Phase diagram of SiO2 crystallization upon rice husk combustion to control silica ash quality.

Rice husk (RH), which is an abundant agricultural waste, consists of ca. 20 % silica (SiO2·nH2O). Upon RH combustion, a large amount of silica ash is generated. RH silica is originally amorphous; however, the ash is crystalized depending on the conditions of the combustion. Crystallization of RH occurs at a much lower temperature than that of pure SiO2 due to the eutectic effects of minerals, such as Na and K, that are initially present in RH. Controlling for anti-crystallization is required for expanding the possibility of using RH ash that is abundantly generated by combustion. Here, RH is combusted, followed by a highly thermocontrolled investigation, and the time and temperature dependency of RH ash crystallization are studied. Crystallization is avoidable when the ash is rapidly cooled; for instance, 20 °C/min cooling can avoid crystallization even if the combustion temperature reaches 950 °C. Various pathway patterns for achieving temperature and cooling ratio are plotted on a uniform diagram of temperature vs. time. Furthermore, a border zone, indicating the regions in which RH ash becomes amorphous and crystals, is successfully drawn into the diagram by using the data maintained at a constant temperature. A comparison with a few different types of RH showed that the border zone on the diagram can move depending on their ratios of inorganic elements, causing a eutectic effect.

Ethambutol inhibited the growth of acid-fast bacteria and enhanced the detection of Legionella in environmental water samples.

The growth of acid-fast bacteria often hinders the detection of Legionella in water samples on agar plates by the plate culture method. We studied whether anti-tubercular agents inhibit acid-fast bacteria growth on agar plates. First, the antimicrobial activities of isoniazid, ethionamide, and ethambutol were evaluated against Mycobacterium and Legionella. We found that ethambutol at ≥ 100 µg/mL completely inhibited Mycobacterium growth, but ethambutol at 1,000 µg/mL did not inhibit Legionella growth. Next, the effect of ethambutol dissolved in acid buffer was examined. Cell suspensions of L. pneumophila and Mycobacterium spp. were mixed, and ethambutol-acid buffer was added. After 5 min, mixtures were inoculated on GVPC agar plates and incubated at 36℃ for 6 d. We found that ethambutol inhibited Mycobacterium growth on agar plates, but the Legionella colonies recovered. The effect of ethambutol was also significant in the evaluation using bathwaters. Comparing 1,302 bathwaters, the addition of ethambutol reduced the detection rate of acid-fast bacteria from 30.6% to 0% and increased the detection rate of Legionella from 7.1% to 7.5%. Ethambutol, which selectively inhibited acid-fast bacteria growth, enhanced the detection of Legionella on agar plates and will contribute to improving the accuracy of Legionella testing by the plate culture method.

Successful use of dupilumab for egg-induced eosinophilic gastroenteritis with duodenal ulcer: a pediatric case report and review of literature.

BACKGROUND: Non-esophageal eosinophilic gastrointestinal disorder (non-EoE-EGID) is a rare disease in which eosinophils infiltrate parts of the gastrointestinal tract other than the esophagus; however, the number of patients with non-EoE-EGID has been increasing in recent years. Owing to its chronic course with repeated relapses, it can lead to developmental delays due to malnutrition, especially in pediatric patients. No established treatment exists for non-EoE-EGID, necessitating long-term systemic corticosteroid administration. Although the efficacy of dupilumab, an anti-IL-4/13 receptor monoclonal antibody, for eosinophilic esophagitis, has been reported, only few reports have demonstrated its efficacy in non-EoE EGIDs. CASE PRESENTATION: A 13-year-old boy developed non-EoE-EGID with duodenal ulcers, with chicken eggs as the trigger. He was successfully treated with an egg-free diet, proton pump inhibitors, and leukotriene receptor antagonists. However, at age 15, he developed worsening upper abdominal pain and difficulty eating. Blood analysis revealed eosinophilia; elevated erythrocyte sedimentation rate; and elevated levels of C-reactive protein, total immunoglobulin E, and thymic and activation-regulated chemokines. Upper gastrointestinal endoscopy revealed a duodenal ulcer with marked mucosal eosinophilic infiltration. Gastrointestinal symptoms persisted even after starting systemic steroids, making it difficult to reduce the steroid dose. Subcutaneous injection of dupilumab was initiated because of comorbid atopic dermatitis exacerbation. After 3 months, the gastrointestinal symptoms disappeared, and after 5 months, the duodenal ulcer disappeared and the eosinophil count decreased in the mucosa. Six months later, systemic steroids were discontinued, and the duodenal ulcer remained recurrence-free. The egg challenge test result was negative; therefore, the egg-free diet was discontinued. Blood eosinophil count and serum IL-5, IL-13, and eotaxin-3 levels decreased after dupilumab treatment. The serum levels of IL-5 and eotaxin-3 remained within normal ranges, although the blood eosinophil counts increased again after discontinuation of oral prednisolone. CONCLUSIONS: Suppression of IL-4R/IL-13R-mediated signaling by dupilumab may improve abdominal symptoms and endoscopic and histologic findings in patients with non-EoE-EGID, leading to the discontinuation of systemic steroid administration and tolerance of causative foods.

Self-Assembly of Soot Nanoparticles on the Surface of Resistively Heated Carbon Microtubes in Near-Hexagonal Arrays of Micropyramids.

Almost regular hexagonal arrays of microscopic pyramids consisting of soot nanoparticles are formed on the surface of graphitized hollow filaments, which are resistively heated to ∼1800-2400 °C under an Ar atmosphere containing trace amounts of oxygen (∼300 ppm). At higher temperatures (T > 2300 °C, approximately) the soot particles are represented mainly by multishell carbon nano-onions. The height and width of the pyramids are strongly dependent on the temperature of the resistive heating, diminishing from 5 to 10 µm at T ≈ 1800 °C to ∼1 µm at 2300-2400 °C. Quasi-hexagonal arrays of the micropyramids are organized in the convex "craters" on the surface of the microtubes, which grow with the time of the thermal treatment. The pyramids always point normally to the surface of the craters, except at the boundaries between the craters, where the normal direction is not well-defined. The pyramids are soft and can be easily destroyed by touching them but can be hardened by heating them under an oxygen-free atmosphere. The pyramids are observed only on the exterior surface of the microtubes, not on their inner surface. This suggests that the thermophoretic force generated by a strong temperature gradient near the external surface of the tubes may be the cause of the micropyramid formation. Electrostatic charging of the soot nanoparticles due to thermionic emission may also be relevant to this phenomenon. The micropyramids can function as field emission point sources, as demonstrated with the use of a micronanoprobing station, mounted in a scanning electron microscope.

Characterization of influenza infection in a high-income urban setting in Nairobi, Kenya.

BACKGROUND: Influenza viruses are an important cause of respiratory infections across all age groups. Information on occurrence and magnitude of influenza virus infections in different populations in Kenya however remains scanty, compromising estimation of influenza disease burden. This study examined influenza infection in an urban high-income setting in Nairobi to establish its prevalence and activity of influenza viruses, and evaluated diagnostic performance of a rapid influenza diagnostic test. METHODOLOGY: A cross-sectional hospital-based study was conducted in six private health facilities located within high-income residential areas in Nairobi from January 2019 to July 2020. Patients of all ages presenting with influenza-like illness (ILI) were recruited into the study. Detection of influenza virus was conducted using rapid diagnosis and reverse transcription-polymerase chain reaction (RT-PCR). Data were summarized using descriptive statistics and tests of association. Sensitivity, specificity and area under receiver operating characteristics curve was calculated to establish diagnostic accuracy of the rapid diagnosis test. RESULTS: The study recruited 125 participants with signs and symptoms of ILI, of whom 21 (16.8%) were positive for influenza viruses. Of all the influenza-positive cases, 17 (81.0%) were influenza type A of which 70.6% were pandemic H1N1 (A/H1N1 2009). Highest detection was observed among children aged 5-10 years. Influenza virus mostly circulated during the second half of the year, and fever, general fatigue and muscular and joint pain were significantly observed among participants with influenza virus. Sensitivity and specificity of the diagnostic test was 95% (95% confidence interval 75.1-99.9) and 100% (95% confidence interval 96.5-100.0), respectively. CONCLUSIONS: Findings of this study shows continuous but variable activity of influenza virus throughout the year in this population, with substantial disease burden. The findings highlight the need for continuous epidemiologic surveillance including genetic surveillance to monitor activity and generate data to inform vaccine introduction or development, and other interventions.

Anti-high mobility group box 1 monoclonal antibody suppressed hyper-permeability and cytokine production in human pulmonary endothelial cells infected with influenza A virus.

OBJECTIVE: High mobility group box-1 (HMGB1) has been reported to be involved in influenza A virus-induced acute respiratory distress syndrome (ARDS). We studied the efficacy of an anti-HMGB1 mAb using an in vitro model of TNF-α stimulation or influenza A virus infection in human pulmonary microvascular endothelial cells (HMVECs). METHODS: Vascular permeability of HMVECs was quantified using the Boyden chamber assay under tumor necrosis factor-α (TNF-α) stimulation or influenza A virus infection in the presence of anti-HMGB1 mAb or control mAb. The intracellular localization of HMGB1 was assessed by immunostaining. Extracellular cytokine concentrations and intracellular viral mRNA expression were quantified by the enzyme-linked immunosorbent assay and quantitative reverse transcription PCR, respectively. RESULTS: Vascular permeability was increased by TNF-α stimulation or influenza A infection; HMVECs became elongated and the intercellular gaps were extended. Anti-HMGB1 mAb suppressed both the increase in permeability and the cell morphology changes. Translocation of HMGB1 to the cytoplasm was observed in the non-infected cells. Although anti-HMGB1 mAb did not suppress viral replication, it did suppress cytokine production in HMVECs. CONCLUSION: Anti-HMGB1 mAb might be an effective therapy for severe influenza ARDS.

Graphite-shell-chains selectively and efficiently produced from biomass rich in cellulose and chitin.

Graphite-shell-chains have a worm-like nanocarbon configuration with a graphitic structure and mesopores, and they are easily produced from wood by using iron-group metal-catalysed carbonization at 900 °C. The simple production process with natural resources convinced us that this process may occur somewhere on Earth; the product of this process was indeed discovered as biogenic graphite by geochemists. However, the biogenic graphite was 3.7 billion years old, thus occurring long before wood appeared in the world. Here, we investigated appropriate carbon precursors other than wood in various materials and showed that carbon is selectively and efficiently obtained from biomass rich in cellulose and chitin. To enable selective and efficient production from this biomass, it seems the precursors provide a perfect amorphous carbon matrix where metal catalysts can reside at an active size to constantly create a graphite shell during carbonization. The results suggest that graphite-shell-chains could have existed in ancient times. Application developments of this biomass-derived nanocarbon will be useful for sustainable development goals.

[A Case of Malignant Ameloblastoma Associated with Uncontrollable Hypercalcemia].

Approximately 20-30% of cancers are associated with hypercalcemia, and this is a complication often encountered in cancer care. Hypercalcemia causes disorders such as disturbance of consciousness and, in severe cases, kidney failure and even death. In this report, we present a case of malignant ameloblastoma associated with uncontrollable hypercalcemia followed by a life-threatening disease course. In this case, hypercalcemia shortened the period of home care, and the medical staff could have extended this period by acquiring knowledge that leads to early detection and better control of hypercalcemia. In addition, the choice of the place for end-of-life care may have been expanded by considering the treatment of not only the malignant tumor but also hypercalcemia as its complication.

Corrigendum to "Serum Procalcitonin Levels in Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion".

[This corrects the article DOI: 10.1155/2018/2380179.].

Serum Procalcitonin Levels in Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion.

Procalcitonin (PCT) is used as a biomarker in severe infections. Here, we retrospectively investigated levels of serum PCT, C-reactive protein (CRP), and inflammatory cytokines (IL-6, TNF-α, and IFN-γ) in the second phase of patients with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). Nine AESD pediatric patients (4 men, 5 women; AESD group) admitted to Okayama University Hospital from 2010 to 2016 were compared with 10 control patients with febrile seizures (FS) (3 men, 7 women; FS group). Mean PCT concentrations (ng/mL) in the AESD and FS groups were significantly different, at 9.8 ± 6.7 and 0.8 ± 0.9, respectively (p = 0.0011). CRP (mg/dL) were 0.79 ± 0.89 and 1.4 ± 1.0 (p = 0.21), respectively; IL-6 (pg/mL) were 449.7 ± 705.0 and 118.3 ± 145.4 (p = 0.20), respectively; TNF-α (pg/mL) were 18.6 ± 12.5 and 16.6 ± 6.0 (p = 0.67), respectively; and IFN-γ (pg/mL) were 79.6 ± 158.5 and 41.9 ± 63.7 (p = 0.56), respectively. Ratios of PCT to CRP were 27.5 ± 34.2 and 3.2 ± 6.8 (p < 0.0001), respectively. The sensitivity and specificity in the diagnosis of AESD using a cutoff of PCT/CRP ratio of 1.0 were 100% and 80%, respectively. These results suggest that PCT and the PCT/CRP ratio are useful in auxiliary diagnosis of the second stage of AESD, and in AESD, PCT is likely to increase through a different mechanism.

[Fentanyl Citrate Sublingual Tablets Were Effective in Relieving Symptoms of Akathisia - A Case Report].

Akathisia is a condition wherein sitting calmly and quietly is impossible, with a representative complaint of restless legs. It is generally assumed to be caused by anti-dopamine activity. In severe cases, it has been known to result in suicide attempt. We reported a case of drug-induced akathisia with difficulty in oral intake, in which fentanyl citrate sublingual tablets were found to be effective in relieving symptoms. The patient was a female aged 50's who had a gastric cancer with peritoneal dissemination causing pain and vomiting. Palliative care was requested for management of symptoms. Metoclopramide and haloperidol were administered for vomiting. However, because of the complaints of restless legs, the case was diagnosed as drug-induced akathisia. Fentanyl citrate sublingual tablets were then administered for pain management, resulting in temporary improvement of akathisia symptoms.

[Usefulness of Suvorexant for Complicated Delirium in Cancer Patients Who Experience Sleep Disturbance during Hospitalization].

We investigated the usefulness of suvorexant for complicated delirium in patients with cancer who experience sleep disturbance during hospitalization. Nine patients with malignant tumors complicated with symptoms of delirium and insomnia were included in this study; their palliative care was managed by the palliative care team of our hospital for a period of one year from April 2016 to March 2017. A retrospective follow-up study was then conducted. The Japanese version of DRS-R98 was used to evaluate the severity of the patient's delirium. The total severity score of DRS-R98 significantly decreased after the administration of suvorexant when compared to the score before its administration(6.66±1.73 vs 10±3.20, p=0.0031). In addition, suvorexant did not exhibit any harmful effects. Our results indicate that suvorexant was useful in alleviating delirium symptoms in cancer patients who experience sleep disturbance.

[Assessing Patient Factors Influencing the Discontinuation of Opioids after Intra-Arterial Chemotherapy for Oral Cancer - A Retrospective Study].

Superselective intra-arterial chemoradiation therapy for oral cancer induces the complication of mucositis. Although the associated pain is controlled using opioids, major questions from patients in clinical practice are as follows:(1)the mean number of days from the completion of superselective intra-arterial chemoradiation therapy to the discontinuation of opioid administration, and(2)patient factors enabling the discontinuation of opioids. The purpose of this study was to clarify these points. A retrospective follow-up study was conducted from April 2016 to March 2017 on patients who underwent superselective intra-arterial chemoradiation therapy at our department of oral surgery. The patients were divided into 2 groups:one who discontinued opioids, and the other who did not. Clinical backgrounds and data were compared between the 2 groups. The mean number of days from the completion of superselective intra-arterial chemoradiation therapy to the discontinuation of opioid administration was 51±34.4 days. The absence of diabetes and deliria during treatment were determined as factors contributing to the discontinuation of opioids.

[Patient Factors Enabling the Decannulation of the Gastrostomy Tube after Superselective Intra-Arterial Chemoradiation Therapy for Locally Advanced Oral Cancer - A Retrospective Study].

Superselective intra-arterial chemoradiation therapy for locally advanced oral cancer induces complications such as mucositis, which impedes oral intake. Thus, at our hospital, a gastrostomy is performed in almost all patients during the treatment period to ensure the presence of an alternative administration route for nutrition and drugs. The purpose of this study was to calculate the mean number of days from completion of superselective intra-arterial chemoradiation therapy to the decannulation of gastrostomy, and extract patient factors for the decannulation. A retrospective follow-up study was conducted from April 2016 to March 2017 on patients who underwent superselective intra-arterial chemoradiation therapy at our department of oral surgery. The patients were divided into 2 groups:one who was decannulated and the other who did not. Clinical backgrounds and data were compared between the 2 groups. In the group with the decannulation, the mean period from treatment completion to the decannulation was 132±51.6 days. Heavy alcohol consumption, absence of haphalgesia before treatment, and possible securement of the opening with the breadth of 3 fingers, were determined as factors contributing to the decannulation of gastrostomy tube.

Design of a Program to Learn the Nursing Process by Introducing Digital Stories - For the Promotion of Patient Understanding.

Nursing students have a problem to develop real images of patients by using paper patient-based learning as the initial program to learn the process of nursing care. This paper presents a learning program for the promotion of patient understanding, designed by focusing on digital stories and workshops held in classes.

Effects of Reflection Using the iPad on Students' Motivation to Learn Nursing Techniques.

In technical nursing training, it is necessary for students to adopt extensive perspectives, focusing on not only the accuracy of manual procedures, but also surrounding environments, in order to appropriately evaluate their own practices. Therefore, based on the idea that students need opportunities to objectively evaluate their own practices and improve their learning levels, a method of reflection using videos recorded by themselves with the iPad was developed. These results highlight the importance of providing students with learning materials that will promote discussions, as well as opportunities for successful learning experiences.

Proposal of Comprehensive Model of Teaching Basic Nursing Skills Under Goal-Based Scenario Theory.

The purpose of this study is to design and develop a comprehensive model of teaching basic nursing skills on GBS theory and Four-Stage Performance Cycle. We designed a basic nursing skill program that consists of three courses: basic, application and multi-tasking. The program will be offered as blended study, utilizing e-learning.

Time-programmed release of fluoroscein isocyanate dextran from micro-pattern-designed polymer scrolls.

In this article we present a relevant strategy for a non-trivial time-programmed release of water-soluble macromolecules from biocompatible µ-containers. The system is based on self-scrolled chitosan acetate (CA) fibers, encapsulated in a poly(dimethylsiloxane) matrix. Mass transfer between a fiber and the external environment takes place via the only opened extremity of the fiber. Fluoroscein isocyanate dextran (FID) is initially deposited at the inner surface of the CA fiber according to a programmed pattern. The FID molecules became mobile after the arriving of the swelling front, which propagates along the fiber's axis upon the immersion of the system in aqueous solution. Diffusion of the macromolecules into the environment is enabled by the open-tube geometry of the swollen part of the fiber, while a programmed kinetics of the drug release is due to patterning of the polymer film prior to rolling. The release of the macromolecules can be retarded by a few hours according to the placement of the FID spot with respect to the fibers orifice. A pulsatile release kinetics is demonstrated for a discrete pattern. A few millimeter spacing of the FID spots results in a few hours time interval between the release impulses. Random walk model is plugged in the effective diffusion coefficient for Fick's law and the release kinetics are simulated.

Inhibitory Effects of Edaravone, a Free Radical Scavenger, on Cytokine-induced Hyperpermeability of Human Pulmonary Microvascular Endothelial Cells:A Comparison with Dexamethasone and Nitric Oxide Synthase Inhibitor.

Lung hyperpermeability affects the development of acute respiratory distress syndrome (ARDS), but therapeutic strategies for the control of microvascular permeability have not been established. We examined the effects of edaravone, dexamethasone, and N-monomethyl-L-arginine (L-NMMA) on permeability changes in human pulmonary microvascular endothelial cells (PMVEC) under a hypercytokinemic state. Human PMVEC were seeded in a Boyden chamber. After monolayer confluence was achieved, the culture media were replaced respectively by culture media containing edaravone, dexamethasone, and L-NMMA. After 24-h incubation, the monolayer was stimulated with tumor necrosis factor-α (TNF-α) and interleukin-1ß (IL-1ß). Fluorescein-labeled dextran was added. Then the trans-human PMVEC leak was measured. Expressions of vascular endothelial-cadherin (VE-cadherin) and zonula occludens-1 protein (ZO-1) were evaluated using real-time quantitative polymerase chain reaction and immunofluorescence microscopy. The results showed that TNF-α＋IL-1ß markedly increased pulmonary microvascular permeability. Pretreatment with edaravone, dexamethasone, or L-NMMA attenuated the hyperpermeability and inhibited the cytokine-induced reduction of VE-cadherin expression on immunofluorescence staining. Edaravone and dexamethasone increased the expression of ZO-1 at both the mRNA and protein levels. Edaravone and dexamethasone inhibited the permeability changes of human PMVEC, at least partly through an enhancement of VE-cadherin. Collectively, these results suggest a potential therapeutic approach for intervention in patients with ARDS.

Self-scrolling ability of differentially acetylated chitosan film.

Chitosan film cast on a glass slide was exposed to acetic anhydride vapor, resulting in an acetylation gradient in the film, with preferential acetylation of the exposed surface. The difference in degree of acetylation between the two surfaces of the peeled film was confirmed by attenuated total reflection infrared spectroscopy. Upon immersion of the film in water, differential swelling occurred because the more highly acetylated surface absorbed less water, and the resulting bending moment caused self-scrolling with the more highly acetylated surface inside. Simultaneous peeling and scrolling of films with a thickness of micrometer order, using dilute aqueous hydrofluoric acid, afforded tightly rolled chitosan microtubes. This simple self-scrolling mechanism is potentially applicable for micro-scale design with various naturally occurring polymers.