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Aims: To assess the effectiveness of an unsupervised home‐based pulmonary rehabilitation with self‐management program in patients with chronic obstructive pulmonary disease (COPD). Background: A few recent studies have shown that unsupervised home‐based pulmonary rehabilitation can improve the clinical outcome of patients with COPD. More studies are needed to prove its benefits. Design: This study used a quasi‐experimental design. Methods: Seventy‐two admitted COPD patients were assigned to experimental group or control group through purposeful sampling. Data were collected from March 2016 to November 2017 in the Thoracic Intensive Care Unit of a Medical Center in Taiwan. The Medical Research Council dyspnea scale, the COPD Self‐Efficacy Scale and the Clinical COPD Questionnaire were measured before education and at the first, second and third months after discharge. Results: The Medical Research Council dyspnea scale and COPD Self‐Efficacy Scale results in the experimental group were significantly improved compared with the control group in the third month after discharge. The Clinical COPD Questionnaire score continued to improve in both groups in the third month after discharge, and there was no difference between the two groups. Conclusion: A short‐term unsupervised home‐based pulmonary rehabilitation with self‐ management program had significant benefits for patients with COPD. The long‐term effects need to be confirmed. Summary statement: What is already known about this topic? The literature emphasizes the importance of alternative supervision of home‐based pulmonary rehabilitation rather than center‐based pulmonary rehabilitation for patients who find this inconvenient to access.Few studies have shown that unsupervised home‐based pulmonary rehabilitation can improve the clinical outcome of patients with chronic obstructive pulmonary disease (COPD). What this paper adds? This study demonstrates that a short‐term unsupervised home‐based pulmonary rehabilitation with self‐management program can improve dyspnea during physical activity, self‐care efficacy in certain activities and quality of life after discharge in patients with COPD. The implications of this paper: The findings of this study can be used as the basis for providing a short‐term unsupervised home‐based pulmonary rehabilitation with self‐management program for patients with COPD after discharge.We recommend that patients with COPD undergo unsupervised home‐based pulmonary rehabilitation with self‐management for 3 months after discharge, especially if regular hospital visits for this are not convenient.The effect of longer‐term unsupervised home‐based pulmonary rehabilitation can be further studied in the future. [ABSTRACT FROM AUTHOR]

Background: Endoscopic sinus surgery (ESS) and septoplasty are commonly performed procedures without standardized postoperative pain regimens. There is reluctance to prescribe opioids for postoperative pain given their potential for abuse. Nonsteroidal anti‐inflammatory drugs (NSAIDs) have been demonstrated to reduce or even obviate the need for opioid pain medications after otolaryngologic surgeries, but prospective validation is lacking. Methods: A randomized, controlled study comparing the efficacy of diclofenac sodium to hydrocodone/acetaminophen (APAP) after ESS with or without septoplasty was performed. Participants were given a 100‐mm visual analog pain scale (VAS) at postoperative days (PODs) 1, 2, 3, and 5 after ESS. Two‐sample t tests were used to compare pain scores between groups. Results: One hundred patients enrolled, and 74 patients provided pain scores to the survey. Pain was greatest for both groups on POD 1. Treatment with diclofenac sodium vs hydrocodone/APAP did not statistically impact pain scores at PODs 1, 2, 3, or 5. No cases of epistaxis requiring an emergency room visit or return to the operating room were noted during the study period. Conclusion: Diclofenac sodium may be non‐inferior to hydrocodone/APAP in treating pain after ESS with or without septoplasty in opioid naive patients without pre‐existing pain conditions. Further studies with larger samples are warranted to investigate the potential superiority of diclofenac to hydrocodone/APAP in certain patients after ESS and septoplasty. [ABSTRACT FROM AUTHOR]

Human dental pulp stem/stromal cells (hDPSCs) derived from the permanent secondary dentition are recognised to possess certain advantageous traits, which support their potential use as a viable source of mesenchymal stem/stromal cells (MSCs) for regenerative medicine-based applications. However, the well-established heterogeneous nature of hDPSC subpopulations, coupled with their limited numbers within dental pulp tissues, has impeded our understanding of hDPSC biology and the translation of sufficient quantities of these cells from laboratory research, through successful therapy development and clinical applications. This article reviews our current understanding of hDPSC biology and the evidence underpinning the molecular basis of their heterogeneity, which may be exploited to distinguish individual subpopulations with specific or superior characteristics for regenerative medicine applications. Pertinent unanswered questions which still remain, regarding the developmental origins, hierarchical organisation, and stem cell niche locations of hDPSC subpopulations and their roles in hDPSC heterogeneity and functions, will further be explored. Ultimately, a greater understanding of how key features, such as specific cell surface, senescence and other relevant genes, and protein and metabolic markers, delineate between hDPSC subpopulations with contrasting stemness, proliferative, multipotency, immunomodulatory, anti-inflammatory, and other relevant properties is required. Such knowledge advancements will undoubtedly lead to the development of novel screening, isolation, and purification strategies, permitting the routine and effective identification, enrichment, and expansion of more desirable hDPSC subpopulations for regenerative medicine-based applications. Furthermore, such innovative measures could lead to improved cell expansion, manufacture, and banking procedures, thereby supporting the translational development of hDPSC-based therapies in the future. [ABSTRACT FROM AUTHOR]

Ynones are efficiently reduced with a mild hydride donor in the presence of a catalytic amount of nucleophilic phosphines. The reactions are selective 1,2-reductions that give propargyl alcohols in yields of up to 96%. It is proposed that success in these reactions depends on the activation of ynones by a Lewis base catalyst. A protic additive plays a key role in suppressing the undesired reaction pathways and accelerating the 1,2-reductions. [ABSTRACT FROM AUTHOR]

Using the daily electric power load and meteorological data over the period from January 2006 to September 2010 in Beijing, the general features of the electric power load and the main factors affecting this load have been analysed. The results indicate that winter and summer are the two peak power consumption seasons in each year. This finding could be mainly attributed to the consumption of energy for urban residential cooling or heating. In the summer, the daily minimum temperature was most closely correlated with the maximum power load (correlation co-efficient of 0.65, significant at the 0.1% level); the primary effect of temperature on the maximum power load varied largely from 376 to 858 MW °C −1, and it increased sharply when the daily minimum temperature was higher than 24 °C or the daily maximum temperature was higher than 32 °C. In the winter, the daily maximum temperature was most closely correlated with the power load (−0.45, 0.1% significance), and the primary effect varied from 109 to 391 MW °C −1. However, the relationship between the power load and the temperature was more complicated in the winter: this relationship varied during the central heating period and its pre- and post-periods. Moreover, the temperature humidity index (THI) could explain more of the variance in the daily maximum power load than any single temperature factor in the summer, while the wind-chill temperature index (WCT) did not contribute to this variance in the winter. Finally, due to the rapid urbanization of Beijing, the power load and the priamry effect increased each year. Copyright © 2012 Royal Meteorological Society [ABSTRACT FROM AUTHOR]

Endoscopic approaches have become the preferred method of repairing anterior skull base cerebrospinal fluid (CSF) leaks. METHODS A retrospective review of all patients who underwent endoscopic repair of anterior skull base CSF rhinorrhea during July 1, 2008, through July 31, 2020, was performed. [Extracted from the article]

Convolutional neural networks (CNNs) have demonstrated expert-level performance in cutaneous tumour classification using clinical images, but most previous studies have focused on dermatologist-versus-CNN comparisons rather than their combination. The objective of our study was to evaluate the potential impact of CNN assistance on dermatologists for clinical image interpretation. A multi-class CNN was trained and validated using a dataset of 25,773 clinical images comprising 10 categories of cutaneous tumours. The CNN's performance was tested on an independent dataset of 2107 images. A total of 400 images (40 per category) were randomly selected from the test dataset. A fully crossed, self-control, multi-reader multi-case (MRMC) study was conducted to compare the performance of 18 board-certified dermatologists (experience: 13/18 ≤ 10 years; 5/18＞10 years) in interpreting the 400 clinical images with or without CNN assistance. The CNN achieved an overall accuracy of 78.45% and kappa of 0.73 in the classification of 10 types of cutaneous tumours on 2107 images. CNN-assisted dermatologists achieved a higher accuracy (76.60% vs. 62.78%, P < 0.001) and kappa (0.74 vs. 0.59, P < 0.001) than unassisted dermatologists in interpreting the 400 clinical images. Dermatologists with less experience benefited more from CNN assistance. At the binary classification level (malignant or benign), the sensitivity (89.56% vs. 83.21%, P < 0.001) and specificity (87.90% vs. 80.92%, P < 0.001) of dermatologists with CNN assistance were also significantly improved than those without. CNN assistance improved dermatologist accuracy in interpreting cutaneous tumours and could further boost the acceptance of this new technique. • A multi-class CNN was developed using 25,773 clinical images. • An MRMC study was conducted to evaluate performance of CNN-assisted dermatologists. • CNN-assisted dermatologists achieved a higher accuracy and kappa than unassisted. • Dermatologists with less experience benefited more from CNN assistance. [ABSTRACT FROM AUTHOR]

Summary: Elderly patients may be heterogeneous in their abilities to tolerate immunochemotherapy‐associated toxicities. We describe the morbidity of rituximab‐chemotherapy combinations among 205 newly‐diagnosed diffuse large B‐cell lymphoma (DLBCL) patients aged ≥60 years from 3 tertiary hospitals between 2009 and 2016, and explore the utility of retrospectively‐assigned baseline Comprehensive Geriatric Assessment (CGA) in predicting these toxicities. Seventy‐three percent (146/201) experienced grade ≥3 toxicities, 81% (163/201) needed admission, 52% (107/205) had ≥2 unplanned admissions, 82/201 (41%) required dose reductions (DR) subsequent to Cycle 1, 39/166 (23%) had chemotherapy delays and 26/198 (13%) ceased therapy early. CGA was associated with pre‐emptive baseline DR and perhaps because of this, did not predict grade ≥3 toxicities, ≥2 unplanned admissions or subsequent DR. Three‐year overall survival (OS) of CGA‐fit, CGA‐unfit and CGA‐frail patients was 82%, 60% and 53%, respectively. Three‐year progression‐free survival (PFS) of CGA‐fit, CGA‐unfit and CGA‐frail patients was 66%, 58% and 46%, respectively. OS of CGA‐fit patients was not statistically different from CGA‐unfit patients, but was superior to CGA‐frail patients (hazard ratio 2·892, 95% confidence interval 1·275–6·559, P = 0·011). PFS differences were not statistically significant. Baseline DR and early therapy cessation were associated with inferior OS and PFS independent of CGA. Prospective studies are needed to confirm if CGA‐adapted treatment strategies minimize morbidity and improves survival. [ABSTRACT FROM AUTHOR]

The lethal toxicity values (log 1/LD 50 ) of 527 aliphatic and aromatic compounds in oral, intravenous, intramuscular and intraperitoneal routes were used to investigate the relationships of log 1/LD 50 from different exposure routes. Regression analysis shows that the log 1/LD 50 values are well correlated between intravenous and intraperitoneal or intramuscular injections. However, the correlations between oral and intravenous or intraperitoneal routes are relatively poor. Comparison of the average residuals indicates that intravenous injection is the most sensitive exposure route and oral administration is the least sensitive exposure route. This is attributed to the difference in kinetic process of toxicity testing. The toxic effect of a chemical can be similar or significantly different between exposure routes, depending on the absorption rates of chemicals into blood. Inclusion of hydrophobic parameter and fractions of ionic forms can improve the correlations between intravenous and intraperitoneal or oral routes, but not between intraperitoneal and oral routes. This is due to the differences of absorption rate in different exposure environments from different routes. Several factors, such as experimental uncertainty, metabolism and toxic kinetics, can affect the correlations between intravenous and intraperitoneal or oral routes. [ABSTRACT FROM AUTHOR]

Abstract: An artificial superhydrophobic Poly-p-phenylenebenzobisoxazole (PBO) fiber bundles were designed and prepared using chemical surface modification. Water contact angles as high as 166.3° were achieved. The loading capacities and pressure resistances of these PBO fiber bundle boats were characterized. The highest loading weight of our superhydrophobic boats was more than 9.42g, which was attributed to the air film trapped around the PBO boat surfaces. The depth of the water pressure resistance was about 656.4mm. [Copyright &y& Elsevier]

Abstract: A comprehensive analytical model is proposed to provide a relationship between the macroscopic roughness and contact angle, which is used to develop macroscopic rough surface and to create biomimetic superhydrophobic surfaces. Using chemical surface modification of steel wires, an artificial hydrophobic surface was prepared. A steel mesh mimicking the Asparagus setaceus leaf was created by lowing the surface energy and enhancing macroscopic surface roughness. Water contact angles as high as 129.0° were achieved on the steel mesh with 200μm×200μm pore size. Bad agreement between the predictions based on the original Cassie–Baxter model and experiments was obtained. The version of the Cassie–Baxter model in current use could not be applied to this problem since the roughness magnitude changes from nano/microscopic to macroscopic. A new model, called macroscopic Cassie–Baxter (MCB) model, is constructed by the introduction of contact area density (δ) to original Cassie–Baxter model. It is shown that the measured data is in good agreement with the predicted data based on the MCB model. This model not only for solving macroscopic hydrophobic problems of meshes, but also can be used to solve that of other materials with macroscopic roughness. [ABSTRACT FROM AUTHOR]