Stress Distribution in Wear Analysis of Nano-Y2O3 Dispersion Strengthened Ni-Based μm-WC Composite Material Laser Coating

Oxide-dispersion- and hard-particle-strengthened (ODS) laser-cladded single-layer multi-tracks with a Ni-based alloy composition with 20 wt.% μm-WC particles and 1.2 wt.% nano-Y2O3 addition were produced on ultra-high-strength steel in this study. The investigation of the composite coating designed in this study focused on the reciprocating friction and wear workpiece surface under heavy load conditions. The coating specimens were divided into four groups: (i) Ni-based alloy, nano-Y2O3, and 2 μm-WC (2 μm WC-Y/Ni); (ii) Ni-based alloy with added 2 μm-WC (2 μmWC/Ni); (iii) Ni-based alloy with added 80 μm-WC (80 μmWC/Ni); and (iv) base metal ultra-high-strength alloy steel 30CrMnSiNi2A. Four conclusions were reached: (1) Nano-Y2O3 could effectively inhibit the dissolution of 2 μm-WC. (2) It can be seen from the semi-space dimensionless simulation results that the von Mises stress distribution of the metal laser composite coating prepared with a 2 μm-WC particle additive was very uniform and it had better resistance to normal impact and tangential loads than the laser coating prepared with the 80 μm-WC particle additive. (3) The inherent WC initial crack and dense stress concentration in the 80 μm-WC laser coating could easily cause dislocations to accumulate, as shown both quantitatively and qualitatively, resulting in the formation of micro-crack nucleation. After the end of the running-in phase, the COF of the 2 μm-WC-Y2O3/Ni component samples stabilized at the minimum of the COF of the four samples. The numerical order of the four COF curves was stable from small to large as follows: 2 μm-WC-Y2O3/Ni, 2 μm-WC/Ni, 80 μm-WC/Ni, and 30CrMnSiNi2A. (4) The frictional volume loss rate of 2 μm-WC-Y2O3/Ni was 1.3, which was significantly lower than the corresponding values of the other three components: 2.4, 3.5, and 13.

Loss of Ephaptic Contacts in the Murine Thalamus during Osmotic Demyelination Syndrome

BACKGROUND AND AIM

A murine model mimicking osmotic demyelination syndrome (ODS) revealed with histology in the relay posterolateral (VPL) and ventral posteromedial (VPM) thalamic nuclei adjoined nerve cell bodies in chronic hyponatremia, amongst the damaged 12 h and 48 h after reinstatement of osmolality. This report aims to verify and complement with ultrastructure other neurophysiology, immunohistochemistry, and molecular biochemistry data to assess the connexin-36 protein, as part of those hinted close contacts.This ODS investigation included four groups of mice: Sham (NN; n = 13), hyponatremic (HN; n = 11), those sacrificed 12 h after a fast restoration of normal natremia (ODS12h; n = 6) and mice sacrificed 48 h afterward, or ODS48 h (n = 9). Out of these, thalamic zones samples included NN (n = 2), HN (n = 2), ODS12h (n = 3) and ODS48h (n = 3).

RESULTS

Ultrastructure illustrated junctions between nerve cell bodies that were immunolabeled with connexin36 (Cx36) with light microscopy and Western blots. These cell's junctions were reminiscent of low resistance junctions characterized in other regions of the CNS with electrophysiology. Contiguous neurons showed neurolemma contacts in intact and damaged tissues according to their location in the ODS zones, at 12 h and 48 h post correction along with other demyelinating alterations. Neurons and ephaptic contact measurements indicated the highest alterations, including nerve cell necrosis in the ODS epicenter and damages decreased toward the outskirts of the demyelinated zone.

CONCLUSION

Ephapses contained C × 36between intact or ODS injured neurons in the thalamus appeared to be resilient beyond the core degraded tissue injuries. These could maintain intercellular ionic and metabolite exchanges between these lesser injured regions and, thus, would partake to some brain plasticity repairs.

Smart Mobility and Smart Climate: An Illustrative Case in Seville, Spain

In recent years, smart city projects and initiatives have surged around the globe. Yet, a wide range of factors determine the success or failure of such initiatives and there is still a long road ahead in terms of effective governance and innovation management. In such a context, this study explores the specific case of PCT Cartuja (science and technology park in Seville, Spain)-analyzing several smart-mobility and smart-climate solutions from a Triple Helix Model standpoint. The authors tap into multiple information sources to describe the case and key implications of smart initiatives for both theory and management are discussed. This paper shows the current progress as well as the remaining challenges to illustrate how public-private partnerships and conflict can be effectively managed.

Predictive factors for functional failure of ventral mesh rectopexy in the treatment of rectal prolapse and obstructed defecation

Background

Ventral mesh rectopexy (VMR) is widely accepted for the treatment of rectal prolapse or obstructed defecation. However, despite good anatomical results, the improvement of functional symptoms (constipation or incontinence) cannot always be obtained and in some cases these symptoms may even worsen. The aim of the present study was to identify possible predictors of functional failure after VMR.

Methods

Data of all consecutive patients who had VMR for the treatment of rectal prolapse and/or obstructed defecation between January 2017 and December 2020 in three different pelvic floor surgical centres in Italy were analysed to identify possible predictors of functional failure, intended as persistence, worsening or new onset of constipation or faecal incontinence. Symptom severity was assessed pre- and postoperatively with the Wexner Constipation score and Obstructed Defecation Syndrome score. Quality of life was assessed, also before and after treatment, with the Patients Assessment of Constipation Quality of Life questionnaire, the Pelvic Floor Disability Index and the Pelvic Floor Impact Questionnaire. Faecal incontinence was evaluated with the Cleveland Clinic Incontinence Score. The functional outcomes before and after surgery were compared.

Results

Sixty-one patients were included (M:F ratio 3:60, median age 64 years [range 33–88 years]). Forty-two patients (68.9%) had obstructed defecation syndrome, 12(19.7%) had faecal incontinence and 7 patients (11.5%) had both. A statistically significant reduction between pre- and postoperative Obstructed Defecation Syndrome and Wexner scores was reported (p < 0.0001 in both cases). However, the postoperative presence of constipation occurred in 22 patients (36.1%) (this included 3 cases of new-onset constipation). The presence of redundant colon and the pre-existent constipation were associated with an increased risk of persistence of constipation postoperatively or new-onset constipation (p = 0.004 and p < 0.0001, respectively). The use of postoperative pelvic floor rehabilitation (p = 0.034) may reduce the risk of postoperative constipation.

Conclusions

VMR is a safe and effective intervention for correcting the anatomical defect of rectal prolapse. The degree of prolapse, the presence of dolichocolon and pre-existing constipation are risk factors for the persistence or new onset of postoperative constipation. Postoperative rehabilitation treatment may reduce this risk.

Materials to Be Used in Future Magnetic Confinement Fusion Reactors: A Review

This paper presents the roadmap of the main materials to be used for ITER and DEMO class reactors as well as an overview of the most relevant innovations that have been made in recent years. The main idea in the EUROfusion development program for the FW (first wall) is the use of low-activation materials. Thus far, several candidates have been proposed: RAFM and ODS steels, SiC/SiC ceramic composites and vanadium alloys. In turn, the most relevant diagnostic systems and PFMs (plasma-facing materials) will be described, all accompanied by the corresponding justification for the selection of the materials as well as their main characteristics. Finally, an outlook will be provided on future material development activities to be carried out during the next phase of the conceptual design for DEMO, which is highly dependent on the success of the IFMIF-DONES facility, whose design, operation and objectives are also described in this paper.

Assessing sectoral water stress states from the demand-side perspective through water footprint dimensions decomposition

Due to its essentiality and scarcity, water is subject to stress from the supply and demand side. The SDG and many methods for assessing water stress (WS) are based on water supply, even though the total water supply is uncontrollable by humans in the short term. Conversely, from a water demand perspective, WS arises from the deliberate and manageable use of water to produce goods and services, with few methods proposing to evaluate WS. We propose a method to assess the sectoral demand-side water stress states (DWSS) to fill this gap. The method comprises a quantitative step followed by a qualitative analysis. Quantitatively, an environmentally extended input-output model integrated Brazilian water resource and economic data for 2010 and 2015, including the imported virtual water in the water footprint calculation. Three dimensions of water footprint (DWF) were calculated: consumptive use of water (CUWF), water consumption (CWF), and return to the environment (REWF). The variations in DWFs over time were used as criteria to define five DWSS ranging from weak to strong. Brazilian economy as a whole presented a moderately weak DWSS. Among economic sectors, the most frequent DWSS was moderately weak, with sixteen sectors. The Livestock and Forestry, fishing, and aquaculture sectors had a strong DWSS, while the Slaughter, meat, and dairy and Public administration sectors had weak DWSS. Despite its limitations, the demand-side analysis can complement the usual method from a supply perspective.

hGLUTEN Tool: Measuring Its Social Impact Indicators

hGLUTEN is a technological solution capable of detecting gluten and spoiled food. We measured the social impact of the hGLUTEN tool using two Likert scale surveys with two groups: professionals (engineers/chefs) and end-users. These data have been assessed in accordance with the social impact indicators defined for the Key Impact Pathways introduced by the European Commission for Horizon Europe and the criteria of the Social Impact Open Repository (SIOR). A total of 85% of users, 100% of engineers and 68% of professional chefs consider it very relevant to participate and give their opinion in research projects, which shows the increasingly high level of involvement of the general population. A total of 88% of users were unaware of other applications that detect gluten and were more dependent on guidelines provided by allergy associations and expiry dates of foodstuffs. In addition, only 5% of professional chefs said they were aware of other technology capable of detecting gluten in food, which may indicate a large economic market and good commercialisation possibilities for the tool in the future. Finally, the inclusion of tools to motivate users to promote it has been identified as an area for improvement, which could mean that it should be made more visible in the media to increase its impact and influence.

Hyponatremia and extrapontine myelinolysis in a patient with COVID-19: A case report

Until we have strong evidence to the contrary, symptomatic hyponatremia should be treated with extra caution in COVID-19 co-infection patients as the latter could be another risk factor for the development of extrapontine myelinolysis.

Putative adverse outcome pathways for female reproductive disorders to improve testing and regulation of chemicals

Modern living challenges female reproductive health. We are witnessing a rise in reproductive disorders and drop in birth rates across the world. The reasons for these manifestations are multifaceted and most likely include continuous exposure to an ever-increasing number of chemicals. The cause–effect relationships between chemical exposure and female reproductive disorders, however, have proven problematic to determine. This has made it difficult to assess the risks chemical exposures pose to a woman’s reproductive development and function. To address this challenge, this review uses the adverse outcome pathway (AOP) concept to summarize current knowledge about how chemical exposure can affect female reproductive health. We have a special focus on effects on the ovaries, since they are essential for lifelong reproductive health in women, being the source of both oocytes and several reproductive hormones, including sex steroids. The AOP framework is widely accepted as a new tool for toxicological safety assessment that enables better use of mechanistic knowledge for regulatory purposes. AOPs equip assessors and regulators with a pragmatic network of linear cause–effect relationships, enabling the use of a wider range of test method data in chemical risk assessment and regulation. Based on current knowledge, we propose ten putative AOPs relevant for female reproductive disorders that can be further elaborated and potentially be included in the AOPwiki. This effort is an important step towards better safeguarding the reproductive health of all girls and women.

Hypertonic saline, isotonic saline, water restriction, long loops diuretics, urea or vaptans to treat hyponatremia

Introduction: Hyponatremia is the most common fluid and electrolyte abnormality. It is associated with much higher morbidity and mortality rates than found in non hyponatremic patients.Areas covered: When the physician is faced to a hyponatremic patient he first has to confirm that hyponatremia is associated with hypoosmolality. Then he must answer to a series of questions: What is its origin? Is it acute or chronic? Which treatment is the most appropriate? We will discuss the various options for the treatment of hypotonic hyponatremia. For a better comprehensive approach of the treatment we will also discuss some pathophysiological data. The use of urea in euvolemic and hypervolemic hyponatremia will be particularly discussed. Literature was reviewed from Jan 1970 to Dec 2019.Expert opinion: Prospective studies showing the benefit in decreasing morbidity by increasing SNa in patients with chronic hyponatremia should be done. These studies should also compare the efficacy and side effects of urea therapy compare to vaptans.

Stapled transanal rectal resection for the treatment of rectocele associated with obstructed defecation syndrome: a large series of 262 consecutive patients

BACKGROUND

This study aims to investigate functional results and recurrence rate after stapled transanal rectal resection (STARR) for rectocele associated with obstructive defection syndrome (ODS).

METHODS

A study was conducted on patients with ODS symptoms associated with symptomatic rectocele ≥ 3 cm on dynamic defecography who had STARR at our institution between 01/2007 and 12/2015. Data were prospectively collected and analyzed. ODS was evaluated using the Wexner constipation score. Primary outcomes were functional results, determined by the improvement in 6-month postoperative Wexner constipation score, and 1-year recurrence. Secondary outcomes were operative time, time to return to work, pain intensity measured using the visual analogue scale (VAS), patient satisfaction, and overall postoperative morbidity and mortality at 30 days.

RESULTS

Two-hundred-sixty-two consecutive female patients [median age 54 years (range 20-78)] were enrolled in the study. The median duration of follow-up was 79 months (range 30-138). Sixty (23%) patients experienced postoperative complications, but only 9 patients required reinterventions for surgical hemostasis (n = 7), fecal diversion for anastomotic leakage (n = 1), and recto-vaginal fistula repair (n = 1). Only 1 intraoperative complication (stapler misfire) was reported, and there were no deaths. There was a statistically significant (p < 0.001) reduction in the median (range) Wexner constipation score from 19 (14-24) preoperatively to 9 (5-15) 6 months postoperatively. Only 10 (4%) patients experienced recurrence and only 3 of them required additional reintervention. Patient satisfaction at 1 year was excellent in 86%, good in 13%, and poor in 1% of patients.

CONCLUSIONS

STARR is a safe, effective, and minimally invasive technique for the treatment of rectocele associated with ODS.

Effects of Zr Addition on Strengthening Mechanisms of Al-Alloyed High-Cr ODS Steels

Oxide dispersion strengthened (ODS) steels with different contents of zirconium (denoted as 16Cr ODS, 16Cr-0.3Zr ODS and 16Cr-0.6Zr ODS) were fabricated to investigate the effects of Zr on strengthening mechanism of Al-alloyed 16Cr ODS steel. Electron backscatter diffraction (EBSD) results show that the mean grain size of ODS steels could be decreased by Zr addition. Transmission electron microscope (TEM) results indicate that Zr addition could increase the number density but decrease the mean diameter and inter-particle spacing of oxide particles. Furthermore, it is also found that in addition to Y-Al-O nanoparticles, Y-Zr-O oxides with finer size were observed in 16Cr-0.3Zr ODS and 16Cr-0.6Zr ODS steels. These changes in microstructure significantly increase the yield strength (YS) and ultimate tensile strength (UTS) of ODS steels through mechanisms of grain boundary strengthening and dispersion strengthening.

Internal Delorme's Procedure for Treating ODS Associated With Impaired Anal Continence

OBJECTIVE

The aim of this study was to evaluate the medium-term outcomes of internal Delorme's procedure for treating obstructed defecation syndrome (ODS) patients with impaired anal continence.

PATIENTS AND METHODS

In a retrospective study, 41 ODS patients who underwent internal Delorme's procedure between 2011 and 2015 were divided into 3 subgroups according to their associated symptoms of impaired continence, as urgency, passive fecal incontinence and both, before study. Then the patients' preoperative statuses, perioperative complications, and postoperative outcomes were investigated and collected from standardized questionnaires, including Altomare ODS score, Fecal Incontinence Severity Index (FISI), Patient Assessment of Constipation-Quality of Life Questionnaire (PAC-QoL), and Fecal Incontinence Quality of Life Scale (FIQLS). All results with a 2-tailed P < .05 were considered statistically significant.

RESULTS

At an average 2.8 years of follow-up, there were significant improvements ( P < .01) in Altomare ODS score, FISI, PAC-QoL, and FIQLS in all patients when comparing scores from before the operation with those at the final follow-up. Similar results were also observed in both the urgency subgroup and passive fecal incontinence subgroup, but there were no statistically significant improvements ( P > .05) in Altomare ODS score, FISI, PAC-QoL, or FIQLS in the urgency and passive fecal incontinence subgroups. Anorectal manometry showed the mean value of anal resting pressure increased 20%. Additionally, no major complications occurred.

CONCLUSION

Internal Delorme's procedure is effective without major morbidity for treating ODS associated with urgency or passive fecal incontinence, but it may be less effective for treating ODS associated with both urgency and passive fecal incontinence.

Electromagnetic transduction therapy in non-specific low back pain: A prospective randomised controlled trial

OBJECTIVES

A prospective randomised controlled trial to investigate the efficacy of electromagnetic transduction therapy (EMTT) for treatment of patients with non-specific low back pain.

DESIGN

Two groups with non-specific low back pain were either treated with conventional therapy alone over 6 weeks or in combination with 8 sessions of EMTT.

RESULTS

In both intervention groups the low back pain related pain and the degree of disability decreased significantly at follow-up visits. Combination of EMTT and conventional therapy proved significant superior to conventional therapy alone.

CONCLUSION

EMTT is a promising treatment in patients with non-specific low back pain.

Chronic Severe Hyponatremia and Cardiopulmonary Bypass: Avoiding Osmotic Demyelination Syndrome

Serum sodium concentration affects every cell in the body with respect to cellular tonicity. Hyponatremia is the most frequent electrolyte abnormality encountered, occurring at clinical admission in 22% of elderly patients. Any rapid correction of chronic severe hyponatremia can result in rapid cellular shrinking due to loss of intracellular free water. This is commonly associated with paralysis and severe brain damage due to osmotic demyelination syndrome (ODS). ODS occurs because the body has the ability to compensate for cellular fluid shifts due to chronic hyponatremia (by a decrease in brain concentration of several ions, amino acids, and organic osmolytes). Thus, the neurons are often at a functional state of fluid balance despite the sodium imbalance. The initiation of cardiopulmonary bypass (CPB) can introduce between 1 and 2 L of priming solution containing a normal sodium concentration creating a rapid rise in sodium concentration within the extracellular fluid. This abrupt change establishes a situation where intracellular free water can be lost resulting in cellular shrinking and ODS. In presenting this case study, we hope to add to the current literature with a specific isotonic approach to treating the chronically severe hyponatremic patient pre-CPB, during CPB, and post-CPB.

Self-Etching-Induced Morphological Evolution of ZnO Microrods Grown on FTO Glass by Hydrothermal Method

In this research, the zinc oxide (ZnO) microrods were grown by hydrothermal method on fluorine-doped tin oxide (FTO) glass functionalized by self-assembled monolayer of octadecyltrimethoxysilane (ODS; CH3(CH2)17Si(OCH3)3). The sharp-tip or polygonal shape with specific facets at the top end of ZnO microrods can be obtained by post retention at low temperature. The morphologies were characterized by the field-emission scanning electron microscope (FESEM) and transmission electron microscopy (TEM). The results confirm that the morphology change at the top end is due to self-etching. The mechanism responsible for the formation of various top-end morphologies was proposed. The specific facets that left after 6-h retention were identified. The room-temperature micro-photoluminescence spectra showed a strong ultraviolet emission at 387 nm, and a broad emission at a range of from 500 to 700 nm. The morphology change also influences the photoluminescence (PL) spectra. A satellite peak in the UV emission spectra was observed. The peak may be attributed to the morphology effect of the microrods.

Actual Therapeutic Indication of an Old Drug: Urea for Treatment of Severely Symptomatic and Mild Chronic Hyponatremia Related to SIADH

Oral urea has been used in the past to treat various diseases like gastric ulcers, liver metastases, sickle cell disease, heart failure, brain oedema, glaucoma, Meniere disease, etc. We have demonstrated for years, the efficacy of urea to treat euvolemic (SIADH) or hypervolemic hyponatremia. We briefly describe the indications of urea use in symptomatic and paucisymptomatic hyponatremic patients. Urea is a non-toxic, cheap product, and protects against osmotic demyelinating syndrome (ODS) in experimental studies. Prospective studies showing the benefit to treat mild chronic hyponatremia due to SIADH and comparing water restriction, urea, high ceiling diuretics, and antivasopressin antagonist antagonist should be done.

Health-related quality of life, depression, and anxiety in patients with autoimmune hepatitis

BACKGROUND & AIMS

Improving health related quality of life (HrQoL) in patients with chronic diseases such as autoimmune hepatitis (AIH) should be a major treatment goal. However, little is known on the HrQoL in patients with AIH, and the topic is not given attention in current practice guidelines. We therefore conducted a single center study evaluating HrQoL in 103 consecutive outpatients with AIH.

METHODS

Patient-reported HrQoL data were analysed in relation to clinical disease parameters and compared to representative data of the German population as well as control patients.

RESULTS

Based on patient-reported data, a major depressive syndrome (10.8%) was found to be five times more frequent in AIH patients compared to the general population (p<0.001). The rate of severe symptoms of anxiety was also found to be significantly increased compared to the general population (p=0.006). In seven of the eleven patients who scored for a major depressive syndrome a psychiatric comorbidity had not been diagnosed before. Major factors associated with depression and anxiety were concerns with regard to the progression of the liver disease.

CONCLUSIONS

This study identified--for the first time--a high rate of previously unrecognized severe symptoms of depression and anxiety in patients with AIH. Of importance for daily clinical practice, the factors associated with these symptoms may in part be amenable to targeted counselling and adequate treatment of the disease, thereby offering the chance to improve the care and HrQoL of AIH-patients.

Proposed mechanistic description of dose-dependent BDE-47 urinary elimination in mice using a physiologically based pharmacokinetic model

Polybrominated diphenyl ethers (PBDEs) have been used in a wide variety of consumer applications as additive flame retardants. In North America, scientists have noted continuing increases in the levels of PBDE congeners measured in human serum. Some recent studies have found that PBDEs are associated with adverse health effects in humans, in experimental animals, and wildlife. This laboratory previously demonstrated that urinary elimination of 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) is saturable at high doses in mice; however, this dose-dependent urinary elimination has not been observed in adult rats or immature mice. Thus, the primary objective of this study was to examine the mechanism of urinary elimination of BDE-47 in adult mice using a physiologically based pharmacokinetic (PBPK) model. To support this objective, additional laboratory data were collected to evaluate the predictions of the PBPK model using novel information from adult multi-drug resistance 1a/b knockout mice. Using the PBPK model, the roles of mouse major urinary protein (a blood protein carrier) and P-glycoprotein (an apical membrane transporter in proximal tubule cells in the kidneys, brain, intestines, and liver) were investigated in BDE-47 elimination. The resulting model and new data supported the major role of m-MUP in excretion of BDE-47 in the urine of adult mice, and a lesser role of P-gp as a transporter of BDE-47 in mice. This work expands the knowledge of BDE-47 kinetics between species and provides information for determining the relevancy of these data for human risk assessment purposes.

Expanding research to provide an evidence base for nutritional interventions for the management of inborn errors of metabolism

A trans-National Institutes of Health initiative, Nutrition and Dietary Supplement Interventions for Inborn Errors of Metabolism (NDSI-IEM), was launched in 2010 to identify gaps in knowledge regarding the safety and utility of nutritional interventions for the management of inborn errors of metabolism (IEM) that need to be filled with evidence-based research. IEM include inherited biochemical disorders in which specific enzyme defects interfere with the normal metabolism of exogenous (dietary) or endogenous protein, carbohydrate, or fat. For some of these IEM, effective management depends primarily on nutritional interventions. Further research is needed to demonstrate the impact of nutritional interventions on individual health outcomes and on the psychosocial issues identified by patients and their families. A series of meetings and discussions were convened to explore the current United States' funding and regulatory infrastructure and the challenges to the conduct of research for nutritional interventions for the management of IEM. Although the research and regulatory infrastructure are well-established, a collaborative pathway that includes the professional and advocacy rare disease community and federal regulatory and research agencies will be needed to overcome current barriers.