The use of antimicrobials in Thailand has been reported as one of the highest in the world in human and animal sectors. Our engagement project aimed to improve our understanding of the issue of antimicrobial use and antimicrobial resistance (AMR) among adult Thai communities, and co-create locally relevant solutions to AMR, especially those focusing on raising awareness to improve related policies in Thailand.We conducted a series of online and in-person \'conversations\' according to Wellcome\'s \'Responsive Dialogues\' engagement approach, designed to bring together different voices to understand complex AMR problems and find potential solutions. This approach enabled key AMR stakeholders and policy makers to hear directly from communities and members of the public, and vice versa. Conversations events took place between 25 November 2020 and 8 July 2022, and we engaged 179 AMR key stakeholders and members of the public across Thailand.The issues found were: there were quite a lot of misunderstandings around antimicrobials and AMR; participants felt that communications and engagement around antimicrobial resistance had limited reach and impact; asking for and taking antibiotics for self-limiting ailments is a social norm in Thailand; and there appeared to be a wide availability of cheap antimicrobials. To mitigate the spread of AMR, participants suggested that the messages around AMR should be tailored to the target audience, there should be more initiatives to increase general health literacy, there should be increased availability of AMR related information at the local level and there should be increased local leadership of AMR mitigation efforts.Trial registration Thaiclinicaltrials.org registration: TCTR20210528003 (28/05/2021).

UNASSIGNED: The quality of orthodontic forces in aligners is mainly influenced by their mechanical properties. At present, there is insufficient information on how environmental factors affect the mechanical function of aligners, and studies have shown that patients do not pay enough attention to removing aligners while eating and drinking. Therefore, in this study, we investigated the effect of different chemicals on the mechanical properties of thermoplastic materials.
UNASSIGNED: In this study, 175 thermoplastic samples from Easy-Vac gasket (3A Medes, Korea) were prepared, and their chemical composition, tensile strength, and hardness before and after exposure to solutions of orange juice, Cola, chlorhexidine mouthwash, and distilled water were measured. One-Way analysis of variance (ANOVA), Tamhane\'s test, and Tukey\'s test were used for statistical analysis.
UNASSIGNED: The tensile strength of the sheets increased with continuous exposure to orange juice and chlorhexidine mouthwash, and their hardness decreased with continuous exposure to carbonated beverages. There was no change in the chemical composition of the samples after exposure to different chemicals.
UNASSIGNED: Although these changes are statistically significant, they do not have a significant effect on the result of aligner performance. Therefore, the only concern is the cariogenicity of orange juice and Cola during treatment with aligners and the administration of chlorhexidine mouthwash.

Herein, we evaluated friction dynamics of human skin treated with polyacrylic acid aqueous solutions or gel creams using a sinusoidal motion friction evaluation system to demonstrate the effect of treatment with polymer aqueous solutions on human skin. A polymer aqueous solution or gel cream was applied to the inner forearms of 10 subjects to evaluate temporal changes in friction force under sinusoidal motion. Water content, skin viscoelasticity, and transepidermal water loss were also simultaneously measured to determine the effects on skin conditions. When human skin was treated with the polymer aqueous solution, the friction coefficient immediately after treatment was 0.69-0.99 and the delay time δ, a normalized parameter of the time difference in the delayed response of friction to the movement of the contact probe divided by the friction time T 0 for one round trip, was 0.171-0.179, which was greater than that of untreated skin. This increase was caused by the swelling and softening of the stratum corneum caused by the penetration of water in the polymer aqueous solution, which increased true contact area between the skin and contact probe. A significant difference was observed in the friction coefficient of the skin immediately after treatment with different polymer aqueous solutions. Among polymers (P1-P4), P4, which has a low-salt resistance and low yield stress, had the lowest friction coefficient because of collapsing of the polymer network structures by shearing and reduced viscosity owing to salts on human skin. The skin treated with a gel cream also exhibited a greater friction coefficient than the untreated skin immediately after treatment and 90 min later. This phenomenon can be caused by the occlusive effect of the oil in the gel cream.

An aqueous solution of 2,3-cis gallate type catechin (-)-epigallocatechin-3-O-gallate (EGCg) and caffeine afforded a precipitate of Creaming-down Phenomenon, which crystallized slowly for about three months to give a colorless block crystal. By X-ray crystallographic analysis, the crystal was determined to be a 2 : 2 complex of EGCg and caffeine, in which caffeine molecules were captured in a hydrophobic space formed with three aromatic A, B, and B\' rings of EGCg. It was considered that the solubility of the 2 : 2 complex in water rapidly decreased and the 2 : 2 complex precipitated from aqueous solution. The hydrophobic spaces of EGCg captured a variety of heterocyclic compounds, and the molecular capture abilities of heterocyclic compounds using EGCg from the aqueous solutions were evaluated. Since the C ring of EGCg has two chiral carbon atoms, C2 and C3, the hydrophobic space of EGCg was a chiral space. EGCg captured diketopiperazine cyclo(Pro-Xxx) (Xxx=Phe, Tyr) and pharmaceuticals with a xanthine skeleton, proxyphylline and diprophylline, in the hydrophobic space, and recognized their chirality.

OBJECTIVE: Systematic evaluation of the safety of del Nido cardioplegia compared to cold blood cardioplegia in adult cardiac surgery.
METHODS: We systematically searched PubMed, EMbase, The Cochrane Library and ClinicalTrials.gov for randomized clinical trials (published by 14 January 2024) comparing del Nido cardioplegia to cold blood cardioplegia in adult. Our main endpoints were myocardial injury markers and clinical outcomes. We assessed pooled data by use of a random-effects model or a fixed-effects model.
RESULTS: A total of 10 studies were identified, incorporating 889 patients who received del Nido cardioplegia and 907 patients who received cold blood cardioplegia. The meta-analysis results showed that compared with the cold blood cardioplegia, the del Nido cardioplegia had less volume of cardioplegia, higher rate of spontaneous rhythm recovery after cross clamp release, lower levels of postoperative cardiac troponin T and creatinine kinase-myocardial band, all of which were statistically significant. However, there was no statistically significant difference in postoperative troponin I and postoperative left ventricular ejection fraction. The clinical outcomes including mechanical ventilation time, intensive care unit stay time, hospital stay time, postoperative stroke, postoperative new-onset atrial fibrillation, postoperative heart failure requiring intra-aortic balloon pump mechanical circulation support, and in-hospital mortality of both are comparable.
CONCLUSIONS: Existing evidence suggests that del Nido cardioplegia reduced volume of cardioplegia administration and attempts of defibrillation. The superior postoperative results in CTnT and CK-MB may provide a direction for further research on improvement of the composition of cardioplegia.

Heteropolysaccharides are among the most widely distributed compounds in nature, acting as both tissue building blocks and as a source of nutrients. Their physicochemical and biological properties have been studied thoroughly; however, the microstructural properties of heteropolysaccharides are still poorly understood. This study aims to investigate the micro-structural peculiarities of agarose, gum arabic, hyaluronic and alginic acids by means of confocal laser scanning microscopy (CLSM) and cryogenic scanning electron microscopy (cryo-SEM). Herein, attention is paid to layered complexity of the microstructure differentiating surface, under surface, inner, and substrate interface layers. The scale and pattern of the polysaccharide\'s microstructure depend on the concentration, changing from lamellae to cell-like porous structures. This work provides the insight into micro- and nanoscale mechanisms of self-healing and substrate-induced reorganisation. Thus, investigation of the self-healing mechanism revealed that this diffusion-based process starts from the fibres, turning into lamellae, following by cell-like structures with smaller dimensions. Investigation of the substrate-induced reorganisation ability showed that nano-to-micro (scale) porous substrate causes reorganisation in the interface layer of the studied heteropolysaccharides. This work contributes to understanding the structural peculiarities of heteropolysaccharides by looking at them through a supramolecular, micro-level prism.

Evidence of clinical impact is critical to unlock the potential of digital health solutions (DHSs), yet many solutions are failing to deliver positive clinical results. We argue in this viewpoint that this failure is linked to current approaches to DHS evaluation design, which neglect numerous key characteristics (KCs) requiring specific scientific and design considerations. We first delineate the KCs of DHSs: (1) they are implemented at health care system and patient levels; (2) they are \"complex\" interventions; (3) they can drive multiple clinical outcomes indirectly through a multitude of smaller clinical benefits; (4) their mechanism of action can vary between individuals and change over time based on patient needs; and (5) they develop through short, iterative cycles-optimally within a real-world use context. Following our objective to drive better alignment between clinical evaluation design and the unique traits of DHSs, we then provide methodological suggestions that better address these KCs, including tips on mechanism-of-action mapping, alternative randomization methods, control-arm adaptations, and novel end-point selection, as well as innovative methods utilizing real-world data and platform research.

Forests are a major source of wealth for Canadians, and cellulose makes up the \"skeleton\" of wood fibers. Concentrated H2SO4 and NaOH/urea aqueous solutions are two efficient solvents that can rapidly dissolve cellulose. Our preliminary experiment obtained regenerated wood cellulose films with different mechanical properties from these two solvents. Therefore, herein, we aim to investigate the effects of aqueous solvents on the structure and properties of wood cellulose films. Regenerated cellulose (RC) films were produced by dissolving wood cellulose in either 64 wt% H2SO4 solution (RC-H4) or NaOH/urea aqueous solution (RC-N4). RC-H4 showed the higher tensile strength (109.78 ± 2.14 MPa), better folding endurance (20-28 times), and higher torsion angle (42°) than RC-N4 (62.90 ± 2.27 MPa, un-foldable, and 12°). The increased cellulose contents in the H2SO4 solutions from 3 to 5 wt% resulted in an improved tensile strength from 102.61 ± 1.99 to 132.93 ± 5.64 MPa and did not affect the foldability. RC-H4 also exhibited better water vapor barrier property (1.52 ± 0.04 × 10-7 g m-1 h-1 Pa-1), superior transparency (~90 % transmittance at 800 nm), but lower thermal stability compared to RC-N4. This work provides special insights into the regenerated wood cellulose from two aqueous solvents and is expected to facilitate the development of high-performance RC films from abundant forestry resources.

The extraction of Li+ from liquid lithium resources is a pivotal focus of current research endeavors. Attapulgite (ATP), characterized by its distinctive layered structure and inherent ion exchange properties, emerges as an exceptional material for fabricating lithium-ion sieve. Ion-imprinted chitosan/ATP composite materials are successfully synthesized, demonstrating efficacy in selectively absorbing Li+. The results emphasize the rich functional groups present in H-CTP-2, enhancing its absorbability and selectivity, with an adsorption capacity of 37.56 mg•g-1. The adsorption conforms to the Langmuir and pseudo-second-order kinetic model. Li+ coordination involves amino and hydroxyl group, indicating a chemisorption process. Furthermore, the substantial pore structure and significant specific surface area of ATP significantly promote Li+ adsorption, suggesting its participation not only in chemisorption but also in physical adsorption. The fabricated ion-imprinted materials boast substantial adsorption capacity, exceptional selectivity, and rapid kinetics, highlighting their potential for effectively separating Li+ from aqueous solution.

The effect of aqueous solution chemistry on the ionic hydration structure and its corresponding nanofiltration (NF) selectivity is a research gap concerning ion-selective transport. In this study, the hydration distribution of two typical monovalent anions (Cl- and NO3-) under different aqueous solution chemical conditions and the corresponding transmembrane selectivity during NF were investigated by using in situ liquid time-of-flight secondary ion mass spectrometry in combination with molecular dynamics simulations. We demonstrate the inextricable link between the ion hydration structure and the pore steric effect and further find that ionic transmembrane transport can be regulated by breaking the balance between the hydrogen bond network (i.e., water-water) and ion hydration (i.e., ion-water) interactions of hydrated ion. For strongly hydrated (H2O)nCl- with more intense ion-water interactions, a higher salt concentration and coexisting ion competition led to a larger hydrated size and, thus, a higher ion rejection by the NF membrane, whereas weakly hydrated (H2O)nNO3- takes the reverse under the same conditions. Stronger OH--anion hydration competition resulted in a smaller hydrated size of (H2O)nCl- and (H2O)nNO3-, showing a lower observed average hydration number at pH 10.5. This study deepens the long-overlooked understanding of NF separation mechanisms, concerning the hydration structure.