Consistent and Transferable Force Fields for Statistical Copolymer Systems at the Mesoscale.

The statistical trajectory matching (STM) method was applied successfully to derive coarse grain (CG) models for bulk properties of homopolymers. The extension of the methodology for building CG models for statistical copolymer systems is much more challenging. We present here the strategy for developing CG models for styrene-butadiene-rubber, and we compare the quality of the resulting CG force fields on the structure and thermodynamics at different chemical compositions. The CG models are used through the use of a genuine mesoscopic method called the dissipative particle dynamics method and compared to high-resolution molecular dynamics simulations. We conclude that the STM method is able to produce coarse-grained potentials that are transferable in composition by using only a few reference systems. Additionally, this methodology can be applied on any copolymer system.

Live birth and multiple birth rates in US in vitro fertilization treatment using donor oocytes: a comparison of single-embryo transfer and double-embryo transfer.

OBJECTIVE: To compare live birth rates (LBRs) and multiple birth rates (MBRs) between elective single-embryo transfer (eSET) and double-embryo transfer (DET) in donor oocyte in vitro fertilization (IVF) treatments in both a cycle-level and clinic-level analysis. METHODS: Donor oocyte IVF treatments performed by US IVF clinics reporting to the Centers for Disease Control and Prevention in 2013-2014 were included in the analysis. Primary outcomes included LBR and MBR. Secondary outcomes included gestational age at delivery (GA) and birth weight (BW) of offspring. These outcomes were evaluated on an individual cycle level as well as on the clinic level. RESULTS: In multivariable models, LBR did not change significantly as clinics utilized eSET more frequently. MBR decreased significantly as utilization of eSET increased, from 39% MBR in clinics that utilized eSET 0-9% of the time to 7% MBR in clinics that used eSET 70% of the time (P < .0001). Mean BW and GA of IVF-conceived offspring both increased as clinics utilized eSET more frequently (2778 to 3185 g [P < .0001] and 37.5 to 38.5 weeks [P = .02] for clinics with the lowest and highest eSET utilization, respectively). CONCLUSIONS: US IVF clinics utilizing eSET with higher frequencies have clinically comparable LBRs and significantly lower MBRs than clinics with lower-frequency eSET utilization. Mean offspring BW and GA increased with higher eSET utilization, further confirming the improved safety of this practice.

Functional outcome after transphyseal anterior cruciate ligament reconstruction in young patients with open growth plates.

BACKGROUND: This study evaluates sports ability, rotational laxity and potential growth changes in children after transphyseal ACL reconstruction with metaphyseal fixation technique, considering physis biology by placing drill holes vertically in the femoral anatomic origin in order to reduce volumetric injury to the physis. METHODS: In this retrospective trial of 42 patients data were collected. Thirty-seven were reviewed measuring rotational laxity and anteroposterior tibial translation using the Laxitester (ORTEMA Sport Protection, Markgroeningen, Germany) and the KT1000. Clinical examination was evaluated with the IKDC 2000 knee examination form. Leg axis was determined with digital photography and leg length was assessed clinically. Sports ability was assessed with questionnaires including subjective IKDC, Tegner Activity Scale, Activity Rating Scale and a questionnaire on sports and level of sports. RESULTS: Mean follow-up was 24.9months. Mean age at surgery was 13.2years in boys and 13.1years in girls. IKDC 2000 grading was A or B in 28 patients and C in nine patients. Significant increased anterior tibial translation was observed in neutral position and in external tibia rotation. No growth abnormalities were seen. Fifty-seven percent of the patients were able to participate in competitive sports at follow-up. CONCLUSION: Transphyseal ACL reconstruction with metaphyseal fixation in children with open growth plates can be done with low risk of growth changes. Return to competitive sports is possible although low rotational laxity still exists. LEVEL OF EVIDENCE: IV.

Characterization of direct and indirect cerebral revascularization for the treatment of European patients with moyamoya disease.

BACKGROUND: The best revascularization strategy for moyamoya disease (MMD) remains unknown. Our aim was to characterize angiographic revascularization effects of a bilateral standardized revascularization approach, consisting of superficial temporal artery (STA)-middle cerebral artery (MCA) bypass and encephalomyosynangiosis (EMS) on one hemisphere and single EMS on the contralateral hemisphere of each patient, and to compare the effects of both revascularization strategies on cerebral hemodynamics. METHODS: In 30 patients (18 females/12 males, age 8-63 years), standardized revascularization was performed. Digital subtraction angiography was performed preoperatively and at 7 days, 6 months and 12 months postoperatively. STA-MCA and EMS functions were graded I (poor), II (medium) or III (extensive) according to angiographic aspects. In 20 patients, cerebrovascular reserve capacity (CVRC) was assessed pre- and postoperatively (at 12 months) using xenon CT. RESULTS: After 12 months, STA-MCA/EMS function was grade 1 in 40/40%, grade 2 in 27/26%, and grade 3 in 27/10% of hemispheres, respectively. Twelve months after surgery, single EMS showed grade I in 37%, grade II in 27%, and grade III in 20% of hemispheres. Combined revascularization improved CVRC significantly compared to preoperative measurement (preoperative: 16.5 ± 34.6% vs. postoperative: 60.8 ± 64.22%; p < 0.05). Single EMS did not improve CVRC significantly (preoperative: 21.8 ± 35.9% vs. postoperative: 34.8 ± 63.0%; p < 0.05). CONCLUSIONS: Combined and indirect revascularization may be successfully applied in a bilateral standardized approach. STA-MCA/EMS is superior to single EMS in restoring CVRC in adult MMD patients.

Optimum contracted-for water supply for hotels in arid coastal regions.

Hotels in arid coastal areas use mainly desalinated water for their domestic water demands, and treated wastewater for irrigating green areas. Private water companies supply these hotels with their domestic water needs. There is normally a contractual agreement stating a minimum requirement that has to be supplied by the water company and that the hotel management has to pay for regardless of its actual consumption ("contracted-for water supply"). This paper describes a model to determine what value a hotel should choose for its contracted-for water supply in order to minimize its total annual water costs. An example from an arid coastal tourism-dominated city is presented: Sharm El Sheikh, Egypt.The managers of hotels with expected high occupancy rates (74% and above) can contract for more than 80%. On the other hand, hotels with expected lower occupancy rates (60% and less) can contract for less than 70% of the peak daily domestic water demand. With a green area ratio of 40 m(2)/room or less, an on-site wastewater treatment plant can satisfy the required irrigation demand for an occupancy rate as low as 42%. Increasing the ratio of green irrigated area to 100 m(2)/room does not affect the contracted-for water supply at occupancy rates above 72%; at lower occupancy rates, however, on-site treated wastewater is insufficient for irrigating the green areas. Increasing the green irrigated area to 120 m(2)/room increases the need for additional water, either from externally sourced treated wastewater or potable water. The cost of the former is much lower than the latter (0.58 versus 1.52 to 2.14 US$/m(3) in the case study area).

Tough, bio-inspired hybrid materials.

The notion of mimicking natural structures in the synthesis of new structural materials has generated enormous interest but has yielded few practical advances. Natural composites achieve strength and toughness through complex hierarchical designs that are extremely difficult to replicate synthetically. We emulate nature's toughening mechanisms by combining two ordinary compounds, aluminum oxide and polymethyl methacrylate, into ice-templated structures whose toughness can be more than 300 times (in energy terms) that of their constituents. The final product is a bulk hybrid ceramic-based material whose high yield strength and fracture toughness [ approximately 200 megapascals (MPa) and approximately 30 MPa.m(1/2)] represent specific properties comparable to those of aluminum alloys. These model materials can be used to identify the key microstructural features that should guide the synthesis of bio-inspired ceramic-based composites with unique strength and toughness.

Effects of the selective endothelin A (ET(A)) receptor antagonist Clazosentan on cerebral perfusion and cerebral oxygenation following severe subarachnoid hemorrhage - preliminary results from a randomized clinical series.

OBJECTIVE: To study the effects of clazosentan, a new selective endothelin receptor subtype A antagonist, on cerebral perfusion and cerebral oxygenation following severe aneurysmal subarachnoid haemorrhage (aSAH). METHODS: All 12 patients treated at our institution in the context of a phase IIa, multicenter, randomized trial on clazosentan's safety and efficacy in reducing the incidence of angiographic cerebral vasospasm were included in this substudy. The phase IIa study (n = 34) consisted of two parts: a double-blind, randomized Part A (clazosentan 0.2 mg/kg/h versus placebo) and an open-label Part B (clazosentan 0.4 mg/kg/h for 12 h followed by 0.2 mg/kg/h) for patients with established vasospasm. In parallel to the phase IIa study protocol, which included assessment of vasospasm by angiography and transcranial Doppler sonography, we determined regional cerebral blood flow (rCBF), cerebrovascular resistance, and regional tissue oxygenation. RESULTS: Cerebral perfusion was comparable between treatment groups during the early post-bleeding period (rCBF placebo, 22.6 +/- 3.5 ml/100 g/min versus rCBF clazosentan, 23.9 +/- 1.1 ml/100 g/min). By the time of control angiography (day 8 after aSAH), rCBF decreased by 50% in the placebo group (11.3 +/- 6.7 ml/ 100 g/min) while it remained stable in the clazosentan group (23.5 +/- 12.9 ml/100 g/min). During Part B of the study, all 3 patients who developed haemodynamically relevant vasospasm during placebo treatment, showed a sustained improvement in rCBF upon conversion to clazosentan. CONCLUSIONS: These preliminary data suggest that clazosentan reduces the extent of vasospasm-associated impairment of cerebral perfusion following aSAH. Furthermore, clazosentan may exert beneficial actions on overt vasospasm-associated hypoperfusion.

Evaluation of agricultural reuse practices and relevant guidelines for the alba rancho WWTP (primary and secondary facultative ponds) in Cochabamba, Bolivia.

Many cities in developing countries are experiencing high population growth, which is generating chaotic and unplanned development, reducing land areas available for agriculture, and polluting surface and groundwater. Consequently, the reuse of untreated or partially treated wastewater for agricultural irrigation is increasing in arid and semi-arid regions in developing countries. Cochabamba city in Bolivia also has a high population growth. The climatic characteristics and the lack of clean water sources in this city are forcing the agriculture sector to use treated and untreated wastewater for irrigation. We investigated the effluent quality of the Alba Rancho Wastewater Treatment Plant (WWTP) in Cochabamba, Bolivia, and the existing effluent reuse practices for irrigation of fodder crops in the surrounding agricultural land (La Mayca area). The plant uses primary and secondary facultative ponds, and does not achieve the required effluent quality (according to Bolivian environmental law) for effluent BOD, COD, TDS and faecal coliforms. This paper also includes a brief comparison of guidelines for wastewater reuse in agriculture from several developing and developed countries, comparing the parameters measured as pollution indicators. It appears that for developed countries, the main concern is the health risk that reuse can cause to the farmers and consumers. For developing countries on the other hand, pollution reduction is currently the major aim in their guidelines and standards.

[Reliability of recorded deaths from asthma in Denmark during a 1-year period 1994-1995]. / Pålideligheden af registrerede asthmadødsfald i Danmark i en 1-års-periode 1994-1995.

INTRODUCTION: The aim of this study was to evaluate the accuracy of death certificates over a one-year period, where asthma was given as the cause of death. METHODS: All medical information available was collected on 218 patients by reviewing hospital records, records from general practitioners, and sometimes by interviewing close relatives. A panel of four pulmonologists each examined the information and independently assessed the cause of death. RESULTS: Thirty-nine were excluded, as the cause of death could not be validated. In 16 (9%) of the subjects, asthma was judged to be the definite cause of death and in 12 (7%) a possible cause. Of 151 non-asthma deaths, but registered as asthma, 109 were judged to have suffered or died from COPD and 14 from heart disease. DISCUSSION: The accuracy of Danish death certification in asthma deaths is poor, especially in the elderly, where COPD is often classified as asthma. We conclude that the true mortality from asthma in Denmark is substantially lower than that officially recorded.

Quantitative regional cerebral blood flow measurement techniques improve noninvasive detection of cerebrovascular vasospasm after aneurysmal subarachnoid hemorrhage.

Adequate therapy of vasospasm (VS) in patients suffering from aneurysmal subarachnoid hemorrhage critically depends upon early and reliable diagnosis of cerebral hypoperfusion. The objective of the present study was to evaluate the usefulness of quantitative regional blood flow (rCBF) analysis as an adjunct in noninvasive prediction of VS. Therefore, 33 transcranial Doppler sonography (TCD) studies assuming cerebrovascular VS (TCD flow velocity >120 cm/s) were followed by (s)Xe/CT and cerebral panangiography (PA). TCD plus (s)Xe/CT significantly increased the predictability of VS from 34 to 91%, proving that a combination of TCD and rCBF studies improves the noninvasive detection of VS and might help to prevent unnecessary angiographic examinations.