Novel Composite Planks Made of Shape Memory Polyurethane Foaming Material with Two-Step Foaming Process.

In this study, shape memory polyurethane (SMP) foaming material is used as the main material that is incorporated with carbon fiber woven fabrics via two-step foaming method, forming sandwich-structured composite planks. The process is simple and efficient and facilitates any composition as required. The emphasis of this study is protection performances, involving puncture resistance, buffer absorption, and electromagnetic wave shielding effectiveness. The proposed soft PU foam composite planks consist of the top and bottom PU foam layers and an interlayer of carbon fiber woven fabric. Meanwhile, PU foam is incorporated with carbon staple fibers and an aluminized PET film for reinforcement requirements and electromagnetic wave shielding effectiveness, respectively. Based on the test results, the two-step foaming process can provide the PU foam composite planks with excellent buffer absorption, puncture resistance, and electromagnetic wave shielding effectiveness; therefore, the proposed composite planks contribute a novel structure composition to SMP, enabling it to be used as a protective composite. In addition, the composites contain conductive material and thus exhibit a greater diversity of functions.

Chronic Kidney Disease as A Potential Risk Factor for Uveitis: A 13-Year Nationwide Population-Based Cohort Study in Taiwan.

PURPOSE: To investigate whether patients with chronic kidney disease (CKD) are at increased risk of uveitis. METHODS: Data was collected from the Taiwan National Health Insurance system and included patients newly diagnosed with CKD between 2000 and 2012. The endpoint of interest was a diagnosis of uveitis. RESULTS: 30,256 CKD patients and 121,024 matched comparisons were analyzed. CKD patients were found to have a significantly higher cumulative uveitis incidence. Through multivariate Cox regression analysis, the CKD group was found to have higher risk of developing uveitis (adjusted hazard ratio 1.51). After stratified by gender, age, and comorbidities (hypertension, diabetes, and hyperlipidemia), the increased risk of uveitis in CKD patients remained significant. CONCLUSIONS: Patients with CKD were found to have higher risk of developing uveitis. For patients over 18 years old and with hypertension, diabetes, or hyperlipidemia, the presence of CKD was demonstrated as an additional crucial factor for uveitis development.

Effects of Leisure Obstacles, Job Satisfaction, and Physical and Mental Health on Job Intentions of Medical Workers Exposed to COVID-19 Infection Risk and Workplace Stress.

The purpose of this study was to investigate the effects of leisure obstacles, job satisfaction, physical and mental health, and work intentions of medical workers in Taiwan. SPSS 26.0 and AMOS 24.0 statistical software were used to analyze 208 questionnaires by basic statistical tests, t-tests, and structural model analysis. Results: Under the epidemic, medical workers were unable to develop job identity due to low promotion opportunities and low job achievement. The lack of recreational exercise skills, time, and information created leisure obstacles. In addition, they were unable to express their true selves freely at work, which led to health problems such as reduced enthusiasm, mental weakness, and emotional irritability. In particular, female medical workers felt more strongly about the issues of leisure obstacles and the intention to stay in their jobs. The study found that the higher their job satisfaction, the higher their intention to stay in the job, while the more pronounced the leisure obstacles and physical and mental health problems, the more pronounced their intention to leave.

Under the COVID-19 Environment, Will Tourism Decision Making, Environmental Risks, and Epidemic Prevention Attitudes Affect the People's Firm Belief in Participating in Leisure Tourism Activities?

The study was conducted to understand the travel intentions of Dajia Matsu pilgrimage participants through tourism decision making, environmental risk perception, epidemic prevention attitude, and physical and mental health assessment. A questionnaire survey was used to collect 230 questionnaires in the field during the 2021 pilgrimage, and structural analysis was conducted using SPSS 26.0 and AMOS 20.0 statistical programs. The results showed that environmental risk and physical and mental health awareness were not significantly associated with the travel intention of Dajia Matsu pilgrimage participants (p > 0.05), while travel decision and attitude toward epidemic prevention were significantly associated with travel intention (p < 0.05).

Biodegradable Polyvinyl Alcohol Vascular Stents: Structural Model and Mechanical and Biological Property Evaluation.

This study proposes structural models of biodegradable vascular stents. One, two, or three plies of biodegradable polyvinyl alcohol (PVA) yarns are combined and twisted with twist factors of 2, 3, 4, 5, and 6 to form one-, two-, and three-ply PVA twisted yarns. The braided, warp-knitted, and weft-knitted PVA vascular stents are composed of PVA twisted yarns by using a braider, a warp knitting machine, and a weft knitting machine. The formation and mechanical properties of PVA vascular stents are evaluated, and the biological properties are examined in terms of biocompatibility through in vitro assay and subcutaneous embedding using in vivo assay. Test results indicate that the compression strength of PVA vascular stents is improved when using PVA twisted yarns containing a high number of plies and twist factor. Specifically, weft-knitted PVA vascular stents exhibit the optimal compression strength. PVA vascular stents treated with chemical cross-linking show weight loss lower than 3% after immersion in PBS solution for 30 days. Moreover, the antibacterial test and cell culture results suggest that PVA vascular stents are nontoxic and biocompatible. Subcutaneous embedding results show that PVA vascular stents retain intact formation when subcutaneously embedded in vivo for 28 days, indicating their good biological property. PVA vascular stents are suitable candidates for tissue engineering applications.

Verification of enzymes deterioration due to Cu(II) presence in an enhanced biological phosphorus removal system.

This study experimentally demonstrated that polyphosphate accumulating organisms (PAOs) losing the abilities of anaerobically synthesizing polyhydroxyalkanoates and aerobically taking up phosphate under Cu(II) presence was due to the inhibition of enzyme activities of acetyl-CoA synthases (ACS) and polyphosphate kinase (PPK), respectively. ACS activity tests showed the apparent maximum specific activity (Vmax) of ACS decreased with increasing Cu(II) concentration, revealing Cu(II) is a mixed inhibitor for ACS. Inhibition coefficients showed Cu(II) has a higher affinity for free ACS than for ACS-coenzyme A complex. PPK activity tests showed the Vmax substantially decreased with increasing Cu(II) concentration, revealing Cu(II) is also a mixed inhibitor for PPK. Inhibition coefficients showed Cu(II) more easily bound to free PPK than to PPK-Adenosine triphosphate complex. Experimental data also showed the aerobic mechanism of PAOs taking up phosphate was completely interrupted when 3mgL(-1) of Cu(II) was added.

ß2-glycoprotein I inhibits VEGF-induced endothelial cell growth and migration via suppressing phosphorylation of VEGFR2, ERK1/2, and Akt.

ß(2)-glycoprotein I (ß(2)-GPI) is a plasma glycoprotein with diverse functions, but the impact and molecular effects of ß(2)-GPI on vascular biology are as yet unclear. Based on the limited information available on the contribution of ß(2)-GPI to endothelial cells, we investigated the effect of ß(2)-GPI on cell growth and migration in human aortic endothelial cells (HAECs). The regulation of ß(2)-GPI as part of intracellular signaling in HAECs was also examined. Vascular endothelial growth factor (VEGF) is a pro-angiogenic factor that may regulate endothelial functions. We found that ß(2)-GPI dose-dependently inhibited VEGF-induced endothelial cell growth using the 3-(4,5-dimethylthiazol-2-yl)-2,5-dipenyl tetrazolium bromide assay and cell counts. Using wound healing and Boyden chamber assays, ß(2)-GPI remarkably reduced VEGF-increased cell migration at the physiological concentration. Furthermore, ß(2)-GPI suppressed VEGF-induced phosphorylation of VEGF receptor 2 (VEGFR2), extracellular signal-regulated kinase 1/2 (ERK1/2), and Akt. These results suggest that ß(2)-GPI plays an essential role in the down-regulation of VEGF-induced endothelial responses and may be a useful component for anti-angiogenic therapy.

Intraperitoneal rupture of mature cystic ovarian teratoma secondary to sit-ups.

A case of general peritonitis caused by sudden perforation of a mature cystic ovarian teratoma is presented. The clinical course consisted of progressive abdominal tenderness after a 1600-m run and 12 subsequent sit-ups. An exploratory laparotomy revealed massive ascites and a 10-cm linear perforation over the dome of the tumor, probably caused by a sharp elevation of intra-abdominal pressure generated during the sit-ups. Neither peritoneal granulomatous reaction nor inflammatory adhesions to adjacent bowel loops were found. A search of the English literature did not reveal any similar case.

Early laparoscopy for ileocolic intussusception with multiple recurrences in children.

BACKGROUND: The risks of subsequent episodes and a lead point are common problems in ileocolic intussusception with more than two recurrences. To decrease subsequent recurrence and to detect a lead point, an early laparoscopy was performed for children with ileocolic intussusception. METHODS: This study enrolled six children with multiple recurrences of ileocolic intussusception from January 2004 to August 2007. Using a 5-mm laparoscope and two additional transabdominal wall stab incisions, an appendectomy and an ileocolonic pixie with nonabsorbable sutures were performed simultaneously for all the children after the last successful hydrostatic reduction. RESULTS: The mean operating time was 68.8 +/- 12.6 min (range, 55-86 min). There was no operative morbidity, and no lead point was found in any child. The mean follow-up period was 10.8 +/- 6.7 months (range, 2-20 months). No recurrence was observed during this period. CONCLUSION: The authors suggest that early intervention should be undertaken for ileocolic intussusception with multiple recurrences in children after the last nonsurgical reduction has been attempted successfully. Under this strategy, laparoscopy is an acceptable approach. It allows differentiation of a specific etiologic lesion, the possibility of incomplete reduction, and additional proximal invaginations. Later complications, such as repeat recurrence and associated surgical morbidity, also can be avoided.

A pilot study of subclinical coronary atherosclerosis in systemic sclerosis: coronary artery calcification in cases and controls.

OBJECTIVE: Systemic sclerosis (SSc) is associated with vasculopathy and endothelial cell injury, which could potentially increase the risk of coronary atherosclerosis. Multidetector computed tomography, a noninvasive procedure, generates a coronary calcium score (CCS) as a marker for coronary atherosclerosis. Serum proinflammatory high-density lipoprotein (piHDL) is a potential novel marker of atherosclerotic risk. The objective of the pilot study was to determine 1) the prevalence of subclinical coronary atherosclerosis in SSc and 2) serum piHDL levels as a potential novel marker of atherosclerotic risk in SSc. METHODS: A cross-sectional study of 17 patients with SSc and 17 age-, sex-, and race-matched healthy controls in Cincinnati, Ohio, was conducted. Measurements included CCS; body mass index; lipid profile; and serum levels of high-sensitivity C-reactive protein, homocysteine, and piHDL. RESULTS: Patients with SSc were slightly older (mean 52.8 years) than control subjects (mean 50.6 years; P = 0.01). Coronary calcium was found in 12 participants (9 with SSc, 3 controls; P = 0.03). The mean +/- SD CCS in patients with SSc was significantly greater than the controls (126.6 +/- 251.0 versus 14.7 +/- 52.2; P = 0.003). Five patients with SSc (29%), but no controls, had detectable levels of piHDL (P = 0.06). CONCLUSION: Prevalence of subclinical coronary atherosclerosis is greater in patients with SSc compared with healthy controls. These findings should be confirmed in a larger study.

TNFalpha blockade in human diseases: mechanisms and future directions.

Tumor necrosis factor-alpha (TNFalpha) antagonists have shown remarkable efficacy in a variety of immune-mediated inflammatory diseases (IMIDs). Therapeutic scope and limitations of these agents are reviewed in a recently published article in the Journal. In spite of their therapeutic popularity, little is known about their modes of action in vivo and factors that limit their scope of therapeutic use. Intriguingly, while all TNFalpha antagonists including blocking antibodies and soluble receptors are effective in certain IMIDs, only anti-TNFalpha antibodies are effective in other IMIDs. Early efforts at understanding how TNFalpha antagonists act in IMIDs centered on their ability to neutralize soluble TNFalpha or to block TNF receptors from binding to their ligands. Subsequent studies suggested a role of complement-mediated lysis or antibody-dependent cell cytotoxicity in their therapeutic effects. More recent models postulate that TNFalpha blockers may act by affecting intracellular signaling, with the end result being a hastened cell cycle arrest, apoptosis, suppression of cytokine production, or improved Treg cell function. TNFalpha antagonists can also modulate the functions of myofibroblasts and osteoclasts, which might explain how TNFalpha antagonists reduce tissue damage in chronic IMIDs. Focusing on the human therapeutic experience, this analytical review will review the biology of mechanisms of action, the limiting factors contributing to disease restriction in therapeutic efficacy, and the mechanism and frequency of treatment-limiting adverse responses of TNFalpha antagonists. It is hoped that the overview will address the needs of clinicians to decide on optimal use, spur clinical innovation, and incite translational researchers to set priorities for in vivo human investigations.

TNFalpha blockade in human diseases: an overview of efficacy and safety.

Tumor necrosis factor-alpha (TNFalpha) antagonists including antibodies and soluble receptors have shown remarkable efficacy in various immune-mediated inflammatory diseases (IMID). As experience with these agents has matured, there is an emerging need to integrate and critically assess the utility of these agents across disease states and clinical sub-specialties. Their remarkable efficacy in reducing chronic damage in Crohn's disease and rheumatoid arthritis has led many investigators to propose a new, 'top down' paradigm for treating patients initially with aggressive regimens to quickly control disease. Intriguingly, in diseases such as rheumatoid arthritis and asthma, anti-TNFalpha agents appear to more profoundly benefit patients with more chronic stages of disease but have a relatively weaker or little effect in early disease. While the spectrum of therapeutic efficacy of TNFalpha antagonists widens to include diseases such as recalcitrant uveitis and vasculitis, these agents have failed or even exacerbated diseases such as heart failure and multiple sclerosis. Increasing use of these agents has also led to recognition of new toxicities as well as to understanding of their excellent long-term tolerability. Disconcertingly, new cases of active tuberculosis still occur in patients treated with all TNFalpha antagonists due to lack of compliance with recommendations to prevent reactivation of latent tuberculosis infection. These safety issues as well as guidelines to prevent treatment-associated complications are reviewed in detail in this article. New data on mechanisms of action and development of newer TNFalpha antagonists are discussed in a subsequent article in the Journal. It is hoped that these two review articles will stimulate a fresh assessment of the priorities for research and clinical innovation to improve and extend therapeutic use and safety of TNFalpha antagonism.

Human tail and myelomeningocele.

The human tail is rarely reported and is usually associated with underlying spina bifida occulta. A male newborn presenting a caudal appendage (human tail) with skin-covered myelomeningocele and tethered cord is described. Surgical excision of the human tail and repair of the myelomeningocele were performed 3 days after birth. After the operation, the patient had an uneventful convalescence and received follow-up at our outpatient clinic without any neurological sequelae. To our knowledge, no similar case report exists in the literature. Like other skin-related lesions in the lumbosacral area, the present case of caudal appendage with myelomeningocele is only a cutaneous sign of underlying spinal dysraphism since the skin and nerve system are related by their similar ectodermal origin. After excision of the tail and repair of an underlying lesion, long-term follow-up of the neurological status is warranted.

Facial nerve conduction after sclerotherapy in children with facial lymphatic malformations: report of two cases.

Surgical excision is thought to be the standard treatment of choice for lymphatic malformations. However, when the lesions are limited to the face only, surgical scar and facial nerve injury may impair cosmetics and facial expression. Sclerotherapy, an injection of a sclerosing agent directly through the skin into a lesion, is an alternative method. By evaluating facial nerve conduction, we observed the long-term effect of facial lymphatic malformations after intralesional injection of OK-432 and correlated the findings with anatomic outcomes. One 12-year-old boy with a lesion over the right-side preauricular area adjacent to the main trunk of facial nerve and the other 5-year-old boy with a lesion in the left-sided cheek involving the buccinator muscle were enrolled. The follow-up data of more than one year, including clinical appearance, computed tomography (CT) scan and facial nerve evaluation were collected. The facial nerve conduction study was normal in both cases. Blink reflex in both children revealed normal results as well. Complete resolution was noted on outward appearance and CT scan. The neurophysiologic data were compatible with good anatomic and functional outcomes. Our report suggests that the inflammatory reaction of OK-432 did not interfere with adjacent facial nerve conduction.

Red umbilicus as a clinical manifestation in a 19-month-old girl with typhoid colonic perforation.

Redness of the umbilicus is usually considered to be a reliable sign of underlying gangrenous bowel or peritonitis in tiny infants but seldom among non-neonatal patients. We report a 19-month-old girl with final diagnosis of typhoid colonic perforation who initially presented with abdominal distention and umbilical erythema on arrival at our emergency department. The redness of umbilicus diminished gradually after laparotomy. Thin abdominal wall, severe intra-abdominal soiling, and polymicrobial infection accounted for the inflammatory process spreading to the skin of the umbilicus. Because of its rarity beyond the neonatal period, prompt diagnosis depends on maintaining a high index of suspicion when the abdomen is distended and suddenly tender to palpation.

Leptin augments myofibroblastic conversion and fibrogenic activity of human peritoneal mesothelial cells: a functional implication for peritoneal fibrosis.

BACKGROUND: Myofibroblastic conversion of mesothelial cells is proposed to play an important role in pathological changes following serosal membrane injury. METHODS: Human peritoneal mesothelial cells (HPMCs) were isolated and maintained in culture. The gene expression was assessed by RT-PCR. Activation of signal transduction was determined by western blot and densitometry. Morphological changes were observed by phase-contrast and electron microscopy. RESULTS: In vitro study showed that TGF-beta1-induced myofibroblastic growth of HPMCs was significantly enhanced in the presence of leptin. Augmented expression of alpha-smooth muscle actin, fibronectin and type I collagen mRNA in HPMCs induced by leptin were TGF-beta1-dependent, suggesting that leptin promoted peritoneal fibrogenesis through synergistic activation of the TGF-beta1 signaling system. Leptin and TGF-beta1 synergistically augmented activation of signalling components of mitogen-activated protein kinase (MAPK), STAT3 and Smad but did not modulate the expression of LEPR-B. CONCLUSION: Leptin may act as a profibrogenic TGF-beta1 activated cytokine in peritoneal bioenvironment associated with TGF-beta1 activated pathogenic processes.

Spontaneous perforation of Meckel's diverticulum without peritonitis in a newborn: report of a case.

A case of a newborn male with a perforation of Meckel's diverticulum is reported. The clinical course consisted of progressive abdominal distention and pneumoperitoneum that formed within 29 h after birth. The perforation of Meckel's diverticulum was not associated with peritonitis because meconium did not contaminate the abdominal cavity. The histology of the diverticulum showed a nearly intact muscular layer but a focal muscular defect. Neither any inflammatory phenomena nor ectopic mucosa was found. A congenital focal muscular defect of the diverticulum and a sudden elevation of intraluminal pressure due to bowel movement after birth may thus be the pathogenesis of a spontaneous perforation. A search of the English literature did not reveal any similar case.

Appendicitis in children younger than 3 years of age: an 18-year experience.

Appendicitis in children younger than 3 years of age has always been of concern due to its low incidence and high perforation rate. In this study, we analyzed our experience and evaluated the factors contributing to the delay in diagnosis. During the last 18 years, there were nine children younger than 3 years of age who presented with appendicitis. Four of these patients visited our emergency department within 48 hours after the onset of symptoms, while the symptoms had already persisted for more than 48 hours in the remaining five patients before their arrival in our emergency department. Perforated appendicitis was found in all children. Once the perforation had occurred for more than 2 days, complaints of fever, abdominal distention, and diarrhea were common. Compared to patients with symptoms for less than 2 days, those with symptoms for more than 2 days were younger and had higher serum C-reactive protein levels, significantly longer operation time, duration of postoperative ileus and length of hospital stay (LOS) (p = 0.026, 0.014, 0.018, and 0.014, respectively). No mortality was noted in the entire series, but seven of the nine patients had one or more complications, which may have prolonged LOS; anemia and wound infections were the two most common problems. Since delayed diagnosis is common, a thorough understanding of the clinical course of perforated appendicitis is important. Fever, diarrhea, and abdominal distention seem to be late manifestations. Prolonged LOS, operation time, and postoperative complications may be reduced if the operation is performed earlier.