Common Route Research Articles

Active identification of vertebral fracture in the FLS model of care

SummaryThe identification of vertebral fracture is a key point in an FLS. We have analyzed the characteristics of 570 patients according to the route of identification (referral by other doctors, emergency registry or through VFA), concluding that promoting referral by other doctors with a training campaign is effective.PurposeVertebral fractures (VF) are associated with increased risk of further VFs. Our objective was to analyze the characteristics of patients with VF seen in a Fracture Liaison Service (FLS).MethodsAn observational study was carried out on patients with VF referred to the outpatient metabolic clinic (OMC) after a training campaign, identified in the emergency registry, and captured by VF assessment with bone densitometry (DXA-VFA) in patients with non-VFs. Patients with traumatic VF or VF > 1 year, infiltrative or neoplastic disease were excluded. The number and severity of VFs (Genant) were analyzed. Treatment initiation in the first 6 months after baseline visit was reviewed.ResultsOverall, 570 patients were included, mean age 73. The most common route for identifying VF was through referral to OMC (303 cases), followed by the emergency registry (198) and DXA-VFA (69). Osteoporosis by DXA was found in 312 (58%) patients and 259 (45%) had ≥ 2 VFs. The rate of grade 3 VFs was highest among patients on the emergency registry. Those identified through OMC had a higher number of VFs, a higher rate of osteoporosis, more risk factors and greater treatment initiation. Patients with VFs detected by DXA-VFA were mostly women with a single VF and had a lower rate of osteoporosis by DXA.ConclusionsWe present the distribution of VFs by the route of identification in an FLS. Promoting referral by other doctors with a training campaign may help in the quality improvement of the FLS-based model of care.

Localized Drug Delivery Systems: An Update on Treatment Options for Head and Neck Squamous Cell Carcinomas.

Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers in the world, with surgery, radiotherapy, chemotherapy, and immunotherapy being the primary treatment modalities. The treatment for HNSCC has evolved over time, due to which the prognosis has improved drastically. Despite the varied treatment options, major challenges persist. HNSCC chemotherapeutic and immunotherapeutic drugs are usually administered systemically, which could affect the patient's quality of life due to the associated side effects. Moreover, the systemic administration of salivary stimulating agents for the treatment of radiation-induced xerostomia is associated with toxicities. Localized drug delivery systems (LDDS) are gaining importance, as they have the potential to provide non-invasive, patient-friendly alternatives to cancer therapy with reduced dose-limiting toxicities. LDDSs involve directly delivering a drug to the tissue or organ affected by the disease. Some of the common localized routes of administration include the transdermal and transmucosal drug delivery system (DDSs). This review will attempt to explore the different treatment options using LDDSs for the treatment of HNSCC and radiotherapy-induced damage and their potential to provide a better experience for patients, as well as the obstacles that need to be addressed to render them successful.

Different stages of the infection cycle are enriched for Campylobacter strains with distinct phenotypes and levels of fluoroquinolone resistance.

Campylobacter species are the leading cause of bacterial diarrhoea worldwide and consumption of contaminated chicken meat is the most common route of infection. Chickens can be infected with multiple strains of Campylobacter and during the infection cycle this pathogen must survive a wide variety of environments. Numerous studies have reported a high degree of genetic variability in this pathogen that can use antigenic and phase variation to alter the expression of key phenotypes. In this study the phenotypic profile of isolates from freshly slaughtered chickens, chicken products in the supermarket and stool samples from infected patients were compared to identify phenotypic changes during the passage of the bacteria through the infection cycle. Isolates from different stages of the infection cycle had altered phenotypic profiles with isolates from human stool samples showing a lower ability to form a biofilm and an increased ability to associate with epithelial cells in vitro. Resistance to fluoroquinolones was found in all cohorts but at a much higher occurrence (94%) in isolates from supermarket chicken. Isolates displaying high levels of resistance to fluoroquinolones also were more likely to display a higher tolerance to growth in the presence of oxygen. In conclusion, isolates with specific phenotypes appear to be overly represented at different stages of the infection cycle suggesting that environmental stresses may be enriched for strains with these phenotypes.

A State-of-the-Science Review on Metal Biomarkers.

Biomarkers are commonly used in epidemiological studies to assess metals and metalloid exposure and estimate internal dose, as they integrate multiple sources and routes of exposure. Researchers are increasingly using multi-metal panels and innovative statistical methods to understand how exposure to real-world metal mixtures affects human health. Metals have both common and unique sources and routes of exposure, as well as biotransformation and elimination pathways. The development of multi-element analytical technology allows researchers to examine a broad spectrum of metals in their studies; however, their interpretation is complex as they can reflect different windows of exposure and several biomarkers have critical limitations. This review elaborates on more than 500 scientific publications to discuss major sources of exposure, biotransformation and elimination, and biomarkers of exposure and internal dose for 12 metals/metalloids, including 8 non-essential elements (arsenic, barium, cadmium, lead, mercury, nickel, tin, uranium) and 4 essential elements (manganese, molybdenum, selenium, and zinc) commonly used in multi-element analyses. We conclude that not all metal biomarkers are adequate measures of exposure and that understanding the metabolic biotransformation and elimination of metals is key to metal biomarker interpretation. For example, whole blood is a good biomarker of exposure to arsenic, cadmium, lead, mercury, and tin, but it is not a good indicator for barium, nickel, and uranium. For some essential metals, the interpretation of whole blood biomarkers is unclear. Urine is the most commonly used biomarker of exposure across metals but it should not be used to assess lead exposure. Essential metals such as zinc and manganese are tightly regulated by homeostatic processes; thus, elevated levels in urine may reflect body loss and metabolic processes rather than excess exposure. Total urinary arsenic may reflect exposure to both organic and inorganic arsenic, thus, arsenic speciation and adjustment for arsebonetaine are needed in populations with dietary seafood consumption. Hair and nails primarily reflect exposure to organic mercury, except in populations exposed to high levels of inorganic mercury such as in occupational and environmental settings. When selecting biomarkers, it is also critical to consider the exposure window of interest. Most populations are chronically exposed to metals in the low-to-moderate range, yet many biomarkers reflect recent exposures. Toenails are emerging biomarkers in this regard. They are reliable biomarkers of long-term exposure for arsenic, mercury, manganese, and selenium. However, more research is needed to understand the role of nails as a biomarker of exposure to other metals. Similarly, teeth are increasingly used to assess lifelong exposures to several essential and non-essential metals such as lead, including during the prenatal window. As metals epidemiology moves towards embracing a multi-metal/mixtures approach and expanding metal panels to include less commonly studied metals, it is important for researchers to have a strong knowledge base about the metal biomarkers included in their research. This review aims to aid metals researchers in their analysis planning, facilitate sound analytical decision-making, as well as appropriate understanding and interpretation of results.

Bacterial Profile and Antibiotic Use in Catheter-Associated Urinary Tract Infection Patients at a Tertiary Referral Hospital in Surabaya, Indonesia

Highlights: This study examined patients with catheter-associated urinary tract infections (CAUTI) to find the prevalent bacteria and the frequency of antibiotic use. Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli sensitive to amikacin was found to be the most common pathogen in CAUTI, while ceftriaxone was the most commonly used antibiotic. Abstract Catheter-associated urinary tract infection (CAUTI) is the most typical type of infection associated with healthcare. This infection constitutes a significant health problem due to its complications and frequent recurrence. The high annual incidence of CAUTI leads to infectious complications and a high cost of treatment. Antibiotic-resistant bacteria further complicate the problem because multiresistant pathogenic bacteria are often responsible for these infections. Moreover, the lack of a comprehensive case reporting system in Indonesia hinders the determination of CAUTI incidence. This study aimed to determine the bacterial profile and antibiotic use in CAUTI patients (n=22) at the Internal Medicine Inpatient Unit of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. This retrospective descriptive study collected data from patient medical records to describe the incidence, type of bacteria, sensitivity patterns, and antibiotic use in CAUTI patients. The data collection process included collecting medical records, recording information on data collection sheets, and recapitulating and analyzing the data. The criteria for CAUTI diagnosis were a bacterial count of ≥105 CFU/mL and a catheterization that lasted more than 48 hours. Samples were selected using non-probability sampling, also known as saturation sampling. Meanwhile, variables analyzed in this study were the type of pathogenic bacteria, antibiotics used, age, and sex. Descriptive analysis was employed to analyze the data. The findings suggested that the most common bacteria were Escherichia coli, with eight of nine bacteria showing extended-spectrum beta-lactamase (ESBL) production. Female patients aged 35–65 years were the majority of the CAUTI patients. Amikacin was the antibiotic with the highest sensitivity (90.9%), while ceftriaxone was the most common type of antibiotic administered to the patients. In addition, intravenous (IV) administration was the most common route of antibiotic administration, with an average therapy duration of seven days. In conclusion, identifying the type of pathogenic bacteria and performing antibiotic susceptibility testing can help minimize antibiotic resistance and prevent more severe complications in CAUTI patients.

In Shortly About Hepatitis B

Hepatitis B is an infectious liver disease caused by the hepatitis B virus, which can be mild and last for several weeks, but also a serious lifelong infection (chronic hepatitis B). Acute hepatitis B lasts up to 6 months and is usually of a milder form, but it can also be more severe and require hospitalization. If the organism fails to overcome the viruses, the disease turns into a chronic form that can cause major consequences. Hepatitis B is one of the most common infectious diseases, and it is estimated that there are around 300 million chronic HBV carriers worldwide. The most common route of transmission is after a puncture or cut on an infected needle or other sharp object and the sexual route

Analysis of Dispensing and Utilization Patterns of Medical Cannabis Products in State Licensed Cannabis Dispensaries.

Background: To understand real-world dispensing and utilization patterns of medical cannabis (MC) and its financial impact on patients, we analyzed the database of a cannabis company licensed in New York state. Objectives: To evaluate the tetrahydrocannabinol (THC)/cannabidiol (CBD) dose ratios, association of various medical conditions to THC/CBD dose, and the cost of products in registered patients receiving MC from four licensed state dispensaries. Design: Retrospective analysis conducted on anonymized data between January 1, 2016 and December 31, 2020 listing 422,201 dispensed products from 32,845 individuals aged 18 years and older. Setting/Subjects: Adult patients with medical certification for cannabis use in New York, USA. Measurements: The database included patient's age, gender, qualifying medical condition, type and dose of product, medication directions, and amount of product dispensed. Results: Findings showed a median age of 53 years with 52% of patients female. Males were found to use more products than females (1.06:1). Pain (85%) was the most common medical condition and inhalation (57%) the most common route except when used for cancer-directed treatment and neurological conditions. Individuals received a median of six prescriptions costing a median of $50/product. Average THC:CBD ratios were 28:0.5 mg/day and 12:0.25 mg/dose. Neurological conditions demonstrated the highest average cost [mean (95% confidence interval {CI}): $73 ($71-$75)] and average CBD/dose per product [mean (95% CI): 5.89 (5.38-6.40)]. Individuals with a history of substance use disorder utilizing MC as an alternative substance displayed the highest average THC/dose [mean (95% CI): 14.25 (13.36-15.14)]. Conclusion: MC was utilized for various medical conditions with variability in THC:CBD ratio seen depending on the condition. Cost variation was also observed based on the individual's medical condition.

Ethnomedicinal Plant Resources of Tamang Community in the Konjyosom Rural Municipility, Lalitpur District, Nepal

Background: In Nepal, plant resources play an important role in the health of local communities. However, in many parts of the country, this role and its patterns are understudied. The purpose of this study was to document medicinal plant species and assess their use among the Tamang community in Lalitpur district, Central Nepal. Methods: Ethnomedicinal information was collected through focus group discussions, semi structured interviews with local peoples and key informants from the Tamang community using rapid rural appraisal tools (RRA) across the five wards vz. Nallu, Chaughare, Bhardew, Dalchoki and Sankhu of the Konjyosom rural municipality. Botanical voucher samples were collected for scientific identification. The quantitative data were analyzed for informants consensus factor (ICF), fidelity level (FL) and relative frequency of citation (RFC). Results: A total of 176 plant species were recorded under 82 families and 158 genera as medicinal to treat different ailments. Among them, 169 species were angiosperms, one gymnosperm and six pteridophytes. Herbs (78 spp.) occurred most frequently in the study area, and the leaves (38 spp.) were commonly foraged. The most common route of consumption was oral (98 spp.) and the paste (36 spp.) was frequently administered. The majority of the species (58%) were collected from the forest. The ICF value ranged from 0.26 (digestive) to 0.97 (respiratory). The RFC value ranged from 0.01 to 0.87. Curcuma longa had the highest frequency of citation index of 0.87. is this RFC? Merge these 2 sentences The FL index ranged from 42.86% to 100%. The most preferred medicinal plant species was Curcuma longa which was used to treat cuts and wounds and common cold (51%). Conclusion: Medicinal plants have played a significant role in the health care of local people. This study provides a comprehensive documentation of ethnomedicinal plant species using among the Tamang community of Konjyosom rural municipality, Lalitpur district. This study concluded that it is necessary to document and preserve biodiversity and its associated knowledge, which may lead to additional research activities. Keywords: Ethnic people; Ethnobotanical, Informants, Interview

Utilization and dispensing patterns of medical cannabis products in a state with legalized medical cannabis.

e18844 Background: The medical uses of cannabis-based products have been proposed to include treatment of pain, various neurological, gastrointestinal and psychological conditions. Cancer patients are some of the highest utilizers of medical cannabis-based products. To understand real world use and impact of cannabis-based products, we analyzed the database from 4 dispensaries of a cannabis company licensed in New York state. We aim to evaluate the dose, average THC/CBD ratios, association of various medical conditions to THC/CBD dose and cost of products to individuals receiving cannabis-based products. Methods: A retrospective analysis of anonymized data was conducted on 422,201 dispensed products from 32,845 unique individuals aged 18 years and older between 1/1/2016 and 12/31/2020. The database included patient’s age, gender, qualifying medical condition, type of product, medication directions and amount of product dispensed. Results: Median age was 53 years old and 52% were females. Cancer and non-cancer related pain (85%) were the most common medical condition and inhalation (57%) the most common route. Individuals received a median of 6 prescriptions with median cost of $50/product. Average THC:CBD ratios were 28:0.5mg/day and 12:0.25mg/dose. Highest average cost [mean (95% CI): $73 ($71-$75)] and average CBD/dose per product [mean (95% CI):5.89 (5.38-6.40)] were dispensed for neurological conditions. Highest average THC/dose [mean (95% CI): 14.25 (13.36-15.14)] were found as use as alternative products for those with substance use disorders. Table 1 shows the comparison of gender and route to medical condition. Conclusions: More females received medical cannabis prescriptions while males used more products. Pain was the most common reason for medical cannabis prescriptions. Neurological conditions demonstrated highest average cost and CBD/dose and prescriptions for substance use disorder demonstrated highest THC/dose for products dispensed. Products prescribed had more THC as compared to CBD and inhalation was preferred. As cancer patients increasingly utilize medical cannabis products in conjunction with tumor directed and symptom therapy it will be important to have randomized studies to help guide oncologists. [Table: see text]

Self-assembled short peptides: Recent advances and strategies for potential pharmaceutical applications.

Self-assembled short peptides have intrigued scientists due to the convenience of synthesis, good biocompatibility, low toxicity, inherent biodegradability and fast response to change in the physiological environment. Therefore, it is necessary to present a comprehensive summary of the recent advances in the last decade regarding the construction, route of administration and application of self-assembled short peptides based on the knowledge on their unique and specific ability of self-assembly. Herein, we firstly explored the molecular mechanisms of self-assembly of short peptides, such as non-modified amino acids, as well as Fmoc-modified, N-functionalized, and C-functionalized peptides. Next, cell penetration, fusion, and peptide targeting in peptide-based drug delivery were characterized. Then, the common administration routes and the potential pharmaceutical applications (drug delivery, antibacterial activity, stabilizers, imaging agents, and applications in bioengineering) of peptide drugs were respectively summarized. Last but not least, some general conclusions and future perspectives in the relevant fields were briefly listed. Although with certain challenges, great opportunities are offered by self-assembled short peptides to the fascinating area of drug development.

Narrative design for dementia care: Arranging the built environment of care homes to aid communication

AbstractBackgroundThe built environment has been shown to have significant potential to improve the quality of life and contribute to the well‐being of persons living with dementia. Persons with dementia in residential care suffer from isolation as it is difficult for staff and family members to find common routes of communication when the disease progresses. Within dementia care there is an urgent need to further facilitate communication especially with people living with late stage dementia. Storytelling has been effectively used in art therapy and art interventions for people affected by dementia to enhance communication, social connectivity and well‐being.This presentation explores the possibilities of incorporating a novel type of environmental design in care homes that would enhance narrative agency in residents with dementia thus allowing residents, caregivers and staff members to communicate through storytelling.MethodsDrawing on interdisciplinary research, the primary focus of the presentation is a case study examining the implementation of storytelling design in residential care settings. The case study reports on the co‐creation of a space focused on offering lived experiences for residents with dementia in a London care home highlighting design elements that trigger storytelling and stimulate imagination. Such elements include sensory wall surfaces, furniture, soft furnishings, configuration of space and inclusion of technology. The presentation explores whether this type of design could provide routes of communication between residents, staff and family members thus improving the quality of life of people living with dementia.ResultsBased on this case study example, the presentation discusses the value and impact of appropriate storytelling design on the wellbeing of people with dementia and their carers, and future avenues for improving the physical environment in care homes based on narrative design possibilities.ConclusionThere is a possibility for a significant impact of narrative design to communication, social connectivity and well‐being of people living with dementia.

Evaluation of the influence of Inosine pranobex on the matrix protein system in patients with chronic viral cervicitis

The reproductive potential of both women and men is declining every year. Many factors contribute to the violation of the reproductive function – chemical, physical, mechanical, psychogenic, however, biological factors have the most pronounced effect on reproduction. Chronic viral cervicitis can be not only the cause of infertility and reproductive losses, but also the development of intraepithelial dysplasia, as well as cervical cancer. PVI, as a monoinfection, is quite rare along with HPV. Other UGIs (urogenital infections) act as common routes of transmission and entry gates. The most common association with PVI is herpesvirus infection. An increase in MMP, both systemically and at the local level, may indicate a violation of cell modeling processes, which contributes to the development of autoimmune inflammation with further destruction of the tissues of the reproductive tract. Activation of MMP promotes the release of HSV from the nerve ganglia and reactivation of the infection. Therapy for HPV and HVI (herpes virus infections) are debatable. There is no single standard of treatment, but there are a number of drugs that have antiviral and immunomodulatory effects. Currently, there are no studies on the dynamics of the effect of HPV and HSV infection on the state of MMPs and TIMPs during Inosine pranobex therapy. Objective: to evaluate changes in matrix metalloproteinases 2 and 9 and their tissue inhibitors types 1 and 2 in patients with human papillomavirus and herpes infections after Inosine pranobex therapy. 6 patients with papillomavirus and herpetic infections were examined and treated with drugs containing the active ingredient Inosine pranobex. The levels of MMP-2, MMP-9 and TIMP-1, TIMP-2 in blood serum were determined using specific reagents from R&D Diagnostics Inc. (USA). The dynamics of indicators in the blood serum of patients with PVI showed a decrease in the level of MMP-2, MMP-9, TIMP-1 with a simultaneous increase in TIMP-2 relative to the values before therapy. In patients with PVI and HVI, Inosine pranobex therapy showed a decrease in MMP-2 and MMP-9 levels, no changes in the content of TIMP-1, but an increase in the serum content of TIMP-2. Prior to the use of therapy, an increase in the ratio in the main groups in comparison with the control group was found, however, the largest increase was found in the group with the association of infections. After therapy, positive dynamics was established in the main groups. Thus, the ratio in group I decreased and became equal to the control values. In the II group of patients, the ratio, despite the decrease, remained higher than the control values and higher in comparison with the I group of women.

Environmental Stability and Transmissibility of Enveloped Viruses at Varied Animate and Inanimate Interfaces.

Enveloped viruses have been the leading causative agents of viral epidemics in the past decade, including the ongoing coronavirus disease 2019 outbreak. In epidemics caused by enveloped viruses, direct contact is a common route of infection, while indirect transmissions through the environment also contribute to the spread of the disease, although their significance remains controversial. Bridging the knowledge gap regarding the influence of interfacial interactions on the persistence of enveloped viruses in the environment reveals the transmission mechanisms when the virus undergoes mutations and prevents excessive disinfection during viral epidemics. Herein, from the perspective of the driving force, partition efficiency, and viral survivability at interfaces, we summarize the viral and environmental characteristics that affect the environmental transmission of viruses. We expect to provide insights for virus detection, environmental surveillance, and disinfection to limit the spread of severe acute respiratory syndrome coronavirus 2.

PREVALENSI HBsAg POSITIF PADA PENDONOR DARAH DI UNIT DAERAH PALANG MERAH INDONESIA LOMBOK BARAT

Hepatitis B virus infection is the main cause of acute and chronic hepatitis, cirrhosis and liver cancer, 25% of whom experience jaundice. Blood transfusion is one of the most common routes of HBV transmission. The purpose of this study was to determine the prevalence of reactive and non-reactive HBsAg in the West Lombok Indonesian Red Cross unit. This type of research is descriptive, carried out in June 2022 at the West Lombok Indonesian Red Cross Unit. The results showed that the largest number of donors were men (12,201 people) and the age group of 25-44 years (4,342 people). Based on the results of the HBsAg examination, the prevalence of positive HBsAg in men was 76% and 24% in women.

Optimum k-Nearest Neighbors for Heading Synchronization on a Swarm of UAVs under a Time-Evolving Communication Network.

Heading synchronization is fundamental in flocking behaviors. If a swarm of unmanned aerial vehicles (UAVs) can exhibit this behavior, the group can establish a common navigation route. Inspired by flocks in nature, the k-nearest neighbors algorithm modifies the behavior of a group member based on the k closest teammates. This algorithm produces a time-evolving communication network, due to the continuous displacement of the drones. Nevertheless, this is a computationally expensive algorithm, especially for large groups. This paper contains a statistical analysis to determine an optimal neighborhood size for a swarm of up to 100 UAVs, that seeks heading synchronization using a simple P-like control algorithm, in order to reduce the calculations on every UAV, this is especially important if it is intended to be implemented in drones with limited capabilities, as in swarm robotics. Based on the literature of bird flocks, that establishes that the neighborhood of every bird is fixed around seven teammates, two approaches are treated in this work: (i) the analysis of the optimum percentage of neighbors from a 100-UAV swarm, that is necessary to achieve heading synchronization, and (ii) the analysis to determine if the problem is solved in swarms of different sizes, up to 100 UAVs, while maintaining seven nearest neighbors among the members of the group. Simulation results and a statistical analysis, support the idea that the simple control algorithm behaves like a flock of starlings.

Supramolecular mineralization strategy for engineering covalent organic frameworks with superior Zn-I2 battery performances

•A supramolecular mineralization strategy for constructing COFs is proposed •The strategy holds a generality by modulating different assembly blocks •PY-2PBA COF features strong I2 adsorption and accompanying increased conductivity •The engineered PY-2PBA COF delivers impressive performances in Zn-I2 batteries Construction of covalent organic frameworks (COFs) with fine-tuning pore structures and crystalline orientations at the nano-/meso-scale is vital for their potential applications, but common synthesis routes for COFs always result in the unpredictable nucleation growth and aggregation of small crystals with arbitrary orientations and geometries. Here, we develop a supramolecular mineralization strategy for controllable fabrication of semiconducting COF nanoarchitectures by pre-assembly and subsequent in situ covalent locking of supramolecules. This strategy allows us to change the dynamic covalent chemistry reaction path by reducing the entropy of the system, thus facilitating control over the growth and crystallization of COFs on demand (including 1D, 2D, etc.). The tailor-made COF can effectively suppress the shuttle effect and accelerate the conversion of polyiodide through strong intrinsic electron-pair induce interactions, thereby delivering an outstanding performance in zinc-iodine batteries. The studies create a link between supramolecular chemistry and polymer science for the controllable construction of COF and supramolecular materials. Construction of covalent organic frameworks (COFs) with fine-tuning pore structures and crystalline orientations at the nano-/meso-scale is vital for their potential applications, but common synthesis routes for COFs always result in the unpredictable nucleation growth and aggregation of small crystals with arbitrary orientations and geometries. Here, we develop a supramolecular mineralization strategy for controllable fabrication of semiconducting COF nanoarchitectures by pre-assembly and subsequent in situ covalent locking of supramolecules. This strategy allows us to change the dynamic covalent chemistry reaction path by reducing the entropy of the system, thus facilitating control over the growth and crystallization of COFs on demand (including 1D, 2D, etc.). The tailor-made COF can effectively suppress the shuttle effect and accelerate the conversion of polyiodide through strong intrinsic electron-pair induce interactions, thereby delivering an outstanding performance in zinc-iodine batteries. The studies create a link between supramolecular chemistry and polymer science for the controllable construction of COF and supramolecular materials.

60 Multimodal Imaging and Artificial Intelligence Unveil Hot-Spot Deposition, Bronchial/Alveolar Dose and Cellular Fate of Biopersistent Nanoparticles in the Lung

Abstract Pulmonary delivery is not only of increasing importance to exploit local therapy for lung diseases like COVID-19, but also plays an essential role in interpreting health impact of inhaled hazardous (nano-)materials. Deciphering of biodistribution, biokinetics, and cell-mediated immunity of pulmonary delivered nanoparticles (NPs) remains insufficient. We applied state-of-the-art multimodal imaging and deep learning pipelines to elucidate the intricate deposition profiles and the fate of biopersistent NPs in the lung within cellular resolution. Spatially resolved delivery characteristics like inter- and intra-acinar distribution pattern and regional NP dosage were revealed by tissue-clearing light-sheet fluorescence microscopy for six common routes of pulmonary delivery, i.e., intranasal & oropharyngeal aspiration, intubated instillation, microsprayer application, ventilator-assisted & nose-only aerosol inhalation. Artificial intelligence-driven entire airway 3D segmentation (convolutional neural network) enabled accurate dosimetry of bronchial versus acinar/alveolar NP dose (B/A: 0.04 to 0.18 depending on delivery route) rather than the conventionally simplified 2D central-to-peripheral ratio (C/P: 1.32 to 3.79). Moreover, longitudinal 3D imaging revealed similar intra-acinar NP kinetics independent of delivery route. Inhaled NP relocation from the alveolar-epithelium to interstitium was traditionally claimed as the consequence of passive diffusion/transportation of NPs. This study, however, revealed that acinar NP transport can be attributed to the phagocytosis and migration of tissue-resident macrophages (TRMs) as evidenced by complementary analytical approaches (intravital microscopy, ex vivo 4D live-tissue microscopy, in situ immunofluorescence, ex vivo NP-lung interaction model, flow cytometry). Overall, this study elucidates holistic NP-lung delivery and biokinetics features and TRM immunity on the fate of biopersistent NPs.

Ti3C2Tx MXene integrated hollow carbon nanofibers with polypyrrole layers for MOF-derived freestanding electrodes of flexible asymmetric supercapacitors

Effective customization of Ti3C2Tx MXenes by electrospinning technique is crucial for the preparation of freestanding/flexible electrodes exhibiting enhanced performance in supercapacitors. Herein, we prepared MXenes containing hollow carbon nanofibers (MXHCNF) by co-axial electrospinning, and the inside-out of MXHCNF is decorated with polypyrrole layers (PPy@MXHCNF), which is sufficiently flexible, conductive, and highly functionalized with a unique trilayer morphology. Using the self-designed electroactive PPy@MXHCNF, a ZnCoMOF is homogeneously grown. The as-prepared bimetallic MOF on PPy@MXHCNF is used as a common precursor with which to fabricate the positive (ZCO@PPy@MXHCNF) and negative (NPC@MXHCNF) electrodes by a controlled heat treatment process using a “two from one” strategy. The freestanding positive and negative electrodes provide specific capacitances of 1567.5 F g−1 and 477.2 F g−1 at 1 A g−1, respectively, with high capacitance retention, cyclic stability, and coulombic efficiency. A flexible asymmetric device (ZCO@PPy@MXHCNF//NPC@MXHCNF) is assembled, and it exhibits an energy density of 61.3 Wh kg−1 at a power density of 796.8 W kg−1 and 92.8% capacitance retention after 10,000 GCD cycles. This work provides a unique approach involving MXene modification, polypyrrole decorated electrospun MXHCNFs as efficient substrates for freestanding electrodes, and the use of bimetallic MOF as a common strategic route for both positive and negative electrodes in flexible asymmetric supercapacitors.

Overview Discourse on Inherent Distinction of Multiobjective Optimization in Routing Heuristics for Multi-Depot Vehicle Instances

This paper reviews the research methodologies used in earlier years on the benefits and traits reflected by multi-depot vehicle routing problem (MDVRP) instances and assesses the efficacy of various improvised techniques to improve the current recurrent problems in routing procedures. Management of logistics involves moving finished goods from depots to end-user clients. Routing and scheduling systems that are improved will be able to serve a more significant number of customers in a shorter amount of time while also increasing customer satisfaction. To thoroughly discuss the current state of MDVRP implementation in routing heuristics, an analysis of the selected approaches involving multi-depot task distribution under VRP incorporations is further extrapolated. These approaches address the most common routing issues involving constraints like cost optimality, time window impositions, and load capacity flexibility. Recent research focuses on the advantages, proficiency, problem magnitude, and adaptability in MDVRP. The MDVRP framework can still be significantly improved by reducing routing costs with efficient heuristics to generate optimized solutions.

Evaluation of the late presentation and associated factors of people living with HIV in Turkey.

To identify the frequency of late presentation and late presentation with advanced disease, and associated factors in people living with HIV (PLHIV). Data from PLHIV diagnosed between 2008 and 2021 were retrospectively analyzed. Time of diagnosis (categorized based on key events affecting HIV care continuum e.g., national strategies, HIV guidelines, COVID-19 pandemic) and characteristics of late presenters (LP: CD4 ≤350 cells/mm³ or an AIDS defining event) and late presenters with advanced disease (LPAD: CD4 <200 cells/mm³) were describe. Associations between dependent (LP, LPAD) and independent variables were assessed using univariate/multivariate regression tests and presented as odds ratios (95% confidential interval). Of 1585 individuals (93.7% men), 42.5% were LPs and 19.3% were LPADs. Most common route of transmission was sex between men (54.3%). Non-LPs were younger (30 vs. 34 and 36 years; p < 0.001) and included more men who have sex with men (60.3% vs. 46.3% and 39.5%; p < 0.001). Factors associated with being LP and LPAD were age >30 years, heterosexual/unknown route of transmission (vs. sex between men), diagnosis in 2008-2013 or 2020-2021, (vs. 2014-2019). With reference to Turkish subjects, migrants from Africa had higher odds of being LPAD. LP is still an important health issue in HIV care. Heterosexuality, older age (>30 years), migration from Africa, and the COVID-19 pandemic are associated with delays in HIV presentation in Turkey. These factors need to be considered when developing and implementing policies to enable earlier diagnosis and treatment of PLHIV to achieve UNAIDS 95-95-95 targets.