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g., electrodes, binders, and separators). We also summarize the use of lignin-based materials as heavy metal adsorbents for environmental remediation. This review paves the way to future potentials and opportunities of lignin as a renewable material for energy and environmental applications. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.AIMS The incidence of severe hypoglycemia and its risk factors including an insulin-sensitizing adipokine, adiponectin were prospectively investigated in Japanese patients with type 1 or insulin-treated type 2 diabetes MATERIALS AND METHODS 207 participants with type 1 diabetes (mean age, 55years) and 1,396 with insulin-treated type 2 diabetes (mean age, 65 years) from local diabetes registry were followed for 5 years (follow-up rate 99%). Severe hypoglycemia was defined as events requiring the assistance of others for recovery from hypoglycemia. RESULTS The incidence of severe hypoglycemia was 9.2 per 100 person-year in those with type 1 diabetes and 2.3 per 100 person-year in those with insulin-treated type 2 diabetes, respectively. In type 1 diabetes, the risk was significant in those with history of severe hypoglycemia within a previous year, slow eating, and higher serum adiponectin (the highest vs. the lowest in quartile hazard ratio (HR) 2.36, 95%CI 1.22-4.69). In insulin-treated type 2 diabetes, the risk included age ≥ 65 years, history of severe hypoglycemia within a previous year, alcohol consumption ≥ 60 g/day, larger insulin dose, and higher serum adiponectin (the highest vs. the lowest in quartile, HR 2.95, 95%CI 1.22-4.69). In all participants, the incidence of severe hypoglycemia increased along with serum adiponectin (age-and sex-adjusted HR 1.65 per 1SD increase of log serum adiponectin, 95% CI 1.45-1.87). CONCLUSIONS The incidence of severe hypoglycemia was prospectively determined and the association between severe hypoglycemia and higher serum adiponectin was observed in Japanese patients with type 1 and insulin-treated type 2 diabetes. This article is protected by copyright. Akt Inhibitor VIII All rights reserved.The shallow Caroline Seamount is located in the tropical western Pacific Ocean. Its summit is 57 m below the surface and penetrates the euphotic zone. Therefore, it is ideal for the study of the influence of seamount on plankton distribution. Here, virioplankton abundance and distribution were investigated by flow cytometry (FCM) in the Caroline Seamount in August and September 2017. The total abundance of virus-like particles (VLP) was in the range of 0.64 × 106 -18.77 × 106  particles/ml and the average was 5.37 ± 3.75 × 106  particles/ml. Three to four distinct viral subclusters with similar side scatter but different green fluorescence intensities were identified. Above the deep chlorophyll maximum (DCM), two medium fluorescence virus (MFV) subclusters were discriminated. Between the DCM and the deeper layers, only one MFV subcluster was resolved. In general, low fluorescence viruses (LFV) comprised the most abundant subclusters. In the 75-150 m water column, however, the MFV abundance was higher than the LFV abundance. High fluorescence viruses (HFV) constituted the least abundant subcluster throughout the entire water column. Virioplankton abundance was significantly enhanced at the seamount stations. Environmental factors including water temperature and nitrate concentration were the most correlated with the variation in virioplankton abundance at the seamount stations. Interactions between shallow seamounts and local currents can support large virus standing stocks, causing a so-called indirect "seamount effect" on the virioplankton. © 2020 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.After heart transplantation, adding everolimus (EVL) to standard immunosuppressive regimen mostly relies on converting from calcineurin inhibitors (CNI) to EVL. The aim of this study was to describe the effects of combining low-dose EVL and CNI in maintenance immunosuppression regimen (quadritherapy) and compare it to standard tritherapy associating standard-dose CNI, MMF and corticosteroids. In 3-years registry cohort of heart transplanted patients, those who received quadritherapy were compared to those who received tritherapy. EVL was added after 3 months post-transplantation. Three analyses were performed to control for confounders propensity-score matching, multivariable survival and inverse-probability-score weighting (IPSW) analyses. Among 213 patients who were included (75 with quadritherapy), propensity-score matching selected 64 unique pairs of patients with similar characteristics. In the matched cohort (n=128), quadritherapy was associated with fewer deaths (3 (4.7%) vs 17 (21.9%), p-value=0.007) and biopsy-proven acute rejections (15 (23.4%) vs 31 (48.4%), p-value=0.002). These results were confirmed in the overall cohort (n=213), after multivariable and IPSW analyses. Renal function and donor-specific HLA-antibodies remained similar in both groups. Low-dose combination quadritherapy was associated with fewer deaths and rejections, compared to standard immunosuppression tritherapy. This article is protected by copyright. All rights reserved.This study aimed to explore new therapeutic targets to improve the survival rate of patients with oral squamous cell carcinoma (OSCC).MiR-210-3p, EphrinA3 and EMT related indices were evaluated in OSCC tissues and cell lines. In addition, the relationship between differential EphrinA3 expression and tumour progression was explored through molecular biology techniques, in vitro functional experiments and tumour xenotransplantation models. The expression of EphrinA3 (rs  = -0.719, P  less then  .05) and E-cadherin (rs  = -0.856, P  less then  .05) was negatively correlated with the pathological grading in OSCC tissues. Protein clustering shows EphrinA3 may be associated with tumour progression. EphrinA3 also can regulate the biological behaviour of oral cancer cells. link2 And it regulates the EMT by the PI3K/AKT signalling pathway. MiR-210-3p targeted the gen EFNA3. Up-regulation of miR-210-3p expression can decrease the expression of EphrinA3 and further to influence the biological behaviour of OSCC. The miR-210-3p-EphrinA3-PI3K/AKT signalling axis plays an important role in the progress of OSCC. EphrinA3 may serve as a novel target for oral cancer treatment. © 2020 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.The tick-borne pathogen Anaplasma phagocytophilum is an emerging infectious disease threat, but the overall A. phagocytophilum seroprevalence in humans is unclear. We performed a systematic search of English databases for literature published from 1994 to 2018. Studies reporting serological evidence of A. phagocytophilum infection in humans were included, and the information was extracted by two authors independently. As the study heterogeneity was significant, a random-effects model was used to calculate the overall pooled seroprevalence. Data from 56 studies involving 28,927 individuals from four continents were included. The seroprevalence reported by the studies ranged from 0% to 37.26%. The overall pooled A. phagocytophilum seroprevalence in humans was 8.4% (95% CI 6.6%-10.4%). The seroprevalence was highest in high-risk population (13.8%) and lowest in healthy population (5.0%). The estimated A. phagocytophilum seroprevalence of febrile patient, tick-bitten and tick-borne diseases populations was 6.4%, 8.0% and 9.0%, respectively. This meta-analysis demonstrated first A. phagocytophilum seroprevalence estimates in different populations (healthy, febrile patient, high-risk, tick-bitten and tick-borne diseases populations); it seems likely that present surveillance efforts are missing mild or asymptomatic infections of humans. © 2020 Blackwell Verlag GmbH.PURPOSE The purpose of this study was to develop an auto-planning platform to be interfaced with a commercial treatment planning system (TPS). The main goal was to obtain robust and high-quality plans for different anatomic sites and various dosimetric requirements. METHODS Monaco (Elekta, St. Louis, US) was the TPS in this work. All input parameters for inverse planning could be defined in a plan template inside Monaco. A software tool called Robot Framework was used to launch auto-planning trials with updated plan templates. The template modifier external to Monaco was the major component of our auto-planning platform. For current implementation, it was a rule-based system that mimics the trial-and-error process of an experienced planner. link3 A template was automatically updated by changing the optimization constraints based on dosimetric evaluation of the plan obtained in the previous trial, along with the data of the iterative optimization extracted from Monaco. Treatment plans generated by Monaco with all plequent optimization for final plans was completed by Monaco without further intervention. The plan quality was weakly dependent on the parameter selection in the initial template and the choices of the step sizes for changing the constraint values. CONCLUSION An automated planning platform to interface with Monaco was developed, and our reported tests showed preliminary results for prostate and head and neck cases. © 2020 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.Lysergic acid diethylamide (LSD) is a prototypical serotonergic psychedelic drug and the subject of many clinical investigations. In recent years, a range of lysergamides has emerged with the production of some being inspired by the existing scientific literature. Others, for example various 1-acyl substituted lysergamides, did not exist before their appearance as research chemicals. 1-Cylopropanoyl-LSD (1CP-LSD) has recently emerged as a new addition to the group of lysergamide-based designer drugs and is believed to be psychoactive in humans. In this investigation, 1CP-LSD was subjected to detailed analytical characterizations including various mass spectrometry (MS) platforms, gas and liquid chromatography, nuclear magnetic resonance spectroscopy, solid phase and GC condensed phase infrared spectroscopy. Analysis by GC-MS also revealed the detection of artificially induced degradation products. Incubation of 1CP-LSD with human serum led to the formation of LSD, indicating that it may act as a prodrug for LSD in vivo, similar to other 1-acyl substituted lysergamides. The analysis of blotters and pellets is also included. 1CP-LSD also induces the head-twitch response (HTR) in C57BL/6J mice, indicating that it produces an LSD-like behavioural profile. 1CP-LSD induced the HTR with an ED50 = 430.0 nmol/kg which was comparable with 1P-LSD (ED50 = 349.6 nmol/kg) investigated previously. Clinical studies are required to determine the potency and profile of effects produced by 1CP-LSD in humans. This article is protected by copyright. All rights reserved.BACKGROUND Transcatheter edge-to-edge repair with MitraClip is only approved for treatment of mitral regurgitation but is increasingly used to treat concomitant tricuspid regurgitation (TR) due to its common coexistence and association with poor outcomes. This study aimed to describe the learning curve associated with the challenge of off-label treatment of concomitant TR. METHODS This is a retrospective review of initial and consecutive patients who underwent combined edge-to-edge repair of mitral and tricuspid valves (TVs) at our institution from August 2017 to October 2019. RESULTS Repair of both valves with MitraClip was performed in 22 patients (median age 81.5 years, 32% female). Mean procedure time was 176 ± 47 min; mean fluoroscopy time was 65 ± 24 min. Procedure duration in the first tertile was significantly longer (223 ± 13 min) than in the third tertile (143 ± 23 min, p = .0003). Median number of total clips placed per case was 3; in 15 patients (68%), the anterior and septal leaflets of the TV were clipped.