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Hyperammonemia due to Ureaplasma infection is rare but often fatal, largely due to the delayed recognition, diagnosis, and treatment of the condition. It has mostly been described in solid organ transplant patients in the literature. This case presents the diagnostic challenge of an immunocompromised patient with previous resected pancreatic head adenocarcinoma and chemotherapy, presenting with altered mental status due to hyperammonemia from Ureaplasma infection. It is imperative to consider this condition in unexplained hyperammonemia, especially in immunocompromised patients. Timely diagnosis of this condition can help to reduce complications from encephalopathy such as cerebral edema and seizures.

This study aimed at investigating the surface morphology and nanotopography of normal enamel (NE) and developmentally hypomineralised enamel (HE) when subjected to various pretreatment protocols under scanning electron microscopy (SEM) and atomic force microscopy (AFM). Sixteen NE, 16 creamy/white (CW) HE and 16 yellow/brown (YB) HE specimens sectioned from extracted hypomineralised first permanent molars (FPMs) were included in this study. They were randomly distributed into 12 experimental groups (n = 4). Each group involved the following: (1) deproteinisation with Papacarie Duo® gel or no deproteinisation, and (2) the use of Scotchbond™ Universal Adhesive (Scotchbond) in self-etch (SE) mode or 37% phosphoric acid etchant. Subsequently, the surface morphology and nanotopography of pretreated enamel specimens were evaluated under SEM and AFM, respectively. SEM observation showed that deproteinisation with Papacarie Duo® gel before phosphoric acid etching led to favourable etching patterns. This was consistent across all groups irrespective of the type of enamel specimen and the severity of hypomineralisation. In contrast, AFM results identified three factors that influenced surface parameters: (1) type of enamel specimen, (2) severity of hypomineralisation and (3) etching mode. YB HE recorded higher surface roughness values than CW HE and NE when subjected to the same pretreatment protocol. Deproteinisation and the application of Scotchbond in SE mode led to minimal topographic changes; however, acid etching was associated with an increase in surface roughness. Deproteinisation with Papacarie Duo® gel followed by acid etching contributed to improved etching patterns on HE.

Background The rise of nature-based ecotourism in the past decade has introduced unprecedented challenges in managing the increasing interaction between humans and animals. The potential transmission of antibiotic resistant microbes between humans and non-human primate populations is a concern due to their genetic similarity. Malaysia is well known for hotspots of wildlife diversity where non-human primates like monkeys and orangutans have become popular tourist attractions. In this study, we assessed the prevalence of antimicrobial resistant Staphylococcus aureus, Enterococcus species, and other Enterobacteriaceae in the faeces of human (HS) and two non-human primates (NHP) in Malaysia, the Long-tailed macaque (Macaca fascicularis, MF) and Silvered leaf monkey (Trachypithecus cristatus, TC). In addition, the faecal bacterial composition was profiled to evaluate the potential association between antibiotic resistant profiles and composition of gut microbiota. Results We tested the isolated bacteria using a selection of antibiotics. The results showed that both the number of antibiotic resistant strains and resistance level were higher in humans than NHPs. Overall, the composition of gut microbiome and pattern of antibiotic resistance showed that there was higher similarity between MF and TC, the two NHPs, than with HS. In addition, samples with higher levels of antibiotic resistance showed lower bacterial richness. Homo sapiens had the lowest bacterial diversity and yet it had higher abundance of Bacteroides. In contrast, NHPs displayed higher bacterial richness and greater prevalence of Firmicutes such as Ruminococceae and Oscillospira. Conclusion Higher antibiotic susceptibility in NHPs is likely related to low direct exposure to antibiotics. The lack of resistance may also suggest limited antimicrobial resistance transmission between humans and NHP. Nonetheless, continued monitoring over a long period will help mitigate the risk of anthropozoonosis and zooanthroponosis.

This study aimed at investigating the surface morphology and nanotopography of normal enamel (NE) and developmentally hypomineralised enamel (HE) when subjected to various pretreatment protocols under scanning electron microscopy (SEM) and atomic force microscopy (AFM).Sixteen NE, 16 creamy/white (CW) HE and 16 yellow/brown (YB) HE specimens sectioned from extracted hypomineralised first permanent molars (FPMs) were included in this study. They were randomly distributed into 12 experimental groups (n = 4). Each group involved the following: (1) deproteinisation with Papacarie DuoSEM observation showed that deproteinisation with Papacarie DuoDeproteinisation with Papacarie Duo

Although cartilage degeneration and invasion of the subchondral bone plate in entheseal lesion has been considered to consequently lead bony ankylosis in ankylosing spondylitis (AS), no evident mechanisms are known.To identify histopathological and physiological changes in enthesitis-related ankylosis in AS, we performed molecular characterization of transcription factors and surface markers, and transcriptome analysis with human tissues. Entheseal tissue containing subchondral bone was obtained from the facet joints of 9 patients with AS and 10 disease controls, and assessed by using differential staining techniques. Enthesis cells were isolated, characterized, stimulated with TNF and/or IL-17A, and analysed by cell-based experimental tools.We found diffusely distributed granular tissue and cartilage in the subchondral bone in AS. Co-expression of SOX9, a specific transcription factor in cartilage, and matrix metalloproteinase 13 (MMP13) was found in the granular tissues within the subchondral bone from AS patients. Intriguingly, SOX9 expression was significantly higher in AS enthesis cells than controls and correlated with TNFR1 and IL-17RA expressions, which is important for high reactivity to TNF and IL-17A cytokines. Co-stimulation by TNF and IL-17A resulted in accelerated mineralization/calcification features, and increased OCN expression in AS enthesis cells. Furthermore, SOX9 overexpression in enthesis leads to promoting mineralization feature by TNF and IL-17A stimuli. Finally, OCN expression is elevated in the destructive enthesis of advanced AS.These findings provide insight into the links between inflammation and the mineralization of entheseal tissue as the initiation of spinal ankylosis, emphasizing the importance of SOX9

Significant sleep disturbance can occur following major abdominal surgery. We aimed to evaluate the effectiveness of earplugs and eye masks in improving sleep quality and patient satisfaction, reducing nursing demands and in the incidence of delirium in patients after major abdominal surgery. We conducted a randomised controlled trial in 100 patients undergoing major abdominal surgery. We randomly allocated participants to sleep with or without earplugs and eye masks on postoperative days 1-3. The primary outcome measure was sleep quality as measured by the Richards-Campbell Sleep Questionnaire. Secondary outcomes were patient satisfaction, frequency of nursing demand and incidence of delirium measured by the Neelon and Champagne Confusion Scale. Median (IQR [range]) sleep scores were 64 (38-74 [0-100] and 60 (44-82 [18-100]) for the control and intervention groups, respectively (p = 0.310). Age and Pittsburgh Sleep Quality Index scores were found to be significant factors affecting sleep quality. There were no differences in patient satisfaction, reduction in frequency of nursing demands or incidence of delirium on postoperative days 1-3 after major abdominal surgery. The compliance rate in the intervention group was 60-65%. This study has demonstrated that the use of earplugs and eye masks did not contribute to improvements in sleep quality. Of note, sleep quality was moderate, with higher age and worse baseline sleep quality contributing to worse sleep scores. More studies are needed to investigate interventions to improve sleep quality after major abdominal surgery.

Human adenovirus (HAdV) is one of the common pathogens that are responsible for a wide variety of infectious diseases. There are about 54 different adenovirus serotypes that are responsible for respiratory infections in humans. The prevalence of lower respiratory tract infection (LRTI) - associated with HAdV varies throughout different regions. The prevalence of HAdV in Malaysia is rarely investigated and reported despite severity of infection worldwide. This study was undertaken to identify the HAdV types associated with lower respiratory tract infection (LRTI) in Hospital Sungai Buloh, Malaysia between April 2013 until January 2014, a total of 210 specimens were collected from patients hospitalized with LRTI. Human adenovirus was detected using polymerase chain reaction (PCR). The positive products were sequenced and phylogenetic analysis of the virus was performed. Eighteen of 210 specimens (8.57%) were positive with HAdV infection. Based on the phylogenetic analysis study, HAdV-7 strains were the most common serotype with 11 cases, followed by HAdV-1, HAdV-2 and HAdV-4 with 2 cases each and one case of HAdV-5. The HAdV strains in this study were closely related to strains in Singapore and India. In this study, HAdV infection from LRTI patients in Hospital Sungai Buloh Malaysia were caused by different types of adenovirus mainly HAdV-7. This study will become a reference for further epidemiological study in this country.

Decades of coastal urbanisation have replaced many natural shorelines with seawalls. Marine communities have been documented on these replacement habitats, but little is known about the effects of seawall inclination on the diversity and depth distribution of sessile organisms on this artificial substrate. Surveys of hard coral and other sessile communities in Singapore indicated that benthic communities at the deeper zone (− 2 m chart datum) were significantly different between three sloping (about 33° inclination) and three vertical seawalls of similar age. Hard coral communities were significantly different between sloping and vertical seawalls and between 0 m chart datum and − 2 m chart datum. Hard coral communities on sloping seawalls were also significantly more diverse than on vertical seawalls. At both depths, sloping seawalls were dominated by abiota with hard coral comprising appr. 17% of the total surface, while vertical seawalls were dominated by algal assemblage with hard coral comprising appr. 10% of the total surface. Overall, the results showed that sloping seawalls were significantly better at supporting coral communities, likely due to less intensive habitat compression and buffered wave action on them, especially at 0 m chart datum. The need to understand how surface topography affects benthic and coral communities in light of growing coastal urbanisation is also highlighted. This study emphasises how sloping seawalls can support greater marine biodiversity than vertical seawalls.

Embryonic diapause is a maternally controlled phenomenon. The molecule controlling the onset of the phenomenon is unknown. We demonstrated that overexpression of microRNA let-7a or incubation with let-7g-enriched extracellular vesicles from endometrial epithelial cells prolonged the in vitro survival of mouse blastocysts, which developed into live pups after having been transferred to foster mothers. Similar to in vivo dormant blastocysts, let-7-induced dormant blastocysts exhibited low level of proliferation, apoptosis, and nutrient metabolism. Let-7 suppressed c-myc/mTORC1 and mTORC2 signaling to induce embryonic diapause. It also inhibited ODC1 expression reducing biosynthesis of polyamines, which are known to reactivate dormant embryos. Furthermore, the overexpression of let-7 blocked trophoblast differentiation and implantation potential of human embryo surrogates, and prolonged survival of human blastocysts in vitro, supporting the idea that embryonic diapause was an evolutionary conserved phenomenon. In conclusion, let-7 is the main factor inducing embryonic diapause.

Concrete is widely used in the industry due to its effectiveness in terms of cost and strength. In this study, the introduction of bio-based aggregate as coarse aggregate in lightweight foam concrete will be investigated to find a better solution for fire incidents that are commonly happened. As such, lightweight foam concrete (LWFC) has been applied in many buildings especially in non-load bearing wall to enhance thermal conductivity, sound insulation and fire resistance. The aim of this research is to investigate the effect of incorporating bio-based aggregate namely oil palm shell (OPS) into lightweight form concrete in terms of strength properties and fire resistance. Three different concrete mix was designed containing different percentage of OPS aggregate replacement (0, 5, 10 and 15%). From the result, the compressive strength of the LWFC-CTR mixture had achieved the highest compressive strength at 28-day, which is recorded at 3.82 MPa. The fire resistance of LWFC-OPS 15% had showed a positive outcome with improvement by almost 23.5% compared to control mix at 15 minutes. Therefore, the major finding of this research is the incorporation of eco-friendly OPS aggregate has improved the fire resistance of lightweight foam concrete, which can be used as an alternative solution for non-load bearing walls.

Due to the ever-increasing population and the price of houses, humans in the future may not have the opportunity to own their own land to build houses. With the change of living patterns, small-house families will become more and more popular, even mobile homes. This research uses market analysis, specification analysis, and according to the project design process, uses brainstorming and KJ method to find out design strategies and execute design projects. This research uses an expert industrial design process to design a residential space design suitable for 2040 and conforms to the following design principles: 1. For tomorrow House design will be aesthetic, smart, modern, and simple. 2. For tomorrow houses should have appropriate dimensions design and have moveable functions. 3. For tomorrow houses should include functions, space-saving and high-tech design. 4. For tomorrow house design should be able to accommodate 2-4 people. 5. In order to be multifunctional, the complexity of furniture design will increase. The expert industrial design process, analysis, and design methods described in this study will provide designers with a better grasp of the principles of future residential design, home furniture, and other related product design.

The effect of biologic disease modifying anti-rheumatic drugs (bDMARDs) in treating rheumatoid arthritis (RA) in real-world clinical practice remains unknown in Southeast Asia. We aimed to assess the efficacy and safety of bDMARDs among Malaysian RA patients treated in routine clinical practice. A retrospective medical chart review of RA patients from 11 government hospitals were conducted from January 2003 to January 2014. A standardized questionnaire was used to abstract patient’s demographic, clinical and treatment data. Level of disease activity was measured by DAS28 collected at baseline, 3, 6 and 12 months. Three hundred and one patients were available for analysis, mean age 41 (SD, 10.8) years, mean RA duration 12.3 (SD, 6.9) years and 98% had history of two or more conventional-synthetic DMARDs. There were 467 bDMARD courses prescribed with mean bDMARDs duration use of 12.9 months (SD 14.7). Tumour necrosis factor alpha inhibitors were the most common prescribed bDMARDs (77.1%), followed by Tocilizumab (14.6%) and Rituximab (8.4%). We observed significant improvement in mean DAS28 values from baseline to 3, 6 and 12 months (p

The big data era demands new statistical analysis paradigms, since traditional methods often break down when datasets are too large to fit on a single desktop computer. Divide and Recombine (DR as opposed to the standard approach, which we refer to as horizontal D&R. We demonstrate the concept via an extended Gamma–Poisson model, where summary statistics are extracted from different databases and incorporated directly into the fitting algorithm without having to combine unit record data. By exploiting the natural hierarchy of data, our approa...

To evaluate the achievement of treat-to-target (T2T) strategy in rheumatoid arthritis (RA) and identify factors associated with failed treatment target in a public rheumatology center. A cross-sectional study was conducted from June 2015 to February 2016. RA patients with disease duration greater than 2 years and under T2T for over a year were invited to the study. Demographic, clinical data, disease activity score of 28 joints (DAS28), and clinical disease activity index (CDAI) were collected in a single routine clinic visit. Treatment target was defined as DAS28

Summary This article concerns a class of generalized linear mixed models for two-level grouped data, where the random effects are uniquely indexed by groups and are independent. We derive necessary and sufficient conditions for the marginal likelihood to be expressed in explicit form. These models are unified under the conjugate generalized linear mixed models framework, where conjugate refers to the fact that the marginal likelihood can be expressed in closed form, rather than implying inference via the Bayesian paradigm. The proposed framework allows simultaneous conjugacy for Gaussian, Poisson and gamma responses, and thus can accommodate both unit- and group-level covariates. Only group-level covariates can be incorporated for the binomial distribution. In a simulation of Poisson data, our framework outperformed its competitors in terms of computational time, and was competitive in terms of robustness against misspecification of the random effects distributions.

Episodes with high concentrations of particulate matter (PM) across the seasons were investigated during four 1-month campaigns at a suburban site in Hong Kong. High-resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS) measurements revealed that both regional transport and secondary formation contributed to high PM levels during the episodes at this site. Based on distinct meteorological conditions, episodes were categorized into three types: liquid water content (LWC), solar irradiance (IR), and long-range transport (LRT). Despite the difference in meteorological conditions, all episodes were characterized by a high fraction of sulfate (45–56 %) and organics (23–34 %). However, aerosols in LWC episodes were less aged, consisting of the lowest fraction of secondary organic aerosol (SOA) and the highest fraction of small particles. Large particles mixed internally while freshly formed small particles mixed externally in LWC episodes. Aerosols in LRT episodes, by contrast, were the most aged and consisted of the highest proportion of low-volatility oxygenated organic aerosol (LVOOA) and the lowest proportion of small particles. Both small and large particles mixed externally in LRT episodes. The highest proportion of semi-volatile oxygenated organic aerosol (SVOOA) and a medium proportion of small particles were observed in IR episodes. Both small and large particles were likely externally mixed during IR episodes. Furthermore, aerosols experienced the most dramatic size increase and diurnal variation, with a time lag between SVOOA and LVOOA and a gradual increase in carbon oxidation state (OSc ≈ 2 × O : C − H : C). Five out of 10 episodes were of the IR type, further reflecting the importance of this type of episode. The evolution of aerosol components in one particular episode of the IR type, which exhibited a clear land–sea breeze pattern, was examined in detail. Sulfate and SOA due to photochemical aging were very efficiently produced during the course of 6 h. The “less-oxidized” SOA (SVOOA) was initially formed at a higher rate than the “more-oxidized” SOA (LVOOA). The SVOOA transformed to LVOOA at the later stage of photochemical aging. This transformation was further supported by mass spectral analysis, which showed an increase in the most oxidized ion (CO2+) and decreases in moderately oxidized ones (C2H3O+, C3H3O+ and C3H5O+). By measuring the physical and chemical properties of PM in a highly time-resolved manner, the current study was able to demonstrate the dynamic and complex nature of PM transformation during high-PM episodes.

Gender as an independent predictor in stroke has been well documented. However, data on gender differences among first-ever ischemic stroke in developing country are limited. We aim to describe gender effects on clinical characteristics, thrombolysis treatment received, and outcomes of patients with first-ever ischemic stroke.Data were extracted from the prospective multiethnic stroke registry, National Neurology Registry (NNEUR). Descriptive analysis and logistic regression were performed.A total of 4762 first-ever ischemic stroke patients admitted to 13 government hospitals from July 2009 to June 2015 were available for this study. Slightly over half were male (55.1%), and they were 1.7 years younger than female (mean age, 63.6 versus 61.9 years, p 0.001). Gender-age-adjusted incidence was observed to be higher in females (66.7 per 100,000) compared to males (57.4 per 100,000). First-ever ischemic stroke incidence increased by 24.3 and 11.2% among female and male annually. Female experienced significantly poorer functional outcome and greater 30-day in-hospital mortality compared to male. In subgroup analysis, only 31 (0.65%) patients were treated with thrombolysis.First-ever ischemic stroke incidence increased by 24.3 and 11.2% among female and male annually. There were distinct symptoms at hospital presentation between genders. All our patients discharged home regardless of genders. In summary, Malaysian female first-ever ischemic stroke was older, present with severe stroke, greater number of risk factors and poorer functional outcome and 30-day in-hospital mortality compared to male.

Extraordinary acoustic transmission (EAT) through cascaded both-sides-open disk resonators (BSODRs) in a square lattice array (SLA) is investigated. A single BSODR consists of one disk cavity that is sandwiched by two tubes. These structures are realized by stacking perforated steel plates and immersing them in water. EAT is studied through single-layer, two-layer, three-layer, and four-layer BSODRs in SLAs. The EAT orders increase with increasing numbers of cascading layers. The quality factors of the highest order EAT peaks also increase with increasing numbers of cascading layers. The EAT characteristics of each structure can be predicted using a spring–mass model. A coupled spring–mass model with two oscillators is proposed. The vibration of the steel part is considered one oscillator and that of the water part of the BSODR represents the other oscillator. The model verifies that the EAT resonances are excited by coupling of the vibration from the steel plates to the water part. The experimental transmission spectra agree with the numerically simulated spectra. The EAT frequency is sensitive to the longitudinal sound velocity. Because of the increased quality factor, the figure of merit is enhanced eight times by cascading four BSODR layers. The proposed structure is suitable for acoustic filter and sensor applications.

Concrete is a brittle material and respectively weak in tensile strength and tensile strain. Concrete technology is applied at which concrete is reinforced with steel fibre, as known as steel fibre reinforced concrete (SFRC) to produce a versatile structural material to exhibit superior strength properties in terms of ductility, fracture energy, toughness, strength and durability. The introduction of short, discontinuous and randomly oriented steel fibres into conventional concrete mixes possesses a strong bond with the concrete matrix with high elastic modulus. The goal of this study is to create a standard foresight in determining the potentiality of steel fibre as secondary shear reinforcement to partially or fully replace shear stirrups in conventional concrete. For this purpose, the series of SFRC beam specimens without stirrups which have the same concrete mixing ratios were produced with the inclusion of 0.6 % and 0.7 % steel fibre by volume fractions and compared with conventional normal weight reinforced concrete (NWRC) beam with stirrups. After the beam specimens had attained the target concrete characteristic strength of C25/30, four-point bending test was conducted to investigate the shear behaviour of reinforced concrete beams. The structural performance of shear beams was evaluated in the response of load-deflection, load-steel strain, crack patterns and failure modes. Test results indicated that with incorporation of steel fibres, the compressive strength and splitting tensile strength were improved, ultimate shear strength was improved up to 36 % at addition of 0.7 % steel fibre content, but water absorption was reduced. Besides, NWRC beam with stirrup increased 43 % in ultimate shear strength which possessed better performance in ductility.

Porphine is the simplest form of porphyrin, made up from four pyrrolic compounds, connected by methyne bridges. All porphyrin and its derivatives do have colours. Reduced form of porphyrins has dark or blue colour whilst uncharged porphyrins are red in colour. Porphyrins and its derivatives can be synthetically synthesized as well as naturally found in nature. The present of substituents and substituents arrangement directly influence the light absorbance and redox activities. Thereby, porphyrins are frequently used in optoelectronics and photovoltaics applications. This paper reviews the available methods to synthesis meso-substituted porphyrins. Three conditions of porphyrins immobilisation through chain-growth polymerisation, namely electrochemical polymerization, molecular self-assembly and stepwise-surface modification are highlighted and discussed. From the discussions, electrochemical polymerisation is suggested as the potential method for future project. It is expected that the light absorption re...

It is essential to optimize HVAC (Heating, Ventilation and Air-Conditioning) system for a thermal plant or an electric vehicle since it has a significant effect on the thermal efficiency. PTC (positive temperature coefficient) heaters are often used for a heating system and the power module of the PTC heaters, IGBT (insulated gate bipolar mode transistor), requires thermal management. In this study, in order to maximize the cooling performance for IGBT, a novel method that uses forced convection inside the HVAC duct with heat sinks was developed. In addition, heat sinks were optimized in terms of IGBT junction temperature and heat sink weight by 3-dimensional CFD (Computational Fluid Dynamics) simulation. The results show that the junction temperature of IGBT for 5.6kW PTC heater can be maintained at about 335K.

Background: Stroke remains a major health burden worldwide. The incidence and prevalence rates of stroke are decreasing in developed countries, an opposite trend is taking place in the Asia Pacific, where an increasing number of patients are being diagnosed with acute stroke. The results of the present study on acute stroke in multi-ethnic Malaysia will significantly contribute to the global stroke epidemiological data. We aimed to present epidemiological data of stroke including incidence and prevalence rates as well as associated risk factors from a prospective nationwide hospital-based registry from 2010 to 2014. Methods: Patients diagnosed with stroke upon admission at the hospital were prospectively enrolled into the registry from January 1, 2010, to December 31, 2014. Descriptive analyses were performed. Results: A total of 7668 patients were available for analysis. On average, patients were aged 62.7 years (standard deviation of 12.5). Ischemic stroke accounts for 79.4% of the cohort with a slightly higher proportion of male patients (55%). Ischemic stroke incidence is estimated to increase annually by 29.5% and hemorrhagic stroke by 18.7%. Hypertension is a major risk factor for both ischemic and hemorrhagic strokes regardless of stroke event with an excess of 8.4% hypertensive female compare to male patients ( P ≤ .001). Majority of patients with ischemic and hemorrhagic strokes experienced mild and moderate stroke with 11.7% and 21.1%, respectively, documented as severe ( P ≤ .001). Conclusions: The incidence and prevalence of stroke in Malaysia increased dramatically in the 5-year study period. Therefore, implementation of risk factor control strategies is important to prevent further increase of stroke burden in the country.

Micro-grid system is an integrated energy system as it consists of distributed energy resources (DERs) and multiple electrical loads operating in parallel or islanded grid. The primary objective of this project is to examine whether Micro-grid implementation can reduce the cost of energy. It can be determined through the modelling bus bar system; 26-Bus Test System. This application can be divided into three aspects which are modelling, simulation and analysis. The power system analysis was conducted under two conditions, steady state condition and contingencies condition using two different methods which are optimal power flow and economic dispatch. Newton-Raphson algorithm was introduced during the power flow analysis. The optimal power flow and economic dispatch for total generation cost was obtained through PowerWorld software simulation.

Biodegradable polycarbonate-based ABA triblock copolyelectrolytes were synthesized and formulated into physically cross-linked hydrogels. These biocompatible, cationically, and anionically charged hydrogel materials exhibited pronounced shear-thinning behavior, making them useful for a variety of biomedical applications. For example, we investigated the antimicrobial activity of positively charged thiouronium functionalized hydrogels by microbial growth inhibition assays against several clinically relevant Gram-negative and Gram-positive bacteria. It is noteworthy that these hydrogels exhibited broad spectrum killing efficiencies approaching 100%, thereby rendering these thixotropic materials attractive for treatment of skin and other surface bound infections. Finally, cationic trimethylammonium containing hydrogels and anionic carboxylic acid functionalized hydrogels were utilized to sustain the release of negatively charged (diclofenac) and positively charged (vancomycin) therapeutics, respectively. Collectively, the present work introduces a simple method for formulating charged hydrogel materials that are capable of interacting with various analytes of interest through noncovalent interactions.

Earthquakes are a hazard in Taiwan and elsewhere. In 1946, for example, a Richter scale 6.1 earthquake caused 556 causalities and damaged more than 4,000 buildings in Sin-hua, Tainan City, Taiwan. This study inves tigates the aspects of resident preferences with respect to earthquake shelters. A questionnaire survey was designed to reflect the viewpoints of respondents in the context of earthquakes, including: (1) factors affecting evacuation behavior, (2) historical street district damage prevention and (3) analysis of evacuation choices. A logistic model for evacuation behavior in major earthquakes is presented, and its significant variables discussed in the context of future urban disaster planning. Keywords Evacuation behavior, logistic regression model, shelter. Language: en

Our aim was to explore the effects of functional groups at carbon-2 (C2) of a sugar on the conformational properties of the peptide backbone. Three monosaccharides, mannose, galactose, and N-acetylgalactosamine (GalNAc), were added separately to the serine side-chain of a hamster prion peptide because it is a sensitive model for comparing the effect of protein modification on the conformational properties of the polypeptide chain. In buffer, this prion peptide goes through a gradual coil-to-β structural conversion and forms amyloid fibrils slowly during incubation. Our results showed that a sugar with an N-acetyl amino group in the equatorial configuration (GalNAc) or with a hydroxyl group in the axial configuration (mannose) on C2 had a greater inhibitory effect on the amyloidogenesis of the prion peptide than a sugar with the hydroxyl group in the equatorial configuration (galactose). We suggest that galactosylation has less effect than mannosylation or GalNAc glycosylation on promoting turn formation at the glycosylation site and on inhibition of amyloidogenesis. The anti-amyloidogenic property of mannose implies that protein mannosylation has an anti-aggregation function.

The aim of this study is to apply the zero thickness element approach to investigate the upper bound value of limit analysis with the different failure mechanism of a shallow tunnel excavation in soft clay. This interface is modelled as a contact element with zero thickness and with the Coulomb's friction behaviour. The procedure of numerical analysis adopted the zero thickness element particularly developed and installed into the finite element program in the laboratory. A series of finite element analysis is used to investigate the solutions of stability and simulate the soil progressive failure mechanism due to a shallow tunnel excavation. Four geometry of failure mechanism are taken into account the effects of overburden depth and critical collapse ratio. According to the results obtained, the upper bound values between the limit equilibrium analysis and the numerical calculation are theoretically coincidence, and also the progressive failure mechanism of cohesive soil can be practically predicted. The numerical analyses show that the predicted stability ratio is in reasonable agreement with the analytical solutions in the limit analysis.

BACKGROUND Allogeneic bone marrow transplantation is under investigation for a range of nonmalignant indications, including tolerance induction through mixed chimerism. This strategy has so far been tested experimentally only in young recipients. Due to immunosenescence, older patients have an increase in memory T cells (TMEM) as well as other alterations to their immune system, which may influence the potential to induce tolerance. We therefore investigated the impact of immunosenescence on chimerism-based tolerance induction. METHODS Groups of young (2 months) and old (12 months) C57BL/6 recipients received BALB/c bone marrow under nonmyeloablative (3 Gy) and minimal (1 Gy) total body irradiation and treatment with costimulation blockade, T-cell depletion, or rapamycin. Multilineage chimerism, clonal deletion, and lymphocyte subsets were analyzed by flow cytometry. Tolerance was assessed by skin and heart grafts and enzyme-linked immunospot, intracellular cytokine, and mixed lymphocyte reaction assays. RESULTS Unexpectedly, chimerism and tolerance were established in old recipients with comparable-and in some cases increased-efficacy as in young recipients employing costimulation blockade-based or T-cell depletion-based conditioning with 1 or 3 Gy total body irradiation. TMEM reactivity in (naive) old mice was augmented in response to polyclonal but not to allogeneic stimulation, providing a mechanistic underpinning for the susceptibility to chimerism induction despite increased TMEM frequencies. Tolerance in old recipients was associated with peripheral and central clonal deletion and a higher frequency of regulatory T cells. CONCLUSION Advanced age does not impair bone marrow engraftment, thereby widening the clinical potential of experimental protocols inducing transplantation tolerance through mixed chimerism.

To identify the prevalence and associated factors of psychiatric morbidities and to evaluate the effectiveness of the Hospital Anxiety and Depression Scale (HADS) in screening for psychiatric morbidity in patients with knee osteoarthritis in a local orthopaedic clinic.A cross-sectional study was conducted from October 2013 to June 2014 to examine patients with knee osteoarthritis at a specialist orthopaedic clinic. They were evaluated for psychiatric diagnoses using the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I). Socio-demographic and clinical characteristics were compared between patients with and without psychiatric morbidity. Patients were also assessed using the HADS with accuracy compared with the psychiatric diagnoses made by the SCID-I.Of the 115 patients, 39% had current psychiatric disorders. Logistic regression analysis revealed that limitation of physical activity, perceived absence of confidant, a history of psychiatric illness, and follow-up in orthopaedic clinic for ≥ 5 years were independent factors associated with psychiatric disorders.The prevalence of psychiatric morbidity in patients with knee osteoarthritis was significant. Recognition of independent associated factors can aid in early identification and intervention in patients who are at risk of developing psychiatric morbidity. The HADS is a useful means to screen for psychiatric morbidity in these patients.

The entity 'B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma (BL)' refers to B cell neoplasms that share overlapping characteristics of BL and DLBCL. A subset of these 'grey-zone lymphomas' possesses C-MYC and IGH translocations but, in addition, contains additional rearrangements of BCL2 and/or BCL6 genes. The aim of this study was to investigate if the proliferation fraction by Ki67 immunostaining can be used to identify such double-/triple-hit lymphomas. We studied 492 cases of mature aggressive B cell neoplasms by histology, immunohistochemistry and interphase fluorescence in-situ hybridization (FISH) using break-apart probes against C-MYC, BCL2, BCL6, IGH, MALT1, PAX5 and CCND1. Forty Burkitt lymphomas and 28 cases of MYC(+) double-/triple-hit lymphomas were identified. Of the latter, 77% and 54% displayed proliferation fractions exceeding 75% and 90%, respectively. With a cut-off of >75% by Ki67 immunostaining, the sensitivity and specificity for detection of MYC(+) double/triple translocations was 0.77 and 0.36. Raising the proliferation fraction criterion to >90% improved the specificity to 0.62 at the expense of a low sensitivity of 0.54. Immunostaining for Ki67 is not a useful approach to prescreen B cell lymphomas for MYC(+) double/triple translocations.

IANA exhausted its IPv4 address space in 2011, and IPv6 is the next generation to replace IPv4. However, the IPv6 transition techniques are still immature and holding back the development of the next-generation Internet. Hence, IPv4-IPv6 coexistence is becoming increasingly imminent. During the coexistence period, the Internet will consist of IPv4-only, IPv6-only, and dual-stack segments. Both the network infrastructure and operations must support IPv4-only, IPv6-only, and dual-stack accordingly. This article develops a 4over6 virtualization architecture that virtualizes IPv4-only networks over IPv6-only networks. This architecture enables two IPv4- only segments to communicate over an IPv6-only network by using an IPv4-in-IPv6 tunnel. The architecture can be examined in different areas such as addressing schema, layer 3 routing, and packet forwarding. The 4over6 virtualization architecture is being standardized in IETF. Various implementations and deployment scenarios are actively discussed in the ISP and vendor communities.

Brain death impairs donor organ quality and accelerates immune responses after transplantation. Detailed aspects of immune activation following brain death remain unclear. We have established a mouse model and investigated the immediate consequences of brain death and anesthesia on immune responses.C57JBl/6 mice (n=6/group) were anesthetized with isoflurane (ISF) or ketamine/xylazine (KX); subsequently, animals underwent brain death induction and were followed for 3h under continuous ventilation. Blood pressure was monitored continuously and animals were resuscitated with normal saline to achieve normotension. Immune activation in brain dead animals was analyzed by IFNγ-ELispot, MLR, and flow-cytometry. Sham-operated and naïve animals served as controls.Blood pressure remained stable in both BD/KX and BD/ISF animals during the 3h observation time. Brain death was linked to systemic immune activation: IFNγ-expression of splenocytes and lymphocyte proliferation rates was significantly elevated subsequent to brain death (p0.02,0.01); T-cell activation markers CD28 and CD69 had increased in brain dead animals (p0.03,0.02). Isoflurane treatment in sham controls throughout the observation period (3.5h) revealed anesthesia associated IFNγ-expression and lymphocyte activation which were not observed when animals were treated with ketamine/xylazine (p0.04,0.009).This study reports on a reproducible and hemodynamically stable brain death mouse model. Hemodynamic stability was not impacted through either isoflurane or ketamine/xylazine induction. Of clinical relevance, prolonged anesthesia with isoflurane had been linked to pro-inflammatory cytokine activation. Brain death caused systemic immune activation in organ donors.

International audience; Salmonella genomic island I (variant SGII-J3) has been previously identified in multi-drug resistant (MDR) Salmonella enterica serovar Virchow isolated from humans in 1994. In this study, antimicrobial resistance, genotypes and genetic relationship were investigated in 96 S. Virchow isolates collected from humans in 2004-2006. XbaI-PFGE analysis separated 96 isolates into two main related-clusters, I and II, which consisted of four major pulsotypes differing in prevalence by year. The majority of isolates were MDR to chloramphenicol, sulfonamide, trimethoprim and tetracyclines associated with antimicrobial resistance genes dfrA1, floR2, sull and tet(G) of variant SGII-J3. Among nine variants, we determined two novel variants SGII-J4 and -J5, which have undergone different homologous recombinational events resulting in partial deletions of the MDR region. The first one contained an empty integron structure and the second presented a deletion extending from the IS6100 element to the adjacent SGII backbone. SGII-J3 is largely encountered in clonally related MDR S. Virchow isolates collected from humans which spread vertically. The genomic island SGII appears to be largely responsible for the diversity of MDR phenotypes among S. Virchow isolates in Taiwan.

The risk of acquiring variant Creutzfeldt–Jakob disease is closely related to polymorphism at codon 129 of the human prion gene, because almost all variant Creutzfeldt–Jakob disease patients are Met/Met homozygotes. Although animal transmission experiments corroborated this seeding discrimination, the origin of the differential seeding efficiency of the bovine prion seed for human codon 129 polymorphism remained elusive. Here, we used a short prion protein (PrP) peptide as a model system to test whether seeding discrimination can be found in this simple system. We used a previously developed ‘seed-titration method’ and time-resolved CD spectroscopy to compare sequence-dependent seeding efficiency regarding codon 129 polymorphism. Our results showed that the MetVal substitution on the human PrP (huPrP) peptide decreased seeding efficiency by 10 times when fibrils formed from bovine PrP (bPrP) peptide were used as the seed. To explore whether the different seeding barrier is due to the chemical and structural properties of Met and Val or whether another residue is involved in this peptide model, we constructed three bPrP mutants, V112M, L138I and N143S, in each of which one residue was replaced by the corresponding human residue. Our data showed that Leu138 in the bPrP seed might be the key residue causing the different seeding efficiencies related to 129M/V polymorphism and the interference effect of huPrP129V in the huPrP129M/V mixture. We propose a ‘surface competition hypothesis’ to explain the big seeding barrier caused by 129V in the PrP peptide seeding experiment. Structured digital abstract • huPrP aggregates with bPrP by circular dichroism (View Interaction 1, 2) • bPrP aggregates with bPrP by circular dichroism (View interaction) • bPrP aggregates with bPrP by electron microscopy (View interaction) • bPrP aggregates with bPrP by fluorescence technology (View interaction) • huPrP aggregates with huPrP by electron microscopy (View interaction) • huPrP aggregates with huPrP by fluorescence technology (View interaction) • huPrP aggregates with huPrP by circular dichroism (View interaction)

Many studies relating to vehicle door closure have focused on noise and vibration, and little attention has been given to the pressure rise or velocity distribution inside a cabin. Too high a pressure rise may, however, exert a resistive force when a car door closes and induce a mechanical reaction of the pars flaccida related to passenger comfort. Thus, this study investigates the effects of the angular velocity of the door and the body leakage on variations in the cabin flows. First, tests for the body leakage were performed for 43 vehicles. Then, three-dimensional numerical analyses with a dynamic mesh were performed and experiments were conducted to verify the results. It was found that the pressure rise is a strong function of the door's angular velocity and that the peak pressure increases almost linearly with increasing angular velocity. However, the body leakage has less effect on the pressure rise unless the extent of the leakage is significantly increased. The pressure rise that occurs while closing a cabin door could be greatly reduced by lowering the door's angular velocity or by developing a mechanism that can greatly increase the body leakage temporarily.

More than 20 unrelated proteins can form amyloid fibrils in vivo which are related to various diseases, such as Alzheimer's disease, prion disease, and systematic amyloidosis. Amyloid fibrils are an ordered protein aggregate with a lamellar cross-beta structure. Enhancing amyloid clearance is one of the targets of the therapy of these amyloid-related diseases. Although there is debate on whether the toxicity is due to amyloids or their precursors, research on the degradation of amyloids may help prevent or alleviate these diseases. In this study, we explored the amyloid-degrading ability of nattokinase, a fibrinolytic subtilisin-like serine protease, and determined the optimal conditions for amyloid hydrolysis. This ability is shared by proteinase K and subtilisin Carlsberg, but not by trypsin or plasmin.

An event emitting a Σ- -hyperon from a Ξ- -hyperon nuclear capture at rest has been observed in a hybrid-emulsion experiment. The event has been analyzed as the first observation of the weak decay of the S = - 2 system.

Efficient incorporation of novel DNA sequences into a specific site in the genome of living human cells remains a challenge despite its potential utility to genetic medicine, biotechnology, and basic research. We find that a precisely placed double-strand break induced by engineered zinc finger nucleases (ZFNs) can stimulate integration of long DNA stretches into a predetermined genomic location, resulting in high-efficiency site-specific gene addition. Using an extrachromosomal DNA donor carrying a 12-bp tag, a 900-bp ORF, or a 1.5-kb promoter-transcription unit flanked by locus-specific homology arms, we find targeted integration frequencies of 15%, 6%, and 5%, respectively, within 72 h of treatment, and with no selection for the desired event. Importantly, we find that the integration event occurs in a homology-directed manner and leads to the accurate reconstruction of the donor-specified genotype at the endogenous chromosomal locus, and hence presumably results from synthesis-dependent strand annealing repair of the break using the donor DNA as a template. This site-specific gene addition occurs with no measurable increase in the rate of random integration. Remarkably, we also find that ZFNs can drive the addition of an 8-kb sequence carrying three distinct promoter-transcription units into an endogenous locus at a frequency of 6%, also in the absence of any selection. These data reveal the surprising versatility of the specialized polymerase machinery involved in double-strand break repair, illuminate a powerful approach to mammalian cell engineering, and open the possibility of ZFN-driven gene addition therapy for human genetic disease.

Background: The cascade heat pump cycle is used when a large difference between the condensing temperature and the evaporating temperature exist. Methods: This study uses ejectors to improve the performance of a cascade heat pump cycle that utilizes refrigerants R134a and R404a. Ejectors were applied to the high-stage cycle, the low-stage cycle and then to both cycles. Changes in performance according to the condensing temperature, evaporating temperature and ejector entrainment ratio were tracked. Results: Results of the numerical analysis showed that applying ejectors to both the highstage and low-stage cycles provided the greatest efficiency, yielding a 26.9% increase in the COP compared to standard cascade cycles. Conclusion: For COP enhancement, it is beneficial to apply ejectors to both-stage cycles as well as to lower the ejector entrainment ratio as much as possible.

This study was conducted to measure the cross sectional area (CSA) of the ulnar nerve (UN) in the cubital tunnel and to evaluate the role of high-resolution ultrasonography in the diagnosis of ulnar nerve neuropathy (UNN).This was a cross sectional study with 64 arms from 32 patients (34 neuropathic, 30 nonneuropathic). Diagnosis was confirmed by nerve conduction study and electromyography. The ulnar nerves were evaluated with 15MHz small footprint linear array transducer. The ulnar nerve CSA was measured at three levels with arm extended: at medial epicondyle (ME), 5cm proximal and 5cm distal to ME. Results from the neuropathic and nonneuropathic arms were compared. Independent T-tests and Pearson correlation tests were used. P value of less than 0.05 was considered significant.Mean CSA values for the UN at levels 5cm proximal to ME, ME and 5cm distal to ME were 0.055, 0.109, 0.045 cm(2) respectively in the neuropathic group and 0.049, 0.075, 0.042 cm2 respectively in the non-neuropathic group. The CSA of the UN at the ME level was significantly larger in the neuropathic group, with p value of 0.005. However, there was no statistical difference between the groups at 5cm proximal and distal to the ME, with p values of 0.10 and 0.35 respectively.There is significant difference in CSA values of the UN at ME between the neuropathic and non-neuropathic groups with mean CSA value above the predetermined 0.10cm(2) cut-off point. High-resolution ultrasonography is therefore useful to diagnose and follow up cases of elbow UNN.