Azithromycin for chronic eosinophilic rhinosinusitis with nasal polyp: a placebo-controlled trial.

BACKGROUND: Chronic eosinophilic rhinosinusitis with nasal polyps (CRSwNP eosinophilic) is characterised by the formation of benign and bilateral nasal polyps. We aimed to compare the effectiveness of azithromycin as an immunomodulator with the use of a placebo in patients presenting with CRSwNP concomitant with asthma and aspirin intolerance after 3 months of treatment and at a 1-year follow-up. METHODOLOGY: We performed a randomised, double-blind, placebo-controlled trial. Patients received 500 mg azithromycin orally three times/week for 12 weeks. Improvement was evaluated by staging, the Sino-Nasal Outcome Test (SNOT-22), and nasal polyp biopsy. Data collected at pretreatment and 3 months posttreatment were compared. Quality of life was evaluated at the 1-year follow-up. RESULTS: Twenty-seven and 21 patients were treated with azithromycin and a placebo, respectively. The medication was well tolerated overall. Twenty patients (74%) in the azithromycin group and three patients (14%) in the placebo group were not refer- red for surgery at the end of the 3-month treatment. Regarding subjective improvement, there was a median decrease only in the azithromycin group, and the between-group difference was significant. SNOT-22 improvement was maintained in the azithromy- cin group at the 1-year follow-up. CONCLUSIONS: Azithromycin could be considered a therapeutic option for patients presenting with CRSwNP concomitant with asthma and aspirin intolerance.

Tuning the Schottky barrier height in graphene/monolayer-GeI2 van der Waals heterostructure.

We use first-principles simulations to investigate the structural and electronic properties of a heterostructure formed by graphene and monolayer GeI2 (m-GeI2). While graphene has been extensively studied in the last 15 years, m-GeI2 has been recently proposed to be a stable 2D semiconductor with a wide-band gap, Liu et al (2018 J. Phys. Chem. C 122 22137). By staking both structures we obtain a metal-semiconductor junction, with great potential for applications in the designing of new (opto)electronic devices. The results show that the graphene Dirac cone is preserved in the graphene/m-GeI2 heterostructure. We find that there are no chemical bonds at the graphene and m-GeI2 interface, thus the heterostructure interactions are ruled by van der Waals (vdW) forces. The interface between graphene and m-GeI2 results in a n-type Schottky contact. Furthermore, we show that a transition from n-type to p-type Schottky contact can be obtained by decreasing the interlayer distance. We also modulated the Schottky barrier heights by applying a perpendicular external electric field through the vdW heterostructure. In particular, positive values resulted in an increase of the n-type Schottky barrier height, while negative electric field values induced a transition from n-type to p-type Schottky contact. From our results, we show that m-GeI2 is an interesting material to design new electronic Schottky devices based on graphene vdW heterostructures.

Investigating the preservation of π-conjugation in covalently functionalized carbon nanotubes through first principles simulations.

We performed a theoretical investigation of single-walled carbon nanotubes (CNTs) functionalized with triazine molecules. Upon adsorption, the influence of the molecule orientation on the CNTs' electronic properties is examined by combining first-principles density functional theory calculations and simulations of X-ray Absorption Near-Edge Structure (XANES) at the C K-edge. Our calculations show that the electronic properties of functionalized CNTs can preserve the same features of pristine CNTs, for both semiconductor and metallic CNTs, depending on the orientation of the covalently bonded molecule. For that configuration, we observe a breakage of the CNT C-C bond at the molecule adsorption site. Moreover, the XANES spectra reveal that sp2 bonding hybridization is preserved along the CNT network. On the other hand, the electronic properties of pristine CNTs are no longer preserved for adsorbed molecule orientations resulting in intact C-C bond at the adsorption site. In this case, the XANES spectra indicate that the molecule-CNT interactions result in sp3 hybridization. Our findings help to elucidate whether π-conjugation is preserved in functionalized CNTs, demonstrating that calculations of XANES spectra are a powerful tool to resolve such systems.

Aetiology, imaging features, and evolution of spontaneous perirenal haemorrhage.

AIM: To evaluate the aetiology, imaging features, and the evolution of spontaneous perirenal haemorrhage detected by imaging. MATERIALS AND METHODS: In this retrospective study, the hospital database was searched for all cases of spontaneous perinephric haemorrhage detected by imaging between January 2000 and December 2012. Imaging examinations were reviewed and the following parameters were recorded: the location, extension, and total volume of the haematoma, presence of active extravasation, the haematocrit effect, and highest density. The resolution time was calculated using follow-up imaging. The final aetiology for all cases was assessed via clinical, radiological, and histopathological data. Differences in imaging features of haemorrhage according to aetiology group were analysed with independent samples test and Fisher's exact test. RESULTS: Eighty-one haematomas were identified in 78 patients during this 13-year period. Causes of perirenal haemorrhage included coagulation disorders (22/81, 27.1%), ruptured renal cyst (11/81, 13.6%), rupture of abdominal aortic aneurysm (9/81, 11.1%), renal cell carcinoma (9/81, 11.1%), adrenal masses (9/81, 11.1%), polycystic kidney disease (7/81, 8.6%), angiomyolipoma (6/81, 7.4%), renal vascular diseases (2/81, 2.4%), and recurrent pyelonephritis (1/81, 1.2%). Haematomas associated with coagulation abnormalities and vascular diseases presented with larger volumes and were more likely to extent to the pararenal space more so than other groups; ruptured renal cyst and renal cell carcinomas tended to be more associated with subcapsular haematomas. The haematocrit effect and haemorrhage involving renal parenchyma were more often observed in the group with coagulation abnormalities. CONCLUSION: Imaging features, such as location and extension, could help radiologists identify possible aetiologies of spontaneous perirenal haemorrhage.

An ab initio investigation of Bi2Se3 topological insulator deposited on amorphous SiO2.

We use first-principles simulations to investigate the topological properties of Bi2Se3 thin films deposited on amorphous SiO2, Bi2Se3/a-SiO2, which is a promising substrate for topological insulator (TI) based device applications. The Bi2Se3 films are bonded to a-SiO2 mediated by van der Waals interactions. Upon interaction with the substrate, the Bi2Se3 topological surface and interface states remain present, however the degeneracy between the Dirac-like cones is broken. The energy separation between the two Dirac-like cones increases with the number of Bi2Se3 quintuple layers (QLs) deposited on the substrate. Such a degeneracy breaking is caused by (i) charge transfer from the TI to the substrate and charge redistribution along the Bi2Se3 QLs, and (ii) by deformation of the QL in contact with the a-SiO2 substrate. We also investigate the role played by oxygen vacancies ([Formula: see text]) on the a-SiO2, which increases the energy splitting between the two Dirac-like cones. Finally, by mapping the electronic structure of Bi2Se3/a-SiO2, we found that the a-SiO2 surface states, even upon the presence of [Formula: see text], play a minor role on gating the electronic transport properties of Bi2Se3.

Pyridine intercalated Bi2Se3 heterostructures: controlling the topologically protected states.

We use ab initio simulations to investigate the incorporation of pyridine molecules (C5H5N) in the van der Waals (vdW) gaps of Bi2Se3. The intercalated pyridine molecules increase the separation distance between the Bi2Se3 quintuple layers (QLs), suppressing the parity inversion of the electronic states at the Γ-point. We find that (i) the intercalated region becomes a trivial insulator. By combining the pristine Bi2Se3 region with the one intercalated by the molecules (py-Bi2Se3), we have a trivial/topological heterojunction (py-Bi2Se3/Bi2Se3) characterized by the presence of topologically protected metallic states at the interfacial region. Next, (ii) we apply an external compressive pressure to the system, and the results are a decrease of the separation distance between the QLs intercalated by pyridine molecules, and the metallic states are shifted toward the bulk region, turning the system back to the insulator. Our findings indicate that, through the intercalation of pyridine molecules in Bi2Se3 [(i)], we may have a number of topologically protected metallic channels embedded in (py-Bi2Se3) m /(Bi2Se3) n heterostructures/superlattices, in addition, through suitable tuning of the external pressure [(ii)], we can control its topological properties, turning on and off the topologically protected metallic states in (py-Bi2Se3)m /(Bi2Se3)n.

Organic molecules deposited on graphene: a computational investigation of self-assembly and electronic structure.

We use ab initio simulations to investigate the adsorption and the self-assembly processes of tetracyanoquinodimethane (TCNQ), tetrafluoro-tetracyanoquinodimethane (F4-TCNQ), and tetrasodium 1,3,6,8-pyrenetetrasulfonic acid (TPA) on the graphene surface. We find that there are no chemical bonds at the molecule-graphene interface, even at the presence of grain boundaries on the graphene surface. The molecules bond to graphene through van der Waals interactions. In addition to the molecule-graphene interaction, we performed a detailed study of the role played by the (lateral) molecule-molecule interaction in the formation of the, experimentally verified, self-assembled layers of TCNQ and TPA on graphene. Regarding the electronic properties, we calculate the electronic charge transfer from the graphene sheet to the TCNQ and F4-TCNQ molecules, leading to a p-doping of graphene. Meanwhile, such charge transfer is reduced by an order of magnitude for TPA molecules on graphene. In this case, it is not expected a significant doping process upon the formation of self-assembled layer of TPA molecules on the graphene sheet.

Mesoscale modeling of shear-thinning polymer solutions.

We simulate the linear and nonlinear rheology of two different viscoelastic polymer solutions, a polyisobutylene solution in pristane and an aqueous solution of hydroxypropylcellulose, using a highly coarse-grained approach known as Responsive Particle Dynamics (RaPiD) model. In RaPiD, each polymer has originally been depicted as a spherical particle with the effects of the eliminated degrees of freedom accounted for by an appropriate free energy and transient pairwise forces. Motivated by the inability of this spherical particle representation to entirely capture the nonlinear rheology of both fluids, we extended the RaPiD model by introducing a deformable particle capable of elongation. A Finite-Extensible Non-Linear Elastic potential provides a free energy penalty for particle elongation. Upon disentangling, this deformability allows more time for particles to re-entangle with neighbouring particles. We show this process to be integral towards recovering the experimental nonlinear rheology, obtaining excellent agreement. We show that the nonlinear rheology is crucially dependent upon the maximum elongation and less so on the elasticity of the particles. In addition, the description of the linear rheology has been retained in the process.

The origin of flow-induced alignment of spherical colloids in shear-thinning viscoelastic fluids.

We have studied the poorly understood process of flow-induced structure formation by colloids suspended in shear-thinning fluids. These viscoelastic fluids contain long flexible chains whose entanglements appear and disappear continuously as a result of brownian motion and the applied shear flow. Responsive particle dynamics simulates each chain as a single smooth brownian particle, with slowly evolving inter-particle degrees of freedom accounting for the entanglements. The colloids mixed homogeneously in all simulated quiescent dispersions and they remain dispersed under slow shear flow. Beyond a critical shear rate, which varies depending on the fluid, the colloids aggregate and form flow-aligned strings in the bulk of the fluid. In this work we explore the physical origins of this hitherto unexplained ordering phenomena, both by systematically varying the parameters of the simulated fluids and by analyzing the flow-induced effective colloidal interactions. We also present an expression for the critical shear rate of the studied fluids.

Alignment of particles in sheared viscoelastic fluids.

We investigate the shear-induced structure formation of colloidal particles dissolved in non-Newtonian fluids by means of computer simulations. The two investigated visco-elastic fluids are a semi-dilute polymer solution and a worm-like micellar solution. Both shear-thinning fluids contain long flexible chains whose entanglements appear and disappear continually as a result of Brownian motion and the applied shear flow. To reach sufficiently large time and length scales in three-dimensional simulations with up to 96 spherical colloids, we employ the responsive particle dynamics simulation method of modeling each chain as a single soft Brownian particle with slowly evolving inter-particle degrees of freedom accounting for the entanglements. Parameters in the model are chosen such that the simulated rheological properties of the fluids, i.e., the storage and loss moduli and the shear viscosities, are in reasonable agreement with experimental values. Spherical colloids dispersed in both quiescent fluids mix homogeneously. Under shear flow, however, the colloids in the micellar solution align to form strings in the flow direction, whereas the colloids in the polymer solution remain randomly distributed. These observations agree with recent experimental studies of colloids in the bulk of these two liquids.

Recovery care facilities.

In a world of rapidly changing policies in healthcare and the constant search for value-based medical care, the anaesthesiologist must be aware of new anaesthetic drugs and techniques utilized in daily practice, and most importantly, be updated on the implications of using these techniques in the ambulatory (day-case) setting without compromising patient safety or jeopardizing the physician-patient relationship. The ambulatory surgery movement has led to some of the most substantial changes in anaesthesia, with special emphasis on recovery care when the patient is rapidly brought into contact with their relatives or escorts shortly after emerging from a sedative or anaesthetic state.