Treatment Modification Research Articles

Advancing Evaluation of Microplastics Thresholds to Inform Water Treatment Needs and Risks.

Although human health impacts of microplastics are not well understood, concern regarding chemical contaminants retained on or within them is growing. Drinking water providers are increasingly asked about these risks, but strategies for evaluating them and the extent of treatment needed to manage them are currently lacking. Microplastics can potentially induce health effects if the concentration of contaminants adsorbed to them exceeds predetermined drinking water guidelines (e.g., Maximum Contaminant Levels). The risk posed by microplastics due to adsorbed contaminants is difficult to determine, but a worst-case scenario can be evaluated by using adsorption capacity. Here, a "Threshold Microplastics Concentration" (TMC) framework is developed to evaluate whether waterborne microplastic concentrations can potentially result in the intake of regulated contaminants on/in microplastics at levels of human health concern and identify treatment targets for managing associated health risk. Exceeding the TMC does not indicate an immediate health risk; it informs the need for detailed risk assessment or further treatment evaluation to ensure particle removal targets are achieved. Thus, the TMC concept and framework provide an updateable, science-based screening tool to determine if there is a need for detailed risk assessment or treatment modification due to waterborne microplastics in supplies used for potable water production.

Variables associated with antibiotic treatment tolerance in patients with Mycobacterium avium complex pulmonary disease

BackgroundTreatment of Mycobacterium avium complex pulmonary disease (MAC-PD) involves prolonged courses of multiple antibiotics that are variably tolerated and commonly cause adverse drug reactions (ADR). The purpose of this retrospective, single-center study was to identify demographic and disease-related variables associated with significant ADRs among patients treated with antibiotics against MAC-PD.MethodsWe reviewed all patients treated with antibiotic therapy for MAC-PD at a single center from 2000 to 2021. Patients were included if they met diagnostic criteria for MAC-PD, were prescribed targeted antibiotic therapy for any length of time and had their treatment course documented in their health record. We compared patients who completed antibiotics as originally prescribed (tolerant) with those whose antibiotic treatment course was modified or terminated secondary to an ADR (intolerant).ResultsOver the study period, 235 patients were prescribed antibiotic treatment with their clinical course documented in our center’s electronic health record, and 246 treatment courses were analyzed. One hundred forty-three (57%) tolerated therapy versus 108 (43%) experienced ADRs. Among the 108 intolerant courses, 67 (63%) required treatment modification and 49 (46%) required premature treatment termination. Treatment intolerance was associated more frequently with smear positive sputum cultures (34% vs. 20%, p = 0.009), a higher Charlson Comorbidity Index (CCI) (4 vs. 6, p = 0.007), and existing liver disease (7% vs. 1%, p = 0.03). There was no between-group difference in BMI (21 vs. 22), fibrocavitary disease (24 vs. 19%), or macrolide sensitivity (94 vs. 80%). The use of daily therapy was not associated with intolerance (77 vs. 79%). Intolerant patients were more likely to be culture positive after 6 months of treatment (44 vs. 25%).ConclusionsPatients prescribed antibiotic therapy for MAC-PD are more likely to experience ADRs if they have smear positive sputum cultures at diagnosis, a higher CCI, or existing liver disease. Our study’s rate of early treatment cessation due to ADR’s was similar to that of other studies (20%) but is the first of its kind to evaluate patient and disease factors associated with ADR’s. A systematic approach to classifying and addressing ADRs for patients undergoing treatment for MAC-PD is an area for further investigation.

The effects of different fiber fractions from sour cherry (Prunus cerasus L.) pomace and fiber modification methods on cake quality.

Sour cherry pomace is the largest byproduct of sour cherry processing with more than 0.4 million tonnes per year. In this study, sour cherry pomace powder (SCPP) has been treated individually or by a combination of microwave (MW), enzymatic hydrolysis, and high pressure to increase soluble dietary fiber (SDF) content. Then, the untreated or treated forms of SCPP, their SDF, and insoluble dietary fiber (IDF) isolates were added (5%) to the reduced-fat cake. Rheological, physical, and textural properties of the full-fat (50%) and the reduced-fat (25% fat) cakes enriched with dietary fiber (DF) were compared. SDF enrichment minimized the negative effect of fat reduction in the cake. Water absorption, mixing tolerance, hardness, and springiness values of the SDF-enriched samples were found as the lowest. Extensibility, energy, weight loss, and cohesiveness values were found to be the highest values with the addition of SDF. All treatments helped to decrease mixing tolerance, dough development, and stability time. MW was the critical treatment for DF modification. Individual MW-treated DF samples increased resistance to extension of the dough samples as compared to the untreated SDF, IDF, and SCPP. Nevertheless, SDF showed better performance in acting as a fat replacer than IDF and SCPP. PRACTICAL APPLICATION: The soluble dietary fiber (SDF) isolate minimized the negative effect of fat reduction in cakes. Water absorption and mixing tolerance of the dough were measured as the lowest. The hardness and springiness of soluble dietary fiber-enriched cakes were found to be the lowest. Extensibility and weight loss reached the highest value when SDF was used. Treatments helped decrease mixing tolerance, dough development, and stability time.

Performance evaluation of self-healing recycled concrete using biomineralization modified recycled aggregate as bacterial carrier

The development of bacteria-based self-healing concrete relies on a carrier that is both compatible with the concrete matrix and capable of effectively protecting bacteria. This study utilized biomineralization modified recycled aggregate (RA) as a bacterial carrier to create bacteria-based recycled concrete with a strong self-healing capability. The workability, compressive strength, durability and self-healing performance of concrete were evaluated. The results showed that the quality of RA was significantly improved after biomineralization modification treatment due to the filling of bio-calcium carbonate in surface pores and microcracks, with an increase in apparent density of 1.9%, a decrease in water absorption and crushing index of 13.9% and 15.3%. The modified RA can provide better bacterial protection, thereby enhancing the crack self-healing efficiency of concrete by forming more bio-calcium carbonate healing product. For cracks with a width of about 0.4 mm, after healing of 56 days, the crack width repair ratio of bacteria-based recycled concrete was 94.5%, with an increase by 61.0% compared to that (only 58.7%) of ordinary recycled concrete. X-ray diffraction (XRD) results showed that the bio-calcium carbonate was calcite. The improvement of RA's quality will also benefit the performance enhancement of concrete. Compared to ordinary recycled concrete, the 28d compressive strength of bacteria-based recycled concrete was increased by 16.6%, the capillary water absorption coefficient was decreased by 37.5%, and the workability and resistance to chloride ion penetration was significantly improved.

Persistence and safety of anti-TNF biosimilars versus originators in immune-mediated inflammatory diseases: an observational study on the French National Health Data System

ObjectivesBiosimilar-originator equivalence has been demonstrated in phase 3 trials in a few indications of infliximab, etanercept and adalimumab. The objective of our study was to compare the persistence and safety...

Синдром острого травматического гастроэнтерита, осложненного сухим кератоконъюнктивитом у щенка мопса

Acute gastroenteritis, accompanied by vomiting and diarrhea, is often found in the practice of a veterinarian. Previously, it was customary to use antimicrobials for the treatment of these patients, since bacterial infections were considered one of the main causes of acute gastrointestinal disorders. Modern microbiome studies have led to a revision of the protocol for the treatment of acute gastroenteritis, now it is recommended to use probiotics, prebiotics, dietary modification and symptomatic treatment.
 The described clinical case reflects the collision of the traditional approach to the treatment of acute gastroenteritis with an antimicrobial drug and a microbiome-friendly treatment option using probiotics, antiemetics and infusion therapy. In this case, the cancellation of the antimicrobial drug led to an improvement in the patient's condition and a rapid recovery.

Hepatic Dysfunction during Induction Chemotherapy in Children with Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma and Its Effects on Subsequent Therapy and Outcome

Abstract Introduction The overall survival rate for childhood acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) has shown tremendous growth in the recent years. Hepatic dysfunction is one of the complications seen during therapy and can add to the underlying morbidity of the disease, delay in chemotherapy, modification of drugs, and rarely fulminant hepatic failure. Objective This article aims to find out the prevalence of hepatic dysfunction during induction chemotherapy for ALL and LBL. Materials and Methods This was a retrospective study, where the data of all children between 1 and 18 years of age with ALL and LBL treated at our center as per the UK-ALL 2003 protocol between December 2013 and December 2021 have been included from the medical records. Hepatic dysfunction was defined as grade 3 and 4 alanine transaminase (ALT) and aspartate transaminase (AST) levels as per Common Terminology Criteria for Adverse Events v5.0 and hyperbilirubinemia as ≥ 1.4 mg/dL as the chemotherapy modification begins at this cutoff. Data from children with hepatic dysfunction was compared with those without hepatic dysfunction using chi-squared test and Student's t-tests. Those variables with a p-value of < 0.2 were analyzed with multivariate regression analysis. Kaplan–Meier survival estimates were used to calculate the event-free survival (EFS). Results A total of 142 children were included in the study. Thirty-one (21.8%) children developed hepatic dysfunction, 14 (9.9%) of them with ALT/AST elevation and 27 (19%) with bilirubin elevation. Weight (mean 25 ± 13.5, p 0.01), body surface area (mean 0.87 ± 0.29, p 0.02), and National Cancer Institute high risk (p 0.005) were associated with hepatic dysfunction in univariate analysis but none of them were significant in multivariate regression analysis. Treatment modification was required in 14/31 children with hepatic dysfunction. Death in induction was more among children with hepatic dysfunction (p < 0.001). There was no significant impact on minimal residual disease outcomes. Five-year EFS (death or relapse) was 59.93 ± 9% in children with hepatic dysfunction as opposed to 72 ± 5.0% in those without hepatic dysfunction (95% confidence interval, p = 0.07). Conclusion One in five children with ALL and LBL on induction therapy developed hepatic dysfunction. Almost half of those with hepatic dysfunction required chemotherapy modifications.

Subcutaneous anakinra in the management of refractory MIS-C in France.

Multisystemic inflammatory syndrome in children (MIS-C) is a therapeutic emergency and can lead to myocardial dysfunction (17%-75%) and heart failure (52%-53%). Intravenous immunoglobulins (IVIG) and corticosteroids (CST) have been validated for the management of this condition. Recent reports suggest that an interleukin-1(IL-1) receptor antagonist, namely anakinra, may be a valuable add-on to the 2019 novel coronavirus disease (COVID-19) treatment for refractory patients. The purpose of this study was to describe the clinico-biological characteristics of patients treated with anakinra as well as the efficacy and safety of subcutaneous anakinra therapy in this condition. The prospective multicentre study of children hospitalized for MIS-C between March 2020 and September 2022, including 23 international paediatric centres, followed for a mean duration of 3.072 ± 3.508 months. The patient data were extracted from the Juvenile Inflammatory Rheumatism (JIR) cohort. The clinico-pathological characteristics, cardiac ultrasound data, and adverse events were reported in patients receiving anakinra. Of the 470 children admitted with MIS-C, 18 French patients (50% girls) with a mean age of 10.06 ± 3.9 years were treated with subcutaneous anakinra. Anakinra was used in two situations, macrophage activation syndrome (MAS) (4 patients) and heart failure (14 patients) with a median left ventricular ejection fraction (LVEF) of 39.5% (30%-45%). The average dose of anakinra received was 2.53 ± 1.3 mg/kg/day for a median duration of 3 days. Prior to introduction, 78% (n = 14/18) of the patients had received CST and 56% (n = 10/18) had received IVIG. Only two patients received IVIG alone and six received CST alone plus anakinra. In 10% of cases, IVIG was poorly tolerated from a cardiovascular point of view and was discontinued. Transient elevations in serum transaminases were noted in four patients on anakinra without the need for treatment or dose modification. In all patients, rapid (48 h) improvement in myocardial function was observed (LVEF > 55%) with a concomitant significant decrease in myocardial enzymes (p < 0.05). All patients survived with complete recovery of cardiac function without sequelae. Subcutaneous anakinra appears to be a safe and effective treatment for the management of heart failure or MAS in MIS-C patients. The value of IVIG in these two situations remains to be reviewed.

INFLUENCE OF MODIFICATION ON PROPERTIES OF ZSM-5 ZEOLITE IN THE REACTION OF TOLUENE ALKYLATION WITH ISOPROPANOL

Bimetallic catalysts based on ZSM-5 zeolite modified with ytterbium and nickel have been prepared. The influence of the concentration of ytterbium (1.7–5.0 wt.%) and nickel (1.0–1.5 wt.%) on the acidic, textural and catalytic properties of the zeolite in the reaction of alkylation of toluene with isopropanol in the temperature range of 300–3500C was studied. It has been shown that the unmodified zeolite HZSM-5 exhibits low selectivity (54.6–58.2%) for isopropyltoluenes (3-IPT, 4-IPT, and 2-IPT) than the modified catalysts. In addition, the content of the valuable 4-IPT isomer does not exceed 44.2%. Modification of HZSM-5 with ytterbium in an amount of 5.0 wt.% leads to an increase in the selectivity for isopropyltoluenes up to 68.7%, and the selectivity for 4-IPT up to 68.8%. Additional modification of the 3%-Yb-HZSM-5 catalyst with nickel in the amount of 1.0 wt.% prevents the formation of 2-IPT and promotes an increase in the yield of 4-IPT. The modified catalysts were characterized by XPA, BET, BJH, and ammonia TPD. Modification, calcination, and successive treatment of the catalyst with air and hydrogen leads to a dispersed distribution of Yb2O3 and metallic nickel oxide nanoparticles in the outer surface and in the pores of the zeolite, which causes a decrease in the specific surface area, total pore volume, and an increase in the fraction of mesopore volume. As a result of the interaction of modifiers with acidic OH groups of the zeolite, the concentration of strong Brønsted acid sites decreases and new, stronger Lewis acid sites form. All this has a decisive effect on the selectivity of 4-IPT formation and the stability of the bimetallic catalyst. The maximum selectivity for 4-IPT on a 3% Yb 1.0% Ni/HZSM-5 bimetallic catalyst is achieved at 3300C and is 71.5% at a toluene conversion of 24.6%.

Effect of In Situ NbC-Cr7C3@graphene/Fe Nanocomposite Inoculant Modification and Refinement on the Microstructure and Properties of W18Cr4V High-Speed Steel.

A novel graphene-coated nanocrystalline ceramic particle, iron-based composite inoculant was developed in this study to optimize the as-cast microstructure and mechanical properties of W18Cr4V high-speed steel (HSS). The effects of the composite inoculant on the microstructure, crystal structure, and mechanical properties of HSS were analyzed using transmission electron microscopy, scanning electron microscopy, energy dispersive spectroscopy, and X-ray diffraction. The (002-) and (020) crystal planes of the Fe3C and Cr7C3 phases, respectively, were collinear at two points in the reciprocal space, indicating a coherent relationship between the Fe3C and Cr7C3 phases in the tempered modified HSS. This contributed to an improved non-uniform nucleation rate and refining of the HSS grains. The mechanical properties of the modified steel exhibited a general improvement. Specifically, the modification treatment enhanced the hardness of HSS from HRC 63.2 to 66.4 and the impact toughness by 48.3%.

Primary Treatment Modification and Treatment Tolerability Among Older Chemotherapy Recipients With Advanced Cancer

Older adults with advanced cancer are less likely to tolerate treatment with cytotoxic chemotherapy compared with younger patients due to their aging-related conditions. Hence, oncologists sometimes opt to employ primary treatment modifications (deviation from standard of care) during the first cycle of chemotherapy. To examine the association between primary treatment modification and treatment tolerability in older adults with advanced cancer who were starting new palliative chemotherapy regimens. This cohort study was a secondary analysis of the GAP70+ (Geriatric Assessment Intervention for Reducing Toxicity in Older Patients with Advanced Cancer) trial, which was conducted between July 2014 and March 2019. The GAP70+ trial included patients aged 70 years or older who had advanced (ie, incurable) cancer, had 1 or more geriatric assessment domain impairments, and planned to start a new palliative chemotherapy regimen. Data analysis was conducted in November 2022. Receipt of standard-of-care chemotherapy regimens vs primary treatment modification defined as any change from National Comprehensive Cancer Network guidelines or published clinical trials (eg, primary dose reduction, schedule change). Tolerability outcomes were assessed within 3 months of treatment. These outcomes included the following: (1) any grade 3 to 5 toxic effect, according to the National Cancer Institute Common Terminology Criteria for Adverse Events; (2) patient-reported functional decline, defined as the development of worse dependency in activities of daily living using scale scores; and (3) a composite adverse outcome (an end point that combined toxic effects, functional decline, and 6-month overall survival). Multivariable cluster-weighted generalized estimating equation models examined the association between primary treatment modification and outcomes adjusting for covariates. This study included 609 patients with a mean (SD) age of 77.2 (5.2) years; more than half (333 [54.7%]) were men. Race and ethnicity was available for 607 patients: 39 (6.4%) were Black, 539 (88.5%) were non-Hispanic White, and 29 (4.8%) were of other race or ethnicity. Nearly half (281 [46.1%]) received a primary modified treatment regimen. The most common cancer types were gastrointestinal cancer (228 [37.4%]) and lung cancer (174 [28.6%]). In multivariable analysis, primary treatment modification was associated with a reduced risk of grade 3 to 5 toxic effects (relative risk [RR], 0.85 [95% CI, 0.77-0.94]) and functional decline (RR, 0.80 [95% CI, 0.67-0.95]). Patients who received primary treatment modification had 32.0% lower odds of having a worse composite adverse outcome (odds ratio, 0.68 [95% CI, 0.48-0.97]). In this cohort study, primary treatment modification was associated with improved tolerability of chemotherapeutic regimens among older adults with advanced cancer and aging-related conditions. These findings may help optimize cancer treatment dosing in older adults with advanced cancer and aging-related conditions.

Prescription Trends on the Preference of Hypoglycemic Agents for the Management of Diabetes Mellitus in India

The management of type 2 diabetes requires multifactorial approach in terms of diet, lifestyle modification and pharmacological treatment to prevent or delay complications and maintain the quality of life. Several studies have been conducted to enhance the treatment of type 2 diabetes. However, there was a lack of data regarding the prescription pattern of antidiabetics among clinicians. So, a cross-sectional, questionnaire based study was conducted to gather information about the prevalence, risk factors, and management of diabetes within a population. The data was collected from 551 doctors across all over India. About 44% doctors reported that 5-10 patients per week were newly diagnosed with type 2 diabetes. In this study, 66% of the doctors reported cardiovascular events as a major complication and 28% of the doctors reported renal complications in uncontrolled type 2 diabetes patients. 48% of the 551 clinicians used DPP4 inhibitors as an add on, followed by 30% who reported the use of SGLT2 inhibitors. Notably, 92% of the participants reported urinary tract infection as the most common undesirable effect in their patients, with the usage of dapagliflozin. Nearly 30% of the clinicians in our survey have prescribed SGLT2 inhibitors for patients who are at &gt;50% risk of developing chronic kidney disease. The results from our study, stated that most of the clinicians use DPP4 inhibitors and SGLT2 inhibitors as an add on to metformin in patients with a failure to control the glycaemic index. Dapagliflozin is prescribed not only to control the glycaemic index but also to reduce the hospitalization due to heart failure and other cardiovascular and renal co-morbidities.

Well-established carbon nanomaterials: modification, characterization and dispersion in different solvents

Three different types of carbon nanomaterials, SWCNTs, MWCNTs and GNPs were prepared, modified, characterized, and their dispersibility behavior in three different solvents was evaluated. The carbon nanotubes were synthesized by using the well-known chemical vapor deposition method and the graphene nanoplatelets by wet physicochemical treatment techniques. Their characterization was accomplished by using various advanced techniques, such as powder X-ray diffraction and Raman spectroscopy, X-ray photoelectron spectroscopy, scanning electron microscopy and N2 adsorption at 77 K. Furthermore, the carbon nanostructures were modified via plasma treatment and wet chemical surface modification in order to enhance their dispersion characteristics, for achieving more homogenous suspensions and therefore to be remained dispersed over a reasonable period of time without any sedimentation. The effect of treatment parameters and the use of different solvents were thoroughly studied mainly by optical methods, but also by using the DIN/EN classified ISO method of oil absorption and UV–Vis spectroscopy. The enhanced dispersion rate is observed in both CNTs and GNPs materials following their surface treatment, especially when using the solvent n-methyl-2-pyrrolidone. The aforementioned studied nanomaterials are perfect candidate fillers for preparing polymeric mixed matrix membranes.Graphical abstract

An Impressive Response to Zoldronic Acid Treatment for Chronic Recurrent Multifocal Osteomyelitis: A Case Report.

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare, non-infectious inflammatory disease with a prevalence of 1 to 2/106, causing multiple lytic bone lesions. There are no established protocols for treating CRMO; thus, current practice is largely empirical. Data on the use of zoledronic acid (ZA) in juvenile CRMO are scarce. A 12-year-old male child with a history of multiple aseptic osteomylitis, affecting the chest wall, right ankle, and wrist, had no fever. Cultures and a bone biopsy ruled out infection or malignancy. The patient's condition stayed stable while taking naproxen (20 mg/kg/day) and methotrexate (10 mg/week) for 1.5 years until he experienced right elbow pain, swelling, no overlying skin erythema, and a restricted range of motion. The laboratory tests all came back normal, including white blood cell (WBC) count, erythrocyte sedimentation rate, C-reactive protein, and immunoglobin assays. The magnetic resonance imaging showed a focal lesion in the medial humeral condyle with increased signal intensity on T2 and short tau inversion recovery, mild joint effusion, and no cortical break. Thus, intravenous ZA infusion commenced at 0.0125 mg/kg initially, followed by 0.025 mg/kg 3 months later, with a marked improvement in the patient's clinical symptoms and radiological findings. Non-steroidal anti-inflammatory drugs and methotrexate were initially effective in treating our patient's condition, but a recurrence necessitated treatment modification. To the best of our knowledge, this case is the first documented instance of the use of ZA in CRMO in Iraq and Arab nations.

Estimating rare disease prevalence and costs in the USA: a cohort study approach using the Healthcare Cost Institute claims data

ObjectiveThe study capitalised on national insurance claims data to gather information on patient characteristics and associated costs to better understand the diagnosis and treatment of rare diseases (RDs).Materials and methodsData...

Effects of the combination of phenolic-resin impregnation and heat treatment on physical, mechanical and decay resistance of Taxodium hybrid “Zhongshanshan” wood

ABSTRACT This study aimed to evaluate the influence of cooperative modification treatments and treatment sequencing on the properties of treated fast-growing wood. Two integrated treatment methods including, impregnation with Phenol-Formaldehyde resin followed by heat treatment (PF-HT), and heat treatment antecedent to impregnation with Phenol-Formaldehyde resin (HT-PF) were applied on Taxodium hybrid “Zhongshanshan” wood. Comprehensive characterization was undertaken, investigating micro-morphology, chemical structure, mechanical properties, shrinkage and expansion properties, and decay resistance before and after treatment. Results indicated that the weight percentage gain (WPG) of the HT-PF wood exceeded that of the PF-HT wood, and the WPG of the former displayed an ascending tendency with increasing heating temperature, reaching a final difference of 10%. For instance, the modulus of elasticity of the HT-PF wood was 18% higher than that of the PF-HT wood in the bending test at a temperature of 215°C. Throughout the dynamic water adsorption test, both the hydrated water percentage and the dissolved water percentage of PF-HT wood were lower than those of PF-HT wood. After 3 months of exposure to brown-rot fungi, both HT-PF wood and PF-HT wood achieved a high level of decay resistance.

Considerations for Gender-Affirming Hormonal and Surgical Care Among Transgender and Gender Diverse Adolescents and Adults With Congenital Heart Disease.

Transgender and gender diverse (TGD) individuals and long-term survivors with adult congenital heart disease (ACHD) are both growing populations with specialized needs. No studies assess temporal trends or evaluate the care of TGD individuals with ACHD. Meetings between congenital cardiology and gender-affirming care specialists identified unique considerations in TGD individuals with ACHD. A retrospective chart review was then performed to describe patient factors and outpatient trends in those with an ACHD diagnosis undergoing gender-affirming hormonal or surgical care (GAHT/S) at 1 adult and 1 pediatric tertiary care center. Thirty-three TGD individuals with ACHD were identified, 21 with a history of GAHT/S. Fourteen (66%) had moderate or complex ACHD, 8 (38%) identified as transgender male, 9 (43%) transgender female, and 4 (19%) other gender identities. Three had undergone gender-affirming surgery. There were zero occurrences of the composite end point of unplanned hospitalization or thrombotic event over 71.1 person-years of gender-affirming care. Median age at first gender-affirming appointment was 16.8 years [interquartile range 14.8-21.5]. The most common treatment modification was changing estradiol administration from oral to transdermal to reduce thrombotic risk (n=3). An increasing trend was observed from zero TGD patients with ACHD attending a gender diversity appointment in 2012 to 14 patients in 2022. There is a growing population of TGD patients with ACHD and unique medical and psychosocial needs. Future studies must fully evaluate the reassuring safety profile observed in this small cohort. We share 10 actionable care considerations for providers with a goal of overseeing a safe and fulfilling gender transition across all TGD patients with ACHD.

Longitudinal Genotype-Phenotype (Vineland Questionnaire) Characterization of 15 ADNP Syndrome Cases Highlights Mutated Protein Length and Structural Characteristics Correlation with Communicative Abilities Accentuated in Males.

Activity-dependent neuroprotective protein (ADNP) is essential for neurodevelopment and de novo mutations in ADNP cause the ADNP syndrome. From brain pathologies point of view, tauopathy has been demonstrated at a young age, implying stunted development coupled with early/accelerated neurodegeneration. Given potential genotype-phenotype differences and age-dependency, we have assessed here a cohort of 15 individuals (1-27-year-old), using 1-3 longitudinal parent (caretaker) interview/s (Vineland 3 questionnaire) over several years. Our results indicated developmental delays, or even developmental arrests, coupled with potential spurts of development at early ages. Severe outcomes correlated with the truncating high impact mutation, in other words, the remaining mutated protein length as well as with the tested individual age, corroborating the hypothesis of developmental delays coupled with accelerated aging. A significant correlation was noted between mutated protein length and communication, implying a high impact of ADNP on communicative skills. Additionally, correlations were discovered between the two previously described epi-genetic signatures in ADNP emphasizing aberrant acquisition of motor behaviors, with truncating mutations around the nuclear localization signal being mostly affected. Finally, all individuals seem to acquire an age equivalent of 1-6years, requiring disease modification treatment, such as the ADNP-derived drug candidate, NAP (davunetide), which has recently shown efficacy in women suffering from the neurodegenerative disorder, progressive supranuclear palsy (PSP), a late-onset tauopathy.

Preparation and properties of halogen-free flame retardant PE based wood-plastic composite materials

ABSTRACT The experiment carried out halogen-free flame retardant modification treatment on polyethylene-based wood-plastic composite materials. The results showed that after adding flame retardant, the ignition time of the material increased to 76 seconds, an increase of 22 seconds. At combustion temperatures above 530°C, only a small amount of the material’s residue continues to evaporate. When the temperature rises to 800°C, the difference in the residual carbon content of the samples gradually becomes larger. The residual carbon content of sample 1# is only 10.1%. At this time, the residual carbon content of samples 7#, 8# and 9# are respectively Reaching 27.12%, 27.09% and 25.60%. The above results show that the thermal stability of composite materials has been greatly improved after adding nano-flame retardants, providing new ideas and methods for the application of flame retardant and halogen-free flame retardant materials of wood-plastic composites.

Fabrication of Superhydrophobic–Hydrophilic Patterned Cu@Ag Composite SERS Substrate via Femtosecond Laser

Ultralow concentration molecular detection is critical in various fields, e.g., food safety, environmental monitoring, and disease diagnosis. Highly sensitive surface-enhanced Raman scattering (SERS) based on ultra-wettable surfaces has attracted attention due to its unique ability to detect trace molecules. However, the complexity and cost associated with the preparation of traditional SERS substrates restrict their practical application. Thus, an efficient SERS substrate preparation with high sensitivity, a simplified process, and controllable cost is required. In this study, a superhydrophobic–hydrophilic patterned Cu@Ag composite SERS substrate was fabricated using femtosecond laser processing technology combined with silver plating and surface modification treatment. By inducing periodic stripe structures through femtosecond laser processing, the developed substrate achieves uniform distribution hotspots. Using the surface wettability difference, the object to be measured can be confined in the hydrophilic region and the edge of the hydrophilic region, where the analyte is enriched by the coffee ring effect, can be quickly located by surface morphology difference of micro-nanostructures; thus, greatly improving detection efficiency. The fabricated SERS substrate can detect Rhodamine 6G (R6G) at an extraordinarily low concentration of 10−15 mol/L, corresponding to an enhancement factor of 1.53 × 108. This substrate has an ultralow detection limit, incurs low processing costs and is simple to prepare; thus, the substrate has significant application potential in the trace analysis field.