Bacillus pasteurii. In particular, the use of lightweight aggregates as bacterial carriers in concrete can increase the chance of bacterial survival. Once the external environment meets the growth conditions of the bacteria, the vitality of the strain can be restored. Such a system can greatly improve the feasibility and success rate of bacterial mineralization in concrete. The test project included the microscopic testing of concrete crack repair, mainly to understand the crack repair effect of lightweight aggregate concrete with implanted bacterial strains, and an XRD test to confirm that the repair material was produced by the bacteria. The results show that the implanted bacterial strains can undergo Microbiologically Induced Calcium Carbonate Precipitation (MICP) and can effectively fill the cracks caused by external concrete forces by calcium carbonate deposition. According to the results on the crack profile and crack thickness, the calcium carbonate precipitate produced by the action of Bacillus pasteurii is formed by the interface between the aggregate and the cement paste, and it spreads over the entire fracture surface and then accumulates to a certain thickness to form a crack repairing effect. The analysis results of the XRD test also clearly confirm that the white crystal formed in the concrete crack is calcium carbonate. From the above test results, it is indeed feasible to use Bacillus pasteurii in the self-healing of concrete cracks.At present, the commonly used repair materials for concrete cracks mainly include epoxy systems and acrylic resins, which are all environmentally unfriendly materials, and the difference in drying shrinkage and thermal expansion often causes delamination or cracking between the original concrete matrix and the repair material. This study aimed to explore the feasibility of using microbial techniques to repair concrete cracks. The bacteria used were environmentally friendly  Micro-cracks are an almost inevitable feature of general concrete. Many studies report ,11,12,13Many researchers have attempted to incorporate specific healing agents directly into concrete mix to repair cracks by their reaction. However, most of the proposed healing agents are chemical substances that are not environmentally friendly . In receBacillus pasteurii DSM33, which is a Gram-positive aerobic bacterium that is ubiquitous in the soil and produces a large amount of intracellular urease. Basically, urease catalyzes the hydrolysis of urea to produce carbon dioxide, ammonia, and hydroxide ions. The reaction equation is as follows:Bacillus licheniformis, urea, and calcium chloride, calcium carbonate deposition can be induced to repair concrete cracks. De Muynck et al. [Bacillus subtilis is a Bacillus strain that also has the ability to induce calcium carbonate deposition.The most commonly used strain for biomineralization is bstances ,20. The bstances  showed tk et al.  pointed k et al. . It is ak et al. ,25,26. Ik et al.  pointed Bacillus pasteurii is close to a round rod or a spiral, and its cell diameter is about 0.5 to 3 μm. Studies by Mitchell [Bacillus species are more suitable for survival in soil environments with a void size greater than 6 μm. This is also the main reason why bacteria cannot be directly mixed into concrete. Wanga [Bacillus sphaericus spores into a hydrogel and mixed it with normal concrete. The test results were surprising, and the spore viability did not decrease. This proves that specimens containing biohydrogel can fix cracks in concrete. The maximum crack width that the specimen can heal is about 0.5 mm, while the healing crack width of non-biological hydrogels is 0–0.3 mm. The water permeability of the specimen was reduced by about 68%, indicating a significant improvement. Wiktor [The shape of Mitchell  indicatee. Wanga  encapsul. Wiktor  attached. Wiktor  used a sBacillus) will form spores with stronger resistance in cells under harsh environments such as drought and freezing. When the environment is suitable, the spores will germinate to produce new bacteria [Bacillus and anaerobic Clostridium [Certain bacteria  observations and spore staining tests were used to verify whether sporulation occurred. After the spore-treated strains were placed in the lightweight aggregate, the spore-forming strains were re-activated to restore their activity for subsequent concrete crack repair testing.In this study, The lightweight aggregates of the control group were not implanted with biological species and were cured in air, while the lightweight aggregates of the experimental group were implanted with biological species. Among them, the air-cured concrete specimens were regarded as experimental group I, and the cycle-cured concrete specimens were regarded as experimental group II. The crack healing ability of the cracked concrete specimens was examined by a crack microscopic test and an X-ray powder diffraction test. 2/g;Cement: a locally produced Type I Portland cement with a specific gravity of 3.15 and a fineness of 3400 cmWater: general tap water;Fine aggregate: natural sand with a particle size of less than 1 mm;Lightweight aggregate: The lightweight aggregate used was made by crushing natural shale and then firing at 1100–1200 °C. Its surface was porous and irregular in shape with a particle size of 1–8 mm, as shown in Reinforcement: #4 rebar was applied to the beam specimen;Bacillus pasteurii (DSM 33): the strain number was BCRC11596, and it was ordered from the Taiwan Food Industry Development Institute;Bacillus pasteurii;Calcium lactate: this was implanted in lightweight aggregates as a nutrient source for Yeast extract (YE): this is in powder form and contains a wide variety of vitamins, minerals, amino acids, etc., which are widely used as nutrients, and its leachate can be used as a medium with considerable efficacy;Calcium acetate: this was used as a source of calcium ions during curing;Urea: this was used as source of carbonate ions during curing.The materials used in this study were as follows:(1)Immerse the treated lightweight aggregates into a nutrient source  for 30 min.(2)After the soaking is completed, drain and take out the lightweight aggregates and place them in an oven at 37 °C for 5 days.(3)Repeat steps (1) and (2) once, and immerse the lightweight aggregates in the nutrient source twice.(4)Dip the lightweight aggregates containing the nutrient source into the bacterial spore solution for 30 min.(5)Drain the soaked lightweight aggregates and place them in an oven at 37 °C for 5 days to complete the work of strain implantation in lightweight aggregates.The steps used for implanting the strain into lightweight aggregates were as follows:After the strains were implanted into the lightweight aggregate   to understand the changes in strain appearance and spore culture. The mode of SEM observation in the experiment was secondary electron imaging, and the image was presented by an upper detector (SEI) and a lower detector (LEI), depending on the type and position of the detector.In this study, powder samples were randomly taken from inside the concrete specimen and near the surface of the crack. A component analysis of powder samples was performed by a high-resolution X-ray diffractometer . When the calcium carbonate crystal was irradiated with X-rays, the angles (Theta) reflected by the X-rays were mainly 29.3°, 39.5°, and 47.3°. When calcium hydroxide was irradiated with X-rays, the angle of reflection by X-ray irradiation was mainly 34.1°. As for Quartz, when X-rays were irradiated, the angles reflected by X-rays were mainly 26.4° and 69.1°.Bacillus pasteurii in the SEI or LEI shooting mode, the surrounding environment shows that there was no other impurity in the Bacillus and that the surface of the Bacillus was smooth and there was no adhesion phenomenon. After heating, there were many white spots (SEI) and particles (LEI) in addition to the Bacillus itself around the Bacillus pasteurii image. Moreover, the appearance of the Bacillus became more and more uneven, and in some cases, the Bacillus was observed to have protrusions and particle adhesion on the surface.From the results of the photographs shown in Bacillus pasteurii was flat and clean under the conditions of SEI or LEI, and the appearance of the Bacillus was also different. After heating, the appearance of the Bacillus was broken and there were more impurities in the image. In a high-temperature environment, in order to cope with the severe environment, Bacillus pasteurii will produce spores to continue life. It can be speculated that the white spots (SEI), particles, and protrusions (LEI) in the image after heating may be spores, because the spores of Bacillus will be released from the broken sporangia when they mature. The image obtained by the FE-SEM observation was the only appearance of a living thing. In order to confirm that the observed image was a spore of Bacillus pasteurii, the spore staining method was used for observation. The spore staining method mainly uses malachite green solution to stain the spores, and safranin solution is used to infect the cell wall of the Bacillus, and this is then observed by an optical electron microscope at 800 times magnification.It can be seen from the image results that the unheated Bacillus pasteurii was densely distributed under microscope observation, and the Bacillus body was red, while the heated Bacillus pasteurii was loosely distributed and exhibited a green, non-rod shaped cell. From the experimental results, it was found that the number of cells of the Bacillus was less after heating than when the Bacillus was not heated. It is speculated that when the bacteria respond to the harsh environment, after depositing their own DNA into the spore, they will die by themselves to continue life. The green spots observed in Bacillus.The image results of According to the results of the FE-SEM observations and spore staining, it can be inferred that the test can indeed make the bacteria produce spores.bacilli by re-cultivation after the Bacillus pasteurii was heated to form spores. The test results are shown in The reactivation test was carried out to verify whether the spores were germinated into Bacillus pasteurii was planted into the aggregate as a biological strain, it was necessary to further understand whether the nutrient source could still be provided to restore the activity again. The test results are shown in Bacillus pasteurii spores can be re-germinated after being stored in the lightweight aggregate.After the spore-formed Bacillus pasteurii strain will still be released after activation. Therefore, the MICP reaction should be possible.For the strains revived by the lightweight aggregates containing biological species, the urease production and activity was further confirmed. The test results are shown in Bacillus pasteurii, which becomes spores, can restore its activity again by giving nutrients. On the other hand, it confirmed that the re-cultivation of the bacterial spores in lightweight aggregates restores the activity. From the preliminary biological tests of the lightweight aggregate re-culture test and the urease test containing biological species, it is known that the use of lightweight aggregate as a carrier of the strain is feasible. The strain is still active and forms a specific chemical reagent , which can successfully induce the urease action of the bacteria to form a calcium carbonate precipitate.The urease test was carried out on strains cultured from lightweight aggregates containing biological species. On the one hand, this was done to determine whether In the crack repair test of lightweight aggregate concrete, two different specimen types were planned. One was a cylindrical specimen, and the other was a beam specimen (the center is placed with #4 steel bars to prevent breakage, as shown in th day of curing (as shown in This study used a splitting method (as shown in Under a controlled load, the beam specimens produced flexural cracks (as shown in Bacillus pasteurii was less susceptible to disturbance when it produced calcium carbonate precipitate for crystal stack repair. If the flexural crack width reached about 1.2 mm (As can be seen from t 1.2 mm , the calTo further understand the effectiveness of biobacterial mineralization and accumulation, this study compared the crack profiles of the specimens. As is clear from Bacillus pasteurii was repaired with calcium carbonate crystals, a large amount of calcium carbonate precipitate formed from the outer edge of the crack. After sealing the outer edge of the crack, it extended to the inside and continued to slowly deposit calcium carbonate crystals for repair. According to the test results of the crack self-healing of the concrete cylindrical specimens and beam specimens, it is known that experimental group II of the circulating curing method can use the biological strains to repair the cracks in the concrete. In order to further understand the repairable depth of the crack after the action of the biological strains, the experimental group II concrete specimen was cut along the vertical plane of the crack, and the vertical section was observed. The observed crack width was approximately 0.5 mm (as shown in It can be seen from Bacillus pasteurii also provided additional calcium carbonate formation on the crack surface. The concrete specimen did nothing more than form a protective layer, which made it difficult for oxygen to enter the sample, thus causing the internal Bacillus pasteurii activity to be reduced, and it was difficult to form calcium carbonate crystals. Therefore, the calcium carbonate crystal formed at the center of the sample was smaller than the crystal on the surface of the sample. It can also be seen from the figure that the peak of the calcium carbonate crystal of the experimental group II samples at both the center and the surface was higher than that of the experimental group I samples. This result is consistent with the previous observations, which means that experimental group II specimens can produce significant calcium carbonate precipitation for crack repair.Moreover, in the experimental group II samples, Bacillus pasteurii can be made to sporulate by heating.According to the results of the FE-SEM observations and spore staining, it can be inferred that Bacillus pasteurii spore culture medium and the re-cultivation of lightweight aggregates containing biological bacteria, it can be seen that the Bacillus pasteurii spores in the lightweight aggregate can be reactivated into bacteria by re-administering nutrients to restore activity, and the urease test confirmed that bacteria in the lightweight aggregate could induce MICP to produce calcium carbonate precipitate.From the Bacillus pasteurii, so the repairability of concrete cracks is not as expected.From the crack repair test, it is known that the lightweight aggregate concrete containing biological bacteria requires additional urea and calcium source maintenance to repair the 0.1–2.0 mm wide crack. Concrete nutrients cured in the air are not sufficient to provide Bacillus pasteurii starts from the boundary between the aggregate and the cement paste, fills the entire fracture surface, and then deposits to a certain thickness. Thus, the repair effect of the concrete can be formed.According to the observations of the crack profile and the depth of crack repair, it is known that the calcium carbonate precipitate produced by the action of Bacillus pasteurii is repaired with calcium carbonate crystals, a large amount of calcium carbonate precipitate is formed from the outer edge of the crack, and the outer edge of the crack is sealed. Further extending to the inside, the calcium carbonate crystals are slowly accumulated for repair.The results of the XRD analysis confirmed that the white crystal formed in the concrete crack was calcium carbonate, and the closer to the surface of the specimen, the higher the calcium carbonate content. Because the bacterial growth environment at the surface is better, the MICP reaction is more obvious. Therefore, when Bacillus pasteurii strain can induce MICP and produce calcium carbonate crystals to fill small cracks in concrete. The Bacillus pasteurii used in this study and the calcium carbonate formed by it have been confirmed to be harmless to the human body, so it should be feasible to use this method in the self-healing of concrete cracks.This study demonstrates that the use of lightweight aggregate as a carrier and the implantation of the According to the test results and analysis, the comprehensive conclusions are as follows:


This paper deals with the experimental studies conducted on the effects of using sea sand on the properties of polymer concrete modified using epoxy resin. The physical properties including workability, mechanical properties, and durability properties were evaluated as a function of sea-sand substitution. The results obtained behave as strong evidence for the feasibility of using sea sand as fine aggregate to solve the problem associated with the exhaustion of natural aggregates when used in combination with epoxy polymer. A clear understanding of the behavior of polymer concrete with sea sand as aggregate was obtained through some preliminary investigations. The test results showed a significant improvement in the compressive and flexural strength due to the sea-sand substitution in polymer concrete. Resistance to the water intrusion was also improved for the concrete mixes due to the inclusion of epoxy resin. The quality and the integrity of the concrete were also improved, as evident from the SEM analysis and infrared (IR) spectroscopy, and the results function as solid basis for the use of sea-sand polymer-modified concrete for practical applications. Results also show that 15% replacement of fine aggregate by sea sand in air-cured polymer concrete exhibited enhanced strength and durability properties; thus, the produced concrete can be an effective material for unreinforced concrete applications. Polymer concrete is in no way new to civil engineering, and several attractive properties were achieved due to its superior performance . SeveralHence, the present research work aimed at investigating the properties of epoxy-modified sea-sand concrete, as well as the internal microstructure of the produced concrete. Polymer concrete shows significant resistance to chloride penetration, and this study aimed at utilizing the lower chloride penetration capacity of epoxy concrete to mitigate the drawback of sea-sand concrete. Thus, the present work not only focuses on studying the strength variations, but also serves as an initiative to propose the widespread usage of epoxy-modified sea-sand polymer concrete to ensure sustainability in the building construction industry.3 of the concrete is presented in Type Iordinary Portland cement (OPC)  was the cement used in the present study. The concrete mixes were produced using natural river sand and sea sand for fine aggregates, and coarse aggregate. The natural river sand conforms to Zone III as per BIS 383-1970 . The finThe workability of the polymer concrete was assessed by measuring the slump values at constant water-binder ratios (IS 1199-1959) . The comThe workability of the epoxy-modified concrete containing different proportions of sea sand is shown in 3 to 2222 kg/m3 with increasing sea-sand substitution ratio and epoxy substitution in the concrete.The bulk densities of the concrete mixes are shown in The compressive strength of the concrete specimens at various ages after being subjected to different curing conditions is shown in 2, which is a major hydration product of cement. This helps in the formation of C3A , which enhances the durability and strength of concrete. Due to the pore-occupying nature of the polymers, they occupy the capillary pores, contributing to an increase in strength.The compressive strength of sea-sand-substituted polymer concretes showed a strength improvement in normal curing and water curing. Generally, the reaction of hydrated pastes of cement with dissolved chlorides and sulfate present in the sea sand leads to the formation of calcium bicarbonates and gypsum, leading to leaching and weakening of the insoluble aggregates. Cement reacts with dissolved salts, leading to the formation of gypsum and complex compounds like ettringite and brucite, which lead to brittleness of the cement matrix, causing strength loss and disruptive expansion. The addition of polymer retards the formation of these complex compounds by controlling the formation of Ca(OH)Thus, it can be concluded that the addition of epoxy polymer played an important role in the improvement of compressive strength at all ages. The higher strength of air-cured specimens may be due to the minimal quantity of epoxy used. An excess quantity of epoxy resins may disturb the hydration mechanism, thereby reducing the compressive strength of concrete. Sea sands have the ability to increase the compressive strength of concrete at early ages, and epoxy resin increases the strength at later ages. Previous works also saw improved compressive strength of the sea-sand concrete at early ages when compared to the strength of ordinary concrete .As per the flexural strength results shown in The bond strength of the concrete mixes is shown in The water absorption of the polymer concrete mixes is shown in −1 to 4000 cm−1 is due to the presence of –OH bonds in the concrete, which corresponds to the chemically combined water of the hydration product Ca(OH)2. The presence of –OH bonds in all the concrete mixes indicates the formation of well-reacted hydration products. The water crystal lattice of CSH gel may also be indicated by the –OH band. The CSH gel formation is indicated by the band formed around 1000 cm−1. The spectra clearly show a strong CSH band with relatively higher intensity in all the epoxy-modified sea-sand concrete mixes when compared to the normal concrete mix. The epoxy-modified concrete showed out-of-plane bending of the phenyl ring around 300–700 cm−1. The band around 1200cm−1 corresponds to the H–O–H deformation which is different in the epoxy concrete, signifying the presence of stretching vibrations of C=C of epoxy polymer. This further confirms that the epoxy resin reacted well with the H–O–H deformations to form highly stable complexes.FTIR spectra of the polymer concrete mixes are shown in The morphology of the polymer concrete mixes and the plain concrete as obtained from the SEM imaging is shown in Generally, sea sand should be subjected to pre-treatments or de-salting procedures to remove the excess chloride content for use in concrete applications due to itsadverse effect on concrete properties by promoting corrosion of reinforcement. The present study utilized sea sand without appropriate de-salting procedures and, hence, cannot be used for reinforced structural applications, which is the limitation of the present study. The high cost associated with the de-salting procedure and lack of appropriate technologies prompted the direct use of sea sand in concrete. With this background, future studies will try to determine the possibility of using sea sand in epoxy-modified concrete for reinforced concrete applications by conducting corrosion studies, thereby ensuring the safety and durability of the proposed methodology.In the current investigation, the properties of concrete utilizing epoxy resin as a cement substitute and sea sand as a substitute for river sand were investigated to their suitability for unreinforced concrete applications. Both epoxy substitution and sea-sand substitution affect the workability of concrete, but the effect of the latter is minimal. The compressive strength development was accelerated at the early ages due to sea sand, whereas the polymer cement concrete produced stronger concrete when compared to the conventional concrete at the latter ages. About 30% improvement in the compressive strength and 35% improvement in the flexural strength were achieved in the 20% sea-sand-substituted air-cured polymer concrete at 180 days when compared to the conventional concrete. The flexural strength of the epoxy concrete was further enhanced by the incorporation of sea sand that acted as a micro filler. Bond strength was markedly superior with improved pull-out strength of the polymer concrete in the presence of sea sand as fine aggregate. Other parameters such as water absorption and pore spaces were reduced showing the superior performance of epoxy-modified sea-sand concrete. Compared to ordinary concrete, the initial and secondary rate of water absorption was also reduced, showing the greater resistance to water permeability. The microstructure of polymer sea-sand concrete showed significant morphological improvement at the inside of the concrete, indicating the bonding between sea sand and the cement matrix. Thus, a limited supply of fine aggregates may be compensated for by the utilization of sea sand as fine aggregate without disturbing the ecosystem and sustainability of the concrete structures when used in combination with epoxy resins.


Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA.n = 65 and women = 41) in Brazil during 2013–2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model.A cross-sectional design was employed to recruit 106 PLWHA , that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education years, time of diagnosis to HIV months, and type of combined antiretroviral therapy (cART) (with protease inhibitor “WI/PI = 1” or without protease inhibitor “WO/PI = 0”); and model five for women , that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months, body circumference of chest, and race (Asian) .Results support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (rThe proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA. The human immunodeficiency virus (HIV) remains one of the most serious global health threats of our time. Global estimates from 2016 found that 36.7 million people are living with HIV. Low- and middle-income countries, primarily in Africa and Latin America, represent 27.5 million (75%) of the total people living with HIV worldwide [A few decades ago, people living with HIV/AIDS (PLWHA) were given a short life expectancy. At the peak of the HIV epidemic between 1990 and 2000, life expectancy for PLWHA dropped to 49.5 years in some low- and middle-income countries; HIV and AIDS (acquired immunodeficiency syndrome) combined, decreased life expectancy by approximately 20 years . With cAThe improvement of the cART therapeutic regimen is one of the greatest public health achievements of the past few decades, and the HIV infection has transitioned into a manageable chronic illness . In moreLipodystrophy is associated with an increased risk for the development of non-communicable diseases among PLWHA. The literature has suggested that PLWHA under cART treatment with lipodystrophy—mainly those with visceral fat accumulation—are at increased risk of developing cardiovascular diseases –17 and dMultiple factors are associated with the pathophysiology of lipodystrophy, including cART’s protease inhibitor (PI) that appears to accelerate the rate of development of body composition and metabolic alterations , 24. OthThe prevalence of lipodystrophy among people living with HIV/AIDS can range from 41 to 70% , 30. ThiPredictive models using anthropometric methods such as skinfold thickness and body circumferences are typically used with the general population to measure body composition , 38 and We employed a cross-sectional study design to evaluate people diagnosed with HIV/AIDS that were under cART treatment at the University Hospital of Ribeirao Preto School of Medicine, University of Sao Paulo, Brazil (HC- FMRP- USP/ UETDI). The study was conducted from November 2013 to November 2014. During the period of the study, 1298 people living with HIV/AIDS were receiving treatment at the HC- FMRP- USP/ UETDI. We set up a study booth next to the waiting room of the hospital. Using convenience sampling, we invited all people living with HIV/AIDS that were waiting for an appointment with a health professional to join our study. A total of 125 people living with HIV/AIDS agreed to participate, but 19 patients did not meet the inclusion and/or exclusion criteria. The inclusion criteria for this study were: diagnosed with HIV/AIDS, aged between 18 and 69 years, being under cART treatment, and with or without physical signs of lipodystrophy. The exclusion criteria were: being treated for opportunistic diseases or cancer, use of ergogenic products which could cause body composition alterations, being pregnant, using prosthesis, amputated, or engaged in an exercise program sometime in the past 6 months. We were able to reach about 10% of the people living with HIV/AIDS in treatment at our hospital. Our final sample included 106 people (65 men and 41 women) living with HIV/AIDS.A DXA scan allows for a non-invasive, accurate, and fast measurement of body composition. In our study, we used the DXA Hologic instrument model QDR 4500 W, which was operated by a trained technician following standard procedures . We usedWe collected anthropometric measurements of participants in order to establish anthropometric predictive models for the diagnosis of lipodystrophy. The measurements included body weight and height, which were respectively assessed by a Filizola® electronic anthropometric scale and a Filizola® aluminum stadiometer. Skinfold thickness (SK) was measured in six regions: triceps, subscapular, suprailiac, abdomen , thigh, and medial calf. The Prime® compass (Harpenden Scientific model) was used to measure each participant’s skinfolds. The guidelines for carrying out the skinfold thickness measures are those described by Harrison et al. (1988) . Body ciIn addition to investigating if the combination of SK and/or BC can best predict the FMR, we created ratios, or “adjusted variables,” based on the literature on the measurement characteristics of lipohypertrophy and lipoatrophy . The bodTo ensure the quality of our data we took three precautionary steps. First, all the anthropometric measurements listed above were collected by the same evaluator at three-time points, and the median values were used. In addition, the measurements were conducted with 6 patients at a time and they were re-tested an hour later to confirm accuracy. Finally, the technical error of measurement (TEM) was calculated. TEM values were assessed for body circumferences (TEM ≤0.71 cm) and skinfold thickness (TEM ≤0.60 mm), ensuring the reliability of the measurements within established limits .Prior to conducting data analysis, we checked the database and cleaned for errors of data entry and impossible/inconsistent values. Means and standard deviations were calculated for all variables by sex, with a confidence interval of 95%. The Kolmogorov-Smirnov test was used to examine the normality of the distribution of continuous variables. The Student t-test and U Mann Whitney test for independent variables were used to assess differences between men and women based on their anthropometric measurements and additional predictor variables.To control for sex differences in body composition in people living with HIV/AIDS, we studied men and women separately. Our sample was classified into two groups, men and women, for data analysis and anthropometric predictive models for the diagnosis of lipodystrophy.n = 8), anthropometric ratios (n = 10), and all anthropometric variables (n = 32) were used in the principal components analysis. The Eigenvalues (> 1) and highest extraction value (> 0.90) were adopted as criteria for the inclusion of variables. The principal component analysis reduced the number of variables to eleven: BC of right arm extended, BC of right arm contracted, SK triceps, BC of abdomen to arm extended ratio, body weight, SK thigh, BC of right thigh, BC of left arm extended, sum SK trunk (abdomen + subscapular + suprailiac) to sum SK appendicular  ratio, SK abdomen, and BC right arm contracted corrected. We then conducted the stepwise linear regression using the reduced number of variables for each sex. However, we did not find high values for the adjusted R2 for the predictive models in both sexes (data not shown).We chose to use principal component analysis to select the variables for the predictive model’s generation in an attempt to reduce the amount of variables while not jeopardizing the assumptions expected for predictions. A total of 50 variables, including additional predictor variables  variables for the additional predictor variables ‘race’ and ‘type of cART’ to investigate their effect on the models. The standard error of the estimate (SEE) was used to define the accuracy of predictive models. To investigate limits of agreements between FMR predicted by DXA and FMR estimated by predictive models, 95% CI was used. The FMR estimated by predictive models is the outcome variable in this study. All the statistical analyses were carried out using SPSS® version 23.0 with a significance level of p < 0.05.The limits of VIF = < 4.0, and Eigenvalues = > 0.7 were adopted. The adjusted R2PRESS and SEE PRESS were expressed for all predictive models by sex. The PRESS analysis was carried out using Minitab® software version 17.We conducted cross-validations by “leave and out” from the predicted residual error sum of squares (PRESS) method to measure the efficiency of each predictive model generated. The Rn = 30), 24% consumed alcoholic drinks (n = 25), and 3% used illicit drugs (n = 4).Average age of the participants was 46.2 ± 9.6 years, time of diagnosis of HIV 115.3 ± 80 months (9.6 years), and exposure to cART 87.4 ± 63.1 months (7.3 years). Formal education was 8.3 ± 3.5 years, 28% were smokers (p = 0.966), diagnosis of HIV (p = 0.387), and exposure to cART treatment (p = 0.306). We observed similar proportions (%) of self-reported race/ethnicity between men and women: White (69.2 / 53.6), Black (7.7 / 12.2), Asian (6.2 / 12.2), and Brown (16.9 / 22.0), respectively. Men used cART with-protease inhibitor (PI) (47.7%) and without-PI (52.3%), and women used cART with-PI (36.6%) and without-PI (63.4%). Men had on average three more years of formal education than women (p = 0.011).Results of the descriptive analysis by sex Table  showed hp = 0.255 and p = 0.359, respectively) right arm extended and contracted (p = 0.526 and p = 0.335), left medial calf (p = 0.214), right thigh corrected (p = 0.977), right medial calf (p = 0.238), abdomen (p = 0.409), and ratio of waist/medial calf (p = 0.071). Regarding DXA, we observed differences in body composition among sex for all variables, where men have a higher body weight (kg) and FMR values, , and lower total trunk fat (kg) (p < 0.001) and total leg fat (kg) (p < 0.001).For the anthropometric measurements, there were no statistical differences between sexes in most body circumferences (BC): left arm extended and contracted .We considered adjusted model 6 to be “the best” predictive model because it includes few independent variables and a higher power of prediction. Linear regression resulted in a high adjusted R(Men adjusted model 6)Figure 2 values were observed between 0.69 and 0.83, of the SEE between 0.10 and 0.13, and of the 95% CI between 0.87 and 1.06. For non-adjusted predictive models we observed variations of the adjusted R2 values between 0.27 and 0.78, of the SEE between 0.11 and 0.20, and of the 95% CI between 0.81 and 1.03.Table 2 value of 0.78, a SEE value of 0.11, and a 95% CI value of 0.81 to 0.93. The variables included were: skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months, body circumference of chest, and race (Asian) .We considered non-adjusted model 5 to be “the best” predictive model for women because it includes few independent variables and a high power of prediction. From the linear regression, we had a high adjusted R(Women non-adjusted model 5)Figure 2PRESS value of 0.73, and a small SEE PRESS value of 0.15. For the best predictive model for women (non-adjusted model 5)  Table , we had The main goal of this study was to predict and validate methods to diagnose lipodystrophy among people living with HIV/AIDS through anthropometric measurements and using DXA as a reference method. Prediction models were validated for both men and women. Our predictive models advance the field of HIV/AIDS studies by proposing a method for the diagnosis of lipodystrophy that is objective, accurate, low cost, and easy to use. In public health, especially in low- and middle-income countries, our predictive models should lead to improvements in the understanding of the prevalence, incidence, risk factors, pathogenesis, prevention, and treatment of lipodystrophy. In addition, the feasible identification of body composition alterations of lipodystrophy will contribute to interventions from health professionals that lead to better health outcomes on the overall well-being of people living with HIV/AIDS. To date, only France , Portugahttp://www2.eerp.usp.br/pos/arquivos/Routine_Models_Men_and_Women.xls).Our study is important not only in the context of Brazil—place of residence of study participants—but to other countries with limited resources available to develop such studies, including Eastern and Southern African countries, the regions hit hardest by HIV/AIDS. To ensure global dissemination and accessibility, lipodystrophy diagnosis based on our predictive models can be found in an excel file in the following link   comparedIn addition, ‘adjusted model 6’ included important variables such as “education,” “time of diagnosis to HIV,” and “type of cART,” which are important social and physiological determinants for body composition alterations. Our findings on the associations between these factors and the development of lipodystrophy in people living with HIV/AIDS are supported by two systematic reviews , 47. The” is a dummy variable. Dichotomizing the variable as presence of “race (Asian)” or no presence provided us with accurate predictive power.For women, we believe that the best predictive model is ‘non-adjusted model 5’. For this model, only three anthropometric variables were included: skinfold thickness of thigh, skinfold thickness of subscapular, and body circumference of breast. Zulfa et al. (2016)  used antThis study represents a first step towards proposing an objective, accurate, and low operational cost tool for lipodystrophy diagnosis and monitoring in men and women living with HIV/AIDS. We believe that the greatest challenge in the future is developing accessible predictive models separately for lipoatrophy and lipohypertrophy. This next step will enable better comprehension of the pathways that contribute to losses and gains in fat mass, and promotion of specific treatments (pharmacologic or otherwise) for each. Also, further analysis is needed to establish whether the predictive models for lipodystrophy differ between people living with HIV/AIDS in treatment for opportunistic disease, for those who are over 69 years old, and for those who are younger. The use of our findings in future studies of HIV/AIDS will allow for more reliable estimates of lipodystrophy prevalence, incidence, and cause, and more effective prevention and treatment strategies.Findings should be interpreted with caution. Due to the amount of independent variables to estimate fat mass ratio and the separation of the sample into men and women, there are limitations regarding sample size of this study. We have chosen to separate men and women due to the similar number of people living with HIV/AIDS for both sexes in our total sample size. In addition, the body composition differences among sexes is established in the literature and confirmed in our results. In accordance with statistical assumptions, we reduced the number of independent variables through the principal component analysis. However, after we conducted stepwise linear regression adopting the reduced number of independent variables, we did not have predictive models with accurate predictive power for lipodystrophy diagnosis in men and women. In this case we assumed the inclusion of all additional predictor variables, anthropometric ratios, and all anthropometric variables.2 values for our best predictive model for men (77) and women (78) is limited, but is representative of the complex factors which influence the high variability in body composition alterations in people living with HIV/AIDS. While the accuracy and significance could be greater, a prediction of 80% for lipodystrophy diagnosis can be achieved using an accessible and low operational cost tool that represents a great advancement in the health care services available to people living with HIV/AIDS.The power of prediction based on the adjusted RIn our study we did not exclude people living with HIV/AIDS with diabetes mellitus or other chronic metabolic diseases. These conditions are often experienced by people living with HIV/AIDS under cART treatment. Even though some chronic metabolic diseases may influence body composition alterations, our goal was to study the most typical group of people living with HIV/AIDS. However, we understand that the presence of diabetes mellitus or other chronic metabolic diseases could have influenced our predictive models.Accurate and sex-specific predictive models using anthropometric measurements were proposed to diagnose lipodystrophy in people living with HIV/AIDS. We believe this information will advance the public health field by assisting health professionals in diagnosing and monitoring lipodystrophy at a low cost, and thus will contribute to decreasing the adverse health effects of lipodystrophy in people living with HIV/AIDS.


In addition, the first four arginine residues (R1-R4) in Nav DIVS4 have position-specific functions in the fast inactivation process, and mutations in these residues are associated with diverse phenotypes of Nav-related diseases (sodium channelopathies). R1 and R2 mutations commonly display a delayed fast inactivation, causing a gain-of-function, whereas R3 and R4 mutations commonly display a delayed recovery from inactivation and profound use-dependent current attenuation, causing a severe loss-of-function. In contrast, mutations of residues of pGCTC in Nav DIVS1-3 can also alter fast inactivation. Such alterations in fast inactivation may be caused by disrupted interactions of DIVS4 with DIVS1-3. Despite fast inactivation of Navs occurs from both the open-state  and closed state , changes in CSI have received considerably less attention than those in OSI in the pathophysiology of sodium channelopathies. CSI can be altered by mutations of arginine residues in DIVS4 and residues of pGCTC in Navs, and altered CSI can be an underlying primary biophysical defect of sodium channelopathies. Therefore, CSI should receive focus in order to clarify the pathophysiology of sodium channelopathies.The segment 4 (S4) voltage sensor in voltage-gated sodium channels (Na In. In56]. v1.4 .10.1080/v1.1, D1544, N1554, E1561, N1577, F1584, E1587 and D1608 are thought to be residues of pGCTC  and R1128H (R3) mutations in rat Nav1.4 DⅢS4, equivalent to R1135C (R3) and R1135H (R3) mutations in human Nav1.4 DⅢS4 found in hypoPP, respectively, displayed an enhanced CSI, accelerated entry into CSI and delayed recovery from CSI , one of the residues of pGCTC, in DIVS1 and R1632C (R4) (homologous residue to R1457 in Nav1.4) in DIVS4 in Nav1.5, both of which were found in BrS with SSS and SVTs [v1.5. The marked acceleration of the entry into CSI of N1541D may be caused by a voltage-dependent modification of coupling of N1541D in DIVS1 with R1632 in DIVS4 during subthreshold depolarization; N1541D markedly affects the coupling in the CSI process. In contrast, the marked delay of the recovery from CSI of R1632C may be caused by a slowed remobilization of DIVS4 to the hyperpolarized/resting position during repolarization through disrupted native electrostatic interactions of DIVS4 and DIVS1, as with the R1128C (R3) and R1128H (R3) mutations in rat Nav1.4 DⅢS4.Regarding Nareported –67. Howeand SVTs ,57. Bothvs, neutralizing or charge-reversing mutations of arginine residues (R1-R4) in DIVS4 or residues of pGCTC in DIVS1-3  may modify the native electrostatic interactions of DIVS4 and DIVS1-3 in the activation and inactivation processes, including CSI. Further structure-function studies will be required to prove this hypothesis. Furthermore, in addition to the importance of coupling of DIVS4 with DIVS1-3 in the CSI process, other mechanisms involved in CSI may be present and need to be elucidated. Clinically, enhanced CSI of R1632C and N1541D in Nav1.5 is the primary biophysical defect causing a severe loss-of-function of Nav1.5 and may underlie the pathophysiology of overlapping arrhythmic phenotypes [vs may also be an underlying factor as a primary biophysical defect in sodium channelopathies.Given the resemblance of functional abnormalities among homologous residues in Navs differs with respect to gating pore currents (or ω-currents) [Although the arginine residues of the S4 segments in DⅢ and DIV appear to have domain-specific important roles in the fast inactivation, those in DⅠ and DⅡ do not appear to have important roles ,6. In adurrents) –70.vs, gating pore currents were first observed in substitutions of R1 and R2 in Nav1.2 DⅡS4 [vs. It is noteworthy that the gating pore currents in Navs have small amplitudes (less than 1% of the ɑ-pore conductance) and are smaller than those in the voltage-gated potassium channels (Kvs) because of the formation of ɑ-pores: Kvs have four identical gating pores but Navs have only a single gating pore in each ɑ-pore. Moreover, substitutions of the arginine residues of S4 in DIV are more resistant to the creation of gating pore currents than those in DⅠ-DⅢ, possibly because the pGCTC in DIV is spread over a larger distance [Gating pore currents were originally observed in the Shaker channel by Starace and Bezanilla . Substit1.2 DⅡS4 . Later, distance ,74,75.v1.4, all hypoPP mutations that have been identified are missense substitutions at arginine (R1 or R2) residues of S4. More surprisingly, all mutations in DⅠ-DⅢ that have been examined, except for those in DIV, create gating pore currents that flow either protons or non-selective cations, depending on the arginine positions and substituted residues [v1.4 [v1.4 DⅢS4, which is associated with hypoPP, showed enhanced CSI over a voltage range for which this mutation increases gating pore currents. This suggests that an increase of gating pore currents at subthreshold voltages may be one of the causes for the enhancement of CSI [Evidence is accumulating on the pathophysiological roles of gating pore currents in sodium channelopathies, although there is no apparent evidence of their pathophysiological roles in potassium channelopathies. Curiously, in Naresidues ,70,74,75es [v1.4 ,70,74,75t of CSI .v1.5, gating pore currents are thought to be associated with a particular clinical phenotype: dilated cardiomyopathy (DCM) with cardiac arrhythmias [v1.5 associated with this phenotype are located at S4 in DⅠ and DⅡ, but are not present in DIV. R219H (R1) mutation of S4 in DⅠ, which does not promote apparent alteration in Nav1.5, creates gating pore currents that conduct protons [v1.5, create gating pore currents that conduct non-selective cations [v1.4 and Nav1.5 contribute to the clinical phenotypes need to be clarified.On the other hand, in Nahythmias ,70. Most protons ,70,76. I cations ,70,77–79vs have domain-specific functions in terms of fast inactivation and gating pore currents. Regarding the fast inactivation, R1-R4 mutations in Nav DIVS4 have position-specific functions. R1 and R2 mutations in Nav DIVS4 commonly display a delayed fast inactivation, which causes a gain-of-function of Nav. R3 and R4 mutations in Nav DIVS4 commonly display a marked hyperpolarizing shift in steady-state availability, delayed recovery from inactivation, and profound use-dependent current attenuation, which cause a severe loss-of-function of Nav. Thus, R1-R4 mutations in Nav DIVS4 exhibit position-specific diverse phenotypes in sodium channelopathies. Regarding the gating pore currents, mutations of arginine residues of S4 in Nav DⅠ-DⅢ, but not DIV, create those, which may underlie the pathophysiology of diverse clinical phenotypes. On the other hand, mutations of residues of pGCTC in Nav DIVS1-3 can also alter fast inactivation. These changes in fast inactivation of Navs may be caused by disrupted interactions of DIVS4 and DIVS1-3. In addition, mutations of arginine residues in Nav DIVS4 and residues of pGCTC in Nav DIVS1-3 can alter not only OSI but also CSI through disrupted interactions of DIVS4 and DIVS1-3. Since altered CSI can be an underlying factor as a primary biophysical defect in sodium channelopathies, CSI should receive a greater degree of focus going forward in order to clarify the pathophysiology of sodium channelopathies.S4 segments in Na


The performances of the pixelated CsI(Tl) scintillation screens based on oxidized silicon micro-pore array templates with different CsI(Tl) micro-column shapes and array structures in X-ray imaging were simulated using the Geant4 Monte Carlo simulation code. The shapes of the micro-columns include square, hexagonal and circular, and the array structures include square and hexagonal arrangements. The pitch size of the pixelated CsI(Tl) scintillation screens was set to 4 µm, and the incident X-ray energy was set to 20 keV. The ratios of the number of scintillation photons that propagate along the CsI(Tl) micro-columns to the total number of scintillation photons of the micro-columns gradually decrease with the increase in total reflection time on the lateral surfaces of the micro-columns. However, these ratios are closely related to the shapes of the micro-columns and the incident positions of X-ray on the cross-sections of the micro-columns, especially for the circular micro-column. The sequence of bottom light outputs stimulated by a uniform flood field of X-ray from high to low corresponds to the circular, square and hexagonal CsI(Tl) micro-columns with the same cross-section areas. In addition, all spatial resolutions in terms of modulation transfer functions (MTFs) for the pixelated CsI(Tl) scintillation screens with square and hexagonal array structures are over 100 lp/mm. However, the resolution for the pixelated screen with the hexagonal array structure is approximately 8.5% higher than that for the screen with the square array structure. Moreover, the former screen has a higher detective quantum efficiency (DQE) than the latter screen at the same thickness. The pixelated CsI(Tl) scintillation screen with circular micro-column and hexagonal array structure in X-ray imaging has superior performance compared to other pixelated screens in this work. With the development of X-ray imaging, the screens must have better spatial resolution and detection efficiency. To ensure adequate detection efficiency, the scintillation screens typically require a sufficient thickness3. However, increasing the thickness of the scintillation screens often comes at the expense of their spatial resolution because of the lateral spreading of scintillation light4. To overcome this limitation, CsI(Tl) scintillation screens with a needle-like columnar structure were developed through a thermal evaporation method5. The vertical columnar structure can suppress the lateral spreading of scintillation light and preserve the spatial resolution of X-ray imaging. However, this kind of structure is not perfect. The cross-talk of scintillation light between adjacent columns remains due to the lack of effective optical isolation. To solve this problem, the pixelated CsI(Tl) scintillation screens based on silicon micro-pore array templates were investigated6. The screens were made of silicon micro-pore array templates with oxidized reflective pore walls and filled with a CsI(Tl) scintillator7. Due to the total reflection, the scintillation light with an incident angle smaller than the critical angle αc will be guided to propagate along the CsI(Tl) column, and the light that enters the pore walls will be basically absorbed by the pore walls and hardly transmit into the adjacent columns.CsI(Tl) scintillation screens have been widely used in X-ray imaging such as mammography, micro-tomography, and nondestructive testing2 reflective layers is illustrated in Fig. 14, some are hexagonal columns12, and some are circular columns15. However, there remains a lack of research on which type of column is more favourable to guide the scintillation light propagating along the column. In addition, the structure of the prepared pixelated CsI(Tl) scintillation screens is mostly a square array14. When the pitch size of the structured scintillation screen approaches the pixel size of the corresponding photoelectric device such as a CCD (charge coupled device) and CMOS , the Moiré patterns easily occur because of the interaction between the periodic scintillation array of the CsI(Tl) screen and the pixelated photoelectric device. To avoid this effect, the pixelated CsI(Tl) screens with a hexagonal array structure were developed12. The effect of the array structure of the scintillation screen on the spatial resolution and detective quantum efficiency (DQE) of X-ray imaging is also worth studying.The principle of the scintillation light guided by the pore walls with SiO16. Its functionality and modelling capabilities in event category, geometry module, tracking category, electromagnetic physics, and particle-matter interactions17 make it particularly suitable for simulating the behaviour of scintillation screens in X-ray imaging. In this work, the guide effects of the oxidized silicon micro-pores filled with a CsI(Tl) in different shapes on scintillation light were simulated by using Geant4. The performances of the pixelated CsI(Tl) scintillation screens with different array structures in X-ray imaging were also simulated and compared.Geant4 is a Monte Carlo software toolkit for the simulation of the passage of particles through matter. It is used in many experiments and projects in various application domains, including particle physics, astrophysics, space science, medical physics and radiation protection2 layer on the inner wall of the silicon pore can be grown by the thermal oxidation method. Because the refractive index of SiO2 (n = 1.46) is less than that of CsI(Tl) (n = 1.74), the SiO2 layer can help to improve the guide effect of silicon pore on scintillation light. The pixelated scintillation screens are made of oxidized silicon micro-pore array templates filled with a CsI(Tl) scintillator. In this simulation, the pitch size of the pixelated CsI(Tl) scintillation screens was set to 4 μm 12, and the pore wall was set to consist of an 800 nm thick silicon layer covered with a 100 nm thick SiO2 layer at each side. The incident X-ray energy was set to 20 keV. The level of the Entrance Surface Air Kerma (ESAK) was set to 1.0 mGy, which could ensure the stability of the results.The silicon micro-pore array templates with different pore shapes and array structures can be fabricated by photolithography and then by inductively coupled plasma (ICP), electrochemical etching, etc. A SiOrs, rh and rc are the apothems of the square, hexagonal and circular micro-columns as shown in Fig. rc was set to 1.5 µm, rs and rh were 1.33 and 1.43 µm, respectively.The light guide effects of CsI(Tl) micro-columns in oxidized silicon micro-pores with square, hexagonal and circular shapes and lengths of 10–100 µm were simulated. To compare the results of the CsI(Tl) micro-columns in these three shapes, their cross-sectional areas should be the same, i.e., entclass1pt{minimaThe pixelated CsI(Tl) scintillation screens with square and hexagonal array structures used in the simulation are shown in Fig. The performances of the pixelated CsI(Tl) scintillation screens are characterized by the light output (LO), modulation transfer function (MTF) and detective quantum efficiency (DQE) of the detection system in X-ray imaging.18. The bottom light output was defined by the mean number of scintillation photons per incident X-ray photon detected by the CCD.The mean number of generated scintillation photons per incident X-ray photon of pixelated screen was simulated by exposing the screen to a uniform flood field of X-ray. The scintillation photons can uniformly emit in all directions. However, the micro-column array structures can effectively guide the scintillation light that propagate along the columns. The photons that reach the backside of the screens were counted by an ideal CCD with a pixel size smaller than the pitch size of the pixelated CsI(Tl) scintillation screens. The refractive index of silicone oil for optical coupling between the screens and the CCD was set to 1.4318. An edge spread function (ESF) was acquired by using an edge phantom, which was the response of the X-ray imaging system to an opaque object with a straight edge. The MTF was calculated by Fourier transform of a line spread function (LSF), which was derived from the differential of the ESF along the direction (assuming the direction of the x-axis) perpendicular to the straight edge19The spatial resolution of an X-ray imaging system is commonly described by its MTF. In this work, the MTF was simulated according to the standard edge measurement methodThe value of the MTF at zero frequency was normalized to unity. The spatial resolution of the X-ray imaging system was defined by the frequency where MTF = 0.1.22, which considers the MTF, noise power spectrum (NPS) and Swank factor. The expression for the DQE is as follows23Q is the quantum detection efficiency of a screen, which can be evaluated as the ratio of the number of X-rays that deposit their energy in the screen to the number of X-rays incident on the screen; AS is the Swank Factor24. The NPS is the output noise power spectrum of an X-ray imaging system; it quantitatively describes the amount and frequency of the noise in an imaging system. Each normal incident X-ray photon that interacts with a scintillation screen produces a 2D point spread function (PSF). The NPS produced by each detected X-ray photon along the x-axis direction was computed by summing the 2D PSF in the y-axis direction and taking the square of the magnitude of its Fourier transformf) over all detected eventsThe DQE is the most crucial imaging characteristic and refers to the efficiency of a detector to convert incident X-ray energy into an image signal. It was simulated using the recently developed Fujita-Lubberts-Swank (FLS) method17. A number of parameters need to be used in the simulation: light yield, emission spectrum, optical attenuation coefficient, refractive index, etc. The scintillation light yield of CsI(Tl) was set to 54 photons/keV25. The emission spectrum of CsI(Tl) was obtained from the results of ref.26. The optical attenuation coefficient was determined by the transmission spectrum of the CsI(Tl) crystal27. The refractive index of CsI(Tl) in the wavelength range from 300 to 900 nm was obtained from ref.28. Additionally, the refractive indices and optical attenuation coefficients of Si and SiO2 were obtained from refs30. The refractive index of air was set to 1.The Monte Carlo simulation was performed using the Geant4 version 10.0 toolkit2. However, the bottom light output of the CsI(Tl) micro-column is closely related to its shape, as shown in Fig. The simulated X-ray absorption and the mean number of generated scintillation photons per incident X-ray photon of a CsI(Tl) micro-column in the square, hexagonal or circular oxidized silicon micro-pore are shown in Figs To better understand the effect of the shape on the light guide behaviour of CsI(Tl) micro-column, the proportion of the number of scintillation photons that pass through n total reflections on the lateral surface of the micro-column to the total number of scintillation photons stimulated by the normal incident X-ray was simulated, as shown in Fig. It was simulated that the proportion of the number of scintillation photons that pass through the total reflection to the total number of scintillation photons as a function of the incident position of X-ray on the cross section of the CsI(Tl) micro-column in different shapes. For simplicity, only those special positions on lines 1  and 2  were considered in the simulation, as shown in Fig. Figure The performance of the pixelated CsI(Tl) scintillation screens with hexagonal and square array structures was simulated. Based on the above study, the circular CsI(Tl) micro-column has the best guide effect on scintillation light, so it was used to build the pixelated CsI(Tl) scintillation screens here.The simulated X-ray absorptions and mean numbers of generated scintillation photons per incident X-ray photon of the pixelated CsI(Tl) scintillation screens with square and hexagonal array structures are shown in Figs The distributions of scintillation light that reach the bottoms of the pixelated CsI(Tl) scintillation screens with square and hexagonal array structures are shown in Fig. The bottom light outputs of the pixelated CsI(Tl) scintillation screens with square and hexagonal array structures are shown in Fig. 13 of the pixelated CsI(Tl) scintillation screen with same pitch size, array structure and thickness. Furthermore, all spatial resolutions for both screens with square and hexagonal array structures slightly decrease with the increase in thickness. For the 40 μm and 100 μm thick square array screens, they are 111.5 and 107.8 lp/mm, respectively. However, for the 40 μm and 100 μm thick hexagonal array screens, they are 121.3 and 117.0 lp/mm, respectively. The spatial resolution for the pixelated CsI(Tl) scintillation screen with a hexagonal array structure is approximately 8.5% higher than that for the screen with a square array structure at the same thickness. The reason of the improvement is related to the compactness of the micro-column arrangement.The modulation transfer functions (MTFs) of the pixelated CsI(Tl) scintillation screens with square and hexagonal array structures at 40 μm and 100 μm thicknesses are shown in Fig. The detective quantum efficiencies (DQEs) at zero frequency for the pixelated CsI(Tl) scintillation screens with both square and hexagonal array structures as functions of the screen thickness are shown in Fig. The X-ray imaging performances of the pixelated CsI(Tl) scintillation screens based on oxidized silicon micro-pore array templates with different CsI(Tl) micro-column shapes and array structures were simulated using the Geant4 Monte Carlo simulation code. The micro-columns had square, hexagonal and circular shapes, and the array structures included square and hexagonal arrangements. The guide effect of a filled CsI(Tl) micro-column in different shapes on the scintillation light was investigated. The proportions of the number of scintillation photons that propagate along the CsI(Tl) micro-columns to the total number of scintillation photons of the micro-columns gradually decrease with the increase in number of total reflections on the lateral surfaces of the micro-columns. However, these proportions are closely related to the shapes of the micro-columns and incident positions of X-ray on the cross sections of the micro-columns. When the incident positions of X-rays are at the centres of the cross sections of the micro-columns, the proportions for the micro-columns in all shapes are relatively limited. When the incident positions of X-rays depart from the centres of the cross sections, the proportions for the square and hexagonal micro-columns vary little, but the proportion for the circular micro-column increases exponentially. The bottom light output stimulated by a uniform flood field of X-ray of the circular micro-column is significantly higher than that in square and hexagonal columns with the same cross-section areas.On the basis of the above research, the X-ray imaging performances of the pixelated CsI(Tl) scintillation screens with square and hexagonal array structures with a period of 4 μm were simulated, where the CsI(Tl) micro-columns are cylindrical. Although the bottom light outputs of the screens with both structures increase with the screen thickness, the result of the screen with the hexagonal array is approximately 15% higher than that of the screen with the square array. All spatial resolutions in terms of MTFs for both screens with square and hexagonal array structures exceed 100 lp/mm and only slight decrease with the increase in thicknesses. The resolution of the pixelated CsI(Tl) scintillation screen with the hexagonal array structure is approximately 8.5% higher than that of the screen with the square array structure at the same thickness. As expected, all DQEs for the pixelated CsI(Tl) scintillation screens with square and hexagonal array structures decrease with the spatial frequency and increase with the screen thickness. However, the DQE for the screen with the hexagonal array structure is higher than that for the screen with the square array structure at the same thickness, which implies that the former screen has a better overall signal-to-noise transfer properties than the latter screen. The performance of the pixelated CsI(Tl) scintillation screen with the circular micro-column and hexagonal array structure in X-ray imaging is superior to those of the other screens studied in this work.


Mood-induced heroin choice was associated with self-reported heroin use to cope with negative affect ( p < .05), but not social pressure ( p = .39) or cued craving ( p = .52), and with subjective mood reactivity ( p = .007). These data suggest that acute negative mood is a trigger for heroin seeking in heroin-dependent individuals, and this effect is pronounced in those who report using heroin to cope with negative affect, and those who show greater subjective reactivity to negative triggers. Interventions should seek to target negative coping motives to build resilience to affective triggers for relapse.Acute growth in negative affect is thought to play a major role in triggering relapse in opiate-dependent individuals. Consistent with this view, three lab studies have demonstrated that negative mood induction increases opiate craving in opiate-dependent individuals. The current study sought to confirm these effects with a behavioral measure of heroin seeking, and test whether the effect is associated with self-reported opiate use to cope with negative affect and subjective reactivity to mood induction. Participants were heroin-dependent individuals engaged with treatment services (n = 47) and control participants (n = 25). Heroin users completed a questionnaire assessing reasons for using heroin: negative affect, social pressure, and cued craving. Baseline heroin choice was measured by preference to enlarge heroin versus food thumbnail pictures in two-alternative forced-choice trials. Negative mood was then induced by depressive statements and music before heroin choice was tested again. Subjective reactivity was indexed by negative and positive mood reported at the pre-induction to post-test timepoints. Heroin users chose heroin images more frequently than controls overall (  According to negative reinforcement theory, negative affective states act as powerful triggers for drug use behavior, motivating drug use to cope with those states . EvidThree studies have tested whether negative mood induction motivates opiate craving in opiate-dependent individuals. The study by Childress and colleagues  recruiteOne limitation of the existing literature is that there is no demonstration of negative mood induction increasing a behavioral measure of heroin-seeking behavior. The three prior studies all measured opiate craving which has an unknown relationship to behavior . To addrThe second limitation of the existing literature is that individual sensitivity to mood-induced opiate craving remains obscure. The two studies by Hyman et al. and Stathopoulou et al. , 23 founvia word of mouth from the community. Exclusion criteria included history of substance dependence or any other DSM-IV axis I disorders. Participants were matched for gender , and age, t(34.26) = 1.66, p = .11. A chi-square comparing three categories of educational attainment  was non-significant, χ2 = 4.48, p = .11, suggesting the two groups were matched for educational attainment. One opiate-using participant was excluded for showing an extremely outlying reduction in heroin choice from pre- to post-induction (>3 times the inter quartile range), leaving 46 opiate users and 25 control participants in the analyzed data set. The study was approved by the Western Sydney University Human Research Ethics Committee, and participants provided informed written consent.Participation was open to males and females aged 18–65 being treated for current heroin addiction by opioid medication at the Royal Prince Alfred (RPA) Hospital Drug Health Clinic in Sydney, Australia. Data were collected from 47 opiate-dependent outpatients  after they received opiate medication. In total, 2 participants (4.3%) were aged 19–24, 14 (29.8%) were 25–39, 16 (34.0%) were 40–49, and 15 participants (31.9%) were 50+ years of age. Thirty-five participants were receiving methadone (mean dose = 79 mg), 2 participants received buprenorphine (mean dose = 6 mg), and 10 participants were receiving suboxone (mean dose = 21 mg). The majority of these participants were currently unemployed, educated to high school level, and single. Eligibility criteria included: 1) current attendance in treatment for heroin addiction, 2) over 18 years of age, 3) English speaking, and 4) receiving opiate medication for the last 30 days. Healthy controls that did not have a history of opiate addiction were recruited Participants reported gender and age. Heroin users completed the Reasons for Drinking Questionnaire (RFDQ), adapted for heroin use . InstrucThe trial structure and timings of the heroin picture choice task are shown in F = 19.85, p = .001, ηp2 = .223, and interaction between group and block, F = 4.04, p = .048, ηp2 = .055, and no significant main effect of block, F = 1.64, p = .21, ηp2 = .023. The main effect of block was significant in heroin users, F = 6.96, p = .01, ηp2 = .134, but not controls, F = .26, p = .62, ηp2 = .011. These results indicate that heroin users chose heroin images more frequently, and showed increased heroin choice following negative mood induction, compared to controls.F = 12.40, p = .001, ηp2 = .152. In heroin users, there was a significant main effect of mood state, F = 6.06, p = .02, ηp2 = .119, but no effect of timepoint, F = .12, p = .73, ηp2 = .003, or interaction between mood state and timepoint, F = .91, p = .34, ηp2 = .020. By contrast, in controls, there was a significant main effect of mood state, F = 39.22, p < .001, ηp2 = .620, and a significant interaction between mood state and timepoint, F = 26.79, p < .001, ηp2 = .528, with negative mood increasing significantly from pre to post, F = 17.23, p < .001, ηp2 = .419, and positive mood decreasing significantly from pre to post, F = 16.06, p < .001, ηp2 = .401. Thus, heroin users showed no change in subjective mood following mood induction, whereas controls showed the appropriate change in mood states.r = .29, p < .05, but not with RFDQ heroin use due to social pressure, r = −.13, p = .39, or cued craving, r = .10, p = .52. Furthermore, as shown in r = .39, p = .007, but not with the change in positive mood r = −.19, p = .20. RFDQ heroin use to cope with negative affect did not correlate significantly with the change in negative mood, r = .28, p < .06. Thus, heroin users’ change in heroin choice from baseline to test was amplified in those who reported heroin use to cope with negative affect, and those who reported the greatest increase in negative mood following induction.As shown in The study found that opiate-dependent individuals chose heroin over food images more frequently than control participants. This accords with results from two studies with cocaine-dependent individuals, who chose cocaine over pleasant pictures more frequently than control participants , 26. PerThe second finding was that negative mood induction increased heroin choice in opiate-dependent individuals but not control participants. This extends prior induction studies with opiate users –23, by iSensitivity to mood-induced heroin choice was also found to correlate with subjective changes in negative mood, consistent with two prior opiate studies , 23 and Finally, sensitivity to mood-induced heroin choice was found to correlate with self-reported opiate use to cope with negative affect, but not other opiate use motives . This finding contradicts the study by Stathopoulou and colleagues  which foWe might further speculate that individual sensitivity to mood-induced heroin choice is a risk factor for relapse. The basis for this claim is that such sensitivity is associated with relapse risk in alcohol- –18 and cOne limitation of the current study was that we did not observe an overall change in subjective mood following negative mood induction in the heroin user group, whereas controls did show changes to self-reported positive and negative mood. Despite this, the increase in heroin choice at test for the heroin user group, as well as the correlation between this effect and their change in negative mood, indicated that the mood induction procedure did impact the heroin user group. However, these effects were small and were perhaps reduced by the opiate replacement medications taken shortly before the experiment, similarly to acute alcohol, which has been shown to reduce mood induction effects . Future The second limitation was that we did not employ a control condition to determine whether the change in heroin picture choice was due to the mood induction or time. Previous studies have shown that drug choice remains stable over time then jumps following induction . SimilarThe third limitation was that we could not obtain indices of psychiatric state in the two groups, because we had access to drug-using clients for an extremely short period during their hospital visit. As a consequence, we are unable to test whether the differential mood induction effect between the two groups was due to drug user status, or confounded psychiatric symptoms, such as anxiety or depression, which are known to be associated with greater sensitivity to mood induction effects on alcohol seeking , 27.This study was approved by the Western Sydney University Human Research Ethics Committee.LHo designed the procedure and wrote the first draft of the manuscript. LHa and AB programmed the task and contributed to the analysis. JM and SC ran the participants and contributed to the analysis. GW and AM oversaw the running of the experiment. All authors contributed to the writing of the manuscript.LHo received an Alcohol Research UK grant (RS17/03).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


AbstractNeostromboidea to separate the Strombidae, Rostellariidae, and Seraphsidae from their sister families Struthiolariidae and Aporrhaidae. There is significant value to understanding evolutionary processes within Stromboidea to recognise the universal similarity in the position of the eye on the end of peduncles and a diminished cephalic tentacle that arises from the middle to the end on that peduncle. This is in contrast to other members of the Stromboidea where the eye is located at the base of the cephalic tentacle. These physiological differences represent two set of organisms with divergent and independent evolutionary life histories and therefore these differences need to be identifiable within the nomenclature to bring meaning to the way we name things.This paper defines a new crown clade  Stromboidea Rafinesque, 1815 systematics has suffered from the effects of taxonomic inflation that has destroyed the evolutionary contextualisation that was once found within the historical nomenclature  included the now separated Rostellariidae Gabb, 1868 and Seraphsidae Jung, 1974, both of which share a universal similarity in the positioning of the eye on the end of the peduncle, and a diminished cephalic tentacle that arises from the middle to the end on the peduncle. This contrasts with other members of the Stromboidea, the outgroups Struthiolariidae Gabb, 1868 and Aporrhaidae Gray, 1850, where the eye is located at the base of the cephalic tentacle, which is not reduced  Terebellumterebellum  (Seraphsidae) and Tibiafusus  (Rostellariidae) than Struthiolariidae Gabb, 1868 and Aporrhaidae Gray, 1850.Diagnosis: The animal possesses eyes on the end of the peduncles. The cephalic tentacle is also located on the peduncle towards the distal end. The radula has a central rachidian tooth with three lateral teeth either side. The foot is laterally compressed, with a defined propodium and a metapodium. The shell form changes upon maturation with the development of an outer lip structure.Remarks: Neostromboidea is well supported in previous revisions and studies on the phylogeny of Stromboidea . The ancestral resolution of Neostromboidea is extremely unstable, with many conflicting views on the exact ancestors that provide a division between Neostromboidea and the two immediate outgroups Struthiolariidae and Aporrhaidae (Phyllocheilus Gabb, 1868 and Pterodonta d’Orbigny, 1843 form the shared common ancestor of the new clade and the Aporrhaidae and Strutholariidae based on gross morphology and the similarities with known stromboidal ancestors of Rostellariidae.The rrhaidae . It is pPugnellidae Kiel & Bandel, 1999, which is considered an ancestor of Strombidae (Pugnellidae, which is now considered to be a descendant of the Aporrhaidae (Strombidae, the presence of a posterior rostrum with a groove, and, importantly, the extension of the callus from the inner lip, which covers a greater portion of the teleoconch (The Cretaceous clade rombidae , is somerrhaidae . This poleoconch .Struthiolariidae and Aporrhaidae differ from Neostromboidea in having a broad rather flattened foot, as well as eyes on the base of the tentacles rather than on peduncles as with the Neostromboidea (Struthiolariidae and Aporrhaidae from the Seraphsidae (Morphologically, recent members of the omboidea . These romboidea , 1991. Haphsidae . Given tNeostromboidea incorporates those taxa that developed a basal sinus on the shell outer lip in conjunction with eyes placed on peduncles. The co-evolution of this shell structure and morphological trait allowed the eyestalk to protrude whilst the animal remained aperture face down on the substrate, protecting the soft parts from exposure. Furthermore, the movement of the cephalic tentacle towards the distal end of the eyestalk, thus protruding out from the basal sinus, enables the animal to achieve sensory awareness without any of the soft parts being exposed. There is much greater resolution within the Stromboidea with the recognition and naming of this clade, enabling researchers to focus on the evolution of either of the two divergent evolutionary trajectories of that clade’s members.The


IgG4-related sclerosing cholangitis (IgG4-SC) is one of the most common extra-pancreatic manifestation of IgG4-related disease (IgG4-RD) and is clinically distinct from primary sclerosing cholangitis (PSC). IgG4-RD is an increasingly recognized immune-mediated fibroinflammatory systemic disease, mostly affecting middle-aged and older male populations that can affect multiple organs. The presence of extra-biliary clinical manifestations of IgG4-RD, such as parotid and lacrimal swelling, lymphadenopathy, autoimmune pancreatitis, and retroperitoneal fibrosis, if present could provide important clues to diagnosis. High serum IgG4 levels, characteristic radiological  or biopsy findings  in the setting of these features is diagnostic of this disease process. However, isolated IgG4-SC might be a diagnostic challenge, and the distinction is important as management of this disorder is vastly different from other causes of cholangitis such as PSC. Systemic corticosteroid therapy is the mainstay of therapy. Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is a relatively uncommon but increasingly recognized entity. It was first described in 2001 by Hamano et al. . SclerosAn 81-year-old male presented to the clinic with yellowish discoloration of skin and urine for 2 weeks. He denied any fever, abdominal pain, nausea, vomiting, melena, hematochezia, or acholic stools. Past medical history was significant for hypertension, hyperlipidemia, diabetes mellitus type II, coronary artery disease, and chronic kidney disease stage IV. He reported recent loss of appetite but denied any significant weight changes. Ultrasound ordered by primary care physician showed intra- and extra-hepatic biliary dilation with distension of gall bladder without cholelithiasis. He was sent to the emergency department (ED) for further evaluation.On examination, blood pressure was 133/60 mmHg, heart rate was 75 beats per minute, respiratory rate was 23 breaths per minute, temperature was 97.7°F, and oxygen saturation was 98% in room air. He had mild icteric sclera, and chronic venous stasis changes in bilateral lower extremities were noted. Bowel sounds were normal, and no hepatosplenomegaly or abdominal tenderness was noted on exam.3, and platelet count of 214,000/mm3. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated at 326 and 321 IU/L, respectively. Total bilirubin was 3.1 mg/dl with direct bilirubin of 1.8 mg/dl. Alkaline phosphatase (ALP) was 1,219 IU/L with lipase 250 IU/L. Renal function tests were at baseline at 1.72 mg/dl (baseline 1.7–1.9 mg/dl). Recent upper and lower endoscopy (1 month earlier) did not show significant abnormalities, except for mild antral gastropathy. A computed tomography (CT) scan of abdomen and pelvis revealed stable pelvic adenopathy with largest lymph node measuring 4.4 × 1.7 cm (which was noted on the earlier CT scan as well). The pancreatic tissue and abdominal vessels appeared normal. With concern for underlying malignancy, a lymph node biopsy was performed. Endoscopic retrograde of cholangiopancreatography revealed distal common bile duct stricture of 3 cm without obstruction, for which a biliary stent was placed. No pancreatic lesions were observed, and biliary brushings were negative for malignancy.Laboratory investigations showed a hemoglobin count of 11 g/dl, white blood cell count of (WBC) 3800 cell/mm3. AST, ALT, and bilirubin levels were within normal limits, and ALP was elevated at 127 IU/L. The CT scan of abdomen revealed intrahepatic biliary ductal dilatation and gall bladder wall thickening with pericholecystic inflammatory stranding with normal pancreas , nausea, and right upper quadrant pain for 2 days. Complete blood counts revealed elevated white cell count of 18,700/mmpancreas . He was Meanwhile, histopathology from the earlier right iliac lymph node biopsy revealed sinus histiocytic aggregates interlaced with lymphocytes and plasma cells , majoritAs there was no evidence to suggest a lymphoma or a plasma cell neoplasm, a diagnosis of IgG-related disease was considered. Additional immunohistochemistry showed that the plasma cells present expressed predominantly IgG ; of thesA diagnosis of IgG4-related sclerosing cholangitis was made, and he was started on prednisone 40 mg daily for 6 weeks. A follow-up CT scan of abdomen after a month revealed significant reduction in the size of his pelvic lymph nodes with largest lymph node measuring 1.8 × 0.7 cm . EndoscoAlthough reported as a relatively rare disease with a prevalence of 100 per 100,000 adults based on limited studies done in Japan , the preThe differentiation of IgG4-SC from primary sclerosing cholangitis (PSC) and cholangiocarcinoma is clinically very important as IgG4-SC usually has a good response to steroid therapy . IgG-SC The Japanese IgG4-RD committee has recently published a diagnostic criterion for IgG4-SC 2012) based on a combination of 4 features: (1) characteristic biliary imaging findings—diffuse swelling or organ mass, (2) elevation of serum IgG4 concentrations ≥135 mg/dl), (3) coexistence of IgG4-related diseases, and (4) characteristic histopathological features of steroid therapy are optional criteria to confirm accurate diagnosis of IgG4-SC , 12. Typ based on5 mg/dl, Glucocorticoids remain the mainstay of therapy for remission induction in all patients with active IgG4-RD. Retrospective studies performed have shown good response to immunosuppression (prednisone at a dose of 30–40 mg per day), which generally leads to a rapid induction of disease remission , 5. In rIsolated IgG4-SC is a difficult entity to diagnose with vague presentation and overlapping symptoms with PSC, cholangiocarcinoma, other autoimmune conditions, and malignancy. Appropriate clinical, serologic, radiologic, and pathologic features may aid in diagnosis, although none in isolation is diagnostic. Glucocorticoids are the mainstay of therapy, and rituximab might be added as a steroid-sparing agent, especially in refractory or steroid-dependent cases. Close follow-up is recommended due to its chronic and relapsing course.