Optimization of kerf and surface roughness of Al 7 475-T7 351 alloy machined with WEDM process using the grey-based Taguchi method

In this study, the eff ects of cutting parameters on kerf and surface roughness were experimentally investigated in WEDM. Al 7 475-T7 351 alloy was selected as the work material to conduct experiments. The factors selected for the optimization are the pulse on time, table feed rate and the wire speed, each of the factors in three diff erent levels. An optimal parameter combination of the WEDM process was obtained by applying the grey relational analysis (GRA). Also, the analysis of variance (ANOVA) was carried out for fi nding out the contribution and the eff ects of machining parameters on the multiple performance characteristics (MPC)

Procalcitonin and other acute phase reactants in patients with chronic obstructive pulmonary disease exacerbation

The aim of this study was to investigate the correlation between procalcitonin and other acute phase reactants, and also analyze their relationship with clinical situation in chronic obstructive pulmonary disease (COPD) acute exacerbations.Materials and methods: The study was made with 122 acute COPD exacerbated patients, who were admitted to emergency service. Patients with below 0.25 ng/ml PCT value included Group 1, and the patients with PCT values ≥ 0.25 ng/ml Group 2. Serum procalcitonin levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) values and white blood cell (WBC) counts were measured. Also, patients hospitalization time and mortality rates were recorded and compared with PCT.Results: Patients were divided in 3 groups according to their clinical diagnosis; Pneumonia (n=27), Mycoplasma-Chlamydia pneumonia (n=11) and the patients with only COPD exacerbation(n=84). Mean PCT values according to the groups were 9.47 ± 8.1 ng/ml, 0.41 ± 0.2 ng/ml, and 0.21 ± 0.05 ng/ml respectively. The relationship between PCT with CRP and white blood cell has been found between significiant (p=0.001, p=0.005 respectively), whereas the relationship between PCT and ESR was nonsignificant (p=0.55). Procalcitonin and CRP had a positive correlation with the hospitalization time (p=0.034, p=0.022 respectively). The mean ± standard error of PCT for the patients who died was 28.3 ± 27.5 ng/ml, and the difference between patients who died or were discharged was statistically significant (p= 0.012).Conclusion: PCT can be a useful indicator for morbidity and prognosis in COPD patients

Essential oil composition of sixteen elite cultivars of Mentha from western Himalayan region, India

The hydrodistilled essential oils of 16 cultivars of Mentha, viz. M. arvensis L., M. spicata L. and M. citrata Ehrh., were analysed and compared by gas chromatography and gas chromatography-mass spectrometry. Fifty-seven constituents representing 92.8-99.8% of the total essential oil composition were identified. Monoterpenoids (88.1-98.6%) are the major constituents of the essential oils. The major constituents of the oils in 9 cultivars of M. arvensis are menthol (73.7-85.8%), menthone (1.5-11.0%), menthyl acetate (0.5-5.3%), isomenthone (2.1-3.9%), limonene (1.2-3.3%) and neomenthol (1.9-2.5%). Carvone (51.3-65.1%), limonene (15.1-25.2%), -pinene (1.3-3.2%) and 1,8-cineole (≤0.1-3.6%) are the major constituents in 5 cultivars of M. spicata, while in one cultivar (Ganga) of M. spicata the major constituents are piperitenone oxide (76.7%), α-terpineol (4.9%) and limonene (4.7%). Linalool (59.7%), linalyl acetate (18.4%), nerol (2.0%), trans-p-menth-1-en-2-ol (1.8%), a-terpineol (1.5%) and limonene (1.1%) are the major constituents of M. citrata

Clinical use of gadobutrol for contrast-enhanced magnetic resonance imaging of neurological diseases

Kenneth T Cheng1, Hannah Y Cheng2, Kam Leung31Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA; 2Freelance Technical Writer, New Orleans, LA, USA; 3National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD, USAAbstract: Contrast-enhanced magnetic resonance imaging (CE-MRI) is an important clinical tool for diagnosing neurological diseases. The appropriate use of a suitable MRI contrast agent or contrast pharmaceutical is essential for CE-MRI to produce desirable diagnostic images. Currently, there are seven contrast agents (CAs) or pharmaceuticals approved for clinical imaging of the central nervous system (CNS) in the US, Europe, or Japan. All of the clinically approved CAs are water-soluble gadolinium-based contrast agents (GBCAs) which do not penetrate the CNS blood–brain barrier (BBB). These agents are used for imaging CNS areas without a BBB, or various pathologies, such as tumors and infection that break down the BBB and allow CAs to enter into the surrounding parenchyma. Clinically, GBCAs are most useful for detecting primary and secondary cerebral neoplastic lesions. Among these CNS GBCAs, gadobutrol (Gd-BT-DO3A, Gadovist™) is a neutral, nonionic, macrocyclic compound that showed promising results from clinical trials of CNS imaging. In comparison with other GBCAs, Gd-BT-DO3A has relatively high in vitro kinetic stability and r1 relaxivity. Gd-BT-DO3A has been recently approved by the US Food and Drug Administration (FDA) in 2011 for CNS imaging. A review of available literature shows that Gd-BT-DO3A exhibits similar safety and clinical efficacy profiles to other GBCAs. Gd-BT-DO3A has the distinguishing feature that it is the only clinical agent commercially available in a formulation of 1.0 M concentration with a relatively higher in vitro T1 shortening per unit volume than other clinical GBCAs which are only available in 0.5 M concentration. This double concentration of Gd-BT-DO3A may allow a relatively higher concentration of the agent to localize in the CNS and produce a better contrast enhancement at the same clinical dose as other GBCAs. Several recent published multicenter clinical trials appeared to support this potential advantage of Gd-BT-DO3A.Keywords: Gadovist, Gd-BT-DO3A, CE-MRI, CNS imaging, MRI contrast agent, gadoliniu

ESMO Clinical Practice Guideline update on the use of immunotherapy in early stage and advanced renal cell carcinoma

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Telemedicine infectious diseases consultations and clinical outcomes: A systematic review

Background: Telemedicine use is increasing in many specialties, but its impact on clinical outcomes in infectious diseases has not been systematically reviewed. We reviewed the current evidence for clinical effectiveness of telemedicine infectious diseases consultations, including outcomes of mortality, hospital readmission, antimicrobial use, cost, length of stay, adherence, and patient satisfaction. Methods: We queried Ovid MEDLINE 1946-, Embase.com 1947-, Scopus 1823-, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov 1997- through August 5, 2019, for studies looking at clinical outcomes of infectious diseases in the setting of telemedicine use. We did not restrict by language or year of publication. Clinical outcomes searched included 30-day all-cause mortality, 30-day readmissions, patient compliance/adherence, patient satisfaction, cost or cost-effectiveness, length of hospital stay, antimicrobial use, and antimicrobial stewardship. Bias was assessed using standard methodologies. PROSPERO CRD42018105225. Results: From a search pool of 1154 studies, only 18 involved telemedicine infectious diseases consultation and our selected clinical outcomes. The outcomes tracked were heterogeneous, precluding meta-analysis, and the majority of studies were of poor quality. Overall, clinical outcomes with telemedicine infectious diseases consultation seem comparable to in-person infectious diseases consultation. Conclusions: Although in widespread use, the clinical effectiveness of telemedicine infectious diseases consultations has yet to be sufficiently studied. Further studies, or publication of previously collected and available data, are warranted to verify the cost-effectiveness of this widespread practice. Systematic review registration: PROSPERO CRD42018105225