Spirulina in Clinical Practice: Evidence-Based Human Applications

Spirulina or Arthrospira is a blue-green alga that became famous after it was successfully used by NASA as a dietary supplement for astronauts on space missions. It has the ability to modulate immune functions and exhibits anti-inflammatory properties by inhibiting the release of histamine by mast cells. Multiple studies investigating the efficacy and the potential clinical applications of Spirulina in treating several diseases have been performed and a few randomized controlled trials and systematic reviews suggest that this alga may improve several symptoms and may even have an anticancer, antiviral and antiallergic effects. Current and potential clinical applications, issues of safety, indications, side-effects and levels of evidence are addressed in this review. Areas of ongoing and future research are also discussed

Electronic Actuation of a Motorcycle Clutch

ME450 Capstone Design and Manufacturing Experience: Fall 2015The problem that the Michigan Formula SAE Racing Team would like to solve is how to reduce tire slip in straight-line acceleration situations. Solving this will result in faster acceleration times and more points in the competition. As per the sponsor’s request, the solution will be approached through the implementation of clutch-control, a form of launch control using a closed-loop system. The main user requirements of the project include generating at least 10 ft-lbs of torque, avoiding bending moment damage with a safety factor of 1.2, disassembling the system from the vehicle within 20 minutes, and creating a high speed system that can adjust the clutch within .02 seconds. These specifications were used to choose the AmpFlow A28-150 High Performance motor along with the MAE3 Absolute Magnetic Encoder Kit for the final design. A proof-of-concept electrical circuit that is connected to a small DC motor has been built that allows the system to drive current from the power source and protect the motor from backwards flowing current by implementing an opto-isolator. The controls model in Simulink has also been created where mock signals were run through the code to determine the program’s validity. When the motor was connected to the power source, the clutch lever could be actuated through its full range of motion proving that it could generate enough torque. Welding the truss onto the mounting frame resulted in minimal deflection which validated stiffness. In addition, the disassembling/assembling the system took two minutes, well under the limit. The next steps for this project would be to create a more robust circuit involving thicker wiring for the AmpFlow motor, determining coefficient for the PID controller, and testing vehicle lap times with the system integrated into the car to validate that the system results in faster acceleration times.http://deepblue.lib.umich.edu/bitstream/2027.42/117348/1/ME450-F15-Project30-FinalReport.pd

Eosinophilic Esophagitis for the Otolaryngologist

Objectives. This paper focuses on current diagnostic and treatment options for Eosinophilic Esophagitis (EE). Study Design. literature review. Results. EE can be suspected on history and endoscopy although definitive diagnosis is strictly based on histopathology. It is a relatively new entity and is often misdiagnosed as gastroesophageal reflux (GERD). Eosinophilic infiltration of the esophageal mucosa is responsible for esophageal symptoms which can range from mild to debilitating dysphagia and food impaction, when untreated. In fact recurrent foreign body and food impaction can often be blamed for undiagnosed EE. There seems to be a strong familial component and association with allergy. The introduction of transnasal esophagoscopy in adult laryngology has enabled otolaryngologists to readily diagnose EE and promoted awareness of this often difficult to recognize entity. Conclusions. Despite higher awareness, the literature suggests that EE remains a commonly misdiagnosed condition especially in the otolaryngology community. Genetic studies are required to unfold the true familial and genetic component of this fascinating entity

The Impact of Aortic Occlusion Balloon on Mortality After Endovascular Repair of Ruptured Abdominal Aortic Aneurysms: A Meta-analysis and Meta-regression Analysis

INTRODUCTION:We aimed to investigate whether the use of aortic occlusion balloon (AOB) has an impact on mortality of patients undergoing endovascular repair of ruptured abdominal aortic aneurysms (RAAAs).METHODS:A meta-analysis of the English-language literature was undertaken through February 2013. Articles reporting data on outcome after endovascular repair of RAAAs were identified and information regarding the use of AOB was sought.RESULTS:Included in this meta-analysis were 39 eligible studies reporting 1277 patients. The pooled perioperative mortality was 21.6% (95% CI 18.1-25.1%). There was significant within-study heterogeneity (I(2) 50.2%, P < 0.001). A total of 200 patients required AOB with an estimated pooled proportion of 14.1% (8.9-19.3%). Individual random-effects meta-regression investigating the effect of AOB and other risk factors on mortality revealed a significant linear association of hemodynamic instability, bifurcated endograft approach, and primary conversion to open repair with mortality and a nonlinear (second degree polynomial) association of AOB with mortality. On multivariable meta-regression models, both hemodynamic instability and AOB were found to be statistically significant, independent predictors of mortality. In particular, there was a statistically significant negative correlation between AOB and mortality and a positive effect of hemodynamic instability on mortality. In practical terms, mortality was significantly higher in studies with a higher proportion of hemodynamically unstable patients and lower in studies with a higher rate of AOB use.CONCLUSION:This study provides meta-analytical evidence that the use of an AOB in unstable RAAA patients undergoing endovascular repair may improve the results

Chronic Cough, Reflux, Postnasal Drip Syndrome, and the Otolaryngologist

Objectives. Chronic cough is a multifactorial symptom that requires multidisciplinary approach. Over the last years, general practitioners refer increasingly more chronic cough patients directly to the otolaryngologist. The aim of this paper is to highlight the issues in diagnosis and management of chronic cough patients from the otolaryngologist perspective. Design. Literature review. Results. Gastroesophageal reflux and postnasal drip syndrome remain one of the most common causes of chronic cough. Better diagnostic modalities, noninvasive tests, and high technology radiological and endoscopic innovations have made diagnosis of these difficult-to-treat patients relatively easier. Multidisciplinary assessment has also meant that at least some of these cases can be dealt with confidently in one stop clinics. Conclusions. As the number of referrals of chronic cough patients to an Ear Nose Throat Clinic increases, the otolaryngologist plays a pivotal role in managing these difficult cases

Transfer systems for rank two elementary Abelian groups: characteristic functions and matchstick games

We prove that Hill's characteristic function $\chi$ for transfer systems on a lattice $P$ surjects onto interior operators for $P$. Moreover, the fibers of $\chi$ have unique maxima which are exactly the saturated transfer systems. In order to apply this theorem in examples relevant to equivariant homotopy theory, we develop the theory of saturated transfer systems on modular lattices, ultimately producing a ``matchstick game'' that puts saturated transfer systems in bijection with certain structured subsets of covering relations. After an interlude developing a recursion for transfer systems on certain combinations of bounded posets, we apply these results to determine the full lattice of transfer systems for rank two elementary Abelian groups.Comment: 25 pages, comments welcome

Instruments evaluating the clinical findings of laryngopharyngeal reflux: A systematic review

Objectives: To identify the instruments for evaluating the clinical findings (ICFs) of laryngopharyngeal reflux (LPR) designed for use with regard to diagnosis and treatment effectiveness. Methods: The PubMed, Scopus, and Cochrane databases were used to search for subject headings following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Three investigators retrieved relevant studies published between 1990 and 2018 describing the evolution of laryngopharyngeal findings throughout LPR treatment. Issues of clinical relevance, that is, LPR diagnosis, treatments, and signs assessed for diagnosis or as therapeutic outcomes, were assessed. The investigators also evaluated the psychometric properties (conceptual model, content validity, consistency, reliability, concordance, convergent validity, known-groups validity, responsiveness to change, and interpretability) of the ICF. The risk of bias was assessed with the tool of the Clarity Group and Evidence Partners. Results: The search identified 1,227 publications with a total of 4,735 LPR patients; of these studies, 53 met the inclusion criteria. Of these 53 studies, we identified 10 unvalidated and six validated ICFs. None of the validated ICFs included all the psychometric properties. The main identified deficiencies related to ICF psychometric validation included variable construct validity, disparate and uncertain reliabilities, and a lack of interpretability. The lack of consideration of certain LPR laryngeal and extralaryngeal signs is the main weakness of ICFs, biasing content, and construct validities. Conclusion: The low specificity of LPR signs, the lack of consideration of many findings, and the absence of a gold standard for diagnosis constitute barriers to the further validation of these ICFs. Additional studies are needed to develop complete and reliable ICFs. Laryngoscope, 2018

Septic thrombophlebitis with acute osteomyelitis in adolescent children: a report of two cases and review of the literature

The triad of acute osteomyelitis, deep venous thrombophlebitis, and septic pulmonary embolism is a rare, but life-threatening syndrome in children that requires prompt recognition and treatment. We report two cases of acute osteomyelitis complicated by septic thrombophlebitis and pulmonary emboli. Both patients required operative drainage to remove the septic focus. Recognition of any one component of the triad should prompt a search for the other associated disorders. Aggressive management with early antibiotic administration, anticoagulation, and surgical debridement can be life saving