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To the Editor,Eutylone [1-(1,3-benzodioxol-5-yl)-2-(ethylamino) butan-1-one], also known as bk-EBDB or N-ethylbutylone, is a synthetic cathinone that first appeared in Poland in 2014 [1]. In the US...

Introduction: Seizure is a common poisoning-related neurological presentation in the emergency department (ED). Although brain computed tomography (CT) is recommended in patients presenting with first seizures, its role in patients with a suspected drug/substance-induced seizure (DSS) remains inconclusive. This study evaluated whether brain CT examination changes the management and outcome of DSS patients. Methods: We retrospectively reviewed adult patients presenting to the ED with a DSS in Linkou and Taipei Chang Gung Memorial Hospital, Taiwan, from January 2008 to December 2015. We also analyzed whether the brain CT examinations found meaningful acute abnormalities and their impact on subsequent management. We compared the differences between DSS patients undergoing CT scans or not to identify factors that affect the decision to arrange brain CT. Results: The study enrolled 97 patients (69 males). The most common cause of DSS was alcohol withdrawal (58.76%), followed by carbon monoxide (12.37%) and stimulants (8.25%). Eight (8.25%) patients developed status epilepticus, 15 (15.46%) were intubated, and 37 (37.76%) were admitted, including 12 (12.26%) to the intensive care unit. Brain CT was performed in 64 (66.0%) patients and four had abnormal reports that led to further imaging studies. The abnormal findings ultimately had no significant clinical impact. Patients who underwent CT scans had a worse Glasgow Coma Scale score (p = 0.024) and higher rate of status epilepticus (p = 0.031). Conclusion: Brain CT does not provide substantial information for the care of DSS patients. Multi-center prospective studies are needed to obtain stronger evidence.

Purpose Previous reports have identified the important role of zinc in bone health. Although the risk of zinc deficiency is still a concern in the U.S., there has never been an in-depth study of the association between zinc status and bone health in a sample representing the country. Methods We included 2,895 subjects (aged ≥ 40 years) from National Health and Nutrition Examination Survey (NHANES) 2013–2014 to explore the relationship among three biomarkers of zinc (serum, food, and total intake), the bone mineral density (BMD) of the total spine and femur, the FRAX® scores, and the previous history of bone fractures. Results We showed a one-unit increase in the ln-serum zinc level was associated with an increase in the total spine BMD (s = 0.068; S.E. = 0.028; P = 0.030) and total femur BMD (s = 0.061; S.E. = 0.017; P = 0.003), while a one-unit increase in the ln-food zinc intake amount was correlated with an increase in the total femur BMD in the participants (s = 0.023; S.E. = 0.009; P = 0.021). The ln-total zinc intake amount was correlated with an increase in the total femur BMD in women (s = 0.016; S.E. = 0.007; P = 0.041). We also found food zinc intake was negatively correlated with the FRAX® score, while increased levels of all three zinc biomarkers were associated with a decreased incidence of previous bone fractures. Conclusions In this representative survey of American adults above 40 years old, higher zinc status was associated with higher total spine and femoral BMD, lower FRAX® scores, and lower incidence of previous fractures. If this finding is causal, increased zinc intake remains an important issue for Americans.

An investigation into the compression forming of cylinder using the commercial code SUPERFORM is developed. The cylinder billet compressed between the upper and lower dies is meshed by a quadrangle elastic-plastic element. The numerical simulation based on the FEM also compares with the slab method established by us. In the slab method analysis, the stress distributions are estimated by considering the coulomb friction between the dies and the cylinder. Throughout this study, the effects of frictional coefficient, rotating angular speed, reduction and aspect ratio etc upon the compression force, the effective stress and the effective strain, and velocity field are discussed systematically. For verifying the validity of two models, comparisons of compression forces based both modes are carried out to prove the feasibility of both models.

The study mainly aims at the asymmetrical PV 1 cold rolling of sheet to investigate the minimum thickness. For the purpose of deriving the minimum thickness, the complete equation for asymmetrical cold rolling of sheet is derived by an analytical approach based on the slab method. Two analytical models for the minimum thickness of asymmetrical PV cold rolling are established, Model I considering the same frictional coefficients for the upper and lower rolls, whilst Model II considers different frictional coefficients for the upper and lower rolls. The relationships between the ratio of effective radius to initial thickness and bite angle for the two models are proposed. The comparisons of front tension, rolling force per unit width, reduction, and limiting roll speed ratio for the two models are examined. From an analytical approach, the values of minimum thickness can be obtained. The study proposes a new analytical technique to explore the minimum thickness.