In-situ biosynthesized plant exudate gums­silver nanocomposites as corrosion inhibitors for mild steel in hydrochloric acid medium.

Natural gums due to availability, multifunctionality, and nontoxicity are multifaceted in application. In corrosion inhibition applications, their performance, in unmodified form is unsatisfactory because of high hydration rate, solubility issues, algal and microbial contamination, as well as thermal instability. This work attempts to enhance the inhibitive performance of Berlinia grandiflora (BEG) and cashew (CEG) exudate gums through various modification approaches. The potential of biogenic BEG and CEG gums-silver (Ag) nanocomposites (NCPs) for corrosion inhibition of mild steel in 1 M HCl is studied. The nanocomposites were characterized using the FTIR, UV-vis, and TEM techniques. The corrosion studies through the gravimetric and electrochemical (PDP, EIS, LPR, and EFM) analyses reveal moderate inhibition performance by the nanocomposites. Furthermore, the PDP results reveal that both inhibitors are mixed-type with maximum corrosion inhibition efficiencies (IEs) of 61.2 % and 54.2 % for BEG-Ag NCP and CEG-Ag NCP, respectively at an optimum concentration of 1.0 %. Modification of these inhibitors with iodide ion (KI) significantly increased the IE values to 90.1 % and 88.5 % for BEG-Ag NCP and CEG-Ag NCP at the same concentration. Surface observation of the uninhibited and inhibited steel samples using SEM/EDAX, 3D Surface profilometer, and AFM affirm that the modified nanocomposites are highly effective.

Quantitative flow ratio to predict long-term coronary artery bypass graft patency in patients with left main coronary artery disease.

PURPOSE: Fractional flow reserve (FFR) has been demonstrated in some studies to predict long-term coronary artery bypass graft (CABG) patency. Quantitative flow ratio (QFR) is an emerging technology which may predict FFR. In this study, we hypothesised that QFR would predict long-term CABG patency and that QFR would offer superior diagnostic performance to quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS). METHODS: A prospective study was performed on patients with left main coronary artery disease who were undergoing CABG. QFR, QCA and IVUS assessment was performed. Follow-up computed tomography coronary angiography and invasive coronary angiography was undertaken to assess graft patency. RESULTS: A total of 22 patients, comprising of 65 vessels were included in the analysis. At a median follow-up of 3.6 years post CABG (interquartile range, 2.3 to 4.8 years), 12 grafts (18.4%) were occluded. QFR was not statistically significantly higher in occluded grafts (0.81 ± 0.19 vs. 0.69 ± 0.21; P = 0.08). QFR demonstrated a discriminatory power to predict graft occlusion (area under the receiver operating characteristic curve, 0.70; 95% confidence interval [CI], 0.52 to 0.88; P = 0.03). At long-term follow-up, the risk of graft occlusion was higher in vessels with a QFR > 0.80 (58.6% vs. 17.0%; hazard ratio, 3.89; 95% CI, 1.05 to 14.42; P = 0.03 by log-rank test). QCA (minimum lumen diameter, lesion length, diameter stenosis) and IVUS (minimum lumen area, minimum lumen diameter, diameter stenosis) parameters were not predictive of long-term graft patency. CONCLUSIONS: QFR may predict long-term graft patency in patients undergoing CABG.

Hydrothermal biomass processing for green energy transition: insights derived from principal component analysis of international patents.

As efforts to achieve Net Zero are intensifying, there is a strong need to identify the technological positioning of green process innovations that can support the green energy transition. A veritable contender to support these efforts is the hydrothermal biomass processing technology. This process innovation comprises diverse techniques that can convert biomass substrates into valuable low-carbon fuels. Coordination across all available conversion approaches is encouraged to propel the application of those that consider the environmental and sustainability impacts. We assessed the innovation intensity for different techniques under this green process innovation through applying natural language processing and deployment of principal component analysis on patent data. We positioned our techniques within four distinctive groups (intense, dormant, emerging, and exploratory). In this way, we tracked which hydrothermal technique currently dominates international applications and which ones are gaining traction in the future.

Comparison of diagnostic performance between quantitative flow ratio, non-hyperemic pressure indices and fractional flow reserve.

BACKGROUND: Quantitative flow ratio (QFR) is an estimate of fractional flow reserve (FFR) and is derived from 3-dimensional quantitative coronary angiography. The DILEMMA score is an angiographic technique developed to predict FFR. Unlike other diastolic indices such as instantaneous wave-free ratio (iFR), diastolic pressure ratio (dPR) and dPR25-75, neither QFR nor DILEMMA score require pressure wires. This study sought to compare the diagnostic performance of QFR, diastolic indices and DILEMMA score to predict FFR. METHODS: Between January 2010 and December 2013, patients who underwent invasive coronary angiography and FFR assessments were retrospectively studied. iFR and dPR were derived from FFR pressure tracings. QFR was computed using commercial software. RESULTS: Eighty-five lesions (25% FFR significant) were included in this study. Median FFR was 0.88 (0.81-0.92). QFR (rs=0.801), iFR (rs=0.710), dPR (rs=0.716), dPR25-75 (rs=0.715) and DILEMMA score (rs=-0.623) significantly correlated with FFR (P<0.001). QFR ≤0.8 had a specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of 95%, 86%, 86% and 95% respectively of predicting significant FFR (P<0.001). Receiver-operating characteristic (ROC) analysis revealed the AUC to predict significant FFR for QFR (0.947), iFR (0.880), dPR (0.883), dPR25-75 (0.880) and DILEMMA score (0.916) were not significantly different. However, QFR was a better predictor of FFR than iFR (0.947 vs. 0.770, P<0.01). CONCLUSIONS: QFR had excellent correlation and accuracy as measured against FFR. When compared to other diastolic indices and DILEMMA score, QFR performed at least as well as the other indices. QFR predicts FFR better than it predicts iFR. QFR is a convenient tool to assess significance of coronary stenosis and a reliable alternative to pressure-wire based indices. Prospective studies are required to investigate the performance and cost-effectiveness of QFR when independently used to guide clinical decision making.

Angiographic Functional Scoring of Coronary Artery Disease Predicts Mortality in Patients With Severe Aortic Stenosis Undergoing TAVR.

BACKGROUND/PURPOSE: Coronary artery disease (CAD) is common in patients undergoing transcatheter aortic valve replacement (TAVR), although its prognostic significance is questionable. Significant CAD stratified using SYNTAX score (SS) has been associated with greater mortality, yet it is unknown whether the functional impact of CAD also impacts outcomes in this cohort. DILEMMA score (DS) is a validated angiographic functional scoring tool that correlates with fractional flow reserve and instantaneous wave-free ratio. This study sought to assess the functional impact of CAD on outcomes in patients undergoing TAVR for severe aortic stenosis (AS). METHODS/MATERIALS: 229 patients were included in this analysis. Patients underwent angiographic DS and SS and were classified using predefined values. The primary endpoint was one-year all-cause mortality, with secondary endpoints of 30-day major adverse cardiac and cerebrovascular events (MACCE). RESULTS: The mean age was 83.9 ± 0.5 years (55.0% female), with 11.8% all-cause mortality. CAD defined by ≥30% stenosis in any vessel was not associated with adverse outcomes (HR = 1.08, p = 0.84). However, the risk of one-year mortality was greater in patients with either SS > 9 (20.8% vs. 9.4%, HR 2.34, p = 0.03) or DS > 2 (18.4% vs. 8.5%, HR = 2.28, p = 0.03). Both scoring systems were also associated with 30-day MACCE (both p < 0.05). After multivariate adjustment, independent predictors of one-year mortality were DS > 2 (HR = 2.29, p = 0.04), left ventricular ejection fraction <50% (HR 2.66, p = 0.04) and COPD (HR 2.43, p = 0.04). CONCLUSION: Our results demonstrate that angiographic functional scoring is independently predictive of both 12-month mortality and 30-day MACCE following TAVR.

Evidence mapping of interactions on concomitant use of Chinese medicine and platinum-based chemotherapy: a scoping review protocol.

BACKGROUND: The utilization of Chinese herbal medicine (CHM) has gained popularity and acceptance worldwide. Increasing use of CHM either as a stand-alone or an adjunctive treatment for cancers has given rise to increasing concern on potential herbal-drug reactions. Possible combinatory effects are important to be explored in evaluating the rationality of integrating CHM and chemotherapy in clinical practice. This study aims to update the current knowledge on herbal-drug interactions (HDI) of the commonly used platinum-based chemotherapy (PtC) in cancer patients. METHODS: Systemic searches will perform on online databases (English and Chinese) to identify papers from inception until December 2019 for inclusion into the review. The search strategy will be following PRISMA Scoping Reviews Checklist as a quality assurance step. All records retrieved will be screened by 2 independent reviewers. The preclinical studies and clinical studies that involve in assessing the concurrent use of CHM and PtC will be considered. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses will be used as scoping review framework. DISCUSSION: This scoping review will explore the compatibility or combination rule of CHM-PtC and assist in understanding HDI in CHM-PtC co-treatment. Identification of active properties in CHM's HDI and understanding pharmacokinetics and pharmacodynamic of the CHM alone or as co-treatment are essential for patients' safety profile. It will provide a new insight for future practice in cancer treatment. STUDY REGISTRATION: This protocol has been registered in the Research Register (https://www.researchregistry.com/) with an unique registration number: reviewregistry790.

Tunable plasmonic effects arising from metal-dielectric nanorods.

We have investigated the plasmonic effects in a two-dimensional periodic array of metallodielectric nanorods with and without the rotational angle, in which the integration of the localized surface plasmon resonance (SPR) and hollow plasmon resonance (HPR) properties is performed. Four patterns of nanostructures are investigated. We make use of the three-dimensional finite element method to obtain the simulation results, which demonstrate that the localized SPR and HPR in metallodielectric nanorods enhance the near-field intensity and increase the depth of the transmittance dip, providing an additional degree of freedom in the control of the light wave at the nanoscale. Numerical results show that the depth of the transmittance dip and sensitivity of case 1 and case 2 can be elevated to a value of 83.21% and 6.7 times, respectively, when the rotational angle of metal-dielectric nanorods varies from 0° to 90°. The sensitivity of case 3 and case 4 can be raised to the magnitude of 700-1091 nm/RIU (where RIU is the refractive index unit), and the characteristics enable the extensive applications for nanophotonic devices with high performance in a predictable manner.

Effects of herbal medicine for xerostomia in head and neck cancer patients: an observational study in a tertiary cancer hospital.

PURPOSE: More than 80% head and neck cancer patients endured radiotherapy-induced xerostomia which impacts their quality of life (QoL). This observational study evaluated the effect of herbal treatment on head and neck cancer patients' xerostomia and QoL. METHODS: Head and neck cancer patients were recruited from July 2016 till March 2017 at National Cancer Institute, Ministry of Health, Malaysia. All study participants continued their standard oncology surveillance. Treatment group participants additionally received Chinese herbal treatment. The assessments included unstimulated salivary flow rate (USFR), stimulated salivary flow rate (SSFR), and QoL questionnaire. RESULTS: Of 42 recruited participants, 28 were in the treatment group and 14 were in the control group. Participants were mainly Chinese (71.4%), stage III cancer (40.5%), and had nasopharynx cancer (76.2%). The commonly used single herbs were Wu Mei, San Qi, and Tian Hua Fen. Sha Shen Mai Dong Tang, Liu Wei Di Huang Wan, and Gan Lu Yin were the frequently prescribed herbal formulas. The baseline characteristics, USFR, SSFR, and QoL between control and treatment groups were comparable (p > 0.05). USFR between control and treatment groups were similar throughout the 6-month study period. SSFR for the treatment group significantly improved from 0.15 ± 0.28 ml/min (baseline) to 0.32 ± 0.22 ml/min (p = 0.04; at the 3rd month) and subsequently achieved 0.46 ± 0.23 ml/min (p = 0.001; at the 6th month). The treatment group had better QoL in terms of speech (p = 0.005), eating (p = 0.02), and head and neck pain (p = 0.04) at the 6th month. CONCLUSION: Herbal treatment may improve xerostomia and QoL in post-radiotherapy head and cancer patients.

A systematic review on Chinese herbal treatment for radiotherapy-induced xerostomia in head and neck cancer patients.

BACKGROUND: Over 80% of head and neck cancer patients suffer from radiotherapy-induced xerostomia (dry mouth). Xerostomia affects cancer patients' quality of life, and xerostomia sometimes persists throughout the patients' lifetime. This review aimed to evaluate the effectiveness and safety of Chinese herbs in relieving radiotherapy induced xerostomia. METHODS: Systematic searches were conducted on 6 databases (English and Chinese). Studies published up till May 2017 were considered for inclusion. RESULTS: A final 14 RCTs (total 994 head and neck cancer patients undergoing radiotherapy) compared Chinese herbs with no herbs, were included in analysis. Very low to moderate quality of evidence found Chinese herbal treatment may relief radiotherapy-induced xerostomia and other related complications (such as oral mucositis and loss of appetite) in head and neck cancer patients. CONCLUSION: There is limited evidence that Chinese herbal treatment may relief radiotherapy-induced xerostomia and other related complications in head and neck cancer patients.

Tunable Optical Performances on a Periodic Array of Plasmonic Bowtie Nanoantennas with Hollow Cavities.

We propose a design method to tune the near-field intensities and absorption spectra of a periodic array of plasmonic bowtie nanoantennas (PBNAs) by introducing the hollow cavities inside the metal nanostructures. The numerical method is performed by finite element method that demonstrates the engineered hollow PBNAs can tune the optical spectrum in the range of 400-3000 nm. Simulation results show the hollow number is a key factor for enhancing the cavity plasmon resonance with respect to the hotspot region in PBNAs. The design efforts primarily concentrate on shifting the operation wavelength and enhancing the local fields by manipulating the filling dielectric medium, outline film thickness, and hollow number in PBNAs. Such characteristics indicate that the proposed hollow PBNAs can be a potential candidate for plasmonic enhancers and absorbers in multifunctional opto-electronic biosensors.

Oral vancomycin desensitisation to treat Clostridium difficile infection in a vancomycin allergic patient.

The prevalence of Clostridium difficile infection (CDI) is increasing worldwide. Oral vancomycin is an effective and frequently used treatment. However, patients with CDI who are allergic to intravenous vancomycin cannot receive oral vancomycin due to the risk of anaphylaxis if given the oral form.We present a case where oral vancomycin desensitisation was used to successfully treat a vancomycin allergic patient with recurrent CDI.

Load-dependent assembly of the bacterial flagellar motor.

UNLABELLED: It is becoming clear that the bacterial flagellar motor output is important not only for bacterial locomotion but also for mediating the transition from liquid to surface living. The output of the flagellar motor changes with the mechanical load placed on it by the external environment: at a higher load, the motor runs more slowly and produces higher torque. Here we show that the number of torque-generating units bound to the flagellar motor also depends on the external mechanical load, with fewer stators at lower loads. Stalled motors contained at least as many stators as rotating motors at high load, indicating that rotation is unnecessary for stator binding. Mutant stators incapable of generating torque could not be detected around the motor. We speculate that a component of the bacterial flagellar motor senses external load and mediates the strength of stator binding to the rest of the motor. IMPORTANCE: The transition between liquid living and surface living is important in the life cycles of many bacteria. In this paper, we describe how the flagellar motor, used by bacteria for locomotion through liquid media and across solid surfaces, is capable of adjusting the number of bound stator units to better suit the external load conditions. By stalling motors using external magnetic fields, we also show that rotation is not required for maintenance of stators around the motor; instead, torque production is the essential factor for motor stability. These new results, in addition to previous data, lead us to hypothesize that the motor stators function as mechanosensors as well as functioning as torque-generating units.

Woman with chest pain and shortness of breath since age 18.

We present an interesting case of a 38-year-old woman who presented with a history of left-sided chest pain, dyspnoea and palpitations. The symptoms have been occurring since age 18, and were previously diagnosed as costochondritis. Because of the suspicious history, the patient underwent further cardiac investigations. The echocardiogram demonstrated an abnormal structure adjacent to the aortic valve. A diagnostic coronary angiogram revealed a large left circumflex artery fistulating into the right atrium. Surgery was performed to ligate the fistula. The patient recovered well and has been asymptomatic since.