Plasma lipids paediatric reference intervals: Indirect estimation using a large 14-year database.

OBJECTIVES: Establishing direct reference intervals (RIs) for paediatric patients is a very challenging endeavour. Indirect RIs can address this problem, using existing clinical laboratory databases from real-world data research. Compared to the traditional direct method, the indirect approach is highly practical, widely applicable, and low-cost. Considering the relevance of dyslipidemia in the paediatric age, to provide better laboratory services to the local paediatric population, we established population-specific lipid RIs via data mining. METHODS: Our laboratory information system was searched for cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) of patients aged less than 18 years, performed from January 2009 until December 2022. RIs were estimated using RefineR algorithm. RESULTS: Values from 215,594 patients were initially collected. After refining data on the basis of specific exclusion criteria that left 17,933 patients, we determined the RIs for each analyte, including corresponding 95% confidence interval (95% CI). Age and sex partitions were required for proper stratification of the heterogenous subpopulations. Age-related variations in TC and TG values were observed mainly in children until 5 years. RIs were defined for children less than 3 years and for those of 3-18 years. In our population, the obtained RIs were comparable with those of the literature, but the upper TG limit in subjects under the age of 3 (2.03 mmol/L with 95% CI: 1.45-2.86) was lower than that previously reported. CONCLUSIONS: Our RIs, necessary for paediatric lipid monitoring, are tailored to the serviced patient population as should be done whenever possible.

Multiple Sclerosis: An Emergency Medicine-Focused Narrative Review.

BACKGROUND: Multiple sclerosis (MS) is a rare but serious condition associated with significant morbidity. OBJECTIVE: This review provides a focused assessment of MS for emergency clinicians, including the presentation, evaluation, and emergency department (ED) management based on current evidence. DISCUSSION: MS is an autoimmune disorder targeting the central nervous system (CNS), characterized by clinical relapses and radiological lesions disseminated in time and location. Patients with MS most commonly present with long tract signs (e.g., myelopathy, asymmetric spastic paraplegia, urinary dysfunction, Lhermitte's sign), optic neuritis, or brainstem syndromes (bilateral internuclear ophthalmoplegia). Cortical syndromes or multifocal presentations are less common. Radiologically isolated syndrome and clinically isolated syndrome (CIS) may or may not progress to chronic forms of MS, including relapsing remitting MS, primary progressive MS, and secondary progressive MS. The foundation of outpatient management involves disease-modifying therapy, which is typically initiated with the first signs of disease onset. Management of CIS and acute flares of MS in the ED includes corticosteroid therapy, ideally after diagnostic testing with imaging and lumbar puncture for cerebrospinal fluid analysis. Emergency clinicians should evaluate whether patients with MS are presenting with new-onset debilitating neurological symptoms to avoid unnecessary testing and admissions, but failure to appropriately diagnose CIS or MS flare is associated with increased morbidity. CONCLUSIONS: An understanding of MS can assist emergency clinicians in better diagnosing and managing this neurologically devastating disease.

Reference intervals for cardiometabolic risk factors in China: a national multicenter cross-sectional study on an adult population sample.

Background: The reference intervals (RIs) of adult blood lipid parameters currently used in China are not derived from the results of research in local populations and have not been adjusted for age and sex. In this study, we aimed to determine accurate RIs for blood lipid parameters and blood glucose (GluG) for Chinese adults using a national multicenter study. Methods: A total of 11,333 adults between 18 and 90 years of age were recruited in seven representative regions in China between June 2020 and December 2020. Hospitals participating in the study were regrouped into two geographical regions, southern China (Changsha, Chengdu, Hangzhou, and Nanning) and northern China (Beijing, Shenyang, and Ningxia), according to their geographical and administrative location. All samples were freshly collected and measured collectively in one laboratory on the Mindray full Automatic biochemical analyzer chemistry BS2000 analytical systems. Outliers were removed using the Tukey test. Three-level nested analysis of variance and scatter plot were used to explore the variations in sex, age, and region. Percentile curves of each indicator were plotted using the least mean square (LMS) method. The lower limit (2.5th percentile) and the upper limit (97.5th percentile) of the RI were determined by using nonparametric statistical methods. We also calculated the 90% confidence interval (CI) for the lower and upper limits. Results: A total of 8,283 participants were enrolled in the final analysis, with 3,593 (43.4%) men and 4,690 (56.6%) women. Regionality was observed in three analytes [small dense low density lipoprotein cholesterol (sd-LDLC), GluG, and apolipoprotein A1 (ApoA1)]. In northern China, the sd-LDLC and GluG levels in Shenyang were significantly higher than those in Ningxia and Beijing (P<0.05). In southern China, the sd-LDLC and GluG levels in Nanning were significantly higher than those in the three other cities (P<0.05), whereas the sd-LDLC and GluG levels in Chengdu were significantly lower than those in the three other cities (P<0.05). The level of ApoA1 in Chengdu was significantly higher than that in the three other cities. The homocysteine (HCY) level in male participants was clearly higher than that in female participants [ratio of standard deviation (SDR)sex =0.56], whereas the levels of high density lipoprotein cholesterol (HDLC) (SDRsex =0.40) and ApoA1 (SDRsex =0.27) in males were lower. The GluG and HCY level increased gradually with age. In females aged 45-55 years, there was an interesting change in scatter charts, where triglyceride (TG) and total cholesterol (TC) increased rapidly. We also found that for the age group of >55 years, the levels of TG and TC in females gradually surpassed those in males. Conclusions: The findings of this study may help establish age- and sex-specific reference values for the blood lipids of Chinese adults and serve as a valuable guide for the screening, diagnosis, treatment, prevention, and monitoring of cardiovascular disease (CVD).

Age-, season- and gender-specific reference intervals of serum 25-hydroxyvitamin D3 for healthy children (0 ~ 18 years old) in Nanning area of China.

Establishing specific reference intervals (RIs) of serum 25-hydroxyvitamin D3 [25(OH)D] for children is essential for improving the accuracy of diagnosis and prognosis monitoring of diseases such as rickets and growth retardation. The study including 6,627 healthy children was conducted to establish specific RIs of 25(OH)D for children in Nanning area of China. The results showed that there were statistically significant differences among age, season, and gender of serum 25(OH)D levels, and the age-specific RIs of serum 25(OH)D were 20.3 ~ 53.6 ng/mL for 0 ~ ≤ 1 year and 18.9 ~ 49.6 ng/mL for 2 ~ ≤ 3 years. The age-, season-specific RIs of serum 25(OH)D for 4 ~ ≤ 6 years in spring-summer and autumn-winter were 15.8 ~ 42.6 ng/mL and 15.2 ~ 37.7 ng/mL, respectively. The age-, gender-specific RIs of serum 25(OH)D for 7 ~ ≤ 18 years for males and females were 12.1 ~ 36.1 ng/mL and 10.8 ~ 35.3 ng/mL, respectively. This study successfully established the RIs of serum 25(OH)D, which may help to improve disease diagnosis and monitoring for children in the Nanning area of China.

Joint Active and Passive Beamforming in RIS-Assisted Secure ISAC Systems.

This paper investigates joint beamforming in a secure integrated sensing and communications (ISAC) system assisted by reconfigurable intelligent surfaces (RIS). The system communicates with legitimate downlink users, detecting a potential target, which is a potential eavesdropper attempting to intercept the downlink communication information from the base station (BS) to legitimate users. To enhance the physical-layer secrecy of the system, we design and introduce interference signals at the BS to disrupt eavesdroppers' attempts to intercept legitimate communication information. The BS simultaneously transmits communication and interference signals, both utilized for communication and sensing to guarantee the sensing and communication quality. By jointly optimizing the BS active beamformer and the RIS passive beamforming matrix, we aim to maximize the achievable secrecy rate and radiation power of the system. We develop an effective scheme to find the active beamforming matrix through fractional programming (FP) and semi-definite programming (SDP) techniques and obtain the RIS phase shift matrix via a local search technique. Simulation results validate the effectiveness of the proposed methods in enhancing communication and sensing performance. Additionally, the results demonstrate the effectiveness of introducing the interference signals and RIS in enhancing the physical-layer secrecy of the ISAC system.

Obsessive-compulsive symptoms and brain lesions compatible with multiple sclerosis.

Autoimmune-mediated obsessive-compulsive disorder (OCD) can occur in multiple sclerosis (MS). Here, a well-studied case study of a patient with OCD and MS-compatible diagnostic findings is presented. The 42-year-old female patient had displayed OCD symptoms for 6 years. Magnetic resonance imaging (MRI) identified several periventricular and one brainstem lesion suggestive of demyelination. Cerebrospinal fluid (CSF) analyses detected an increased white blood cell count, intrathecal immunoglobulin (Ig) G and IgM synthesis, CSF-specific oligoclonal bands, and a positive MRZ reaction. Neopterin was increased, but sarcoidosis was excluded. In the absence of neurological attacks and clues for MRI-based dissemination in time, a radiologically isolated syndrome, the pre-disease stage of MS, was diagnosed. Neurotransmitter measurements of CSF detected reduced serotonin levels. In the absence of visible strategic demyelinating lesions within the cortico-striato-thalamo-cortical circuits, OCD symptoms may relate to reduced intrathecal serotonin levels and mild neuroinflammatory processes. Serotonin abnormalities in MS should be studied further, as they could potentially explain the association between neuroinflammation and mental illnesses.

Enhancing the Extinction Efficiency and Plasmonic Response of Bimetallic Nanoparticles of Au-Ag in Robust Thin Film Sensing Platforms.

The extinction efficiency of noble metal nanoparticles (NPs), namely gold (Au) and silver (Ag), are dependent on their size and surrounding dielectric. Exploiting the Localized Surface Plasmon Resonance (LSPR) phenomenon, the composition and structure of the NPs might be tailored to achieve a configuration that optimizes their response (sensitivity) to environmental changes. This can be done by preparing a bimetallic system, benefiting from the chemical stability of Au NPs and the higher scattering efficiency of Ag NPs. To enhance the LSPR sensing robustness, incorporating solid supports in the form of nanocomposite thin films is a suitable alternative. In this context, the NPs composed of gold (Au), silver (Ag), and their mixture in bimetallic Au-Ag NPs, were grown in a titanium dioxide (TiO2) matrix using reactive DC magnetron sputtering. Thermal treatment at different temperatures (up to 700 °C) tuned the LSPR response of the films and, consequently, their sensitivity. Notably, the bimetallic film with Au/Ag atomic ratio 1 exhibited the highest refractive index sensitivity (RIS), with a value of 181 nm/RIU, almost one order of magnitude higher than monometallic Au-TiO2. The nanostructural analysis revealed a wide NP size distribution of bimetallic NPs with an average size of 31 nm, covering about 20% of the overall surface area. These findings underscore the significant potential of bimetallic film systems, namely AuAg-TiO2, in LSPR sensing enhancement.

Effect of Production Bias on Radiation-Induced Segregation in Ni-Cr Alloys.

We present an in-depth investigation into the Radiation-Induced Segregation (RIS) phenomenon in Ni-Cr alloys. All the pivotal factors affecting RIS such as surface's absorption efficiency, grain size, production bias, dose rate, temperature, and sink density were systematically studied. Through comprehensive simulations, the individual and collective impacts of these factors were analyzed, enabling a refined understanding of RIS. A notable finding was the significant influence of production bias on point defects' interactions with grain boundaries/surfaces, thereby playing a crucial role in RIS processes. Production bias alters the neutrality of these interactions, leading to a preferential absorption of one type of point defect by the boundary and consequent establishment of distinct surface-mediated patterns of point defects. These spatial patterns further result in non-monotonic spatial profiles of solute atoms near surfaces/grain boundaries, corroborated by experimental observations. In particular, a positive production bias, signifying a higher production rate of vacancies over interstitials, drives more Cr depletion at the grain boundary. Moreover, a temperature-dependent production bias must be considered to recover the experimentally reported dependence of RIS on temperature. The severity of radiation damage and RIS becomes more pronounced with increased production bias, dose rate, and grain size, while high temperatures or sink density suppress the RIS severity. Model predictions were validated against experimental data, showcasing robust qualitative and quantitative agreements. The findings pave the way for further exploration of these spatial dependencies in subsequent studies, aiming to augment the comprehension and predictability of RIS processes in alloys.

Caracterización bibliométrica y temática de la investigación sobre VIH-sida en España (2010-2019) / Bibliometric and thematic characterization of the research on HIV-aids in Spain (2010-2019)

Introducción: La constitución de la Red de Investigación en Sida (RIS) constituyó un hito para el impulso de la investigación sobre el VIH en España. Se analiza la investigación española en el área, evaluando específicamente el papel que ha desempeñado la RIS en la misma. Métodos: Se identificaron las publicaciones sobre VIH-sida con la participación de instituciones españolas en la Web of Science a lo largo del período 2010-2019, caracterizando bibliométricamente la actividad investigadora e identificando mediante un análisis de clústeres los ámbitos temáticos de investigación. Resultados: Se han identificado 3.960 documentos (promedio de 396 documentos/año), el 42% de los cuales han sido firmados en colaboración internacional. Los investigadores de la RIS han participado en el 60% de los documentos, presentando una producción científica y citación sensiblemente superior a los autores no vinculados a la misma. Cinco clústeres temáticos articulan la investigación, centrados en el abordaje clínico y terapéutico de las personas que viven con el VIH, la coinfección y la comorbilidad con otras enfermedades, la caracterización genética del virus, el desarrollo de vacunas y el estudio de su transmisión en colectivos específicos o asociado a las conductas sexuales. Conclusión: La investigación española sobre el VIH, impulsada en gran medida por los grupos de la RIS ha alcanzado un estadio de madurez, con un notable incremento de la producción científica, la participación en redes cooperativas internacionales y un destacado impacto y visibilidad.(AU)

Introduction: The establishment of the Spanish AIDS Research Network (RIS) was a milestone for the promotion of HIV research in Spain. We analyse Spanish HIV research, assessing the role that RIS has played in it. Methods: We identified publications on HIV-aids with the participation of Spanish institutions in the Web of Science over the period 2010-2019, characterising research activity by means of bibliometrics and identifying the thematic areas of research through a cluster analysis. Results: A total of 3960 documents have been identified (average of 396 documents/year), 42% of which have been signed in international collaboration. RIS researchers have participated in 60% of the documents, presenting a scientific production and citation significantly higher than authors not linked to the RIS. Five thematic clusters articulate the research, focusing on the clinical and therapeutic approach to people living with HIV, co-infection and co-morbidity with other diseases, the genetic characterisation of the virus, the development of vaccines and the study of its transmission in specific groups or associated with sexual behaviour. Conclusion: Spanish HIV research, largely driven by RIS groups, has reached a stage of maturity, with a notable increase in scientific production, participation in international cooperative networks and an outstanding impact and visibility.(AU)

Deep Learning-Based Link Quality Estimation for RIS-Assisted UAV-Enabled Wireless Communications System.

In recent years, unmanned aerial vehicles (UAVs) have become a valuable platform for many applications, including communication networks. UAV-enabled wireless communication faces challenges in complex urban and dynamic environments. UAVs can suffer from power limitations and path losses caused by non-line-of-sight connections, which may hamper communication performance. To address these issues, reconfigurable intelligent surfaces (RIS) have been proposed as helpful technologies to enhance UAV communication networks. However, due to the high mobility of UAVs, complex channel environments, and dynamic RIS configurations, it is challenging to estimate the link quality of ground users. In this paper, we propose a link quality estimation model using a gated recurrent unit (GRU) to assess the link quality of ground users for a multi-user RIS-assisted UAV-enabled wireless communication system. Our proposed framework uses a time series of user channel data and RIS phase shift information to estimate the quality of the link for each ground user. The simulation results showed that the proposed GRU model can effectively and accurately estimate the link quality of ground users in the RIS-assisted UAV-enabled wireless communication network.

CSI acquisition in RIS-assisted mobile communication systems.

Reconfigurable intelligent surface- (RIS) assisted mobile communication is a promising technological paradigm thanks to the attractive advantages of low cost and flexible control of electromagnetic waves. However, the low-cost features of RISs entail some fundamental challenges to the acquisition of channel state information (CSI), which is essential for the optimal RIS design. To tackle this problem, there have been extensive studies on CSI acquisition in RIS-assisted mobile communication systems, from the perspective of architectural improvement as well as specific mathematical solutions. This article aims to overview the existing works on CSI acquisition in RIS-assisted mobile communication systems.

Optimal Deployment Strategy for Reconfigurable Intelligent Surface under LoSD via Joint Active and Passive Beamforming.

A reconfigurable intelligent surface (RIS) is a new and revolutionizing technology to achieve spectrum-efficient (SE) and energy-efficient (EE) wireless networks. In this paper, we study an optimal deployment strategy of RIS in a line-of-sight domain (LoSD) based on an actual deployment scenario, which jointly considers path loss, transmit power and the energy efficiency of the system. Furthermore, we aim to minimize the transmit power via jointly optimizing its transmit beamforming and the reflect phase shifts of RIS, subject to the quality-of-service (QoS) constraint, namely, the signal-to-noise ratio (SNR) constraint at the user. However, this optimization problem is non-convex with intricately coupled variables. To tackle this challenge, we first apply proper transformation on the QoS constraint and then propose an efficient alternating optimization (AO) algorithm. Simulation results demonstrate that compared to a conventional endpoint deployment strategy that simply deploys RIS at the transceiver ends, our proposed LoSD deployment strategy significantly reduces the transmit power by optimizing the available LoS links when a single RIS is relayed. The impact of the number of reflect elements on the system EE is also unveiled.

Performance of a Double RIS Communication System Aided by Partially Active Elements.

Reconfigurable intelligent surface (RIS) has emerged as a promising technology to enhance the spectral efficiency of wireless communication systems. However, if there are many obstacles between the RIS and users, a single RIS may not provide sufficient performance. For this reason, a double RIS-aided communication system is proposed in this paper. However, this system also has a problem: the signal is attenuated three times due to the three channels created by the double RIS. To overcome these attenuations, an active RIS is proposed in this paper. An active RIS is almost the same as a conventional RIS, except for the included amplifier. Comprehensively, the proposed system overcomes various obstacles and attenuations. In this paper, an active RIS is applied to the second RIS. To reduce the power consumption of active elements, a partially active RIS is applied. To optimize the RIS elements, the sum of the covariance matrix is found by using channels related to each RIS, and the right singular vector is exploited using singular value decomposition for the sum of the covariance matrix. Then, the singular value of the sum of the covariance value is checked to determine which element is the active element. Simulation results show that the proposed system has better sum rate performance compared to a single RIS system. Although it has a lower sum rate performance compared to a double RIS with fully active elements, the proposed system will be more attractive in the future because it has much better energy efficiency.

RIS-Aided Proactive Mobile Network Downlink Interference Suppression: A Deep Reinforcement Learning Approach.

A proactive mobile network (PMN) is a novel architecture enabling extremely low-latency communication. This architecture employs an open-loop transmission mode that prohibits all real-time control feedback processes and employs virtual cell technology to allocate resources non-exclusively to users. However, such a design also results in significant potential user interference and worsens the communication's reliability. In this paper, we propose introducing multi-reconfigurable intelligent surface (RIS) technology into the downlink process of the PMN to increase the network's capacity against interference. Since the PMN environment is complex and time varying and accurate channel state information cannot be acquired in real time, it is challenging to manage RISs to service the PMN effectively. We begin by formulating an optimization problem for RIS phase shifts and reflection coefficients. Furthermore, motivated by recent developments in deep reinforcement learning (DRL), we propose an asynchronous advantage actor-critic (A3C)-based method for solving the problem by appropriately designing the action space, state space, and reward function. Simulation results indicate that deploying RISs within a region can significantly facilitate interference suppression. The proposed A3C-based scheme can achieve a higher capacity than baseline schemes and approach the upper limit as the number of RISs increases.

A Review of Phase-Change Materials and Their Potential for Reconfigurable Intelligent Surfaces.

Phase-change materials (PCMs) and metal-insulator transition (MIT) materials have the unique feature of changing their material phase through external excitations such as conductive heating, optical stimulation, or the application of electric or magnetic fields, which, in turn, results in changes to their electrical and optical properties. This feature can find applications in many fields, particularly in reconfigurable electrical and optical structures. Among these applications, the reconfigurable intelligent surface (RIS) has emerged as a promising platform for both wireless RF applications as well as optical ones. This paper reviews the current, state-of-the-art PCMs within the context of RIS, their material properties, their performance metrics, some applications found in the literature, and how they can impact the future of RIS.

Delay Minimization in RIS-Assisted URLLC Systems under Reliability Constraints.

The ultra-reliable and low-latency communication (URLLC) systems are expected to support the stringent quality of service (QoS) demands in the Internet of Things (IoT) networks. In order to support the strict latency and reliability constraints, it is preferable to deploy a reconfigurable intelligent surface (RIS) in the URLLC systems to improve the link quality. In this paper, we focus on the uplink of an RIS-assisted URLLC system, and we propose to minimize the transmission latency under the reliability constraints. To solve the non-convex problem, a low-complexity algorithm is proposed by using the Alternating Direction Method of Multipliers (ADMM) technique. The RIS phase shifts optimization, which is typically non-convex, is efficiently solved by formulating as a Quadratically Constrained Quadratic Programming (QCQP) problem. Simulation results verify that our proposed ADMM-based method is able to achieve better performance than the conventional semi-definite relaxation (SDR)-based method with lower computational complexity. Our proposed RIS-assisted URLLC system is able to significantly reduce the transmission latency, which highlights the great potential in deploying RIS in the IoT networks with strict reliability requirements.

Workload Balancing in Emergency Night Shifts for a Multicenter Diagnostic Imaging Department: a RIS-Integrated Solution.

The purpose of this short report is to illustrate the implementation of a RIS function for balancing radiological activities and workloads between two different teams of radiologists from the same Diagnostic Department during emergency nights and holiday shifts. One group is from the main hospital, Arcispedale S.Maria Nuova di Reggio Emilia, and the other group belongs to the five minor hospitals in the district of Reggio Emilia.The implementation of a dedicated balancing function in the RIS system successfully allows the balancing of the radiological activity between two or more teams of different radiologists, while preserving the care continuity of care and the involved workers' experience and confidence in reporting.

Prevalence and prognostic value of prodromal symptoms in relapsing-remitting multiple sclerosis.

INTRODUCTION: Several studies have suggested the possibility that disease prodromes might occur months or even years before a multiple sclerosis diagnosis. OBJECTIVES: To describe the profile of prodromal symptoms and the possible relationship between the occurrence of individual symptoms and clinical course characteristics in patients with relapsing-remitting multiple sclerosis (RRMS), and to assess their role as predictors of further disease course. MATERIAL AND METHODS: The cohort included 564 patients with RRMS. Patients were stratified based on their current EDSS score, and the annual EDSS growth rate was calculated. Logistic Regression Analysis was used to study the relationship between prodromal symptoms and disease progression. RESULTS: The most commonly reported prodromal symptom was fatigue (42%). The following symptoms were significantly more common in women than in men: headache (39.7% vs. 26.5%, p < 0.05), excessive sleepiness (19.1% vs. 11.1%, p < 0.05) and constipation (18.0% vs. 11.1%, p < 0.05). Prodromal urinary and cognitive disturbances, fatigue and pain complaints were significantly more common in patients with the highest annual EDSS increase (p < 0.05). Multivariate analysis revealed some potential predictors of long-term disability progression: hesitancy in starting urination predicted EDSS increase by 0.6 point (p < 0.05), while deterioration in everyday functioning because of cognitive disturbances, and pain complaints, were associated with an EDSS increase of 0.5 (p < 0.05), and 0.4 (p < 0.05), respectively. CONCLUSIONS: Prodromal pain, urinary and cognitive complaints (especially when these lead to deterioration of everyday functioning) were associated with a higher EDSS increase rate, and may thus be regarded as possible predictors of worse clinical outcomes in RRMS patients.

Incidental demyelination in magnetic resonance imaging and 10-year risk of multiple sclerosis: A data lake cohort study.

BACKGROUND AND PURPOSE: There is an absence of data from large population-based cohort studies on the incidence of radiologically isolated syndrome (RIS). The incidence of RIS and the subsequent risk for multiple sclerosis (MS) were investigated. METHODS: A population-based, retrospective cohort study was conducted using a data-lake-based analysis of digitalized radiology reports. All brain and spinal cord magnetic resonance imaging (MRI) in people aged 16-70 during the years 2005-2010 (n = 102,224) were screened using optimized search terms to detect cases with RIS. The subjects with RIS were followed up until January 2022. RESULTS: The cumulative incidence of RIS was 0.03% when all MRI modalities were included and 0.06% when only brain MRI was included according to MAGNIMS 2018 recommendation criteria. With the Okuda 2009 criteria, the respective figures were 0.03% and 0.05% (86% concordance). The overall risk for MS after RIS was similar, 32% by using the MAGNIMS and 32% by using the Okuda definition of RIS. Individuals aged <35.5 years exhibited the most significant predisposition to MS (80%), whilst those >35.5 years had less than 10% risk of MS. MS diagnosed after RIS constituted 0.8% of the incident MS cases in the population during 2005-2010. CONCLUSIONS: A population-wide context was provided for the incidence of RIS and its relationship to MS. MAGNIMS recommendations were only slightly more sensitive to detect RIS compared to the Okuda criteria. RIS has a subtle effect on the overall incidence of MS, yet the risk for MS in individuals under the age of 35.5 years is substantial.

Mechanistic insight into humic acid-enhanced sonophotocatalytic removal of 17ß-estradiol: Formation and contribution of reactive intermediates.

In this study, humic acid (HA) enhanced 17ß-estradiol (17ß-E2) degradation by Er3+-CdS/MoS2 (ECMS) was investigated under ultrasonic and light conditions. The degradation reaction rate of 17ß-E2 was increased from (14.414 ± 0.315) × 10-3 min-1 to (122.677 ± 1.729) × 10-3 min-1 within 90 min sonophotocatalytic (SPC) reaction with the addition of HA. The results of quenching coupled with chemical probe experiments indicated that more reactive intermediates (RIs) including reactive oxygen species (ROSs) and triplet-excited states were generated in the HA-enhanced sonophotocatalytic system. The triplet-excited states of humic acid (3HA*), hydroxyl radical (•OH), and superoxide radical (•O2-) were the dominant RIs for 17ß-E2 elimination. In addition, the energy- and electron-transfer process via coexisting HA also account for 12.86% and 29.24% contributions, respectively. The quantum yields of RIs in the SPC-ECMS-HA system followed the order of 3HA* > H2O2 > 1O2 > â€¢O2-> •OH. Moreover, the spectral and fluorescence characteristics of HA were further analyzed during the sonophotocatalytic reaction process. The study expanded new insights into the comprehension of the effects of omnipresent coexisting HA and RIs formation for the removal of 17ß-E2 during the sonophotocatalytic process.