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Objective:Pressure ulcers (PUs) severely impact health outcomes in neonatal intensive care, with up to 28% prevalence and doubled mortality rates. Due to their only partially developed stratum corneum, neonates are highly susceptible to PUs because of a lack of adequate support surfaces. The occipital region of the head and hip are the main risk areas due to immobility and newborn body proportions. The main goal of the study was to investigate the impact of reduction in local pressure in these body areas by two air mattress designs and different filling states.Method:Two innovative air-filled mattress prototypes (prototype 1 and prototype 2), consisting of three different segments (head, trunk and feet regions), were developed to reduce local interface pressures by optimising pressure distribution, and were assessed with three air pressure filling states (0.2kPa, 0.4kPa and 0.6kPa). A baby doll was used to investigate pressure distribution and local pressure impact. It measured 51cm and the weight was modified to be 1.3kg, 2.3kg and 3.3kg, representing premature to term newborn weights, respectively. A specialised foam mattress and an unsupported surface were considered as controls.Results:The interface pressures at the hip region for newborn models could be reduced by up to 41% with mattress prototype 1 and 49% with prototype 2 when filled with 0.2kPa air pressure. It was found that the size and the pressure inside air segments was crucial for interface pressure.Conclusion:Our results demonstrated that air mattresses achieved lower interface pressures compared to conventional support surfaces, and that the benefit of the air mattresses depended on their filling status. The importance of using innovative, segmented designs that were tailored to meet the specific needs of highly vulnerable paediatric patients was demonstrated.

Melanoma is one of the most sensitive tumors to immune modulation, and the major challenge for melanoma patients’ survival is immune checkpoint inhibitor (ICI) therapy. γδ T lymphocytes play an antitumoral role in a broad variety of tumors including melanoma and they are optimal candidates for cellular immunotherapy. Thus, a comprehensive analysis of the correlation between γδ T cells and immune checkpoint receptors in the context of melanoma was conducted, with the aim of devising an innovative combined immunotherapeutic strategy. In this study, using the GEPIA2.0 database, a significant positive correlation was observed between the expression of γδ T cell–related genes (TRGC1, TRGC2, TCRD) and immune checkpoint genes (PDCD1, HAVCR2, LAG3), highlighting the potential role of γδ T cells in the immune response within melanoma. Moreover, flow cytometry analysis unveiled a significant augmentation in the population of γδ T cells within melanoma lesions, which exhibited the expression of immune checkpoint receptors including LAG3, TIM3, and PD1. Analysis of single-cell RNA sequencing data revealed a significant enrichment and functional reprogramming of γδ T cell clusters in response to ICIs. Interestingly, the effects of ICI therapy varied between Vδ1 and Vδ2 γδ T cell subsets, with distinct changes in gene expression patterns. Last, a correlation analysis between γδ T cell abundance, immune checkpoint gene expression, and clinical outcomes in melanoma patients showed that low expression of immune checkpoint genes, including LAG3, HAVCR2, and PDCD1, was associated with improved 1-year overall survival, emphasizing the significance of these genes in predicting patient outcomes, potentially outweighing the impact of γδ T cell abundance. This study offers critical insights into the dynamic interaction between γδ T cells, immune checkpoint receptors, and melanoma, providing valuable perspectives for potential therapeutic avenues and predictive markers in this intricate interplay.A comprehensive analysis exploring the intricate correlation between γδ T cells and immune checkpoint receptors in melanoma is the focus of this study. Our findings provide a solid foundation for further exploration, suggesting the strategic combination of adoptive transfer or in vivo activation of γδ T cells with immune checkpoint inhibitor therapy as a compelling approach to enhance anti-tumor responses.

Zusammenfassung.Hintergrund:Vulväre Neoplasien sind gynäkologische Erkrankungen mit zum Teil einschneidenden Folgen für die Betroffenen. Neben physischen Komplikationen leiden die Frauen häufig unter psychischen Problemen. Die mit Scham besetzte Krankheit führt zu einer Verminderung der Lebensqualität und beeinträchtigt das Sozialleben. Es ist wenig bekannt darüber, was diese Frauen an sozialer Unterstützung erhalten. Ziel:Das Ziel dieser qualitativen Studie war, zu beschreiben, wie betroffene Frauen die Unterstützung durch das soziale Umfeld in der Zeit von der Diagnose bis sechs Monate postoperativ erleben bzw. vermissen. Methode:In der vorliegenden Sekundäranalyse wurde ein qualitatives Design gewählt. Es wurden 20 transkribierte Interviews aus der WOMAN-PRO-Studie mittels qualitativer Inhaltsanalyse nach Mayring ausgewertet. Ergebnisse:Die Analyse ergab vier Hauptkategorien: Eine schlimme Krankheit haben zeigt, wie die Frauen die Diagnose als Schock erlebten, mit welchen Tabuthemen sowie Schuldfragen sie sich auseinandersetzen mussten. Stark ausgeprägt war die Kategorie Sich allein fühlen, bedingt durch Nicht-Sprechen, Nicht-Hinschauen und Nicht-Handeln. In Selber anpacken wird beschrieben, welche Strategien den Frauen halfen, aus dem Alleinsein herauszufinden. In Hilfe erfahren wird deutlich, dass diejenigen Frauen, die von sich aus mit dem sozialen Umfeld in Kontakt traten, in der Regel soziale Unterstützung erhielten. Schlussfolgerungen:Diese Patientinnen haben einen hohen Bedarf an umfassenden Informationen sowie an emotionaler und praktischer Unterstützung durch das private Umfeld und besonders auch durch die Gesundheitsfachleute. Eine definierte Bezugs- und Vertrauensperson während des ganzen Behandlungsprozesses ist zu empfehlen.

This paper presents the methods deployed by the Horizon 2O2O SCIPPER project to characterize emission performance of vessels, mainly under the perspective of checking compliance to new emissions regulations. Various on-board and remote measurement techniques have been demonstrated within five experimental campaigns conducted at Europe's main sea areas and ports. Almost a thousand of ship plumes has been measured and crossed checked with various instrumentation, revealing the emission profile of ships during actual operation Accuracy of each measurement technique was also tested. Emission measurements are further exploited to assess the impact of shipping on air quality of coastal areas, by identifying the transformations of pollutants performed in the atmosphere as plume evolves and quantifying onshore pollutants concentrations attributed to shipping activity.

Post-transplant lymphoproliferative disorder is a life-threatening complication of immunosuppression following transplantation mediated by failure of T cells to control Epstein–Barr virus (EBV)–infected and transformed B cells. Typically, a modification or reduction of immunosuppression is recommended, but insufficiently defined thus far. In order to help delineate this, we characterized EBV-antigen–specific T cells and lymphoblastoid cell lines from healthy donors and in patients with a kidney transplant in the absence or presence of the standard immunosuppressants tacrolimus, cyclosporin A, prednisolone, rapamycin, and mycophenolic acid. Phenotypes of lymphoblastoid cell-lines and T cells, T cell–receptor–repertoire diversity, and T-cell reactivity upon co-culture with autologous lymphoblastoid cell lines were analyzed. Rapamycin and mycophenolic acid inhibited lymphoblastoid cell-line proliferation. T cells treated with prednisolone and rapamycin showed nearly normal cytokine production. Proliferation and the viability of T cells were decreased by mycophenolic acid, while tacrolimus and cyclosporin A were strong suppressors of T-cell function including their killing activity. Overall, our study provides a basis for the clinical decision for the modification and reduction of immunosuppression and adds information to the complex balance of maintaining anti-viral immunity while preventing acute rejection. Thus, an immunosuppressive regime based on mTOR inhibition and reduced or withdrawn calcineurin inhibitors could be a promising strategy for patients with increased risk of or manifested EBV-associated post-transplant lymphoproliferative disorder.

Nitrogen (N) isotopic fractionation during nitrogen oxides (NOx) cycling and conversion into atmospheric nitrate alters the original N isotopic composition (δ15N) of NOxemissions. Limited quantification of these isotopic effects in urban settings hampers the δ15N‐based identification and apportionment of NOxsources. δ15N of nitrogen dioxide (NO2) measured during winter in downtown Fairbanks, Alaska, displayed a large temporal variability, from −10.2 to 24.1‰. δ15N(NO2) records are found to be driven by equilibrium isotopic fractionation, at a rate in very close agreement with theoretical predictions. This result confirms that N isotopic partitioning between NO and NO2can be accurately predicted over a wide range of conditions. This represents an important step for inferring NOxemission sources from isotopic composition measurement of reactive nitrogen species. After correcting our δ15N(NO2) measurements for N fractionation effects, a δ15N‐based source apportionment analysis identifies vehicle and space heating oil emissions as the dominant sources of breathing‐level NOxat this urban site. Despite their large NOxemissions, coal‐fired power plants with elevated chimney stacks (>26 m) appear to make a small contribution to surface NOxlevels in downtown Fairbanks (likely less than 18% on average). The combined uncertainties of the δ15N of NOxfrom heating oil combustion and of the influence of low temperatures on the δ15N of NOxemitted by vehicle exhaust prevent a more detailed partitioning of surface NOxsources in Fairbanks. Nitrogen (N) stable isotopes measured in atmospheric reactive N (Nr) species can help trace emission sources of nitrogen oxides (NOx). However, large uncertainties subsist regarding the factors controlling the variability of N isotopes in Nrspecies, preventing a precise isotope‐based emission source apportionment. This study presents a comprehensive analysis of the enrichment of 15N–14N (δ15N) in atmospheric nitrogen dioxide (NO2) collected during the Alaskan Layered Pollution And Chemical Analysis (ALPACA) 2022 international winter campaign in Fairbanks, Alaska. Building on in situ meteorological and trace gas, the isotopic fractionation effect driving the significant δ15N variability of NO2observed in downtown Fairbanks is quantified with great precision. The δ15N records corrected for equilibrium fractionation effects are discussed in light of a local NOxemission inventory. In particular, the influence of emissions from coal‐fired power plants with high stack heights on surface air pollution is addressed. A temporal variability in NO2nitrogen isotopes is measured during winter in downtown Fairbanks, AlaskaIsotope exchange fractionation drives NO2nitrogen isotope distribution, at a rate in excellent agreement with theoretical predictionsA15N‐based source apportionment indicates vehicle and oil space heating emissions are the main sources of NOxin downtown Fairbanks A temporal variability in NO2nitrogen isotopes is measured during winter in downtown Fairbanks, Alaska Isotope exchange fractionation drives NO2nitrogen isotope distribution, at a rate in excellent agreement with theoretical predictions A15N‐based source apportionment indicates vehicle and oil space heating emissions are the main sources of NOxin downtown Fairbanks

The Alaskan Layered Pollution and Chemical Analysis (ALPACA) field campaign included deployment of a suite of atmospheric measurements in January–February 2022 with the goal of better understanding atmospheric processes and pollution under cold and dark conditions in Fairbanks, Alaska. We report on measurements of particle composition, particle size, ice nucleating particle (INP) composition, and INP size during an ice fog period (29 January–3 February). During this period, coarse particulate matter (PM10) concentrations increased by 150% in association with a decrease in air temperature, a stronger temperature inversion, and relatively stagnant conditions. Results also show a 18%–78% decrease in INPs during the ice fog period, indicating that particles had activated into the ice fog via nucleation. Peroxide and heat treatments performed on INPs indicated that, on average, the largest contributions to the INP population were heat‐labile (potentially biological, 63%), organic (31%), then inorganic (likely dust, 6%). Measurements of levoglucosan and bulk and single‐particle composition corroborate the presence of dust and aerosols from combustion sources. Heat‐labile and organic INPs decreased during the peak period of the ice fog, indicating those were preferentially activated, while inorganic INPs increased, suggesting they remained as interstitial INPs. In general, INP concentrations were unexpectedly high in Fairbanks compared to other locations in the Arctic during winter. The fact that these INPs likely facilitated ice fog formation in Fairbanks has implications for other high latitude locations subject to the hazards associated with ice fog. The Alaskan Layered Pollution and Chemical Analysis field campaign occurred January–February 2022 with the goal of better understanding the atmosphere and atmospheric pollution during the winter in Fairbanks, Alaska. We studied a rare subset of atmospheric particles called ice nucleating particles which facilitate the formation of ice fog by allowing water to freeze at temperatures above −38°C. During our study, there was an ice fog event that coincided with a pollution event. During this event, there was a significant increase in coarse particulate matter associated with a decrease in temperature and calm winds. Ice nucleating particle concentration in the air decreased during the ice fog event indicating that the INPs had activated into the ice fog and were not able to be captured. We determined that most INPs were heat‐labile (potentially biological), followed by organic. Very few INPs were inorganic. Inorganic INPs increased during the ice fog period while heat‐labile and organic INPs decreased indicating that they were being selectively activated into the fog. Overall, INP concentrations in Fairbanks were quite high compared to other Arctic locations and carries implications for ice fog formation in other high‐latitude locations. Fairbanks had higher wintertime ice nucleating particle (INP) concentrations than other high‐latitude locationsINP concentrations in Fairbanks decreased during the ice fog period, indicating that INPs were activated into the fogINP composition in Fairbanks was dominated by heat‐labile INPs Fairbanks had higher wintertime ice nucleating particle (INP) concentrations than other high‐latitude locations INP concentrations in Fairbanks decreased during the ice fog period, indicating that INPs were activated into the fog INP composition in Fairbanks was dominated by heat‐labile INPs

In emerging economies such as China, marked by profound regional disparities in terms of socio-economic wealth and technology, different regions use not only different levels of inputs into the innovation process, but also produce different outputs with qualitative diversity that is seldom sufficiently acknowledged. This paper uses structured expert interviews (AHP) to provide insights into the innovation profiles of four selected Chinese regions: Beijing, Shanghai, Chongqing and Kunming. It combines information on drivers of innovation as well as innovation characteristics and objectives to establish and compare regional innovation profiles.

The OH-initiated degradation of 2-amino-2-methyl-1-propanol [CH3C(NH2)(CH3)CH2OH, AMP] was investigated in a large atmospheric simulation chamber, employing time-resolved online high-resolution proton-transfer reaction-time-of-flight mass spectrometry (PTR-ToF-MS) and chemical analysis of aerosol online PTR-ToF-MS (CHARON-PTR-ToF-MS) instrumentation, and by theoretical calculations based on M06-2X/aug-cc-pVTZ quantum chemistry results and master equation modeling of the pivotal reaction steps. The quantum chemistry calculations reproduce the experimental rate coefficient of the AMP + OH reaction, aligning k(T) = 5.2 × 10–12× exp (505/T) cm3molecule–1s–1to the experimental value kexp,300K= 2.8 × 10–11cm3molecule–1s–1. The theoretical calculations predict that the AMP + OH reaction proceeds via hydrogen abstraction from the −CH3groups (5–10%), −CH2– group, (>70%) and −NH2group (5–20%), whereas hydrogen abstraction from the −OH group can be disregarded under atmospheric conditions. A detailed mechanism for atmospheric AMP degradation was obtained as part of the theoretical study. The photo-oxidation experiments show 2-amino-2-methylpropanal [CH3C(NH2)(CH3)CHO] as the major gas-phase product and propan-2-imine [(CH3)2C═NH], 2-iminopropanol [(CH3)(CH2OH)C═NH], acetamide [CH3C(O)NH2], formaldehyde (CH2O), and nitramine 2-methyl-2-(nitroamino)-1-propanol [AMPNO2, CH3C(CH3)(NHNO2)CH2OH] as minor primary products; there is no experimental evidence of nitrosamine formation. The branching in the initial H abstraction by OH radicals was derived in analyses of the temporal gas-phase product profiles to be BCH3/BCH2/BNH2= 6:70:24. Secondary photo-oxidation products and products resulting from particle and surface processing of the primary gas-phase products were also observed and quantified. All the photo-oxidation experiments were accompanied by extensive particle formation that was initiated by the reaction of AMP with nitric acid and that mainly consisted of this salt. Minor amounts of the gas-phase photo-oxidation products, including AMPNO2, were detected in the particles by CHARON-PTR-ToF-MS and GC×GC-NCD. Volatility measurements of laboratory-generated AMP nitrate nanoparticles gave ΔvapH= 80 ± 16 kJ mol–1and an estimated vapor pressure of (1.3 ± 0.3) × 10–5Pa at 298 K. The atmospheric chemistry of AMP is evaluated and a validated chemistry model for implementation in dispersion models is presented.

To avoid the middle-income trap, China’s leaders call for innovation to accelerate development in China. However, since it is not clear how innovation and (regional) development reinforce each other, there is no blueprint strategy for successful innovation capacity building throughout China. Due to resource scarcity in its “Western” regions, it is thus far from certain that innovation capacity building will support regional development. Departing from sociology of knowledge, narrations are constitutive of policy practice. This article analyses narrative patterns of policy experts to understand how innovation capacity building and regional development are negotiated in China’s lagging “West.” The comparison of Yunnan and Chongqing cases demonstrates that innovation capacity building is primarily infused with theoretical expectations: resource scarcity does not allow for grounding innovation as a strategy of regional development in the local context. This leads to narrations of “local” alternatives to innovation capacity building in centralist China.

The OH-initiated photo-oxidation of piperazine and 1-nitropiperazine as well as the photolysis of 1-nitrosopiperazine were investigated in a large atmospheric simulation chamber. The rate coefficient for the reaction of piperazine with OH radicals was determined by the relative rate method to be kOH-piperazine= (2.8 ± 0.6) × 10–10cm3molecule–1s–1at 307 ± 2 K and 1014 ± 2 hPa. Product studies showed the piperazine + OH reaction to proceed both via C–H and N–H abstraction, resulting in the formation of 1,2,3,6-tetrahydropyrazine as the major product and in 1-nitropiperazine and 1-nitrosopiperazine as minor products. The branching in the piperazinyl radical reactions with NO, NO2, and O2was obtained from 1-nitrosopiperazine photolysis experiments and employed analyses of the 1-nitropiperazine and 1-nitrosopiperazine temporal profiles observed during piperazine photo-oxidation. The derived initial branching between N–H and C–H abstraction by OH radicals, kN–H/(kN–H+ kC–H), was 0.18 ± 0.04. All experiments were accompanied by substantial aerosol formation that was initiated by the reaction of piperazine with nitric acid. Both primary and secondary photo-oxidation products including 1-nitropiperazine and 1,4-dinitropiperazine were detected in the aerosol particles formed. Corroborating atmospheric photo-oxidation schemes for piperazine and 1-nitropiperazine were derived from M06-2X/aug-cc-pVTZ quantum chemistry calculations and master equation modeling of the pivotal reaction steps. The atmospheric chemistry of piperazine is evaluated, and a validated chemical mechanism for implementation in dispersion models is presented.

IMPORTANCE: The standard of care for refeeding inpatients with anorexia nervosa, starting with low calories and advancing cautiously, is associated with slow weight gain and protracted hospital stay. Limited data suggest that higher-calorie refeeding improves these outcomes with no increased risk of refeeding syndrome. OBJECTIVE: To compare the short-term efficacy, safety, and cost of lower-calorie vs higher-calorie refeeding for malnourished adolescents and young adults with anorexia nervosa. DESIGN, SETTING, AND PARTICIPANTS: In this multicenter randomized clinical trial with prospective follow-up conducted at 2 inpatient eating disorder programs at large tertiary care hospitals, 120 adolescents and young adults aged 12 to 24 years hospitalized with anorexia nervosa or atypical anorexia nervosa and 60% or more of median body mass index were enrolled from February 8, 2016, to March 7, 2019. The primary analysis was a modified intent-to-treat approach. INTERVENTIONS: Higher-calorie refeeding, beginning at 2000 kcal/d and increasing by 200 kcal/d vs lower-calorie refeeding, beginning at 1400 k/cal and increasing by 200 kcal every other day. MAIN OUTCOMES AND MEASURES: Main outcomes were end-of-treatment outcomes; the primary end point of this trial will be clinical remission over 12 months. Short-term efficacy was defined a priori as time to restore medical stability in the hospital, measured by the following 6 indices: 24-hour heart rate of 45 beats/min or more, systolic blood pressure of 90 mm Hg or more, temperature of 35.6 °C or more, orthostatic increase in heart rate of 35 beats/min or less, orthostatic decrease in systolic blood pressure of 20 mm Hg or less, and 75% or more of median body mass index for age and sex. The prespecified safety outcome was incidence of electrolyte abnormalities; cost efficacy was defined as savings associated with length of stay. RESULTS: Because 9 participants withdrew prior to treatment, the modified intention-to-treat analyses included 111 participants (93%; 101 females [91%]; mean [SD] age, 16.4 [2.5] years). Higher-calorie refeeding restored medical stability significantly earlier than lower-calorie refeeding (hazard ratio, 1.67 [95% CI, 1.10-2.53]; P = .01). Electrolyte abnormalities and other adverse events did not differ by group. Hospital stay was 4.0 days shorter (95% CI, −6.1 to −1.9 days) among the group receiving higher-calorie refeeding, which was associated with a savings of $19 056 (95% CI, −$28 819 to −$9293) in hospital charges per participant. CONCLUSIONS AND RELEVANCE: In the first randomized clinical trial in the US to compare refeeding approaches in patients with anorexia nervosa and atypical anorexia nervosa, higher-calorie refeeding demonstrated short-term efficacy with no increase in safety events during hospitalization. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02488109

Small studies reported poor post-partum outcomes among young women living with perinatal HIV infection who are now ageing into adulthood and becoming pregnant. For targeted clinical intervention, we sought to identify women in this population at risk of poor post-partum virological control.

We report on a new method for analyzing atmospheric submicrometer particulate organic matter which combines direct particle sampling and volatilization with online chemical ionization mass spectrometric analysis. Technically, the method relies on the combined use of a CHARON (“Chemical Analysis of Aerosol Online”) particle inlet and a proton-transfer-reaction time-of-flight mass spectrometer (PTR-ToF-MS). Laboratory studies on target analytes showed that the ionization conditions in the PTR-ToF-MS lead to extensive fragmentation of levoglucosan and cis-pinonic acid, while protonated oleic acid and 5α-cholestane molecules remain intact. Potential problems and biases in quantitative and qualitative analyses are discussed. Side-by-side atmospheric comparison measurements of total particulate organic mass and levoglucosan with an aerosol mass spectrometer (AMS) were in good agreement. Complex and clearly distinct organic mass spectra were obtained from atmospheric measurements in three European cities (Lyon, Valencia, Innsbruck). Data visualization in reduced-parameter frameworks (e.g., oxidation state of carbon vs carbon number) revealed that the CHARON-PTR-ToF-MS technique adds significant analytical capabilities for characterizing particulate organic carbon in the Earth’s atmosphere. Positive matrix factorization (PMF) was used for apportioning sources of atmospheric particles in late fall in Innsbruck. The m/zsignatures of known source marker compounds (levoglucosan and resin acids, polycyclic aromatic hydrocarbons, nicotine) in the mass spectra were used to assign PMF factors to biomass burning, traffic, and smoking emission sources.

The OH-initiated photo-oxidation of piperidine and the photolysis of 1-nitrosopiperidine were investigated in a large atmospheric simulation chamber and in theoretical calculations based on CCSD(T*)-F12a/aug-cc-pVTZ//M062X/aug-cc-pVTZ quantum chemistry results and master equation modeling of the pivotal reaction steps. The rate coefficient for the reaction of piperidine with OH radicals was determined by the relative rate method to be kOH-piperidine= (1.19 ± 0.27) × 10–10cm3molecule–1s–1at 304 ± 2 K and 1014 ± 2 hPa. Product studies show the piperidine + OH reaction to proceed via H-abstraction from both CH2and NH groups, resulting in the formation of the corresponding imine (2,3,4,5-tetrahydropyridine) as the major product and in the nitramine (1-nitropiperidine) and nitrosamine (1-nitrosopiperidine) as minor products. Analysis of 1-nitrosopiperidine photolysis experiments under natural sunlight conditions gave the relative rates jrel= j1-nitrosoperidine/jNO2= 0.342 ± 0.007, k3/k4a= 0.53 ± 0.05 and k2/k4a= (7.66 ± 0.18) × 10–8that were subsequently employed in modeling the piperidine photo-oxidation experiments, from which the initial branchings between H-abstraction from the NH and CH2groups, kN–H/ktot= 0.38 ± 0.08 and kC2–H/ktot= 0.49 ± 0.19, were derived. All photo-oxidation experiments were accompanied by particle formation that was initiated by the acid–base reaction of piperidine with nitric acid. Primary photo-oxidation products including both 1-nitrosopiperidine and 1-nitropiperidine were detected in the particles formed. Quantum chemistry calculations on the OH initiated atmospheric photo-oxidation of piperidine suggest the branching in the initial H-abstraction routes to be ∼35% N1, ∼50% C2, ∼13% C3, and ∼2% C4. The theoretical study produced an atmospheric photo-oxidation mechanism, according to which H-abstraction from the C2position predominantly leads to 2,3,4,5-tetrahydropyridine and H-abstraction from the C3position results in ring opening followed by a complex autoxidation, of which the first few steps are mapped in detail. H-abstraction from the C4position is shown to result mainly in the formation of piperidin-4-one and 2,3,4,5-tetrahydropyridin-4-ol, whereas H-abstraction from N1under atmospheric conditions primarily leads to 2,3,4,5-tetrahydropyridine and in minor amounts of 1-nitrosopiperidine and 1-nitropiperidine. The calculated rate coefficient for the piperidine + OH reaction agrees with the experimental value within 35%, and aligning the theoretical numbers to the experimental value results in k(T) = 2.46 × 10–12× exp(486 K/T) cm3molecule–1s–1(200–400 K).

Hand and face transplants are becoming increasingly common, recording progressively more penile, uterus, abdominal wall, and allotransplantation cases reported worldwide. Despite current protocols allow long-term survival of the allografts, the ultimate goal of donor-specific tolerance has not been achieved yet. In fact, the harmful adverse effects related to the lifelong administration of immunosuppressive agents are the main drawbacks for vascularized composite allotransplantations. Research is very active in investigating alternative methods to induce greater tolerance while minimizing toxicity. Adipose-derived stem cells (ASCs) represent promising cell therapies for immunomodulation in preclinical and clinical settings. Their clinical appeal is due to their easy harvest in large quantities through a noninvasive and well-accepted approach; they may well promote donor-specific tolerance and potentially reduce immunosuppression. Several experimental studies exist, but lacking review articles reporting current evidence. This work proposes a literature review on the immunomodulatory role of ASCs in vascularized composite allotransplantations. In vitro and in vivo evidence will be summarized. The role that cell passaging and upstream progenitors—the so-called spheroid ASCs—may play in modulating the immune response will also be discussed. Finally, this article will summarize current knowledge on biodistribution, migration, and homing of injected stem cells. This review may well provide useful information for preclinical and clinical studies, aiming at a breakthrough for donor-specific tolerance.

Catherine Milneand colleagues present the findings of their review, ccna2@juno.com

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