► Exposure time is favorable for a Porous skin and particle morphology in VIPS. ► Porous skin and particle morphology are beneficial to the hydrophobic surface. ► The micro-nano bionic spheres ...contribute to the high CA on the PVDF surfaces. ► Low surface energy also contributes to the high CA on the PVDF surfaces.
The present investigation revealed how the surface morphology and hydrophobicity of polyvinylidene fluoride (PVDF) membranes, which were prepared via a vapor-induced phase separation (VIPS) method, were affected by the exposure time. The mass variation of the cast film was recorded. Membrane morphologies were observed by scanning electron microscopy (SEM) and thermal behaviors of membranes were examined by differential scanning calorimetry (DSC). Wide angle X-ray diffraction (WAXD) was employed to analyze the crystalline structures of the overall membranes and the surface layers. The results showed that different membrane morphologies and hydrophobicities could be obtained by changing the exposure time. A long exposure time facilitated the crystallization process, resulting in the formation of a porous skin and particle morphology, which increased the hydrophobicity of the surface. A short exposure time favored the formation of a digitate macrovoid and dense skin resulting from liquid–liquid phase separation in the immersion process, which reduced surface hydrophobicity. The water permeate flux in vacuum membrane distillation was greatly affected by the membrane porosity and surface hydrophobicity.
1 Department of Biomedical Engineering, Vanderbilt University, and 2 Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; and 3 National Institutes of Health, ...National Institute of Diabetes and Digestive and Kidney Diseases\Clinical Endocrinology Branch, Bethesda, Maryland
Submitted 13 May 2008
; accepted in final form 15 July 2008
ActiGraph accelerometers are a useful tool for objective assessment of physical activity in clinical and epidemiological studies. Several generations of ActiGraph are being used; however, little work has been done to verify that measurements are consistent across generations. This study employed mechanical oscillations to characterize the dynamic response and intermonitor variability of three generations of ActiGraph monitors, from the oldest 7164 ( n = 13), 71256 ( n = 12), to the newest GT1M ( n = 12). The response due to independent radius (22.1–60.4 mm) and frequency (25–250 rpm) changes were measured, as well as intermonitor variability within each generation. The 7164 and 71256 have similar relationships between activity counts and radius ( P = 0.229) but were significantly different from the GT1M ( P < 0.001). The frequency responses were nonlinear in all three generations. Although the response curve shapes were similar, the differences between generations at various frequencies were significant ( P < 0.017), especially in the extremes of the measurement range. Intermonitor variability was markedly reduced in the GT1M compared with the 7164 and 71256. Other measurement differences between generations include decreased peak counts and decreased sensitivity in low-frequency detection in the GT1M. The results of this study revealed an improvement of the intermonitor variability by the GT1M monitor. However, the reduced sensitivity in low-count ranges in the GT1M may not be well suited for monitoring sedentary or light-intensity movements. Furthermore, the algorithms for energy expenditure predictions developed using older 7164 monitors may need to be modified for the GT1M.
calibration; mechanical testing
Address for reprint requests and other correspondence: M. P. Rothney, NIDDK\CEB, 10 Center Dr. MSC 1613, 10 CRC\6-3940, Bethesda, MD 20892 (e-mail: rothneym{at}niddk.nih.gov )
Background
Children with autism spectrum disorder (ASD) are impaired in social communication and interaction with peers, which may reflect diminished social motivation. Many children with ASD show ...enhanced stress when playing with other children. This study investigated social and stress profiles of children with ASD during play.
Methods
We utilized a peer interaction paradigm in a natural playground setting with 66 unmedicated, prepubertal, children aged 8–12 years 38 with ASD, 28 with typical development (TD). Salivary cortisol was collected before and after a 20‐min playground interaction that was divided into periods of free and solicited play facilitated by a confederate child. Statistical analyses included Wilcoxon rank‐sum tests, mixed effects models, and Spearman correlations to assess the between‐group differences in social and stress functioning, identify stress responders, and explore associations between variables, respectively.
Results
There were no differences between the groups during unsolicited free play; however, during solicited play by the confederate, significant differences emerged such that children with ASD engaged in fewer verbal interactions and more self‐play than the TD group. Regarding physiological arousal, children with ASD as a group showed relatively higher cortisol in response to social play; however, there was a broad range of responses. Moreover, those with the highest cortisol levels engaged in less social communication.
Conclusions
The social interaction of children with ASD can be facilitated by peer solicitation; however, it may be accompanied by increased stress. The children with ASD that have the highest level of cortisol show less social motivation; yet, it is unclear if it reflects an underlying state of heightened arousal or enhanced reactivity to social engagement, or both.
Purpose To directly compare the clinical effectiveness of maxillomandibular advancement (MMA) and uvulopalatopharyngoplasty (UPPP)—performed alone and in combination—for the treatment of moderate to ...severe obstructive sleep apnea (OSA). Patients and Methods The investigators designed and implemented a retrospective cohort study composed of patients with moderate to severe OSA (baseline AHI >15). The predictor variable was operative treatment and included MMA, UPPP, and UPPP followed by MMA (UPPP/MMA). The primary outcome variable was the apnea-hypopnea index (AHI) measured preoperatively and 3 months to 6 months postoperatively. Other variables were grouped into the following categories: demographic, respiratory, and sleep parameters. Descriptive and bivariate statistics were computed. Results The sample was composed of 106 patients grouped as follows: MMA (n = 37), UPPP (n = 34), and UPPP/MMA (n = 35) for treatment of OSA. There were no significant differences between the 3 groups for the study variables at baseline, except for AHI. Surgical treatment resulted in a significant decrease in AHI in each group: MMA (baseline AHI, 56.3 ± 22.6 vs AHI after MMA, 11.4 ± 9.8; P < .0001), UPPP/MMA (baseline AHI, 55.7 ± 49.2 vs AHI after UPPP/MMA, 11.6 ± 10.7; P < .0001), and UPPP (baseline AHI, 41.8 ± 28.0 vs AHI after UPPP, 30.1 ± 27.5; P = .0057). After adjusting for differences in baseline AHI, the estimated mean change in AHI was significantly larger for MMA compared with UPPP (MMA AHI, −40.5 vs UPPP AHI, −19.4; P = < .0001). UPPP/MMA was no more effective than MMA ( P = .684). Conclusion The results of this study suggest that MMA should be the surgical treatment option of choice for most patients with moderate to severe OSA who are unable to adequately adhere to CPAP.
Cognitive dysfunction is a feature in multiple sclerosis (MS), a chronic inflammatory demyelinating disorder. A notable aspect of MS brains is hippocampal demyelination, which is closely associated ...with cognitive decline. However, the mechanisms underlying this phenomenon remain unclear. Chitinase-3-like (CHI3L1), secreted by activated astrocytes, has been identified as a biomarker for MS progression. Our study investigates CHI3L1’s function within the demyelinating hippocampus and demonstrates a correlation between CHI3L1 expression and cognitive impairment in patients with MS. Activated astrocytes release CHI3L1 in reaction to induced demyelination, which adversely affects the proliferation and differentiation of neural stem cells and impairs dendritic growth, complexity, and spine formation in neurons. Our findings indicate that the astrocytic deletion of CHI3L1 can mitigate neurogenic deficits and cognitive dysfunction. We showed that CHI3L1 interacts with CRTH2/receptor for advanced glycation end (RAGE) by attenuating β-catenin signaling. The reactivation of β-catenin signaling can revitalize neurogenesis, which holds promise for therapy of inflammatory demyelination.
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•Astrocyte-derived CHI3L1 impairs neurogenesis and cognition•Knockout of CHI3L1 in astrocytes mitigates neurogenic deficits and cognition•CHI3L1 interacts with CRTH2/RAGE to impede neurogenesis•Reactivation of β-catenin signaling ameliorates neurogenesis and cognition
Song et al. demonstrate that astrocyte-derived CHI3L1 engages with the CRTH2/RAGE receptor to impede neurogenesis and cognition by attenuating β-catenin signaling in the demyelinated hippocampus. CHI3L1 suppresses NSC proliferation via the CRTH2 receptor and hinders the neuronal development via the RAGE receptor rather than CRTH2.
Guillain-Barré syndrome (GBS) is an immune-mediated inflammatory polyradiculoneuropathy, which commonly leads to a very high level of neurological disability. Especially, after the global outbreak of ...severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the causation between GBS and SARS-CoV-2 infection and the coronavirus disease 2019 (COVID-19) vaccination have aroused widespread concern. In the review, we analyzed the impacts of SARS-CoV-2 infection and COVID-19 vaccination on GBS globally, aiming to further understand the characteristics of GBS associated with COVID-19. Based on the electrophysiological data, patients suffering from GBS related to COVID-19 manifested as an acute inflammatory demyelinating polyneuropathy (AIDP). Moreover, we summarized the current findings, which may evidence GBS linking to SARS-CoV-2 infection and COVID-19 vaccination, and discussed the underlying mechanisms whether and how the SARS-CoV-2 virus and COVID-19 vaccination can induce GBS and its variants.
A comprehensive and systematic assessment of the global burden of aortic aneurysms (AA) has been lacking. Therefore, we estimated AA regional deaths and years of life lost (YLL) in 21 regions ...worldwide for 1990 and 2010. We used the GBD (Global Burden of Disease) 2010 study causes of death database and the cause of death ensemble modeling approach to assess levels and trends of AA deaths by age, sex, and GBD region. The global AA death rate per 100,000 population was 2.49 (95% CI: 1.78 to 3.27) in 1990 and 2.78 (95% CI: 2.04 to 3.62) in 2010. In 1990 and 2010, the highest mean death rates were in Australasia and Western Europe: 8.82 (95% CI: 6.96 to 10.79) and 7.69 (95% CI: 6.11 to 9.57) in 1990 and 8.38 (95% CI: 6.48 to 10.86) and 7.68 (95% CI: 6.13 to 9.54) in 2010. YLL rates by GBD region mirrored the mortality rate pattern. Overall, men had higher AA death rates than women: 2.86 (95% CI: 1.90 to 4.22) versus 2.12 (95% CI: 1.33 to 3.00) in 1990 and 3.40 (95% CI: 2.26 to 5.01) versus 2.15 (95% CI: 1.44 to 2.89) in 2010. The relative change in median death rate was +0.22 (95% CI: 0.10 to 0.33) in developed nations versus +0.71 (95% CI: 0.28 to 1.40) in developing nations. The smallest relative changes in median death rate were noted in North America high income, Central Europe, Western Europe, and Australasia, with estimates of +0.07 (95% CI: -0.26 to 0.37), +0.08 (95% CI: -0.02 to 0.23), +0.09 (95% CI: -0.02 to 0.21), and +0.22 (95% CI: -0.08 to 0.46), respectively. The largest increases were in Asia Pacific high income, Southeast Asia, Latin America tropical, Oceania, South Asia, and Central Sub-Saharan Africa. Women rather than men drove the increase in the Asia Pacific high-income region: the relative change in median rates was +2.92 (95% CI: 0.6 to 4.35) versus +1.05 (95% CI: 0.61 to 2.42). In contrast to high-income regions, the observed pattern in developing regions suggests increasing AA burden, which portends future health system challenges in these regions.
Common single nucleotide polymorphisms at chromosome 4q25 (rs2200733, rs10033464) are associated with both lone and typical atrial fibrillation (AF). Risk alleles at 4q25 have recently been shown to ...predict recurrence of AF after ablation in a population of predominately lone AF, but lone AF represents only 5%-30% of AF cases.
To test the hypothesis that 4q25 AF risk alleles can predict response to AF ablation in the majority of AF cases.
Patients enrolled in the Vanderbilt AF Registry underwent 378 catheter-based AF ablations (median age 60 years; 71% men; 89% typical AF) between 2004 and 2011. The primary end point was time to recurrence of any nonsinus atrial tachyarrhythmia (atrial tachycardia, atrial flutter, or AF).
Two-hundred atrial tachycardia, atrial flutter, or AF recurrences (53%) were observed. In multivariable analysis, the rs2200733 risk allele predicted a 24% shorter recurrence-free time (survival time ratio 0.76; 95% confidence interval CI 0.6-0.95; P = .016) compared with wild type. The heterozygous haplotype demonstrated a 21% shorter recurrence-free time (survival time ratio 0.79; 95% CI 0.62-0.99) and the homozygous risk allele carriers a 39% shorter recurrence-free time (survival time ratio 0.61; 95% CI 0.37-1.0; P = .037).
Risk alleles at the 4q25 loci predict impaired clinical response to AF ablation in a population of patients with predominately typical AF. Our findings suggest that the rs2200733 polymorphism may hold promise as an objectively measured patient characteristic that can be used as a clinical tool for selecting patients for AF ablation.
Respiratory failure requiring mechanical ventilation (MV) is a common and severe complication of Guillain-Barré syndrome (GBS) with a reported incidence ranging from 20 % to 30 %. Thus, we aim to ...develop a nomogram to evaluate the risk of MV in patients with GBS at admission and tailor individualized care and treatment.
A total of 633 patients with GBS (434 in the training set, and 199 in the validation set) admitted to the First Hospital of Jilin University, Changchun, China from January 2010 to January 2021 were retrospectively enrolled. Subjects (n = 71) from the same institution from January 2021 to May 2022 were prospectively collected and allocated to the testing set. Multivariable logistic regression analysis was applied to build a predictive model incorporating the optimal features selected in the least absolute shrinkage and selection operator (LASSO) in the training set. The predictive model was validated using internal bootstrap resampling, an external validation set, and a prospective testing set, and the model's performance was assessed by using the concordance index (C-index), calibration curves, and decision curve analysis (DCA). Finally, we established a multivariable logistic model by using variables of the Erasmus GBS Respiratory Insufficiency Score (EGRIS) and did the same analysis to compare the performance of our predictive model with the EGRIS model.
Variables in the final model selected by LASSO included time from onset to admission, facial and/or bulbar weakness, Medical Research Council sum score at admission, neutrophil-to-lymphocyte ratio, and platelet-lymphocyte ratio. The model presented as a nomogram displaying favorable discriminative ability with a C-index of 0.914 in the training set, 0.903 in the internal validation set, 0.953 in the external validation set, and 0.929 in the testing set. The model was well-calibrated and clinically useful as assessed by the calibration curve and DCA. As compared with the EGRIS model, our predictive model displayed satisfactory performance.
We constructed a nomogram for early prediction of the risk of MV in patients with GBS. This model had satisfactory performance and appeared more efficient than the EGRIS model in Chinese patients with GBS.
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign, self-limiting disease characterized by local lymphadenopathy. Central nervous system ...involvement in KFD is extremely rare and remains a diagnostic challenge. Only 41 cases of aseptic meningitis associated with KFD have been reported worldwide, with just four cases (including our case) of KFD with meningitis as the first symptom. We report a case of KFD accompanied by aseptic meningitis with severely high intracranial pressure (400 mmH
O), increased white blood cell count (56 × 10
/L), and moderately elevated protein level (0.52 g/L). This case is unique in the delayed appearance of lymphadenopathy. After 1 month of treatment with steroids, fever, headache, and lymphadenopathy gradually disappeared, and the result of cerebrospinal fluid examination gradually became normal. In conclusion, based on our case findings and our literature review on KFD with aseptic meningitis, a diagnosis of KFD should be considered when delayed appearance of lymphadenopathy is observed in patients with aseptic meningitis.
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