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Idiopathic CD4+ lymphocytopenia (ICL) is a rare disorder characterized by low counts of CD4+ cells ( less then 300/mm3) in absence of other known causes of immunosuppression. A few cases of progressive multifocal leukoencephalopathy (PML) were reported in association with ICL with variable outcome. We describe the case of a 40 year-old man diagnosed with PML, which showed a monophasic course. Causes of primary and secondary immunodeficiency were ruled out, only a "borderline" ICL was found. This case highlights that a severe immunodepression could not be an absolute prerequisite in developing PML and also points the attention on current definition of ICL.Encephalopathy is emerging as a recurrent complication of COVID-19 yet remains poorly characterized. We report the case of a middle-aged woman with COVID-19-related encephalopathy presenting as expressive aphasia and inattentiveness, subsequently progressing to agitation and marked confusion. Brain MRI and CSF analysis were unremarkable, while EEG showed slowing with frontal sharp waves. Neuropsychiatric symptoms resolved following treatment with tocilizumab. CNS involvement in COVID-19 may present as a subacute encephalopathy characterized by prominent frontal lobe dysfunction, with language disturbances as first neurological manifestation. Future studies should further investigate the role of tocilizumab in treating COVID-19-related encephalopathy.This study aimed to evaluate the effect of light attenuation by ceramic veneers on the degree of conversion (DC), flexural strength (FS) and color change (CC) of resin cements containing different photoinitiators. Thus, samples included resin cements containing different photoinitiators (a) camphorquinone (CQ)/ethyl 4-(dimethylamino)benzoate (EDMAB); (b) CQ/4-(N,N-dimethylamino) phenethyl alcohol (DMPOH); (c) CQ/2(dimethylamino) ethyl methacrylate (DMAEMA); (d) CQ/ethyl 4-(dimethylamino)benzoate (EDMAB) + diphenyl(2,4,6-trimethylbenzoyl)-phosphine oxide (TPO); (e) TPO; and (f) phenylbis(2.4.6-trimethylbenzoyl)phosphine oxide (BAPO). Ceramic veneers (10 × 10 mm) were 0.4 mm, 0.7 mm, 1.0 mm or 1.5 mm thick. The light irradiance of a multiple-peak LED through ceramic veneers was measured (n = 5) using a spectrometer. DC (micro-Raman spectrometer) and FS (Bar-shaped specimens) were tested in cements with and without the veneers. Color change was evaluated before and after UV artificial aging. Data were submitted to ANOVA and Tukey's test (α = 0.05). The violet spectrum showed the lowest irradiance values through the veneer, considering all thicknesses. BAPO had the highest DC values for all veneers. CQ/EDMAB + TPO, CQ + EDMAB, and CQ + DMPOH showed similar DC values concerning all thicknesses. TPO (1.0 mm) showed the lowest DC and FS values. CQ + TPO and CQ/amines showed similar FS values. CQ + EDMAB and CQ + DMAEMA showed the highest color change values while TPO showed the lowest. It was concluded that the physical and chemical properties of the resin cement were improved with BAPO. CQ/EDMAB + TPO showed the greatest color stability, considering all veneer groups and control, without affecting the other properties assessed.Ti6Al4V sub-millimetric cellular structures arise as promising solutions concerning the progress of conventional orthopedic implants due to its ability to address a combination of mechanical, physical and topological properties. Such ability can improve the interaction between implant materials and surrounding bone leading to long-term successful orthopedic implants. Selective Laser Melting (SLM) capability to produce high quality Ti6Al4V porous implants is in great demand towards orthopedic biomaterials. In this study, Ti6Al4V cellular structures were designed, modeled, SLM produced and characterized targeting orthopedic implants. For that purpose, a set of tools is proposed to overcome SLM limited accuracy to produce porous biomaterials with desired dimensions and mechanical properties. Morphological analyses were performed to evaluate the dimensional deviations noticed between the model CAD and the SLM produced structures. Tensile tests were carried out to estimate the elastic modulus of the Ti6Al4V cellular structures. The present work proposes a design methodology showing the linear correlations found for the dimensions, the porosity and the elastic modulus when comparing the model CAD designs with Ti6Al4V structures by SLM.As a mechanoactive tissue, articular cartilage undergoes compression and shear on a daily basis. With the advent of high resolution and sensitive mechanical testing methods, such as micro- and nanoindentation, it has become possible to assess changes in small-scale mechanical properties due to compression and shear of the tissue. However, investigations on the changes of these properties before and after joint articulation have been limited. To simulate articular loading of cartilage in the context of human gait, a previously developed bioreactor system was used. Immediately after bioreactor testing, the stiffness was measured using microindentation. Specifically, we investigated whether the mechanical response of the tissue was transient or permanent, dependent on counterface material, and an effect limited to the superficial zone of cartilage. We found that cartilage surface stiffness increases immediately after articular loading and returns to baseline values within 3 hr. Cartilage-on-cartilage stiffening was found to be higher compared to both alumina- and cobalt chromium-on-cartilage stiffening, which were not significantly different from each other. This stiffening response was found to be unique to the superficial zone, as articular loading on cartilage with the superficial zone removed showed no changes in stiffness. The findings of this study suggest that the cartilage superficial zone may adapt its stiffness as a response to articular loading. As the superficial zone is often compromised during the course of osteoarthritic disease, this finding is of clinical relevance, suggesting that the load-bearing function deteriorates over time.The aim of the study was to compare the outcomes for the fatigue mechanical behavior of bonded simplified lithium disilicate restorations, with and without an internal adjustment by grinding with diamond bur in running two fatigue tests Staircase and Step-stress testing approaches. Ceramic discs (IPS e.max CAD) were prepared (Ø = 10 mm; thickness = 1.0 mm), submitted to an in-lab simulation of CAD/CAM milling (#60 SiC paper) and allocated into 2 groups according to the internal adjustment by grinding of the cementation surface no adjustment (CTRL); or grinding with a coarse diamond bur (GR). Adhesive cementation (Multilink N) was performed onto epoxy resin discs (Ø = 10 mm; thickness = 2 mm) after ceramic/epoxy surface treatments. The cemented assemblies of each group were randomly assigned into 2 subgroups considering two fatigue tests (n = 15) Staircase - SC (250,000 cycles; 20 Hz), or Step-stress - SS (10,000 cycles per step; 20 Hz). selleck chemicals llc Roughness, topographic and fractographic analyses were additionally performed. Statistical analyses were carried out using the Dixon and Mood method for Staircase data, and Kaplan-Meier and Mantel-Cox (log-rank) tests for Step-stress data. Ceramic restorations having its intaglio surface ground (GR group SC test = 306.67 N; SS test = 646.67 N) presented lower fatigue failure load (FFL) values than the CTRL group (SC test = 879.28 N; SS test = 1090.00 N), regardless of the fatigue testing approach. The percentage of mean FFL decrease comparing the CTRL to GR group was higher for SC (65.1%) than the SS (40.7%) approach. However, a different total number of cycles was applied for each method. Both fatigue tests were able to detect the negative effect of internal adjustments of lithium disilicate glass-ceramic simplified restorations on their mechanical behavior. Therefore, both methods can be applied for similar evaluations (fatigue testing for ceramic restorations).The present paper discusses two fuzzy Surrogate Safety Metrics (SSMs) for rear-end collision, the Proactive Fuzzy SSM (PFS) and Critical Fuzzy SSM (CFS). The objective is to investigate their applicability for evaluating the real-time rear-end risk of collision of vehicles to support the operations of advanced driver assistance and automated vehicle functionalities (from driving assistance systems to fully automated vehicles). The proposed Fuzzy SSMs are evaluated and compared to other traditional metrics on the basis of empirical observations. To achieve this goal, an experimental campaign was organized in the AstaZero proving ground in Sweden. The campaign consisted of two main parts a car-following experiment with five vehicles solely driven by Adaptive Cruise Control (ACC) systems and a safety critical experiment, testing the response of the Autonomous Emergency Braking (AEB) system to avoid collisions on a static target. The proposed PFS is compared with the safe distance defined by the well-known Responsibility Sensitive Safety (RSS) model, showing that it can produce meaningful results in assessing safety conditions also without the use of crisp safety thresholds (like in the case of RSS). The CFS outperformed the well-known Time-To-Collision (TTC) SSM in the a-priori identification of the cases, where the tested vehicles were not able to avoid the collision with the static target. Moreover, results show that CFS at the time of the first deceleration is correlated with the velocity of the vehicle at the time of collisions with the target.This paper investigates factors associated with the severity of pedestrian outcomes from motor vehicle crashes by analyzing a database of all 13,856 reported pedestrian crashes in Colorado over an 11-year period from 2006 to 2016. A total of 14,391 pedestrians were involved in these crashes, resulting in 612 (4.3%) pedestrian fatalities, 11,576 (80.4%) pedestrian injuries, and 2203 (15.3%) property damage only outcomes. The objective is to analyze crash records, as similarly compiled by other states, to show how lives potentially saved by improved factor levels can be estimated as needed for benefit-cost comparisons of alternative countermeasures. Odds ratios of fatal versus non-fatal pedestrian outcomes are computed both independently (unadjusted) and from logistic regression (adjusted) for each factor level accounting for possible correlations between factors. Also computed are odds ratios for fatal plus incapacitating injuries and odds ratios for just 2011-2016 versus all years. This study found that intersection proximity, lighting condition, vehicle type and speed, pedestrian age, pedestrian impairment, and driver impairment by drugs or alcohol were all significant factors associated with the severity of pedestrian outcomes from motor vehicle crashes. Risk ratios from these odds ratios are used to estimate lives potentially saved by having better factor levels present at the time of these crashes. These estimates reflect the relative magnitudes of benefits that might be achieved by potential countermeasures taking into account the number of cases affected.Japanese forests were exposed to multiple sources of radioactive contamination. To acquire scientific guidance on forest management planning, it is crucial to understand the long-term radiocesium (137Cs) distribution (and redistribution) over time. To obtain robust evidence of the residual global fallout of 137Cs (137Cs-GFO) after a few decades, we determined 137Cs-GFO inventory in forest soil at 1171 soil pits of 316 plots evenly spaced across Japan from 2006 to 2011, shortly before the Fukushima Dai-ichi Nuclear Power Plant accident. The activity concentration measurements were performed using a NaI well-type scintillation counter. The average (±SD) 137Cs-GFO in forest soil (0-30 cm from the surface) of the National Forest Soil Carbon Inventory (NFSCI) sampling plots uniformly extracted from the entire country was estimated to be 2.27 ± 1.73 kBq m-2 (n = 316) as of Oct. 1, 2008. A high nationwide spatial variation was found in 137Cs-GFO, where relatively high 137Cs-GFO was found along the Sea of Japan compared with the total annual precipitation.
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