The Chaperone-Active State of HdeB at pH 4 Arises from Its Conformational Rearrangement and Enhanced Stability Instead of Surface Hydrophobicity.

HdeA and HdeB are dimeric ATP-independent acid-stress chaperones, which protect the periplasmic proteins of enteric bacteria at pH 2.0 and 4.0, respectively, during their passage through the acidic environment of the mammalian stomach. Despite being structurally similar, they exhibit distinct functional pH optima and conformational prerequisite for their chaperone action. HdeA undergoes a dimer-to-monomer transition at pH 2.0, whereas HdeB remains dimeric at pH 4.0. The monomerization of HdeA exposes its hydrophobic motifs, which facilitates its interaction with the partially folded substrates. How HdeB functions despite maintaining its dimeric conformation has been poorly elucidated in the literature. Herein, we characterized the conformational states and stability of HdeB at its physiologically relevant pH and compared the data with those of HdeA. At pH 4.0, HdeB exhibited distinct spectroscopic signatures and higher stability against heat and guanidine-HCl-induced denaturation than at pH 7.5. We affirm that the pH 4.0 conformer of HdeB was distinct from that at pH 7.5 and that these two conformational states were hierarchically unrelated. Salt-bridge mutations that perturbed HdeB's intersubunit interactions resulted in the loss of its stability and function at pH 4.0. In contrast, mutations affecting intrasubunit interactions enhanced its function, albeit with a reduction in stability. These findings suggest that, unlike HdeA, HdeB acts as a noncanonical chaperone, where pH-dependent stability and conformational rearrangement at pH 4.0 play a core role in its chaperone function rather than its surface hydrophobicity. Such rearrangement establishes a stability-function trade-off that allows HdeB to function while maintaining its stable dimeric state.

Comparison of weight-based and pinna size method for ProSeal laryngeal mask airway size selection in children receiving general anesthesia: A randomized clinical study.

Background and Aims: Several methods are in use for LMA ProSeal™ size selection in pediatric patients. Weight-based method is most commonly used. Pinna size-based method is a promising new technique for accurate size selection. Material and Methods: A total of 146 children aged between 6 months and 12 years undergoing surgery under general surgery were included. They were randomized into either pinna-based group (group X) or weight-based group (group Y). Both groups were compared for accurate placement of ProSeal™ laryngeal mask airway (PLMA), ease of insertion, number of attempts needed, and peak airway pressures. Results: A Comparable number of patients had a Brimacombe score of 3 and above, indicating correct placement in both groups (P = 0.407). PLMA was easily inserted in 79.5% and 87.7% of patients of groups X and Y, respectively (P = 0.180). Insertion was found to be difficult in 20.5% of patients in group X, whereas it was difficult in only 12.3% of patients of group Y (P = 0.180). The two groups were comparable as per the number of attempts needed for insertion (P = 0.161). Mean peak airway pressures too were comparable between both groups. Ease of insertion too, was statistically insignificant between both groups. Conclusions: Pinna size-based estimation of LMA size is an effective alternative method to weight-based selection.

Impact of construction parameters on ergonomic and thermo-physiological comfort performance of knitted occupational compression stocking materials.

This work investigates the effect of varying the knitting structure and stitch length (SL) on various thermo-physiological and ergonomic comfort properties of the occupational graduated compression socks. Thermo-physiological comfort, ergonomic comfort and dimensional stability of theses stockings were analysed in a comparative manner. Obtained results were evaluated statistically using the technique of analysis of variance (ANOVA). A Fisher's multiple comparison test was commissioned to analyze the relationship between the alteration of stitch length (SL) on various utility functions and properties desired in the occupational compression socks. In order to examine whether the difference of stitch length is significant, p values were determined. Further the influence of knitting structures e.g., plain, 2 × 2 Rib and 1 × 3 Rib was analysed on the selected properties. The interactive effect of both stitch length (SL) and knitting structure was studied using statistical techniques. It was concluded that knitting structure has a stronger impact on thermo-physiological and ergonomic comfort properties. Results showed a significant variation in thermo-physiological and ergonomic comfort by altering stitch length by means of the statistical analysis. An innovative approach for the manufacturers has been developed for optimizing performance in compression stockings. The construction of the compression socks can thus be optimized in terms of constructional parameters to provide optimum comfort to the users.

Amino acids and glycine derivatives differently affect refolding of mesophilic and thermophilic like α-amylases: implications in protein refolding and aggregation.

α-amylases are industrially important enzymes which are used in different starch-based industries. They are adapted to different environmental conditions like extremes of temperature, pH and salinity. Herein, α-amylases from Bacillus amyloliquifaciens (BAA) and Bacillus licheniformis (BLA), representing mesophilic and thermophilic-like proteins, respectively, have been used to investigate the effect of naturally occurring osmolytes like arginine, proline, glycine and its methyl derivatives, sarcosine and betaine on their refolding. In this study, we have shown that among amino acids and glycine derivatives, betaine is the most promising osmolyte, while arginine and glycine exhibit moderately positive effect at their lower concentrations on the refolding of BAA only. Except betaine, all other osmolytes above 0.25 M showed inhibitory effect on the native enzyme activity of BLA and BAA. However, aggregation kinetics monitored by static light scattering indicates suppression of aggregation by all of these osmolytes. Further investigation by tryptophan and ANS fluorescence spectroscopy indicates the formation of compact hydrophobic core in the presence of the osmolytes. The morphology of protein aggregates having different sizes was visualized by atomic force microscopy ,and it was observed that amorphous aggregates of variable heights were formed. Our study highlights the importance of differential effects of arginine, proline, glycine, sarcosine and betaine on the native state as well as on refolding of BLA and BAA which may be helpful in devising strategies for developing effective protein formulation and prevention of aggregation of industrially and therapeutically important proteins.Communicated by Ramaswamy H. Sarma.

Computational Analysis of Mechanical Properties in Polymeric Sandwich Composite Materials.

This article focuses on the computational analysis of sandwich composite materials based on polypropylene, polyester, glass, and cotton fibers. In the automotive components prepared from these fiber materials, the various components are used in different proportions. Through the manufacturing process, isotropic materials become somewhat anisotropic. Part of this article is aimed at obtaining input values of material characteristics for calculations using finite element analysis (FEM) and the comparison of experimental results with FEM-based material models created using the Digimat 2023.1 software. This article analyzes the modeling of two-phase as well as multiphase composite materials. This work focuses on calculations using FEM according to the test defined in the PR375 standard for loading the finished product in the luggage compartment of a car. The defined methodology enables the application of the FEM-based calculation directly to the product design in the initial phase of research. The construction and production of expensive prototypes and the subsequent production of automotive parts is replaced by computer-based simulation. This procedure makes it possible to simulate several optimization cycles over a relatively shorter time. From the results of computational simulations, it is clear that materials based on PP/PET/glass fibers show a much higher modulus of elasticity than materials created using cotton, i.e., materials of the PP/PET/cotton type. In order to achieve a high strength and stiffness, it is, therefore, appropriate to use glass fibers in the composite materials used for such applications.

Facile-Solution-Processed Silicon Nanofibers Formed on Recycled Cotton Nonwovens as Multifunctional Porous Sustainable Materials.

Limited efficiency, lower durability, moisture absorbance, and pest/fungal/bacterial interaction/growth are the major issues relating to porous nonwovens used for acoustic and thermal insulation in buildings. This research investigated porous nonwoven textiles composed of recycled cotton waste (CW) fibers, with a specific emphasis on the above-mentioned problems using the treatment of silicon coating and formation of nanofibers via facile-solution processing. The findings revealed that the use of an economic and eco-friendly superhydrophobic (contact angle higher than 150°) modification of porous nonwovens with silicon nanofibers significantly enhanced their intrinsic characteristics. Notable improvements in their compactness/density and a substantial change in micro porosity were observed after a nanofiber network was formed on the nonwoven material. This optimized sample exhibited a superior performance in terms of stiffness, surpassing the untreated samples by 25-60%. Additionally, an significant enhancement in tear strength was observed, surpassing the untreated samples with an impressive margin of 70-90%. Moreover, the nanofibrous network of silicon fibers on cotton waste (CW) showed significant augmentation in heat resistance ranging from 7% to 24% and remarkable sound absorption capabilities. In terms of sound absorption, the samples exhibited a performance comparable to the commercial standard material and outperformed the untreated samples by 20% to 35%. Enhancing the micro-roughness of fabric via silicon nanofibers induced an efficient resistance to water absorption and led to the development of inherent self-cleaning characteristics. The antibacterial capabilities observed in the optimized sample were due to its superhydrophobic nature. These characteristics suggest that the proposed nano fiber-treated nonwoven fabric is ideal for multifunctional applications, having features like enhanced moisture resistance, pest resistance, thermal insulation, and sound absorption which are essential for wall covers in housing.

Elastomer-Based Sealing O-Rings and Their Compatibility with Methanol, Ethanol, and Hydrotreated Vegetable Oil for Fueling Internal Combustion Engines.

Green methanol, ethanol, and diesel-based hydrotreated vegetable oils are some of the renewable liquid fuels that show satisfactory performance in diesel engines. A notable advantage of these fuels is that they are renewable and do not require significant modifications in the existing engines for successful operation. Suitable fuel systems, especially their material compatibility, remain unresolved, and therefore, it is a weak link in their large-scale adaptation. Elastomer-based sealing O-rings lose their mechanical properties after a short exposure time to these fuels, adversely impacting their functionality. This research study evaluated the long-term material compatibility of different elastomer-based sealing materials by immersing the O-rings in these test fuels (hydrotreated vegetable oil, methanol, ethanol, and diesel) for different time intervals (i.e., up to 15 months). The material compatibility was assessed mainly by investigating these changes in various mechanical properties of these O-rings, namely tensile strength (ΔTs), elongation at break (ΔEb), Shore A hardness (ΔH), and mass (ΔM). The degradation of mechanical properties was studied and analyzed during the immersion interval from 0.9 to 15.2 months and compared with O-rings kept in a normal atmosphere. It was noted that individual fuels affect various mechanical properties significantly. In a short interval of 0.9 months (28 days), significant changes in the mechanical properties of the sealing O-rings were observed.

An Analysis of the Performance and Comfort Properties of Fire-Protective Material by Using Inherently Fire-Retardant Fibers and Knitting Structures.

This paper investigates the development of fabric materials using several blends of inherently fire-resistant (FR) fibers and various knitted structures. The samples are evaluated with respect to their performance and comfort-related properties. Inherently fire-resistant fibers, e.g., Nomex, Protex, carbon and FR viscose, were used to develop different structures of knitted fabrics. Cross-miss, cross-relief, and vertical tubular structures were knitted by using optimum fiber blend proportions and combinations of stitches. Several important aspects of the fabric samples were investigated, e.g., their physical, mechanical and serviceability performance. Thermo-physiological and tactile/touch-related comfort properties were evaluated in addition to flame resistance performance. An analysis of mechanical performance indicated that the knitted structure has a significant influence on the tensile strength, bursting strength and pilling resistance. The cross-relief structure proved to be the strongest followed by the cross-miss and vertical tubular structures. The FR station suits made from 70:30 Protex/Nomex exhibited the best combination of tensile and bursting strength; therefore, this material is recommended for making a stable and durable station suit. Interestingly, it was also concluded from the experimental study that knitted samples with a cross-relief structure exhibit the best fire-resistance performance. Fiber blends of 70:30 Protex/Nomex and 70:30 Nomex/carbon were found to be optimum in terms of overall performance. The best flame resistance was achieved with Nomex:carbon fiber blends. These results were confirmed with vertical flammability tests, TGA, DTGA and cone calorimetry analysis. The optimization of blend composition as well as knitting structure/architecture is a crucial finding toward designing the best FR station suit in terms of mechanical, dimensional, thermal, thermo-physiological and flame resistance performance.

Interventions to promote cost-effectiveness in adult intensive care units: consensus statement and considerations for best practice from a multidisciplinary and multinational eDelphi study.

BACKGROUND: There is limited evidence to guide interventions that promote cost-effectiveness in adult intensive care units (ICU). The aim of this consensus statement is to identify globally applicable interventions for best ICU practice and provide guidance for judicious use of resources. METHODS: A three-round modified online Delphi process, using a web-based platform, sought consensus from 61 multidisciplinary ICU experts (physicians, nurses, allied health, administrators) from 21 countries. Round 1 was qualitative to ascertain opinions on cost-effectiveness criteria based on four key domains of high-value healthcare (foundational elements; infrastructure fundamentals; care delivery priorities; reliability and feedback). Round 2 was qualitative and quantitative, while round 3 was quantitative to reiterate and establish criteria. Both rounds 2 and 3 utilized a five-point Likert scale for voting. Consensus was considered when > 70% of the experts voted for a proposed intervention. Thereafter, the steering committee endorsed interventions that were identified as 'critical' by more than 50% of steering committee members. These interventions and experts' comments were summarized as final considerations for best practice. RESULTS: At the conclusion of round 3, consensus was obtained on 50 best practice considerations for cost-effectiveness in adult ICU. Finally, the steering committee endorsed 9 'critical' best practice considerations. This included adoption of a multidisciplinary ICU model of care, focus on staff training and competency assessment, ongoing quality audits, thus ensuring high quality of critical care services whether within or outside the four walls of ICUs, implementation of a dynamic staff roster, multidisciplinary approach to implementing end-of-life care, early mobilization and promoting international consensus efforts on the Green ICU concept. CONCLUSIONS: This Delphi study with international experts resulted in 9 consensus statements and best practice considerations promoting cost-effectiveness in adult ICUs. Stakeholders (government bodies, professional societies) must lead the efforts to identify locally applicable specifics while working within these best practice considerations with the available resources.

Durability and Accelerated Ageing of Natural Fibers in Concrete as a Sustainable Construction Material.

This paper presents an experimental study on the influence of alkaline environments on natural fibers of plant and mineral origin in concretes. The durability of concrete-based composite materials is influenced by the properties of the reinforcing fiber, and the serviceability of concrete is dependent on its durability. The aim of the present study is to investigate the strength, weight loss %, and surface degradation of jute, sugarcane, coconut, sisal, as well as basalt fibers through an accelerated aging method when used as reinforcements in concrete. The samples were immersed in an alkaline environment of sodium and calcium hydroxide at two different levels of pH for one week. Further, the fibers were immersed in NaOH and Ca(OH)2 solutions of 1 M, 2 M, 4 M, and 6 M concentrations for 48 h in order to investigate the gradual effect of an alkaline environment on the mechanical properties of the fiber. It was concluded that the weight loss % was greatest for jute fibers when used in concrete composite, while there was no significant effect on the basalt fiber samples. The strength of jute fiber in the concrete sample was also most severely affected by the aging process, compared to other fibers. The strength of basalt fibers in a concrete composite was least affected by the aging process. In some cases, the sisal fiber sample showed an increase in fiber tenacity after the aging process due to fibrillation, which might have increased the interfacial area. The fiber microstructure before and after the aging was evaluated through the use of scanning electron microscopy (SEM). SEM analyses of different fibers were carried out to investigate surface degradation. The fiber pull-out strength was found to be the greatest for basalt fiber, followed by jute and sisal. This is indicative of the excellent adhesion of such fibers with cement in a concrete composite. In these cases, the use of sisal fiber results in defibrillation and increased specific surface area. Sugarcane and coconut fibers ruptured due to their inherent weakness and provided only a small increment in the mechanical performance of the concrete. Basalt fiber-reinforced concrete offered the greatest compressive strength, followed by jute and sisal. These observations provide crucial information regarding the durability and aging of natural fiber-reinforced concrete.

Taguchi-TOPSIS based optimization of comfort in compression stockings for vascular disorders.

Compression stockings/socks are one of the most essential materials to treat vascular disorders in veins. However, the comfort of wearing such stockings over prolonged period of time is a major problem. There is limited research in the area of comfort optimization while retaining the compressional performance. The current work is carried out with an aim to determine the optimum level of the input factors e.g., knitting structure, plaiting yarn linear density and main yarn linear density for achieving desired stretch recovery percentage and thermo-physiological comfort properties of compression socks used in treatment of vascular disorders. Their optimum combination was determined by using Taguchi based techniques for order of preference by similarity to ideal solution i.e., TOPIS. In this study, thickness, areal density, air permeability, thermal resistance, over all moisture management capacity (OMMC), stretch and recovery % were optimized simultaneously by using Taguchi-TOPSIS method. The results showed that linear density of plaiting and main yarn has significant influence on all the comfort related properties for compression stockings/socks. The optimum sample had linear density 20 denier for Lycra covered by 70 denier of nylon 66 in the plaiting yarn. It also suggested 120 denier nylon 66 in the main yarn knitted into a plain single jersey structure. The percentage contribution of the factors i.e., structure, plaiting yarn linear density and main yarn linear density was obtained by using ANOVA which are 7%, 31% and 42% respectively. It is worth mentioning that in case of compression stockings, the main yarn linear density has more significant effect on comfort properties as compared to other independent parameters. The results were verified by experiment, and the accuracy was relatively high (maximum error 8.533%). This study helped to select suitable knit structure with the change of linear densities of plaiting yarn and main yarn for comfortable compression stocking/sock and will fulfill the potential requirement for treatment of venous/vascular disorders. The novel methodology involving TOPSIS method helped in analyzing the cumulative contribution of the input parameters to achieve optimum compression as well as comfort performance. This modern approach is based on contemporary scientific principles and statistical approximations. This study may provide benchmark solutions to complex problems involving multiple interdependent criteria.

Thromboprophylaxis practices in neurocritical care-A cross-sectional survey among neurocritical care practitioners.

Background and Aims: Thromboprophylaxis practice patterns are quite diverse in neurocritical care patients. The risk of venous thromboembolism remains high in this group due to prolonged immobilised status, extended length of stay and multiple comorbidities. The aim was to comprehend the thromboprophylaxis practices among neurocritical care practitioners in India. Methods: The cross-sectional online questionnaire-based survey was undertaken among the neurocritical care practitioners. Two investigators framed two sets of 15 questions in the first stage and reviewed them with experts. In the second stage, a set of 22 questions was prepared by a third investigator and pretested among ten experts. The questions were emailed to the participants with a link to the survey. The responses were analysed using Statistical Package For The Social Sciences software. Results: Of the 185 responses, 53% reported that thromboprophylaxis is practised less often in neurocritical care than in general critical care. The usage of pharmacoprophylaxis among neurosurgical cases, traumatic brain injuries and brain strokes varies widely. There was a preference to use pharmacoprophylaxis in patients with Glasgow Coma Scale (GCS) below nine among many (68.2%), and low molecular weight heparin (LMWH) was the preferred choice in such cases. The reluctance to use heparin because of fear of bleed was high (82%). Most (78.9%) believed pharmacoprophylaxis could reduce venous thromboembolic events (VTEs) and mortality. Conclusion: Thromboprophylaxis practices among neurocritical care patients remain quite heterogeneous. There is a dilemma in patients with intracranial haemorrhagic lesions regarding pharmacoprophylaxis.

Adverse Events during Intrahospital Transport of Critically Ill Patients: A Multicenter, Prospective, Observational Study (I-TOUCH Study).

Background: Critically ill patients are frequently transported to various locations within the hospital for diagnostic and therapeutic purposes, which increases the risk of adverse events (AEs). This multicenter prospective observational study was undertaken to determine the incidence of AEs related to intrahospital transport, their severity, and their effects on patient outcomes. Patients and methods: We included consecutive unstable critically ill patients requiring intrahospital transport, across 15 Indian tertiary care centers over 5 months (October 11, 2022-February 20, 2023). Apart from the demographics and severity of illness, data related to transport itself, such as indications and destination, incidence of AEs, their category and treatment required, and patient outcomes, were recorded in a standard form. Results: Eight hundred and ninety-three patients were transported on 1065 occasions out of the intensive care unit (ICU). The mean (SD) acute physiology and chronic health evaluation II score of the patients was 15.38 (±7.35). One hundred and two AEs occurred, wherein cardiovascular instability was the most common occurrence (31, 30.4%). Two patients had cardiac arrest immediately after transport. Acute physiology and chronic health evaluation II [odds ratio (OR): 1.02, 95% confidence interval (CI) - 1.00-1.05, p = 0.04], emergent transport (OR: 5.11, 95% CI - 3.32-7.88, p = 0.00), and team composition (OR: 5.34, 95% CI - 1.63-17.5, p = 0.00) during transport were found to be independent predictors of AEs. Conclusion: We found a high incidence of AEs during intrahospital transport of critically ill patients. These events were more common during emergent transports and when the patients were transported by doctors. Transport by itself was not related to ICU mortality. We feel that stabilization of the patients before transport and adherence to a standardized protocol may help in minimizing the AEs, thereby enhancing patient safety. How to cite this article: Zirpe KG, Tiwari AM, Kulkarni AP, Govil D, Dixit SB, Munjal M, et al. Adverse Events during Intrahospital Transport of Critically Ill Patients: A Multicenter, Prospective, Observational Study (I-TOUCH Study). Indian J Crit Care Med 2023;27(9):635-641.

Fluids and Early Vasopressors in the Management of Septic Shock: Do We Have the Right Answers Yet?

Septic shock is a common condition associated with hypotension and organ dysfunction. It is associated with high mortality rates of up to 60% despite the best recommended resuscitation strategies in international guidelines. Patients with septic shock generally have a Mean Arterial Pressure below 65 mmHg and hypotension is the most important determinant of mortality among this group of patients. The extent and duration of hypotension are important. The two initial options that we have are 1) administration of intravenous (IV) fluids and 2) vasopressors, The current recommendation of the Surviving Sepsis Campaign guidelines to administer 30 ml/kg fluid cannot be applied to all patients. Complications of fluid over-resuscitation further delay organ recovery, prolong ICU and hospital length of stay, and increase mortality. The only reason for administering intravenous fluids in a patient with circulatory shock is to increase the mean systemic filling pressure in a patient who is volume-responsive, such that cardiac output also increases. The use of vasopressors seems to be a more appropriate strategy, the very early administration of vasopressors, preferably during the first hour after diagnosis of septic shock, may have a multimodal action and potential advantages, leading to lower morbidity and mortality in the management of septic patients. Vasopressor therapy should be initiated as soon as possible in patients with septic shock.

JNJ-10450232 (NTM-006), A novel non-opioid with structural similarities to acetaminophen, produces relatively long-lasting analgesia after a single dose in patients undergoing 3rd molar extraction.

JNJ-10450232 (NTM-006) is a non-opioid, non-NSAID analgesic and antipyretic compound with structural similarity to acetaminophen. Preclinical models show comparable analgesia relative to acetaminophen and no evidence of hepatotoxicity associated with overdose. Moreover, it was safe and generally well tolerated in a First-in-Human Study. This single-dose, single-center, inpatient, randomized, double-blind study in moderate-to-severe acute pain following third molar extraction compared efficacy and safety of 250 mg and 1000 mg JNJ-10450232 (NTM-006), 1000 mg acetaminophen, and placebo during the 24 h following administration. While onset of action of 1000 mg JNJ-10450232 (NTM-006) was relatively slower compared with acetaminophen, its duration of action was sustained up to 24 h being superior beginning 7 h after administration. No clinically important differences among treatment groups in nature or severity of adverse events were observed and no serious adverse events were reported. Increased bilirubin, potentially due to UGT1A1 inhibition and ingestion of blood from oral surgery, was the most commonly reported adverse event and the only event reported by ≥ 5% of subjects across treatment groups. These data support further evaluation of JNJ-10450232 (NTM-006) for the treatment of moderate-to-severe pain. CLINICALTRIALS.GOV ID: NCT02209181.

Numerical and Experimental Analysis of Mechanical Properties in Hybrid Epoxy-Basalt Composites Partially Reinforced with Cellulosic Fillers.

The current work is focused on numerical and experimental studies of woven fabric composites modified by hybridisation with biological (cellulosic) filler materials. The mechanical performance of the composites is characterized under tensile, bending and impact loads and the effect of hybridisation is observed with respect to pure and nonhybrid composites. Numerical models are developed using computational tools to predict mechanical performance under tensile loading. The computational prediction results are compared and validated with relevant experimental results. This research is aimed at understanding the mechanical performance of basalt-epoxy composites partially reinforced with micro-/nano-sized bio-fillers from cellulose and intended for various application areas. Different weave structures, e.g., plain, twill, matt, etc., were investigated with respect to the mechanical properties of the hybrid composites. The effects of hybridizing with cellulose particles and different weave patterns of the basalt fabric are studied. In general, the use of high-strength fibres such as basalt along with cellulosic fillers representing up to 3% of the total weight improves the mechanical performance of the hybrid structures. The thermomechanical performance of the hybrid composites improved significantly by using basalt fabric as well as by addition of 3% weight of cellulosic fillers. Results reveal the advantages of hybridisation and the inclusion of natural cellulosic fillers in the hybrid composite structures. The material developed is suitable for high-end applications in components for construction that demand advanced mechanical and thermomechanical performance. Furthermore, the inclusion of biodegradable fillers fulfills the objectives of sustainable and ecological construction materials.

Evaluation of Mechanical Properties and Filler Interaction in the Field of SLA Polymeric Additive Manufacturing.

The paper deals with research focused on the use of fillers in the field of polymeric materials produced by additive technology SLA (stereolithography). The aim of the research is to evaluate 3D printing parameters, the mechanical properties (tensile strength, hardness), and the interaction of individual phases (polymer matrix and filler) in composite materials using SEM analysis. The tested fillers were cotton flakes and ground carbon fibres in different proportions. For the photosensitive resins, the use of cotton flakes as filler was found to have a positive effect on the mechanical properties not only under static but also under cyclic loading, which is a common cause of material failure in practice. The cyclic stress reference value was set at an amplitude of 5-50% of the maximum force required to break the pure resin in a static tensile test. A positive effect of fillers on the cyclic stress life of materials was demonstrated. The service life of pure resin was only 168 ± 29 cycles. The service life of materials with fillers increased to approximately 400 to 540 cycles for carbon fibre-based fillers and nearly 1000 cycles for cotton flake-based fillers, respectively. In this paper, new composite materials suitable for the use of SLA additive manufacturing techniques are presented. Research demonstrated the possibilities of adding cotton-based fillers in low-cost, commercially available resins. Furthermore, the importance of material research under cyclic loading was demonstrated.

Netarsudil monotherapy as the initial treatment for open-angle glaucoma and ocular hypertension in Indian patients: A real-world evaluation of efficacy and safety.

Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40-80. The best way to manage primary open-angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open-label, real-world, multicentric, observation-based 3-month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first-line therapy. Diurnal IOP measurements, best-corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day-1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty-nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once-daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first-line treatment in primary open-angle glaucoma and ocular hypertension was both safe and effective.