Enhanced Handheld Engine Ethanol Study

This study examined consumer and professional grade handheld engines. Twenty-four consumer grade 50 hour Emissions Determination Period (EDP) trimmers and 24 professional grade 300 hour EDP backpack leaf blowers were run on four different ethanol fuel concentrations; E0, E10, E15, and E20. Six engines of each type were run on each of the fuel blends through their full EDP. All engines were broken-in and adjusted to manufacturer specifications on E0. Then engines were emissions tested on E0 to provide a baseline and to determine the rich to lean order of the engines. Next, the leanest operating engine received E20 and the richest operating engine received E0 to simulate a worst-case scenario in the field. The engines’ emissions, performance, temperatures, and wear were measured during the study to see if E15 or E20 would cause any other issues than E0 or E10 which the engines are design to consume. Measurements were taken at the beginning of the study along with half way through the EDP and at the end of the EDP

Two Atypical Cases of Classical Hairy Cell Leukaemia and Hairy Cell Leukaemia Variant: A Case Study

Introduction: Classical Hairy Cell Leukaemia (cHCL) and Hairy Cell Leukaemia variant (HCL-v) are both rare and slow-growing mature B cell neoplasms. According to flowcytometry data, they fall into the group classified as CD5- CD10- B cell lymphoproliferative disorders. Methods: Two cases with features atypical to two neoplasms at the time of diagnosis were studied. Results: Case 1 was a 15 year old male with right cervical lymph nodes (1x1 cm) in the posterior triangle, a few ecchymotic patches on the arm and a massive splenomegaly. C-reactive protein (CRP) level was 53 mg/dL. Erythrocyte Sedimentation Rate (ESR) was 98 mm/1 st hour. Full Blood Count (FBC) revealed typical features of pancytopenia with monocytopenia. The liver and renal profiles were normal. Morphology of bone marrow was suggestive of cHCL. Flowcytometry and BRAF V600E mutation was positive confirming the diagnosis of cHCL. Case 2 was a 55 year old male presenting with moderate splenomegaly and absolute lymphocytosis. The FBC revealed leukocytosis which is commonly seen with monocytopenia. Blood pictures revealed many hairy cells with moderately basophilic cytoplasm and visible nucleoli suggesting HCL-v. Flowcytometry findings and negative BRAF V600E mutation confirmed HCL-v. Conclusions: Clinical findings, blood images, morphology of bone marrow, flowcytometric findings and positive BRAF V600E mutation confirmed the diagnosis of cHCL in case 1 (15 year old boy) making it as a very rare case. The morphological findings on blood, the presence of characteristic CD markers on flowcytometry and negativity of BRAF V600E confirmed the case 2 as HCL-v, despite having CD10 positivity and monocytopenia.Keywords: Flowcytometric immunophenotyping, Hairy cell leukaemia, Hairy cell leukaemia varian

Multiple myeloma: routes to diagnosis, clinical characteristics and survival - findings from a UK population-based study

Prompt cancer diagnosis may align UK survival with European averages. We examined the impact of route to diagnosis on survival for multiple myeloma patients diagnosed 2012–2013 using data from our population‐based patient cohort that links to national death notifications and collects details on treatment and response (n = 441). Emergency presentation was associated with advanced disease and poorer outcomes, and was the commonest route to diagnosis (28·1%) followed by General Practitioner urgent (19·0%) and two‐week wait (17·2%) referrals. CRAB (elevated Calcium, Renal failure, Anaemia, Bone lesions) distribution varied by route (P < 0·001), with patients with emergency presentations most likely to have ≥2 features and significantly worse survival (log‐rank test χ2 = 13·8, P = 0·0002)

Risk factors for delay in symptomatic presentation of leukaemia, lymphoma and myeloma

Background: UK policy aims to improve cancer outcomes by promoting early diagnosis, which for many haematological malignancies is particularly challenging as the pathways leading to diagnosis can be difficult and prolonged. Methods: A survey about symptoms was sent to patients in England with acute leukaemia, chronic lymphocytic leukaemia (CLL), chronic myeloid leukaemia (CML), myeloma and non-Hodgkin lymphoma (NHL). Symptoms and barriers to first help seeking were examined for each subtype, along with the relative risk of waiting >3 months’ time from symptom onset to first presentation to a doctor, controlling for age, sex and deprivation. Results: Of the 785 respondents, 654 (83.3%) reported symptoms; most commonly for NHL (95%) and least commonly for CLL (67.9%). Some symptoms were frequent across diseases while others were more disease-specific. Overall, 16% of patients (n=114) waited >3 months before presentation; most often in CML (24%) and least in acute leukaemia (9%). Significant risk factors for >3 months to presentation were: night sweats (particularly CLL and NHL), thirst, abdominal pain/discomfort, looking pale (particularly acute leukaemias), and extreme fatigue/tiredness (particularly CML and NHL); and not realising symptom(s) were serious. Conclusions: These findings demonstrate important differences by subtype, which should be considered in strategies promoting early presentation. Not realising the seriousness of some symptoms indicates a worrying lack of public awareness

Is increased time to diagnosis and treatment in symptomatic cancer associated with poorer outcomes?:Systematic review

background: It is unclear whether more timely cancer diagnosis brings favourable outcomes, with much of the previous evidence, in some cancers, being equivocal. We set out to determine whether there is an association between time to diagnosis, treatment and clinical outcomes, across all cancers for symptomatic presentations. methods: Systematic review of the literature and narrative synthesis. results: We included 177 articles reporting 209 studies. These studies varied in study design, the time intervals assessed and the outcomes reported. Study quality was variable, with a small number of higher-quality studies. Heterogeneity precluded definitive findings. The cancers with more reports of an association between shorter times to diagnosis and more favourable outcomes were breast, colorectal, head and neck, testicular and melanoma. conclusions: This is the first review encompassing many cancer types, and we have demonstrated those cancers in which more evidence of an association between shorter times to diagnosis and more favourable outcomes exists, and where it is lacking. We believe that it is reasonable to assume that efforts to expedite the diagnosis of symptomatic cancer are likely to have benefits for patients in terms of improved survival, earlier-stage diagnosis and improved quality of life, although these benefits vary between cancers

Effects of Ethanol Blended Fuel on Small Engines

Today gasoline sold in the United States is E10 (10% ethanol) but government has been trying to increase the allowable ethanol content in gasoline to concentrations as high as E20. Before this type of change can happen there needs to be sufficient research on the effects of these fuels on engines. The small engine ethanol study was focused on determining the effects of low level ethanol blends on 2- stroke trimmers. The engines in the study were operated on blends of 0%, 10%, 15%, and 20% ethanol. All 12 engines received performance, emission, and durability tests throughout their emissions determination period. The cycle used to age the engines was 51 seconds of wide open throttle and 9 seconds of idle. Performance test were contain three separate test such as starting test, acceleration test and, hot restart test. These test were used to test full throttle stability, maximum RPM under load, and multi-position stability on the engines. For the emission testing portion, exhaust gases were sampled and monitored for their levels for hydrocarbons, nitrogen oxides, carbon monoxide, and carbon dioxide. After all testing was complete the engines were taken apart and measured to determine the effects on internal engine components. Research shows that E0 and E10 engines both lost 24.5% and 27.8% power and E15 engines lost 43.8% power while the E20 engines lost 33.9% power. E15 and E20 engines produced much more hydrocarbons throughout their lifetime. As a conclusion research indicates that ethanol blends above 10% produce less power throughout the lifetime of the engines tested

Uncommon presentation of hypereosinophilic syndrome

The hypereosinophilic syndrome is a group of diseases characterised by persistent blood eosinophilia, defined as more than 1500 cells per micro liter [1], with end-organ involvement and no recognised secondar