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Conclusions Adopting more stringent emission standards in France and Italy would save money and lives.Background Vein graft stenosis is a major complication of coronary artery bypass surgery and peripheral arterial bypass procedures. Experimental models of this clinical complication have used in vivo grafting procedures, relying on the relatively modest neointimal thickening in these models as a surrogate for clinical graft stenosis without regard to the donor site origin of the vein graft. Materials and methods In a standard rat model of vein grafting, three different donor sites were used to supply veins used as interpositional grafts to the femoral artery the superficial inferior epigastric vein, the common femoral vein, and the posterior facial vein (distal branch of the jugular vein). Grafts were harvested as 4 wk and histomorphometrically evaluated for the extent of neointimal formation and lumen narrowing. Results The posterior facial vein showed significantly thicker neointima and a greater extent of lumen narrowing than the other two graft sources, despite having a similar diameter to the femoral vein and nearly twice the initial diameter of the epigastric vein. Conclusions The source of donor graft material can greatly influence the extent of neointimal response after interpositional vein grafting to arterial flow. These findings support use of the posterior facial vein graft over other more standard donor vein grafts in research directed at understanding the causes and prevention of vein graft stenosis.Background The growth of the aging population coupled with the increasing incidence of thyroid cancer warrants a better understanding of thyroid cancer in older adults. We aimed to investigate the variation of treatment patterns and determine if the extent of surgery is associated with disease-specific mortality in older adults with differentiated thyroid cancer (DTC). Methods We performed a population-based study using the Surveillance, Epidemiology, and End Results 18 program to examine patients diagnosed with DTC between 2004 and 2015. Patients were stratified by age younger adults (aged 18-54 y), middle adults (aged 55-64 y), older adults (aged 65-79 y), and super elderly (aged ≥80 y). Disease-specific mortality was estimated using Kaplan-Meier curves and compared using the log-rank test. Multivariable Cox regression was used to assess associations between clinicopathologic characteristics and treatment patterns on disease-specific mortality. Results Of 117,098 patients with DTC, 72,368 were younger adulth a worse disease-specific survival. Surgical decision-making in the older population is complex, and future prospective studies are needed to assess this age-related treatment variation.Background For the past 30 y, the incidence rate of malignant melanoma has risen steadily. Ultraviolet radiation exposure has been identified as the most prevalent modifiable risk factor for melanoma. Here, next-generation sequencing was used to analyze the relationship between multiple sun exposure factors and select cancer-related genes to determine the relationship of sun exposure on the molecular profiles of melanomas. Methods The collection and analysis of study samples were approved by the institutional review board. The patient cohort consisted of 173 patients whose melanoma tissue samples underwent next-generation sequencing analysis for somatic mutations of 50 cancer-related genes. Univariate and multivariate analyses were conducted. Results Patients with a history of blistering sunburn had an absolute mutation incidence of 1.67 mutations per patient, compared with patients without a history of blistering sunburn, who had an absolute mutation incidence of 1.16 mutations per patient (P = 0.028). A BRAF mutation was found in more tumors of patients who reported visiting a tanning salon (57.14%), compared with those who had not (18.75%; P = 0.0463). Patients with a previous history of skin cancer were more likely to have a CDKN2A mutation (20.83%), compared with those without a previous history of skin cancer (7.76%; P = 0.0292). Conclusions The trends seen in the molecular profiles of melanomas with respect to various sun exposure factors suggest that sun exposure impacts genetic makeup. Considering the increase in absolute mutation incidence in patients with a history of blistering sunburn suggests that additional genes may contribute to the pathology of malignancy. Future studies will use the unique molecular profiles of melanomas to personalize patient treatments.Background Invasive surgical procedures occur infrequently in an emergency department setting; however, procedural competence is expected from trauma residents. Emergent procedures are challenging to train in a formal manner because of the urgent nature when they present. To supplement education, new and creative teaching tools such as simulation and multidisciplinary training are being used. Our study organized a multidisciplinary simulated learning workshop with surgery and emergency medicine residents for invasive, emergent procedures. Materials and methods In total, 14 surgical and 36 emergency medicine residents at our institution participated in a simulated learning experience. Ten workshops were organized, with six to seven residents participating in each session. Using a human cadaveric model, all residents were taught by senior-level residents and attendings from both specialties on how to perform uncommonly or anatomically challenging emergent invasive procedures. A pre- and post-laboratory survey was completed by all the residents to assess confidence in performing each of the 13 procedures. Results All residents (N = 50), who participated in the study, completed pre- and post-laboratory surveys. Comparison of the pre- and post-laboratory confidence levels indicated significant increases in confidence in performing all procedures. Residents stated that this multidisciplinary approach to education in a controlled setting was helpful and fostered a collaborative relationship between both specialties. Conclusions Although some surgical procedures remain uncommon in the emergency department, competency is nevertheless expected for appropriate patient care. Using a collaborative simulation-based cadaver laboratory to teach emergent procedures significantly improved residents' confidence while concurrently fostering professional relationships.Background Significant disparities in access to prompt helicopter transport exist among rural trauma populations. We evaluated the impact of an additional helicopter base on transport time and mortality in a rural adult trauma population. Materials and methods We performed a retrospective cohort study of adult patients with trauma transported by helicopter from scene to a level one trauma center between 2014 and 2018. A new rural helicopter base added to the trauma center's catchment area in 2016 served as the transition time for an interrupted time series analysis. Patients injured in this base's county and adjoining counties were analyzed. Baseline characteristics were compared with a Student's t-test and Pearson's chi-squared test. Cox and linear regression models evaluated the new base's effect on mortality and transport time, respectively. Results A total of 332 patients were analyzed 120 (36.1%) transported before the addition of the new helicopter base and 212 (63.9%) transported after. Patients transported after the addition of the base had higher injury severity score (13.7 versus 10.1, P less then 0.001) and were more likely to receive blood en route (19.3% versus 6.7%, P = 0.005). After the addition of the base, there was a decreased hazard ratio for mortality (hazard ratio 0.26, 95% confidence interval 0.11-0.65, P = 0.004) with no significant change in transport time (-36.7 min, P = 0.071) for the area. Conclusions Local helicopter transport units may confer improved survival for the injured patient. This study demonstrates the important role of helicopter transport within a regional trauma system and the impact that expanded access to rapid air transport can have on mortality.Background Methamphetamine (METH) use is on the rise globally, with the number of treatment seekers increasing exponentially across the globe. Evidence-based therapies are needed to meet rising treatment needs. This systematic review intends to appraise the existing evidence to identify effective non-pharmaceutical approaches for the treatment of METH use disorder. Methods Five electronic bibliographic databases-Ovid (Medline), Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science and PsycINFO- were searched to identify relevant studies that were published between January 1995 to February 2020. Studies were selected and assessed by two independent reviewers. A systematic review of data from both randomised control trials (RCT) and non-RCTs was conducted to appraise the evidence. Results A total of 44 studies were included in the review. Behavioural interventions, i.e. cognitive behavioural therapy (CBT), contingency management (CM), exercise, residential rehabilitation based therapies, repetitive transcranial magnetic stimulation (rTMS), and matrix model demonstrated treatment efficacy in promoting abstinence, reducing methamphetamine use or craving in the participants. While CM interventions showed the strongest evidence favouring the outcomes assessed, tailored CBT alone or with CM was also effective in the target population. Conclusions Behavioural interventions should be considered as the first line of treatment for methamphetamine use disorder. Future studies should address the longevity of the effects, and limitations due to smaller sample sizes and high dropout rates to enable better assessment of evidence.Background This study examines whether MOUD increases treatment completion and retention in both short-term (ST) and long-term (LT) residential programs using a national dataset. Methods Data were extracted from the 2015-2017 TEDS-D (Treatment Episode Dataset-Discharge) datasets for opioid using adults in ST (n = 87,296) and LT (n = 66,623) residential treatment. Primary outcome variables were treatment completion and retention (ST length of stay >10 days; LT >90 days). Logistic regression estimated the effects of MOUD on the probability of treatment completion and retention separately for ST and LT residential treatment, controlling for individual background characteristics. Results Only 18% of clients in residential treatment programs had MOUD in their treatment plans. For ST residential treatment, MOUD was associated with a 40% increased likelihood of treatment completion (OR = 1.404) and 34% increased retention (OR = 1.337). For LT residential treatment, MOUD was associated with a 26% reduced likelihood of treatment completion (OR = 0.743) and no significant increase in retention. Post hoc analysis suggests insurance coverage may be influencing outcomes. Conclusions Despite MOUD being a standard of care for OUD, MOUD is particularly under-utilized in residential treatment. Further research should focus on how best to integrate MOUD within short-term residential treatment and to explore the potential viability of MOUD in long-term residential programs. Given the risk of overdose following residential treatment, for at least short-term residential programs, this setting may be advantageous for integrating psychosocial treatments with early MOUD engagement in a structured therapeutic environment as part of a long-term continuum of care recovery program.Gastric carcinoma (GC) ranks fifth in terms of cancer morbidity and third in cancer-related death worldwide and imposes enormous health and economic burdens. The molecular mechanisms underlying GC formation and progression remain unclear. Our aim was to identify the involvement of circular RNA circFOXO3 in GC, and to determine the underlying mechanisms. In this study, we revealed a stimulatory role of circular RNA circFOXO3 in tumor growth in vivo. CircFOXO3 enhanced GC cell proliferation and migration in vitro and promoted tumor growth of GC cells in vivo. Bioinformatic analysis revealed that circFOXO3 might regulate USP44 expression by specifically binding to microRNA (miR)-143-3p. Existence of circFOXO3-miR-143-3p-USP44 axis in GC cells was confirmed by RNA-binding protein immunoprecipitation, luciferase reporter assay, and an RNA pull-down experiments. All the data indicate that circFOXO3 promotes GC cell proliferation and migration by upregulating USP44 expression via targeting of miR-143-3p.The morbidity of SARS-CoV-2 (COVID-19) is reaching 3 Million landmark causing and a serious public health concern globally and it is enigmatic how several antiviral and antibody treatments were not effective in the different period across the globe. With the drastic increasing number of positive cases around the world WHO raised the importance in the assessment of the risk of spread and understanding genetic modifications that could have occurred in the SARS-CoV-2. Using all available deep sequencing data of complete genome from all over the world (NCBI repository), we identified several hundreds of point mutations or SNPs in SARS-CoV-2 all across the genome. This could be the cause for the constant change and differed virulence with an increase in mortality and morbidity. Among the 12 different countries (one sequence from each country) with complete genome sequencing data, we noted the 47 key point mutations or SNPs located along the entire genome that might have impact in the virulence and response to different antivirals against SARS-CoV-2. In this regard, key viral proteins of spike glycoprotein, Nsp1, RdRp and the ORF8 region got heavily mutated within these 3 months via person-to-person passage. We also discuss what could be the possible cause of this rapid mutation in the SARS-CoV-2.Genomic variants in both ADTRP and TFPI genes are associated with risk of coronary artery disease (CAD). ADTRP regulates TFPI expression and endothelial cell functions involved in the initiation of atherosclerotic CAD. ADTRP also specifies primitive myelopoiesis and definitive hematopoiesis by upregulating TFPI expression. However, the underlying molecular mechanism is unknown. Here we show that transcription factor POU1F1 is the key by which ADTRP regulates TFPI expression. Luciferase reporter assays, chromatin-immunoprecipitation (ChIP) and electrophoretic mobility shift assay (EMSA) in combination with analysis of large and small deletions of the TFPI promoter/regulatory region were used to identify the molecular mechanism by which ADTRP regulates TFPI expression. Genetic association was assessed using case-control association analysis and phenome-wide association analysis (PhenGWA). ADTRP regulates TFPI expression at the transcription level in a dose-dependent manner. The ADTRP-response element was localized to a 50 bp region between -806 bp and -756 bp upstream of TFPI transcription start site, which contains a binding site for POU1F1. Deletion of POU1F1-binding site or knockdown of POU1F1 expression abolished ADTRP-mediated transcription of TFPI. ChIP and EMSA demonstrated that POU1F1 binds to the ADTRP response element. Genetic analysis identified significant association between POU1F1 variants and risk of CAD. PhenGWA identified other phenotypic traits associated with the ADTRP-POU1F1-TFPI axis such as lymphocyte count (ADTRP), waist circumference (TFPI), and standing height (POU1F1). These data identify POU1F1 as a transcription factor that regulates TFPI transcription in response to ADTRP, and link POU1F1 variants to risk of CAD for the first time.Objective Type 1 diabetes onset is preceded by a pre-inflammatory stage leading to insulitis and followed by targeted destruction of the insulin-producing beta cells of the pancreas. Osteopontin (OPN) is a secreted phosphoprotein with cytokine properties, implicated in many physiological and pathological processes, including infection and autoimmunity. We have previously identified up-regulated osteopontin transcripts in the pancreatic lymph nodes of the NOD (Non-Obese Diabetic) mouse at the pre-diabetic stages. Investigating the underlined disease initiating mechanisms may well contribute to the development of novel preventive therapies. Our aim was to construct opn null mice in a NOD autoimmune-prone genetic background and address the pathogenic or protective role of the osteopontin molecule in the early stages of type 1 diabetes. Methods We generated opn null mutant mice in a NOD genetic background by serial backcrossing to the existing C57BL/6 opn knockout strain. The presence of opn wild type or null ally-state of T1D pathogenesis. We report that the OPN protein structure of the NOD/ShiLtJ strain corresponds to the a-type allele of the osteopontin gene. Comparative analysis of the single nucleotide polymorphisms between the a-type and b-type alleles indicates that the majority of variations are within the non-coding regions of the gene. Conclusions The construction of opn null mice in an autoimmune genetic background (NOD.B6.Cg-spp1-/-) provides important tools for the study of the implication of the OPN in type 1 diabetes, offering the possibility to address the significance of this molecule as an early marker of the disease and as a therapeutic agent in preclinical studies.We have investigated 765 unrelated individuals from Azerbaijan using AmpFlSTR® Identifiler® Plus PCR Amplification Kit. For each STR locus basic population-genetic and forensic parameters were determined. The calculated P-values (PHWE) for the accuracy of the Hardy-Weinberg equilibrium (HWE) tests, showed that this parameter had a statistically significant value (PHWE = 0.0000) only for the THO1, D18S51 and FGA loci. The values of parameters for the set of 15 STR loci such as CPE, CPD, CTPI and the PP showed that the given set of loci can be confidently used to solve identification problems for the studied population. Multiple population differentiation tests performed between Azerbaijan and other 17 world populations revealed that between Azerbaijan and Iraqi, Iranian, Turkish populations there were no significant differences on all STR loci. Additionally, comparisons of Fischer genetic distance indices (FST) P-values did not reveal any statistically significant difference between Azerbaijan and Iranian populations at P less then 0.05. However, with South African black population differences at all STR loci were detected. Both tests did not reveal a locus by which our population would differ from all the other compared populations. PCA and PCoA analyzes showed that the Azerbaijani population was grouped with different populations in different quarters, showing a negative and zero correlation, respectively. Regarding the location of the Azerbaijan population, there are some differences between NJ and UPGMA phylogenetic trees. For example, in the NJ tree, Azerbaijan population was grouped with Iranian, but in the UPGMA tree, it was grouped with the Turkish population. Based on Nei's genetic distance between populations the second tree has a more realistic outcome.Isolated substances and those organically synthesized have stood out over the years for their therapeutic properties, including their antibacterial activity. These compounds may be an alternative to the production of new antibiotics or may have the ability to potentiate the action of preexisting ones. In this context, the objective of this study was to evaluate the in vitro antibacterial and efflux pump inhibitory activity of hydroxyamines derived from lapachol and norlachol, more specifically the compounds 2-(2-Hydroxyethylamino)-3-(3-methyl-2-butenyl)-1,4 dihydro-1,4-naphthalenedione, 2-(2-Hydroxyethylamino)-3-(2-methyl-propenyl)[1,4]naphthoquinone and 2-(3-Hydroxypropylamino)-3-(3-methyl-2-butenyl)-[1,4]naphthoquinone, against Staphylococcus aureus strains carrying the NorA efflux pump mechanism. The substances were synthesized from 2-hydroxy-quinones, lapachol and nor-lapachol, obtaining the corresponding 2-methoxylated derivatives via dimethyl sulfate alkylation in a basic medium, which then reacted chemns and the discovery of functional ligands associated with a reduction in bacterial resistance.Using data from the Health and Retirement Study (1994-2012), we studied the association between adult children's education and financial and caregiving support they provided to their aging parents in the last years of the parents' life. We controlled for the circumstances of parents' death, their functional limitations, whether they were in long-term care or home-care settings in the last year of their life, and in some models, various measures of parents' self-reported health. Estimates suggest that having a college degree and above has a significantly positive association with monetary transfers and knowledge support children provide to their parents. Estimates remained robust in models that included parent fixed effects. Evidence of children's education on instrumental support to parents was nonlinear in that although some college education increased instrumental support, but, a college degree did not have a statistically significant effect. Gender did not play a moderating role in the relationship between offspring education and support towards parents.Scene construction refers to the capacity to imagine richly detailed scenes in one's mind's eye and has been demonstrated to be compromised across a range of clinical disorders in which episodic memory processes are also affected. It remains unclear however, how task demands modulate the content of the to-be-simulated scenes. Here, we sought to investigate the capacity for social forms of scene construction in the behavioural-variant of frontotemporal dementia (bvFTD), a progressive neurodegenerative disorder characterised by pronounced social cognitive and executive dysfunction, alongside episodic memory impairments. Twenty bvFTD patients, 14 Alzheimer's disease (AD) patients, and 20 healthy controls completed a scene construction task involving imagining social (e.g., busy restaurant, crowded train), and non-social (e.g., forest, abandoned warehouse) scenes, as well as a comprehensive neuropsychological battery. Relative to Controls, patient groups provided significantly fewer contextual details during scen important for future studies to address.Recently, the issues of land-based plastics and their associated challenges in the marine world have been widely publicised in the media and scientific literature. Thus far, despite these communications, there have been few reports that have focused on the issues that acute plastic waste generation and its poor management pose to human health and the global environment. Also, articles on ways to mitigate these issues particularly in sub-Saharan Africa have not been documented. Indeed, there is significant scope for improvements in plastic waste management in developing countries, which offer a wide range of economic and environmental benefits. Plastic waste generation in sub-Saharan Africa is dependent on many factors like urbanization, etc. Currently, the population of sub-Saharan Africa is around 1 billion as of the year 2019, the amount of generated waste is 180 million tonnes at the rate of 0.5% per capita per day, the amount that is openly dumped is 70% and the plastic waste generated annually is 17 million tonnes. Therefore, this study aims to provide an overview of the plastic lifecycle and problems associated with plastic waste management in sub-Saharan Africa, including current practices, public participation and opinion, and government regulations. In addition, this highlight aims to outline the impact of plastic waste proliferation on man and the environment; and the economic and environmental benefits of proper plastic waste management. Critical discussion of current processes and the suitability of potential solutions provide the basis for proposition on mitigation measures to avert the negative impact of plastic waste.Millions of tonnes of virgin (primary) plastic are produced annually, while recoverable (secondary) plastic rapidly accumulates as waste in landfills and the environment. Single-use plastics (SUPs) have short lifespans, and most of this waste is generated by packaging from global food industries. Food packaging waste comprises approximately one-third (8 million tonnes) of all Canadian municipal solid waste, and only 20% is recovered for reuse or recycling. Extended producer responsibility (EPR) strategies leverage corporate resources to reduce SUP waste generated by consumers. Implementation of EPR strategies allows local jurisdictions to gain greater control over their waste streams. Although Canada has had a national EPR strategy since 2009, it is currently only implemented for packaging in five provinces (e.g., British Columbia, Saskatchewan, Manitoba, Ontario and Québec), and is currently under development in New Brunswick. In this short communication, a case example of EPR implementation in Nova Scotia is provided which highlights the potential economic benefits for municipalities ($14-17 M CAD in estimated savings), for improved solid waste management and for increasing recycling rates. Further, a regional EPR strategy is recommended for all Atlantic Canadian provinces (e.g., Newfoundland and Labrador, New Brunswick, Prince Edward Island and Nova Scotia) now that the Canadian federal government has announced a move towards zero plastic waste under the Ocean Plastics Charter.For sustainable growth, an economic model must tend toward a circular system, especially in the field of waste management. This work focuses on the valorization of spent fluid catalytic cracking catalyst from oil refineries, which generate 400,000 metric tons of spent catalyst per year worldwide, most of which is sent to landfills. A new alternative to landfilling is proposed for this waste, based on the combination of acid leaching for the recovery of lanthanum, a valuable rare earth, and the reuse of the leached solid residue as a cement substitute. A comparative life cycle assessment was made, including four environmental impact categories, i.e. global warming, fossil resource scarcity, mineral resource scarcity and water consumption, in order to quantify the potential environmental benefits of secondary lanthanum recovery from industrial waste with respect to primary lanthanum extraction from mineral resources. A maximum of 85.6% La recovery was achieved and 15 wt% of cement can be substituted with leached solid residue without changing the original cement classification. The waste management process presented in this paper promotes the sustainable management of the spent fluid catalytic cracking catalyst and contributes to the development of a new resource for a critical material such as lanthanum. The implementation of this novel waste management process could reduce global warming and mineral resource scarcity but would increase fossil resource scarcity and water consumption in comparison with primary La extraction.Bitumen ages in the short and long-term due to environmental conditions. As the bitumen ages, it loses its original properties and flexibility. Hardened bitumen causes certain distresses in pavement that may endanger traffic safety and reduce travel comfort. Bitumen is one of recoverable material, however some techniques may not be ecological due to considerable energy, time, and cost. On the other hand, recovering of aged bitumen might be eco-friendlier, energy-efficient, and economic by using bio-based waste materials such as waste vegetable cooking oils (WVCO). In this perspective, this paper was established on the idea of sustainable recovery of aged bitumen and WVCO. Base bitumen was aged in case of short-term (ST) and long-term (LT) in laboratory condition and modified with WVCO ranging from 2 to 10% by weight of bitumen. To determine the effect of WVCO modification on aged bitumen conventional and rheological test methods were utilized. To find the optimum rate of WVCO for full recovery of aged bitumen, an index called Pure Rejuvenation Index (PRI) was specified and applied for each test results. It can be concluded from PRI analyses that WVCO can be used as rejuvenator to recover aged bitumen and approximately 3% and 6% of WVCO are required for ST and LT aged bitumen cases, respectively. However, different test methods yield different optimum rates of WVCO for ST and LT aged bitumen. Recovering of WVCO and aged bitumen by using together may provide environmental protection and conservation of resources.The purpose of the present study was to assess the differences between the human serum and plasma proteomes, and the stability of human plasma proteins under different storage conditions following blood collection, by means of SWATH-MS analysis. When we compared plasma and serum prepared immediately after blood sampling, 95.5% of 176 quantified proteins differed by less than 1.5-fold. When we compared plasma samples prepared by centrifugation after storage of blood at room temperature for 0, 15 or 30 min, or under refrigeration at 0-5 °C for 1, 4 or 8 h, no protein showed a significant change (q less then 0.05) that amounted to 1.5-fold or more, except hemoglobins. Those proteins were greatly increased in a single sample at 8 h, probably due to hemolysis. Comparison of data from the same samples indicates that the blood proteome is more stable than the blood metabolome. The present results suggest that most components of the proteome are essentially the same in plasma and serum, and are stable under the sto, the blood proteome appears to be more stable than the blood metabolome, based on previously reported metabolomics data with same samples. These data will be helpful in designing protocols for blood sampling and for blood biomarker discovery and validation.Lansoprazole (LPZ) is an acid pump inhibitor, which readily degrades upon acidic or basic conditions and under heating. We investigated here LPZ stability upon incorporation in particles made of cyclodextrin metal-organic frameworks (CD-MOFs). LPZ loaded CD-MOFs were successfully synthesized, reaching high LPZ payloads of 23.2 ± 2.1 wt%, which correspond to a molar ratio of 11 between LPZ and γ-CD. The homogeneity of LPZ loaded CD-MOFs in terms of component distribution was confirmed by elemental mapping by STEM-EDX. Both CTAB, the surfactant used in the CD-MOFs synthesis, and LPZ compete for their inclusion in the CD cavities. CTAB allowed obtaining regular cubic particles of around 5 µm with 15 wt% residual CTAB amounts. When LPZ was incorporated, the residual CTAB amount was less than 0.1 wt%, suggesting a higher affinity of LPZ for the CDs than CTAB. These findings were confirmed by molecular simulations. Vibrational circular dichroism studies confirmed the LPZ incorporation inside the CDs. Solid-state NMR showed that LPZ was located in the CDs and that it remained intact even after three years storage. Remarkably, the CD-MOFs matrix protected the drug upon thermal decomposition. This study highlights the interest of CD-MOFs for the incorporation and protection of LPZ.The thermal behavior of carvedilol and loratadine was studied by differential scanning calorimetry (DSC). The glass-forming ability, as well as the the tendency for crystallization from the glass (glass stability) and from the metastable and equilibrium melt were also investigated by DSC. In addition this technique was also used to characterize the glass transition of carvedilol and loratadine by determining the activation energy of the structural relaxation, the dynamic fragility, and the heat capacity jump associated with the glass transformation. Different aspects of the molecular mobility in carvedilol and loratadine were analyzed by Thermally Stimulated Depolarization Currents (TSDC), while in carvedilol the Dielectric Relaxation Spectroscopy (DRS) technique was also used. Carvedilol stands out for its high values of specific heat jump and dynamic fragility, which has been attributed to the particular mobility of this glass-former in the glass transformation region, a consequence of specific characteristics of its molecular structure. These molecular features are also at the origin of a relaxation above Tg that has been detected and characterized by TSDC; the DRS investigation allowed to better understand the molecular dynamics in carvedilol in the amorphous solid, in the metastable liquid state and in the glass transformation region. Finally, the secondary relaxations in loratadine were studied by TSDC, while those in carvedilol were studied by the two dielectric techniques and the results were compared and discussed.Spray freeze drying is a particle engineering technique that allows the production of porous particles of low density with excellent aerosol performance for inhalation. There are a number of operating parameters that can be manipulated in order to optimise the powder properties. In this study, a two-fluid nozzle was used to prepare spray freeze dried formulation of voriconazole, a triazole antifungal agent for the treatment of pulmonary aspergillosis. A full factorial design approach was adopted to explore the effects of drug concentration, atomisation gas flow rate and primary drying temperature. The aerosol performance of the spray freeze dried powder was evaluated using the next generation impactor (NGI) operated with different inhaler devices and flow rates. The results showed that the primary drying temperature played an important role in determining the aerosol properties of the powder. In general, the higher the primary drying temperature, the lower the emitted fraction (EF) and the higher the fine particle fraction (FPF). Formulations that contained the highest voriconazole concentration (80% w/w) and prepared at a high primary drying temperature (-10 °C) exhibited the best aerosol performance under different experimental conditions. The high concentration of the hydrophobic voriconazole reduced surface energy and cohesion, hence better powder dispersibility. The powders produced with higher primary drying temperature had a smaller particle size after dispersion and improved aerosol property, possibly due to the faster sublimation rate in the freeze-drying step that led to the formation of less aggregating or more fragile particles. Moreover, Breezhaler®, which has a low intrinsic resistance, was able to generate the best aerosol performance of the spray freeze dried voriconazole powders in terms of FPF.Berberine chloride (Brb) is a natural isoquinoline quaternary alkaloid that displayed a set of beneficial biological properties such as antioxidant, antimicrobial, antitumor, anti-inflammatory, and antiviral. Brb is poorly soluble in water and body fluids and its intestinal absorption is very low, which predetermine its low bioavailability. Polymeric nanoparticles seem to be a good platform to overcome these drawbacks. In this study, for the first time, stable aqueous dispersions of nanoparticles (NPs) based on complexes of Brb and poly(methacrylic acid) (PMA) or poly(acrylic acid) (PAA), were successfully prepared by mixing their dilute aqueous solutions as evidenced by the performed dynamic light scattering (DLS) and transmission electron microscopy (TEM) analyses. It was found that the mean diameter and zeta potential of NPs depended on the Brb molar fraction. In the case of Brb/PMA and Brb/PAA NPs the encapsulation efficiency was observed to approach a maximum value of 58.9 ± 0.5% and of 78.4 ± 0.9%, respectively, at values of Brb molar fraction at which maximum amount of complexes was obtained. The performed differential scanning calorimetry (DSC) and X-ray diffraction (XRD) analyses revealed that Brb incorporated in the NPs was in the amorphous state. The Brb release profile was pH-dependent. The Brb-containing NPs displayed good antioxidant capacity close to that of free Brb. In vitro cell viability studies demonstrated that the Brb/PMA (PAA) NPs exerted a higher cytotoxicity against HeLa tumor cell than non-tumor BALB/c 3T3 mouse fibroblast cells. Thus, the obtained NPs are promising candidates in the drug delivery systems in the treatment of cervical tumors.Patients' genetic characteristics, age, gender, diet, and lifestyle affect the success of medical treatment. The treatment's effectiveness can be increased by using personalized medication; however, using conventional large-scale drug production methods can restrict tablet geometry and drug dosage combinations. To create these personalized drugs, 3D printing has been studied as an alternative production method. In this study, stereolithography 3D printing is used to create custom tablet geometries using a novel biocompatible photochemistry consisting of ascorbic acid (AA) encapsulated in a poly(ethylene glycol) dimethacrylate (PEGDMA)-based polymer network and polymerized using riboflavin as a photoinitiator. The printing process is customized for the chemistry and different geometries (small and large tablet, coaxial annulus, 4-circle pattern and honeycomb pattern) with surface area to volume ratios ranging from 0.6 to 1.83 are fabricated. The tablets' microstructures are examined and the cumulative release rates in gastrointestinal conditions are analyzed periodically for 6 h. After 1 h of release, honeycomb and coaxial annulus tablet gels exhibit higher release rates at approximately 80%. The experimental data is fitted to empirical release kinetic models and the Higuchi model is shown to yield the best fitting results. Overall, by using a novel biocompatible photochemistry and 3D printing we have shown that it is possible to successfully load and release ascorbic acid as a model agent, opening up a new class of manufacturing protocols to encapsulate ascorbic acid and other water-soluble vitamins as well as many different drugs for drug delivery applications.18-α-Glycyrrhetinic acid (GA) is a bioactive compound extracted from licorice that exhibits many biological and pharmacological effects such as anti-inflammatory and antioxidant activities on the skin. However, its lipophilic nature results in poor bioavailability that limits clinical applications. Liposomes, presenting the ability to carry both hydrophobic and hydrophilic payloads and a good cytocompatibility, are effective to overcome this barrier. Furthermore, the addition of permeation enhancers such as ethanol into liposomal formulations helps the diffusion of these systems through the skin barrier. Here, we aimed to formulate GA-loaded ethanolic liposomes, using a natural soybean lecithin via a microfluidic approach. Using a fused deposition modeling (FDM) 3D printer we customized a microfluidic chip, and manufactured vesicles that presented spherical shape with a size of 202 ± 5.2 nm, a narrow size distribution and a good stability over a period of 30 days. After reaching a drug encapsulation efficiency of 63.15 ± 2.2%, liposomes were evaluated for their cytocompatibility and skin permeation potentiality after hydrogelation using xanthan gum. The in vitro release and permeation studies were performed using Franz diffusion cells comparing two different media and three synthetic membranes including a polymeric skin-mimicking membrane. The selected formulation presented no cytotoxicity and an increased permeation compared to GA saturated hydrogel. It could perform therapeutically better effects than conventional formulations containing free GA, as prolonged and controlled release topical dosage forms, which may lead to improved efficiency and better patient compliance.Delirium is a common symptom in patients admitted to our hospital with COVID-19, and in cases of hyperactive delirium we have frequently observed behaviors that pose a significant risk of disease transmission to health care providers. Managing this symptom has emerged as an important challenge, as our local health care system has been strained by providers becoming sick or quarantined. Preventative and non-pharmacologic interventions remain critical for managing delirium in such patients, though occasionally pharmacologic treatment is required. When use of an antipsychotic medication is indicated, we recommend that providers consider foregoing the lowest common dose and instead start with the next incrementally higher dose to more quickly and reliably ensure the safety of both patients and providers. We do not recommend initiating prophylactic treatment or escalating doses in a manner that conflicts with currently accepted guidelines without carefully considering the risks and benefits.Purpose Soccer match-play is typically contested over 90 min; however, in some cup and tournament scenarios, when matches are tied, they proceed to an additional 30 min, which is termed "extra-time" (ET). This systematic review sought to appraise the literature available on 120-min of soccer-specific exercise, with a view to identifying practical recommendations and future research opportunities. Methods The review was conducted according to the PRISMA guidelines. Independent researchers performed a systematic search of PubMed, CINAHL and Psych Info in May 2019, with the following keywords entered in various combinations "soccer," "football," "extra-time," "extra time," "120 minutes," "120 min, "additional 30 minutes," and "additional 30 min." Results The search yielded an initial 73 articles. Following the screening process, 11 articles were accepted for analyses. Articles were subsequently organized into the following 5 categories movement demands of extra-time, performance responses to extra-time, physiologic and neuromuscular response during extra-time, nutritional inventions, and recovery and extra-time. The results highlighted that during competitive match-play, players cover 5%-12% less distance relative to match duration (i.e., meters per minute) during ET compared to the preceding 90 min. Reductions in technical performance (i.e., shot speed, number of passes and dribbles) were also observed during ET. Additionally, carbohydrate provision may attenuate and improve dribbling performance during ET. Moreover, objective and subjective measures of recovery may be further compromised following ET when compared to 90 min. Conclusion Additional investigations are warranted to further substantiate these findings and identify interventions to improve performance during ET.Purpose This quasi-experimental study examined the impact of height-adjustable desks in combination with prompts to break up prolonged sitting time during class time and identified social and motivational factors associated with breaking up sitting time among adolescents. Teachers' perceptions of strategies were also examined. Methods Over 17 weeks, 1 classroom in a government secondary school in Melbourne, Australia, was equipped with 27 height-adjustable desks and prompts (posters and desk stickers) to break up classroom sitting time. Teachers received professional development in the use of the desks and prompts. One group of adolescents (n = 55) had 2-5 lessons/week using the height-adjustable desks in an intervention classroom, and a comparison group matched by year level and subject (n = 50) was taught in traditional "seated" classrooms. Adolescents wore an activPAL monitor at baseline (T0), 4 weeks (T1), and 17 weeks (T2) and completed a survey at T0 and T2. Six teachers participated in interviews at T2. Effect sizes were calculated (d). Results Linear mixed models found that, compared to the traditional "seated" classrooms, the adolescents in the intervention classroom had significantly lower sitting time (T1 -9.7 min/lesson, d = -0.96; T2 -6.7 min/lesson, d = -0.70) and time spent in sitting bouts >15 min (T2 -11 min/lesson, d = -0.62) and had significantly higher standing time (T1 7.3 min/lesson, d = 0.84; T2 5.8 min/lesson, d = 0.91), number of breaks from sitting (T1 1.3 breaks/lesson, d = 0.49; T2 1.8 breaks/lesson, d = 0.67), and stepping time (T1 2.5 min/lesson, d = 0.66). Intervention classroom adolescents reported greater habit strength (d = 0.58), self-efficacy for breaking up sitting time (d = 0.75), and indicated that having a teacher/classmate remind them to stand as helpful (d = 0.50). Conclusion This intervention shows promise for targeting sitting behaviors in the classroom and indicates that incorporating social and motivational strategies may further enhance outcomes.Objective Clear cell meningioma is a rare histologic variant, accounting for only 0.2 - 0.8% of all meningiomas. Given their relative infrequency, few cases have been reported in the literature. We present one of the largest series of intracranial clear cell meningiomas and study the treatments and outcomes in these patients. Methods Patients with histologically proven clear cell meningioma between 2003 and 2018 were identified for inclusion in this study. Relevant clinical and radiographic data were obtained via retrospective review and analyzed. Kaplan-Meier and Cox proportional-hazards analyses were used to compare overall- and progression-free survival. Results A total of 35 patients underwent surgical resection for clear cell meningioma, including 18 females and 17 males, with a mean age of 59.3 years. Gross-total resection was achieved in 22 patients (62.9%), and 11 patients (31.4%) received adjuvant postoperative radiotherapy. Tumors recurred in 17 patients (48.6%), with a mean time to recurrence of 31.3 months. Mean postoperative follow-up was 66.3 months. In multivariable analysis, adjuvant radiotherapy and gross total tumor resection were both independently associated with prolonged progression-free survival (p 0.274). Conclusions This series of 35 patients with clear cell meningioma shows distinct contrast to prior series, with a higher mean age and a nearly 11 male-to-female ratio. While extent of resection and adjuvant postoperative radiotherapy are both independently associated with greater progression-free survival in clear cell meningioma, tumor recurrence remains a challenge in the treatment of these patients.Background Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is an extremely rare monogenic autosomal disease associated with the HtrA serine protease 1 (HTRA 1) gene mutation. Recently, a few genetically confirmed CARASIL cases with novel HTRA 1 mutations have been reported in countries other than Japan. Case description Here, we report a case of a patient presenting with worsening right hemiplegia and hemiparesthesia. Physical examination revealed that the patient had typical clinical features of CARASIL, including thinning hair, cognitive impairment, emotional changes, lumbago, and gait disorder, among others. Brain magnetic resonance imaging (MRI) showed abnormal diffuse symmetrical changes in white matter and hypertensive diffusion-weighted imaging (DWI) signals in the left centrum ovale and right splenium of the corpus callosum, and susceptibility-weighted imaging (SWI) showed multiple cerebral microbleeds. Lumbar MRI showed herniated discs with degenerative changes. A genetic test showed a novel homozygous nucleotide variation of c.847G>T in the HTRA1 gene, thereby resulting in p.Gly283Ter. Thus, the patient met the diagnostic criteria for CARASIL. We provide a literature review of genetically confirmed CARASIL cases reported to date. Conclusion CARASIL is a rare autosomal recessive disease with an HTRA1 mutation. Familiarity with the early clinical and imaging features of CARASIL combined with a genetic test is key for its early diagnosis.Object Suprasellar arachnoid cysts are a rare but important pediatric neurosurgical pathology with unknown ideal management. They have been previously managed with techniques including open craniotomy with microsurgical fenestration, cysto-peritoneal (CP) shunting, endoscopic ventriculocystostomy (VC), and endoscopic ventriculocystocisternostomy (VCC), without a consistent consensus on the best surgical approach. We present an overview of the literature on surgical management of suprasellar arachnoid cysts. Methods A literature search following PRISMA guidelines was conducted for all articles evaluating treatment modalities for suprasellar arachnoid cysts, using Pubmed, OVID and Web of Science. Results Twenty-five articles on management of suprasellar arachnoid cysts in children were identified. Few published studies exist that examine different types of surgical management across a single institution. The majority of studies reported best clinical outcomes in patients treated with endoscopic approaches when compared with microsurgical fenestration or CP shunting, reporting lower rates of infection, shunt-dependence and need for revision in addition to better resolution of clinical symptoms. Further, most studies argue that VCC is superior to VC, offering better long-term improvement of clinical symptoms and lower rates of failure. Conclusions This study examines the current literature on suprasellar arachnoid cyst surgical management to conclude that endoscopic approach in comparison to other approaches has the best outcomes. Of the endoscopic options available, ventriculocystocisternostomy, provides patients with the best long-term resolution of symptoms and lowest need for revision. These findings should be further investigated with larger multi-center studies to further compare different surgical techniques and outcomes.Background Extraosseous Ewing's sarcoma (EES) usually has a pseudocapsule and high vascularity, making it well circumscribed and focally dense contrast enhancement on magnetic resonance imaging (MRI). Consequently, it is difficult to diagnose and distinguish from other spinal tumors, based on pre-treatment radiological findings alone. Here, we present a case of EES involving the thoracic spinal column, which was suspected to be spinal schwannoma through pre-treatment radiological findings. Case description A 54-year-old woman was admitted to our hospital with upper back and left-sided chest pain. Contrast-enhanced MRI of the thoraco-lumbar spine showed a 17 × 12 mm sized mass in the epidural region and left neural foramen at the T6-T7 level. Our preliminary diagnosis was spinal schwannoma. The patient underwent T6 hemilaminectomy. Intraoperatively, the lesion appeared as gray-colored soft mass with high vascularity, which seemed to have originated from the left T6 nerve root. The tumor was excised with en-bloc resection. Histopathological examination of the lesion revealed classical ES with high cellularity of small round cells. Immunohistochemistry revealed strong positivity for CD99 and FLI-1. Intensity-modulated radiation therapy (IMRT) was performed. The patient did not receive chemotherapy. Five years after surgery, follow-up spinal MRI and PET-CT revealed no recurrence of the tumor or no new lesions. Conclusion Clinicians should consider EES in the differential diagnosis of other neural foraminal spinal tumors, such as schwannoma. If clinicians are confident that EES has been removed completely and that there are no other lesions, radiotherapy is sufficient and additional chemotherapy may not be necessary.