Risks of Glaucoma among Individuals with Psoriasis: A Population-based Cohort Study.

BACKGROUND: Psoriasis is a chronic systemic disorder with ocular involvement. OBJECTIVES: The aim of the present study is to evaluate the risk of glaucoma among psoriatic patients. METHODS: Subjects of this cohort study were selected based on Chang Gung Research Database from January 1, 2003, to December 31, 2012. Follow-up ended on December 31, 2017. The participants of the control group were matched with the psoriatic group by gender, age, and index date at a 4:1 ratio. The hazard ratios of glaucoma were estimated using Cox regression analysis. We also evaluated the relationship between the risk of glaucoma and systemic therapies as well as phototherapy and topical corticosteroid in patients with psoriasis. RESULTS: A total of 6,682 patients with psoriasis and 26,728 matched controls were enrolled. The study population is composed of mainly Males accounting for 64.2% of the study population. The psoriatic group had higher incidence rates than the control group for glaucoma (adjusted hazard ratio 1.405 [95% confidence interval, 1.051-1.879]). Psoriatic patients receiving psoralen and ultraviolet-A (PUVA) therapy for more than 200 sessions had an increased risk of glaucoma. CONCLUSIONS: Psoriatic patients had an increased risk of glaucoma. Long-term PUVA therapy raised the risk of glaucoma in psoriatic populations.

Development and Validation of Small-Size Mechanism for RP-3 Aviation Fuel with High Precision.

In this study, a kerosene surrogate model fuel containing 73% n-dodecane, 14.7% 1,3,5-trimethylcyclohexane, and 12.3% n-propylbenzene (percentage in mass) is developed by considering both the physical and chemical characteristics of practical aviation kerosene. By combining the small-size C0-C4 (carbon number) core mechanism and the large hydrocarbon submechanisms, a low- and high-temperature chemical kinetic mechanism including 43 species and 136 reactions is constructed for the kerosene surrogate model fuel. The performance of the 43-species mechanism is validated by examining various experimental ignition delay times and laminar flame speeds of single component of n-dodecane and practical kerosene. The predicted main species concentrations during the oxidation process in the jet-stirred reactor by this small-size mechanism exhibit generally acceptable performance with the corresponding experimental data of RP-3 kerosene. The results of brute force sensitivity analysis indicate that the mechanism retains key reaction paths. This relatively small size can be applied to the simulation of computational fluid dynamics to further explore the practical problems of aviation fuel application in engine.

Effects of Ethanol and Methanol on the Combustion Characteristics of Gasoline with the Revised Variation Disturbance Method.

This paper proposes a revised variation disturbance method to provide valuable information and reference for fuel design or optimization of internal combustion engines to realize the comprehensive and quantitative evaluation of the effects of blending agents on the combustion performance of primary fuels. In this method, methanol and ethanol are blended into gasoline to form six kinds of alcohol-gasoline (E10, E20, E30, M10, M20, and M30). Then, the ignition delay, adiabatic flame temperature, component concentration, fuel-burning rate, extinction strain rate, and CO emission of gasoline and alcohol-gasoline are studied by system simulation in a wide range of operating conditions. Based on the new variation disturbance method, the effects of methanol and ethanol on the combustion performance of gasoline are next analyzed globally and characterized quantitatively. The comprehensive results of ethanol and methanol on the gasoline's combustion are visually presented. The method proposed in this paper is preliminarily validated based on the analysis of the microscopic mechanism of combustion. The results show that the blending of ethanol and methanol has positive effects on gasoline combustion, and ethanol can rapidly ignite the gasoline in a wide range of operating conditions and is superior to methanol in terms of fuel combustion, stability, and pollutant discharge. Based on the treatment of simulated values of six combustion characteristics selected in this paper and the calculations of the variation disturbance method, the total disturbance values of ethanol and methanol to gasoline combustion are obtained as 0.8493 and 0.2605, respectively. That is, ethanol has a more significant effect on improving the combustion performance of gasoline than methanol. In addition, based on the analysis results of the combustion, it is found that the blending of ethanol enlarges the reaction of notable components in gasoline. This finding also proves the effectiveness and validity of the scientific method utilized in this paper.

NRAS Mutations May Be Involved in the Pathogenesis of Cutaneous Rosai Dorfman Disease: A Pilot Study.

BACKGROUND: Purely cutaneous Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disorder limited to the skin. To date, its pathogenesis remains unclear. Owing to recent findings of specific mutations in the mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) pathway in histiocytic proliferative disorders, it provides a novel perspective on the pathomechanism of cutaneous RDD. We aim to investigate the genomic mutations in MAPK/ERK pathway in cutaneous RDD. METHODS: We retrospectively recruited all cases of cutaneous RDD from two hospitals in Taiwan from January 2010 to March 2020 with the clinicopathologic features, immunohistochemistry, and treatment. Mutations of neuroblastoma RAS viral oncogene homolog (NRAS), Kirsten rat sarcoma 2 viral oncogene homolog (KRAS), and v-raf murine sarcoma viral oncogene homolog B1 (BRAF) in MAPK/ERK pathway were investigated by the highly sensitive polymerase chain reaction with Sanger sequencing. RESULTS: Seven patients with cutaneous RDD were recruited with nine biopsy specimens. The median age was 46 years (range: 17-62 years). Four of seven patients (57.1%) received tumor excision, while the other three chose oral and/or topical or intralesional steroids. NRAS mutation was detected in 4 of 7 cases (4/7; 51.7%), and NRAS A146T was the most common mutant point (n = 4/7), followed by NRAS G13S (n = 2/7). There is no KRAS or BRAF mutation detected. CONCLUSIONS: We report the NRAS mutation is common in cutaneous RDD, and NRAS A146T was the most frequent mutation in this cohort. Mutations in the NRAS gene can activate the RAS/MAPK signaling and have been reported to be associated with various cancers. It indicates that NRAS mutation in MAPK/ERK pathway may involve the pathogenesis of cutaneous RDD.

Balser Plate Stabilization for Traumatic Sternoclavicular Instabilities or Medial Clavicle Fractures: A Case Series and Literature Review.

OBJECTIVE: This study was performed to observe the effect of internal Balser plate fixation for treating unstable sternoclavicular joints (SCJ) and displaced medial clavicle fractures. METHODS: From April 2009 to September 2016, 17 consecutive patients who underwent open reduction and internal Balser plate fixation for SCJ dislocations or medial clavicle fractures were retrospectively reviewed. There were 11 male and six female patients, with a mean age of 45.6 ± 15.5 years. Standardized treatment procedures consisted of reduction, creating a space posterior dorsal osteal face of the sternal manubrium, an inverted Balser plating, and postoperative immobilization. At follow-up, plain radiographs were assessed for fracture union, implant loosening, degenerative changes, and joint congruity. Clinical evaluation included: completion of the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire; determination of the Constant and Murley score and visual analog scale (VAS) score; and assessment of intraoperative and postoperative complications. RESULTS: All patients were followed up, at a mean follow-up of 20.1 ± 7.9 months, each fracture had a solid union, and each dislocation showed no sign of recurrent dislocation. The mean shoulder forward flexion was 162.9° ± 8.1°. The mean DASH score was 5.2 ± 5.2 points. The mean Constant and Murley joint function score was 93.7 ± 7.9 points, with 15 excellent cases and two good cases. The mean VAS score was 1.1 ± 1.4 points, showing significant improvement compared with the VAS score preoperatively. Postoperative complications included one wound hematoma which was healed after a debridement and one recurrent instability due to hook migration, which underwent revision reconstruction. All patients were satisfied with their treatment outcome at the final follow-up. CONCLUSION: Sternoclavicular joints dislocation or medial clavicle fractures can be treated successfully with Balser plate fixation. This technique permits early functional exercise while preserving the SCJ.

Quantitative Evaluation of Myocardial Strain After Myocardial Infarction with Cardiovascular Magnetic Resonance Tissue-Tracking Imaging.

To investigate the value of cardiovascular magnetic resonance tissue-tracking (CMR-TT) imaging in the differentiation of subendocardial and transmural myocardial infarction (MI) and determine whether strain parameters are enable to detect adverse left ventricular (LV) remodeling.Global peak circumferential, longitudinal, and radial strains (GPCS, GPLS, GPRS) and segmental peak circumferential, longitudinal, and radial strains (PCS, PLS, PRS) in accordance with the 16-segment model were all derived. All positive segments were divided into two groups according to transmural degree. All patients were dichotomized in accordance with the existence of LV remodeling, which was defined as infarct size (IS) > 24%.Patients with MI showed significant lower GPRS, GPCS, and GPLS than the control group (16.41% ± 8.92%, -8.77%± 3.51%, -7.54% ± 2.43% versus 32.41% ± 12.99%, -14.92% ± 3.32%, -11.50% ± 2.51%). Lower PRS [3.25% (-5.57, 7.835) versus 19.94% (12.50, 30.75), P < 0.001] and PCS (-3.81 ± 4.60% versus -8.97± 4.43%, P < 0.001) can be found in transmural infarcted segments compared to subendocardial infarcted segments. PLS between transmural and subendocardial infarcted segments (-4.03% ± 4.88% versus -4.34% ± 4.98%), without however statistical significance (P = 0.523). The optimal cutoff value for PRS in the discriminate diagnosis of MI was 8.97% with a sensitivity of 81.8% and specificity of 98.0%. The optimal cutoff value for PCS was -7.56% with a sensitivity of 83.6% and specificity of 72.1%. Receiver operating characteristic (ROC) analysis revealed an optimal cutoff GPRS of 15.45%, and GPCS of -6.72% yielded high diagnostic accuracy in the identification of remodeling, which was higher than left ventricular ejection fraction (LVEF).CMR-TT can differentiate between subendocardial and transmural infarction and detect LV remodeling, and the diagnostic value was superior to conventional functional parameters.

[Treatment of aseptic ulnar diaphyseal nonunion with locking compression plate and autogenous iliac bone graft].

OBJECTIVE: To investigate the clinical results of locking compression plate combined with autologous iliac bone graft in the treatment of aseptic ulnar nonunion. METHODS: From March 2009 to July 2017, 22 patients with aseptic ulnar diaphyseal nonunion with complete follow-up data were treated with surgery, including 12 males and 10 females, aged from 16 to 58 (39.7±9.9) years old and ranging in course of disease from 10 to 192 (39.4±55.7) months. There were 15 atrophic nonunions, 5 hypertrophic nonunions and 2 synovial pseudo-articular nonunions. After debridement of the nonunion, locking compression plate was used to fix the nonunion and autogenous iliac bone graft was given. Bone healing rate, surgical complications and clinical results were evaluated. RESULTS: All the patients were followed up, and the duration ranged from 13 to 42 months, with a mean of (22.5±8.2) months, and 1 patient did not heal. Visual analogue pain scores ranged from 0 to 3 (0.9±0.9). Pronation of forearm was 47 to 86 (69.0±14.7) degrees, supination was 35 to 85 (63.0±9.4) degrees, wrist flexion was 20 to 80 (51.0±10.2) degrees, wrist flexion was 32 to 88 (71.0±11.7) degrees, elbow flexion contracture was 0 to 25 (9.0±5.6) degrees, further flexion was 105 to 150 (134.0±13.9) degrees, and grip strength was 87% on the opposite side. According to the Anderson scoring system, 8 cases were excellent, 11 were satisfied, 2 were not satisfied, and 1 was failed. CONCLUSIONS: LCP combined with autologous iliac bone graft can effectively treat aseptic ulna diaphyseal nonunion.

The risk factors of nonunion after intramedullary nailing fixation of femur shaft fracture in middle age patients.

Although the optimal treatment for femur shaft fracture is intramedullary nailing fixation, nonunion still occurs. We determined the oligotrophic nonunion rate among femur fractures managed operatively and identified risk factors for reoperation. This was a retrospective clinical study. The data of the patients between 40 and 70 years old with diaphyseal femur fracture who have received reamed and interlocked intramedullary nailing fixation in our hospital from February 2014 to April 2018 were collected. They were followed at regular intervals for at least 1 year after the operation. The primary outcome was nonunion of the fracture site that required reoperation in accordance with the radiographic union scale for tibial shaft fracture (RUST), which is a reasonable score system for lower limb diaphyseal fracture. Three of them were hypertrophic nonunion (1.9%) and the other 13 cases were oligotrophic nonunion (8.6%) at postoperative 12 months follow-up. All of the postoperative plain films showed adequate reduction quality. The three hypertrophic nonunion cases were all obese male with fracture site comminution. Fracture at the proximal third junction, hypertension (HTN) and diabetes mellitus (DM) was significantly associated with oligotrophic nonunion of the fracture site from logistic regression analysis. The mean RUST score 3 months after the operation was not significantly different between the union group and nonunion group but was significantly lower 6 months after the operation in the nonunion group. In conclusion, intramedullary nailing of the femur shaft fractures was associated with a low risk of nonunion at the 1-year follow-up in the middle age group. Those with comorbidity such as obese, HTN, and DM, with fracture site at the proximal third junction or comminution should be followed up closely and rehabilitation with cause aggressively. Radiographic scale as the RUST score at postoperative 6 months could be used to predict this complication.

[Effects of light quality ratio on photosynthetic characteristics and quality of purple lettuce]. / ä¸åŒå ‰è´¨é æ¯”å¯¹ç´«å¶ç”Ÿèœå ‰åˆç‰¹æ€§å’Œå“è´¨çš„å½±å“.

To explore the effects of different light quality ratios on the growth and development of purple lettuce, we used LED intelligent light control console as light source to study the effects of adding different proportions of red and blue light (1:1, 2:1, 4:1 and 1:2) to the white light on photosynthetic characteristics and commercial quality of purple lettuce (Lactuca sativa L. cv 'Zhongshu Purple Lettuce'). The results showed that when the ratio of red to blue light was 4:1, the chlorophyll content, RuBP carboxylase activity, electron transport efficiency of photosynthesis, net photosynthetic rate and growth were all significantly higher than that in control and other treatments, whereas the nitrate content was the lowest. When the ratio of red to blue light was 1:2, the contents of soluble protein, vitamin C, secondary metabolites such as anthocyanins, flavonoids, total phenolic compounds, and the contents of antioxidant capacity were significantly higher than those in the control and other treatments. We concluded that adding appropriate ratios of red to blue light to the white light could increase photosynthesis and improve commercial quality of purple lettuce.

Theoretical Prediction of Rate Constants for Hydrogen Abstraction by OH, H, O, CH3, and HO2 Radicals from Toluene.

Hydrogen abstraction from toluene by OH, H, O, CH3, and HO2 radicals are important reactions in oxidation process of toluene. Geometries and corresponding harmonic frequencies of the reactants, transition states as well as products involved in these reactions are determined at the B3LYP/6-31G(2df,p) level. To achieve highly accurate thermochemical data for these stationary points on the potential energy surfaces, the Gaussian-4(G4) composite method was employed. Torsional motions are treated either as free rotors or hindered rotors in calculating partion functions to determine thermodynamic properties. The obtained standard enthalpies of formation for reactants and some prodcuts are shown to be in excellent agreement with experimental data with the largest error of 0.5 kcal mol(-1). The conventional transition state theory (TST) with tunneling effects was adopted to determine rate constants of these hydrogen abstraction reactions based on results from quantum chemistry calculations. To faciliate its application in kinetic modeling, the obtained rate constants are given in Arrhenius expression: k(T) = AT(n) exp(-EaR/T). The obtained reaction rate constants also agree reasonably well with available expermiental data and previous theoretical values. Branching ratios of these reactions have been determined. The present reaction rates for these reactions have been used in a toluene combustion mechanism, and their effects on some combustion properties are demonstrated.