Controlling nanodomain morphology of epoxy thermosets templated by poly(caprolactone)-block-poly(dimethylsiloxane)-block-poly(caprolactone) ABA triblock copolymer

In this paper, triblock copolymer was incorporated into epoxy to prepare nano thermosets. After studying the compatibility between polydimethylsiloxane (PDMS), polycaprolactone (PCL) and bisphenol A epoxy resin (E-54), poly(caprolactone)–poly(dimethylsiloxane)–poly(caprolactone) (PCL-b-PDMS-b-PCL) triblock copolymer was incorporated into bisphenol A epoxy resin (E-54) and cured with DDS. A nano structure was formed and the size of the spherical phase became larger with increasing PCL-b-PDMS-b-PCL. According to the fact that TGDDM/PCL was compatible and TGDDM/PDMS was incompatible during the curing reaction, the mechanism of nano structure formation was self-assembly. The factors of influencing nano structure formation were discussed with regard to different curing temperatures and accelerators. Curing kinetics was utilized to study the effect of accelerator on nano structure formation.

FTIR spectrum of PDMS and PCL-b-PDMS-b-PCL triblock copolymer..     

Evaluation of factors related to glycaemic control among South Korean patients with type 2 diabetes

Aims

To examine specific self‐care behaviours, depression, and diabetes‐related stress among South Korean patients with type 2 diabetes and to evaluate whether these factors are related to glycaemic control.

Methods

This cross‐sectional study included 171 patients with type 2 diabetes who visited an endocrinology clinic. A structured questionnaire and electronic medical records were used to collect data regarding self‐care behaviours, depression, diabetes‐related distress, and glycaemic control between May 2015 and July 2015.

Results

Compared with the group with good glycaemic control, the group with poor glycaemic control had significantly lower values for medication adherence and significantly greater values for regimen‐related distress. Depression was not significantly associated with glycaemic control. In logistic regression analysis, only medication adherence was independently associated with glycaemic control.

Conclusions

Medication adherence should be continuously emphasized and monitored in clinical practice to effectively manage glycaemic control among patients with type 2 diabetes. Furthermore, consideration of diabetes‐related distress may help improve glycaemic control among patients with type 2 diabetes.     

Comparison of the accuracy of noninvasive hemoglobin monitoring for preoperative evaluation between adult and pediatric patients: a retrospective study

We measured noninvasive hemoglobin (SpHb) levels during the pre-anesthesia visit in patients planning elective surgery. Differences between SpHb and laboratory-measured hemoglobin (Hb_lab) were compared between adult and pediatric patients. In the pre-anesthesia visiting office, we routinely monitor noninvasive Hb levels with oxygen saturation and heart rate using Masimo Radical-7® Pulse CO-Oximetry (Masimo Corp., Irvine, CA, USA). We attached the R1 20 (body weight, 10–50 kg) or R1 25 (body weight?>?30 kg) probe on the index finger. After signal stabilization, SpHb and perfusion index (PI) were recorded. We retrospectively reviewed the recorded data and included patients who visited the anesthesiologist within 24 h after venous sampling. Bias was calculated by subtracting Hb_lab from SpHb. We compared the biases of adult and pediatric patients (<?18 years) and evaluated correlation coefficients between the bias and Hb_lab. Records of 105 patients were reviewed and 100 data points of 50 patients in each group were analyzed. The median?±?interquartile range bias was ??2.6?±?2.2 and ??1.2?±?1.5 g/dL in adult and pediatric patients, respectively (P?<?0.001); the corresponding mean?±?standard deviation PIs were 4.4?±?3.1 and 5.9?±?2.7, respectively (P?=?0.19). Bias was inversely proportional to Hb_lab irrespective of age. The correlation coefficient between the bias and Hb_lab was ??0.81 in adults and ??0.54 in pediatric patients (P?<?0.001). SpHb and Hb_lab measured during pre-anesthesia visits showed a smaller difference in pediatric than in adult patients. Lower Hb_lab corresponded to higher accuracy.     

Alcohol consumption and the risk of incident pulmonary embolism in US women and men

Essentials

• The association of moderate alcohol consumption with pulmonary embolism (PE) risk remains unclear.
• In three large US cohorts, we evaluated the association of alcohol consumption with PE risk.
• We found no evidence of an association of alcohol consumption amount or frequency with PE risk.
• Secondary analyses of type and heavy episodic drinking also yielded null findings.

Summary

Background

Moderate alcohol consumption has been variably associated with hemostatic and fibrinolytic factor levels, but the association between alcohol consumption and the risk of incident pulmonary embolism (PE) remains uncertain.

Objective

To evaluate alcohol consumption amount and frequency in relation to PE risk.

Methods

Nurses’ Health Study (NHS), NHS II and Health Professionals Follow‐Up Study participants free of venous thromboembolism (VTE) at baseline (n = 217 442) reported alcohol consumption by type, quantity and frequency, every 2–4 years. Incident PE cases were identified by self‐report and confirmed for participants without cancer. In this cohort study, we used Cox proportional hazards models to estimate multivariable‐adjusted hazard ratios (HRs) for PE associated with alcohol consumption amount and, separately, frequency. Secondary analyses evaluated alcohol type and heavy episodic drinking in relation to PE risk, and amount and frequency in relation to medical record‐confirmed idiopathic PE and any self‐reported VTE risk. Cohort‐specific analyses were pooled using random‐effects meta‐analysis.

Results

During ≥ 20 years of follow‐up, we identified 1939 PE events. We found no strong evidence of an association between PE risk and alcohol consumption amount (pooled HR_adj for 5.0–14.9 g day^?1 vs. abstention = 0.97 [95% CI, 0.79, 1.20]) or frequency (pooled HR_adj for 5–7 drinking days per week vs. abstention = 1.04 [95% CI, 0.88, 1.23]). Secondary analyses of type, heavy episodic drinking, idiopathic PE and VTE also yielded null findings.

Conclusions

Among three large prospective cohorts of US men and women, we found no evidence of an association between the amount or frequency of alcohol consumption and PE risk.

     

Opsoclonus-myoclonus syndrome following long-term use of cyclosporine

Background: Cyclosporine A (CsA) is a widely used immunosuppressive agent that may provoke unexpected neurologic complications. The mechanism is unclear and variable intervals have been reported between CsA administration and onset of the related side effects. Here, we describe a case of delayed-onset CsA neurotoxicity presenting as opsoclonus-myoclonus syndrome (OMS).

Case details: A 37-year-old woman with a two-week period of opsoclonus and upper extremity myoclonus was admitted to our hospital. The patient had been taking CsA for 17 years after receiving a kidney transplant. Further evaluation did not reveal any other abnormalities. Seven days after switching from CsA to tacrolimus, in the absence of additional immune-modulating therapy, her neurologic symptoms improved considerably.

Conclusion: This is the case of delayed, long-term complications of CsA presenting as OMS. Symptoms resolved by substituting CsA with another immunomodulating drug. The etiology of the neurologic complications may involve paradoxically-enhanced delayed-type hypersensitivity.     

Functional classification of aortic regurgitation using cardiac computed tomography: comparison with surgical inspection

In patients with aortic regurgitation (AR), a precise preoperative assessment of aortic valve (AV) pathology is important if AV repair or sparing operation is an alternative option. The aim of this study was to assess the diagnostic accuracy of computed tomography (CT) for evaluating the AR mechanism compared with surgical inspection. 59 patients with AR who underwent AV surgery and preoperative cardiac CT were evaluated. AR mechanism was classified into type 1 (aortic dilatation or cusp perforation), type 2 (prolapsed cusp) and type 3 (cusp retraction). Agreement between CT and surgical inspection was obtained. Correlation between aortic regurgitant orifice (ARO) and imaging parameters were evaluated. On surgical inspection, type 1 AR was noted in 22 patients, type 2 in 16 and type 3 in 21. Agreement regarding the AR mechanism on CT was excellent (intra-class correlation coefficient, 0.81). At the patient level, the Cohen’s κ value for CT findings with surgical inspection was of 0.89. At the cusp level, moderate agreement was noted between CT and surgical inspection. In the per-cusp analysis, CT had a sensitivity of 72.6%, specificity of 85.1%, positive predictive value of 73.8% and negative predictive value of 84.3% for the detection of aortic cusp abnormality. The diameter, perimeter and area of aortic annulus had moderate correlation with ARO (r?=?0.54–0.66, P?<?0.001). CT-derived classification of AR mechanism showed excellent agreement with surgical inspection.     

透明帽辅助内镜下取出食管异物疗效的Meta分析

目的评价透明帽辅助内镜下取出食管异物的临床价值。方法通过计算机检索Pubmed、CNKI数据库、Web of Knowledge、Cochrane图书馆对照试验注册库和万方数据库从建库至2017年的有关透明帽辅助内镜取出食管异物的相关文献,采用Cochrane协作网提供的RevMan 5.0版软件进行统计处理,对纳入资料的异质性进行分析,计算OR值和95%可信区间。结果按照入选标准,纳入了9项临床试验,共1 103例患者。Meta分析结果显示:透明帽辅助内镜异物取出术成功率更高(OR=8.58,95%CI:4.49～16.38,P 0.05)、视野更清晰(OR=7.35,95%CI:5.20～10.40,P 0.05)、并发症发生率低(OR=0.34,95%CI:0.25～0.46,P 0.05)、患者耐受性好(OR=2.78,95%CI:2.08～3.72,P 0.05)。结论透明帽辅助内镜下食管异物取出术是一种安全有效的内镜下取异物的方法,其患者耐受性好,可提供更好的内镜下操作视野,有利于提高手术成功率,值得进一步推广应用。