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BACKGROUND: Hypothesizing that early treatment yields improved prognosis, we aimed to investigate how the timing of immunosuppressive treatment relates to interstitial lung disease (ILD) development and the course of pulmonary function in systemic sclerosis (SSc). METHODS: A cohort was created using data from the EUSTAR database and Nijmegen Systemic Sclerosis cohort, including adult patients who started their first immunosuppressive treatment (ie mycophenolate mofetil, methotrexate, cyclophosphamide, tocilizumab or rituximab) after SSc diagnosis, and no signs of ILD on high-resolution CT. ILD-free survival and the course of forced vital capacity % predicted (ppFVC) were assessed for up to 5 years follow-up comparing patients who started early (disease duration ≤ 3 years) vs late with immunosuppression. RESULTS: 1052 patients met the eligibility criteria. The early treatment group (n = 547, 52%) showed a higher prevalence of male sex, diffuse cutaneous subtype (53.1% vs 36.5%), and anti-topoisomerase-I antibody (ATA, 51.1% vs 42.7%). Most patients were treated with methotrexate (60.1%), whereas only a few patients were treated with biologicals (1.7%). The incidence of ILD was 46.6% after mean (SD) 3.6(1.4) years; the hazards ratio for ILD in the early treatment group was 1.13 (95% CI: 0.93-1.38) after adjustment for confounders. PpFVC trajectories were comparable between groups. CONCLUSION: Our findings did not confirm a preventive role of early initiation of immunosuppressive therapy vs late initiation on ILD development. However, our findings should be interpreted with caution, considering the high inflammatory, ATA-positive enriched nature of the cohort, confounding by indication, and very few patients were treated with biologicals.
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The Association of Southeast Asian Nations is blessed with agricultural resources, and with the growing population, it will continue to prosper, which follows the abundance of agricultural biomass. Lignocellulosic biomass attracted researchers' interest in extracting bio-oil from these wastes. However, the resulting bio-oil has low heating values and undesirable physical properties. Hence, co-pyrolysis with plastic or polymer wastes is adopted to improve the yield and quality of the bio-oil. Furthermore, with the spread of the novel coronavirus, the surge of single-use plastic waste such as disposable medical face mask, can potentially set back the previous plastic waste reduction measures. Therefore, studies of existing technologies and techniques are referred in exploring the potential of disposable medical face mask waste as a candidate for co-pyrolysis with biomass. Process parameters, utilisation of catalysts and technologies are key factors in improving and optimising the process to achieve commercial standard of liquid fuel. Catalytic co-pyrolysis involves a series of complex mechanisms, which cannot be explained using simple iso-conversional models. Hence, advanced conversional models are introduced, followed by the evolutionary models and predictive models, which can solve the non-linear catalytic co-pyrolysis reaction kinetics. The outlook and challenges for the topic are discussed in detail.
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Due to the COVID-19 pandemic orthognathic surgery was suspended in the UK. The effect this had on patients, to date, is unknown. A multi-centre, cross-sectional survey was conducted in the UK to investigate the health-related impact on patients on the orthognathic surgery pathway, including those on the waiting list for surgery. A structured questionnaire was designed to explore the impact of the pandemic on patients whose orthognathic treatment was temporarily cancelled. Ninety-five questionnaires were returned giving a response rate of 65%. When asked if the delay due to the pandemic had caused emotional distress, 63% (51/81) agreed. During the pandemic respondents experienced more distress in relation to dental appearance (60%, 51/83), self-confidence (52% 50/83), facial appearance (53%, 44/83), and ability to eat and chew (59%, 50/83). One hundred percent of patients would have appliances fitted or their appliances adjusted during the pandemic, and 93% stated that they would attend for surgery if they were offered this during the pandemic. In conclusion, patients appear to have experienced emotional distress in relation to the delay with their orthognathic treatment. They should be given greater priority during the remobilisation of elective surgery and should have access to ongoing psychological support when delays affect their treatment. The 'surgery-first' approach may be considered for suitable patients to minimise the duration of the treatment journey.
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COVID-19 , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Estudos Transversais , Humanos , Pandemias , Inquéritos e QuestionáriosRESUMO
The one-neutron knockout from ^{52}Ca in inverse kinematics onto a proton target was performed at â¼230 MeV/nucleon combined with prompt γ spectroscopy. Exclusive quasifree scattering cross sections to bound states in ^{51}Ca and the momentum distributions corresponding to the removal of 1f_{7/2} and 2p_{3/2} neutrons were measured. The cross sections, interpreted within the distorted-wave impulse approximation reaction framework, are consistent with a shell closure at the neutron number N=32, found as strong as at N=28 and N=34 in Ca isotopes from the same observables. The analysis of the momentum distributions leads to a difference of the root-mean-square radii of the neutron 1f_{7/2} and 2p_{3/2} orbitals of 0.61(23) fm, in agreement with the modified-shell-model prediction of 0.7 fm suggesting that the large root-mean-square radius of the 2p_{3/2} orbital in neutron-rich Ca isotopes is responsible for the unexpected linear increase of the charge radius with the neutron number.
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Mastitis is an economically important production disease in the dairy industry worldwide. There is limited information on the aetiology of clinical mastitis (CM) and subclinical mastitis (SCM) in Australia's Mediterranean pasture-based production system. A prospective study was conducted in the south-west region of Western Australia to characterise the bacterial pathogens associated with CM and SCM cases and their associated antimicrobial susceptibility profiles. A total of 102 CM and 132 SCM milk samples were collected in twelve dairy farms between April 2020 and September 2020 recovering a total of 310 bacterial isolates. The isolates were evaluated for their antimicrobial susceptibility to twelve antibiotics using the agar disk diffusion (ADD) method. The most common pathogens associated with CM was Bacillus spp. (35.29%), followed by coagulase-negative staphylococci (CNS) (22.55%), Pseudomonas spp. (19.61%), Staphylococcus aureus (10.78%), Escherichia coli (5.88%) and Streptococcus uberis (2.94%). The most common pathogens associated with SCM was CNS (44.70%), followed by Bacillus spp. (30.30%), S. aureus (20.45%), Strep. uberis (15.91%), coliforms (Citrobacter spp., Cronobacter spp., Enterobacter spp., Klebsiella spp., Kosakonia spp., Morganella spp., Serratia spp.) (9.86%), environmental Streptococci (6.06%) and E. coli (6.06%). Beta-lactams resistance was the most common resistance observed in the Staphylococcal isolates and a high proportion of Streptococcal isolates exhibited resistance to enrofloxacin. Overall, the proportion of bacterial pathogens isolated in this study was comparable to the figures reported in other studies in Australia. Future research should focus on risk factors and the determination of resistant genetic components among the common isolates.
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Doenças dos Bovinos , Mastite Bovina , Mastite , Animais , Bovinos , Escherichia coli , Feminino , Mastite/veterinária , Mastite Bovina/epidemiologia , Estudos Prospectivos , Staphylococcus aureusRESUMO
Direct proton-knockout reactions of ^{55}Sc at â¼220 MeV/nucleon were studied at the RIKEN Radioactive Isotope Beam Factory. Populated states of ^{54}Ca were investigated through γ-ray and invariant-mass spectroscopy. Level energies were calculated from the nuclear shell model employing a phenomenological internucleon interaction. Theoretical cross sections to states were calculated from distorted-wave impulse approximation estimates multiplied by the shell model spectroscopic factors, which describe the wave function overlap of the ^{55}Sc ground state with states in ^{54}Ca. Despite the calculations showing a significant amplitude of excited neutron configurations in the ground-state of ^{55}Sc, valence proton removals populated predominantly the ground state of ^{54}Ca. This counterintuitive result is attributed to pairing effects leading to a dominance of the ground-state spectroscopic factor. Owing to the ubiquity of the pairing interaction, this argument should be generally applicable to direct knockout reactions from odd-even to even-even nuclei.
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The human fetal osteoblast cell line (hFOB 1.19) has been proposed as an accessible experimental model for study of osteoblast biology relating to drug development and biomaterial engineering. For their multilineage differentiation potential, hFOB has been compared to human mesenchymal progenitor cells and used to investigate bone-metabolism in vitro. Hereby, we studied whether and to what extent the conditionally immortalized cell line hFOB 1.19 can serve as a surrogate model for bone-marrow derived mesenchymal stromal cells (bmMSC). hFOB indeed exhibit specific characteristics reminiscent of bmMSC, as colony formation, migration capacity and the propensity to grow as multicellular aggregates. After prolonged culture, in contrast to the expected effect of immortalization, hFOB acquired a delayed growth rate. In close resemblance to bmMSC at increasing passages, also hFOB showed morphological abnormalities, enlargement and finally reduced proliferation rates together with enhanced expression of the cell cycle inhibitors p21 and p16. hFOB not only have the ability to undergo multilineage differentiation but portray several important aspects of human bone marrow mesenchymal stromal cells. Superior to primary MSC and osteoblasts, hFOB enabled the generation of continuous cell lines. These provide an advanced basis for investigating age-related dysfunctions of MSCs in an in vitro 3D-stem cell microenvironment.
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Osso e Ossos/embriologia , Técnicas de Cultura de Células/métodos , Células-Tronco Mesenquimais/citologia , Osteoblastos/citologia , Osso e Ossos/citologia , Osso e Ossos/metabolismo , Diferenciação Celular , Linhagem Celular , Movimento Celular , Proliferação de Células , Meios de Cultivo Condicionados , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Inibidor de Quinase Dependente de Ciclina p21/metabolismo , Humanos , Células-Tronco Mesenquimais/metabolismo , Osteoblastos/metabolismoRESUMO
Twenty-one two-proton knockout (p,3p) cross sections were measured from neutron-rich nuclei at â¼250 MeV/nucleon in inverse kinematics. The angular distribution of the three emitted protons was determined for the first time, demonstrating that the (p,3p) kinematics are consistent with two sequential proton-proton collisions within the projectile nucleus. Ratios of (p,3p) over (p,2p) inclusive cross sections follow the trend of other many-nucleon removal reactions, further reinforcing the sequential nature of (p,3p) in neutron-rich nuclei.
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Here we present new information on the shape evolution of the very neutron-rich ^{92,94}Se nuclei from an isomer-decay spectroscopy experiment at the Radioactive Isotope Beam Factory at RIKEN. High-resolution germanium detectors were used to identify delayed γ rays emitted following the decay of their isomers. New transitions are reported extending the previously known level schemes. The isomeric levels are interpreted as originating from high-K quasineutron states with an oblate deformation of ßâ¼0.25, with the high-K state in ^{94}Se being metastable and K hindered. Following this, ^{94}Se is the lowest-mass neutron-rich nucleus known to date with such a substantial K hindrance. Furthermore, it is the first observation of an oblate K isomer in a deformed nucleus. This opens up the possibility for a new region of K isomers at low Z and at oblate deformation, involving the same neutron orbitals as the prolate orbitals within the classic Zâ¼72 deformed hafnium region. From an interpretation of the level scheme guided by theoretical calculations, an oblate deformation is also suggested for the ^{94}Se_{60} ground-state band.
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On the 18th of March 2020, the Malaysia government declared a movement control order (MCO) due to the unprecedented COVID-19 pandemic. Although the majority of patients presented with respiratory-related symptoms, COVID-19 patients may present atypically with neurological manifestations and may even have an increased risk of stroke. The Malaysia Stroke Council is concerned regarding the level of care given to stroke patients during this pandemic. During the recent National Stroke Workflow Steering Committee meeting, a guide was made based on the currently available evidences to assist Malaysian physicians providing acute stroke care in the hospital setting in order to provide the best stroke care while maintaining their own safety. The guide comprises of prehospital stroke awareness, hyperacute stroke care, stroke care unit and intensive care unit admission, post-stroke rehabilitation and secondary prevention practice. We urge continuous initiative to provide the best stroke care possible and ensure adequate safety for both patients and the stroke care team.
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Betacoronavirus , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Acidente Vascular Cerebral/terapia , COVID-19 , Humanos , Unidades de Terapia Intensiva , Malásia , Guias de Prática Clínica como Assunto , SARS-CoV-2 , Acidente Vascular Cerebral/diagnóstico por imagem , Reabilitação do Acidente Vascular Cerebral , Tomografia Computadorizada por Raios XRESUMO
AIMS: Copeptin, a surrogate of vasopressin, is elevated in type 1 diabetes (T1D) and predicts kidney disease and cardiovascular mortality. Given the cardiorenal protective effects of SGLT2 inhibition (SGLT2i), our aim was to examine: 1) the relationship between serum copeptin, metabolic, renal and systemic hemodynamic parameters in adults with T1D; and 2) serum copeptin after SGLT2i with empagliflozin. MATERIALS AND METHODS: In this post-hoc, exploratory analysis, serum copeptin, glomerular filtration rate (GFRInulin), effective renal plasma flow (ERPFPAH), plasma renin angiotensin aldosterone system markers, HbA1c, 24-hour urine volume and sodium excretion were measured in 40 participants with T1D (24.3±5.1 years) during eu- and hyperglycaemia before and after 8 weeks of 25mg of daily empagliflozin. RESULTS: Higher baseline copeptin correlated with higher HbA1c, lower 24-hour urine volume and sodium excretion, after correcting for age, sex, systolic blood pressure, and HbA1c. Copeptin concentrations increased in response to empagliflozin under euglycaemia (4.1±2.1 to 5.1±2.8pmol/L, P=0.0053) and hyperglycaemia (3.3±1.4 to 5.6±2.8pmol/L, P<0.0001). The rise in copeptin in response to empagliflozin correlated with change in 24-hour urine volume, but was independent of changes in fractional excretion of sodium and haematocrit. CONCLUSIONS: Elevated serum copeptin was associated with worse glycaemic control and lower diuresis and natriuresis. SGLT2i increased serum copeptin in adults with T1D, and the rise correlated with change in diuresis, but not natriuresis and hemo-concentration. Further work is required to evaluate the clinical implications of elevated copeptin with SGLT2i, including whether it is simply a marker of diuresis or may contribute to cardiorenal disease long-term.
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Diabetes Mellitus Tipo 1/tratamento farmacológico , Glicopeptídeos/sangue , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Adulto , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/fisiopatologia , Feminino , Taxa de Filtração Glomerular/efeitos dos fármacos , Taxa de Filtração Glomerular/fisiologia , Hemoglobinas Glicadas/análise , Controle Glicêmico , Hemodinâmica/efeitos dos fármacos , Hemodinâmica/fisiologia , Humanos , Masculino , Natriurese/efeitos dos fármacos , Natriurese/fisiologia , Sistema Renina-Angiotensina/efeitos dos fármacos , Inibidores do Transportador 2 de Sódio-Glicose/farmacologia , Adulto JovemRESUMO
The growing concerns over product quality have increased demand for high quality dried food products and encouraged researchers to explore and producers of such products to implement novel microwave (MW)-assisted drying methods. This paper presents a critical review of the key principles and drawbacks of MW-assisted drying as well as needs for future research. In this article, recent research into application of microwaves as an alternative heat source, applications and progress in hybrid MW-assisted drying that rely on various drying media and combined two or three stages of MW-assisted drying for the preservation of food products is reviewed critically. The effect of different MW-assisted drying methods, conditions and initial pretreatments on the thermophysical properties, color, nutritional value and rehydration potential of dried food products is discussed in detail along with the discussion on how the material properties evolve and change in structure, color, and composition during MW-assisted drying and recent attempts at mathematical modeling of these changes made for different fruits and vegetables. It should be noted that most of the published results were obtained in laboratory-scale dryers. Pilot-scale testing is needed to bridge the gap between laboratory research and industrial applications to fulfill the potential for novel hybrid and combined MW-assisted drying methods and to expand their role in food processing.
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Dessecação , Manipulação de Alimentos/métodos , Tecnologia de Alimentos , Micro-Ondas , Frutas , Humanos , VerdurasRESUMO
OBJECTIVE: To investigate preterm birth (PTB) phenotypes in women with different autoimmune rheumatic diseases in a large population-based cohort. DESIGN: Retrospective cohort study. SETTING: California, USA. POPULATION: All live singleton births in California between 2007 and 2011 were analysed. Patients with autoimmune disease at delivery were identified by International Classification of Diseases, Ninth Revision , Clinical Modification (ICD-9-CM), codes for systemic lupus erythematosus (SLE), systemic sclerosis (SSc), rheumatoid arthritis (RA), polymyositis/dermatomyositis (DM/PM), and juvenile idiopathic arthritis (JIA). METHODS: Maternally linked hospital and birth certificate records of 2 481 516 deliveries were assessed (SLE n = 2272, RA n = 1501, SSc n = 88, JIA n = 187, DM/PM n = 38). Multivariable Poisson regression models estimated the risk ratios (RRs) for different PTB phenotypes (relative to term deliveries) for each autoimmune disease compared with the general obstetric population, adjusting for maternal age, race/ethnicity, body mass index, smoking, education, payer, parity, and prenatal care. MAIN OUTCOME MEASURES: Preterm birth (PTB) was assessed overall (20-36 weeks of gestation) and by subphenotype: preterm prelabour rupture of membranes (PPROM), spontaneous birth, or medically indicated PTB. The risk of PTB overall and for each phenotype was partitioned by gestational age: early (20-31 weeks of gestation) and late (32-36 weeks of gestation). RESULTS: Risks for PTB were elevated for each autoimmune disease evaluated: SLE (RR 3.27, 95% CI 3.01-3.56), RA (RR 2.04, 95% CI 1.79-2.33), SSc (RR 3.74, 95% CI 2.51-5.58), JIA (RR 2.23, 95% CI 1.54-3.23), and DM/PM (RR 5.26, 95% CI 3.12-8.89). These elevated risks were observed for the majority of PTB phenotypes as well. CONCLUSIONS: Women with systemic autoimmune diseases appear to have an elevated risk of various PTB phenotypes. Therefore, preconception counselling and close monitoring during pregnancy is crucial. TWEETABLE ABSTRACT: This study found that women with systemic autoimmune diseases have an elevated risk of preterm birth phenotypes.
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Doenças Autoimunes/epidemiologia , Complicações na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Doenças Reumáticas/epidemiologia , Adulto , California/epidemiologia , Feminino , Idade Gestacional , Humanos , Paridade , Fenótipo , Pré-Eclâmpsia/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de RiscoRESUMO
Exclusive cross sections and momentum distributions have been measured for quasifree one-neutron knockout reactions from a ^{54}Ca beam striking on a liquid hydrogen target at â¼200 MeV/u. A significantly larger cross section to the p_{3/2} state compared to the f_{5/2} state observed in the excitation of ^{53}Ca provides direct evidence for the nature of the N=34 shell closure. This finding corroborates the arising of a new shell closure in neutron-rich calcium isotopes. The distorted-wave impulse approximation reaction formalism with shell model calculations using the effective GXPF1Bs interaction and ab initio calculations concur our experimental findings. Obtained transverse and parallel momentum distributions demonstrate the sensitivity of quasifree one-neutron knockout in inverse kinematics on a thick liquid hydrogen target with the reaction vertex reconstructed to final state spin-parity assignments.
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Nuclear magic numbers correspond to fully occupied energy shells of protons or neutrons inside atomic nuclei. Doubly magic nuclei, with magic numbers for both protons and neutrons, are spherical and extremely rare across the nuclear landscape. Although the sequence of magic numbers is well established for stable nuclei, experimental evidence has revealed modifications for nuclei with a large asymmetry between proton and neutron numbers. Here we provide a spectroscopic study of the doubly magic nucleus 78Ni, which contains fourteen neutrons more than the heaviest stable nickel isotope. We provide direct evidence of its doubly magic nature, which is also predicted by ab initio calculations based on chiral effective-field theory interactions and the quasi-particle random-phase approximation. Our results also indicate the breakdown of the neutron magic number 50 and proton magic number 28 beyond this stronghold, caused by a competing deformed structure. State-of-the-art phenomenological shell-model calculations reproduce this shape coexistence, predicting a rapid transition from spherical to deformed ground states, with 78Ni as the turning point.
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Fifty-five inclusive single nucleon-removal cross sections from medium mass neutron-rich nuclei impinging on a hydrogen target at â¼250 MeV/nucleon are measured at the RIKEN Radioactive Isotope Beam Factory. Systematically higher cross sections are found for proton removal from nuclei with an even number of protons as compared to odd-proton number projectiles for a given neutron separation energy. Neutron removal cross sections display no even-odd splitting, contrary to nuclear cascade model predictions. Both effects are understood through simple considerations of neutron separation energies and bound state level densities originating in pairing correlations in the daughter nuclei. These conclusions are supported by comparison with semimicroscopic model predictions, highlighting the enhanced role of low-lying level densities in nucleon-removal cross sections from loosely bound nuclei.
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In this paper, the effect of channel annealing and oxygen flow rate in P-type tin-monoxide (SnO) thin film transistor (TFT) was investigated to reach the process compatibility with n-type oxide-based TFT. The optimized P-type SnO TFT with a small threshold voltage of -0.1 V, a high field-effect mobility of 4 cm² V-1 s-1 and an on/off current ratio of >10² was proposed. From the experimental results, the 150 °C channel annealing revealed a metallic behavior but a semiconductor-like property at a higher 200 °C that was favorable for transistor rectification. Besides, the higher oxygen flow rate was also helpful for improving device mobility and driving current, but shows a slight increase in off-state leakage, which is unavoidable due to the increase of grain in SnO channel.
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The chemical composition of the Gaoping River in Taiwan reflects the weathering of both silicate and carbonate rocks found in its metasedimentary catchment. Major dissolved ion chemistry and radiocarbon signatures of dissolved inorganic carbon (DIC) reveal the importance of pyrite-derived sulphuric acid weathering on silicates and carbonates. Two-thirds of the dissolved load of the Gaoping River derives from sulphuric acid-mediated weathering of rocks within its catchment. This is reflected in the lowest reported signatures DI14C for a small mountainous river (43 to 71 percent modern carbon), with rock-derived carbonate constituting a 14C-free DIC source. Using an inverse modelling approach integrating riverine major dissolved ion chemistry and DI14C, we provide quantitative constraints of mineral weathering pathways and calculate atmospheric CO2 fluxes resulting from the erosion of the Taiwan orogeny over geological timescales. The results reveal that weathering on Taiwan releases 0.31 ± 0.12 MtC/yr, which is offset by burial of terrestrial biospheric organic carbon in offshore sediments. The latter tips the balance with respect to the total CO2 budget of Taiwan such that the overall system acts as a net sink, with 0.24 ± 0.13 MtC/yr of atmospheric CO2 consumed over geological timescales.
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The first γ-ray spectroscopy of ^{52}Ar, with the neutron number N=34, was measured using the ^{53}K(p,2p) one-proton removal reaction at â¼210 MeV/u at the RIBF facility. The 2_{1}^{+} excitation energy is found at 1656(18) keV, the highest among the Ar isotopes with N>20. This result is the first experimental signature of the persistence of the N=34 subshell closure beyond ^{54}Ca, i.e., below the magic proton number Z=20. Shell-model calculations with phenomenological and chiral-effective-field-theory interactions both reproduce the measured 2_{1}^{+} systematics of neutron-rich Ar isotopes, and support a N=34 subshell closure in ^{52}Ar.