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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.

Deinagkistrodon acutus, also known as the hundred-pace viper or Chinese moccasin, is a clinically significant venomous snake in Taiwan. To address the lack of knowledge on the venom proteome of D. acutus, the venom composition was studied by a bottom-up proteomic approach combining reverse phase high-performance liquid chromatography, SDS-PAGE, and LC-MS/MS analysis. The immunoreactivity and cross-reactivity of Taiwanese freeze-dried D. acutus antivenom (DA-AV) and hemorrhagic antivenom (FH-AV) were investigated, as well. The proteomic analysis revealed the presence of 29 distinct proteins from D. acutus venom belonging to 8 snake venom protein families. Snake venom metalloproteinase (SVMP, 46.86%), C-type lectin (CLEC, 37.59%), phospholipase A2 (PLA2, 7.33%) and snake venom serine protease (SVSP, 6.62%) were the most abundant proteins. In addition to DA-AV, FH-AV also showed a profile of broad immunorecognition toward the venom of D. acutus. Remarkably, both antivenoms specifically reacted with the HPLC fractions containing SVMPs, and the titer was 5-10 times higher than fractions of other components. This information helps us to deeply understand the pathophysiology of D. acutus envenomation and guide us to development of more effective antivenom for clinical treatment.

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.

In this work, slab method and upper bound method are proposed to investigate the twist compression forming of cylinder. Both upper bound method and slab method assume the friction between the cylinder and the die as constant shear friction (τ = mk). The total power rate of the energy consumption with a 3D velocity field based on the upper bound method is constructed. An optimum variable parameter is obtained by using the energy minimization method. The upper and lower dies are rotated in different directions, so the cylinder is compressed with the twist circumstance, and the frictional shear stresses (τ) are not acted in the radial direction. The stresses (τ) are acted in an arbitrary direction at angle α from the radial direction relative to the r-axis. According to the velocity relations between radial direction and circumferential direction, angle ( can be determined. Combining the upper bound method with the slab method, the effects of frictional factor, aspect ratio, height reduction, and angular velocity etc on the twist compression forming characteristics are explored effectively. The feasibility of both models can be realized by comparisons of two models and the experiments.

An analytical modified model of the cold bonding rolling of unbounded double-layers sheet is formulated to obtain the stress field of the double-layers sheet at the roll gap via the direct derivation without using Runge–Kutta numerical method. Generally Coulomb friction at the interface of unbounded sheets and between rolls and double-layers sheet are assumed. However, when the frictional coefficient at the interface of unbounded sheets is high enough, the friction needs to be modified. Thus hybrid friction should be taken into account at the interface so as to obtain the realistic rolling characteristics. In this study, the neutral point between the rolls and the double-layers sheet, the rolling pressure distribution along the contact interface between the rolls and the double-layers sheet, the horizontal stress of the whole double-layers sheet, the horizontal stresses in the component layers, the realistic shear stress at the interface of double-layers sheet, the rolling force, and the rolling torque, etc., can be calculated easily and effectively. Besides, obtaining the bonding point at the interface and the thickness ratio of the clad sheet at the exit are of great important. Moreover, the bonding conditions of the cold bond rolling of the unbounded double-layers sheet can be found to provide useful knowledge in carrying out the bond rolling to prevent the failure. In summary the complete formulae of the rolling pressure distribution, the rolling force, the rolling torque can be derived by this analytical modified model. This analytical approach proposed is suitable for the on-line bond rolling.

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.

Light scattered from a binary, viscous, heat conducting, diffusive, and reacting mixture by spontaneous fluctuations was theoretically examined using the hydrodynamical approach with a generalized form for Fick's law that was obtained by a thermodynamical theory based on the entropy inequality. An additional inertial‐diffusive term occurs in the diffusion equation and results in another Lorentzian contribution to the Rayleigh line and also adds to the non‐Lorentzian contribution to the Brillouin doublet. Explicit results for the autocorrelation functions and spectra are presented for (1) a binary, viscous, diffusive, thermally conducting mixture without reaction and (2) a binary, viscous, thermally conducting reacting mixture without diffusion. Comparison of the theoretical spectrum for a gaseous xenon‐helium mixture to experimental data demonstrates the importance of the inertial‐diffusive term and provides an explanation of the failure of the classical hydrodynamical theory. In addition, the case of ace...