bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatability studies of textile wastewater on an aerobic fluidized bed biofilm reactor (FABR): a case study
Authors: Arun Kumar Thalla , Saravanan S.
Published: May 2009

The performance of a pilot scale aerobic fluidized bed biofilm process and chemical coagulation for textile wastewater treatment was studied. In order to enhance biological treatment efficiency of textile wastewater, poly urethane cubes were incorporated as a supporting media for attached growth. Fenton's reagent was used as a coagulant in the present study. The fluidized bed biofilm process was operated at four HRTs (3, 4.5, 6 and 8 hour) and the results showed that the COD removal efficiency increased from 69% to 94% when the HRT increased from 3 to 4.5 and there of the removal efficiency remained constant around 94%, even though using relatively low MLSS concentration and short sludge retention time. COD and TDS removals of 94.2% and 93.3% were achieved by overall combined process (FABR + Coagulation aided Sedimentation). After the treatment there is remarkable decrease in colour in addition to COD and TDS.

This combined process was highly competitive in comparison to the other similar combined systems. It was concluded that this combined process was successfully employed and much effectively decreased they COD, TDS and color of textile wastewater treatment at pilot scale.
Appropriate wastewater treatment systems for developing countries: criteria and indictor assessment in Thailand
Authors: Singhirunnusorn W. , Stenstrom M. K.
Published: May 2009

This paper presents a comprehensive approach with factors to select appropriate wastewater treatment systems in developing countries in general and Thailand in particular. Instead of focusing merely on the technical dimensions, the study integrates the social, economic, and environmental concerns to develop a set of criteria and indicators (C&I) useful for evaluating appropriate system alternatives. The paper identifies seven elements crucial for technical selection: reliability, simplicity, efficiency, land requirement, affordability, social acceptability, and sustainability. Variables are organized into three hierarchical elements, namely: principles, criteria, and indicators. The study utilizes a mail survey to obtain information from Thai experts—academicians, practitioners, and government officials—to evaluate the C&I list. Responses were received from 33 experts on two multi-criteria analysis inquiries—ranking and rating—to obtain evaluative judgments. Results show that reliability, affordability, and efficiency are among the most important elements, followed by sustainability and social acceptability. Land requirement and simplicity are low in priority with relatively inferior weighting. A number of criteria are then developed to match the contextual environment of each particular condition. A total of 14 criteria are identified which comprised 64 indicators. Unimportant criteria and indicators are discarded after careful consideration, since some of the indicators are local or site specific.
Model-based control of MF/UF filtration processes: pilot plant implementation and results
Authors: Busch J. , Marquardt W.
Published: May 2009

Membrane micro- and ultrafiltration processes are widespread in water and wastewater treatment applications. Owing to the complex filtration mechanisms and the few available measurement information, they are typically operated using simple control approaches. However, two negative consequences are the sub-optimal performance and the relatively inflexible operation despite dynamic operating conditions. In previous publications, a model-based, adaptive run-to-run control approach for filtration processes has been introduced to improve process performance. It exploits the structure of cyclically operated filtration processes, where one cycle comprises a filtration and a backwashing phase. This contribution focuses on the experimental validation of the approach at a pilot-scale membrane bioreactor for municipal wastewater treatment. Necessary modifications to the approach and details on its implementation are discussed. The controller yields very good results with respect to prediction quality, optimization results, and stability. In addition to improved operational safety, savings of up to 50% are achieved with respect to energy consumption and membrane strain.
Studying Social Policy and Resilience to Adversity in Different Welfare States: Britain and Sweden
Authors: Jones Chris , Burström Bo , Marttila Anneli , Canvin Krysia , Whitehead Margaret
Published: May 2009

Is poverty more damaging to health in Britain than in Sweden, and if so, why? Following previous research by the authors that suggested such an effect, a new comparative study is examining whether there are aspects of the social and policy context in Britain that add to and reinforce the health-damaging experience of being poor. Conversely, are there other aspects of living in Sweden that are supportive for people in poverty, which make the experience of poverty less stressful and health-damaging? Stemming from this ongoing study, the aim of this article is to present a framework for understanding the context in which social welfare policies are formed and operate in Britain and Sweden. It then uses the framework to consider the “upstream” influences of ideology, culture, and values on policy development in the two countries and what these developments might mean for the health and well-being of people facing financial adversity in the two societies.
Vaginal Birth after Cesarean (VBAC) Outcomes Associated with Increasing Number of Prior VBACs
Authors: Stamilio David M , Shanks Anthony
Published: May 2009

Evaluation of: Mercer BM, Gilbert S, Landon MB et al., for the National Institute of Child Health and Human Development Maternal–Fetal medicine Units Network: Labor outcomes with increasing number of prior vaginal births after cesarean delivery. Obstet. Gynecol. 111(2), 285–291 (2008). From a prospective US multicenter cohort of 45,988 patients with a singleton gestation and a prior cesarean, 13,532 women that elected to attempt a vaginal birth after cesarean (VBAC) were selected for this secondary analysis. This study was conducted to estimate the success rates and risks of an attempted VBAC according to the number of previously successful VBAC attempts. Outcomes evaluated included VBAC success, maternal major morbidity (e.g., uterine rupture and surgical complications), neonatal morbidity (e.g., intensive care nursery admission and acidemia) and maternal and neonatal death. The VBAC success rate rose incrementally from 63.3 to 91.6% in patients that had from zero to four or more prior successful VBACs. Uterine rupture and peripartum risks decreased by 50% after the initial successful VBAC and did not increase with increasing prior VBAC number. Neonatal morbidity did not increase with increasing VBAC number.
A review of published reports regarding zoonotic pathogen infection in veterinarians
Authors: Baker Whitney S. , Gray Gregory C.
Published: May 2009

Objective—To identify published reports regarding zoonotic pathogen infection among veterinarians.

Design—Literature review.

Procedures—The PubMed electronic database of medical literature published between 1966 and November 2007 was searched. Clinical case reports and reports of outbreak investigations were also identified through searches of the literature outside of PubMed and searches of references listed in included articles. Reports eligible for inclusion included controlled and uncontrolled studies examining seroprevalence of animal pathogens in veterinarians, serosurveys involving veterinarians, and reports of zoonotic pathogen infections causing clinical illness.

Results—66 relevant articles were identified. This included 44 seroepidemiologic studies (some examined > 1 pathogen), 12 case reports, 3 outbreak investigations, and 7 self-reported surveys (including 4 related to personal protective equipment use). Of the 44 seroepidemiologic studies, 37 (84%) identified an increased risk of zoonotic pathogen infection among veterinarians, and 7 (16%) identified no increased risk or a decreased risk. Surveys also documented that veterinarians often failed to use recommended personal protective equipment.

Conclusions and Clinical Relevance—Our review indicated that veterinarians had an increased risk of infection with a number of zoonotic pathogens. It also suggested that veterinarians may inadvertently serve as biological sentinels for emerging pathogens and could potentially spread zoonotic pathogens to their families, community members, and the animals for which they provide care. Professional and policy measures should be implemented to reduce the risk that veterinarians will become infected with, or transmit, zoonotic pathogens.
Traumatic pneumocephalus in a dog
Authors: Haley Allison C. , Abramson Carley
Published: May 2009

Case Description—A 17-month-old dog was evaluated because of progressive tetraparesis. The dog had a history of craniofacial trauma at 2 months of age.

Clinical Findings—Results of a neurologic examination were suggestive of a lesion localized to the medulla. Computed tomography revealed extensive pneumocephalus extending throughout the ventricular system and into the cranial cervical subarachnoid space.

Treatment and Outcome—Because of the deterioration in the dog's clinical condition, an emergency bilateral transfrontal craniectomy was performed. A large amount of pyogranulomatous material was found intraoperatively. Neurologic and computed tomographic abnormalities were no longer evident during a recheck examination 8 weeks after surgery.

Clinical Relevance—Findings suggested that pneumocephalus should be considered in the differential diagnosis for dogs with neurologic signs of an intracranial abnormality, particularly if the dog has a history of craniofacial trauma.
The concentration of uric acid in patients with metabolic syndrome and cardiovascular diseases
Authors: Kowalski Jan , Krzemińska Anna , Banach Maciej , Pawlicki Lucjan , Śliwczyńska-Rodziewicz Dorota , Barylski Marcin
Published: May 2009

The association of elevated serum uric acid (hyperuricemia, gout) with the presence of classical coronary risk factors and coronary artery disease (CAD) or myocardial infarction (MI) has been analysed in many epidemiological studies. Numerous studies have revealed that hypertension, high body mass index (BMI), lipid disorders (especially raised triglyceride (TG) levels and low high dense lipoprotein cholesterol (HDL-C) level), and increased creatinine or insulin levels have caused hyperuricemia. Gout has often occurred with typical disorders for the metabolic syndrome X. Significant correlation of the serum uric level and the CAD presence and severity of coronary atherosclerosis confirmed by coronary angiography has been observed in women. Hyperuricemia has also indirect influence on progress of CAD by physical activity restriction, what causes sedentary mode of life and lead to obesity. Therefore, we conducted our study in order to estimate uric acid levels in patients with metabolic syndrome and coexisting cardiovascular system diseases.
The meaning of early percutaneous coronary intervention in acute coronary syndrome with preserved ST elevation
Authors: Wierzbicka Magdalena , Kośmider Maciej , Bielecka-Dąbrowa Agata , Goch Jan
Published: May 2009

To determine if delaying the primary precutaneous coronary intervention (PCI) for >6 hours for acute coronary syndrome with preserved ST elevation (STE-ACS) affects the PCI angiography effectiveness and clinical prognosis. The PCI was performed: for 71% of patients <6h (group 1), for 29% of patients >6h from the beginning of pain (group 2). For 1% of patients from group 1 and 3.4% of patients from group 2, no passage has been opened in the artery after STE-ACS. In spite of opening the passage mechanically, the phenomenon of lack of tissue reflow occurred in 2.7% of patients from group 1 and 12% of patients from group 2. Dangerous ventricular arrhythmias occurred more frequently in patients from group 2, including VF, asystole, haemodynamic complications classed 4° according to the Killip-Kimball scale and death. In an univariate logistic regression analysis, the following risk factors for death during the hospital phase were identified: delayed PCI >6 hours, 4° haemodynamic complications according to the Killip-Kimball scale, LVEF <40%, FV, p-k III block, TIMI <3, and no-reflow. In a multivariate logistic regression analysis, 4° according to the Killip-Kimball scale turned out to be the only risk factor for death during the hospital phase. Delaying PCI during STE-ACS for >6 hours significantly lowers the statistical chance to recover both full permeability and effective tissue reflow in the artery responsible for STE-ACS, which is connected with a significantly higher risk of serious complications, as well as with 8.5% risk of death during the hospital phase. The most significant, independent factor determining the survival of patients with STE-ACS after PCI is lack of cardiogenic shock.
The functional antagonist Met-RANTES: A modified agonist that induces differential CCR5 trafficking
Authors: Kiss Debra , Longden James , Fechner Gregory , Avery Vicky
Published: May 2009

CC chemokine receptor 5 (CCR5) is a pro-inflammatory chemokine receptor that is expressed on cells of the immune system, and specializes in cell migration in response to inflammation and tissue damage. Due to its key role in cell communication and migration, this receptor is involved in various inflammatory and autoimmune diseases, in addition to HIV infection. Met-RANTES is a modified CCR5 ligand that has previously been shown to antagonize CCR5 activation and function in response to its natural ligands in vitro. In vivo, Met-RANTES is able to reduce inflammation in models of induced inflammatory and autoimmune diseases. However, due to the fact that Met-RANTES is also capable of partial agonist activity regarding receptor signaling and internalization, it is clear that Met-RANTES does not function as a conventional receptor antagonist. To further elucidate the effect of Met-RANTES on CCR5, receptor trafficking was investigated in a CHO-CCR5-GFP cell line using the Opera confocal plate reader. The internalization response of CCR5 was quantified, and showed that Met-RANTES internalized CCR5 in a slower, less potent manner than the agonists CCL3 and CCL5. Fluorescent organelle labeling and live cell imaging showed CCL3 and CCL5 caused CCR5 to traffic through sorting endosomes, recycling endosomes and the Golgi apparatus. In contrast, Met-RANTES caused CCR5 to traffic through sorting endosomes and the Golgi apparatus in a manner that was independent of recycling endosomes. As receptor trafficking impacts on cell surface expression and the ability of the receptor to respond to more ligand, this information may indicate an alternative regulation of CCR5 by Met-RANTES that allows the modified ligand to reduce inflammation through stimulation of a pro-inflammatory receptor.
Surgical outcome of phrenic nerve transfer to the anterior division of the upper trunk in treating brachial plexus avulsion
Authors: Dong Zhen , Zhang Cheng-Gang , Gu Yu-Dong
Published: May 2009

Object

The purpose of this investigation was to study the surgical results of phrenic nerve transfer to the anterior division of the upper trunk of the brachial plexus.

Methods

Between 2002 and 2005, 40 patients received a phrenic nerve transfer to the anterior division of the upper trunk of the brachial plexus to restore elbow flexion. These cases were followed postoperatively for > 2 years, and the efficacy of the surgery and related factors were evaluated.

Results

The overall effective rate of this procedure was 82.5% (Medical Research Council Grade ≥ 3). The results show that for patients with surgical delay of > 1 year or prolongation of the latency of the preoperative phrenic nerve evoked potential > 20%, the recovery rates were 25 and 50%, respectively.

Conclusions

Phrenic nerve transfer to the anterior division of the upper trunk of the brachial plexus is a simple procedure that causes minor surgical trauma and yields good recovery of elbow flexion. It is suitable in patients with a relatively intact structure at the division level of the brachial plexus.
Estimated Time for Occurrence of Smoking-Related Consequences among Pregnant and Non-Pregnant Women
Authors: Ortendahl Monica , Uttermalm Alf , Simonsson Bo , Näsman Per , Wallsten Tuula
Published: May 2009

Objectives: To study time estimates by women smokers for when smoking-related consequences will occur given continuing or quitting smoking. The relationship of these estimates to pregnancy and intent to quit smoking was also investigated. Methods: Over a two-week period, eighty women, selected to constitute four subgroups formed by pregnant vs. non-pregnant and trying vs. not trying to quit smoking, rated times at which they would expect smoking-related consequences to occur given continuing or quitting smoking. Results: Somatic health consequences were estimated to occur later than consequences related to mood and social relations. All consequences were estimated to occur later given quitting smoking. Pregnancy had an effect on the estimated time that consequences would occur, with pregnant women estimating earlier occurrence of consequences related to mood and social relations than non-pregnant women did. Conclusion: Health messages should stress consequences for somatic health in quitting smoking, since outcomes later in time might have too low a value to exert a positive effect on decisions to quit smoking.
Nurturing Freedom of Expression through Teaching Global Media Literacy
Authors: Moeller Susan
Published: May 2009

Freedom of expression is both a life and death matter and a bread and butter issue. Free media that allow a diversity of voices to be heard and all ideas to be discussed play a central role in the sustaining and monitoring of good government, as well as in the fostering of economic development and the encouraging of corporate transparency and accountability. Students in both developed and developing nations need to understand that there is no global issue or political arena in which the statement of problems and the framing of possible solutions are not influenced by media coverage. The Salzburg Academy on Media and Global Change is the meeting point where universities from around the world, media organizations and international institutions such as the UN and UNESCO have worked jointly for the first time in order to build a global media literacy curriculum, related lesson plans, exercises and resources to teach students to evaluate the media they read, hear and see, as well as teach them to speak out for themselves. The GML materials are written by a global commu nity for a global community and aim to prepare students the world over for active and inclusive roles in information societies.

La libertad de expresión es cuestión de vida o muerte. Los medios de comunicación independientes cumplen un rol central en el mantenimiento de un gobierno adecuado, así como en el fomento del desarrollo económico y en el apoyo a la transparencia corporativa y la rendición de cuentas. Por otro lado, los estudiantes de todo el mundo necesitan comprender la influencia de los medios para formular sus problemas y sus posibles soluciones. La Academia Salzburgo de los Medios de Comunicación y los Cambios Mundiales ha sido punto de encuentro para que Universidades de todo el mundo, organizaciones mediáticas e instituciones internacionales (como la ONU y la UNESCO) hayan colaborado en construir un programa curricular para la alfabetización mediática mundial, con ejercicios y recursos para enseñar a ver y escuchar los medios, actuar ante los medios, a través de los medios, e incluso creando sus propios medios de comunicación social. Los materiales son elaborados por y para una comunidad mundial, con el fin de preparar a estudiantes en todo el mundo a cumplir roles activos e incluyentes en la sociedad de la información.
Exploring Media Education as Civic Praxis in Africa
Authors: Banda Fackson
Published: May 2009

This article argues that African media education must define a pedagogical agenda for citizenship. That task lies in a postcolonial revisionism of liberal modes of thought and practice about media. This neo-colonial dependence of African media education is evident in the pedagogical emphasis on professional- journalistic automation. However, Africans are increasingly becoming politically and civically apathetic. This analysis calls for an emancipatory vision of journalism that is embedded in civil society. It uses a case study of radio listening clubs to illustrate the civic influence of the media in Malawi and Zambia. It concludes by proposing a model of media education for citizenship. The key tenets of the model include enhancing critical analysis of the correlation between media, democracy and development; developing an emancipatory vision of journalism; cultivating an active citizenship; entrenching a viable institutional infrastructure of democracy; and promoting an informed adherence to human rights.

Este trabajo sostiene que la educación en medios africana debe definir una agenda pedagógica para la ciudadanía. Esa tarea se sitúa en un revisionismo poscolonial de formas liberales de pensamiento y práctica acerca de los medios. Esta dependencia neo-colonial de la educación en medios africana es evidente en el énfasis pedagógico de la automatización periodística-profesional. Sin embargo, los africanos se están volviendo crecientemente apáticos, política y cívicamente. Esta aportación demanda una visión emancipatoria del periodismo inmerso en la sociedad civil. Se basa en el estudio de caso de clubs de radio-escuchas para ilustrar la influencia cívica de los medios en Malawi y Zambia, y propone un modelo de educación mediática para la ciudadanía. La tesis clave de este modelo incluye realzar el análisis crítico de la correlación entre medios, democracia y desarrollo; desarrollar una visión emancipatoria del periodismo; cultivar una ciudadanía activa; fortificar una infraestructura institucional viable de democracia, y promover una adhesión informada a los derechos humanos.
Criteria of Media Education Program for Chilean teachers: A proposal for Continuous Training
Authors: de-Fontcuberta-Balaguer María del Mar
Published: May 2009

The article explains the results of a research about Media Education in Chilean Secondary School curriculum, its problems, and training and attitudes of teachers of Spanish Language and Communication. The analysis applies definitions and parameters adopted by UNESCO in Viena (1999) and Seville (2002) which indicate that Media Education means to teach and learn «with»» and «about» media more than «through» media. It proposes a schedule for continuous training of teachers in this field.

Este trabajo, desarrollado por un grupo de investigación chileno, expone los resultados de una investigación sobre la presencia de la educación en medios en el currículum de la enseñanza media chilena, los problemas que plantea y la formación y actitudes de los profesores de Lengua Castellana y Comunicación en ese ámbito. Para su análisis adopta las definiciones y parámetros contemplados por la UNESCO en Viena (1999) y Sevilla (2002) que indican, entre otros aspectos, que la educación en medios trata sobre la enseñanza y el aprendizaje «con» y «sobre» los medios, más que «a través» de los medios. El estudio concluye con una propuesta para implementar la formación continua de profesores en ese campo.
Deployment to Military Bases With Open Burn Pits and Respiratory and Cardiovascular Disease
Authors: Savitz David A. , Woskie Susan R. , Bello Anila , Gaither Rachel , Gasper Joseph , Jiang Lan , Rennix Christopher , Wellenius Gregory A. , Trivedi Amal N.
Published: April 2024

Importance

Many veterans who served in Afghanistan and Iraq during Operations Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) were deployed to military bases with open burn pits and exposed to their emissions, with limited understanding of the long-term health consequences.

Objective

To determine the association between deployment to military bases where open burn pits were used for waste disposal and the subsequent risk of developing respiratory and cardiovascular diseases.

Design, Setting, and Participants

This retrospective observational cohort study used Veterans Health Administration medical records and declassified deployment records from the Department of Defense to assess Army and Air Force veterans who were deployed between 2001 and 2011 and subsequently received health care from the Veterans Health Administration, with follow-up through December 2020. Data were analyzed from January 2023 through February 2024.

Exposure

Duration of deployment to military bases with open burn pits.

Main Outcomes and Measures

Diagnosis of asthma, chronic obstructive pulmonary disease, interstitial lung disease, hypertension, myocardial infarction, congestive heart failure, ischemic stroke, and hemorrhagic stroke.

Results

The study population included 459 381 OEF and OIF veterans (mean [SD] age, 31.6 [8.7] years; 399 754 [87.0%] male). Median (IQR) follow-up from end of deployment was 10.9 (9.4-12.7) years. For every 100 days of deployment to bases with burn pits, veterans experienced increased adjusted odds for asthma (adjusted odds ratio [aOR], 1.01; 95% CI, 1.01-1.02), chronic obstructive pulmonary disease (aOR, 1.04; 95% CI, 1.02-1.07), hypertension (aOR, 1.02; 95% CI, 1.02-1.03), and ischemic stroke (aOR, 1.06; 95% CI, 0.97-1.14). Odds of interstitial lung disease, myocardial infarction, congestive heart failure, or hemorrhagic stroke were not increased. Results based on tertiles of duration of burn pit exposures were consistent with those from the continuous exposure measures.

Conclusions and Relevance

In this cohort study, prolonged deployment to military bases with open burn pits was associated with increased risk of developing asthma, COPD, and hypertension. The results also point to a possible increased risk in ischemic stroke. The novel ability to use integrated data on deployment and health outcomes provides a model for additional studies of the health impact of environmental exposures during military service.
Lessons in Truth-Telling From the Novels of Thomas Wolfe
Authors: Meisenberg Barry
Published: April 2024

This essay describes the author’s experience with learning about building trust with every patient and family interaction through literature.
Home-Monitoring Vision Tests to Detect Active Neovascular Age-Related Macular Degeneration
Authors: Hogg Ruth E. , Sivaprasad Sobha , Wickens Robin , O’Connor Sean , Gidman Eleanor , Ward Elizabeth , Treanor Charlene , Peto Tunde , Burton Ben J. L. , Knox Paul , Lotery Andrew J. , Donnelly Michael , Rogers Chris A. , Reeves Barnaby C.
Published: April 2024

Importance

Most neovascular age-related macular degeneration (nAMD) treatments involve long-term follow-up of disease activity. Home-monitoring would reduce the burden on patients and their caregivers and release clinic capacity.

Objective

To evaluate 3 vision home-monitoring tests for patients to use to detect active nAMD compared with diagnosing active nAMD at hospital follow-up during the after-treatment monitoring phase.

Design, Setting, and Participants

This was a diagnostic test accuracy study wherein the reference standard was detection of active nAMD by an ophthalmologist at hospital follow-up. The 3 home-monitoring tests evaluated included the following: (1) the KeepSight Journal (KSJ [International Macular and Retinal Foundation]), which contains paper-based near-vision tests presented as word puzzles, (2) the MyVisionTrack (mVT [Genentech]) vision-monitoring mobile app, viewed on an Apple mobile operating system–based device, and (3) the MultiBit (MBT [Visumetrics]) app, viewed on an Apple mobile operating system–based device. Participants were asked to test weekly; mVT and MBT scores were transmitted automatically, and KSJ scores were returned to the research office every 6 months. Raw scores between hospital follow-ups were summarized as averages. Patients were recruited from 6 UK hospital eye clinics and were 50 years and older with at least 1 eye first treated for active nAMD for at least 6 months or longer to a maximum of 42 months before approach. Participants were stratified by time since starting treatment. Study data were analyzed from May to September 2021.

Exposures

The KSJ, mVT, and MBT were compared with the reference standard (in-hospital ophthalmologist examination).

Main Outcomes and Measures

Estimated area under receiver operating characteristic curve (AUROC). The study had 90% power to detect a difference of 0.06, or 80% power to detect a difference of 0.05, if the AUROC for 2 tests was 0.75.

Results

A total of 297 patients (mean [SD] age, 74.9 [6.6] years; 174 female [58.6%]) were included in the study. At least 1 hospital follow-up was available for 312 study eyes in 259 participants (1549 complete visits). Median (IQR) home-monitoring testing frequency was 3 (1-4) times per month. Estimated AUROC was less than 0.6 for all home-monitoring tests, and only the KSJ summary score was associated with lesion activity (odds ratio, 3.48; 95% CI, 1.09-11.13; P = .04).

Conclusions and Relevance

Results suggest that no home-monitoring vision test evaluated provided satisfactory diagnostic accuracy to identify active nAMD diagnosed in hospital eye service follow-up clinics. Implementing any of these evaluated tests, with ophthalmologists only reviewing test positives, would mean most active lesions were missed, risking unnecessary sight loss.
Outcomes of Immediate Total Thyroidectomy in First-Side Loss of Neuromonitoring Signal
Authors: Ramesh Sruthi , Van Den Berg Nadia H. , Sheahan Patrick
Published: April 2024

Importance

Use of intraoperative neuromonitoring (IONM) during thyroidectomy can nearly eliminate the risk of postoperative bilateral vocal cord palsy (VCP) by indicating staged surgery in cases of loss of signal (LOS) on the first side of planned total thyroidectomy. However, aborting planned total thyroidectomy may lead to persistence of symptoms, delay in adjuvant treatment, and patient inconvenience and distress. There are few data to guide a selective approach to total thyroidectomy in patients with first-side LOS.

Objective

To investigate outcomes of immediate bilateral surgery in patients undergoing total thyroidectomy with first-side LOS.

Design, Setting, and Participants

This cohort study was a retrospective review of outcomes for patients undergoing thyroidectomy between January 2016 and July 2023 at an academic tertiary referral center for thyroid surgery. Consecutive patients scheduled for total thyroidectomy using IONM were included. Exclusion criteria were preoperative VCP, deliberate sacrifice of recurrent laryngeal nerve (RLN), inadvertent RLN resection, and surgery performed without IONM.

Exposures

Total thyroidectomy performed using IONM.

Main Outcome Measures

Vocal mobility on first postoperative day as assessed by flexible laryngoscopy; secondary outcome measures included subjective voice assessment, other postoperative complications, and long-term vocal mobility.

Results

Among 400 patients undergoing planned total thyroidectomy (mean age, 50.5 years [range, 4-88 years]; 318 female [79.5%]), 51 (12.8%) had first-side LOS, of whom 37 (9.3%) had persistent LOS. Twenty-nine patients (56% of procedures with first-side LOS, including 18 with persistent LOS) proceeded to immediate total thyroidectomy. Postoperatively, 16 patients (55% of patients undergoing total thyroidectomy following first-side LOS, including 14 of 18 with persistent LOS) had impaired vocal mobility. One patient had bilateral VCP that did not require tracheostomy, and 2 had postoperative hypoparathyroidism. Of those whose surgery was aborted after first-side LOS, 8 of 22 (36%) underwent completion thyroidectomy at a later stage. In those undergoing completion thyroidectomy, 2 of 8 (25%) had temporary VCP after the second surgery, 2 (25%) had permanent hypoparathyroidism, and 1 (12.5%) developed inoperable cancer. Postoperative VCP was fully reversible in all but 1 patient.

Conclusion and Relevance

Among patients planned for total thyroidectomy who develop first-side LOS, immediate total thyroidectomy may be considered among those who have pressing reasons for same, and where surgical difficulties might be anticipated in a secondary surgery.
Boosting Efficiency and UV Resistance in Perovskite Solar Cells via Sunscreen Ingredient Octinoxate
Authors: Zhi Chongyang , Li Can , Wan Zhi , Liu Chuan , Jiang Zhe , Zunair Hassan , Du Liming , Zhang Shangchen , Li Zhihao , Shi Jishan , Li Zhen
Published: April 2024

UV radiation presents a substantial challenge to the stability of perovskite solar cells (PSCs), limiting their applications in harsh environments such as outer space. Herein, UV‐resistant molecule octinoxate (OCT) is introduced to mitigate the adverse effects of UV irradiation. OCT additive demonstrates the capability to modulate the crystallization process, resulting in perovskite films with larger grains and enhanced crystallinity. Moreover, OCT doping also facilitates charge extraction in PSCs. The PSCs with OCT doping exhibit an enhanced efficiency, increasing from 22.46% to 24.64%, along with improved stability with a T85 of 1000 h under continuous light exposure. Functioning as a sunscreen material, OCT mitigates UV‐induced degradation by absorbing irradiation and hindering I2 escape. Even after continuous exposure to 18.7 kWh m−2 UV illumination, the OCT‐doped PSCs maintain over 92% of their initial efficiency, meeting the 15 kWh m−2 UV exposure requirement specified in the IEC:61215 PV robustness testing standard. This study offers a straightforward approach to enhance the durability of PSCs under UV radiation, opening avenues for their application in extreme environments.
Inflammation‐Responsive Hydrogel Accelerates Diabetic Wound Healing through Immunoregulation and Enhanced Angiogenesis
Authors: He Fang , Xu Pengqin , Zhu Zhikang , Zhang Ying , Cai Chenghao , Zhang Yuxiang , Shao Jiaming , Jin Fang , Li Qiong , You Jiahuan , Zhou Hanlei , Zhang Wei , Wei Jintao , Hong Xudong , Zhang Zhongtao , Han Chunmao , Zhang Yuqi , Gu Zhen , Wang Xingang
Published: April 2024

Angiogenesis is a prominent component during the highly regulated process of wound healing. The application of exogenous vascular endothelial growth factor (VEGF) has shown considerable potential in facilitating angiogenesis. However, its effectiveness is often curtailed due to chronic inflammation and severe oxidative stress in diabetic wounds. Herein, an inflammation‐responsive hydrogel incorporating Prussian blue nanoparticles (PBNPs) is designed to augment the angiogenic efficacy of VEGF. Specifically, the rapid release of PBNPs from the hydrogel under inflammatory conditions effectively alleviates the oxidative stress of the wound, therefore reprogramming the immune microenvironment to preserve the bioactivity of VEGF for enhanced angiogenesis. In vitro and in vivo studies reveal that the PBNPs and VEGF co‐loaded hydrogel is biocompatible and possesses effective anti‐inflammatory properties, thereby facilitating angiogenesis to accelerate the wound healing process in a type 2 diabetic mouse model.
J‐Aggregate Promoting NIR‐II Emission for Fluorescence/Photoacoustic Imaging‐Guided Phototherapy
Authors: Ou Changjin , Zhao Ziqi , An Lei , Zheng Liangyu , Gao Fan , Zhu Qin , Wang Wenjun , Shao Jinjun , Xie Linghai , Dong Xiaochen
Published: April 2024

J‐aggregate is a promising strategy to enhance second near‐infrared window (NIR‐II) emission, while the controlled synthesis of J‐aggregated NIR‐II dyes is a huge challenge because of the lack of molecular design principle. Herein, bulk spiro[fluorene‐9,9′‐xanthene] functionalized benzobisthiadiazole‐based NIR‐II dyes (named BSFX‐BBT and OSFX‐BBT) are synthesized with different alkyl chains. The weak repulsion interaction between the donor and acceptor units and the S…N secondary interactions make the dyes to adopt a co‐planar molecular conformation and display a peak absorption >880 nm in solution. Importantly, BSFX‐BBT can form a desiring J‐aggregate in the condensed state, and femtosecond transient absorption spectra reveal that the excited states of J‐aggregate are the radiative states, and J‐aggregate can facilitate stimulated emission. Consequently, the J‐aggregated nanoparticles (NPs) display a peak emission at 1124 nm with a high relative quantum yield of 0.81%. The efficient NIR‐II emission, good photothermal effect, and biocompatibility make the J‐aggregated NPs demonstrate efficient antitumor efficacy via fluorescence/photoacoustic imaging‐guided phototherapy. The paradigm illustrates that tuning the aggregate states of NIR‐II dye via spiro‐functionalized strategy is an effective approach to enhance photo‐theranostic performance.
Selectivity Switch in Non‐Directed Palladium‐Catalyzed C−H Olefination of Chlorobenzene Derivatives
Authors: Fichez Jeanne , Lapuh Maria I. , Truong Lina , Oulyadi Hassan , Buttard Floris , Besset Tatiana
Published: April 2024

A palladium(II)‐catalyzed oxidative C−H olefination of chlorobenzene derivatives, which favored the functionalization at the ortho‐to‐chlorine position, was reported. The catalytic system employed a commercially available quinoline ligand to access a wide panel of olefinated aryl chlorides in moderate to high yields from feedstock chemicals (42 examples, 28 to 93% yields). The synthetic utility of the method was further demonstrated by the coupling of various bio‐relevant acrylate partners offering straightforward access to structurally diverse complex molecules. A computational study of the reaction allowed us to confirm that the C−H activation step, occurring through a Concerted Metalation‐Deprotonation mechanism, determined the site‐selectivity of the transformation. The regioselectivity was controlled by the pKa of the C−H bond (more acidic position) and the lower distortion of chlorobenzene in the key transition structure.
Structural Pharmacology of TRPV4 Antagonists
Authors: Fan Junping , Guo Chang , Liao Daohong , Ke Han , Lei Jing , Xie Wenjun , Tang Yuliang , Tominaga Makoto , Huang Zhuo , Lei Xiaoguang
Published: April 2024

The nonselective calcium‐permeable Transient Receptor Potential Cation Channel Subfamily V Member4 (TRPV4) channel regulates various physiological activities. Dysfunction of TRPV4 is linked to many severe diseases, including edema, pain, gastrointestinal disorders, lung diseases, and inherited neurodegeneration. Emerging TRPV4 antagonists show potential clinical benefits. However, the molecular mechanisms of TRPV4 antagonism remain poorly understood. Here, cryo‐electron microscopy (cryo‐EM) structures of human TRPV4 are presented in‐complex with two potent antagonists, revealing the detailed binding pockets and regulatory mechanisms of TRPV4 gating. Both antagonists bind to the voltage‐sensing‐like domain (VSLD) and stabilize the channel in closed states. These two antagonists induce TRPV4 to undergo an apparent fourfold to twofold symmetry transition. Moreover, it is demonstrated that one of the antagonists binds to the VSLD extended pocket, which differs from the canonical VSLD pocket. Complemented with functional and molecular dynamics simulation results, this study provides crucial mechanistic insights into TRPV4 regulation by small‐molecule antagonists, which may facilitate future drug discovery targeting TRPV4.
Combination of a TGF‐β ligand trap (RAP‐GRL) and TMPRSS6‐ASO is superior for correcting β‐thalassemia
Authors: Guerra Amaliris , Hamilton Nolan , Rivera Ariel , Demsko Perry , Guo Shuling , Rivella Stefano
Published: April 2024

A recently approved drug that induces erythroid cell maturation (luspatercept) has been shown to improve anemia and reduce the need for blood transfusion in non‐transfusion‐dependent as well as transfusion‐dependent β‐thalassemia (BT) patients. Although these results were predominantly positive, not all the patients showed the expected increase in hemoglobin (Hb) levels or transfusion burden reduction. Additional studies indicated that administration of luspatercept in transfusion‐dependent BT was associated with increased erythropoietic markers, decreased hepcidin levels, and increased liver iron content. Altogether, these studies suggest that luspatercept may necessitate additional drugs for improved erythroid and iron management. As luspatercept does not appear to directly affect iron metabolism, we hypothesized that TMPRSS6‐ASO could improve iron parameters and iron overload when co‐administered with luspatercept. We used an agent analogous to murine luspatercept (RAP‐GRL) and another novel therapeutic, IONIS TMPRSS6‐LRx (TMPRSS6‐ASO), a hepcidin inducer, to treat non‐transfusion‐dependent BT‐intermedia mice. Our study shows that RAP‐GRL alone improved red blood cell (RBC) production, with no or limited effect on splenomegaly and iron parameters. In contrast, TMPRSS6‐ASO improved RBC measurements, ameliorated splenomegaly, and improved iron overload most effectively. Our results provide pre‐clinical support for combining TMPRSS6‐ASO and luspatercept in treating BT, as these drugs together show potential for simultaneously improving both erythroid and iron parameters in BT patients.
Bifunctional Ligand Enables Gold‐Catalyzed Propargyl C−H Functionalization via Reactive Gold Allenylidene Intermediate
Authors: Wei Yongliang , Jiang Jingxing , Jing Yaru , Ke Zhuofeng , Zhang Liming
Published: April 2024

Gold allenylidene species have been seldom exploited as reactive intermediates in synthetically versatile catalytic reactions. By employing alkynylbenziodoxoles as the substrates and bifunctional WangPhos as the metal ligand, this work demonstrated ready catalytic access to these intermediates of general substitution patterns and their electrophilic reactivities at the γ‐carbon center with a diverse range of nucleophiles. The reaction is driven by the reductive decomposition of the benziodoxole moiety and achieves the replacement of a propargylic proton with an N/O/C‐based nucleophile, hence realizing reactivity umpolung. Corroborated by Density Functional Theory (DFT) calculations, the reaction mechanism involves a mild propargylic deprotonation. In contrast to prior works employing a tertiary amine functionality, a weakly BrØnsted‐basic amide group in WangPhos is surprisingly effective in deprotonation at the propargylic position under a gold‐ligand cooperation regime.
In‐Situ Cyclized Polyacrylonitrile as an Electron Selective Layer for n‐i‐p Perovskite Solar Cell with Enhanced Efficiency and Stability
Authors: Gu Wei‐Min , Jiang Ke‐Jian , Jiao Xinning , Gao Cai‐Yan , Fan Xin‐Heng , Yang Lian‐Ming , Song Yanlin
Published: April 2024

In situ cyclized polyacrylonitrile (CPAN) is developed to replace n‐type metal oxide semiconductors (TiO2 or SnO2) as an electron selective layer (ESL) for highly efficient and stable n‐i‐p perovskite solar cells (PSCs). The CPAN layer is fabricated via facile in situ cyclization reaction of polyacrylonitrile (PAN) coated on a conducting glass substrate. The CPAN layer is robust and insoluble in common solvents, and possesses n‐type semiconductor properties with a high electron mobility of 4.13×10−3 cm2 V−1 s−1. With the CPAN as an ESL, the PSC affords a power conversion efficiency (PCE) of 23.12 %, which is the highest for the n‐i‐p PSCs with organic ESLs. Moreover, the device with the CPAN layer holds superior operational stability, maintaining over 90 % of their initial efficiency after 500 h continuous light soaking. These results confirm that the CPAN layer would be a desirable low‐cost and efficient ESL for n‐i‐p PSCs and other photoelectronic devices with high performance and stability.
All‐organic shell–core PVDF/PMMA composite fiber films with enhanced piezoelectric performance for flexible sensing and energy harvesting
Authors: Li Xiao , Yuan ChongXiao , Gao Guoqi , Zhou Hengqing , Zhang Nannan , Yang Xinyue , Liu Xiaofang , Sun Huajun
Published: April 2024

The demand for self‐powered sensing technology and energy harvesting system necessitates high‐performance and flexible piezoelectric materials. This paper presents a novel approach utilizing coaxial electrospinning to fabricate all‐organic PVDF/PMMA piezoelectric fiber films with a shell–core structure. The resulting fiber films, cut into 2 × 2 cm2 square pieces and hot‐pressed every three pieces, demonstrate enhanced piezoelectric properties while retaining high flexibility. The interaction between the CO bonds in the PMMA polymer and the CH2 in PVDF promotes the arrangement of F atoms in PVDF, enhancing the content of the piezoelectric active phase. Additionally, the coaxial electrospinning process fosters vertically oriented hydrogen bonds between PVDF and PMMA, augmenting cross‐linking and improving mechanical properties. Notably, when the PVDF to PMMA layer volume ratio is 5:1, the piezoelectric coefficient (|d33|) of the composite fiber film exhibits a significant 60% increase from 10 pC N−1 in neat PVDF to 16 pC N−1. This research holds substantial promise for applications in self‐powered sensing and energy harvesting piezoelectric materials.
Isalo scorpion cytotoxic peptide‐strengthened immune function through the JAKs/STATs signaling pathway of the immune organ of grass carp (Ctenopharyngodon idella) challenged with Aeromonas hydrophila
Authors: He Yuanlin , Hu Qiyu , Zhou Xiaoqiu , Wu Pei , Jiang Weidan , Liu Yang , Jin Xiaowan , Ren Hongmei , Feng Lin
Published: April 2024

To investigate the impact of Isalo scorpion cytotoxic peptide (IsCT) on the immune function of immune organ (head kidney, spleen, and skin) of grass carp (Ctenopharyngodon idella), 540 fish (136.88 ± 0.72 g) were supplied with a different amount of IsCT (0, 0.6, 1.2, 1.8, 2.4, and 3.0 mg/kg diet) through a period of 60 days. Afterward, 24 fish were randomly selected from each group and were inoculated with Aeromonas hydrophila for a period of 6 days. Our findings suggested that appropriate IsCT complementation: (1) attenuated skin morbidity and histopathological structural changes in the head kidney and spleen (p < 0.05), which ensured the structural integrity of the immune organs; (2) increased the activity and expression of immune substances (p < 0.05), which in turn increased the function of the immune organs, promoting immune responses; (3) through the regulation of the Janus kinase/signal transducers and activators of transcription (JAKs/STATs) signaling pathway, the mRNA expression of anti‐inflammatory cytokines increased and the mRNA expression of pro‐inflammatory cytokines decreased, which in turn increased the function of the immune organs, reducing the inflammatory response (p < 0.05). However, the addition of IsCT did not affect the expression of IL‐12p35, STAT2, and STAT3a in the immune organ. Ultimately, this study provided evidence that IsCT enhanced immune function via the JAKs/STATs signaling pathway in the immune organ in grass carp after challenged with Aeromonas hydrophila.
High‐Density and Freestanding Porous Carbon Film for Compact Sodium‐Ion Storage
Authors: Lin Xiaomin , Zhang Weicai , Chen Jiaao , Lu Jiacong , Zheng Mingtao , Liu Yingliang , Liang Yeru
Published: April 2024

Porous carbon materials are often difficult to achieve high density while possessing high porosity, which limits their application in compact energy storage. Here, a design of freestanding porous‐yet‐dense carbon films with a tunable density (1.08–1.33 g cm−3) and porosity (specific surface area of 0–423.8 m2 g−1) is presented through an assembly of porous carbon nanosheet with graphene oxide under vacuum filtration. The typical freestanding carbon films simultaneously deliver a high density of 1.08 g cm−3 and a high specific surface area of 423.8 m2 g−1 when the porous carbon nanosheet content is 75 wt.%. As anode materials for sodium‐ion batteries, the optimized freestanding carbon films deliver high volumetric capacity (270 mAh cm−3 at 20 mA g−1), high initial capacity efficiency (81 %) and superior long‐term cycling stability (1300 cycles with a capacity decay rate of 0.012 % per cycle). This study provides a promising direction for creating freestanding electrodes that meet both high‐porosity and high‐density requirements for compact sodium‐ion batteries.