Locally Sustainable Biodiesel Production from Waste Cooking Oil and Grease Using a Deep Eutectic Solvent: Characterization, Thermal Properties, and Blend Performance.

As part of local sustainability efforts, biodiesel was synthesized via transesterification using a deep eutectic solvent (DES) without further washing from on-campus, dining facility waste cooking oil and grease. Before moving forward with repurposing used DES as a solvent in chemistry teaching labs, we determined the suitability of the biodiesel as an alternative fuel blended with diesel to power campus utility vehicles. Biodiesel components were characterized by gas chromatography-mass spectrometry (GC-MS), Fourier transform infrared spectroscopy (FTIR), nuclear magnetic resonance spectroscopy (1H NMR), viscometer, differential scanning calorimetry (DSC), and evolved gas analysis during pyrolysis with a thermogravimetric analyzer coupled with FTIR (TGA-FTIR). The four major components of fatty acid methyl esters (FAMEs) in the biodiesel were methyl oleate, methyl linoleate, methyl palmitate, and methyl stearate. Kinematic viscosity over typical temperature ranges was within optimal values recommended by the American Biodiesel Standard (ASTM D6751), with a 30:70 biodiesel/diesel blend experimental viscosity of 3.43 cSt at 40 °C and a calculated viscosity of 10.13 cSt at 0 °C. The pure biodiesel's cold-temperature onset of crystal formation is -10.1 °C versus -16.4 °C for a 30:70 biodiesel/diesel blend. Pyrolysis indicates good thermal stability, however, with an increased CO2 evolution in the blended fuel at higher temperatures as compared to that in the pure biodiesel and the pure diesel. Combustion gas analysis indicates virtually complete combustion of the blended fuel to CO2 and H2O with only trace amounts of CO. Overall results indicate that the biodiesel synthesized using DES is a suitable fuel for campus utility vehicles in the local moderate temperature climate and affords increased local sustainability by using used DES repurposed in our chemistry teaching labs.

Learning Active Implementation Frameworks: the role of implementation teams in a case study from Pakistan.

In Pakistan, although coverage of Maternal, Newborn, and Child Health (MNCH) services has increased, the attributable disease burden remains high, indicating quality of these services remains suboptimal. To address this quality gap, challenges associated with the implementation of MNCH services will need to be addressed and effective use of the various MNCH guidelines will need to be supported, evaluated, and continuously improved. Even though the application of the field of implementation science and practice in the low- and middle-income settings has been limited, it is our belief, based on the experience described in this article that these competencies could enhance health professionals' ability to, not only successfully integrate MNCH guidelines into health systems, but to also support their effective and sustainable use. To address this capacity gap in Pakistan, the Health Services Academy, as a member of the World Health Organization's Human Reproduction Program (HRP) Alliance for Research Capacity Strengthening (RCS), has engaged, over the course of 16 months, in the 'Implementation for the Professional Learner Program' in 2019. This innovative implementation science and practice capacity-building program is developed and conducted by The World Health Organization (WHO) Collaborating Centre for Research Evidence for Sexual and Reproductive Health at the University of North Carolina at Chapel Hill (UNC). The initial cohort of this Program also included Palestine's West Bank, and Egypt. The objectives of this Program were to cultivate implementation science and practice competencies, and to support the development of national, community-based or institution-based implementation teams. The expected outcomes of this program included, further enhancement of the capacity of local health professionals in implementation science, systemic change and the effective use of innovations in practice at sub-national/regional levels.

Scleromyxedema histopathologically mimicking hypercellular fibrous papules (angiofibomas): Case report of an unusual histopathological presentation.

Scleromyxedema (SMX) is an inflammatory condition of unknown etiology strongly associated with monoclonal gammopathy. Classical histopathology of SMX is characterized with the triad of diffuse mucin deposits, increased amount of collagen, and presence of stellate fibroblasts. Herein, we report an unusual histopathological variant of SMX in a 41-year-old female with lesions of the nose histopathologically mimicking cellular angiofibromas. The dome-shaped papules were characterized by increased collagen bundles and fascicles of spindle cells. Widened vessels were seen at the periphery of the proliferation. Cells expressed CD68. Factor XIIIa was expressed only by dendritic cells. The mucin was highlighted with colloidal iron. In sum, we draw attention to this unusual variant of SMX, which should be suspected in a setting of multiple "angiofibromas/fibrous papules" on the face with presence of mucin.

Applicability of EULAR/ACR classification criteria for dermatomyositis to amyopathic disease.

BACKGROUND: Existing classification systems for idiopathic inflammatory myopathies (IIMs) fail to permit classification and/or diagnosis of amyopathic dermatomyositis (ADM) in patients. OBJECTIVE: In light of the new European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for IIM, we evaluated the likelihood of the skin variables included in the EULAR/ACR criteria (Gottron's sign, Gottron's papules, and heliotrope rash) to give a high probability of classifying patients with ADM. METHODS: This retrospective study evaluated 211 adult patients with dermatomyositis at the University of Pennsylvania. The EULAR/ACR criteria were used to determine the probability of classification for patients with ADM. RESULTS: Of patients with ADM, 73.7% would be classified as having a reasonable probability of dermatomyositis on the new EULAR/ACR criteria and 26.3% would not meet the suggested 55% minimum probability cutoff to be classified as having it on the basis of the EULAR/ACR criteria. LIMITATIONS: This study was conducted with a retrospective design at a tertiary academic medical center. CONCLUSIONS: The 3 skin variables included in the EULAR/ACR classification criteria for IIM improve on previous criteria but miss classifying some patients with ADM. It is important to consider additional variables such as skin biopsy results to encompass more of these patients and prevent the inclusion of any skin diseases mimicking ADM.

Human mesenchymal stem cells stimulate EaHy926 endothelial cell migration: combined proteomic and in vitro analysis of the influence of donor-donor variability.

Mesenchymal stem cells (MSCs) stimulate angiogenesis within a wound environment and this effect is mediated through paracrine interactions with the endothelial cells present. Here we report that human MSC-conditioned medium (n=3 donors) significantly increased EaHy-926 endothelial cell adhesion and cell migration, but that this stimulatory effect was markedly donor-dependent. MALDI-TOF/TOF mass spectrometry demonstrated that whilst collagen type I and fibronectin were secreted by all of the MSC cultures, the small leucine rich proteoglycan, decorin was secreted only by the MSC culture that was least effective upon EaHy-926 cells. These individual extracellular matrix components were then tested as culture substrata. EaHy-926 cell adherence was greatest on fibronectin-coated surfaces with least adherence on decorin-coated surfaces. Scratch wound assays were used to examine cell migration. EaHy-926 cell scratch wound closure was quickest on substrates of fibronectin and slowest on decorin. However, EaHy-926 cell migration was stimulated by the addition of MSC-conditioned medium irrespective of the types of culture substrates. These data suggest that whilst the MSC secretome may generally be considered angiogenic, the composition of the secretome is variable and this variation probably contributes to donor-donor differences in activity. Hence, screening and optimizing MSC secretomes will improve the clinical effectiveness of pro-angiogenic MSC-based therapies.

Greater occipital nerve excision for occipital neuralgia refractory to nerve decompression.

BACKGROUND: Patients who undergo occipital nerve decompression for treatment of migraine headaches due to occipital neuralgia have already exhausted medical options for treatment. When surgical decompression fails, it is unknown how best to help these patients. We examine our experience performing greater occipital nerve (GON) excision for pain relief in this select, refractory group of patients. METHODS: A retrospective chart review supplemented by a follow-up survey was performed on all patients under the care of the senior author who had undergone GON excision after failing occipital nerve decompression. Headache severity was measured by the migraine headache index (MHI) and disability by the migraine disability assessment. Success rate was considered the percentage of patients who experienced a 50% or greater reduction in MHI at final follow-up. RESULTS: Seventy-one of 108 patients responded to the follow-up survey and were included in the study. Average follow-up was 33 months. The success rate of surgery was 70.4%; 41% of patients showed a 90% or greater decrease in MHI. The MHI changed, on average, from 146 to 49, for an average reduction of 63% (P < 0.001). Migraine disability assessment scores decreased by an average of 49% (P < 0.001). Multivariate analysis revealed that a diagnosis of cervicogenic headache was associated with failure of surgery. The most common adverse effect was bothersome numbness or hypersensitivity in the denervated area, occurring in up to 31% of patients. CONCLUSIONS: Excision of the GON is a valid option for pain relief in patients with occipital headaches refractory to both medical treatment and surgical decompression. Potential risks include failure in patients with cervicogenic headache and hypersensitivity of the denervated area. To provide the best outcome to these patients who have failed all previous medical and surgical treatments, a multidisciplinary team approach remains critical.

Direct visualization of reversible switching of micropatterned polyelectrolyte brushes on gold surfaces using laser scanning confocal microscopy.

We apply confocal fluorescence microscopy for real time studies of reversible conformational changes of poly(methacryloyloxyethyl phosphate) (PMEP) brushes chemically grafted onto gold substrates. Oregon green 488 fluorophores chemically attached onto the PMEP polymers were used as reporters for probing the conformational changes. Use of a specially designed liquid flow microchamber allowed dynamic imaging of the brushes under varying environmental conditions. The fluorescence intensities exhibited fully reversible brightness changes on alternation of the solution in the chamber between water and KCl. This reversible quenching behavior is consistent with a conformational change between an extended and a collapsed brush configuration. The fluorescence quenching behavior of the brushes was found to be dependent on ion concentration as well as polymer grafting density and was caused by nonradiative energy transfer to the polymer scaffold and the gold substrate.