Fabrication of Ni-Rich 58NiTi and 60NiTi from Elementally Blended Ni and Ti Powders by a Laser Powder Bed Fusion Technique: Their Printing, Homogenization and Densification.

Compared to the equiatomic or near-equiatomic NiTinol alloys, Ni-rich NiTi alloys are suitable to be employed in structural applications as they exhibit higher hardness and are dimensionally stable. This research aimed to process two different grades of Ni-rich NiTi alloys, 58NiTi and 60NiTi, from Ni-Ti powder mixtures having about 58 wt.% and 60 wt.% Ni, respectively. This was performed by a laser powder bed fusion technique. At the first stage of this research, the printability of the used powder mixtures was investigated by applying different sets of printing parameters. Two appropriate sets were then selected to print the samples. Microstructural study of the printed parts revealed the existence of inhomogeneity in the microstructures. In addition, depending on the applied set of parameters, some amounts of cracks and pores were also present in the microstructure of these parts. Postprinting hot isostatic pressing procedures, performed at different temperatures, were developed to cause the reaction of phases, homogenize the parts, and possibly eliminate the existing flaws from the samples. Effects of these applied treatments on the microstructure, phase composition, density, dimensional integrity, and hardness of parts were sequentially studied. In essence, 58NiTi and 60NiTi parts having phase compositions complying with those of the equilibrium phase diagram were obtained in this research. However, the mentioned cracks and pores, formed in the microstructure of as-printed parts, could not be fully removed by postprocessing treatments.

Impact of epilepsy on employment in Malaysia.

INTRODUCTION: Studies on the impact of epilepsy on employment have been extensively performed in European and some Asian countries but not in Southeast Asia such as Malaysia, a country with a robust economy, low unemployment rate, and minimal social security benefits for the unemployed. This study aims to determine the impact of epilepsy on employment in Malaysia. METHODS: Two hundred fifty subjects (52.4% male) with a mean age of 35.2 years were recruited from a tertiary neurology clinic in Malaysia. RESULTS: Of the 250 subjects, 69.6% were employed full-time, 10.4% employed part-time, and 20.0% unemployed. Furthermore, 42.8% had a monthly income below poverty line, i.e., RM1000 (USD 320). Unemployment was associated with female gender, lower education level, younger age of seizure onset, less responsiveness to first antiepileptic drug (AED), higher seizure frequency and less seizure freedom, and higher total score in seizure severity scale. The age of onset (p=0.017), total score in the seizure severity scale (p=0.018), and the responsiveness to first AED (p=0.045) were the significant predictors of unemployment. Patients with part-time employment had similar education level with those who were unemployed, but they are more likely to be male and married, with intermediate age of seizure onset and seizure severity but with higher seizure frequency. As compared to their age-matched siblings, the patients were more likely to be unemployed (OR 13.1), to be single, and to have lower education level and lower monthly income. CONCLUSION: Patients with epilepsy have high unemployment rate in Malaysia despite a robust economy and minimal social security. Besides those who were unemployed, many were in part-time or low-income employment.

Evaluating the effect of dissolved oxygen on simultaneous nitrification and denitrification in polyurethane foam contact oxidation reactors.

The effects of dissolved oxygen on simultaneous nitrification and denitrification were evaluated in polyurethane foam contact oxidation reactors in a municipal wastewater treatment process. It was observed that nitrate could be removed at low dissolved oxygen levels, but the removal rate was gradually reduced as the dissolved oxygen concentration increased to a higher level of 6.0 mg/L. Nitrogen removal remained optimal within the dissolved oxygen range of 0.5 to 1.0 mg/L. Denaturing gradient gel electrophoresis (DGGE) analysis revealed that the diversity of the microbial community changed accompanying dissolved oxygen values of 0.5 to 1.0 mg/L, 2.5 to 3.5 mg/L, 6.0 to 6.5 mg/L, and 10.0 to 12.0 mg/L, in turn, which was supported by the Shannon-Wiener index of 1.56, 1.71, 1.43, and 1.56, accordingly. Both DGGE profiling and phylogenetic analysis confirmed that the nitrifiers in reactors that are responsible for nitrification during the experiment include Nitrosospira sp., Nitrosomonas sp., and Nitrospira sp.

Exposure to polystyrene microplastics impairs hippocampus-dependent learning and memory in mice.

Microplastics (MPs) pollution has become a serious environmental issue worldwide, but its potential effects on health remain unknown. The administration of polystyrene MPs (PS-MPs) to mice for eight weeks impaired learning and memory behavior. PS-MPs were detected in the brain especially in the hippocampus of these mice. Concurrently, the hippocampus had decreased levels of immediate-early genes, aberrantly enhanced synaptic glutamate AMPA receptors, and elevated neuroinflammation, all of which are critical for synaptic plasticity and memory. Interestingly, ablation of the vagus nerve, a modulator of the gut-brain axis, improved the memory function of PS-MPs mice. These results indicate that exposure to PS-MPs in mice alters the expression of neuronal activity-dependent genes and synaptic proteins, and increases neuroinflammation in the hippocampus, subsequently causing behavioral changes through the vagus nerve-dependent pathway. Our findings shed light on the adverse impacts of PS-MPs on the brain and hippocampal learning and memory.

The Epidemiology of Hand, Foot and Mouth Disease in Asia: A Systematic Review and Analysis.

CONTEXT: Hand, foot and mouth disease (HFMD) is a widespread pediatric disease caused primarily by human enterovirus 71 (EV-A71) and Coxsackievirus A16 (CV-A16). OBJECTIVE: This study reports a systematic review of the epidemiology of HFMD in Asia. DATA SOURCES: PubMed, Web of Science and Google Scholar were searched up to December 2014. STUDY SELECTION: Two reviewers independently assessed studies for epidemiologic and serologic information about prevalence and incidence of HFMD against predetermined inclusion/exclusion criteria. DATA EXTRACTION: Two reviewers extracted answers for 8 specific research questions on HFMD epidemiology. The results are checked by 3 others. RESULTS: HFMD is found to be seasonal in temperate Asia with a summer peak and in subtropical Asia with spring and fall peaks, but not in tropical Asia; evidence of a climatic role was identified for temperate Japan. Risk factors for HFMD include hygiene, age, gender and social contacts, but most studies were underpowered to adjust rigorously for confounding variables. Both community-level and school-level transmission have been implicated, but their relative importance for HFMD is inconclusive. Epidemiologic indices are poorly understood: No supporting quantitative evidence was found for the incubation period of EV-A71; the symptomatic rate of EV-A71/Coxsackievirus A16 infection was from 10% to 71% in 4 studies; while the basic reproduction number was between 1.1 and 5.5 in 3 studies. The uncertainty in these estimates inhibits their use for further analysis. LIMITATIONS: Diversity of study designs complicates attempts to identify features of HFMD epidemiology. CONCLUSIONS: Knowledge on HFMD remains insufficient to guide interventions such as the incorporation of an EV-A71 vaccine in pediatric vaccination schedules. Research is urgently needed to fill these gaps.

[Effect of carbon/nitrogen ratio on short-cut nitrification and denitrification of polyurethane biofilm reactor].

The short-cut nitrification and denitrification process of a polyurethane biofilm reactor was studied at four different carbon to nitrogen ratios (C/N ratios) (C/N =15:1, 10:1, 5:1 and 1.8:1) with focus on reactor performance and microbial community composition. Results showed that when the influent carbon/nitrogen ratio decreased from 15 to 10, 5 and 1.8, the nitrite accumulation rate was increased from 56.1% to 62.3%, 72.3% and 83.2% after 100 d operation. System achieved the optimal removal efficiency at an influent carbon/nitrogen ratio of 10 with 99.1% of ammonia removal and 91.0% of total nitrogen removal. Simultaneous nitrification and denitrification occurred in the polyurethane biofilm system at different influent carbon/nitrogen ratio. As the influent carbon/nitrogen ratio decreased from 15 to 10, 5 and 1.8, the efficiency of simultaneous nitrification and denitrification was gradually reduced. The microbial biofilm analysis indicated that the microbial diversity of biofilm with an influent carbon/nitrogen ratio of 15 was significantly higher than that in other conditions. The predominant ammonia oxidizing bacteria and nitrite oxidizing bacteria were Nitrosospira sp. and Nitrospira sp., respectively, and the predominant denitrifying bacteria were Pseudomonas sp.

Sarcocystis nesbitti causes acute, relapsing febrile myositis with a high attack rate: description of a large outbreak of muscular sarcocystosis in Pangkor Island, Malaysia, 2012.

BACKGROUND: From the 17th to 19th January 2012, a group of 92 college students and teachers attended a retreat in a hotel located on Pangkor Island, off the west coast of Peninsular Malaysia. Following the onset of symptoms in many participants who presented to our institute, an investigation was undertaken which ultimately identified Sarcocystis nesbitti as the cause of this outbreak. METHODOLOGY/PRINCIPAL FINDINGS: All retreat participants were identified, and clinical and epidemiological information was obtained via clinical review and self-reported answers to a structured questionnaire. Laboratory, imaging and muscle biopsy results were evaluated and possible sources of exposure, in particular water supply, were investigated. At an average of 9-11 days upon return from the retreat, 89 (97%) of the participants became ill. A vast majority of 94% had fever with 57% of these persons experiencing relapsing fever. Myalgia was present in 91% of patients. Facial swelling from myositis of jaw muscles occurred in 9 (10%) patients. The median duration of symptoms was 17 days (IQR 7 to 30 days; range 3 to 112). Out of 4 muscle biopsies, sarcocysts were identified in 3. S. nesbitti was identified by PCR in 3 of the 4 biopsies including one biopsy without observed sarcocyst. Non-Malaysians had a median duration of symptoms longer than that of Malaysians (27.5 days vs. 14 days, p = 0.001) and were more likely to experience moderate or severe myalgia compared to mild myalgia (83.3% vs. 40.0%, p = 0.002). CONCLUSIONS/SIGNIFICANCE: The similarity of the symptoms and clustered time of onset suggests that all affected persons had muscular sarcocystosis. This is the largest human outbreak of sarcocystosis ever reported, with the specific Sarcocystis species identified. The largely non-specific clinical features of this illness suggest that S. nesbitti may be an under diagnosed infection in the tropics.

Airway strategies for lung isolation in a patient with high-velocity nail gun injuries to the right cardiac ventricle and floor of the mouth: a case report.

INTRODUCTION: We report a case of deliberate self-harm in which three three-inch nails were fired from a nail gun resulting in mandibular fixation and two penetrating injuries to the right cardiac ventricle. This combination of high-velocity penetrating injury has not been previously described. CASE PRESENTATION: A 69-year-old Caucasian man with a medical history of chronic depression was brought to hospital after a failed suicide attempt. The attempt consisted of self-asphyxiation with car exhaust fumes and shooting himself thrice with a three-inch nail gun. He sustained a penetrating nail injury to the floor of his mouth, effectively pinning his mouth closed, and penetrating injuries to the right ventricular free wall and at the junction of the right atrioventricular septum. The patient required emergency surgery with requirements for thoracotomy and sternotomy, lung isolation and cardiopulmonary bypass. CONCLUSIONS: This is the first reported case of a combination high-velocity penetrating nail gun injury to the face and the right cardiac ventricle. This rare case offers airway strategies to accommodate the surgical requirement for lung separation for penetrating chest trauma in a patient with iatrogenically limited mouth opening.

Encapsulation of a glycosaminoglycan in hydroxyapatite/alginate capsules.

The development of suitable vehicles for the delivery of growth-inducing factors to fracture sites is a challenging area of bone repair. Bone-specific glycosaminoglycan molecules are of particular interest because of their high stability and proven effect on bone growth. Calcium alginate capsules are popular as delivery vehicles because of their low immunogenic response; they offer a versatile route that enables the controlled release of heparin (a member of the glycosaminoglycan family). In this study, hydroxyapatite (HA)/alginate composite capsules are explored as novel drug delivery vehicles for heparin, using both medium- and low-viscosity alginates. The composition, structure, and stability of the capsules are fully characterized and correlated to the release of heparin in vitro. Heparin is found to associate both with the alginate matrix through polymeric flocculation and also with the HA crystals in the composite beads. The mechanism by which heparin is released is dictated by the stability of the capsule in a particular release media and by the composition of the capsule. The use of medium-viscosity alginate is advantageous with respect to both drug loading and prolonging the release. The inclusion of HA increases the encapsulation efficiency, but because of its destabilizing effect to the alginate hydrogel matrix, it also increases the rate of heparin release. The bioactivity of heparin is fully retained throughout the assembly and release processes.

Sirolimus-eluting stent implantation for treatment of proximal left anterior descending coronary artery lesions: long-term outcome and predictors of adverse cardiac events.

OBJECTIVES: Acute and long-term results after sirolimus-eluting stent (SES) implantation of proximal left anterior descending coronary artery (LAD) disease were evaluated. BACKGROUND: Although SES has been used increasingly for the treatment of LAD disease, data regarding their safety and efficacy in a real-world population are limited. METHODS: We investigate the short- and long-term results in 966 patients who underwent SES implantation for stenosis of proximal LAD. RESULTS: The procedural success rate was 97.6%, and procedural non-Q-wave myocardial infarction (MI) rate was 14.5%. In-hospital major complications occurred in five patients (0.5%), including three deaths and two Q-wave MIs. During follow-up (20.4 +/- 8.9 months), there were 16 deaths (1.7%; 10 cardiac, 6 noncardiac), 2 Q-wave MIs, and 22 target lesion revascularizations (2.3%). Late stent thrombosis occurred in two patients (0.2%), 14 and 23 months after the procedure. The event-free survival rates for cardiac death/Q-wave MI were 98.6% +/- 0.4% at 1 year and 97.8% +/- 0.6% at 2 years. The cumulative probabilities of survival without major adverse cardiac events (MACE) were 96.7% +/- 0.6% at 1 year and 95.4% +/- 0.8% at 2 years. In multivariate analysis, stented length (HR 1.04, 95%CI 1.01-1.07, P = 0.009) and infarct-related artery (HR 5.18, 95%CI 1.09-24.64, P = 0.039) were independently related to cardiac death/Q-wave MI. In addition, stented length (HR 1.04, 95%CI 1.02-1.06, P < 0.001) and left ventricular dysfunction (HR 2.66, 95%CI 1.07-6.63, P = 0.036) were significant independent predictors of MACE. CONCLUSIONS: SES implantation for proximal LAD disease appears safe and effective in a real-world population, and the independent predictors of MACE included stented length and left ventricular dysfunction.