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A patent-pending single design of an ultralow-loss (ULL) magnetic ballast for T5 high-efficient (T5-HE) fluorescent lamps rated from 14 to 35 W is presented. Based on the use of a nonlinear physical low-pressure discharge lamp model, it is discovered that the same set of ballast parameters can be chosen for operating T5-HE 14-, 21-, 28-, and 35-W lamps at their respective rated power at a mains voltage in the range of 220–240 V. With energy efficiency higher than and lifetime much longer than their electronic counterparts and being recyclable, the ULL ballasts offer a more environmentally friendly solution to T5-HE lamps than electronic ballasts. This single-ballast design offers great convenience to both ballast manufacturers and users, because only one product design can cover a range of the most popular T5-HE lamps. Both theoretical analysis and experimental results are included to confirm the validity of the proposal. [ABSTRACT FROM AUTHOR]

The high-voltage and low-current features of T5 lamps imply that the copper and core losses of the magnetic ballast can be greatly reduced. This paper shows that magnetic ballasts for high-voltage T5 lamps are not only feasible but their luminous and ballast-loss performance can be better than those of the electronic ballasts. Contrary to common belief, high frequency operation of T5 28 W lamps increases the luminous efficacy by an average of 3.6% only (less than 5%). Practical implementation of an ultra-low-loss magnetic ballast system for T5 28 W lamps is presented. Its total system power is less than the 32 W upper limit specified for Class A2 of energy-efficient electronic ballast for T5 28 W lamps. High-luminous efficacy of 75.63–77.66 lm/W can be achieved. This important breakthrough has the potential of reversing the existing trend of using electronic ballasts as the energy-saving technology in lighting industry. With a better luminous efficacy, lower product and maintenance costs, much longer lifetime, and the use of recyclable metallic materials over its electronic counterparts, this patent-pending proposal provides a truly sustainable lighting solution to the lighting industry. [ABSTRACT FROM PUBLISHER]

Standardized reporting of data is crucial for out-of-hospital cardiac arrest (OHCA) research. While the implementation of first responder systems dispatching volunteers to OHCA is encouraged, there is currently no uniform reporting standard for describing these systems. A steering committee established a literature search to identify experts in smartphone alerting systems. These international experts were invited to a conference held in Hinterzarten, Germany, with 40 researchers from 13 countries in attendance. Prior to the conference, participants submitted proposals for parameters to be included in the reporting standard. The conference comprised five workshops covering different aspects of smartphone alerting systems. Proposed parameters were discussed, clarified, and consensus was achieved using the Nominal Group Technique. Participants voted in a modified Delphi approach on including each category as a core or supplementary element in the reporting standard. Results were presented, and a writing group developed definitions for all categories and items, which were sent to participants for revision and final voting using LimeSurvey web-based software. The resulting reporting standard consists of 68 core items and 21 supplementary items grouped into five topics (first responder system, first responder network, technology/algorithm/strategies, reporting data, and automated external defibrillators (AED)). This proposed reporting standard generated by an expert opinion group fills the gap in describing first responder systems. Its adoption in future research will facilitate comparison of systems and research outcomes, enhancing the transfer of scientific findings to clinical practice., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘MPM is chair of Region of Lifesavers, shareholder of SmartResQ ApS, and received speaker honoraria from Stryker. RG is Board Director of Guidelines, European Resuscitation Council, and chair of the Task Force Education, Implementation and Teams, International Liaison Committee on Resuscitation. TS is member of the editorial board, Resuscitation and Resuscitation Plus, member of the science and education committee BLS of the ERC, and member of the ILCOR social media working group. CDD is member of the editorial board of the journal Resuscitation, treasurer of the UK Resuscitation Council and ALS working group member of ILCOR. AA is a consultant with Boston Scientific, Backbeat, Biosense Webster, Cairdac, Corvia, Daiichi-Sankyo, Medtronic, Merit, Microport CRM, and Philips; received speaker fees from Daiichi-Sankyo, Boston Scientific, Biosense Webster, Medtronic, Microport CRM, and Philips; participates in clinical trials sponsored by Boston Scientific, Medtronic, Microport CRM, and Zoll Medical; and has intellectual properties assigned to Boston Scientific, Biosense Webster, and Microport CRM. TB has research, clinical and educational roles in resuscitation care, including in first responder systems. He is a member of the Pre-Hospital Emergency Care Council (Ireland). EB is working group member in ESCAPE-NET and PARQ COST action. BB is treasurer of the European Resuscitation Council (ERC), Chairman of the German Resuscitation Council (GRC), Member of the Advanced Life Support (ALS) Task Force of the International Liaison Committee on Resuscitation (ILCOR), Member of the Executive Committee of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), Founder of the “Deutsche Stiftung Wiederbelebung”, Federal Medical Advisor of the German Red Cross (DRK), Co-Editor of “Resuscitation”, Editor of the Journal “Notfall + Rettungsmedizin”, Co-Editor of the Brazilian Journal of Anesthesiology. He received fees for lectures from the following companies: Forum für medizinische Fortbildung (FomF), Baxalta Deutschland GmbH, ZOLL Medical Deutschland GmbH, C.R. Bard GmbH, GS Elektromedizinische Geräte G. Stemple GmbH, Novartis Pharma GmbH, Philips GmbH Market DACH, Bioscience Valuation BSV GmbH. HJB is member of the executive committee of the German Resuscitation Council and vice chair of Region of Lifesavers. SC is member of the editorial board of the journal Resuscitation, member of the advisory board drone delivery Canada and received speaker honoraria from Zoll Medical. ED is shareholder of EVapp VZW, Belgium. DF is co-founder and operations manager of the Heartrunner Citizen Responder System, Sweden and member of the tech&ops committee of EENA (European Emergency Number Association). FLH is shareholder of FirstAED ApS, Denmark. MJ is a working group leader in the EU-funded network PARQ-COST, focusing on cardiac arrest research. JJ is CEO of the non-profit organisation Region der Lebensretter e.V. TAK is employed at Stan B.V. running the national citizen responder network HartSlagNu in the Netherlands. MK is chief medical director, Vienna Emergency Medical Service, and executive president PULS – Austrian Cardiac Arrest Association. KM is member of the editorial board of the journal Resuscitation. SO is employed at the German Red Cross and is board member of the GRC. DDS provided unpaid scientific consulting to CPRSave, a company developing a novel SAS system, and his department received a small grant from the PulsePoint Foundation to increase SAS participation in Allegheny County, PA, US. AS is vice president of the Italian Resuscitation Council (IRC). JSchwietring is chief medical director, ADAC (air rescue) LRG gGmbH. FS is chair elect, European Resuscitation Council and chair, ILCOR Social Media Working Group. PS is chair of the medical committee, Ontario Para & Summer Games and board member, Peel Paramedic Association. HLT is co-founder of PacingCure. He has received funding from the European Union's Horizon 2020 research and innovation programme under acronym ESCAPE-NET, registered under grant agreement No 733381, and the COST Action PARQ (grant agreement No CA19137) supported by COST (European Cooperation in Science and Technology). GT is employed at Resuscitec GmbH, shareholder of Resuscitec GmbH, and board member of the GRC and Region der Lebensretter. JGanter is board member of Region of Lifesavers. SV is president of EVapp NGO, and shareholder Prior-IT BV. CM, KCT, RB, MLC, RC, DD, MME, DE, MCTG, JGronewald, MH, LH, TM, KM, WMN, JSowa, RS, JU, WAW have no conflicts of interest.’., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Purpose: Osteoarthritis (OA) of the knee is a multifactorial degenerative disease typically defined as the 'wear and tear' of articular joint cartilage. However, recent studies suggest that OA is a disease arising from chronic low-grade inflammation. We conducted a study to investigate the relationship between chronic inflammatory mediators present in both the systemic peripheral blood system and localised inflammation in synovial fluid (SF) of OA and non-OA knees; and subsequently made direct comparative analyses to understand the mechanisms that may underpin the processes involved in OA., Methods: 20-Plex proteins were quantified using Human Magnetic Luminex® assay (R&D Systems, USA) from plasma and SF of OA (n = 14) and non-OA (n = 14) patients. Ingenuity Pathway Analysis (IPA) software was used to predict the relationship and possible interaction of molecules pertaining to OA., Results: There were significant differences in plasma level for matrix metalloproteinase (MMP)-3, interleukin (IL)-27, IL-8, IL-4, tumour necrosis factor-alpha, MMP-1, IL-15, IL-21, IL-10, and IL-1 beta between the groups, as well as significant differences in SF level for IL-15, IL-8, vascular endothelial growth factor (VEGF), MMP-1, and IL-18. Our predictive OA model demonstrated that toll-like receptor (TLR) 2, macrophage migration inhibitory factor (MIF), TLR4 and IL-1 were the main regulators of IL-1B, IL-4, IL-8, IL-10, IL-15, IL-21, IL-27, MMP-1 and MMP-3 in the plasma system; whilst IL-1B, TLR4, IL-1, and basigin (BSG) were the regulators of IL-4, IL-8, IL-10, IL-15, IL-18, IL-21, IL-27, MMP-1, and MMP-3 in the SF system., Conclusion: The elevated plasma IL-8 and SF IL-18 may be associated with the pathogenesis of OA via the activation of MMP-3., (Copyright © 2019. Published by Elsevier B.V.)

Aim: To determine the value of mammography and breast ultrasound (US) in predicting outcomes in HER2 positive breast cancer patients (pts) within Neo-ALTTO trial., Patients and Methods: Mammography and US were required at baseline, week 6 and surgery. Two independent blinded investigators reviewed the measurements and assigned the corresponding response category. Pts showing complete or partial response according to RECIST (v1.1) were classified as responders. The association between imaging response at week 6 or prior to surgery was evaluated with respect to pathological complete response (pCR) and event-free Survival (EFS)., Results: Of the 455 pts enrolled in the trial, 267 (61%) and 340 (77%) had evaluable mammography and US at week 6; 248 (56%) and 309 (70%) pts had evaluable mammography and US prior to surgery. At week 6, 32% and 43% of pts were classified as responders by mammography and US, respectively. pCR rates were twice as high for responders than non-responders (week 6: 46% versus 23% by US, p < 0.0001; 41% versus 24% by mammography, p = 0.007). Positive and negative predictive values of mammography and US prior to surgery were 37% and 35%, and 82% and 70%, respectively. No significant correlation was found between response by mammography and/or US at week 6/surgery and EFS., Conclusions: Mammography and US were underused in Neo-ALTTO although US had the potential to assess early response whereas mammography to detect residual disease prior to surgery. Our data still emphasise the need for further imaging studies on pts treated with neoadjuvant HER2-targeted therapy., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Despite increasing use of bone graft in Malaysia, there was still lack of data to quantify knowledge level on bone banking among orthopaedic community who are involved in transplantation related work. Therefore, a survey on awareness in tissue banking specifically bone banking, usage and choice of bone grafts was conducted. From 80 respondents, 82.5% were aware about tissue banking however only 12.5% knew of the existence of tissue banks in Malaysia. Femoral head was the bone allograft most often used as a substitute to autograft. Only 34.8% respondents preferred irradiated bone grafts whilst 46.9% preferred nonirradiated, indicating the need to educate the importance of radiation for sterilising tissues. Exhibition was the most preferred medium for awareness programme to disseminate information about bone banking in the orthopaedic community. The professional awareness is necessary to increase the knowledge on the use of bone graft, hence to increase bone transplantation for musculoskeletal surgeries in the country.

This paper unveils a platform to develop a compact, simple, reusable and disposable, and cost effective hand-held urinalysis device for home-health-care and doctor's office uses. A polymeric optical waveguide and colorimetric absorption were used as an optical sensor and sensing mode, respectively. The results of the tests show that the device was able to deliver quantitative results with the detection limits better than 0.1g/L, 0.2g/L, 0.025 g/L, and 0.1g/L for glucose, creatinine, albumin and total protein, respectively. There are some superiorities of this device as compared to the dip-stick counterpart, that are, better sensitivity, ability to deliver quantitative results and reusability. The device is being further miniaturized to use a LED and photodiode as a light source and detector, respectively. It is believed the device has potential for early diagnostic and wellness monitoring tool., (Copyright © 2011 Elsevier B.V. All rights reserved.)

We report a case of 20-year-old man who presented with bilateral femoral nerve palsy following resuscitation for traumatic massive blood loss and its consequence. A high suspicious index for this complication may lead to its early recognition. Its related pathoanatomy is discussed based on the described evidences in the literature. Nonoperative treatment remains as a recommended option for coagulopathy-related neuropathy.

Purpose: To study the safety and efficacy of dose escalation in tumor for locally advanced nasopharyngeal carcinoma (NPC)., Methods and Materials: From September 2000 to June 2004, 50 patients with T3-T4 NPC were treated with intensity-modulated radiotherapy (IMRT). Fourteen patients had Stage III and 36 patients had Stage IVA-IVB disease. The prescribed dose was 76 Gy to gross tumor volume (GTV), 70 Gy to planning target volume (PTV), and 72 Gy to enlarged neck nodes (GTVn). All doses were given in 35 fractions over 7 weeks. Thirty-four patients also had concurrent cisplatin and induction or adjuvant PF (cisplatin and 5-fluorouracil)., Results: The average mean dose achieved in GTV, GTVn, and PTV were 79.5 Gy, 75.3 Gy, and 74.6 Gy, respectively. The median follow-up was 25 months, with 4 recurrences: 2 locoregional and 2 distant failures. All patients with recurrence had IMRT alone without chemotherapy. The 2-year locoregional control rate, distant metastases-free and disease-free survivals were 95.7%, 94.2%, and 93.1%, respectively. One treatment-related death caused by adjuvant chemotherapy occurred. The 2-year overall survival was 92.1%., Conclusions: Dose escalation to 76 Gy in tumor is feasible with T3-T4 NPC and can be combined with chemotherapy. Initial results showed good local control and survival.

Melioidosis is caused by an infection by Burkholderia pseudomallei. Osteomyelitis is a recognised manifestation of melioidosis but Burkholderia pseudomallei is a relatively rare aetiological agent in musculoskeletal infections. We report a 32-year-old diabetic man with septicaemia due to melioidotic infection of the spleen, liver and distal femur. The osteomyelitis relapsed despite being treated with the standard radical debridement and insertion of gentamycinimpregnated polymethylmetacrylate (PMMA) beads, followed by an optimal antibiotic therapy. The PMMA-gentamycin beads were then removed. The bone defect was debrided and packed with calcium hydroxyapatite blocks filled with ceftazidime powder. The osteomyelitis was successfully treated and the patient remained free of infection four years postoperatively. Computed tomography demonstrated successful incorporation of the calcium hydroxyapatite into host bone.

A prospective cohort study was undertaken at two centers to look for the incidence of deep vein thrombosis (DVT) following knee arthroscopic surgery. Eighty-four patients who had 90 arthroscopic procedures were reviewed. The relevant risk factors: past or family history of DVT, smoking, oral contraceptives, body weight, haemoglobin level, platelet count, tourniquet time and type of anaesthesia were documented. All patients were subjected to preoperative and post-operative duplex ultrasound. Only one patient (1.2 %) was noted to have DVT involving the peroneal vein. We concluded that the incidence of DVT after knee arthroscopy was very low in this study population.

We report a case of delayed diagnosis of tarsal tunnel syndrome caused by a ganglion arising from the talo-calcaneal joint. Unusually the symptoms were mainly due to the lateral planter nerve compression with a positive Tinel's sign. A surgical decompression was successful in relieving the dysaesthesia in spite of a 7 years history.

A 19-year old girl suffered from relapse of chronic myeloid leukemia (CML) after bone marrow transplantation. The disease was controlled by interferon and imatinib mesylate, but was complicated by autoimmune hyperthyroidism. She presented with unilateral proptosis with no extraocular muscle or visual defect at 26 months follow-up. Systemic investigations showed no recurrence of leukemia or thyrotoxicosis. Magnetic resonance imaging revealed an extensive retro-orbital base of skull lesion. A trans-oral biopsy showed fibrous dysplasia and continuous observation was advised. The unusual sequence of events and the differential diagnoses for unilateral proptosis in post bone marrow transplantation (BMT) cases are discussed.

The rib is an uncommon site of osteosarcoma. With the use of adjuvant chemotherapy and aggressive surgical resection of the metastatic pulmonary lesions, extrapulmonary metastases are becoming more clinically evident. Primary rib osteosarcoma with extrapulmonary metastasis is exceedingly rare. A case is reported, showing that the pattern of metastasis of rib osteosarcoma is similar to that of primary bone osteosarcoma. The liver metastasis occurred after resection of the metastatic pulmonary lesions. A CT scan of the primary rib lesion and liver metastasis both showed a lace-like enhancement pattern, its histological appearance corresponding with neoplastic osteoid. With the increasing use of CT abdomen for localization of extrapulmonary metastases, lace-like enhancement may be seen more readily in the future.

Lysine 318 in the conserved sequence SXXXGXGKS of bacteriophage T7 gene 4A' protein was mutated to an alanine to understand the effect of this substitution on the helicase and primase activities. The dTTPase activity of 4A'/K318A mutant protein was much lower than that of 4A', and both Km and kcat values were affected. The Km of the mutant protein was 3-5-fold higher, and the kcat was about 100-fold lower, than that of 4A'. The mutation did not affect the ability of 4A'/K318A to assemble into hexamers or bind DNA in the presence of MgdTTP. Interestingly, the mutant protein does not bind DNA in the presence of MgdTMP-PCP. The reduced dTTPase activity, however, decreased the helicase activity of the mutant protein to an undetectable level, whereas its primase activity was only 1.5-2.5-fold lower. When 4A'/K318A mutant protein was mixed with 4A', heterooligomers were formed and the helicase and the DNA-dependent dTTPase activities of 4A' were inhibited, but the DNA-independent activity actually increased. The extent of decrease in activities upon heterooligomer formation depended both on the length of time 4A' and 4A'/K318A proteins were incubated and on the concentration of the mutant protein. In addition, the decrease in the dTTPase activity was observed only when the two proteins were incubated in the absence of MgdTTP and DNA, conditions under which both proteins form unstable hexamers. Even though 4A'/K318A does not bind a 30-mer DNA in the presence of MgdTMP-PCP, heterooligomers were capable of binding DNA with the same stoichiometry as 4A'. Protein-DNA cross-linking experiments with (dT)30 and poly(5-BrdU) showed that DNA interacts with five and perhaps all six subunits of 4A'. Therefore, unless heterooligomer restores the ability of the mutant protein to bind DNA in the presence of MgdTMP-PCP, these results suggest that the DNA can bind 4A' by interacting with a few subunits. However, a fully active hexamer is required for both the helicase and the single-stranded M13 DNA-dependent dTTPase activities.