Real-road NOx and CO2 emissions of city and highway China-6 heavy-duty diesel vehicles.

The emission of heavy-duty vehicles has raised great concerns worldwide. The complex working and loading conditions, which may differ a lot from PEMS tests, raised new challenges to the supervision and control of emissions, especially during real-world applications. On-board diagnostics (OBD) technology with data exchange enabled and strengthened the monitoring of emissions from a large number of heavy-duty diesel vehicles. This paper presents an analysis of the OBD data collected from more than 800 city and highway heavy-duty vehicles in China using remote OBD data terminals. Real-world NOx and CO2 emissions of China-6 heavy-duty vehicles have been examined. The results showed that city heavy-duty vehicles had higher NOx emission levels, which was mostly due to longer time of low SCR temperatures below 180°C. The application of novel methods based on 3B-MAW also found that heavy-duty diesel vehicles tended to have high NOx emissions at idle. Also, little difference had been found in work-based CO2 emissions, and this may be due to no major difference were found in occupancies of hot running.

All-on-four hybrid - implante pterigoide para solução posterior de maxila atrófica / All-on-four hybrid ­ Pterygoid implant for posterior solution of atrophic maxilla

O edentulismo tem uma série de consequências deletérias para a saúde bucal e geral. As consequências bucais variam desde a bem conhecida reabsorção do rebordo residual até uma função mastigatória prejudicada, uma dieta não saudável, incapacidade social e má qualidade de vida da saúde bucal. Para superar essas dificuldades, pode-se dispor de procedimentos cirúrgicos, como os implantes pterigoideos. Realizar uma análise, por meio de revisão de literatura, da técnica all-on-four híbrida com implantes pterigoideos, como alternativa a reabilitação em maxila atrófica. Foi realizada uma revisão da literatura, com seleção de artigos indexados nas bases de dados PubMed, Scielo, Cochrane e Google Acadêmico. Nesses levantamentos foram utilizados termos como: "all-on-four", "implantes inclinados", "implantes pterigoideos", "implantes zigomáticos" e "maxilla atrófica", e suas correspondentes em inglês. Com essa revisão de literatura pode-se inferir que a técnica all-on-four híbrida utilizando implantes pterigoideos para reabilitação de maxila atrófica é uma possibilidade segura, eficaz e previsível que soluciona casos que apresentam limitações ósseas. Quando bem executada pelo profissional é possível devolver ao paciente função e estética anteriormente comprometidas, consequentemente reestabelecimento da qualidade de vida do indivíduo.

Edentulism has a number of deleterious consequences for oral and general health. Oral consequences range from the well-known residual ridge resorption to impaired masticatory function, an unhealthy diet, social disability and poor oral health quality of life. To overcome these difficulties, surgical procedures can be used, such as pterygoid implants. However, these are not without complications. Through a literature review, of the hybrid all-on-four technique with pterygoid implants as an alternative to rehabilitation in atrophic maxilla. For this, bibliographic research was carried out in the databases PubMed, Scielo, Cochrane and Google Scholar, using the following search terms: "all-on-four", "tilted implants", "pterygoid implants", "zygomatic implants" e "atrophic maxilla", in both Portuguese and English languages. With this literature review, It can be inferred that the hybrid all-on-four technique using pterygoid implants for rehabilitation of atrophic maxilla is a safe, effective and predictable possibility that solves cases with bone limitations. When well performed by the professional, it is possible to return previously compromised function and aesthetics to the patient, consequently reestablishing the individual's quality of life.

Explainable AI and transformer models: Unraveling the nutritional influences on Alzheimer's disease mortality.

This pioneering study introduces the use of transformer-based machine learning models and explainable AI approaches to explore the impact of nutrition on Alzheimer's disease (AD) mortality. Using data from the Third National Health and Nutrition Examination Survey (Nhanes iii 1988 to 1994) and the NHANES III Mortality-Linked File (2019) databases, we investigate the intricate relationship between various nutritional factors and AD mortality. Our approach features a novel application of transformer models, which are then benchmarked against established methods like random forests and support vector machines. This comparison not only underscores the strengths of transformer models in handling complex medical datasets but also highlights their potential for providing deeper insights into disease progression. Key findings, such as the significant roles of Platelet distribution width in AD mortality in transformer and Serum Vitamin B12 in random forest, are enhanced by the use of Explainable Artificial Intelligence (XAI), particularly the Shapley Additive Explanations (SHAP) and the integrated gradient methods. This study serves as a vital step forward in applying advanced AI techniques to medical research, offering new perspectives in understanding and combating Alzheimer's Disease.

Establishment of the improved colonization of Escherichia coli laboratory strain in the intestine mediated by single gene deletion.

In light of the emerging importance of the gut microbiome in human health, there is a need to improve the colonization efficiency of therapeutic bacteria called probiotics. Despite their recognized potential, artificially administered bacteria exhibit poor colonization in the intestine, limiting their therapeutic efficacy. Addressing this challenge requires innovative strategies; however, reported examples are limited. In nature, including in the intestinal tract, bacteria live via biofilm formation. Recently, it has been reported that RNase I, a member of the RNase T2 family conserved among almost all species, including bacteria, inhibits biofilm formation in Escherichia coli. In this study, we focus on these results and investigate the relationship between high biofilm formation and intestinal attachment using a non-settling E. coli laboratory strain as a probiotic model. The intestinal colonization abilities were evaluated through a microfluidic device mimicking the intestinal tract and through oral administration to mice. The in vitro and in vivo experiments showed that the E. coli strain lacking RNase I exhibited remarkable stability in intestinal colonization. We investigated the observation of colonization using fluorescence in situ hybridization, and inoculated E. coli cells were aggregated with the gut microbiome in the cecum and colon. This study proposes a technique to improve the intestinal colonization of bacteria by simply manipulating a single gene disruption, and it is expected to contribute to future research on the colonization of useful bacteria.

Changes in high school students attitudes toward health sciences following a hands-on outreach STEM program.

Despite attempts to diversify healthcare workplaces and education, racial and ethnic minorities (REM) remain underrepresented in these fields. This study investigated changes in high school students' health science interest following a single exposure, hands-on anatomy laboratory visit. One hundred and eighty-eight high school students participated in a single day, one-hour visit to a human anatomy laboratory on a university campus. Participants engaged in hands-on activities centered around both human and animal specimens led by university mentors. Using a modified Science Technology Engineering and Mathematics-Career Interest Survey (STEM-CIS) questionnaire, health science STEM interest was calculated before and after the visits and compared using a paired t-test (α = 0.05). A 2 × 2 ANOVA (α = 0.05) was run on pre-to-post-visit interest score differences with factors of Race (White/REM) and Gender (Male/Female) to determine if race/ethnicity and/or gender moderated the gains observed. Overall, health science STEM interest increased significantly from pre- to post-visit (p < 0.001), and these gains were greater in REM students (p < 0.05) but did not differ as a function of gender. These findings indicate that a single visit to an anatomy laboratory with hands-on activities can be used as a tool to engage high school aged students in STEM and may be particularly beneficial for racial/ethnic minority students, potentially influencing health science STEM interest.

Metal-on-metal hip resurfacing arthroplasty: is it safe and reliable? A synopsis of the past, the present, and the future of HRA.

This paper discusses the existing literature in the field of metal-on-metal (MoM) hip resurfacing arthroplasty (HRA), the background (why was it developed), the past (what was the evidence leading to its rise and fall in clinical use), the present situation (why a potential resurgence), and the future directions for potential improvements. All literature relevant to MoM HRA was reviewed and summarized to provide a comprehensive summary. Furthermore, a detailed literature search was performed on PubMeD, MEDLINE, and Google Scholar to identify all clinical studies reporting a minimum 10 years of outcomes for modern MoM HRA devices from February 2018 to February 2023. In addition, joint registry data over the same time period, available in the public domain, was examined to extract related information on MoM HRA. Metal ions are present in almost all types of hip replacement; on the whole, however, the risk of revision for resurfacing due to metal-related pathologies is very low, but higher than in other types of bearings. There are studies that show that some brands of MoM resurfacing prostheses have achieved excellent clinical outcomes in long-term follow-up studies and are still in use although less commonly than in early 2000s. Use of alternative bearing surfaces has demonstrated excellent results in the short-term and a very critical long-term follow-up of these cases still will help establish their place in the hip arthroplasty world. HRA deserves a permanent place in the armamentarium of orthopedic surgeons and in the hand of experienced surgeons.

Primate cerebrospinal fluid CHI3L1 reflects brain TREM2 agonism.

INTRODUCTION: Triggering receptor expressed on myeloid cells 2 (TREM2) agonists are being clinically evaluated as disease-modifying therapeutics for Alzheimer's disease. Clinically translatable pharmacodynamic (PD) biomarkers are needed to confirm drug activity and select the appropriate therapeutic dose in clinical trials. METHODS: We conducted multi-omic analyses on paired non-human primate brain and cerebrospinal fluid (CSF), and stimulation of human induced pluripotent stem cell-derived microglia cultures after TREM2 agonist treatment, followed by validation of candidate fluid PD biomarkers using immunoassays. We immunostained microglia to characterize proliferation and clustering. RESULTS: We report CSF soluble TREM2 (sTREM2) and CSF chitinase-3-like protein 1 (CHI3L1/YKL-40) as PD biomarkers for the TREM2 agonist hPara.09. The respective reduction of sTREM2 and elevation of CHI3L1 in brain and CSF after TREM2 agonist treatment correlated with transient microglia proliferation and clustering. DISCUSSION: CSF CHI3L1 and sTREM2 reflect microglial TREM2 agonism and can be used as clinical PD biomarkers to monitor TREM2 activity in the brain. HIGHLIGHTS: CSF soluble triggering receptor expressed on myeloid cells 2 (sTREM2) reflects brain target engagement for a novel TREM2 agonist, hPara.09. CSF chitinase-3-like protein 1 reflects microglial TREM2 agonism. Both can be used as clinical fluid biomarkers to monitor TREM2 activity in brain.

Evaluation of the International Society on Thrombosis and Haemostasis definition of major bleeding in Arizona rattlesnake bites.

INTRODUCTION: In 2023, a group of experts proposed that a definition of major bleeding in pharmaceutically anticoagulated patients be used in all snakebite trials. This includes bleeding that results in death, is life-threatening, causes chronic sequelae, or consumes major healthcare resources, including bleeding into a major area or hemoglobin concentration decrease ≥20 g/L. We hypothesized that a decline in hemoglobin concentration ≥20 g/L is common but rarely clinically significant in our population of Arizona rattlesnake bite patients. METHODS: Poison center records of rattlesnake bites in humans from 2018 through 2022 were retrospectively reviewed and assessed for major bleeding by the above criteria. RESULTS: Four hundred and eighty-one patients met the inclusion criteria, of whom 265 (55.1%) had a hemoglobin concentration decrease ≥20 g/L. No patients died, and there was no evidence of bleeding into a critical organ. Three patients (1.1%) received blood transfusions. A decrease in hemoglobin concentration ≥20 g/L was 100% sensitive for identifying the major bleeding-associated outcomes; however, specificity was only 45.2%. Measures of healthcare utilization and chronic sequelae were somewhat higher in patients with a decrease in hemoglobin concentration ≥20 g/L. DISCUSSION: Laboratory manifestations of hemotoxicity were common in this population, but hemorrhage was rare. While over half of patients met the major bleeding criterion of a decline in hemoglobin concentration ≥20 g/L, only 1.1% had bleeding that was potentially life-threatening as measured by receipt of a red blood cell transfusion. None died or had bleeding into a critical area. While nonspecific for major bleeding, a drop in hemoglobin concentration correlated with worse envenomation severity: these patients received more vials of antivenom, had a higher medical bill, a longer hospital stay, and were less likely to report full recovery at 90 days. CONCLUSIONS: A decrease in hemoglobin concentration ≥20 g/L should not be used as evidence of major bleeding for Arizona rattlesnake envenomation studies, but it may have a role as an indirect marker of envenomation severity.

Hepatoprotective effects of Xiaoyao San formula on hepatic steatosis and inflammation via regulating the sex hormones metabolism.

BACKGROUND: The modified Xiaoyao San (MXS) formula is an adjuvant drug recommended by the National Health Commission of China for the treatment of liver cancer, which has the effect of preventing postoperative recurrence and metastasis of hepatocellular carcinoma and prolonging patient survival. However, the molecular mechanisms underlying that remain unclear. AIM: To investigate the role and mechanisms of MXS in ameliorating hepatic injury, steatosis and inflammation. METHODS: A choline-deficient/high-fat diet-induced rat nonalcoholic steatohepatitis (NASH) model was used to examine the effects of MXS on lipid accumulation in primary hepatocytes. Liver tissues were collected for western blotting and immunohistochemistry (IHC) assays. Lipid accumulation and hepatic fibrosis were detected using oil red staining and Sirius red staining. The serum samples were collected for biochemical assays and NMR-based metabonomics analysis. The inflammation/lipid metabolism-related signaling and regulators in liver tissues were also detected to reveal the molecular mechanisms of MXS against NASH. RESULTS: MXS showed a significant decrease in lipid accumulation and inflammatory response in hepatocytes under metabolic stress. The western blotting and IHC results indicated that MXS activated AMPK pathway but inhibited the expression of key regulators related to lipid accumulation, inflammation and hepatic fibrosis in the pathogenesis of NASH. The metabonomics analysis systemically indicated that the arachidonic acid metabolism and steroid hormone synthesis are the two main target metabolic pathways for MXS to ameliorate liver inflammation and hepatic steatosis. Mechanistically, we found that MXS protected against NASH by attenuating the sex hormone-related metabolism, especially the metabolism of male hormones. CONCLUSION: MXS ameliorates inflammation and hepatic steatosis of NASH by inhibiting the metabolism of male hormones. Targeting male hormone related metabolic pathways may be the potential therapeutic approach for NASH.

Nephrology Partnership for Advancing Technology in Healthcare (N-PATH) Erasmus+ project: The Renal Expert in Vascular Access (REVAC) module.

The Renal Expert in Vascular Access (REVAC) is one of the four modules of the Nephrology Partnership for Advancing Technology in Healthcare (N-PATH) project, the first European-wide advanced training course in diagnostics and interventional nephrology, funded by Erasmus+ Knowledge Alliance, a European Commission program. The N-PATH primary goal was to train 40 young European nephrologists in both theoretical knowledge and practical skills related to interventional nephrology. The REVAC module focused on the crucial aspects of vascular access (VA) care in nephrology practice, as a complementary training path to the actual residency program. The aim was to provide nephrology fellows with comprehensive knowledge and skills related to VA management. The methodology was based on face-to-face meetings and online learning, modern facilities, experienced tutors, cutting edge simulators, augmented reality tools by means of a multidisciplinary international faculty and hands-on-courses. A feedback survey reported the experience of fellows who attended the REVAC module, confirming the positive impact on their ongoing nephrology training. We are confident that this project will revitalize their nephrology careers and will help training the next generation of nephrologists; they will be able to manage VA needs with the help of multi-disciplinary teams to safely optimize the care of hemodialysis patients.

Standard: human intestine-on-a-chip.

Organs-on-chips are microphysiological systems that allow to replicate the key functions of human organs and accelerate the innovation in life sciences including disease modeling, drug development, and precision medicine. However, due to the lack of standards in their definition, structural design, cell source, model construction, and functional validation, a wide range of translational application of organs-on-chips remains a challenging. "Organs-on-chips: Intestine" is the first group standard on human intestine-on-a-chip in China, jointly agreed and released by the experts from the Chinese Society of Biotechnology on 29th April 2024. This standard specifies the scope, terminology, definitions, technical requirements, detection methods, and quality control in building the human intestinal model on a chip. The publication of this group standard will guide the institutional establishment, acceptance and execution of proper practical protocols and accelerate the international standardization of intestine-on-a-chip for translational applications.

[19]Starphene: Combined In-Solution and On-Surface Synthesis Towards the Largest Starphene.

Starphenes are structurally appealing three-fold symmetric polycyclic aromatic compounds with potential interesting applications in molecular electronics and nanotechnology. This family of star-shaped polyarenes can be regarded as three acenes that are connected through a single benzene ring. In fact, just like acenes, unsubstituted large starphenes are poorly soluble and highly reactive molecules under ambient conditions making their synthesis difficult to achieve. Herein, we report two different synthetic strategies to obtain a starphene formed by 19 cata-fused benzene rings distributed within three hexacene branches. This molecule, which is the largest starphene that has been obtained to date, was prepared by combining solution-phase and on-surface synthesis. [19]Starphene was characterized by high-resolution scanning tunneling microscopy (STM) and spectroscopy (STS) showing a remarkable small HOMO-LUMO transport gap (0.9 eV).

Accessing Meals on Wheels: A qualitative study exploring the experiences of service users and people who refer them to the service.

AIMS: This study aimed to explore the perceptions of Meals on Wheels (MoWs) service users (SUs), and people who refer them to MoWs ('referrers'), with accessing and commencing the service in England, the barriers that might hinder service uptake, and what information would be valued when considering accessing the service. METHODS: Semistructured interviews were conducted in May-July 2022 with seven SUs and 21 referrers, recruited from four MoWs providers across England. Data were analysed using inductive thematic analysis. RESULTS: Participants indicated various pathways into the service, but referrers (family members) were more likely to be the ones enquiring about, and commencing, MoWs for SUs. Once an enquiry about MoWs had been made, the service was perceived as straightforward to set up. However, existing preconceptions and stereotypes were perceived to act as barriers to accessing MoWs. Information that participants deemed important to have available when deciding on whether to access MoWs related to the meals, the specific services provided, the reliability and flexibility of delivery and the cost of services. CONCLUSION: These findings could inform MoWs service providers' public awareness strategies about MoWs, to facilitate referrals to the service for adults with care and support needs. PATIENT OR PUBLIC CONTRIBUTION: An advisory group of people with lived experience of MoWs (users of the service and their family referrers) extensively discussed the findings of the research and advised on the implications and future dissemination steps.

TikTok for language teachers: Affordances of TikTok on teachers' identity and emotional vulnerability.

This qualitative study examines how five secondary school TESOL teachers in Thailand use TikTok to express their emotions and shape their professional identities. The research uses semi-structured interviews and thematic analysis to explore the platform's role as an emotional outlet and a medium for enhancing teacher-student relationships. Findings indicate that TikTok helps teachers manage work-related stress and allows them to present authentic selves, facilitating deeper connections with students. This interaction further informs their pedagogical practices and supports their professional identity development. The study suggests that TikTok's ability to bridge emotional expression with professional engagement offers valuable insights for integrating social media into educational frameworks. Recommendations are provided for leveraging these platforms to enhance teachers' well-being and instructional strategies, highlighting the need for further research with a broader sample. This study demonstrates the potential of social media to impact teaching dynamics and professional growth.

Design and implementation of a lab-on-a-chip for assisted reproductive technologies.

Introduction: The microfluidic device is highly optimized to remove oocytes from the cumulus-corona cell mass surrounding them. Additionally, it effectively captures and immobilizes the oocytes, aiding in assessing their quality and facilitating the injection of sperm into the oocyte. In this study, a novel microfluidic chip was designed and manufactured using conventional soft lithography methods. Methods: This research proposes the utilization of a microfluidic chip as a substitute for the conventional manual procedures involved in oocyte denudation, trapping, and immobilization. The microfluidic chip was modeled and simulated using COMSOL Multiphysics® 5.2 software to optimize and enhance its design and performance. The microfluidic chip was fabricated using conventional injection molding techniques on a polydimethylsiloxane substrate by employing soft lithography methods. Results: A hydrostatic force was applied to guide the oocyte through predetermined pathways to eliminate the cumulus cells surrounding the oocyte. The oocyte was subsequently confined within the designated trap region by utilizing hydraulic resistance along the paths and immobilized by applying vacuum force. Conclusion: The application of this chip necessitates a lower level of operator expertise compared to enzymatic and mechanical techniques. Moreover, it is feasible to continuously monitor the oocyte's state throughout the procedure. There is a reduced need for cultural media compared to more standard approaches.

Clip-on lens for scanning tunneling luminescence microscopy.

We demonstrate and verify the in-situ addition of a collecting lens for electroluminescence experiments to an existing scanning tunneling microscope. We fabricate a simple clip-on lens that we reversibly attach at the sample plate via regular sample transfer tools to collimate the light emitted from a plasmonic tunneling junction to the viewport ordinarily used for optical access. The proximity of the lens to the tunneling junction allows us achieve good collection efficiencies, demonstrating the quick turnaround of converting an existing setup with optical access into a practical scanning luminescence microscope. We verify the function of the clip-on lens by measuring the bias dependent plasmon of Au, Ag, and spatial luminescence maps.•Reversible clip-on lens.•In-situ transfer.•Luminescence.

A pilot study of optical coherence tomography-guided transbronchial biopsy in peripheral pulmonary lesions.

BACKGROUND: The diagnosis of peripheral pulmonary lesions (PPLs) remains challenging. Despite advancements in guided transbronchial biopsy (TBB) techniques, diagnostic yields haven't reached ideal levels. Optical coherence tomography (OCT) has been developed for application in pulmonary diseases, yet no data existed evaluating effectiveness in diagnosing PPLs. RESEARCH DESIGN AND METHODS: This study included patients who underwent OCT and radial endobronchial ultrasound (R-EBUS)-guided TBB. OCT and R-EBUS imaging features were analyzed to differentiate between benign and malignant PPLs and subtypes of lung cancer. RESULTS: A total of 89 patients were included in this study. The diagnostic yield of OCT-guided TBB stood at 56.18%, R-EBUS-guided TBB was 83.15% (P<0.01). The accuracy of OCT to judge the nature of lesions was 92.59%, while R-EBUS was 77.92%. The accuracy of OCT in predicting squamous carcinoma (SCC) and adenocarcinoma were both 91.30%. CONCLUSIONS: Although the diagnostic yield of OCT-guided TBB fell short of that achieved by R-EBUS, OCT possessed the capability to judge the nature of lesions and guide the pathological classification of malignant lesions. Further extensive prospective studies are necessary to thoroughly assess the characteristics of this procedure. CLINICAL TRIAL REGISTRATION: https://register.clinicaltrials.gov/ identifier is NCT06419114.

Comparison of 4% Albumin and Ringer's Acetate on Hemodynamics in On-pump Cardiac Surgery: An Exploratory Analysis of a Randomized Clinical Trial.

OBJECTIVES: Compare hemodynamics between 4% albumin and Ringer's acetate. DESIGN: Exploratory analysis of the double-blind randomized ALBumin In Cardiac Surgery trial. SETTING: Single-center study in Helsinki University Hospital. PARTICIPANTS: We included 1,386 on-pump cardiac surgical patients. INTERVENTION: We used 4% albumin or Ringer's acetate administration for cardiopulmonary bypass priming, volume replacement intraoperatively and 24 hours postoperatively. MEASUREMENTS AND MAIN RESULTS: Hypotension (time-weighted average mean arterial pressure of <65 mmHg) and hyperlactatemia (time-weighted average blood lactate of >2 mmol/L) incidences were compared between trial groups in the operating room (OR), and early (0-6 hours) and late (6-24 hours) postoperatively. Associations of hypotension and hyperlactatemia with the ALBumin In Cardiac Surgery primary outcome (≥1 major adverse event [MAE]) were studied. In these time intervals, hypotension occurred in 118, 48, and 17 patients, and hyperlactatemia in 313, 131, and 83 patients. Hypotension and hyperlactatemia associated with MAE occurrence. Hypotension did not differ between the groups (albumin vs Ringer's: OR, 8.8% vs 8.5%; early postoperatively, 2.7% vs 4.2%; late postoperatively, 1.2% vs 1.3%; all p > 0.05). In the albumin group, hyperlactatemia was less frequent late postoperatively (2.9% vs 9.1%; p < 0.001), but not earlier (OR, 22.4% vs 23.6%; early postoperatively, 7.9% vs 11.0%; both p > 0.025 after Bonferroni-Holm correction). CONCLUSIONS: In on-pump cardiac surgery, hypotension and hyperlactatemia are associated with the occurrence of ≥1 MAE. Compared with Ringer's acetate, albumin did not decrease hypotension and decreased hyperlactatemia only late postoperatively. Albumin's modest hemodynamic effect is concordant with the finding of no difference in MAEs between albumin and Ringer's acetate in the ALBumin In Cardiac Surgery trial.