, Japan, South Korea, Brazil and China. There was a general consensus among the workshop participants that to maximise global regulatory acceptance of data generated with defined approaches, international harmonisation and standardisation are needed. Potential assessment criteria were defined for a systematic evaluation of existing defined approaches that would facilitate their translation into international standards, e.g., into a performance-based Test Guideline. Informed by the discussions at the workshop, the ICATM members propose practical ways to further promote the regulatory use and facilitate adoption of defined approaches for skin sensitisation assessments.

Altering surface fluctuations by blending tethered and untethered chains

"Partially tethering" a thin film of a polymer melt by covalently attaching to the substrate a fraction of the chains in an unentangled melt dramatically increases the relaxation time of the surface height fluctuations. This phenomenon is observed even when the film thickness, h, is 20 times the unperturbed chain radius, R_g,tethered, of the tethered chains, indicating that partial tethering is more influential than any physical attraction with the substrate. Furthermore, a partially tethered layer of a low average molecular weight of 5k showed much slower surface fluctuations than did a reference layer of pure untethered chains of much greater molecular weight (48k), so the partial tethering effect is stronger than the effects of entanglement and increase in glass transition temperature, T_g, with molecular weight. Partial tethering offers a means of tailoring these fluctuations which influence wetting, adhesion, and tribology of the surface.

Correlation of insulin-like growth factor 1 and osteoarthritic cartilage degradation: a spontaneous osteoarthritis in guinea-pig

OBJECTIVE

The pathogenesis of osteoarthritis centers on the imbalance between catabolic and anabolic processes in cartilage metabolism. Insulin growth factor 1 (IGF-1) has been shown to have anabolic effects in cartilage in vitro. This study aim to determine whether IGF-1 on cartilage is associated with loss of chondrocyte and extracellular matrix breakdown using the Hartley guinea pig model.

MATERIALS AND METHODS

Cartilage from the medial and lateral tibial plateau of 6-month and 12-month old Hartley guinea pigs were used for this study. Histological analysis was performed with hematoxylin-eosin (HE) and toluidine blue staining. Safranin-O staining was used to quantify proteoglycan (PG) loss and the extent of cartilage damage by Modified Mankin score. Distribution of IGF-1 was demonstrated with in situ hybridization techniques. IGF-1 mRNA levels were assessed using Real-time PCR.

RESULTS

Histological loss of chondrocytes, and cartilage matrix and decreased IGF-1 distribution were demonstrated in a temporal and spatial manner. Compared to the 6-month old samples, the 12-month specimens had significantly cartilage degeneration and less cartilage matrix and PGs staining. Decreased level of IGF-1 was also observed in the 12-month samples. These observations were more pronounced in the medial tibial plateau when compared to the lateral plateau.

CONCLUSIONS

The decreased level of IGF-1 may play a critical role for maintaining the balance between catabolic and anabolic processes in cartilage metabolism during the development of osteoarthritis. Thus, the increase of IGF-1 may be applicable to developing OA therapy.

Genetic diversity and population structure analysis in Perilla frutescens from Northern areas of China based on simple sequence repeats

In this study, 21 simple sequence repeat (SSR) markers were used to evaluate the genetic diversity and population structure among 77 Perilla accessions from high-latitude and middle-latitude areas of China. Ninety-five alleles were identified with an average of 4.52 alleles per locus. The average polymorphic information content (PIC) and genetic diversity values were 0.346 and 0.372, respectively. The level of genetic diversity and PIC value for cultivated accessions of Perilla frutescens var. frutescens from middle-latitude areas were higher than accessions from high-latitude areas. Based on the dendrogram of unweighted pair group method with arithmetic mean (UPGMA), all accessions were classified into four major groups with a genetic similarity of 46%. All accessions of the cultivated var. frutescens were discriminated from the cultivated P. frutescens var. crispa. Furthermore, most accessions of the cultivated var. frutescens collected in high-latitude and middle-latitude areas were distinguished depending on their geographical location. However, the geographical locations of several accessions of the cultivated var. frutescens have no relation with their positions in the UPGMA dendrogram and population structure. This result implies that the diffusion of accessions of the cultivated Perilla crop in the northern areas of China might be through multiple routes. On the population structure analysis, 77 Perilla accessions were divided into Group I, Group II, and an admixed group based on a membership probability threshold of 0.8. Finally, the findings in this study can provide useful theoretical knowledge for further study on the population structure and genetic diversity of Perilla and benefit for Perilla crop breeding and germplasm conservation.

Enhanced viscoelastic property of iron oxide nanoparticle decorated organoclay fluid under magnetic field

Stable hydrophobic nanocomposites of magnetic nanoparticles and clay are prepared by the self-assembly of magnetite (Fe₃O₄) nanoparticles on surfaces of exfoliated clay platelets. Due to the attractive interaction between hydrophobic groups, oleic acid coated nanoparticles are strongly attached to the surface of cetyl trimethylammonium cation coated clay platelets in organic media. Crystal structure and magnetic property of composite particles are examined using electron microscopy, x-ray diffractometer and vibration sample magnetometer. In addition, composite particles are dispersed in mineral oil and rheological properties of composite particle suspensions are characterized using steady-state and oscillatory measurements. Magnetite nanoparticle decorated organoclay forms a tunable network in mineral oil. When a magnetic field is applied, the composite particle fluid exhibits higher storage modulus and maintains a solid-like property at larger strain. Our results show that the viscoelastic property of the magnetite nanoparticle decorated organoclay fluid is controlled by applying external magnetic field.

A Light Illumination Enhancement Device for Photoacoustic Imaging: In Vivo Animal Study

Photoacoustic (PA) imaging detects acoustic signals generated by thermal expansion of a light-excited tissue or contrast agents. PA signal amplitude and image quality directly depend on the light fluence at the target depth. With conventional PA imaging systems, approximately 30% energy of incident light at the near-infrared region would be lost due to reflection on the skin surface. Such light loss directly leads to a reduction of PA signal and image quality. A new light delivery scheme that collects and redistributes reflected light energy was recently suggested, which is called the light catcher. In our previous study, proof of concept using a finite-element simulation model was shown and a laboratory-built prototype of the light catcher was applied on tissue-mimicking phantoms. In this paper, we present an elaborate prototype of a high-frequency PA probe with the light catcher fabricated using 3-D printing technology, which is conformal to a subcutaneous tumor in mice. The in vivo usefulness of the developed prototype was evaluated in a mouse tumor model. Equipped with the light catcher, PA signal amplitude from the clinical photosensitizer injected into the mouse tumor was enhanced by 33.7%, which is approximately equivalent to the percent light loss due to reflection on the skin.

Prevalence of Traumatic Findings on Routine MRI in a Large Cohort of Professional Fighters

BACKGROUND AND PURPOSE

Previous studies investigating MR imaging abnormalities among fighters have had small sample sizes. This investigation assessed a large number of fighters using the same conventional sequences on the same scanner.

MATERIALS AND METHODS

Conventional 3T MR imaging was used to assess 499 fighters (boxers, mixed martial artists, and martial artists) and 62 controls for nonspecific WM changes, cerebral microhemorrhage, cavum septum pellucidum, and cavum vergae. The lengths of the cavum septum pellucidum and cavum vergae and the ratio of cavum septum pellucidum to the septum pellucidum lengths were assessed.

RESULTS

The prevalence of nonspecific WM changes was similar between groups. Fighters had a prevalence of cerebral microhemorrhage (4.2% versus 0% for controls, P = .152). Fighters had a higher prevalence of cavum septum pellucidum versus controls (53.1% versus 17.7%, P < .001) and cavum vergae versus controls (14.4% versus 0%, P < .001). The lengths of the cavum septum pellucidum plus the cavum vergae (P < .001), cavum septum pellucidum (P = .025), and cavum septum pellucidum to the septum pellucidum length ratio (P = .009) were higher in fighters than in controls. The number of fights slightly correlated with cavum septum pellucidum plus cavum vergae length (R = 0.306, P < .001) and cavum septum pellucidum length (R = 0.278, P < .001). When fighters were subdivided into boxers, mixed martial artists, and martial artists, results were similar to those in the whole-group analysis.

CONCLUSIONS

This study assessed MR imaging findings in a large cohort demonstrating a significantly increased prevalence of cavum septum pellucidum among fighters. Although cerebral microhemorrhages were higher in fighters than in controls, this finding was not statistically significant, possibly partially due to underpowering of the study.

Novel Carrier Doping Mechanism for Transparent Conductor: Electron Donation from Embedded Ag Nanoparticles to the Oxide Matrix

A trade-off between the carrier concentration and carrier mobility is an inherent problem of traditional transparent conducting oxide (TCO) films. In this study, we demonstrate that the electron concentration of TCO films can be increased without deteriorating the carrier mobility by embedding Ag nanoparticles (NPs) into Al-doped ZnO (AZO) films. An increment of Ag NP content up to 0.7 vol % in the AZO causes the electron concentration rising to 4 × 10²⁰ cm^-3. A dependence of the conductivity on temperature suggests that the energy barrier for the electron donation from Ag NPs at room temperature is similar to the Schottky barrier height at the Ag-AZO interface. In spite of an increase in the electron concentration, embedded Ag NPs do not compromise the carrier mobility at room temperature. This is evidence showing that this electron donation mechanism by Ag NPs is different from impurity doping, which produces both electrons and ionized scattering centers. Instead, an increase in the Fermi energy level of the AZO matrix partially neutralizes Al impurities, and the carrier mobility of Ag NP embedded AZO film is slightly increased. The optical transmittance of mixture films with resistivity less than 1 × 10^-3 Ω·cm still maintains above 85% in visible wavelengths. This opens a new paradigm to the design of alternative TCO composite materials which circumvent an inherent problem of the impurity doping.

Low-Temperature Modification of ZnO Nanoparticles Film for Electron-Transport Layers in Perovskite Solar Cells

An electron-transport layer (ETL) that selectively collects photogenerated electrons is an important constituent of halide perovskite solar cells (PSCs). Although TiO₂ films are widely used as ETL of PSCs, the processing of TiO₂ films with high electron mobility requires high-temperature annealing and TiO₂ dissociates the perovskite layer through a photocatalytic reaction. Here, we report an effective surface-modification method of a room-temperature processed ZnO nanoparticles (NPs) layer as an alternative to the TiO₂ ETL. A combination of simple UV exposure and nitric acid treatment effectively removes the hydroxyl group and passivates surface defects in ZnO NPs. The surface modification of ZnO NPs increases the power conversion efficiency (PCE) of PSCs to 14 % and decreases the aging of PSCs under light soaking. These results suggest that the surface-modified ZnO film can be a good ETL of PSCs and provide a path toward low-temperature processing of efficient and stable PSCs that are compatible with flexible electronics.

Gas-Phase Conformations and N-Glycosidic Bond Stabilities of Sodium Cationized 2'-Deoxyguanosine and Guanosine: Sodium Cations Preferentially Bind to the Guanine Residue

2'-Deoxyguanosine (dGuo) and guanosine (Guo) are fundamental building blocks of DNA and RNA nucleic acids. In order to understand the effects of sodium cationization on the gas-phase conformations and stabilities of dGuo and Guo, infrared multiple photon dissociation (IRMPD) action spectroscopy experiments and complementary electronic structure calculations are performed. The measured IRMPD spectra of [dGuo+Na]⁺ and [Guo+Na]⁺ are compared to calculated IR spectra predicted for the stable low-energy structures computed for these species to determine the most favorable sodium cation binding sites, identify the structures populated in the experiments, and elucidate the influence of the 2'-hydroxyl substituent on the structures and IRMPD spectral features. These results are compared with those from a previous IRMPD study of the protonated guanine nucleosides to elucidate the differences between sodium cationization and protonation on structure. Energy-resolved collision-induced dissociation (ER-CID) experiments and survival yield analyses of protonated and sodium cationized dGuo and Guo are performed to compare the effects of these cations toward activating the N-glycosidic bonds of these nucleosides. For both [dGuo+Na]⁺ and [Guo+Na]⁺, the gas-phase structures populated in the experiments are found to involve bidentate binding of the sodium cation to the O6 and N7 atoms of guanine, forming a 5-membered chelation ring, with guanine found in both anti and syn orientations and C2'-endo (²T₃ or ³T₂) puckering of the sugar. The ER-CID results, IRMPD yields and the computed C1'-N9 bond lengths indicate that sodium cationization activates the N-glycosidic bond less effectively than protonation for both dGuo and Guo. The 2'-hydroxyl substituent of Guo is found to impact the preferred structures very little except that it enables a 2'OH···3'OH hydrogen bond to be formed, and stabilizes the N-glycosidic bond relative to that of dGuo in both the sodium cationized and protonated complexes.

Sclerosing mucoepidermoid carcinoma of the sublingual gland

INTRODUCTION

Sclerosing mucoepidermoid carcinoma of the salivary gland is a rare subtype of mucoepidermoid carcinoma. The most common site of sclerosing mucoepidermoid carcinoma of the salivary glands is the parotid gland, followed by the submandibular gland, and the minor salivary glands.

OBSERVATION

Here we report the first case of sclerosing mucoepidermoid carcinoma of the sublingual gland.

DISCUSSION

Clinicians should consider sclerosing mucoepidermoid carcinoma in the differential diagnosis of salivary gland neoplasm. Surgical excision with clear margins seems to be a sufficient initial treatment option for sclerosing mucoepidermoid carcinoma of the salivary gland.

Rickettsia parkeri and "Candidatus Rickettsia andeanae" in Questing Amblyomma maculatum (Acari: Ixodidae) From Mississippi

Amblyomma maculatum Koch (Acari: Ixodidae), the primary vector for Rickettsia parkeri, may also be infected with a rickettsia of unknown pathogenicity, "Candidatus Rickettsia andeanae." Infection rates with these rickettsiae vary geographically, and coinfected ticks have been reported. In this study, infection rates of R. parkeri and "Ca. R. andeanae" were evaluated, and rickettsial DNA levels quantified, in 335 questing adult A. maculatum collected in 2013 (n = 95), 2014 (n = 139), and 2015 (n = 101) from Oktibbeha County, MS. Overall infection rates of R. parkeri and "Ca. R. andeanae" were 28.7% and 9.3%, respectively, with three additional A. maculatum (0.9%) coinfected. While R. parkeri-infected ticks were detected all three years (34.7% in 2013; 13.7% in 2014; 43.6% in 2015), "Ca. R. andeanae" was not detected in 2013, and was detected at rates of 10.8% in 2014, and 15.8% in 2015. Interestingly, rickettsial DNA levels in singly-infected ticks were significantly lower in "Ca. R. andeanae"-infected ticks compared to R. parkeri-infected ticks (P < 0.0001). Thus, both infection rates and rickettsial DNA levels were higher for R. parkeri than "Ca. R. andeanae." Infection rates of R. parkeri were also higher, and "Ca. R. andeanae" lower, here compared to A. maculatum reported previously in Kansas and Oklahoma. As we continue to monitor infection rates and levels, we anticipate that understanding temporal changes will improve our awareness of human risk for spotted fever rickettsioses. Further, these data may lead to additional studies to evaluate potential interactions among sympatric Rickettsia species in A. maculatum at the population level.

Deformation mechanisms to ameliorate the mechanical properties of novel TRIP/TWIP Co-Cr-Mo-(Cu) ultrafine eutectic alloys

In the present study, the microstructural evolution and the modulation of the mechanical properties have been investigated for a Co-Cr-Mo (CCM) ternary eutectic alloy by addition of a small amount of copper (0.5 and 1 at.%). The microstructural observations reveal a distinct dissimilarity in the eutectic structure such as a broken lamellar structure and a well-aligned lamellar structure and an increasing volume fraction of Co lamellae as increasing amount of copper addition. This microstructural evolution leads to improved plasticity from 1% to 10% without the typical tradeoff between the overall strength and compressive plasticity. Moreover, investigation of the fractured samples indicates that the CCMCu alloy exhibits higher plastic deformability and combinatorial mechanisms for improved plastic behavior. The improved plasticity of CCMCu alloys originates from several deformation mechanisms; i) slip, ii) deformation twinning, iii) strain-induced transformation and iv) shear banding. These results reveal that the mechanical properties of eutectic alloys in the Co-Cr-Mo system can be ameliorated by micro-alloying such as Cu addition.

Activation of Vanilloid Receptor 1 (VR1) by Eugenol

The structural similarity of eugenol with capsaicin suggests that these two agents may share molecular mechanisms to produce their effects. We investigated the effects of eugenol in comparison with those of capsaicin using whole-cell patch clamp and Fura-2-based calcium-imaging techniques in a heterologous expression system and with sensory neurons. In vanilloid receptor 1 (VR1)-expressing human embryonic kidney (HEK) 293 cells and trigeminal ganglion (TG) neurons, eugenol activated inward currents, whereas capsazepine, a competitive VR antagonist, and ruthenium red (RR), a functional VR antagonist, completely blocked eugenol-induced inward currents. Moreover, eugenol caused elevation of [Ca2+]i, and this was completely abolished by both capsazepine and ruthenium red in VR1-expressing HEK 293 cells and TG neurons. Our results provide strong evidence that eugenol produces its effects, at least in part, via VR1 expressed by the sensory nerve endings in the teeth.