Solid catalysts of chromium–tungsten–manganese oxides were prepared and used to synthesize fatty acid methyl ester (FAME) through esterification of palm fatty acid distillate (PFAD). Experiments were ...conducted in a batch reactor at a temperature range of 130–190 °C. The physical and chemical properties of the catalysts were characterized by Brunauer–Emmet–Teller, scanning electron microscopy, transmission electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, and thermal gravimetric analysis. The treatment conditions during catalyst preparation, effect of reaction parameters, and catalyst stability were investigated. The catalyst (CrWMnO2) was the most active with maximum FAME content of 85% at optimal reaction conditions of 170 °C reaction temperature for 3 h, methanol-to-PFAD molar ratio of 3:1, catalyst dosage of 1.5 wt.%, and reusability of catalyst for several cycles. Results showed that CrWMnO2 is a potential catalyst for FAME synthesis from feedstock containing high free fatty acid.
•Chromium–tungsten–manganese mixed oxides are used as solid catalyst.•Catalyst is used for esterification of palm fatty acid distillate to methyl esters.•The maximum methyl ester content is 85%.•The catalyst is stable with activity of more than 80% up to the third run.
There remains uncertainty regarding optimal definitive management for malignant posterior circulation infarcts (MPCI). While guidelines recommend neurosurgery for malignant cerebellar infarcts that ...are refractory to medical therapy, concerns exist about the functional outcome and quality of life after decompressive surgery.
This study aims to evaluate the outcomes of surgical intervention compared to medical therapy in MPCI.
In this systematic review, MEDLINE, Embase and Cochrane databases were searched from inception until 2 April 2021. Studies were included if they involved posterior circulation strokes treated with neurosurgical intervention and reported mortality and functional outcome data. Data were collected according to PRISMA guidelines.
The search yielded 6677 studies, of which 31 studies (comprising 723 patients) were included for analysis. From the included studies, we found that surgical therapy led to significant differences in mortality and functional outcomes in patients with severe disease. Neurological decline and radiological criteria were often used to decide the timing for surgical intervention, as there is currently limited evidence for preventative neurosurgery. There is also limited evidence for the superiority of one surgical modality over another.
For patients with MPCI who are clinically stable at the time of presentation, in terms of mortality and functional outcome, surgical therapy appears to be equivocal to medical therapy. Reliable evidence is lacking, and further prospective studies are rendered.
Antiferromagnetic (AF) and ferrimagnetic (FiM) thin films have burgeoning significance in memory and computing applications due to their robustness and ultrafast and energy-efficient switching ...dynamics. Mn
3
Ga features a multitude of spin orders that can be meticulously controlled with stoichiometry, temperature, and strain modulations. In this work, we have carefully designed three suitable stacks of Mn
3
Ga thin films on MgO (111), STO (111) and STO (111)/Ta substrates deposited across varying substrate temperatures up to 500°C. The delicate interplay of strain and temperature tuning is examined by characterizing their magnetic, crystallographic, and morphological properties. The FiM tetragonal
τ
-Mn
3
Ga and AF hexagonal
ε
-Mn
3
Ga phases display relatively low saturation magnetizations of 10–60 and ≤ 20 kA/m, respectively. No preferential in-plane or out-of-plane magnetic anisotropy is observed for both
τ
- and
ε
-Mn
3
Ga phases. Critically, we observed that the STO strain-regulated
τ
-phase is stabilized over a wider temperature window and provides more compact, uniformly dispersed grains with average grain size of ~ 100 nm. This work establishes a sturdy methodology in understanding Mn
3
Ga thin film growth for eventual AF- and FiM-based memory and computing applications.
We describe a new service model, the Orthopaedic Assessment Unit (OAU), designed to provide care for trauma patients during the COVID-19 pandemic. Patients without COVID-19 symptoms and isolated ...musculoskeletal injuries were redirected to the OAU.
We prospectively reviewed patients throughput during the peak of the global pandemic (7 May 2020 to 7 June 2020) and compared with our historic service provision (7 May 2019 to 7 June 2019). The Mann-Whitney and Fisher Exact tests were used to test the statistical significance of data.
A total of 1,147 patients were seen, with peak attendances between 11am and 2pm; 96% of all referrals were seen within 4h. The majority of patients were seen by orthopaedic registrars (52%) and nurse practitioners (44%). The majority of patients suffered from sprains and strains (39%), followed by fractures (22%) and wounds (20%); 73% of patients were discharged on the same day, 15% given follow up, 8% underwent surgery and 3% were admitted but did not undergo surgery. Our volume of trauma admissions and theatre cases decreased by 22% and 17%, respectively (
=0.058; 0.139). There was a significant reduction of virtual fracture clinic referrals after reconfiguration of services (
<0.001).
Rapid implementation of a specialist OAU during a pandemic can provide early definitive trauma care while exceeding national waiting time standards. The fall in trauma attendances was lower than anticipated. The retention of orthopaedic staff in the department to staff the unit and maintain a high standard of care is imperative.
Posaconazole is an antifungal with a wide-spectrum of activity against common and emerging fungal pathogens. In this randomised, open-label, two-way crossover study, the potential for drug ...interactions with posaconazole via the cytochrome P450 (CYP450) enzyme pathway was evaluated. Thirteen subjects received posaconazole tablets (2×100
mg) once daily for 10 days or no treatment; following a 14-day washout period, subjects were crossed over to the alternate treatment. The inhibition spectra of posaconazole were examined using a cocktail of the following probe substrates: caffeine (CYP1A2), tolbutamide (CYP2C8/9), dextromethorphan (CYP2D6 and total CYP3A4), chlorzoxazone (CYP2E1), and midazolam (hepatic CYP3A4). Except for midazolam, which was intravenously infused on Day 10, the cocktail probes were administered simultaneously on Day 9 during both treatment periods. Blood and urine samples were collected at specified times to quantitate probe substrates and/or metabolites. Based on insignificant differences in mean probe ratios, posaconazole did not inhibit CYP1A2, 2C8/9, 2D6, or 2E1. However, the midazolam AUC
(tf) was higher in the posaconazole than no-treatment group (93.4
ng
h/ml versus 51.4
ng
h/ml,
P<0.01), indicating inhibition of hepatic CYP3A4. Drug interactions mediated by various CYP450 are common with the currently available triazole antifungals, however these results suggest that posaconazole may have an improved and more narrow drug interaction profile (CYP3A4 only) compared with other triazoles.
Recent studies have shown that a tumor's biological response to radiation varies over time and has a dynamic nature. Dynamic biological features of tumor cells underscore the importance of using ...fractionation and adapting the treatment plan to tumor volume changes in radiation therapy treatment. Adaptive radiation therapy (ART) is an iterative process to adjust the dose of radiation in response to potential changes during the treatment. One of the key challenges in ART is how to determine the optimal timing of adaptations corresponding to tumor response to radiation. This paper aims to develop an automated treatment planning framework incorporating the biological uncertainties to find the optimal adaptation points to achieve a more effective treatment plan. First, a dynamic tumor-response model is proposed to predict weekly tumor volume regression during the period of radiation therapy treatment based on biological factors. Second, a Reinforcement Learning (RL) framework is developed to find the optimal adaptation points for ART considering the uncertainty in biological factors with the goal of achieving maximum final tumor control while minimizing or maintaining the toxicity level of the organs at risk (OARs) per the decision-maker's preference. Third, a beamlet intensity optimization model is solved using the predicted tumor volume at each adaptation point. The performance of the proposed RT treatment planning framework is tested using a clinical non-small cell lung cancer (NSCLC) case. The results are compared with the conventional fractionation schedule (i.e., equal dose fractionation) as a reference plan. The results show that the proposed approach performed well in achieving a robust optimal ART treatment plan under high uncertainty in the biological parameters. The ART plan outperformed the reference plan by increasing the mean biological effective dose (BED) value of the tumor by 2.01%, while maintaining the OAR BED within +0.5% and reducing the variability, in terms of the interquartile range (IQR) of tumor BED, by 25%.
•Proposed a tumor response model to predict weekly tumor volume regression during the course of radiation therapy treatment.•Developed a reinforcement learning model to find the optimal policy for adaptive radiation therapy treatment (ART).•Achieved a robust optimal ART treatment plan under high uncertainty in the biological parameters•Increased the mean biological effective dose (BED) value of the tumor while maintaining the OAR BED within +0.5%.•Reduced the BED variability in worst cases in an adaptive fractionation scheme.
Cochlear inflammatory diseases, such as tympanogenic labyrinthitis, are associated with acquired sensorineural hearing loss. Although otitis media is extremely frequent in children, tympanogenic ...labyrinthitis is not commonly observed, which suggests the existence of a potent anti-inflammatory mechanism modulating cochlear inflammation. In this study, we aimed to determine the molecular mechanism involved in cochlear protection from inflammation-mediated tissue damage, focusing on IL-10 and hemoxygenase-1 (HMOX1) signaling. We demonstrated that IL-10Rs are expressed in the cochlear lateral wall of mice and rats, particularly in the spiral ligament fibrocytes (SLFs). The rat SLF cell line was found to inhibit nontypeable Haemophilus influenzae (NTHi)-induced upregulation of monocyte chemotactic protein-1 (MCP-1; CCL2) in response to IL-10. This inhibition was suppressed by silencing IL-10R1 and was mimicked by cobalt Protoporphyrin IX and CO-releasing molecule-2. In addition, IL-10 appeared to suppress monocyte recruitment through reduction of NTHi-induced rat SLF cell line-derived chemoattractants. Silencing of HMOX1 was found to attenuate the inhibitory effect of IL-10 on NTHi-induced MCP-1/CCL2 upregulation. Chromatin immunoprecipitation assays showed that IL-10 inhibits NTHi-induced binding of p65 NF-κB to the distal motif in the promoter region of MCP-1/CCL2, resulting in suppression of NTHi-induced NF-κB activation. Furthermore, IL-10 deficiency appeared to significantly affect cochlear inflammation induced by intratympanic injections of NTHi. Taken together, our results suggest that IL-10/HMOX1 signaling is involved in modulation of cochlear inflammation through inhibition of MCP-1/CCL2 regulation in SLFs, implying a therapeutic potential for a CO-based approach for inflammation-associated cochlear diseases.
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