Research Progresses in Understanding the Pathophysiology of Moyamoya Disease

Background: The pathogenesis of moyamoya disease (MMD) is still unknown. The detection of inflammatory molecules such as cytokines, chemokines and growth factors in MMD patients' biological fluids supports the hypothesis that an abnormal angiogenesis is implicated in MMD pathogenesis. However, it is unclear whether these anomalies are the consequences of the disease or rather causal factors as well as these mechanisms remain insufficient to explain the pathophysiology of MMD. The presence of a family history in about 9-15% of Asian patients, the highly variable incidence rate between different ethnic and sex groups and the age of onset support the role of genetic factors in MMD pathogenesis. However, although some genetic loci have been associated with MMD, few of them have been replicated in independent series. Recently, RNF213 gene was shown to be strongly associated with MMD occurrence with a founder effect in East Asian patients. However, the mechanisms leading from RNF213 mutations to MMD clinical features are still unknown. Summary: The research on pathogenic mechanism of MMD is in its infancy. MMD is probably a complex and heterogeneous disorder, including different phenotypes and genotypes, in which more than a single factor is implicated. Key Message: Since the diagnosis of MMD is rapidly increasing worldwide, the development of more efficient stratifying risk systems, including both clinical but also biological drivers became imperative to improve our ability of predict prognosis and to develop mechanism-tailored interventions. (C) 2016 S. Karger AG, BaselPeer reviewe

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Precious metal modified redox metal oxides and their application in oxidation catalysis

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Mixed-metal MIL-100(Sc,M) (M=Al, Cr, Fe) for Lewis acid catalysis and tandem C−C bond formation and alcohol oxidation

The authors thank Johnson Matthey and the EPSRC for an Industrial CASE award to L.M. We gratefully acknowledge the IAESTE UK for a scholarship to B.E. They also thank the Leverhulme Trust (F/00 268/BJ), EPSRC (EP/J501542/1), and the EaStCHEM Research Computing Facility.The trivalent metal cations Al3+, Cr3+, and Fe3+ were each introduced, together with Sc3+, into MIL-100(Sc,M) solid solutions (M=Al, Cr, Fe) by direct synthesis. The substitution has been confirmed by powder X-ray diffraction (PXRD) and solid-state NMR, UV/Vis, and X-ray absorption (XAS) spectroscopy. Mixed Sc/Fe MIL-100 samples were prepared in which part of the Fe is present as α-Fe2O3 nanoparticles within the mesoporous cages of the MOF, as shown by XAS, TGA, and PXRD. The catalytic activity of the mixed-metal catalysts in Lewis acid catalysed Friedel–Crafts additions increases with the amount of Sc present, with the attenuating effect of the second metal decreasing in the order Al>Fe>Cr. Mixed-metal Sc,Fe materials give acceptable activity: 40 % Fe incorporation only results in a 20 % decrease in activity over the same reaction time and pure product can still be obtained and filtered off after extended reaction times. Supported α-Fe2O3 nanoparticles were also active Lewis acid species, although less active than Sc3+ in trimer sites. The incorporation of Fe3+ into MIL-100(Sc) imparts activity for oxidation catalysis and tandem catalytic processes (Lewis acid+oxidation) that make use of both catalytically active framework Sc3+ and Fe3+. A procedure for using these mixed-metal heterogeneous catalysts has been developed for making ketones from (hetero)aromatics and a hemiacetal.PostprintPeer reviewe

A practical demonstration of electronic promotion in the reduction of ceria coated PGM catalysts

When ceria is deposited over supported PGM catalysts its reducibility is dependent on the work function of the underlying metal

Shoe manufacturing wastes: Characterisation of properties and recovery options

Using the renowned shoe manufacturing sector in Marche Region (Italy) as a case-study, this paper deals with the characterisation of (1) the chemical and physical properties of representative types of shoe manufacturing wastes, (2) the quality profile of a particular material recovery finalised to a soil destination, and (3) the flue gas emissions from burning tests in view of the potential for energy recovery. The property characterisation has primarily revealed the following aspects: a general condition of resulting higher ash contents in shoe waste materials having a mineral or synthetic processing origin; and relatively high energy contents, ranging on the whole expressed as LHV (lower heating value) from 15,710 kJ kg-1 (for vegetable-tanned leather dust) to 42,439 kJ kg-1 (for natural rubber). The characterisation of a fertiliser that can be generated from the particular waste type of vegetable-tanned leather dust has determined an interesting quality profile classifiable as organic-nitrogen fertiliser with acceptable values of the humification parameters and heavy metal contents significantly below the assumed quality limits. Finally, simplified pilot-scale burning tests have provided the following findings: higher NOx emissions produced from leather-based materials as compared with the cellulose-based material, which are likely attributable to the substantial “fuel nitrogen” content of the original animal skins; higher HCl emissions produced from the leather-based materials in comparison with the cellulose-based material; and a more even combustion process occurred for the leather dust than for the other shoe materials

Remarkable Lewis acid catalytic performance of the scandium trimesate metal organic framework MIL-100(Sc) for C-C and C=N bond-forming reactions

The porous metal organic frameworks scandium trimesate MIL-100(Sc), scandium terephthalates MIL-101(Sc), MIL-88B(Sc) and MIL-68(Sc), scandium 4,4'-biphenyl-dicarboxylate MIL-88D(Sc) and the scandium 3,3',5,5-azobenzene- tetracarboxylate socMOF(Sc) have been compared as Lewis acid catalysts against Sc3+-exchanged zeolite Beta, MIL-100(Cr), MIL-101(Cr), MIL-100(Fe) and the divalent MOFs HKUST-1(Cu), CPO-27(Ni) and STA-12(Ni), each of which can be prepared with coordinatively unsaturated metal sites. The performance of these MOFs has been investigated in several Lewis acid-catalysed reactions that are of importance in organic synthesis but have rarely been studied using MOF catalysts. These reactions were (i) the intermolecular carbonyl ene reaction of nucleophilic alkenes and electron-poor aldehydes, (ii) a Friedel-Crafts type Michael addition between electron-rich heterocycles and electron-deficient alkenes and (iii) ketimine and aldimine formation. In each of these, MIL-100(Sc) is both active and selective and significantly outperforms the other catalysts. Filtration and recycle tests indicate that catalysis over MIL-100(Sc) is heterogeneous. The study of Michael addition reactions carried out over scandium-bearing MOFs with different window sizes on indole-based substrates of varying molecular dimensions indicates that most of the catalysis that involves molecules small enough to enter the pores occurs within the internal pore space. These results indicate MIL-100(Sc) is an exceptional Lewis acidic MOF catalyst, and suggest that MIL-100(Sc) and new derivatives of it could find application as recyclable solid catalysts in synthetic chemistry.</p