An Update on Clinical Utility of Musculoskeletal Ultrasonography in Knee Osteoarthritis.

In knee osteoarthritis (KOA), timely and accurate assessment of the severity is essential to help orthopedic surgeons determine the most appropriate therapeutic strategies and evaluate disease outcomes and responses for corresponding treatments. In KOA, musculoskeletal ultrasonography (MSUS) could effectively help detect various abnormalities, including synovitis, osteophytes, and cartilage damage. Further, MSUS could be used to monitor the response to different therapies in KOA, to guide local diagnostic and therapeutic procedures. In the future, applications based on continuously evolving US tools could enhance the clinical utility of MSUS in KOA.

Investigation on the effect of output mirror transmission in WS2-based red-light passively Q-switched Pr:ZBLAN all-fiber lasers.

We report the experimental investigation of visible passively Q-switched Pr3+-doped all-fiber lasers with tungsten disulfide (WS2) saturable absorber, where red-light short-pulse generations from different output mirror transmissions are systemically characterized. The proposed simple and compact all-fiber linear cavity was constructed by a fiber-pigtail-based blue laser-diode pump, a Pr3+-doped fluorozirconate glass active fiber, and the fiber end-facet mirrors. Integrating a free-standing layered WS2 film into the laser cavity initiated the Q-switching operation. Stable microsecond-duration output pulses with kilohertz repetition rates are achieved, corresponding to a few mW/nJ average output power and single-pulse energy. The comparisons on red-light Q-switched output parameters for output transmissions of both ∼40% and ∼80% are performed. This work could provide a useful guideline to manipulate the output performance of visible pulsed all-fiber lasers for various practical applications.

All-fiber passively Q-switched 604 nm praseodymium laser with a Bi2Se3 saturable absorber.

We experimentally demonstrated a simple passively Q-switched praseodymium (Pr3+)-doped all-fiber laser at 604 nm with a Bi2Se3 saturable absorber (SA). A Bi2Se3/polyvinyl alcohol composite film is sandwiched between two ferrules to construct a fiber-compatible Q-switcher. Two fiber end facet mirrors build a compact-linear resonator. The repetition rate of the achieved 604 nm Q-switching pulse can be widely tuned from 86.2 to 187.4 kHz, and the pulse duration can be as narrow as 494 ns. To the best of our knowledge, this is the shortest operation wavelength of a Bi2Se3-based pulsed all-fiber laser at 604 nm.

Analysis of EPA and DHA in the viscera of marine fish using gas chromatography.

The viscera of 10 kinds of marine fishes were collected for fish oil extraction and detection of DHA and EPA, two most important polyunsaturated fatty acids. The fish oil extraction ratio for the evaluated fishes varied from 0.95% to 10.18% (wt%). Pseudosciaena crocea presented the highest fish oil yield, followed by Mustelus manazo, Hippoglossus and Sciaenopsocellatus. A gas chromatography method was then established for analysis of EPA/DHA. The EPA concentration (in methyl ester form) in the fish oil varied from 1.39 to 10.65(mg/g). Epinephelus awoara presented the highest EPA concentration (p<0.05), followed by Epinephelussp, Sciaenopsocellatus and Hippoglossus. The DHA concentration (in methyl ester form) in the fish oil varied from 0.58 to 37.02 (mg/g). Epinephelus awoara presented the highest DHA concentration (p<0.05), followed by Sciaenopsocellatus, Pseudosciaena crocea and Hippoglossus. No strict positive correlation between the EPA/DHA concentration and the sea depth where the fish live was observed. The fishes living in middle depth presented highest EPA/DHA concentration.

Tailoring the plasmonic whispering gallery modes of a metal-coated resonator for potential application as a refractometric sensor.

Plasmonic whispering gallery (WG) modes confined in metal-coated resonators are theoretically investigated by electromagnetic analyses. The resonance can be tuned from internal surface plasmonic WG modes to the hybrid state of the plasmonic mode by an introduced isolation layer. As the coated metal is reduced in size, the optical resonance is shifted out by the mode coupling of the internal and external surface plasmonic WG modes. Based on the optical leak of the plasmonic WG mode, the optical influences led by the surroundings with a variable refractive index are considered. Device performance criteria such as optical power leak, resonant wavelength shift, and threshold gain are studied. Full wave simulations are also employed and the results present good consistency with analytic solutions. The metal-coated resonator assisted by an active material is expected to provide promising performance as a refractometric sensor.

Metallically coated dielectric rectangle resonator.

The double transfer matrix method (DTMM) is proposed for calculating the eigenvalues of the resonant mode of a metallically coated dielectric rectangle resonator. Two-dimensional electromagnetic analyses are performed to investigate the optical influences induced by planar structure parameters. The results show that there theoretically exists a highest Q-factor resonance for both TE and TM modes at a certain length-width ratio with fixed resonant wavelength and resonator area. Due to the influence of surface plasma polaritons (SPPs) trapped at the corners of the resonator which is not considered in DTMM, the TM mode resonances are deformed and deviate severely from that of the analytical model. The geometric deformation on the resonator is introduced by replacing the four right angles with circular boundaries, and the SPP accompanied mode behaviors are corrected to the standing waves.

Continuous selenite biotransformation and biofuel production by marine diatom in the presence of fulvic acid.

In this study, the biochemical response of Phaeodactylum tricornutum to varying concentrations of inorganic selenium (Se) was investigated. It was observed that, when combined with fulvic acid, P. tricornutum exhibited enhanced uptake and biotransformation of inorganic Se, as well as increased microalgal lipid biosynthesis. Notably, when subjected to moderate (5 and 10 mg/L) and high (20 and 40 mg/L) concentrations of selenite under fulvic acid treatment, there was a discernible redirection of carbon flux towards lipogenesis and protein biosynthesis from carbohydrates. In addition, the key parameters of microalgae-based biofuels aligned with the necessary criteria outlined in biofuel regulations. Furthermore, the Se removal capabilities of P. tricornutum, assisted by fulvic acid, were coupled with the accumulation of substantial amounts of organic Se, specifically SeCys. These findings present a viable and successful approach to establish a microalgae-based system for Se uptake and biotransformation.

A quantitative structure-property relationship analysis of soot-water partition coefficients for persistent organic pollutants.

Geometrical optimization and electrostatic potential calculations have been performed at the HF/6-31G level of theory for investigated persistent organic pollutants (POPs). A number of statistically based parameters have been obtained. Relationship between soot-water partition coefficients (logK(SC)) of POPs and the structural descriptors has been established by the multiple linear regression method. The result shows that the quantities derived from electrostatic potential V(s)(-)¯ and V(s,max), together with molecular surface area (A(S)) and the energy of the highest occupied molecular orbital (E(HOMO)) can be well used to express the quantitative relationship between structure and logK(SC) (QSPR) of POPs. Predictive capability of the model has been demonstrated by leave-one-out cross-validation with the cross-validated correlation coefficient of 0.9797. Furthermore, the predictive power of this model was further examined for the external test set with the correlation coefficient of 0.9811 between observed and predicted logK(SC), validating the robustness and good predictive ability of our model. Furthermore, in order to further investigate the applicability of these parameters derived from electrostatic potential in prediction of soot-water partition coefficient for organic pollutants, eleven polycyclic aromatic hydrocarbons (PAHs), eleven polychlorinated biphenyls (PCBs) and nine phenyl urea herbicides (PUHs) from other source have also been studied. The QSPR models established may provide a new powerful method for predicting soot-water partition coefficients (logK(SC)) of organic pollutants.

Metallically confined microdisks with in-plane multiple guided emissions.

We theoretically present in-plane multiple guided emissions of metallically confined microdisk lasers which can be applied to drive multiple elements in compact photonic integration at the same time. Two to four-port microdisks with transverse magnetic and electric polarizations are investigated based on finite difference time domain simulation and padé approximation. Modes filtering of coupling ports are verified by the calculated mode quality factors (Q) which are decided by the matching of coupling ports with the energy density distribution of corresponding modes. Single mode lasing operation of semiconductor microdisk with guided emissions is possibly realized by selectively pumping.

Port output of metallo-dielectric confined circular microlasers.

Port output of metallo-dielectric confined circular microlasers directly connected with a coupling waveguide in radial direction is presented and numerically investigated by the finite-difference time-domain method and the Padé approximation. The quality factors of fundamental whispering-gallery modes confined in microlasers with dimensions of around 1 µm do not deteriorate until the output waveguide can support a one-order guided wave. The port-output metallo-dielectric microlasers with low threshold are expected. In addition, the mode characteristics of port-output metallo-dielectric microlasers are studied based on ample modes of larger cavity, where coupled modes and standing-wave-like modes dominate in the cavity with a wide output port.

Palliative Rehabilitation Improves Health Care Utilization and Function in Frail Older Adults with Chronic Lung Diseases.

OBJECTIVES: The Integrated Care for Advanced REspiratory Disorders (ICARE) service is a stay-in, post-acute care program for hospitalized patients with chronic, nonmalignant lung diseases. It provides palliative rehabilitation-a novel model integrating functional rehabilitation with early palliative care. We compare reduction of health care utilization among ICARE participants vs matched controls receiving usual care. DESIGN: This is a prospective, propensity score-matched study. Primary outcomes were reduction in hospital readmissions and length of stay and emergency department (ED) visits, comparing the period 6 months before and after ICARE, or 6 months before and after hospital discharge (for controls). Secondary outcomes included 6-minute walking distance (6MWD) and Modified Barthel Index (MBI). SETTING: Participants were matched 1:1 to controls by age, respiratory diagnosis, socioeconomic strata, index hospitalization length of stay, frailty, and recent admissions into intensive care unit or noninvasive ventilation units. METHODS: Multidisciplinary interventions focused on symptom relief, functional rehabilitation, targeted comorbidity management, and postdischarge care coordination. RESULTS: One hundred pairs of patients were matched. Participants were older adults (mean age 73.9 ± 8.2 years) with prolonged index hospitalization (median 12.0 days; interquartile range 7-18). Overall, 57% had high Hospital Frailty Risk Scores and 71% had overlapping respiratory diagnoses, the most common commonest being COPD (89%), followed by interstitial lung disease (54%) and bronchiectasis (28%). Small reductions in health care utilization were observed among controls. ICARE was associated with a further 9.1 ± 19.9 days' reduction in hospitalization length of stay (P < .001), 0.8 ± 1.9 lesser admission (P < .001), and 0.6 ± 2.2 fewer ED visits (P < .02). Participants with longest index hospitalization were observed to have greatest reduction in length of stay. 6MWD and MBI scores improved by 41.0 ± 60.2 m and 12.3 ± 11.6 points, respectively (both P < .001). Greater improvement was observed in patients with lower baseline 6MWD and MBI scores. Prescription of slow-release opioids rose from 9% to 49%. Treatment for anxiety and depression rose from 5% to 19%. CONCLUSIONS AND IMPLICATIONS: Integrating palliative care with postexacerbation functional rehabilitation was associated with short-term reduction in health care utilization, improved functional capacity, and increased treatment of dyspnea, anxiety, and depression.

An Update on the Emerging Role of Visfatin in the Pathogenesis of Osteoarthritis and Pharmacological Intervention.

Osteoarthritis (OA) is one of the most common degenerative joint diseases that affects millions of people worldwide, mainly the aging population. Despite numerous published reports, little is known about the pathology of this disease, and no feasible treatment plan exists to stop OA progression. Recently, extensive basic and clinical studies have shown that adipokines play a key role in OA development. Moreover, some drugs associated with adipokines have shown chondroprotective and anti-inflammatory effects on OA. Visfatin has been shown to play a detrimental role in the progression of OA. It increases the production of matrix metalloproteinases and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), induces the production of interleukin (IL)-1ß, IL-6, and tumor necrosis factor-α, affects the differentiation of mesenchymal stem cells to adipocytes, and induces osteophyte formation by inhibiting osteoclastogenesis. Although some side effects of chemical visfatin inhibitors have been reported, they were shown to be successful in the treatment of diabetes, cancer, and other diseases that can utilize Chinese herbs, further suggesting that similar therapeutic strategies could be used in OA prevention and treatment. Here, we describe the pathophysiological mechanism of visfatin in OA and discuss some potential pharmacological interventions using Chinese herbs.

[Identification of A Case of DEL Blood Group with DAT Positive Phenotype and Pedigree Analysis].

OBJECTIVE: To identify the blood group of a patient with DEL phenotype combined with positive direct anti-human globulin test and to analyze the pedigree. METHODS: Routine serological reagents were used for serological analysis of RhD blood group in the pedigree members. Exons and flanking sequences of RHD gene were amplified, sequenced and analyzed for heterozygosity. The familial genetic state of DEL phenotype was further analyze in the family members. RESULTS: The DAT was strongly positive in the proband. The 1227G>A allele (RHD*DEL1) was present in the exon 9 of RHD gene, and the mother was the carrier of RHD*DEL1. The proband was identified as RHD+/RHD-, suggesting the CD1227Ae/Cde haplotype. CONCLUSION: The proband is DEL phenotype (RHD*DEL1).

QSPR models for the physicochemical properties of halogenated methyl-phenyl ethers.

Halogenated methyl-phenyl ethers (anisoles) are ubiquitous organic compounds in the environment. In the present study, geometrical optimization and electrostatic potential calculations have been performed for 134 halogenated anisoles at the HF/6-31G* level of theory. A number of statistically based parameters have been obtained. Linear relationships between sub-cooled liquid vapor pressures (lgp(L)), n-octanol/water partition coefficient (lgK(ow)) and aqueous solubilities (-lgS(w,L)) of halogenated anisoles and the structural descriptors have been established by multiple regression method. The result shows that the quantities derived from electrostatic potential V(min), V(s,max), summation operatorV(s)(+), summation operatorV(s)(-), V(s,av)(-) and nu, together with the molecular volume (V(mc)) and E(HOMO) can be well used to express the quantitative structure-property relationships of halogenated anisoles, which proves the general applicability of this parameter set to a great extent. Good predictive capabilities have also been demonstrated. Based on these excellent equations, the predicted values have been presented for those halogenated anisoles whose experimentally determined physicochemical properties are unavailable.

Quantitative structure-chromatographic retention relationship for polycyclic aromatic sulfur heterocycles.

Polycyclic aromatic sulfur heterocycles (PASHs) are of concern in petroleum geochemistry and environmental chemistry. In the present study, geometrical optimization and electrostatic potential calculations have been performed for 114 PASHs reported previously at the HF/6-31G* level of theory. A group of 25 statistically based parameters have been extracted. Linear relationships between gas-chromatographic retention index (RI) and the structural descriptors have been established by stepwise linear regression analysis. The result shows that two quantities derived from positive electrostatic potential on molecular surface, V(s)(+) (the average value of the positive electrostatic potentials on molecular surface) and sigma(+)(2) (a measure of dispersion tendency of positive electrostatic potential), together with V(mc) (the molecular volume) and E(HOMO) (the energy of the highest occupied molecular orbital) can be well used to express the quantitative structure-retention relationship (QSRR) of PASHs. Predictive capability of the model has been demonstrated by leave-one-out cross-validation with the cross-validated correlation coefficient (R(CV)) of 0.992. Furthermore, when splitting the 114 PASH samples into calibration and test sets in the ratio of 2:1, a similar treatment yields an equation of almost equal statistical quality and very similar regression coefficients, validating the robustness of our model. Predictions for six PASHs from other source have also been made. The QSRR model established may provide a new powerful method for predicting chromatographic properties of aromatic organosulfur compounds.

[Identification of Phenotype and Genotype in One Case with Weak D blood group].

OBJECTIVE: To investigate the phenotype and genotype of the weak D blood group in one case of Chinese Han people. METHODS: Phenotype of blood sample was identified with serologic tests; PCR-SBT was applied for the analysis of genotype and RhD zygosity. RESULTS: Both saline and gel card tests demonstrated this case to be dCcee, which was contrary to glass bead card result. Some of the RBC D epitopes were negative.c.1022T>A allele was identified with PCR-SBT and the zygosity analysis showed this case to be D/d. CONCLUSION: RHD*1022 A is more suitable to be categorized as weak partial D other than weak D in a Chinese Han people.

QSPR/QSAR models for prediction of the physicochemical properties and biological activity of polybrominated diphenyl ethers.

Polybrominated diphenyl ethers (PBDEs) are a group of important persistent organic pollutants. In the present study, geometrical optimization and electrostatic potential calculations have been performed for all 209 PBDE congeners at the HF/6-31G level of theory. A number of statistically-based parameters have been obtained. Linear relationships between gas-chromatographic relative retention time (RRT), n-octanol/air partition coefficient (lgK(OA)), 298 K supercooled liquid vapour pressures (lgp(L)), Henry's law constant (lgH) and Ah receptor binding affinity (-lgRBA) of PBDEs and the structural descriptors have been established by multiple regression method. The result shows that the quantities derived from electrostatic potential V(s,max),V(s,min),Pi, Sigma V+(S), V-(S) , nu, sigma 2(tot), and N-(v), together with the molecular volume (Vmc) can be well used to express the quantitative structure-property relationships of PBDEs, which proves the general applicability of this parameter set to a great extent. Good predictive capabilities have also been demonstrated. Based on these equations, the predicted values have been presented for those PBDE congeners whose experimentally determined physicochemical properties are unavailable. The QSAR model for the Ah receptor binding affinity is relatively poor, which can be ascribed to the complexity of factors which affect biological activity and the limitations of the present parameter set in describing steric characters of the molecule.

Effect of dexmedetomidine-induced anesthesia on the postoperative cognitive function of elder patients after laparoscopic ovarian cystectomy.

OBJECTIVE: To investigate the effect of dexmedetomidine at maintenance dose on the postoperative function of elder patients after general anesthesia for laparoscopic ovarian cystectomy. METHODS: We enrolled a total of 96 elder patients who were admitted to this hospital for laparoscopic ovarian cystectomy under general anesthesia between March 2015 and March 2017, and divided them into two groups, Group A (n = 48) and B (n = 48). Patients in both groups received the same methods for anesthesia induction and maintenance drugs. At the beginning of operation, patients in Group A received the intravenous injection of dexmedetomidine (0.8 µg/kg) followed by maintenance dose [0.5 µg/(kg h)] to the end of operation, while those in Group B underwent intravenous injection of 0.9% normal saline at the same rate, during which blood pressure, heart rate, oxyhemoglobin saturation and dosage of anesthetics at T1 (5 min after being delivered into the operation room), T2 (immediately after anesthesia induction), T3 (immediately after intubation), T4 (immediately after operation), T5 (immediately after end of operation) and T6 (immediately after extubation). Then, the levels of NSE, IL-6, CRP and HMGB1 were compared between two groups at 24 h before the operation, at the end, 24 h, 3 d and 7 d after operation. Besides, we also compared the postoperative cognitive functions and incidence of adverse reactions at 1 d before, 1, 2, 3 and 7 d after operation through MOCA scales. RESULTS: At T3, T4 and T6, comparisons of the average arterial pressure and heart rate showed that the differences between the two groups had statistical significance (p < .05). At the end of operation, and at 24 h, 3 d and 7 d after operation, we found that the levels of IL-6 and CRP in patients of two groups were all significantly elevated when compared with those before operation; at the end of operation and at 24 h and 3 d after operation, the levels of IL-6 and CRP in the Group B were higher than those in the Group A, and the differences had statistical significance (p < .05). At the end of operation and at 24 h and 3 d after operation, the levels of NSE and HMGB1 in two group were higher than those before operation, and a more significant elevation was identified in Group B with statistically significant differences (p < .05); at 7 d after operation, a decreasing trend was found in the level of HMGB1, which, however, remained higher than the preoperative level, and the level in Group B was still higher than that in Group A with statistically significant differences (p < .05). At 2 d after operation, we found that the scores of MOCA in the Group B were remarkably decreased in comparison with the scores in Group A with a statistically significant difference (p < .05). Moreover, the incidence rate of postoperative cognitive dysfunction (POCD) in the Group A was significantly lower than that in the Group B, and the difference had statistical significance (p < .05). CONCLUSION: Dexmedetomidine can ameliorate the postoperative cognitive functions of elder patients who received the laparoscopic ovarian cystectomy under general anesthesia, and effectively decrease the incidence rate of POCD without any obvious or severe adverse reaction. Thus, it can serve as a kind of adjuvant drug for general anesthesia in clinical practice.

Prediction of Poor Short-Term Prognosis and Unmet Needs in Advanced Chronic Obstructive Pulmonary Disease: Use of the Two-Minute Walking Distance Extracted from a Six-Minute Walk Test.

OBJECTIVES: Prognostic challenges hinder the identification of patients with advanced chronic obstructive pulmonary disease (COPD) for timely palliative interventions. We postulate that a two-minute derivative (two-minute walking distance [2MWD]) of a standard six-minute walk test (6MWT) can identify frail subjects with poorer survival for early palliative intervention. The primary outcome of interest is mortality at 18 months. Secondary objectives include evaluation of the relationship between the 2MWD and ability to self-care, dyspnea-related disabilities, nutrition, forced expiratory volume in first second (FEV1), quality of life (QoL), and comorbidity burden. DESIGN AND SETTING: One hundred twenty-four subjects with stage 3 and 4 COPD were recruited and followed up. Ability to self-care, dyspnea-related disabilities, airflow limitation, nutrition, and QoL were measured by using modified Barthel index (MBI), Modified Medical Research Council (MMRC) dyspnea scale, FEV1 (% predicted), BODE [BMI(B), FEV1(O), MMRC(D), 6MWT(E)] index, updated ADO [Age(A), MMRC(D), FEV1(O)] index, Subjective Global Assessment (SGA), and St. George's Respiratory Questionnaire (SGRQ), respectively. Survival data were prospectively collected and analyzed. RESULTS: The 2MWD correlates highly with BODE and predicts updated ADO independent of age, co-morbidities, long-term oxygen therapy (LTOT), body mass index, and FEV1. Log-rank test performed with Kaplan-Meier plots demonstrates that 2MWD ≤80 m significantly predicts survival time (p < 0.05). Cox proportional hazard regression shows a 3.6-time greater probability of 18-month mortality (hazard ratio [HR] 3.57; 95% confidence interval [CI] 1.26-10.13; p < 0.05). In addition, 2MWD strongly predicted MBI and MMRC, independent of age, co-morbidities, LTOT, body mass index, and FEV1. Subjects with 2MWD ≤80 m have a poorer ability to self-care (median MBI 90 vs. 100), lower FEV1 (32.9% ± 9.8% vs. 38.1% ± 9.4%), poorer QoL (mean SGRQ 46.6 ± 16.2 vs. 36.6 ± 13.3), and greater dyspnea-related disability (mean MMRC 1.7 ± 0.7 vs. 0.9 ± 0.6), and they are more malnourished (40.4% vs. 9.7%; RR 1.51) (all p < 0.001). CONCLUSION: 2MWD ≤80 m identifies subjects with higher mortality, greater functional dependence, poorer in nutrition, greater dyspnea, and lower QoL. Incorporation of 2MWD into composite prognostic indices can enhance predictive accuracy and identify patients requiring early proactive palliative interventions.

Association of interleukin-18 and asthma.

Cytokine-mediated immunity plays a dominant role in the pathogenesis of various immune diseases, including asthma. The recent identification of the family interleukin (IL)-1-related cytokine IL-18 now contributes to our understanding of the fine-tuning of cellular immunity. IL-18 can act as a cofactor for Th2 cell development and IgE production and also plays an important role in the differentiation of Th1 cells. Recent work identified an IL-18 association with the pathogenesis of asthma, wherein increased IL-18 expression was found in the serum of patients. Furthermore, IL-18 polymorphisms with susceptibility to asthma were reported, suggesting that IL-18 may be therapeutically relevant to asthma. In this review, we discuss the role of IL-18 in the pathogenesis of asthma and its therapeutic potential based on current research.