Direct epitaxial integration of magnetic layers with wide bandgap nitride semiconductors will enable spin-controlled transport and photonic phenomena, seeding ideas for functional spintronic devices. ...Using plasma-assisted molecular beam epitaxy (MBE) in a previously unexplored window, significantly improved ferrimagnetic Mn 4 N layers are successfully grown on GaN with ~1 nm surface roughness. Distinct from earlier reports, the Mn 4 N layers grown on GaN are found to be 001 oriented with 12-fold in-plane symmetry in the diffraction pattern. This unique epitaxial registry originates from three equivalent rotational domains. The ferrimagnetic magnetotransport properties of low growth temperature Mn 4 N layers on GaN are comparable to those reported on cubic substrates such as MgO. However, a sign-flip of the Hall resistance is discovered for Mn 4 N layers grown above 300 °C.
The management of fracture-related infection has undergone radical progress following the development of international guidelines. However, there is limited consideration to the realities of ...healthcare in low-resource environments due to a lack of available evidence in the literature from these settings. Initial antimicrobial suppression to support fracture union is frequently used in low- and middle-income countries despite the lack of published clinical evidence to support its practice. This study aimed to evaluate the outcomes following initial antimicrobial suppression to support fracture union in the management of fracture-related infection.
A retrospective review of consecutive patients treated with initial antimicrobial suppression to support fracture healing followed by definitive eradication surgery to manage fracture-related infections following intramedullary fixation was performed. Indications for this approach were; a soft tissue envelope not requiring reconstructive surgery, radiographic evidence of stable fixation with adequate alignment, and progression towards fracture union.
This approach was associated with successful treatment in 51/55 (93 %) patients. Fracture union was achieved in 52/55 (95 %) patients with antimicrobial suppression alone. Remission of infection was achieved in 54/55 (98 %) patients following definitive infection eradication surgery. Following antibiotic suppression, 6/46 (13 %) pathogens isolated from intra-operative samples demonstrated multi-drug resistance.
Initial antimicrobial suppression to support fracture healing followed by definitive infection eradication surgery was associated with successful treatment in 93 % of patients. The likelihood of remission of infection increases when eradication surgery is performed in a healed bone. This approach was not associated with an increased risk of developing multi-drug-resistant infections compared to contemporary bone infection cohorts in the published literature.
IV
Purpose
68‐gallium (Ga‐68) ethylenediaminetetraacetic acid (EDTA) aerosols and Galligas were compared in evaluation of inhaled‐particle deposition and clearance in volunteers with or without ...obstructive pulmonary diseases.
Methods
Nonsmoking healthy volunteers, healthy smokers, asthma patients and patients with chronic obstructive pulmonary disease (COPD) were recruited to undergo the dynamic lung ventilation positron emission tomography/computerized tomography (PET/CT) scans within two consecutive days. The inhaled particles were Ga‐68–labelled carbon nanoparticles (Galligas, 30‐60 nm in size) and Ga‐68–labelled EDTA aerosols (1‐2 μm in size), respectively. The volunteers’ lung function parameters were measured for comparison.
Results
Central deposition and inhomogeneity of both tracers were negatively correlated with lung function parameters, including the ratio of forced expiratory volume at 1 second to forced vital capacity (FEV1/FVC). The central or hilum deposition of Galligas, but not 68‐gallium (Ga‐68) EDTA, was negatively correlated with the maximal expiratory flow at 25%, 50% and 75% of the forced vital capacity. Compared with Galligas, Ga‐68 EDTA aerosols were more concentrated in the central region in all groups except for the healthy nonsmokers. Ventilation inhomogeneity was more evident when using Ga‐68 EDTA aerosols, especially in patients with COPD and asthma patients. In the healthy smokers, the central region accumulated more Ga‐68 EDTA at 30 minutes after inhalation than immediately after inhalation. Ga‐68 EDTA cleared faster in lungs than Galligas.
Conclusions
Both Galligas and Ga‐68 EDTA aerosols can be used for PET/CT lung ventilation scan. However, Ga‐68 EDTA aerosols showed more advantages in diagnosis and evaluation of obstructive airway diseases by revealing the inhaled‐particle deposition and clearance.
Virtual Reality (VR) has been used to enhance EFL learners’ speaking skills due to its immersive and interactive features. This study thus investigated the effects of VR on elementary school ...students' English-speaking performance and such affective variables as their willingness to communicate (WTC) and learning autonomy. Fifty-six EFL sixth graders participated in a tour in a museum. When learning and practicing dialogues and vocabulary related to the museum, students in the experimental group (n = 28) were guided with Cospaces, a VR software package, with VR headsets, while their counterparts (n = 28) were guided with pictures only. Instruments included a validated speaking test on (1) pronunciation, fluency, and intonation and (2) grammar and lexical use, adopted questionnaires on WTC and learning autonomy, and semi-structured interviews. Results demonstrated that VR significantly increased students’ grammar and lexical use in their speaking performance, but not their pronunciation, fluency and intonation, WTC, or learning autonomy.
Hypercortisolism has been implicated in the development of venous thromboembolic events (VTE). We aimed to characterize VTE risk in endogenous Cushing's syndrome (CS) patients, compare that risk to ...other pathologies, and determine if there are any associated coagulation factor changes.
Medline and Scopus search for "hypercortisolism" and "thromboembolic disease" from January 1980 to April 2017 to include studies that reported VTE rates and/or coagulation profile of CS patients. A systematic review and meta-analysis were performed.
Forty-eight studies met inclusion criteria. There were 7,142 CS patients, average age was 42 years and 77.7% female. Odds ratio of spontaneous VTE in CS is 17.82 (95%CI 15.24-20.85,
< 0.00001) when comparing to a healthy population. For CS patients undergoing surgery, the odds ratio (both with / without anticoagulation) of spontaneous VTE is 0.26 (95%CI 0.07-0.11,
< 0.00001)/0.34 (0.19-0.36,
< 0.00001) when compared to patients undergoing hip fracture surgery who were not treated with anticoagulants. Coagulation profiles in patients with CS showed statistically significant differences compared to controls, as reflected by increases in von Willebrand factor (180.11 vs. 112.53 IU/dL,
< 0.01), as well as decreases in activated partial thromboplastin time (aPTT; 26.91 vs. 30.65,
< 0.001) and increases in factor VIII (169 vs. 137 IU/dL,
< 0.05).
CS is associated with significantly increased VTE odds vs. general population, but lower than in patients undergoing major orthopedic surgery. Although exact timing, type, and dose of anticoagulation medication remains to be established, clinicians might consider monitoring vWF, PTT, and factor VIII when evaluating CS patients and balance advantages of thromboprophylaxis with risk of bleeding.
Exposure to air pollution is associated with chronic obstructive pulmonary disease (COPD). However, findings on the effects of air pollution on lung function and systemic inflammation in Chinese COPD ...patients are inconsistent and scarce. This study aims to evaluate the effects of ambient air pollution on lung function parameters and serum cytokine levels in a COPD cohort in Beijing, China.
We enrolled COPD participants on a rolling basis from December 2015 to September 2017 in Beijing, China. Follow-ups were performed every 3 months for each participant. Serum levels of 20 cytokines were detected every 6 months. Hourly ambient pollutant levels over the same periods were obtained from 35 monitoring stations across Beijing. Geocoded residential addresses of the participants were used to estimate daily mean pollution exposures. A linear mixed-effect model was applied to explore the effects of air pollutants on health in the first-year of follow-up.
A total of 84 COPD patients were enrolled at baseline. Of those, 75 COPD patients completed the first-year of follow-up. We found adverse cumulative effects of particulate matter less than 2.5 μm in aerodynamic diameter (PM
), nitrogen dioxide (NO
), sulfur dioxide (SO
) and carbon monoxide (CO) on the forced vital capacity % predicted (FVC % pred) in patients with COPD. Further analyses illustrated that among COPD patients, air pollution exposure was associated with reduced levels of serum eotaxin, interleukin 4 (IL-4) and IL-13 and was correlated with increased serum IL-2, IL-12, IL-17A, interferon γ (IFNγ), monocyte displacing protein 1 (MCP-1) and soluble CD40 ligand (sCD40L).
Acute exposures to PM
, NO
, SO
and CO were associated with a reduction in FVC % pred in COPD patients. Furthermore, short-term exposure to air pollutants increased systemic inflammation in COPD patients; this may be attributed to increased Th1 and Th17 cytokines and decreased Th2 cytokines.
Sirolimus has been confirmed to be effective for lymphangioleiomyomatosis (LAM), a rare multisystem neoplastic disease in women. The long-term effects of sirolimus treatment for LAM, however, are ...largely unknown. We aimed to analyze the long-term efficacy and safety of sirolimus therapy for LAM with 4-year follow-up.
In total, 142 sporadic LAM patients who took sirolimus for 1-4 years were retrospectively enrolled for this analysis. The variables used for analysis included pulmonary function tests, arterial blood gas analysis, 6-min walking distance (6MWD), St. George's Respiratory Questionnaires (SGRQ) and serum vascular endothelial growth factor-D (VEGF-D) levels before and after the initiation of sirolimus therapy. The rates of change (slope) in those variables were calculated, and adverse events were also analyzed.
In total, 122, 83, 60 and 32 patients out of 142 were followed for 1, 2, 3 and 4 years respectively. Sirolimus treatment improved the change rate in forced expiratory volume in 1 second (FEV
) and forced vital capacity (FVC) compared with the data before treatment (FEV
, - 10 ± 15 vs. - 178 ± 36 ml/y, P < 0.001 and FVC, 54 ± 22 vs.-72 ± 68 ml/y, P < 0.05). In comparison to the baseline measurements, significant improvements were observed in FEV
at the first year; FVC at 1-2 years; arterial oxygen levels, 6MWD, and SGRQ at 1-3 years; and VEGF-D at 1-4 years. Overall, all variables stabilized or improved during the 4 years of observation. Adverse events related to sirolimus were mild.
Sirolimus therapy is effective at improving or stabilizing pulmonary function, oxygen levels, exercise capacity, and quality of life in patients with LAM for up to 4 years. VEGF-D is maintained at a lower level for 4 years after treatment. Adverse events related to sirolimus were mild.
Sex hormones, including androgens, estrogens, and progestogens, are important biomarkers for various diseases. Quantification of sex hormones is typically conducted by LC-MS/MS. At present, most ...methods require liquid-liquid extraction or solid phase extraction for sample preparation. However, these pretreatments are prone to compromise LC-MS/MS throughput. To improve on the current standard practices, we investigated cold-induced phase separation for sex hormone extraction. After protein precipitation with acetonitrile and adjusting the solution constitution with water, samples were stored at −30°C for 10 min to generate two distinct phases: an acetonitrile-rich layer on top of a water-rich layer. During this process, the hydrophobic sex hormones spontaneously separate into the upper layer. This simple and reliable cold-induced phase separation-based LC-MS/MS methodology was used here to simultaneously detect estrone, estradiol, estriol, testosterone, androstenedione, dehydroepiandrosterone, progesterone, and 17-hydroxyprogesterone in serum. Validation of this method indicated satisfactory performance, including acceptable linearity, accuracy, precision, and tractability. Compared with the mainstream liquid-liquid extraction-based method, this new method exhibits significant progress in throughput, which shortens the time cost of sample preparation from 90 to 40 min. We propose that this method can be an excellent alternative for sex hormone analysis in routine clinical laboratories.
Vitamin D metabolite analysis possessed significant clinical value for the pediatric department. However, invasive venipuncture sampling and high blood consumption inflicted much suffering on ...patients. For alleviation, we carried out a LC-MS method for 25-hydroxyvitamin D quantification in only 3 μl of plasma from the considerably less invasive finger-prick blood samples. To improve sensitivity, acylation on C3-hydroxyl (by isonicotinoyl chloride) rather than Diels-Alder adduction on s-cis-diene structure was for the very first time introduced into vitamin D metabolite derivatization. Compared with the existing derivatization approaches, this novel strategy not only prevented isomer interference, but also exhibited higher reacting throughput. For certification, the methodology was systematically validated and showed satisfying consistency with SRM927a. During clinical application, we found a convincing correlation between 25-hydroxyvitamin D and indirect/total bilirubin in jaundiced newborns. Such an observation indicated that vitamin D supplementation may help to achieve optimal outcomes in neonatal jaundice.
Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare interstitial lung disease. COVID-19 is associated with worse prognosis in previous lung diseases patients. But the prognosis of aPAP ...patients after infection with COVID-19 is unclear. In December 2022, China experienced a large-scale outbreak of Omicron variant of the SARS-CoV-2. In this study, we aim to explore the clinical outcomes of aPAP patients infected with COVID-19. A total of 39 aPAP patients were included in this study. 30.77% patients had a decrease in oxygen saturation after COVID-19 infection. We compared the two groups of patients with or without decreased oxygen saturation after COVID-19 infection and found that patients who had previous oxygen therapy (decreased oxygen saturation vs. non decreased oxygen saturation: 6/12 vs. 4/27, P = 0.043), with lower baseline arterial oxygen partial pressure (74.50 + or - 13.61 mmHg vs. 86.49 + or - 11.92 mmHg, P = 0.009), lower baseline DLCO/VA% 77.0 (74.3, 93.6) % vs. 89.5 (78.2, 97.4) %, P = 0.036, shorter baseline 6MWD 464 (406, 538) m vs. 532 (470, 575) m, P = 0.028, higher disease severity score (P = 0.017), were more likely to have decreased oxygen saturation after COVID-19 infection. aPAP patients with poor baseline respiration have a higher probability of hypoxia after COVID-19 infection, but fatal events were rare.
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