Laparoscopic adjustable gastric band (LAGB) has high technical and weight loss failure rates. We evaluate here the 1-year morbidity, mortality, and weight loss of laparoscopic Roux-en-Y-gastric bypass (LRYGB) as a feasible conversion strategy.
Patients with a failed primary LAGB who underwent LRYGB from July 2004 to December 2019 were selected from an electronic database at our center. Patients had a conversion to LRYGB at the same time (one-stage approach) or with a minimum of 3 months in between (two-stage approach). Primary outcomes included 30-day morbidity and mortality. Secondary outcomes were body mass index (BMI), percent excess weight loss (%EWL), and percent excess BMI lost (%EBMIL) at 1 year postoperatively.
A total of 1295 patients underwent a conversion from LAGB to LRYGB at our center: 1167 patients (90.1%) in one stage and 128 patients (9.9%) in two stages. There was no mortality. An early (30-day) postoperative complication occurred in 93 patients (7.2%), with no significant difference found between groups. Hemorrhage was the most common complication in 39 patients (3.0%), and the reoperation was required in 19 patients (1.4%). At 1 year postoperatively, the mean BMI was 28.0 kg/m2, the mean %EWL 72.8%, and the mean %EBMIL 87.0%. No statistically significant difference was found between the groups.
Conversion to LRYGB can be considered as a safe and effective option with low complication rate and good weight loss outcomes at 1 year. One-stage conversion provides the same early outcome as two-step surgery with a competent surgeon.

UNASSIGNED: An accurate prognostic score to predict mortality for adults with COVID-19 infection is needed to understand who would benefit most from hospitalizations and more intensive support and care. We aimed to develop and validate a two-step score system for patient triage, and to identify patients at a relatively low level of mortality risk using easy-to-collect individual information.
UNASSIGNED: Multicenter retrospective observational cohort study.
UNASSIGNED: Four health centers from Virginia Commonwealth University, Georgetown University, the University of Florida, and the University of California, Los Angeles.
UNASSIGNED: Coronavirus Disease 2019-confirmed and hospitalized adult patients.
UNASSIGNED: We included 1,673 participants from Virginia Commonwealth University (VCU) as the derivation cohort. Risk factors for in-hospital death were identified using a multivariable logistic model with variable selection procedures after repeated missing data imputation. A two-step risk score was developed to identify patients at lower, moderate, and higher mortality risk. The first step selected increasing age, more than one pre-existing comorbidities, heart rate >100 beats/min, respiratory rate ≥30 breaths/min, and SpO2 <93% into the predictive model. Besides age and SpO2, the second step used blood urea nitrogen, absolute neutrophil count, C-reactive protein, platelet count, and neutrophil-to-lymphocyte ratio as predictors. C-statistics reflected very good discrimination with internal validation at VCU (0.83, 95% CI 0.79-0.88) and external validation at the other three health systems (range, 0.79-0.85). A one-step model was also derived for comparison. Overall, the two-step risk score had better performance than the one-step score.
UNASSIGNED: The two-step scoring system used widely available, point-of-care data for triage of COVID-19 patients and is a potentially time- and cost-saving tool in practice.

Formamidinium lead triiodide (FAPbI3) exhibits the smallest band gap among lead halide perovskites, which is more desirable for solar cell applications compared to methylammonium-based counterparts. However, it remains a big challenge to prepare phase-pure α-FAPbI3 in addition to controlling the crystal morphology during film formation. Herein, we developed a temperature-assisted crystal growth to prepare high-quality thin films of α-FAPbI3 by sequential blade coating. It is found that depositing organic cation FAI at elevated temperatures facilitates the growth of α-FAPbI3, which otherwise yields mainly a yellow δ-phase at room temperature. In parallel, the crystal morphology of the perovskite films can be effectively manipulated by taking advantage of the porous structure of PbI2. Solar cells prepared with the blade-coated α-FAPbI3 yield a champion efficiency of 18.41%, which is among the highest values for FAPbI3-only solar devices. These results suggest that two-step sequential blade deposition offers a viable approach to fabricate high-quality α-FAPbI3 films for optoelectronic applications.

Finding predictive dissolution tests and valid IVIVCs are essential activities in generic industry, as they can be used as substitutes of human bioequivalence studies. IVIVCs can be developed by two different strategies: a one-step approach or a two-step approach. The objectives of this work were to compare different deconvolution and convolution methods used in the development of two-step level A IVIVCs and to study if the relationship between the in vitro dissolution rate and the in vivo dissolution rate should guide the decision between using a two-step approach or a one-step approach during the development of a new IVIVC. When the in vitro and the in vivo dissolution rates had a linear relationship, valid and biopredictive two-step IVIVCs were obtained, although there was not a combination of deconvolution and convolution methods that could be named as the best one, as long as all the prediction errors for any combination were within the limits. It was not possible to obtain a valid two-step IVIVC when the relationship between dissolution rates was non-linear, but the one-step approach was able to overcome this fact and it gave valid IVIVCs regardless of whether the relationship between dissolution rates was linear or non-linear.

Developing an effective and green method toward organic functional cocrystals based on the solubility-mismatched coformers is highly desirable and very important. Herein, we applied a green two-step liquid-assisted-grinding coassembly (LAGC) in fabricating tetracene-octafluoronaphthalene (TC-OFN) cocrystals from solubility-mismatched pairs of tetracene (TC, poorly soluble, 0.2 mg mL-1) and octafluoronaphthalene (OFN, highly soluble, 0.2 × 104 mg mL-1). Such cocrystals are extremely difficult to prepare through the common solution-processing strategies. More importantly, this two-step LAGC process could allow us to efficiently prepare TC-OFN cocrystals in gram scale. The as-prepared cocrystals displayed the intrinsic green emission of TC with much higher photoluminescence quantum yield (13.75%) comparing with the pure solid TC with the almost-quenched emission (0.41%, aggregation-caused quenching (ACQ)). The ultrafast spectra study on these cocrystals verifies the successful barrier function of OFN molecules in interrupting the well-known singlet fission (SF) in TC solids. Furthermore, this method can allow us to easily fabricate fluorescent TC-OFN water inks, which can be employed to prepare luminescent paintings or highly emissive ultratransparent/flexible films.

In this invited review, we argue for the need to determine whether appetitive and aversive behaviors, be they goal-directed or habitual, share overlapping neural circuitry. To motivate our argument, we first summarize what is currently known about the neural circuits governing aversive and appetitive behaviors by focusing first on the three hypothesized phases of avoidance learning, and then on goal-directed and habitual reward seeking. We then provide several reasons to believe that the neural circuits of appetitive and aversive instrumental behaviors are not completely overlapping. We next discuss an experimental strategy to determine the extent of overlap based on a new computational framework that improves the identification of goal-directed and habitual actions regardless of valence. Finally, we discuss recent work in obsessive-compulsive disorder that uses this computational framework to determine whether patients perform appetitive and aversive versions of the same task using the same behavioral strategies and neural circuits.

In this paper, the two-step high-risk immunization was investigated based on high-risk immunization for the SIRS model in small-world networks and scale-free networks. First, the effects of various immunization schemes are studied and compared. When the number of immune is same, the research result shows that the immune effect of the two-step high-risk immunization strategy is not the best nor the worst. However, the practicability is better compare with others. Furthermore, by changing the proportional of immunization the optimal immune effect can be achieved in the two-step high-risk immunization. Computation results verify that the two-step high-risk immunization is effective, and it is economic and feasible in practice.

When CZTSSe is synthesized using a metal precursor, large voids of nonuniform size form at Mo back contact side. Herein, we demonstrate that the voids and CZTSSe in the lower part of the CZTSSe double layer can be controlled by using an Al2O3-patterned Mo substrate. The CZTSSe in the lower part self-aligns on the Mo-exposed area, while the voids self-align on the Al2O3-coated area. The origin of the self-alignment is expected to be the difference in bonding characteristics between liquid Sn and the metal or oxide surface, e.g., Al2O3. Good wettability generally forms between nonreactive liquid metals and metal surfaces due to the strong metallic bonding. By contrast, poor wettability generally forms between nonreactive liquid metals and oxide surfaces due to the weak van der Waals bonding between the liquid metal and the oxide layer. When the patterning was added, the device efficiency tended to decrease from 8.6% to 10.5%.

OBJECTIVE: The main objective is to evaluate the effectiveness of en masse retraction with temporary skeletal anchorage devices (TSADs) versus two-step retraction with conventional anchorage (CA) in terms of the skeletal, dental, and soft-tissue variables, as well as the duration of retraction or overall orthodontic treatment.
METHODS: An electronic search of PubMed and nine other major databases for prospective, randomized controlled trials (RCTs) and clinical controlled trials (CCTs) was carried out between January 1990 and April 2018. The bibliography in each identified article was checked out. In addition, manual searching was performed in the same time frame in five major orthodontic journals. Adult patients undergoing fixed orthodontic treatment with extraction of maxillary premolars followed by an en masse retraction in the experimental group and two-step retraction of upper anterior teeth in the control group. Methodological index for nonrandomized studies for CCTs and Cochrane\'s risk of bias tool for RCTs were applied.
RESULTS: Four articles (two RCTs and two CCTs) were included in this review and all articles were appropriate for the quantitative synthesis. There was no significant difference between the en masse retraction and two-step retraction groups in terms of SNA, SNB, ANB, and MP-SN angles. Using TSADs gave significantly better results in terms of posterior anchorage and incisors inclination, and greater anterior teeth retraction in comparison with CA (standardized mean difference [SMD] = -3.03 mm, P < 0.001; SMD = 0.74°, P = 0.003; SMD = -0.46 mm, P = 0.03, respectively). En masse/TSAD combination caused a significantly greater increase in nasolabial angle, higher decrease in facial convexity angle, and greater lower lip retraction in comparison with two-step/CA combination (weighted mean difference = 4.73°, P = 0.007; P = 0.0435; SMD = -0.95 mm, P = 0.01, respectively).
CONCLUSIONS: There is weak-to-moderate evidence that using either en masse/TSAD combination or two-step/CA combination would lead to similar skeletal improvement. There is a very weak-to-moderate evidence that using TSADs with en masse retraction would cause better posterior anchorage and incisors inclination, and greater anterior teeth retraction than using CA with two-step retraction. There is weak-to-moderate evidence that using en masse/TSAD combination would lead to a better improvement in the facial profile. According to the quality of evidence, we confirm the need for more well-conducted RCTs in the en masse retraction field.

The influence of light-curing of a one-step self-etch adhesive (1-SEA) prior to the application of different bonding agents (BA) on the micro-tensile bond strength (μTBS) to dentin after 24h and thermal cycling was investigated. Additionally, the degree of conversion was evaluated using Fourier-transform infrared spectroscopy.
Three ion-releasing BAs, BZF-21 (experimental BA), Clearfil SE Protect (CSP), and FL-Bond II (FL-II), were applied subsequently to G-Premio Bond (1-SEA, GPB). Prior to their application, GPB was either light-cured (10s, 1000mW/cm2) or remained uncured. GPB was used as a control and Clearfil SE Bond 2 (CSE2) as a gold-standard 2-step reference. After resin-composite build-up and 24-h water storage (24h), half of the specimens were subjected to 15,000 thermal cycles (TC). Then, the specimens were sectioned into beams and tested under tensile load (1mm/min). The acquired data were analyzed using a 2-way ANOVA and Student\'s t-test with Bonferroni correction, and a two-parameter Weibull analysis, α=0.05.
The μTBS of GPB increased significantly in the uncured groups with BZF-21 (24h: p<0.001, TC: p<0.001) and CSP (24h: p=0.039, TC: p<0.001), and in the light-cured group with CSP after TC (p=0.044). The groups with FL-II were not significantly different from GPB (p=1). No significant difference was found between CSE2 and the uncured groups GPB+BZF-21 (24h: p=1, TC: p=0.452) and GPB+CSP (24h: p=0.671, TC: p=0.566).
BZF-21 and CSP improved the μTBS of GPB to dentin both immediately and after TC. Higher μTBSs were obtained when GPB remained uncured prior to BA application.