Risk Factors for Failure of Initial Intravenous Immunoglobulin Treatment in Kawasaki Disease

The aims of this study were to determine the occurrence and variables associated with the initial intravenous immunoglobulin (IVIG) treatment failure in Kawasaki disease (KD) and to categorize differences in clinical characteristics between responders and nonresponders to initial IVIG treatment. Patients were classified into two groups. Group A included 33 patients who received a single dose of IVIG treatment and responded. Group B included 18 patients who received more than two doses of IVIG due to failure of the initial treatment. The mean duration of fever after initial treatment in group B was significantly longer than it was in group A. In group B, we found that higher bilirubin, aspartate aminotransferase (AST), polymorphonuclear cells (PMN) (%), and lower platelet values at baseline were independent predictors of persistent or recurrent fever in patients with KD. Coronary artery abnormalities were found in 8 patients (44.4%) in group B and in two patients (6.1%) in group A. We found that abnormal liver function tests and a lower platelet count at baseline were possible predictors of nonresponders to IVIG in patients with KD. There is a need for a prospective study focused on baseline hepatobiliary parameters

C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases.

STUDY DESIGN: A multicenter, retrospective review of C5 palsy after cervical spine surgery. OBJECTIVE: Postoperative C5 palsy is a known complication of cervical decompressive spinal surgery. The goal of this study was to review the incidence, patient characteristics, and outcome of C5 palsy in patients undergoing cervical spine surgery. METHODS: We conducted a multicenter, retrospective review of 13 946 patients across 21 centers who received cervical spine surgery (levels C2 to C7) between January 1, 2005, and December 31, 2011, inclusive. P values were calculated using 2-sample t test for continuous variables and χ(2) tests or Fisher exact tests for categorical variables. RESULTS: Of the 13 946 cases reviewed, 59 patients experienced a postoperative C5 palsy. The incidence rate across the 21 sites ranged from 0% to 2.5%. At most recent follow-up, 32 patients reported complete resolution of symptoms (54.2%), 15 had symptoms resolve with residual effects (25.4%), 10 patients did not recover (17.0%), and 2 were lost to follow-up (3.4%). CONCLUSION: C5 palsy occurred in all surgical approaches and across a variety of diagnoses. The majority of patients had full recovery or recovery with residual effects. This study represents the largest series of North American patients reviewed to date

Strength Dependence Of Epoxy Composites On The Average Filler Size Of Non-Oxidized Graphene Flake

Enhancing the filler-to-matrix contact area by incorporating large graphene flakes (GFs) is considered a viable approach for improving the mechanical properties of polymer composites. Graphene oxide (GO) flakes have been initially pursued for this application owing to the advantage of producing large-sized GFs. However, the defective nature of GO makes it technically challenging to precisely assess their dimensional effect on resulting mechanical properties, limiting their versatility as reinforcing materials. Therefore, it is highly desired to fabricate GFs with minimum defects and large lateral size. In this paper, we report the fabrication of high-quality edge functionalized non-oxidized graphene flakes (f-NOGFs) by the liquid exfoliation of graphite intercalation compounds. As-prepared f-NOGFs are over 1 μm in lateral size and contain less than 6.25% of impurity oxygen. By using size-sorted f-NOGFs, we systematically studied the relationship between mechanical properties and lateral sizes in f-NOGFs-incorporated epoxies. We identify that epoxy composites containing 0.6 wt% of f-NOGFs with a lateral size of 1 μm present outstanding mechanical properties; elastic modulus of 3.65 GPa, ultimate tensile strength of 95.74 GPa and toughness of 2.52 MJ m−3. The study presented in this paper could provide better understanding for optimization of the mechanical reinforcement of graphene-polymer composites

Development of Total Capital Investment Estimation Module for Waste Heat Power Plant

Power plants with waste heat collection and utilization have gained increasing interest in the high energy-consuming industries, such as steel-making and cement manufacturing, due to its energy efficiency. Waste heat power plants possess some intrinsic characteristics, for instance, the main equipment and the working fluids. However, at the time of this research, we could not find an economic analysis suitable to address the specialized aspects of waste heat power plant, making it difficult to measure the total capital investment needed for the business feasibility assessment. In this paper, we introduced our total capital investment estimation module developed for a waste heat power plant by considering its intrinsic features. We followed a systems engineering approach in designing and developing our module. We performed a requirements analysis of the stakeholders related to the waste heat power plant. Simultaneously, we consider the technical aspects by exploring the working fluids and main equipment implemented in the plant. Then, we developed the cost models for each equipment and used them as the basis of the proposed total capital investment estimation module. The performance verification showed that our proposed method achieved the initial accuracy target of a 5.78% error range when compared to the real data from the reference case study

Theoretical and experimental investigations of mesoporous C3N5/MoS2 hybrid for lithium and sodium ion batteries

The electrochemical properties of mesoporous CN with a triazole-based C–N framework coupled with MoS as hybrid electrode materials for lithium and sodium ion batteries are investigated. The density functional theory (DFT) calculations suggest that the reversible adsorption of the lithium and sodium ions follows the order CN/MoS hybrid > CN > g-CN. Bader charge analysis shows that the charge transferred from lithium and sodium ions is more distributed across the hybrid material as compared to the pure CN. It is experimentally found that the optimized mesoporous CN/MoS hybrid shows a 3.86 and 10.80 times increase in reversible capacities as compared to mesoporous g-CN for lithium and sodium ion batteries, respectively. Based on the comparative mechanism studies, the limited intercalation kinetics and surface-derived ion storage hinder the application of the mesoporous g-CN in lithium and sodium ion batteries, respectively. The synthesized mesoporous CN/MoS hybrids with mesopore channels, expanded gallery height and desired ion adsorption energies provide insights to improve the electrode performances of carbon nitrides-based materials for lithium and sodium ion batteries

Numerical analysis on the dynamic response of a plate-and-frame membrane humidifier for PEMFC vehicles under various operating conditions

PEMFC needs to be maintained at an appropriate temperature and humidity in a rapidly changing environment for automobile applications. In this study, a pseudo-multi-dimensional dynamic model for predicting the heat and mass transfer performance of a plate-and-frame membrane humidifier for PEMFC vehicles is developed. Based on the developed model, the variations in the temperature and relative humidity at the dry air outlet are investigated according to the air flow acceleration. Moreover, the dynamic response is analyzed as a function of the amplitude and period of the sinusoidal air flow rate at actual operating conditions. The effects of heat transfer on the dynamic response are more dominant than those of mass transfer. The settling time of the temperature and relative humidity at the dry air outlet decrease with the increase in air flow acceleration. In addition, the variations in the temperature and relative humidity at the dry air outlet increase with the increases in the amplitude and period of the sinusoidal air flow rate

How Can Insulin Resistance Cause Alzheimer’s Disease?

Alzheimer’s disease (AD) is a neurodegenerative disorder associated with cognitive decline. Despite worldwide efforts to find a cure, no proper treatment has been developed yet, and the only effective countermeasure is to prevent the disease progression by early diagnosis. The reason why new drug candidates fail to show therapeutic effects in clinical studies may be due to misunderstanding the cause of AD. Regarding the cause of AD, the most widely known is the amyloid cascade hypothesis, in which the deposition of amyloid beta and hyperphosphorylated tau is the cause. However, many new hypotheses were suggested. Among them, based on preclinical and clinical evidence supporting a connection between AD and diabetes, insulin resistance has been pointed out as an important factor in the development of AD. Therefore, by reviewing the pathophysiological background of brain metabolic insufficiency and insulin insufficiency leading to AD pathology, we will discuss how can insulin resistance cause AD

Effects of Radix Polygalae on Cognitive Decline and Depression in Estradiol Depletion Mouse Model of Menopause

Postmenopausal syndrome refers to symptoms caused by the gradual decrease in female hormones after mid-40 years. As a target organ of estrogen, decrease in estrogen causes various changes in brain function such as a decrease in choline acetyltransferase and brain-derived neurotrophic factor; thus, postmenopausal women experience cognitive decline and more depressive symptoms than age-matched men. Radix Polygalae has been used for memory boosting and as a mood stabilizer and its components have shown neuroprotective, antidepressant, and stress relief properties. In a mouse model of estrogen depletion induced by 4-vinylcyclohexene diepoxide, Radix Polygalae was orally administered for 3 weeks. In these animals, cognitive and depression-related behaviors and molecular changes related to these behaviors were measured in the prefrontal cortex and hippocampus. Radix Polygalae improved working memory and contextual memory and despair-related behaviors in 4-vinylcyclohexene diepoxide-treated mice without increasing serum estradiol levels in this model. In relation to these behaviors, choline acetyltransferase and brain-derived neurotrophic factor in the prefrontal cortex and hippocampus and bcl-2-associated athanogene expression increased in the hippocampus. These results implicate the possible benefit of Radix Polygalae in use as a supplement of estrogen to prevent conditions such as postmenopausal depression and cognitive decline