Data-Driven Smart Living Lab to Promote Participation in Rehabilitation Exercises and Sports Programs for People with Disabilities in Local Communities.

Patients discharged from hospitals after an inpatient course of medical treatment for any ailment or traumatic injury that results in disabling conditions and are rendered mobility impaired require ongoing systematic sports and exercise programs to maintain healthy lifestyles. Under such circumstances, a rehabilitation exercise and sports center, accessible throughout local communities, is critical for promoting beneficial living and community participation for these individuals with disabilities. An innovative data-driven system equipped with state-of-the-art smart and digital equipment, set up in architecturally barrier-free infrastructures, is essential for these individuals to promote health maintenance and overcome secondary medical complications following an acute inpatient hospitalization or suboptimal rehabilitation. A federally funded collaborative research and development (R&D) program proposes to build a multi-ministerial data-driven system of exercise programs using a smart digital living lab as a platform to provide pilot services in physical education and counseling with exercise and sports programs for this patient population. We describe the social and critical aspects of rehabilitating such a population of patients by presenting a full study protocol. A modified sub-dataset of the previously generated 280-item full dataset is applied using a data-collecting system-"The Elephant"-as an example of how data acquisition will be achieved to assess the effects of lifestyle rehabilitative exercise programs for people with disabilities.

Real-time detection of vehicle-originated condensable particulate matter through thermodenuder integrated aerosol measurement method at tailpipes.

Condensable particulate matter (CPM) corresponds to primary particulate matter ≤2.5 µm (PM2.5) obtained through the condensation of gaseous air pollutants caused by temperature drops in the atmosphere. The internal combustion of vehicle engines can produce CPM because of the condensable compounds in the exhaust gas. Conventional CPM measurement methods have been developed for coal-fired power plants with stable emissions through sampling and off-site analyses. They are therefore unsuitable for detecting the rapidly changing vehicle-originated CPM. In addition, the current system for evaluating PM2.5 from vehicles, based on the particle measurement program (PMP) protocol, provides only the emission factors of total PM2.5 (and not CPM separately) at a fixed temperature (∼25 °C) and dilution ratio (∼ × 35). This study reports, for the first time, the development of a real-time detection method for vehicle-originated CPM through a thermodenuder (TD) integrated with real-time aerosol instruments. This method was designed to reduce the loss of CPM due to condensation and diffusion while sampling the exhaust gas. It permits the investigation of the effects of dilution gas temperature (5-45 °C) and dilution ratio (up to × 30) on the formation of CPM. During the feasibility test of this method using a diesel vehicle (Euro-4), the real-time total particle number concentrations (PNs) matched well with those obtained by a PMP protocol-based evaluation system. Moreover, this method detected PNs concentrations ten times higher than the detection limit (4 × 106 particles/cm3) of the PMP-based system. The emission factors of the total PM2.5 with a bulk density (1 g/cm3) measured by this method also showed consistency with the results of the PMP protocol. The mass emission factor of CPM determined by deploying the TD was ∼14.57 mg/km (∼63% contribution to the total PM2.5).

Photobiocidal-triboelectric nanolayer coating of photosensitizer/silica-alumina for reusable and visible-light-driven antibacterial/antiviral air filters.

Outbreaks of airborne pathogens pose a major threat to public health. Here we present a single-step nanocoating process to endow commercial face mask filters with photobiocidal activity, triboelectric filtration capability, and washability. These functions were successfully achieved with a composite nanolayer of silica-alumina (Si-Al) sol-gel, crystal violet (CV) photosensitizer, and hydrophobic electronegative molecules of 1H, 1H, 2H, 2H-perfluorooctyltriethoxysilane (PFOTES). The transparent Si-Al matrix strongly immobilized the photosensitizer molecules while dispersing them spatially, thus suppressing self-quenching. During nanolayer formation, PFOTES was anisotropically rearranged on the Si-Al matrix, promoting moisture resistance and triboelectric charging of the Si-Al/PFOTES-CV (SAPC)-coated filter. The SAPC nanolayer stabilized the photoexcited state of the photosensitizer and promoted redox reaction. Compared to pure-photosensitizer-coated filters, the SAPC filter showed substantially higher photobiocidal efficiency (∼99.99 % for bacteria and a virus) and photodurability (∼83 % reduction in bactericidal efficiency for the pure-photosensitizer filter but ∼0.34 % for the SAPC filter after 72 h of light irradiation). Moreover, after five washes with detergent, the SAPC filter maintained its photobiocidal and filtration performance, proving its reusability potential. Therefore, this SAPC nanolayer coating provides a practical strategy for manufacturing an antimicrobial and reusable mask filter for use during the ongoing COVID-19 pandemic.

Evaluation of survival rates of airborne microorganisms on the filter layers of commercial face masks.

After the WHO designated COVID-19 a global pandemic, face masks have become a precious commodity worldwide. However, uncertainty remains around several details regarding face masks, including the potential for transmission of bioaerosols depending on the type of mask and secondary spread by face masks. Thus, understanding the interplay between face mask structure and harmful bioaerosols is essential for protecting public health. Here, we evaluated the microbial survival rate at each layer of commercial of filtering facepiece respirators (FFRs) and surgical masks (SMs) using bacterial bioaerosols. The penetration efficiency of bacterial particles for FFRs was lower than that for SMs; however, the microbial survival rate for all tested masks was >13%, regardless of filtration performance. Most bacterial particles survived in the filter layer (44%-77%) (e.g., the core filtering layer); the outer layer also exhibited significant survival rates (18%-29%). Most notably, survival rates were determined for the inner layers (<1% for FFRs, 3%-16% for SMs), which are in contact with the respiratory tract. Our comparisons of the permeability and survival rate of bioaerosols in each layer will contribute to bioaerosol-face mask research, while also providing information to facilitate the establishment of a mask-reuse protocol.

ICT-Based Health Care Services for Individuals with Spinal Cord Injuries: A Feasibility Study.

In the Republic of Korea, 90.5% of those living with spinal cord injury (SCI) are faced with medical complications that require chronic care. Some of the more common ones include urinary tract infections, pressure sores, and pain symptomatology. These and other morbidities have been recognized to deteriorate the individual's health, eventually restricting their community participation. Telerehabilitation, using information and communication technology, has propelled a modern-day movement in providing comprehensive medical services to patients who have difficulty in mobilizing themselves to medical care facilities. This study aims to verify the effectiveness of health care and management in the SCI population by providing ICT-based health care services. We visited eight individuals living with chronic SCI in the community, and provided ICT-based health management services. After using respiratory and urinary care devices with the provision of home visit occupational therapy, data acquisition was achieved and subsequently entered into a smart device. The entered information was readily accessible to the necessary clinicians and researchers. The clients were notified if there were any concerning results from the acquired data. Subsequently, they were advised to follow up with their providers for any immediate medical care requirements. Digital hand-bike ergometers and specialized seating system cushions are currently in development. The ICT-based health care management service for individuals with SCI resulted in a favorable expected level of outcome. Based on the results of this study, we have proposed and are now in preparation for a randomized clinical trial.

Whole-exome sequencing identifies mutations of KIF22 in spondyloepimetaphyseal dysplasia with joint laxity, leptodactylic type.

Spondyloepimetaphyseal dysplasia with joint laxity (SEMDJL), leptodactylic (lepto-SEMDJL) or Hall type, is an autosomal-dominant skeletal dysplasia manifesting with short stature, joint laxity with dislocation(s), limb malalignment, and spinal deformity. Its causative gene mutation has not yet been discovered. We captured and sequenced the exomes of eight affected individuals in six unrelated kindreds (three individuals in a family and five simplex individuals). Five novel sequence variants in KIF22, which encodes a member of the kinesin-like protein family, were identified in seven individuals. Sanger sequencing of KIF22 confirmed that c.443C>T (p.Pro148Ser) cosegregated with the phenotype in the affected individuals in the family; c.442C>T (p.Pro148Leu) or c.446G>A (p.Arg149Gln) was present in four of five simplex individuals, but was absent in unaffected individuals in their family and 505 normal cohorts. KIF22 mRNA was detected in human bone, cartilage, joint capsule, ligament, skin, and primary cultured chondrocytes. In silico analysis of KIF22 protein structure indicates that Pro148 and Arg149 are important in maintaining hydrogen bonds in the ATP binding and motor domains of KIF22. We conclude that these mutations in KIF22 cause lepto-SEMDJL.

Performance and durability of anode-supported flat-tubular solid oxide fuel cells with Ag-infiltrated cathodes.

An anode-supported flat-tubular solid oxide fuel cell is an advanced cell design, which offers many advantages including a high volumetric power density, a minimized sealing area and a high resistance to thermal cycling. Infiltration of nano-sized noble metal catalysts into a porous cathode is known to be an effective method to improve cathode performances at reduced temperatures, but the cathode stability is of potential concern. This study addresses the performance and durability of anode-supported flat-tubular solid oxide fuel cells with Ag-infiltrated cathodes. Uniformly dispersed Ag nanoparticles on the cathode are formed via a wet infiltration technique combined with subsequent heat-treatment. Although the Ag infiltration results in improved cell performance, the durability tests indicate that the cell performance degrades over time and that the degradation rate increases with increasing Ag loading in the cathode. The observed performance degradation is mainly attributed to formation of large-scale Ag agglomerates. A strategy based on an inter-dispersed composite of Ag and CeO2 nanoparticles is proposed to mitigate the performance degradation.

Development of Prediction Model for Intensive Care Unit Admission Based on Heart Rate Variability: A Case-Control Matched Analysis.

This study aimed to develop a predictive model for intensive care unit (ICU) admission by using heart rate variability (HRV) data. This retrospective case-control study used two datasets (emergency department [ED] patients admitted to the ICU, and patients in the operating room without ICU admission) from a single academic tertiary hospital. HRV metrics were measured every 5 min using R-peak-to-R-peak (R-R) intervals. We developed a generalized linear mixed model to predict ICU admission and assessed the area under the receiver operating characteristic curve (AUC). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated from the coefficients. We analyzed 610 (ICU: 122; non-ICU: 488) patients, and the factors influencing the odds of ICU admission included a history of diabetes mellitus (OR [95% CI]: 3.33 [1.71-6.48]); a higher heart rate (OR [95% CI]: 3.40 [2.97-3.90] per 10-unit increase); a higher root mean square of successive R-R interval differences (RMSSD; OR [95% CI]: 1.36 [1.22-1.51] per 10-unit increase); and a lower standard deviation of R-R intervals (SDRR; OR [95% CI], 0.68 [0.60-0.78] per 10-unit increase). The final model achieved an AUC of 0.947 (95% CI: 0.906-0.987). The developed model effectively predicted ICU admission among a mixed population from the ED and operating room.

Effects of volatile organic compounds and new particle formation on real-time hygroscopicity of PM2.5 particles in Seosan, Republic of Korea.

The hygroscopicity of PM2.5 particles plays an important role in PM2.5 haze in Northeast Asian countries by influencing particle growth and chemical composition. New particle formation (NPF) and atmospheric volatile organic compounds (VOCs) are factors that influence particle hygroscopicity. However, the lack of real-time hygroscopicity measurements has deterred the understanding of their effects on particle hygroscopicity. In this study, two intensive monitoring campaigns were conducted during the summer of 2021 and spring of 2022 using real-time aerosol instruments, including a humidified tandem differential mobility analyzer (HTDMA), in Seosan, Republic of Korea. The hygroscopicity parameter κ was calculated from the real-time HTDMA measurement data (κGf). The diurnal variations in κGf exhibited strong inverse linear correlations with the total concentration of VOCs (CTVOC) during the two campaigns. The higher atmospheric CTVOC in summer increased the growth rate of the particle diameter from 10 to 40 nm (6 nm/h) compared with that in spring (2.7 nm/h), resulting in a faster change in κGf for 40-nm particles in summer than in spring because of the increase in organic matter in the chemical compositions of particles. In addition, NPF events introduced additional tiny fresh particles into the atmosphere, which reduced the κGf of 40-nm particles and increased the intensity of the less hygroscopic peaks (κGf < 0.1) of κ-probability density functions (κ-PDF) in NPF days. However, 100-nm particles exhibited fewer changes in κGf than 40-nm particles, resulting in additional dominant hygroscopic peaks (κ âˆ¼ 0.2) of κ-PDFs in both NPF and non-NPF days. When κGf values measured in Seosan were compared with those in other Northeast Asian countries in the literature, the κ values for 40-nm particles were lower than those (κ > 0.2) measured in Beijing and Guangzhou, but those for 100-nm particles were close to those measured in the two cities.

Detection and characterization of nanomaterials released in low concentrations during multi-walled carbon nanotube spraying process in a cleanroom.

Release of nanomaterials was assessed in a cleanroom workplace designed for the handling of multi-walled carbon nanotubes. During the process, the nanotubes were sprayed in a chamber fitted with an exhaust duct system. The front door of the spraying chamber was completely closed, but rear end of the chamber was partially open. Throughout a series of spray processes, three detectors - an optical particle counter, a nanoparticle aerosol monitor, and an aethalometer - counted and characterized particles escaping the chamber. Concentrations of particle surface area and black carbon emitted by the spraying were assessed assuming zero background aerosol concentration in the cleanroom. Very low concentrations of black carbon, 0.4 µg/m(3), were observed. In conclusion, in a cleanroom, low concentrations of nanomaterials were detected to be emitted from a spraying chamber into the workplace. The level of particles reaching the workplace was sufficiently low to have made their detection difficult in a normal environment. Both target nanomaterial and non-intended incidental nanomaterials were released during spraying. Despite the use of exhaust duct system in the process chamber, workers would be exposed to some particles if the chamber were partially open. The exhaust duct system was not enough to remove all the particles released in the chamber.

Temporal variations of volatile organic compounds inside the cabin of a new electric vehicle under different operation modes during winter using proton transfer reaction time-of-flight mass spectrometry.

Transportation is globally becoming more vehicle-dependent as public awareness towards the health risks caused by cabin-emitted volatile organic compounds (VOCs) increases. Therefore, the need for quantifying their concentration increases as well. This study measured the real-time VOCs in a new mini-truck-type electric vehicle cabin using a proton transfer reaction time-of-flight mass spectrometry under varying cabin heating conditions during winter. A total of 246 ions were detected between m/z 30 and 250, 82 of which were quantified. The total ion count in the cabin was double that of the ambient air. Morning-to-noon concentration of total VOCs increased 2.5 times in the cabin under solar exposure (164.47-405.92 µg·m-3). Additionally, 12 VOCs that either had higher indoor-to-outdoor ratios or globally regulated chosen to investigate the effects of cabin air conditions. Heater operation immediately increased concentrations of some VOCs by 54.62%. Furthermore, blocking solar exposure from windows reduced VOC emissions during heater off and on scenarios by 35.49% and 65.42%, respectively, indicating that window coverage also provided insulation against heat loss. Finally, the fresh air reduced cabin VOCs by 62.83% due to ambient air inflow. However, cabin concentrations remained higher than those of ambient air.

Isolated Oculomotor Nerve Palsy After Temporoparietal Lobar Hemorrhage With a Mass Effect: A Case Report.

We report a case of a patient who presented with ipsilateral oculomotor nerve palsy after a spontaneous left temporoparietal lobar hemorrhage with mass effect. Primary symptomatology included ipsilateral ptosis, dilated fixed pupil, and a lack of superior and medial movement with limited inferior left eye movements. Brain imaging revealed compression of the left upper midbrain due to subtentorial herniation of the hemorrhage, and susceptibility-weighted images sequences showed cerebral microbleed in the left midbrain substantia nigra. Based on our observation from this case, physicians should consider temporoparietal lobar hemorrhage with mass effect as an attributable factor in the etiologic cause of ipsilateral oculomotor nerve palsy.

Synergistic effect of perovskites and nitrogen-doped carbon hybrid materials for improving oxygen reduction reaction.

A fundamental understanding of the electrochemical behavior of hybrid perovskite and nitrogen-doped (N-doped) carbon is essential for the development of perovskite-based electrocatalysts in various sustainable energy device applications. In particular, the selection and modification of suitable carbon support are important for enhancing the oxygen reduction reaction (ORR) of non-platinum group metal electrocatalysts in fuel cells. Herein, we address hybrid materials composed of three representative N-doped carbon supports (BP-2000, Vulcan XC-72 and P-CNF) with valid surface areas and different series of single, double and triple perovskites: Ba0.5Sr0.5Co0.8Fe0.2O3-δ, (Pr0.5Ba0.5)CoO3-δ, and Nd1.5Ba1.5CoFeMnO9-δ (NBCFM), respectively. The combination of NBCFM and N-doped BP-2000 produces a half-wave potential of 0.74 V and a current density of 5.42 mA cm-2 at 0.5 V versus reversible hydrogen electrode, comparable to those of the commercial Pt/C electrocatalyst (0.76 V, 5.21 mA cm-2). Based on physicochemical and electrochemical analyses, we have confirmed a significant improvement in the catalytic performance of low-conductivity perovskite catalyst in the ORR when nitrogen-doped carbon with enhanced electrical conductivity is introduced. Furthermore, it has been observed that nitrogen dopants play active sites, contributing to additional performance enhancement when hybridized with perovskite.

Heuristic Approach to Predict the Performance Degradation of a Solid Oxide Fuel Cell Cathode.

The present work aims to predict the degradation in the performance of a solid oxide fuel cell (SOFC) cathode owing to cation interdiffusion between the electrolyte and cathode and surface segregation. Cation migration in the (La0.60Sr0.40)0.95Co0.20Fe0.80O3-x (LSCF)-Gd0.10Ce0.90O1.95 (GDC) composite cathode is evaluated in relation to time up to 1000 h using scanning transmission electron microscopy (STEM)-energy-dispersive X-ray spectroscopy (EDXS). The resulting insulating phase formed within the GDC interlayer is quantified by means of the volume fraction using a two-dimensional (2D) image analysis technique. For the very first time, the amount of the insulating phase in the GDC interlayer is quantified, and the corresponding performance degradation of the LSCF cathode is predicted. Mathematical relationships are established for the estimation of degradation due to surface segregation of the cathode. The ohmic resistance between the cathode and the GDC interlayer/electrolyte interface and the polarization resistance of the cathode, characterized by electrochemical impedance spectroscopy (EIS), show an excellent match with the predicted results. The combined degradation analysis and modeling for the cathode lifetime prediction provide a systematic understanding of the time-dependent cation migration and segregation behavior.

A multicomponent equimolar proton-conducting quadruple hexagonal perovskite-related oxide system.

Since the high configurational entropy-driven structural stability of multicomponent oxide system was proposed Rost et al. in 2015, many experiments and simulations have been done to develop new multicomponent oxides. Although many notable findings have shown unique physical and chemical properties, high configurational entropy oxide systems that have more than 3 distinct cation sites are yet to be developed. By utilizing atomic-scale direct imaging with scanning transmission electron microscopy and AC-impedance spectroscopy analysis, we demonstrated for the first time that a multicomponent equimolar proton-conducting quadruple hexagonal perovskite-related Ba5RE2Al2ZrO13 (RE = rare earth elements) oxide system can be synthesized even when adding eight different rare earth elements. In particular, as the number of added elements was increased, i.e., as the configurational entropy was increased, we confirmed that the chemical stability toward CO2 was improved without a significant decrement of the proton conductivity. The findings in this work broaden the use of the crystal structure to which the multicomponent model can be applied, and a systematic study on the correlation between the configurational entropy and proton conductivity and/or chemical stability is noteworthy.

Spatial and PMF analysis of particle size distributions simultaneously measured at four locations at the roadside of highways.

In urban areas, particulate matter emitted from vehicles directly affects the health of citizens near roads. Thus, in this study, particle size distribution was measured by the horizontal and vertical distances along a highway road with heavy traffic to characterize the dispersion phenomena of particulate matter emitted from vehicles. In addition, the contribution of pollution sources was analyzed using a source-receptor model. A concentration gradient was observed in which the concentration decreased with the increase in the distance from the road when the wind blew from the road to the monitoring locations. The concentration was slightly higher within 50 m of the road when the wind blows parallel to the road, and similar concentrations were found at the other monitoring locations further away from the roads. In particular, the higher the turbulence intensity of the wind, the lower is the concentration gradient coefficient because of the more enhanced mixing and dispersion. A positive matrix factorization (PMF) model with the measured particle size distribution data in the range of 9-300 nm resulted in a contribution of about 70 % (number) and 20 % (mass) to particle concentrations because of six types of vehicles including LPG, two gasoline vehicles (GDI, MPI), and three diesel vehicles with 3rd, 4th, and 5th emission classes. It showed a decrease in the vehicular contribution as the distance from the road increased. Particle number concentrations decreased with increasing altitude up to 30 m above the ground. The results of this study can be useful in deriving generalized gradient equations of particle concentrations exposed by distance and wind direction at the roadside using traffic and meteorological conditions and for establishing environmental policies, such as roadside exposure assessment, in the future. A CAPSULE ABSTRACT: Dispersion of particles emitted from vehicles on a busy highway was characterized by roadside measurements of horizontal and vertical profiles of particle size distributions measured at four locations. The source profiles and contributions were estimated by major sources using a source-receptor model such as PMF.

The effects of Sutaehwan-Gami on menopausal symptoms induced by ovariectomy in rats.

BACKGROUND: This study was undertaken to evaluate the beneficial effects of a modified prescription of Sutaehwan named Sutaehwan-Gami (SG), created by adding Rhizoma dioscoreae and Carthami semen to Sutaehwan, on menopausal symptoms. METHODS: To evaluate the estrogenic effect of SG, we first examined estrogen receptor (ER) activation by SG treatment in breast adenocarcinoma cells and confirmed the estrogenic effect of SG in vivo ovariectomized rats. The animals were randomized into four groups: Sham operated group (Sham), saline treated ovariectomized group (OVX), SG treated group (SG) and raloxifene treated group (RLX). Animals were provided with SG at a dose of 500 mg/kg bw/day and RLX at a dose of 5.4 mg/kg bw/day with standard rat pellets for 3 months. RESULTS: SG significantly increased ERα phosphorylation, and its downstream effectors, extracellular signal-regulated kinase (ERK) and protein kinase B (Akt) phosphorylation in breast adenocarcinoma cells. Treatment with SG reversed ovariectomy-induced uterine weight reduction and weight gain. Decreases in the levels of GOT and GPT were observed in the SG group. The significantly reduced E2ß level in OVX rats was raised by treatment with SG. Moreover, SG significantly increased the phosphorylation levels of ERK and Akt in the uterus. CONCLUSION: Taken together, these data indicate that SG has phytoestrogen-like properties through ERK and Akt activation, implying that it could be protective and beneficial for the management of menopausal symptoms.

Comparison of total PM emissions emitted from electric and internal combustion engine vehicles: An experimental analysis.

Electric vehicles (EVs) are regarded as zero emission vehicles due to the absence of exhaust emissions. However, they still contribute non-exhaust particulate matter (PM) emissions, generated by brake wear, tire wear, road wear, and resuspended road dust. In fact, because EVs are heavier than internal combustion engine vehicles (ICEVs), their non-exhaust emissions are like to be even higher. While total PM emissions, including exhaust and non-exhaust PM emissions, from ICEVs and EVs have been compared based on the emission factors (EFs) listed in national emission inventories, there have been no comparisons based on experimental determinations. In this study, exhaust and non-exhaust emissions generated from a gasoline ICEV, diesel ICEV, and EV were experimentally investigated. The results showed that the EFs for the total PM emissions of ICEVs and EV were dependent on the inclusion of secondary exhaust PM, the brake pad type, and the regenerative braking intensity of the EV. When only primary exhaust PM emissions were considered in vehicles equipped with non-asbestos organic (NAO) brake pads, the total PM10 EF of the EV (47.7-49.3 mg/V·km) was 10-17 % higher than those of the gasoline ICEV (42.3 mg/V·km) and diesel ICEV (43.2 mg/V·km). However, in vehicles equipped with low-metallic (LM) brake pads, the total PM10 EF of the EV (49.2-57.7 mg/V·km) was comparable or lower than those of the gasoline ICEV (56.3 mg/V·km) and diesel ICEV (57.2 mg/V·km). When secondary PM emissions were included, the EF was always significantly lower for the EV than ICEVs. The total PM10 EF of the EV (47.7-57.7 mg/V·km) was lower than those of the gasoline ICEV (56.5-70.5 mg/V·km) and diesel ICEV (58.0-72.0 mg/V·km). Since secondary PM particles are mostly of submicron size, the EFs of the PM2.5 fraction of the ICEVs (28.7-33.0 mg/V·km) were two times higher than those of the EV (13.9-17.4 mg/V·km).

Low-dose mitotane-induced neurological and endocrinological complication in a 5-year-old girl with adrenocortical carcinoma.

Mitotane is an adrenolytic drug that exhibits therapeutic effects within a narrow target range (14-20 µg/dL). Various complications develop if the upper limit is exceeded. We present the case of a 5-year-old girl with breast development, acne, and pubic hair who was diagnosed with an adrenal mass that was subsequently excised. The pathological finding was adrenocortical carcinoma with a high risk of malignancy, and adjuvant therapy (combined mitotane and radiation therapy) was recommended. Mitotane was initiated at a low dose to allow monitoring of the therapeutic drug level, and high-dose hydrocortisone was also administered. However, the patient exhibited elevated adrenocorticotropic hormone levels and vague symptoms such as general weakness and difficulty concentrating. It was important to determine if these symptoms were signs of the neurological complications that develop when mitotane level is elevated. Encephalopathy progression and pubertal signs appeared 6 months after diagnosis, induced by high mitotane level. The mitotane decreased to subtherapeutic level several months after its discontinuation, at which time endocrinopathy (central hypothyroidism, hypercholesterolemia, and secondary central precocious puberty) developed. The case shows that low-dose mitotane can trigger neurological and endocrinological complications in a pediatric patient, indicating that the drug dose should be individualized with frequent monitoring of the therapeutic level.

Electrospray-assisted ultraviolet aerodynamic particle sizer spectrometer for real-time characterization of bacterial particles.

The ultraviolet aerodynamic particle sizer (UVAPS) spectrometer is a novel, commercially available aerosol counter for real-time, continuous monitoring of viable bioaerosols based on the fluorescence induced from living microorganisms. For aerosolization of liquid-based microorganisms, general aerosolization methods such as atomization or nebulization may not be adequate for an accurate and quantitative characterization of the microorganisms because of the formation of agglomerated particles. In such cases, biological electrospray techniques have an advantage because they generate nonagglomerated particles, attributable to the repulsive electrical forces among particles with unipolar charges. Biological electrosprays are quickly gaining potential for the detection and control of living organisms in applications ranging from mass spectrometry to developmental microbiology. In this study, we investigated the size distribution, total concentration, and fluorescence percentage of bacterial particles in a real-time manner by electrospray-assisted UVAPS. A suspension containing Escherichia coli as a test microorganism was sprayed in a steady cone-jet mode using a specially designed electrospray system with a point-to-orifice-plate configuration based on charge-reduced electrospray size spectrometry. With the electrospray process, 98% of the total E. coli particle number concentration had a size of <1 mum and the geometric mean diameter was 0.779 mum, as compared with the respective values of 78% and 0.907 mum after nebulization. The fractions of fluorescence responsive particles and of particles that contained viable organisms in culture were 12% and 7%, respectively, from the electrospray process and 34% and 24% from nebulization. These results demonstrate that (1) the presence of agglomerated particles can lead to markedly overestimated fluorescence and culturability percentages compared with the values obtained from nonagglomerated particles, and (2) electrospray-assisted UVAPS can provide more accurate and quantitative real-time characterization of liquid-based microorganisms, owing to the generation of nonagglomerated particles.