Anaesthetic-sparing effect of the anxiolytic drug tasipimidine in Beagle dogs

OBJECTIVE

To evaluate the effect of oral tasipimidine on dog handling, ease of catheter placement and propofol and isoflurane requirements for anaesthesia.

STUDY DESIGN

Placebo-controlled, randomized, blinded, experimental trial.

ANIMALS

A group of seven adult Beagle dogs weighing (mean ± standard deviation) 13.1 ± 2.7 kg with a mean age of 18.6 ± 1 months.

METHODS

The dogs underwent four treatments before induction of anaesthesia with propofol. PP: placebo orally (PO) 60 minutes before induction of anaesthesia followed by placebo (NaCl 0.9%) intravenously (IV). TP: tasipimidine 30 μg kg-1 (PO) 60 minutes before induction of anaesthesia followed by placebo (NaCl 0.9%) IV. TMP: tasipimidine 30 μg kg-1 PO 60 minutes before induction of anaesthesia followed by methadone 0.2 mg kg-1 IV. TMPD: tasipimidine 30 μg kg-1 PO 60 minutes before induction of anaesthesia followed by methadone 0.2 mg kg-1 and dexmedetomidine 1 μg kg-1 IV followed by a dexmedetomidine constant rate infusion of 1 μg kg-1 hour-1. Sedation, response to catheter placement, intubation quality, time to loss of consciousness, time to intubation, required dose of propofol and minimum alveolar isoflurane concentration preventing motor movement (MACNM) were determined. A mixed-model analysis or the Friedman and Mann-Whitney test were used; p-value < 0.05.

RESULTS

Response to catheter placement did not differ between treatments. Tasipimidine alone reduced the propofol dose by 30%. Addition of methadone or methadone and dexmedetomidine reduced the propofol dose by 48% and 50%, respectively. Isoflurane MACNM was reduced by 19% in tasipimidine-medicated dogs, whereas in combination with methadone or methadone and dexmedetomidine, isoflurane MACNM was reduced by 35%.

CONCLUSIONS AND CLINICAL RELEVANCE

An anxiolytic dose of tasipimidine induced mild signs of sedation in dogs and reduced propofol and isoflurane requirements to induce and maintain anaesthesia, which needs to be considered in an anaesthetic plan.

Recurrent C3 glomerulopathy after kidney transplantation

The complement system is part of innate immunity and is pivotal in protecting the body against pathogens and maintaining host homeostasis. Activation of the complement system is triggered through multiple pathways, including antibody deposition, a mannan-binding lectin, or activated complement deposition. C3 glomerulopathy (C3G) is a rare glomerular disease driven by complement dysregulation with high post-transplantation recurrence rates. Its treatment is mainly based on immunosuppressive therapies, specifically mycophenolate mofetil and glucocorticoids. Recent years have seen significant progress in understanding complement biology and its role in C3G pathophysiology. New complement-tergeting treatments have been developed and initial trials have shown promising results. However, challenges persist in C3G, with recurrent post-transplantation cases leading to suboptimal outcomes. This review discusses the pathophysiology and management of C3G, with a focus on its recurrence after kidney transplantation.

Q-learning and fuzzy logic multi-tier multi-access edge clustering for 5g v2x communication

The 5th generation (5 G) network is required to meet the growing demand for fast data speeds and the expanding number of customers. Apart from offering higher speeds, 5 G will be employed in other industries such as the Internet of Things, broadcast services, and so on. Energy efficiency, scalability, resiliency, interoperability, and high data rate/low delay are the primary requirements and obstacles of 5 G cellular networks. Due to IEEE 802.11p's constraints, such as limited coverage, inability to handle dense vehicle networks, signal congestion, and connectivity outages, efficient data distribution is a big challenge (MAC contention problem). In this research, vehicle-to-vehicle (V2V), vehicle-to-infrastructure (V2I) and vehicle-to-pedestrian (V2P) services are used to overcome bandwidth constraints in very dense network communications from cellular tool to everything (C-V2X). Clustering is done through multi-layered multi-access edge clustering, which helps reduce vehicle contention. Fuzzy logic and Q-learning and intelligence are used for a multi-hop route selection system. The proposed protocol adjusts the number of cluster-head nodes using a Q-learning algorithm, allowing it to quickly adapt to a range of scenarios with varying bandwidths and vehicle densities.

Recommendations for reporting equivalent black carbon (eBC) mass concentrations based on long-term pan-European in-situ observations

A reliable determination of equivalent black carbon (eBC) mass concentrations derived from filter absorption photometers (FAPs) measurements depends on the appropriate quantification of the mass absorption cross-section (MAC) for converting the absorption coefficient (babs) to eBC. This study investigates the spatial-temporal variability of the MAC obtained from simultaneous elemental carbon (EC) and babs measurements performed at 22 sites. We compared different methodologies for retrieving eBC integrating different options for calculating MAC including: locally derived, median value calculated from 22 sites, and site-specific rolling MAC. The eBC concentrations that underwent correction using these methods were identified as LeBC (local MAC), MeBC (median MAC), and ReBC (Rolling MAC) respectively. Pronounced differences (up to more than 50 %) were observed between eBC as directly provided by FAPs (NeBC; Nominal instrumental MAC) and ReBC due to the differences observed between the experimental and nominal MAC values. The median MAC was 7.8 ± 3.4 m2 g-1 from 12 aethalometers at 880 nm, and 10.6 ± 4.7 m2 g-1 from 10 MAAPs at 637 nm. The experimental MAC showed significant site and seasonal dependencies, with heterogeneous patterns between summer and winter in different regions. In addition, long-term trend analysis revealed statistically significant (s.s.) decreasing trends in EC. Interestingly, we showed that the corresponding corrected eBC trends are not independent of the way eBC is calculated due to the variability of MAC. NeBC and EC decreasing trends were consistent at sites with no significant trend in experimental MAC. Conversely, where MAC showed s.s. trend, the NeBC and EC trends were not consistent while ReBC concentration followed the same pattern as EC. These results underscore the importance of accounting for MAC variations when deriving eBC measurements from FAPs and emphasize the necessity of incorporating EC observations to constrain the uncertainty associated with eBC.

Emerging role of complement in COVID-19 and other respiratory virus diseases

The complement system, a key component of innate immunity, provides the first line of defense against bacterial infection; however, the COVID-19 pandemic has revealed that it may also engender severe complications in the context of viral respiratory disease. Here, we review the mechanisms of complement activation and regulation and explore their roles in both protecting against infection and exacerbating disease. We discuss emerging evidence related to complement-targeted therapeutics in COVID-19 and compare the role of the complement in other respiratory viral diseases like influenza and respiratory syncytial virus. We review recent mechanistic studies and animal models that can be used for further investigation. Novel knockout studies are proposed to better understand the nuances of the activation of the complement system in respiratory viral diseases.

Mitral Annular Calcification-Related Valvular Disease: A Challenging Entity

Mitral valve annular calcification-related valvular disease is increasingly common due to the rising prevalence of age-related mitral annular calcifications. Mitral annular calcification alters the structure and function of the mitral valve annulus, which in turn causes mitral valve regurgitation, stenosis, or both. As it frequently coexists with comorbid conditions and overlapping symptoms, mitral annular calcification-related valvular disease poses significant diagnostic and therapeutic challenges. For instance, left ventricular diastolic dysfunction hinders the assessment of mitral valvular disease. Detection of mitral annular calcifications and assessment of related mitral valve disease hinge on two-dimensional echocardiography. Comprehensive assessment of mitral annular calcifications and related mitral valve disease may require multidetector computed tomography and three-dimensional echocardiography. Invasive hemodynamic testing with exercise helps identify the cause of symptoms in patients with comorbid conditions, and transcatheter interventions have emerged as a viable therapeutic option for older patients. After an outline of the normal mitral annulus, we examine how mitral annular calcifications lead to mitral valve disease and how to accurately assess mitral regurgitation and stenosis. Lastly, we review surgical and transcatheter approaches to the management of mitral annular calcification-related mitral valve regurgitation, stenosis, or both.

Complement terminal pathway inhibition reduces peritoneal injuries in a rat peritonitis model

Peritonitis and the resulting peritoneal injuries are common problems that prevent long-term peritoneal dialysis (PD) therapy in patients with end-stage kidney diseases. Previously, we have analyzed the relationship between the complement system and progression of peritoneal injuries associated with PD, particularly focusing on the early activation pathways and effects of the anaphylatoxins. We here utilized a novel mAb 2H2 that blocks assembly of the membrane attack complex (MAC) to investigate roles of the complement terminal pathway in PD-associated peritoneal injury. We intraperitoneally injected mAb 2H2 anti-C5b-7 (2.5 or 5 mg/rat) once or twice over the five-day course of the experiment to investigate the effects of inhibiting formation of MAC in a fungal rat peritonitis model caused by repeated intraperitoneal administration of zymosan after methylglyoxal pretreatment (Zy/MGO model). Rats were sacrificed on day 5 and macroscopic changes in both parietal and visceral peritoneum evaluated. Peritoneal thickness, the abundance of fibrinogen and complement C3 and MAC deposition in tissue and accumulation of inflammatory cells were pathologically assessed. The results showed that mAb 2H2, but not isotype control mAb, reduced peritoneal thickness and accumulation of inflammatory cells in a dose and frequency-dependent manner in the Zy/MGO model. These effects were accompanied by decreased C3, MAC, and fibrinogen deposition in peritoneum. In conclusion, in the rat Zy/MGO model, complement terminal pathway activation and MAC formation substantially contributed to development of peritoneal injuries, suggesting that MAC-targeted therapies might be effective in preventing development of peritoneal injuries in humans.

Autologous hematopoietic recovery after allogeneic hematopoietic stem cell transplantation: A case-based review

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is widely applied for the treatment of hematologic malignancies, but autologous hematopoietic recovery (AR) after allo-HSCT is rare clinically, especially after myeloablative conditioning (MAC). The mechanism of AR remains unclear so far, but the prognosis for most patients is relatively good. Second transplantation is preferred after disease relapse. Starting from a real-life clinical case scenario, herein we reviewed some of the crucial issues of AR in light of recent refinements, and discussed our patients based on the current evidence.

Host Susceptibility to Nontuberculous Mycobacterial Pulmonary Disease

Nontuberculous mycobacteria (NTM) pulmonary disease is a chronic progressive pulmonary infectious disease caused by low virulence pathogens. The existence of host susceptibility to NTM infection has been recognized from a high incidence among Asians compared to other populations in the United States, a high incidence among slender, middle-aged women, and the presence of familial clusters. Recent whole exome sequencing and genome-wide association studies have identified immune, CFTR, cilia, connective tissue and ion homeostasis genes as host susceptibility genes. Large-scale international collaborative studies and functional analyses are expected to elucidate host susceptibility in the future.

Nuclear transport receptor KA120 regulates molecular condensation of MAC3 to coordinate plant immune activation

The nucleocytoplasmic exchange is of fundamental importance to eukaryotic life and is mediated by karyopherins, a superfamily of nuclear transport receptors. However, the function and cargo spectrum of plant karyopherins are largely obscure. Here, we report proximity-labeling-based proteomic profiling of in vivo substrates of KA120, a karyopherin-β required for suppressing autoimmune induction in Arabidopsis. We identify multiple components of the MOS4-associated complex (MAC), a conserved splicing regulatory protein complex. Surprisingly, we find that KA120 does not affect the nucleocytoplasmic distribution of MAC proteins but rather prevents their protein condensation in the nucleus. Furthermore, we demonstrate that MAC condensation is robustly induced by pathogen infection, which is sufficient to activate defense gene expression, possibly by sequestrating negative immune regulators via phase transition. Our study reveals a noncanonical chaperoning activity of a plant karyopherin, which modulates the nuclear condensation of an evolutionarily conserved splicing regulatory complex to coordinate plant immune activation.

Influence of conditioning regimen intensity on outcomes post-allogeneic hematopoietic cell transplantation for acute myeloid leukemia in complete morphological remission

INTRODUCTION

The literature comparing outcomes between myeloablative (MAC) and reduced intensity conditioning (RIC) for acute myeloid leukemia (AML) is conflicting.

METHODS

We retrospectively analyzed 451 patients who underwent allogenic hematopoietic cell transplantation (alloHCT) for AML in complete remission (CR) with either RIC (n = 331) or MAC (n = 120) with the use of dual T-cell depletion as graft-versus-host disease (GVHD) prophylaxis.

RESULTS

Univariate analysis demonstrated nonrelapse mortality (NRM) at 2 years was 19.1% for MAC and 22.5% for RIC (p = .44). Two-year cumulative incidence of relapse (CIR) was 19.8% for MAC and 24.5% for RIC (p = .15). Two-year overall survival (OS) was 61% and 53% for MAC and RIC, respectively (p = .02). Two-year graft-versus-host disease relapse-free survival (GRFS) was 40.8% for MAC and 33.7% for RIC (p = .30). A propensity score-matched analysis was done matching patients for age, HLA match, in vivo T-cell depletion, and Disease Risk Index (DRI). Two-year OS was 67% for MAC, 66% for RIC (p = .95). A subgroup analysis identified that matched related donor transplants benefit from MAC with OS at 2 years 82.6% versus 57.3% for RIC (p = .006).

CONCLUSIONS

In the matched-related donor setting, MAC regimens may offer superior survival. Overall, for our cohort of predominantly in vivo T-cell depleted patients the outcomes of MAC and RIC were similar.

The risk of pulmonary NTM infections and water-quality constituents among persons with cystic fibrosis in the United States, 2010-2019

Rationale

The prevalence of nontuberculous mycobacterial (NTM) pulmonary disease varies geographically in the United States. Previous studies indicate that the presence of certain water-quality constituents in source water increases NTM infection risk.

Objective

To identify water-quality constituents that influence the risk of NTM pulmonary infection in persons with cystic fibrosis in the United States.

Methods

We conducted a population-based case-control study using NTM incidence data collected from the Cystic Fibrosis Foundation Patient Registry during 2010-2019. We linked patient zip code to the county and associated patient county of residence with surface water data extracted from the Water Quality Portal. We used logistic regression models to estimate the odds of NTM infection as a function of water-quality constituents. We modeled two outcomes: pulmonary infection due to Mycobacterium avium complex (MAC) and Mycobacterium abscessus species.

Results

We identified 484 MAC cases, 222 M. abscessus cases and 2816 NTM-negative cystic fibrosis controls resident in 11 states. In multivariable models, we found that for every 1-standardized unit increase in the log concentration of sulfate and vanadium in surface water at the county level, the odds of infection increased by 39% and 21%, respectively, among persons with cystic fibrosis with MAC compared with cystic fibrosis-NTM-negative controls. When modeling M. abscessus as the dependent variable, every 1-standardized unit increase in the log concentration of molybdenum increased the odds of infection by 36%.

Conclusions

These findings suggest that naturally occurring and anthropogenic water-quality constituents may influence the NTM abundance in water sources that supply municipal water systems, thereby increasing MAC and M. abscessus infection risk.

Mycobacterial Interspersed Repeat Unit-Variable Number Tandem Repeat Typing of Mycobacterium avium Strains Isolated from the Lymph Nodes of Free-Living Carnivorous Animals in Poland

Non-tuberculous mycobacteria (NTM) are ubiquitous organisms, of which some, especially those of the Mycobacterium avium complex (MAC), may be opportunistic animal and human pathogens. Infection with NTM can interfere with tuberculosis (TB) diagnosis and induce zoonoses, especially in immunocompromised individuals. Diseases caused by NTM have become more readily recognized; however, they are likely still underestimated. In this study, we identified and genotyped Mycobacterium avium strains that were isolated during TB monitoring among free-living carnivorous animals from southeastern Poland. In 2011-2020, lymph node samples from 192 such animals were tested for mycobacteria. A total of 41 isolates of M. avium strains were detected with the use of IS901, IS900, IS1245, and mycobacterial interspersed repeat unit-variable number tandem repeat (MIRU-VNTR) identification. Thirty-three were identified as M. avium subsp. avium. These strains were derived from 1 beech marten (Martes foina), 1 common buzzard (Buteo buteo), 2 European badgers (Meles meles), 3 wolves (Canis lupus), and 26 red foxes (Vulpes vulpes). One strain isolated from a wolf was identified as M. avium subsp. hominissuis. The results show the widespread occurrence of MAC bacilli in the studied environment and additionally comprise new data on the molecular characteristics of M. avium subspecies carried by free-living southeastern Polish carnivores.

Treatment of CHO cells with Taxol and reversine improves micronucleation and microcell-mediated chromosome transfer efficiency

Microcell-mediated chromosome transfer is an attractive technique for transferring chromosomes from donor cells to recipient cells and has enabled the generation of cell lines and humanized animal models that contain megabase-sized gene(s). However, improvements in chromosomal transfer efficiency are still needed to accelerate the production of these cells and animals. The chromosomal transfer protocol consists of micronucleation, microcell formation, and fusion of donor cells with recipient cells. We found that the combination of Taxol (paclitaxel) and reversine rather than the conventional reagent colcemid resulted in highly efficient micronucleation and substantially improved chromosomal transfer efficiency from Chinese hamster ovary donor cells to HT1080 and NIH3T3 recipient cells by up to 18.3- and 4.9-fold, respectively. Furthermore, chromosome transfer efficiency to human induced pluripotent stem cells, which rarely occurred with colcemid, was also clearly improved after Taxol and reversine treatment. These results might be related to Taxol increasing the number of spindle poles, leading to multinucleation and delaying mitosis, and reversine inducing mitotic slippage and decreasing the duration of mitosis. Here, we demonstrated that an alternative optimized protocol improved chromosome transfer efficiency into various cell lines. These data advance chromosomal engineering technology and the use of human artificial chromosomes in genetic and regenerative medical research.

Non-alcoholic faty liver disease and liver fibrosis score have an independent relationship with the presence of mitral annular calcification

Non-alcoholic faty liver disease (NAFLD) and liver fibrosis score (FIB 4) are associated with increased mortality from cardiovascular causes. NAFLD and cardiac diseases are different manifestations of systemic metabolic syndrome. In this study, we aimed to reveal the relationship between NAFLD and FIB 4 liver fibrosis scores and mitral annular calcification (MAC). One hundred patients were included in the study. Blood samples and echocardiography measurements were obtained from each subject. The two groups were compared in terms of demographic and echocardiographic characteristics. Thirty-one men and 69 women with a mean age of 48.6 ± 13.1 years were included in the analysis. The patients were divided into two groups as those with MAC (n = 26) and those without (n = 74). The baseline demographic and laboratory data for the two groups were compared. In the group with MAC (+) age, serum creatinine levels, FIB4 and NAFLD Scores; HL, DM rates, angiotensin converting enzyme (ACE) inhibitor and statin usage rates were higher, with statistical significance. NAFLD and FIB 4 liver fibrosis scores have an independent relationship with MAC.

Comparative analysis of tumor biology and prognosis in mucinous and signet-ring cell colon cancers versus classical adenocarcinoma

Background: Limited information is currently available on the natural history and prognosis of two distinct histological subtypes of adenocarcinoma (AC) in the colon: mucinous adenocarcinoma (MAC) and signet-ring cell carcinoma (SRCC). Therefore, the aim of this study is to examine the clinicopathological characteristics of colon MAC and SRCC, comparing them to classical AC, using a large cohort of cases from the United States. Methods: Patients diagnosed with colon AC, MAC, or SRCC from the SEER database between 2000 and 2018 were included in our study. Incidence trends, patient demographics, tumor characteristics, treatment, and survival were analyzed. Results: In our study, we analyzed a total of 310,813 patients with colon cancers, including 271,382 cases of classical AC, 34,750 cases of MAC, and 4,681 cases of SRCC. Over the study period, we observed a decline in the age-adjusted incidence rates of colon AC, MAC, and SRCC. Notably, the MAC and SRCC cohorts differed significantly from AC in terms of patient characteristics, tumor locations, and treatment patterns. Patients with MAC and SRCC had poorer survival outcomes compared to those with AC. Factors associated with worse survival included older age, male sex, poorly differentiated tumors, advanced stage, and the presence of MAC or SRCC histology. On the other hand, surgical intervention was associated with improved survival. Conclusion: Our study underscores the significance of recognizing the distinct features and outcomes associated with different histological subtypes of colon cancer. Further research is warranted to delve into the underlying biological traits that contribute to these differences and to develop more tailored treatment strategies.

Scalable Preparation of the Masked Acyl Cyanide TBS-MAC

This paper describes the three-step synthesis of TBS-MAC, a masked acyl cyanide (MAC) and a versatile one-carbon oxidation state three synthon. We have developed a scalable and detailed synthesis that involves: (1) acetylation of malononitrile to form the sodium enolate, (2) protonation of the enolate to form acetylmalononitrile, and (3) epoxidation of the enol, rearrangement to an unstable alcohol, and TBS-protection to form the title compound. Both the sodium enolate and acetylmalononitrile are bench-stable precursors to the intermediate hydroxymalononitrile, which can be converted to other MAC reagents beyond TBS by varying the protecting group (Ac, MOM, EE, etc.).

Cold Cas: reevaluating the occurrence of CRISPR/Cas systems in Mycobacteriaceae

Bacterial CRISPR/Cas systems target foreign genetic elements such as phages and regulate gene expression by some pathogens, even in the host. The system is a marker for evolutionary history and has been used for inferences in Mycobacterium tuberculosis for 30 years. However, knowledge about mycobacterial CRISPR/Cas systems remains limited. It is believed that Type III-A Cas systems are exclusive to Mycobacterium canettii and the M. tuberculosis complex (MTBC) of organisms and that very few of the >200 diverse species of non-tuberculous mycobacteria (NTM) possess any CRISPR/Cas system. This study sought unreported CRISPR/Cas loci across NTM to better understand mycobacterial evolution, particularly in species phylogenetically near the MTBC. An analysis of available mycobacterial genomes revealed that Cas systems are widespread across Mycobacteriaceae and that some species contain multiple types. The phylogeny of Cas loci shows scattered presence in many NTM, with variation even within species, suggesting gains/losses of these loci occur frequently. Cas Type III-A systems were identified in pathogenic Mycobacterium heckeshornense and the geological environmental isolate Mycobacterium SM1. In summary, mycobacterial CRISPR/Cas systems are numerous, Type III-A systems are unreliable as markers for MTBC evolution, and mycobacterial horizontal gene transfer appears to be a frequent source of genetic variation.

Efficient Cluster Tree Topology Operation and Routing for IEEE 802.15.4-Based Smart Grid Networks

Wireless sensor networks (WSNs) have been utilized as communication infrastructure for smart grid applications. The primary requirement of WSNs for smart grid applications is to transmit delay-critical data from smart grid assets ether at the maximum rate or by reducing collision rates. Additionally, WSNs should utilize the limited resources of the network to provide the required long-term QoS. The achievement of these objectives requires a remarkable design of WSN protocols to satisfy the requirements of smart grid applications. In this study, a multi-channel cluster tree protocol is proposed to prevent collisions and increase network performance. In the proposed scheme, the cluster head serves to broadcast a beacon frame containing information on the allocated channels and time slots. This enables the new node to determine its channel and timeslot. A performance analysis reveals that the proposed scheme can achieve a low end-to-end delay and low collision rates compared with the well-known IEEE 802.15.4 MAC protocols widely used in the literature to provide QoS to smart-grid applications.

Thoracic empyema due to nontuberculous mycobacteria in an immunocompetent patient without pulmonary disease: a case report

BACKGROUND

Pleural involvement by non-tuberculous mycobacteria (NTM), especially NTM empyema in the immunocompetent patient without pulmonary diseases is a rare disease. It is difficult to diagnose with only a few cases of immunodeficient patients in the literature.

CASE PRESENTATION

We describe a 63-year-old male with empyema due to NTM and highlight the challenges of diagnosis.

CONCLUSIONS

Non-tuberculous mycobacterial infection should be considered as a cause of pleuritis or empyema without pulmonary disease, however it is a real diagnostic dilemma.

SDAA: Secure Data Aggregation and Authentication Using Multiple Sinks in Cluster-Based Underwater Vehicular Wireless Sensor Network

Security is one of the major concerns while designing robust protocols for underwater sensor networks (UWSNs). The underwater sensor node (USN) is an example of medium access control (MAC) that should control underwater UWSN, and underwater vehicles (UV) combined. Therefore, our proposed method, in this research, investigates UWSN combined with UV optimized as an underwater vehicular wireless network (UVWSN) that can completely detect malicious node attacks (MNA) from the network. Thus, MNA that engages the USN channel and launches MNA is resolved by our proposed protocol through SDAA (secure data aggregation and authentication) protocol deployed in UVWSN. SDAA protocol plays a significant role in secure data communication, as the cluster-based network design (CBND) network organization creates a concise, stable, and energy-efficient network. This paper introduces SDAA optimized network known as UVWSN. In this proposed SDAA protocol, the cluster head (CH) is authenticated through the gateway (GW) and the base station (BS) to guarantee that a legitimate USN oversees all clusters deployed in the UVWSN are securely established for providing trustworthiness/privacy. Furthermore, the communicated data in the UVWSN network guarantee that data transmission is secure due to the optimized SDAA models in the network. Thus, the USNs deployed in the UVWSN are securely confirmed to maintain secure data communication in CBND for energy efficiency. The proposed method is implemented and validated on the UVWSN for measuring reliability, delay, and energy efficiency in the network. The proposed method is utilized for monitoring scenarios for inspecting vehicles or ship structures in the ocean. Based on the testing results, the proposed SDAA protocol methods improve energy efficiency and reduce network delay compared to other standard secure MAC methods.

Effect of atropine and propofol on the minimum anaesthetic concentration of isoflurane in the freshwater turtle Trachemys scripta (yellow-bellied slider)

OBJECTIVE

To determine if the administration of atropine would reduce the measured minimum anaesthetic concentration of isoflurane (MAC_isoflurane) in freshwater turtles - the yellow-bellied slider (Trachemys scripta scripta).

STUDY DESIGN

Paired, blinded, randomized, prospective studies of 1) the effect of atropine in isoflurane anaesthetized freshwater turtles (T. scripta scripta) and 2) the effect of atropine in yellow-bellied sliders in which anaesthesia was induced with propofol and maintained with isoflurane.

ANIMALS

T. scripta scripta (n = 8), female, adult.

METHODS

Atropine (2 mg kg^-1) or an isovolumetric control injection of saline was administered intraperitoneally 15 minutes prior to induction of anaesthesia with isoflurane. Individual MAC_isoflurane was then determined by end-tidal gas analysis in a bracketing design by an experimenter blinded to the administered drug, with a 2 week washout period. The experiment was repeated, with atropine (2 mg kg^-1) or saline administered intravascularly in combination with propofol for anaesthetic induction. Linear mixed modelling was used to determine the effects of atropine and propofol on the individual MAC_isoflurane. Data are presented as mean ± standard deviation.

RESULTS

Premedication with atropine significantly reduced MAC_isoflurane (p = 0.0039). In isoflurane-induced T. scripta scripta, MAC_isoflurane decreased from 4.2 ± 0.4% to 3.3 ± 0.8% when atropine had been administered. Propofol as an induction agent had a MAC-sparing effect (p < 0.001) such that MAC_isoflurane following propofol and a control injection of saline was 2.3 ± 1.0%, which decreased further to 1.5 ± 0.8% when propofol was combined with atropine.

CONCLUSIONS AND CLINICAL RELEVANCE

Atropine, presumably by inhibiting parasympathetically mediated pulmonary artery constriction, decreases right-to-left cardiac shunting and the MAC_isoflurane in yellow-bellied sliders, and thereby may facilitate control of inhalant anaesthesia. Propofol can be used for induction of anaesthesia and reduces the required concentration of inhaled anaesthesia assessed 1.5 hours following induction.

A Lightweight Authentication MAC Protocol for CR-WSNs

Cognitive radio (CR) has emerged as one of the most investigated techniques in wireless networks. Research is ongoing in terms of this technology and its potential use. This technology relies on making full use of the unused spectrum to solve the problem of the spectrum shortage in wireless networks based on the excessive demand for spectrum use. While the wireless network technology node's range of applications in various sectors may have security drawbacks and issues leading to deteriorating the network, combining it with CR technology might enhance the network performance and improve its security. In order to enhance the performance of the wireless sensor networks (WSNs), a lightweight authentication medium access control (MAC) protocol for CR-WSNs that is highly compatible with current WSNs is proposed. Burrows-Abadi-Needham (BAN) logic is used to prove that the proposed protocol achieves secure and mutual authentication. The automated verification of internet security protocols and applications (AVISPA) simulation is used to simulate the system security of the proposed protocol and to provide formal verification. The result clearly shows that the proposed protocol is SAFE under the on-the-fly model-checker (OFMC) backend, which means the proposed protocol is immune to passive and active attacks such as man-in-the-middle (MITM) attacks and replay attacks. The performance of the proposed protocol is evaluated and compared with related protocols in terms of the computational cost, which is 0.01184 s. The proposed protocol provides higher security, which makes it more suitable for the CR-WSN environment and ensures its resistance against different types of attacks.

Ionized and non-ionized radiation effects on coronary stent implantation

The purpose of this study is to examine the clinical radiation effects on patients with various stents. Several previous researches focused on the mechanical and physical features of the stents, but there have been few studies that focus on the interaction with radiological and clinical radiation. For stent material analysis, the ANSYS package program was employed. These materials and models are often built in three dimensions for three different types of stents made of three various materials. Estimates of blood pressure and thermal radiation were explored, as were the effects of non-ionizing radiation. Furthermore, the radiation attenuation characteristics of stent samples are investigated. The mass attenuation coefficient values are computed using MATLAB code over a large energy range of 0.015-15 MeV, and the findings are validated using theoretical WinXCom results. To determine the gamma-ray attenuation performances of the studied stent samples, variables such as the mass attenuation coefficient (MAC), half-value layer (HVL), tenth-value layer (TVL), mean free path (MFP), effective atomic number (Z_eff), exposure build-up factor (EBF), and energy absorption build-up factor (EABF) are computed. Effective removal cross-sections (Σ_R) of stent samples were acquired to determine the capacity of stent samples to stop fast neutrons. Finally, the ability of stent samples to stop charged alpha and proton particles was evaluated utilizing mass stopping power and projected range parameters. The discovery demonstrates that S3 has the best attenuation as well as the best proton, alpha, and gamma radiation attenuation capability.

Diagnosis and Management of Pulmonary NTM with a Focus on Mycobacterium avium Complex and Mycobacterium abscessus: Challenges and Prospects

BACKGROUND

Nontuberculous mycobacteria (NTM) are ubiquitous. NTM can affect different organs and may cause disseminated diseases, but the pulmonary form is the most common form. Pulmonary NTM is commonly seen in patients with underlying diseases. Pulmonary Mycobacterium avium complex (MAC) is the most common NTM disease and M. abscessus (MAB) is the most challenging to treat. This review is prepared with the following objectives: (a) to evaluate new methods available for the diagnosis of pulmonary MAC or MAB, (b) to assess advances in developing new therapeutics and their impact on treatment of pulmonary MAC or MAB, and (c) to evaluate the prospects of preventive strategies including vaccines against pulmonary MAC or MAB.

METHODS

A literature search was conducted using PubMed/MEDLINE and multiple search terms. The search was restricted to the English language and human studies. The database query resulted in a total of 197 publications. After the title and abstract review, 64 articles were included in this analysis.

RESULTS

The guidelines by the American Thoracic Society (ATS), European Respiratory Society (ERS), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), and Infectious Diseases Society of America (IDSA) are widely applicable. The guidelines are based on expert opinion and there may be a need to broaden criteria to include those with underlying lung diseases who may not fulfill some of the criteria as 'probable cases' for better follow up and management. Some cases with only one culture-positive sputum sample or suggestive histology without a positive culture may benefit from new methods of confirming NTM infection. Amikacin liposomal inhalation suspension (ALIS), gallium containing compounds and immunotherapies will have potential in the management of pulmonary MAC and MAB.

CONCLUSIONS

the prevalence of pulmonary NTM is increasing. The efforts to optimize diagnosis and treatment of pulmonary NTM are encouraging. There is still a need to develop new diagnostics and therapeutics.

Biofilm infection of a central venous port-catheter caused by Mycobacterium avium complex in an immunocompetent child with cystic fibrosis

BACKGROUND

Mycobacterium (M.) chimaera is a non-tuberculous mycobacterium (NTM) that belongs to M. avium complex (MAC). In patients with cystic fibrosis (CF), MAC can cause bronchopulmonary infections that can be prolonged and difficult to treat. MAC infections of sites other than the lungs or central catheters are rare and almost exclusively associated with immunodeficiency.

CASE PRESENTATION

We present a case of an 8-year-old CF patient (delF508 homozygous) with recurrent pulmonary exacerbations, gradual clinical deterioration, B-symptoms (fever, fatigue, weight loss, night sweat), elevated transaminases and intermittent detection of M. chimaera in the sputum without radiological signs of NTM-associated lung disease with a central venous port-catheter. Next-generation sequencing (NGS) revealed M. chimaera port infection that was also confirmed by mycobacterial culture. The patient recovered within 4 weeks after removal of the catheter and initiation of MAC targeted antimicrobial therapy. Electron microscopy of the catheter illustrated the presence of mycobacteria in a biofilm.

CONCLUSIONS

MAC central venous catheter infection needs to be considered in immunocompetent people. NGS is a valuable tool for rapid identification of rare infections. MAC capability of biofilm formation renders catheter removal the central therapeutic intervention for the clearance of the infection.

CFX: Contention-Free Channel Access for IEEE 802.11ax

Orthogonal frequency-division multiple access (OFDMA) has attracted great attention as a key technology for uplink enhancement for Wi-Fi, since it can effectively reduce network congestion and channel access delay. Unfortunately, the traditional random access protocol of Wi-Fi seldom allows these benefits to be achieved, especially in dense network environments, as the access point (AP) rarely gains the channel access needed to trigger OFDMA uplink transmissions due to severe frame collisions. To address this problem, we propose a new channel access scheme called Contention-Free Channel Access for 802.11ax (CFX). In the proposed scheme, users can access the channel without contention, since they are guaranteed a transmission opportunity immediately after another user's transmission. To realize CFX on top of the existing Buffer Status Report/BSR Poll (BSR/BSRP) exchange protocol of 802.11ax, we develop an additional scheme based on shared channel access that helps the AP to obtain the buffer status of users and manage a contention-free channel access schedule. In addition, in order to appropriately utilize the savings from the reduced frame collisions, we conduct sum throughput maximization using an actor-critic proximal policy optimization (PPO)-based deep reinforcement learning approach. The results of an extensive evaluation show that CFX not only significantly improves the uplink performance of Wi-Fi in terms of throughput and channel access delay but can also dynamically adjust the parameters in response to changes in the network status.

An Adaptive Network Design for Advanced Metering Infrastructure in a Smart Grid

A smart grid is a next-generation intelligent power grid that can maximize energy efficiency by monitoring power information in real time and by controlling the flow of power by introducing IT communication technology to the existing power grid. In order to apply a wireless communication network to a smart grid, it is necessary to be able to efficiently process large amounts of power-related data while enabling a high level of reliability and quality of service (QoS) support. In addition, international standards-based design is essential considering compatibility and scalability. The IEEE 802.15.4 standard is considered to be the most powerful communication method for processing data through the smart grid AMI. To reduce the energy consumption, as the duty cycle of the superframe increases, the probability of the congestion increases. However, this binary exponential algorithm in IEEE 802.15.4 standard does not account for the application of traffic characteristics that essentially negatively affect the smart grid network performances in terms of packet delivery ratio and time delay. Therefore, in this paper, we propose a new transmission scheme to reduce performance degradation by excessive collisions in the content access period (CAP), when data transmission is performed in IEEE 802.15.4 applied to smart grids. In addition, we investigated the main research topics required when applying wireless networking technology to smart grids and suggested improvement measures. Simulation results showed that the proposed scheme increased the data delivery rate and reduced the latency, and it was confirmed that reliability was improved.

Obesity prolongs induction times in reptiles

Obesity is common in captive reptiles, and reptiles are increasingly popular as companion animals and in physiological research. Obesity may present a challenge during surgical procedures using inhalation anaesthesia, as the long induction time due to the low reptilian metabolism may increase anaesthetic accumulation in the adipose tissues. This study investigated the impact of obesity on induction and recovery times from inhaled anaesthesia. The temporal change in the partial pressure of isoflurane in different tissues was predicted using a multi-compartment model. Furthermore, as right-to-left shunting can delay anaesthetic uptake and washout, we included an assessment of the combination of cardiac shunting and obesity. The model predictions indicate a clear increase in time to reach 90% equilibration of administered anaesthetic in the brain (T₉₀) of obese non-shunting (lean 47 min, obese >100 min) and shunting (lean 81 min, obese >100 min) reptiles. The combination of obesity and shunting doubled the time to acquisition of mean anaesthetic concentration (a measure used to plan anaesthesia) from 8 min to 19 min. Adipose blood flow highly affected whether the body type had an impact on induction time, with low adipose blood flow abolishing the effect of body type. As T₉₀ was never reached within 100 min with both the obese reptiles, it was not possible to conclude on the effect of obesity on recovery times within this study. Care should therefore be taken when anaesthetising obese reptiles for surgical purposes, to ensure adequate anaesthetic depth is attained, and recovery monitored closely.

Responsiveness and Inter-Rater Reliability of the Pulse Volume Recording Upstroke Ratio (PVRr)

The objective of this study was to evaluate a measure of the responsiveness and reliability of the pulse volume recording upstroke ratio (PVRr). A database of 389 subjects undergoing lower extremity revascularization was analyzed. Subjects were included in the analysis if they had undergone pedal radiographs, had PVRs performed pre- and postlower extremity revascularization, and had regular pulsatile digital waveforms with a pressure recording on both PVRs. The responsiveness of the PVRr was assessed by means of the postoperative percent change in comparison to the digital pressures. A statistically significant negative correlation was observed (Pearson -0.421; p = .007) indicating that as digital pressures increased, the PVRr decreased. Further, measurement of the reliability of the PVRr was performed on a selection of 10 recordings by 2 residents and 3 board-certified surgeons. The observed intraclass correlation coefficient of measurements was 0.960. Results of this investigation provide evidence in support of the responsiveness and inter-rater reliability in the calculation of the pulse volume recording upstroke ratio.

The Mycobacterium avium complex - an underestimated threat to humans and animals

INTRODUCTION AND OBJECTIVE

The Mycobacterium avium complex (MAC) is a group of acid-resistant bacteria within the Mycobacteriaceae. Their cell walls have a specific structure impervious to many disinfectants. Mycobacteria are widespread in the environment and can also be found in food. This aim of the article is to review the current state of knowledge about the sources of infection, symptoms and treatment of MAC diseases in humans and animals, and summarizes the available methods for identifying the bacteria. It pays a special attention to the zoonotic potential of MAC bacteria and possible routes of transmission between humans and animals, including possible food-borne routes.

BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE.

MAC bacterial infections occur both in immunocompetent people and those with functional predispositions and compromised immunity, particularly during HIV infection or immunosuppressive treatment. The incidence of MAC infections in humans is growing, with the most common form of infection being pulmonary disease (MTC-PD); however, there are conflicting reports on the role of Mycobacterium avium paratuberculosis (MAP) in the development of Crohn's disease. MAC bacteria can also attack livestock, household pets, and wild animals. Unfortunately, treatment is lengthy and often fails due to microbiological relapse; there is also increasing evidence of MAC bacteria are developing multi-drug resistance.

CONCLUSIONS

Although new antibiotics are being created to inhibit the growth and division of Mycobacterium avium, there is clearly a need for further research into the virulence factors associated with MAC bacteria. Further studies should also examine the role of MAP in the etiopathogenesis of Crohn's disease.

Approximation of the Ankle-Brachial Index in the Setting of Medial Arterial Calcific Sclerosis

The presence of medial arterial calcific sclerosis is known to cause inaccuracy in the interpretation of noninvasive vascular testing. This substantially limits the utility of an important baseline diagnostic test for peripheral arterial disease. Therefore, the objective of this investigation was to derive a method to effectively factor out calcification in the interpretation of the ankle and digital brachial indices. The noninvasive vascular testing results of 160 subjects were stratified into the absence of calcification, mild calcification, moderate calcification, and severe calcification based on plain film radiographic findings of the infrageniculate vessels. Measurements were then performed of the pulse volume recording (PVR) waveforms at brachial, ankle and digital anatomic levels to include PVR wavelength and PVR upstroke length, with a calculation of the ratio of PVR upstroke length to PVR wavelength. These measurements were compared between groups and then correlated to the ankle and digital brachial indices. A significant difference was observed in the PVR upstroke ratio between the 3 anatomic levels (0.1818 vs 0.2622 vs 0.3191; p < .001), but not between the 4 calcification groups (0.2457 vs 0.2363 vs 0.2694 vs 0.2631; p = .242). A significant negative correlation was observed between the PVR upstroke ratio and the ankle brachial index (ABI) (Pearson -0.454; p = .002) with linear regression indicating the relationship is defined by the formula: Effective ankle brachial index = 1.17 - (1.33 × PVR upstroke ratio at ankle level). A significant negative correlation was also observed between the PVR upstroke ratio and the digital brachial index (Pearson -0.553; p < .001) with linear regression indicating the relationship is defined by the formula: Effective toe brachial index = 1.04 - (1.61 × PVR upstroke ratio at digital level). The results of this investigation demonstrate the feasibility of, and provide equations to approximate, the effective ankle brachial and toe brachial indices in the setting of medial arterial calcification.

The Effect of ZnO, MgO, TiO2, and Na2O Modifiers on the Physical, Optical, and Radiation Shielding Properties of a TeTaNb Glass System

Novel glass samples with the composition 75TeO₂–5Ta₂O₅–15Nb₂O₅–5x (where x = ZnO, MgO, TiO₂, or Na₂O) in mole percent were prepared. The physical, optical, and gamma radiation shielding properties of the glass samples were studied over a wide energy spectrum ranging between 0.015 and 20 MeV. The glasses’ UV–vis spectra were utilized to evaluate the optical energy gap and refractive index. Glass samples had a refractive index ranging from 2.2005 to 2.0967. The results showed that the sample doped with zinc oxide (ZnO) recorded the highest density (ρ_glass), molar polarizability (α_m), molar refraction (Rm), refractive index (n), and third-order nonlinear optical susceptibility (χ³) and the lowest optical energy gap (E_opt) among the samples under investigation. When comparing the current glass system with various standard glass shielding materials, the prepared glass system showed superior shielding performance at energies ranging between 40 and 85 keV. These findings indicate that the prepared glass systems can be used in diagnostic X-rays, especially in dental applications.

Formation and growth mechanisms of polycyclic aromatic hydrocarbons: A mini-review

Polycyclic aromatic hydrocarbons (PAHs) are mostly formed during the incomplete combustion of organic materials, but their importance and presence in materials science, and astrochemistry has also been proven. These carcinogenic persistent organic pollutants are essential in the formation of combustion generated particles as well. Due to their significant impact on the environment and human health, to understand the formation and growth of PAHs is essential. Therefore, the most important growth mechanisms are reviewed, and presented here from the past four decades (1981-2021) to initiate discussions from a new perspective. Although, the collected and analyzed observations are derived from both experimental, and computational studies, it is neither a systematic nor a comprehensive review. Nevertheless, the mechanisms were divided into three main categories, acetylene additions (e.g. HACA), vinylacetylene additions (HAVA), and radical reactions, and discussed accordingly.

Clinical Aspects of Pulmonary Nontuberculous Mycobacteriosis

Nontuberculous mycobacterial (NTM) infections are an emerging problem. Common organisms include Mycobacterium avium, M. intracellulare, and M. kansasii, along with the M. avium intracellulare complex (MAC), which includes both M. avium and M. intracellulare. Typically, NTM infections affect the lungs and subsequently demonstrate a chronic course. Therefore, persistent respiratory symptoms generally indicate of the presence of pulmonary NTM diseases, and chest radiography, along with a sputum examination, are essential for its diagnosis. Because NTM are ubiquitous environmental organisms, a positive culture from a minimum of two separate expectorated sputum samples are required to make a diagnosis. The repertoire of effective drugs for treatment is considerably limited, indicating the need for long-term management with multiple drugs. Establishing a treatment regimen with high therapeutic efficacy and safety is an important issue for the future.

Enhancement of Ceramics Based Red-Clay by Bulk and Nano Metal Oxides for Photon Shielding Features

We prepared red clays by introducing different percentages of PbO, Bi₂O₃, and CdO. In order to understand how the introduction of these oxides into red clay influences its attenuation ability, the mass attenuation coefficient of the clays was experimentally measured in a lab using an HPGe detector. The theoretical shielding capability of the material present was obtained using XCOM to verify the accuracy of the experimental results. We found that the experimental and theoretical values agree to a very high degree of precision. The effective atomic number (Z_eff) of pure red clay, and red clay with the three metal oxides was determined. The pure red clay had the lowest Z_eff of the tested samples, which means that introducing any of these three oxides into the clay will greatly enhance its Z_eff, and consequently its attenuation capability. Additionally, the Z_eff for red clay with 10 wt% CdO is lower than the Z_eff of red clay with 10 wt% Bi₂O₃ and PbO. We also prepared red clay using 10 wt% CdO nanoparticles and compared its attenuation ability with the red clay prepared with 10 wt% PbO, Bi₂O₃, and CdO microparticles. We found that the MAC of the red clay with 10 wt% nano-CdO was higher than the MAC of the clay with microparticle samples. Accordingly, nanoparticles could be a useful way to enhance the shielding ability of current radiation shielding materials.

Design of a CANFD to SOME/IP Gateway Considering Security for In-Vehicle Networks

In recent years, Ethernet has been introduced into vehicular networks to cope with the increasing demand for bandwidth and complexity in communication networks. To exchange data between controller area network (CAN) and Ethernet, a gateway system is required to provide a communication interface. Additionally, the existence of networked devices exposes automobiles to cyber security threats. Against this background, a gateway for CAN/CAN with flexible data-rate (CANFD) to scalable service-oriented middleware over IP (SOME/IP) protocol conversion is designed, and security schemes are implemented in the routing process to provide integrity and confidentiality protections. Based on NXP-S32G, the designed gateway is implemented and evaluated. Under most operating conditions, the CPU and the RAM usage are less than 5% and 20 MB, respectively. Devices running a Linux operating system can easily bear such a system resource overhead. The latency caused by the security scheme accounts for about 25% of the entire protocol conversion latency. Considering the security protection provided by the security scheme, this overhead is worthwhile. The results show that the designed gateway can ensure a CAN/CANFD to SOME/IP protocol conversion with a low system resource overhead and a low latency while effectively resisting hacker attacks such as frame forgery, tampering, and sniffing.

Defining the Time Benefit of Awake Versus General Anesthesia for Single-Level Lumbar Spine Surgery

BACKGROUND

Awake anesthesia with monitored anesthesia care (MAC) might confer time benefits compared with traditional general anesthesia (GA) in the setting of single-level lumbar spine surgery. Therefore, we sought to define the quantitative time difference spent in the operating room between the MAC and GA approaches for single-level lumbar spine surgery.

METHODS

A prospectively maintained database of the senior surgeon was reviewed for single-level lumbar spine surgeries from 2019 to 2020 performed with the patient under either GA or MAC. The patient demographics, clinical features, time in the operating room, and postoperative outcomes were all summarized and statistically compared.

RESULTS

A total of 53 patients satisfied all the selection criteria, with 25 (47%) in the GA group and 28 (53%) in the MAC group. Overall, most patients were men, with a median age of 60 years. The 2 groups were statistically comparable with respect to the demographics and preoperative anesthesia parameters. The time from room arrival to sedation start (median time, 26 vs. 38 minutes; P < 0.01), sedation time (median time, 55 vs. 87 minutes; P < 0.01), and time from sedation end to room exit (median time, 4 vs. 13 minutes; P < 0.01) were all significantly shorter for the MAC group. Additionally, the estimated blood loss was less in the MAC group (P < 0.01).

CONCLUSIONS

We found MAC to be a safe anesthesia option for use in single-level lumbar spine surgery, which led to statistically significant benefits regarding the time under sedation and time in the operating room compared with GA. Future studies are required to understand whether MAC will require other synergistic measures to generate observable change at a health systems level.

Mass absorption cross-section and absorption enhancement from long term black and elemental carbon measurements: A rural background station in Central Europe

Black carbon (BC) is a dominant aerosol light absorber, and its brown carbon (BrC) coating can enhance absorption and lead to uncertainties concerning the radiative forcing estimation. This study investigates the mass absorption cross-section of equivalent BC (MAC_eBC) during a long-term field measurement (2013-2017) at a rural Central European site. The MAC enhancement factor (E_abs) and the contribution of BrC coatings to the absorption coefficient (B_abs) were estimated by combining different approaches. The annual mean B_abs and MAC_eBC values decreased slightly over the measurement period associated with change in the submicron aerosol size distribution. Regardless of the wavelength, B_abs exhibited clear seasonal and diurnal variations, with higher values in winter when a higher absorption Ångström exponent (1.4) was observed due to the local biomass burning (BB). In contrast, MAC_eBC did not have a distinct temporal trend at 600 nm (7.84 ± 2.79 m² g^-1), while it showed a seasonal trend at 370 nm with higher values in winter (15.64 ± 4.77 m² g^-1). During this season, E_{abs_660} was 1.18 ± 0.27 and did not exhibit any clear wavelength dependence, despite the influence of BB. During the study period, BrC-attributed absorption was observed in 31% of the samples, with a contribution of up to 40% of total B_abs. In summer, the E_{abs_660} increased to 1.59 ± 0.60, when a larger BC coating could be formed by secondary aerosol fractions. During this season, MAC_{eBC_660} and E_{abs_660} showed comparable source profiles that were mainly associated with aged air masses over central Europe, thereby supporting the fact that characteristics of coating materials formed during atmospheric aging are a major factor driving the MAC_{eBC_660} measured at the regional background site. Further field investigations of the composition of BC coatings would help to better understand and estimate uncertainties related to the radiative effect of aerosols.

Understanding the Effect of Introducing Micro- and Nanoparticle Bismuth Oxide (Bi2O3) on the Gamma Ray Shielding Performance of Novel Concrete

The aim of this study is to investigate the radiation shielding properties of novel concrete samples with bulk Bi₂O₃ and Bi₂O₃ nanoparticles (Bi₂O₃ NP) incorporated into its composition. The mass attenuation coefficient of the concrete samples without Bi₂O₃ and with 5 and 7 wt% bulk Bi₂O₃ were experimentally determined and were compared against values obtained using the XCOM and Geant4 simulations. Both methods greatly agree with the experimental values. The linear attenuation coefficients (LAC) of blank concrete (C-0), concrete with 5% bulk Bi₂O₃ (C-B5), and concrete with 5% nanoparticle Bi₂O₃ (C-N5) were determined and compared at a wide energy range. We found that the LAC follows the trend of C-0 < C-B5 < C-N5 at all the tested energies. Since both C-B5 and C-N5 have a greater LAC than C-0, these results indicate that the addition of Bi₂O₃ improves the shielding ability of the concretes. In addition, we investigated the influence of nanoparticle Bi₂O₃ on the LAC of the concretes. The half-value layer (HVL) for the concretes with bulk Bi₂O₃ and Bi₂O₃ nanoparticles is also investigated. At all energies, the C-0 has the greatest HVL, while C-N15 has the least. Thus, C-N15 concrete is the most space efficient, while C-0 is the least space efficient. The radiation protection efficiency (RPE) of the prepared concretes was found to decrease with increasing energy for all five samples. For C-0, the RPE decreased from 63.3% at 0.060 MeV to 13.48% at 1.408 MeV, while for C-N15, the RPE decreased from 87.9 to 15.09% for the same respective energies. Additionally, C-N5 had a greater RPE than C-B5, this result demonstrates that Bi₂O₃ NP are more efficient at shielding radiation than bulk Bi₂O₃.

In vitro activity of bedaquiline against Mycobacterium avium complex

Introduction. Nontuberculous mycobacteria (NTM) are widespread in the environment and can cause various diseases in humans, especially immunocompromised patients.Hypothesis. Treatment of diseases caused by NTM is a complicated issue, mainly due to the resistance of the pathogen to most antimicrobial agents. Bedaquiline (Bdq) is now widely used for the treatment of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB).Aim. The main goal of our study was to evaluate the activity of Bdq against Mycobacterium avium complex (MAC), the most common species among NTM.Methodology. A total of 166 MAC cultures (124 Mycobacterium avium and 42 Mycobacterium intracellulare) were studied. The minimum inhibitory concentrations (MICs) of Bdq for M. avium and M. intracellulare were obtained by twofold serial dilutions in the Middlebrook 7H9 medium. MIC ranges were determined and the MIC₅₀, MIC₉₀ and ECOFF values were obtained.Results. The MICs in respect of M. avium ranged from 0.003 to 1.0 µg ml^-1; those for M. intracellulare ranged from 0.003 to 0.5 µg ml^-1. The Bdq MIC₅₀ and MIC₉₀ values were found to be 0.015 and 0.12 µg ml^-1 , respectively, for M. avium and 0.007 and 0.06 µg ml^-1, respectively, for M. intracellulare. The tentative ECOFF values for M. avium and M. intracellulare were 0.12 and 0.06 µg ml^-1, respectively.Conclusion. The main bedaquiline susceptibility parameters for MAC strains isolated in the Moscow region were determined.

Development and validation of an IgM antibody capture ELISA for early detection of Hendra virus

Zoonotic transmission of Hendra virus (HeV) from primary hosts (pteropid bats) to horses, and, occasionally, onward adventitious spread to humans, is associated with high mortality rates in both affected secondary species. The introduction of an effective recombinant G protein vaccine for use in horses has been a major advance for the suppression of disease risk. However, equine HeV vaccination induces neutralising antibody that is indistinguishable from a post infection immune response when using most first line serology assays (eg. VNT and some ELISAs). We have constructed and evaluated an IgM antibody capture (MAC) ELISA which employs yeast expressed HeV nucleoprotein (N). All other serology tests use the G protein which does not detect early infection and is present in the current Hendra virus vaccine and may cause ambiguity in interpretation of results. Thus, this is the first test developed using a N protein which can successfully detect a recent (primarily within the last four weeks) infection of horses with HeV and is not affected by vaccination induced antibody. Testing a limited panel (21 samples) of post infection sera, a normal serum panel (288 samples) and a post vaccination panel (163 samples), we have estimated DSe to be 100 % (95 % CI, 83.9-100.0 %) and DSp to be 98.4 % (95 % CI, 96.8-99.4 %) relative to assigned serology results (VNT, ELISA and Luminex) for the test panels. The HeV IgM MAC ELISA is intended to supplement other molecular and serology test results, with selective use, and is the only serology test which can provide an indication for recent infection which is otherwise not available.

Joint Optimization of Multi-Hop Broadcast Protocol and MAC Protocol in Vehicular Ad Hoc Networks

Beacon messages and emergency messages in vehicular ad hoc networks (VANETs) require a lower delay and higher reliability. The optimal MAC protocol can effectively reduce data collision in VANETs communication, thus minimizing delay and improving reliability. In this paper, we propose a Q-learning MAC protocol based on detecting the number of two-hop neighbors. The number of two-hop neighbors in highway scenarios is calculated with very little overhead using the beacon messages and neighbor locations to reduce the impact of hidden nodes. Vehicle nodes are regarded as agents, using Q-learning and beacon messages to train the near-optimal contention window value of the MAC layer under different vehicle densities to reduce the collision probability of beacon messages. Furthermore, based on the contention window value after training, a multi-hop broadcast protocol combined with contention window adjustment for emergency messages in highway scenarios is proposed to reduce forwarding delay and improve forwarding reliability. We use the trained contention window value and the state information of neighboring vehicles to assign an appropriate forwarding waiting time to the forwarding node. Simulation experiments are conducted to evaluate the proposed MAC protocol and multi-hop broadcast protocol and compare them with other related protocols. The results show that our proposed protocols outperform the other related protocols on several different evaluation metrics.

Clinical Care Redesign to Improve Value for Trigger Finger Release: A Before-and-After Quality Improvement Study

Background: Trigger finger release (TFR) is a commonly performed procedure. However, there is great variation in the setting, care pathway, anesthetic, and cost. We compared the institutional cost for isolated TFR before and after redesigning our clinical care pathway. Methods: Total direct cost to the health system (excluding the surgeon and anesthesiology costs) and time spent by the patient at the surgery center were collected for 1 hand surgeon's procedures at an ambulatory surgery center over a 3-year period. We implemented a redesigned pathway that altered phases of care and anesthetic use by transitioning from intravenous (IV) sedation to wide awake local anesthesia with no tourniquet. Cost data were reported as percentage change in the median and compared both pre- to post-implementation and with 2 control surgeons using the traditional pathway within the same center. Power analysis was based on prior work on a carpal tunnel pathway. Significance was defined by a P-value < .05. Results: Ten TFRs (90% local with IV sedation) and 44 TFRs (89% local alone) were performed pre- and post-implementation, respectively. From pre- to post-implementation, the study surgeon's total direct cost decreased by 18%, while the control surgeons decreased by 2%. Median time spent at the surgery center decreased by 41 minutes post-implementation with significantly shorter setup time in the operating room (OR), total time in the OR, and time spent in recovery prior to discharge. Conclusions: Redesigning the care pathway for TFR led to a decrease in institutional cost and patient time spent at the surgery center.

Secure and Efficient High Throughput Medium Access Control for Vehicular Ad-Hoc Network

The evolution of the internet has led to the growth of smart application requirements on the go in the vehicular ad hoc network (VANET). VANET enables vehicles to communicate smartly among themselves wirelessly. Increasing usage of wireless technology induces many security vulnerabilities. Therefore, effective security and authentication mechanism is needed to prevent an intruder. However, authentication may breach user privacy such as location or identity. Cryptography-based approach aids in preserving the privacy of the user. However, the existing security models incur communication and key management overhead since they are designed considering a third-party server. To overcome the research issue, this work presents an efficient security model namely secure performance enriched channel allocation (S−PECA) by using commutative RSA. This work further presents the commutative property of the proposed security scheme. Experiments conducted to evaluate the performance of the proposed S−PECA over state-of-the-art models show significant improvement. The outcome shows that S−PECA minimizes collision and maximizes system throughput considering different radio propagation environments.

The Diversity of the Mitochondrial Outer Membrane Protein Import Channels: Emerging Targets for Modulation

The functioning of mitochondria and their biogenesis are largely based on the proper function of the mitochondrial outer membrane channels, which selectively recognise and import proteins but also transport a wide range of other molecules, including metabolites, inorganic ions and nucleic acids. To date, nine channels have been identified in the mitochondrial outer membrane of which at least half represent the mitochondrial protein import apparatus. When compared to the mitochondrial inner membrane, the presented channels are mostly constitutively open and consequently may participate in transport of different molecules and contribute to relevant changes in the outer membrane permeability based on the channel conductance. In this review, we focus on the channel structure, properties and transported molecules as well as aspects important to their modulation. This information could be used for future studies of the cellular processes mediated by these channels, mitochondrial functioning and therapies for mitochondria-linked diseases.

Clinical and Immunologic Predictors of Mycobacterium avium Complex Immune Reconstitution Inflammatory Syndrome in a Contemporary Cohort of Patients With Human Immunodeficiency Virus

BACKGROUND

People with human immunodeficiency virus (HIV) can present with new or worsening symptoms associated with Mycobacterium avium complex (MAC) infection shortly after antiretroviral therapy (ART) initiation as MAC immune reconstitution inflammatory syndrome (MAC-IRIS). In this study, we assessed the utility of several laboratory tests as predictors of MAC-IRIS.

METHODS

People with HIV with clinical and histologic and/or microbiologic evidence of MAC-IRIS were identified and followed up to 96 weeks post-ART initiation within a prospective study of 206 ART-naive patients with CD4 <100 cells/µL.

RESULTS

Fifteen (7.3%) patients presented with MAC-IRIS within a median interval of 26 days after ART initiation. Patients who developed MAC-IRIS had lower body mass index, lower hemoglobin levels, higher alkaline phosphatase (ALP), and increased CD38 frequency and mean fluorescence intensity on CD8+ T cells at the time of ART initiation compared with non-MAC IRIS patients. A decision tree inference model revealed that stratifying patients based on levels of ALP and D-dimer could predict the likelihood of MAC-IRIS. A binary logistic regression demonstrated that higher levels of ALP at baseline were associated with increased risk of MAC-IRIS development.

CONCLUSIONS

High ALP levels and increased CD8+ T-cell activation with low CD4 counts at ART initiation should warrant suspicion for subsequent development of MAC-IRIS.

Role of Clofazimine in Treatment of Mycobacterium avium Complex

Background: Non-tuberculous mycobacteria (NTM), specifically Mycobacterium avium complex (MAC), is an increasingly prevalent cause of pulmonary dysfunction. Clofazimine has been shown to be effective for the treatment of M. avium complex, but there were no published large-scale analyses comparing clofazimine to non-clofazimine regimens in MAC treatment. The objective of this large-scale meta-analysis was to evaluate patient characteristics and treatment outcomes of individuals diagnosed with MAC and treated with a clofazimine-based regimen.

Methods: We used Pubmed/Medline, Embase, Web of Science, and the Cochrane Library to search for studies published from January 1, 1990 to February 9, 2020. Two reviewers (SSH and NY) extracted the data from all eligible studies and differences were resolved by consensus. Statistical analyses were performed with STATA (version 14, IC; Stata Corporation, College Station, TX, USA).

Results: The pooled success treatment rate with 95% confidence intervals (CI) was assessed using random effect model. The estimated pooled treatment success rates were 56.8% in clofazimine and 67.9% in non-clofazimine groups. Notably, success rates were higher (58.7%) in treatment of HIV patients with disseminated infection.

Conclusions: Treatment was more successful in the non-clofazimine group overall. However, HIV patients with disseminated infection had higher treatment response rates than non-HIV patients within the clofazimine group.

OSCAR: An Optimized Scheduling Cell Allocation Algorithm for Convergecast in IEEE 802.15.4e TSCH Networks

Today's wireless sensor networks expect to receive increasingly more data from different sources. The Time Slotted Channel Hopping (TSCH) protocol defined in the IEEE 802.15.4-2015 version of the IEEE 802.15.4 standard plays a crucial role in reducing latency and minimizing energy consumption. In the case of convergecast traffic, nodes close to the root have consistently heavy traffic and suffer from severe network congestion problems. In this paper, we propose OSCAR, an novel autonomous scheduling TSCH cell allocation algorithm based on Orchestra. This new design differs from Orchestra by allocating slots according to the location of the node relative to the root. The goal of this algorithm is to allocate slots to nodes according to their needs. This algorithm manages the number of timeslots allocated to each node using the value of the rank described by the RPL routing protocol. The goal is that the closer the node is to the root, the more slots it gets in order to maximize the transmission opportunities. To avoid overconsumption, OSCAR sets up a mechanism to adjust the radio duty cycle of each node by reducing the slots allocated to inactive nodes regardless of their position in the network. We implement OSCAR on Contiki-ng and evaluate its performance by both simulations and experimentation. The performance assessment of OSCAR shows that it outperforms Orchestra on the average latency and reliability, without significantly increasing the average duty cycle, especially when the traffic load is high.