Complex Multimodality Central Airway Management of Aspergillus Pseudomembranous Tracheobronchitis

A 69-year-old woman developed central airway obstruction due to invasive Aspergillus infection resulting in pseudomembranous tracheobronchitis (PTB). Several challenges were encountered in the airway management of this patient including her having relatively smaller airways which were more prone to obstruction by pseudomembranes and made airway interventions difficult. The patient had clinical deterioration in spite of antifungal therapy and bronchoscopic debridement. The multimodality airway techniques included the use of smaller biliary balloons for dilatation, using a hybrid stent to slowly dilate and maintain patency of right main stem and finally the insertion of right secondary carina peripheral Y stent, which resulted in clinical improvement and allowed time for antifungal therapy to take effect. To the best of our knowledge, the use of a peripheral Y stent has never been described in the setting of PTB

Integrated RF MEMS/CMOS Devices

A maskless post-processing technique for CMOS chips is developed that enables the fabrication of RF MEMS parallel-plate capacitors with a high quality factor and a very compact size. Simulations and measured results are presented for several MEMS/CMOS capacitors. A 2-pole coupled line tunable bandpass filter with a center frequency of 9.5 GHz is designed, fabricated and tested. A tuning range of 17% is achieved using integrated variable MEMS/CMOS capacitors with a quality factor exceeding 20. The tunable filter occupies a chip area of 1.2 x 2.1 mm2.Comment: Submitted on behalf of EDA Publishing Association (http://irevues.inist.fr/handle/2042/16838

Determination of caffeine in roasted and irradiated coffee beans with gamma rays by high performance liquid chromatography

The present study was carried out to investigate a simple, quick and organic solvent saving procedure for the high performance liquid chromatography determination of caffeine in two different coffee beans (Indonesian and Brazilian) which roasted at two different temperatures (150 & 220 ºC) and irradiated at 3, 6, and 9 kGy doses by gamma rays. A linear calibration curve was generated with caffeine concentration ranging from 0.005 to 0.25 mg/g with correlation coefficient (R2= 0.9995, n=4) and relative standard deviation ? 2.1 %. The developed procedure provided a 7.3 x 10-9 mg/g and 2.2 x 10-8 mg/g limit of detection and limit of quantification, respectively. The developed method was repeatable and could be applied to determine trace amounts of caffeine in popular irradiated coffee beans with three different irradiation doses. Moreover, irradiation treatments at doses up to 9 kGy showed no significant effect on the caffeine content. Keywords: Caffeine determination; High performance liquid chromatography;  Coffee bean; Roasting; Gamma rays; Statistical analysi

Integrated Forward and Reverse Logistics Network Design

Many manufacturers are moving towards green manufacturing. One of the actions for environment friendly manufacturing is collection of end-of-life products (EOL). EOL products are transported to the proper facilities for reprocessing or proper disposal. Movement of collected products is performed through reverse logistics networks. Reverse logistics networks may be designed independent of forward logistics networks, or as integrated networks, known as integrated forward and reverse logistics (IFRL) networks. Recent research shows that IFRL networks are more efficient than independent networks. In this work, we study a number of IFRL networks. We present a comprehensive mathematical model to represent an assignment and location-routing IFRL network. Afterwards, this model is decomposed into a number of sub-models that represent different IFRL networks. For each network we develop a solution methodology to solve practical size problems. Two sub-models based on the comprehensive model are presented to design two IFRL location-routing networks. The first network considers decision on the location to establish a disassembly plant. The second network considers decisions on the location to establish a manufacturing facility. For both networks, routing decisions are assigning customers to vehicles, and establishing vehicles’ routes. We develop two heuristic methods to solve the models. The heuristics are able to reach optimal or near optimal solutions in reasonable computational times. The vehicle routing problem with simultaneous pickup and delivery and time windows (VRPSPD-TW) is studied in this work. We use a sub-model of the comprehensive model to represent the problem. Classic heuristics and intelligent optimization or metaheuristics are widely used to solve similar problems. Therefore, we develop a heuristic method to solve the VRPSPD-TW. Results of the heuristic serve as initial solutions for a simulated annealing (SA) approach. For most tested problems, the SA approach is able to improve the heuristic solutions, and reach optimal solutions. Computational times are reasonable for the heuristic and SA. We also study the multi-depot vehicle routing problem with simultaneous pickup and delivery and time windows (MDVRPSPS-TW). A sub-model of the comprehensive model represents the problem. The network considers assignment of customers and vehicles to depots, assignment of customers to vehicles and routing of vehicles within customers’ time windows. We develop a 2-phase heuristic and a SA approach to solve the problem. Heuristic solutions serve as initial solutions for the SA approach. SA is able to reach optimum or near optimum solutions. Computational times are reasonable for the heuristic and S

Behavior of RC Wide Beams under Eccentric Loading

Wide beams are one of the widely used structural elements in RC buildings due to the many special features that characterize them. The main objective of this research is to investigate the behavior of wide shallow beams under the effect of eccentric loading acting along their cross sections. To achieve that, an experimental program that consisted of seven wide beams was conducted. All beams were loaded using two concentrated loads at their middle third where the main parameters considered were: the magnitude of the load eccentricity, the longitudinal spacing between shear reinforcement, and the arrangement of the longitudinal reinforcement. Following that, a finite element analysis was performed where the analytical model used was first verified using the data from the experimental program. The results from both the experimental and analytical programs were in good agreement. Then, the finite element analysis was extended through a parametric study where other variables were studies such as the compressive strength of concrete, the transverse spacing between stirrups and the longitudinal reinforcement ratio. The results showed that the value of the load eccentricity, spacing between shear reinforcement, the arrangement of the main reinforcement along the beam cross section, and the compressive strength of concrete significantly affected the torsional resistance of shallow wide beams. Conclusions and recommendations are presented which can be useful for future researchers. Doi: 10.28991/cej-2021-03091766 Full Text: PD

Immunohistochemical analysis of expression and allelotype of mismatch repair genes (hMLH1 and hMSH2) in bladder cancer

Mutation of human homologues of DNA mismatch repair (MMR) genes in tumours has been shown to be associated with the phenomenon of microsatellite instability (MSI). Several studies have reported the occurrence of MSI in bladder cancer, but evidence of involvement of MMR genes in the pathogenesis of this cancer is still unclear. We therefore utilized quantitative immunohistochemical (IHC) image analysis and PCR-based allelotype analysis to determine hMLH1 and hMSH2 genes alteration in a cohort of Egyptian bladder cancer samples. IHC analysis of 24 TCC and 12 SCC revealed marked- intra and intertumour heterogeneity in the levels of expression of the two MMR proteins. One TCC lost MLH1 expression and one lost MSH2, (1/24, 4%), and one SCC lost MSH2 (1/12, 8%). A large proportion of analysed tumours revealed a percentage positivity of less than 50% for MLH1 and MSH2 expression (44% and 69%, respectively). Complete loss of heterozygosity in three dinucleotide repeats lying within, or in close proximity to, hMLH1 and hMSH2 was rare (2/57, (4%) for MLH1; and 1/55, (2%) for MSH2), however allelic imbalance was detected in 11/57 (hMLH1) and 10/55 (hMSH2) at any of the informative microsatellite loci. These alterations in structure and expression of DNA MMR genes suggest their possible involvement in the tumorigenesis and/or progression of bladder cancer. © 2001 Cancer Research Campaign http://www.bjcancer.co

Some microbial treatments against the tomato leaf miner; Tuta absoluta (Merick) under natural field conditions

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Asymmetry of Blinking

PURPOSE. Too investigate asymmetry in eyelid movements with blinking, the stability of the asymmetry, and its modifiability in normal humans. METHODS. Differences in the start time and amplitude between the two eyelids were assessed for voluntary blinks and reflex blinks evoked by supraorbital trigeminal nerve stimulation. These variables were also measured before and up to 18 months after 2 hours of unilateral upper lid restraint. RESULTS. With voluntary blinks, one eyelid consistently began to close earlier and made a larger eyelid movement than the other eyelid. Stimulation of the supraorbital branch of the trigeminal nerve evoked relatively larger amplitude blinks in one eyelid that correlated with the asymmetries of voluntary blinks. There was a continuum of eyelid asymmetry across all subjects that was stable and independent of other biological asymmetries, such as handedness. Briefly reducing eyelid mobility created a long-lasting change in eyelid asymmetry with blinking. CONCLUSIONS. Eyelid asymmetry results from differences in the excitability of motoneurons in the left and right facial motor nuclei and does not appear to involve asymmetries in cortical inputs to the brain stem. Because adaptive processes modify the motoneuron excitability that creates eyelid asymmetry, these processes may underlie changes in blinking associated with facial palsy and may play a role in the development of disorders that affect one side of the face, such as hemifacial spasm. (Invest Ophthalmol Vis Sci. 2006;47:195-201) DOI: 10.1167/iovs.04-1279 H umans exhibit several motor, sensory, and functional asymmetries in which one side of the body is dominant or more responsive than the other. The most evident motor asymmetry is handedness, with people typically being either right or left handed. In addition to this well-known asymmetry, human facial expressions of happiness and sadness produce larger movements of the left than the right side of the face. 1,2 The accepted explanation of this facial motor asymmetry is specialization of the right cerebral hemisphere for emotional expression. Clinical studies suggest that differences in excitability between motoneurons in the left and right facial motor nuclei may create asymmetries for reflex blinking. Facial palsy patients exhibit increased motoneuron excitability in the facial nucleus on the affected relative to the unaffected side of the face. 4 -6 One explanation for this increased excitability in Bell's palsy is changes in the motoneuron membrane properties caused by axotomy. It is also possible that the increased excitability involves an adaptive increase in excitatory presynaptic drive to facial motoneurons, 7 to compensate for muscle weakness. Consistent with this explanation, mimicking facial palsy with unilateral eyelid restraint in normal humans appears to increase motoneuron excitability in the restrained eyelid in the absence of axotomy. 8 Our study determined whether eyelid asymmetry exists in normal individuals and investigated whether eyelid asymmetries result from cortical or brain stem mechanisms. Assessing the timing and amplitude of left and right eyelid movement with cortically controlled voluntary blinks and brain stemgenerated trigeminal reflex blinks demonstrates the presence of functional eyelid asymmetry. Comparison of the eyelid asymmetry present in voluntary and reflex blinks showed that a difference in motoneuron excitability is the primary source of eyelid asymmetry in both voluntary and reflex blinks. We also showed that eyelid asymmetry is a modifiable property of the eyelid motor system. METHODS Subjects All experiments adhered to the tenets of the Declaration of Helsinki. Informed consent from the participants and prior institutional review board approval were obtained. The 18 subjects, 10 men and 8 women, ranging from 22 to 59 (mean, 29 Ϯ 10) years of age, did not have any history of medications or neurologic, eye, or eyelid disorders that would affect blinking. Procedures Upper eyelid position was monitored bilaterally with the magnetic search coil technique using a 30-turn, 2-mm diameter coil attached to the middle of the upper eyelid as close as possible to its margin. 9 Unilateral electrical stimulation of the supraorbital branch of the trigeminal nerve (SO) evoked bilateral trigeminal reflex blinks. To elicit these reflex blinks, a pair of 9-mm diameter gold-plated electrodes (Grass-Telefactor, West Warwick, RI) was placed over both the left and right SO. One electrode of the pair was placed directly over the supraorbital notch and the second approximately 2.5 cm above the first. The SO stimulus was a 170-s constant current delivered at twice the threshold current (2T) necessary to evoke a blink consistently when stimuli occurred with at least a 20-second interstimulus interval. Across all subjects, 2T current intensity ranged from 2.8 to 8 mA. In four of the eighteen subjects, the effect of changing SO stimulus intensity on eyelid asymmetry was also tested. For these subjects, the perception threshold (PT), the lowest SO stimulus intensity at which the subject consistently reported perceiving SO stimulation, was determined. The subjects then received SO stimuli ranging from twice to six times perception threshold (2PT-6PT). Four times perception threshold is roughly equivalent to the twice blink threshold stimulus intensity used for all the other subjects