Ibuprofen is an antipyretic and analgesic drug used for the management of different inflammatory diseases, such as rheumatoid arthritis and osteoarthritis. Due to a short half-life and rapid ...elimination, multiple doses of ibuprofen are required in a day to maintain pharmacological action for a long duration of time. Due to multiple intakes of ibuprofen, certain severe adverse effects, such as gastric irritation, bleeding, ulcers, and abdominal pain are produced. Therefore, a system is needed which not only prolongs the release of ibuprofen but also overcomes the drug’s adverse effects. Hence, the authors have synthesized chondroitin sulfate/sodium polystyrene sulfonate–co-poly(acrylic acid) hydrogels by the free radical polymerization technique for the controlled release of ibuprofen. Sol-gel, porosity, swelling, and drug release studies were performed on the fabricated hydrogel. The pH-responsive behavior of the fabricated hydrogel was determined by both swelling and drug release studies in three different pH values, i.e., pH 1.2, 4.6, and 7.4. Maximum swelling and drug release were observed at pH 7.4, as compared to pH 4.6 and 1.2. Similarly, the structural arrangement and crosslinking of the hydrogel contents were confirmed by Fourier transform infrared spectroscopy (FTIR). Scanning electron microscopy (SEM) evaluated the hard and irregular surface with a few macrospores of the developed hydrogel, which may be correlated with the strong crosslinking of polymers with monomer content. Similarly, thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) demonstrated the high thermal stability of the formulated hydrogel, as compared to pure polymers. A decrease in the crystallinity of chondroitin sulfate and sodium polystyrene sulfonate after crosslinking was revealed by powder X-ray diffraction (PXRD). Thus, considering the results, we can demonstrate that a developed polymeric network of hydrogel could be used as a safe, stable, and efficient carrier for the controlled release of ibuprofen.
The optimal type of esophagectomy and extent of lymphadenectomy for patients after neoadjuvant chemoradiotherapy (nCRT) for esophageal squamous cell carcinoma remain controversial. We hypothesized ...that a more radical resection is associated with better survival.
Data of patients who received nCRT followed by resection for esophageal squamous cell carcinoma between 2012 and 2021 were analyzed. Modified en bloc esophagectomy (mEBE) involves total mediastinal lymphadenectomy and resection of all periesophageal node-bearing tissues. Perioperative outcomes and survival rates of mEBE were compared with those of conventional esophagectomy (CE).
A total of 238 patients were included. Compared with CE, mEBE was associated with a longer operative time, higher total number of resected lymph nodes, fewer complications, and less anastomotic leakage; length of stay was similar between the 2 groups. There was no difference in overall survival rates between patients with ypT0 N0 stage in the mEBE and CE groups; however, in patients with non–ypT0 N0 stage in the mEBE and CE groups, the 3-year overall survival rates were 58.5% and 28.5%, respectively (P < .001). On disease-free survival analysis, no difference was observed in patients with ypT0 N0 stage, whereas patients with non–ypT0 N0 stage after nCRT had significantly better disease-free survival after mEBE compared with CE (49.7% vs 27.2%; P = .017).
Survival after mEBE was significantly better than that after CE. The mEBE did not increase postoperative hospital stay and complication rates.
•Chromosome representation in genetic algorithm (GA) is important but rarely examined.•In modeling chromosome representation, incomplete scheme might be better than complete scheme.•Using incomplete ...scheme, the mapping from chromosome to solution may not be invertible.•Shadow chromosomes are heuristically generated by quality solutions, not by genetic operators.•GAs with shadow chromosomes and incomplete scheme might be better in solving high-dimensional space search problem.
Two conjectures, the use of incomplete chromosome representations and shadow chromosomes may improve the performance of genetic algorithms (GAs), are examined in this study. The examination entails testing distributed flexible job shop scheduling (DFJS) problems subject to preventive maintenance (PM) that involve four scheduling decisions. Genetic algorithms based on a complete chromosome representation that explicitly models the four decisions have been developed previously. By contrast, herein, two incomplete chromosome representations are proposed, whereby the conjectured advantages are two-fold. First, an incomplete chromosome representation models two scheduling decisions, and the remaining two are decoded by heuristic rules designed to ensure the load balance of manufacturing resources. Therefore, scheduling solutions with load imbalance will not be generated, which will help prevent the execution of ineffective searches. Second, a novel method of generating new chromosomes is developed and employed, instead of using traditional genetic operations. These chromosomes, called shadow chromosomes, are generated from good quality scheduling solutions and they may improve performance. Based on these two conjectures, four GAs are proposed. Numerical experiments reveal that each proposed GA outperforms the prior GAs substantially and the two conjectures are thus well justified. These findings shed light on the application of the two conjectures for developing metaheuristic algorithms to solve other high-dimensional space search problems.
Recent developments in nanoscale thermal metrology using electron microscopy have made impressive advancements in measuring either phononic or thermal transport properties of nanoscale samples. ...However, its potential in material analysis has never been considered. Here we introduce a direct thermal absorbance measurement platform in scanning electron microscope (SEM) and demonstrate that its signal can be utilized for atomic number (Z) analysis at nanoscales. We prove that the measured absorbance of materials is complementary to signals of backscattering electrons but exhibits a much higher collection efficiency and signal-to-noise ratio. Thus, it not only enables successful detections of light elements/compounds under low acceleration voltages of SEM but also allows quantitative Z analyses in agreement with simulations. The direct thermal absorbance measurement platform would become an ideal tool for SEM, especially for thin films, light elements/compounds, or biological samples at nanoscales.
Bacterial vaginosis (BV) is the most common vaginal infection globally, with a high recurrent rate after antibiotic treatment. Probiotics consumption is known to improve BV with different efficacy ...among species or strains. After in vitro selection of Lactobacillus strains with growth inhibition and preventing adhesion to HeLa cervical epithelial cells, a randomized and double-blinded trial of two Lactobacillus formula, namely, VGA-1 and VGA-2, in BV patients with Nugent scores of 4–10 was conducted. Among 37 subjects who completed the trial, we observed significantly decreased Nugent scores in both VGA-1 (n = 18) and VGA-2 (n = 19) consumption groups. VGA-1 consumption significantly improved vaginal discharge odor/color and itching at both 2-week and 4-week-consumption, but those only observed after a 4-week-consumption in the VGA-2 group. We also observed a tendency to reduce recurrent rates among enrolled participants after VGA-1 or VGA-2 consumption. The improvement effect of VGA-1/VGA-2 was associated with the significant reduction of interleukin-6 expression after 4-week-consumption and the restoration of normal vaginal microflora by quantitative polymerase chain reaction analysis. In conclusion, VGA-1 or VGA-2 displayed beneficial effects in BV patients, but the VGA-1 formula showed a better efficacy, potentially used for BV intervention.
The integral defense responses of plants triggered by the small molecules of plant pathogens are regarded as plant immunity. The pathogen-associated molecular pattern-triggered immunity (PTI) occurs ...on the recognition of a pathogen by receptors on plant cell surfaces as an infection begins. During the activation of PTI, the effectiveness of a plant's photosynthetic system may be altered. In this study, chlorophyll fluorescence was used to assay the dynamic changes of PTI. When we used flg22
as an elicitor, we found that the photosynthetic electron transport rate (ETR) of
Col-0 was significantly decreased at 2, 4, and 24 h on treatment with a PTI-intensifying protein, plant ferredoxin-like protein (PFLP). In addition, this reduction in the photosynthetic ETR was also carried out with a PTI-intensifying
strain, PMB05, on the induction of flg22
. The disease resistance against bacterial soft rot caused by
subsp.
(Pcc) was still enhanced by PMB05. Interestingly, among the eight tested
species strains, the PTI triggered by HrpN
from
subsp.
exhibited an ETR that was significantly decreased by PMB05. Furthermore, this decrease was consistent with rapid H
O
generation and callose deposition triggered by HrpN
and the disease resistance against bacterial soft rot. Taken together, such results led us to conclude that the assay based on the ETR established in this study can be used as a model for evaluating the effectiveness of plant immunity-intensifying microbes for controlling plant diseases.
In situ chemical oxidation with persulfate anion
(
S
2
O
8
2
-
)
is a viable technique for remediation of groundwater contaminants such as trichloroethylene (TCE). An accelerated reaction using
S
2
O
...8
2
-
to destroy TCE can be achieved via chemical activation with ferrous ion to generate sulfate radicals
(
SO
4
-
·
)
(
E
°
=
2.6
V
)
. The column study presented here simulates persulfate oxidation of TCE in porous media (glass beads and a sandy soil). Initial experiments were conducted to investigate persulfate transport in the absence of TCE in the column. The persulfate flushing exhibited a longer residence time and revealed a moderate persulfate interaction with soils. In TCE treatment experiments, the results indicate that the water or persulfate solution would push dissolved TCE from the column. Therefore, the effluent TCE concentration gradually increased to a maximum when about one pore volume was replaced with the flushing solution in the column. The presence of Fe
2+ concentration within the column caused a quick drop in effluent TCE concentration and more TCE degradation was observed. When a TCE solution was flushing through the soil column, breakthrough of TCE concentration in the effluent was relatively slow. In contrast, when the soil column was flushed with a mixed solution of persulfate and TCE, persulfate appeared to preferentially oxidize soil oxidizable matter rather than TCE during transport. Hence, persulfate oxidation of soil organics may possibly reduce the interaction between TCE and soil (e.g., adsorption) and facilitate the transport of TCE through soil columns resulting in faster breakthrough.
Intravenous immunoglobulin (IVIG) is used in the treatment of immunological, inflammatory and neurological conditions. We aimed to describe the trends in IVIG utilization in Taiwan. We identified ...patients receiving IVIG through the national health insurance (NHI) database. We described the distribution of IVIG use according to main indications. During 2008–2017, IVIG distribution grew 10% per year on average. The population IVIG dose was 8.0 g per thousand capita. Among the total distribution, approximately 60% were NHI-reimbursed. Pediatrics (52.3%), rheumatology (14.0%) and hematology/oncology (11.4%) accounted for the top three services in terms of IVIG consumption. Primary and secondary immune deficiency (29.8%), Kawasaki disease (20.5%) and thrombocytopenia (16.8%) were the top three indications. Neurological conditions only accounted for 3%. In brief, unlike countries with high population use, the proportion of reimbursed IVIG used for neurological conditions was low. Further studies on self-paid IVIG use is needed to completely understand utilization in Taiwan.
Acetaminophen is an odorless and white crystalline powder drug, used in the management of fever, pain, and headache. The half-life of acetaminophen is very short; thus, multiple intakes of ...acetaminophen are needed in a day to maintain a constant pharmacological action for an extended period of time. Certain severe adverse effects are produced due to the frequent intake of acetaminophen, especially hepatotoxicity and skin rashes. Therefore, a drug carrier system is needed which not only prolongs the release of acetaminophen, but also enhances the patient compliance. Therefore, the authors prepared novel aspartic acid-graft-poly(acrylic acid) hydrogels for the controlled release of acetaminophen. The novelty of the prepared hydrogels is based on the incorporation of pH-sensitive monomer acrylic acid with polymer aspartic acid in the presence of ethylene glycol dimethacrylate. Due to the pH-sensitive nature, the release of acetaminophen was prolonged for an extended period of time by the developed hydrogels. Hence, a series of studies was carried out for the formulated hydrogels including sol-gel fraction, FTIR, dynamic swelling, polymer volume analysis, thermal analysis, percent porosity, SEM, in vitro drug release studies, and PXRD analysis. FTIR analysis confirmed the grafting of acrylic acid onto the backbone of aspartic acid and revealed the development of hydrogels. The thermal studies revealed the high thermal stability of the fabricated hydrogels as compared to pure aspartic acid. An irregular surface with a few pores was indicated by SEM. PXRD revealed the amorphous state of the developed hydrogels and confirmed the reduction in the crystallinity of the unreacted aspartic acid by the formulated hydrogels. An increase in gel fraction was observed with the increasing concentration of aspartic acid, acrylic acid, and ethylene glycol dimethacrylate due to the availability of a high amount of free radicals. The porosity study was influenced by the various compositions of developed hydrogels. Porosity was increased due to the enhancement in the concentrations of aspartic acid and acrylic acid, whereas it decreased with the increase in ethylene glycol dimethacrylate concentration. Similarly, the pH-responsive properties of hydrogels were evaluated by dynamic swelling and in vitro drug release studies at two different pH levels (1.2 and 7.4), and a greater dynamic swelling and acetaminophen release were exhibited at pH 7.4 as compared to pH 1.2. An increase in swelling, drug loading, and drug release was seen with the increased incorporation of aspartic acid and acrylic acid, whereas a decrease was detected with the increase in the concentration of ethylene glycol dimethacrylate. Conclusively, the formulated aspartic acid-based hydrogels could be employed as a suitable nonactive pharmaceutical ingredient for the controlled delivery of acetaminophen.
Ventilator-associated pneumonia (VAP) is a critical hospital-acquired infection following non-cardiac surgeries, leading to poor outcomes. This study identifies VAP risk factors in non-cardiac ...surgical patients and determines the causative pathogens. A retrospective analysis with 1:4 propensity-score matching was conducted on patients in a surgical intensive care unit (ICU) from 2010 to 2020 at a private tertiary medical center. Among 99 VAP patients, the mortality rate was 64.7%. VAP risk factors included prolonged mechanical ventilation (odds ratio OR 6.435; p < 0.001), repeat intubation (OR 6.438; p < 0.001), lower oxygenation levels upon ICU admission (OR 0.950; p < 0.001), and undergoing gastrointestinal surgery (OR 2.257; p = 0.021). The 30-day mortality risk factors in the VAP group were late-onset VAP (OR 3.450; p = 0.022), inappropriate antibiotic treatment (OR 4.083; p = 0.041), and undergoing gastrointestinal surgeries (OR 4.776; p = 0.019). Nearly half of the Gram-negative infections were resistant strains, and a third were polymicrobial infections. Non-cardiac surgical patients with VAP face adverse hospital outcomes. Identifying high-risk patients and understanding VAP’s resistant and microbial nature are crucial for appropriate treatment and improved health outcomes.
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