Thymoma and Autoimmune Encephalitis: Clinical Manifestations and Antibodies

To report the clinical, neuroimaging, and antibody associations in patients with autoimmune encephalitis (AE) and thymoma.A retrospective cohort study of 43 patients was conducted. Antibody determination and immunoprecipitation to characterize novel antigens were performed using reported techniques.Patients' median age was 52 years (range: 23-88 years). Forty (93%) had neuronal surface antibodies: gamma-aminobutyric acid receptor A (GABAAR) (15), amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) (13), contactin-associated protein-like 2 (CASPR2) (4), leucine-rich, glioma inactivated 1 (LGI1) (3), glycine receptor (GlyR) (3), and unknown antigens (2). Concurrent antibodies against intracellular antigens occurred in 13 (30%; 9 anti-collapsin response mediator protein 5 [CRMP5]) and were more frequent in anti-AMPAR encephalitis (54% vs 20%; p = 0.037). The most common clinical presentation was encephalitis with multiple T2/fluid-attenuated inversion recovery hyperintense lesions in 23 (53%) patients (15 GABAAR, 5 AMPAR, and 1 unknown neuropil antibody), followed by encephalitis with peripheral nerve hyperexcitability in 7 (16%; 4 CASPR2, 2 LGI1, and 1 unknown antibody), limbic encephalitis in 6 (14%; 4 AMPAR, 1 LGI1, and 1 antibody negative), progressive encephalomyelitis with rigidity and myoclonus in 4 (9%; 3 GlyR and 1 AMPAR antibodies), and encephalitis with normal MRI in 3 (7%; AMPAR antibodies). Anti-GABAAR encephalitis was more prevalent in Japanese patients compared with Caucasians and other ethnicities (61% vs 16%; p = 0.003). In anti-AMPAR encephalitis, 3/4 patients with poor and 0/6 with good outcome had concurrent CRMP5 antibodies (p = 0.033). Immunoprecipitation studies identified metabotropic glutamate receptor 3 antibodies that were additionally found in 5 patients (3 with and 2 without encephalitis).AE in patients with thymoma include several clinical-radiologic syndromes that vary according to the associated antibodies. Anti-GABAAR encephalitis was the most frequent AE and occurred more frequently in Japanese patients

Delamination and Tensile Effect of Fine z-Binder Reinforced on Fiberglass/Polyester Composite for Aerospace Applications

Delamination propagation in laminated composite materials is a common issue that always concerns us when we consider composites for structural purpose. Many possible solutions have been studied; the most famous is the three-dimensional (3D) woven composites materials, which have promising interlaminar fracture resistance but at the cost of increasing density, which for aerospace industry is very important. In this chapter, mode 1 double cantilever beam (DCB) interlaminar fracture toughness tests according to the American Society for Testing and Materials (ASTM) D5528 standard were performed on composite specimens made of E-Glass Saertex 830 g/m2 Biaxial (+/−45°) with Sypol 8086 CCP polyester resin with orthogonal z-axis oriented yarn woven of 0.22 mm diameter nylon monofilament. Four specimens were made with a longitudinal distance between the warp binders of 0.5, 1, 1.5, and 2 cm, respectively. A tensile test according to the ASTM D3039 standard was performed to study how z-binder may affect tensile resistance. The results show a considerable increase in interlaminar fracture toughness, several stress concentrators have been created because of the new yarn and premature failure in the matrix

Delamination and tensile effect of fine z-binder reinforced on fiberglass/polyester composite for aerospace applications

Delamination propagation in laminated composite materials is a common issue that always concerns us when we consider composites for structural purpose. Many possible solutions have been studied; the most famous is the three-dimensional (3D) woven composites materials, which have promising interlaminar fracture resistance but at the cost of increasing density, which for aerospace industry is very important. In this chapter, mode 1 double cantilever beam (DCB) interlaminar fracture toughness tests according to the American Society for Testing and Materials (ASTM) D5528 standard were performed on composite specimens made of E-Glass Saertex 830 g/m2 Biaxial (+/−45°) with Sypol 8086 CCP polyester resin with orthogonal z-axis oriented yarn woven of 0.22 mm diameter nylon monofilament. Four specimens were made with a longitudinal distance between the warp binders of 0.5, 1, 1.5, and 2 cm, respectively. A tensile test according to the ASTM D3039 standard was performed to study how z-binder may affect tensile resistance. The results show a considerable increase in interlaminar fracture toughness, several stress concentrators have been created because of the new yarn and premature failure in the matrix

Carbonation Depth of Sustainable Concrete Made with Agroindustrial and Industrial Waste Exposed to the Urban Environment of the City of Xalapa, Ver; Mexico

In the present investigation the effect of the urban environment of the city of Xalapa, Ver., México in the depth carbonation in Sustainable Concrete made with Agro-Industrial and Industrial Waste Materials like Sugar Cane Bagasse Ash (SCBA) and Silica Fume (SF), was evaluated. The Sustainable Concretes and the Conventional Concrete (Concrete of reference) were designed for a relation water/cement= 0.65 according to the indicated for the ACI 211.1. The Conventional Concrete was elaborated with 100% of Portland cement, and the Sustainable Concretes with partial substitution of Portland cement for the waste of SCBA and SF in percentages of 10, 20, 30, 40, and 50%. The results through the application of phenolphthalein, indicate that the Carbonation depth is proportional to the increase of the substitution of Portland Cement for agro-industrial and industrial waste. The sustainable concrete with 50% of substitution of SCBA-SF presents the worst performance, with a carbonation depth of 1.48 cm, which represents an increment of more of 350% than the conventional concrete at being exposed for one year to the present environment of stud

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia

BackgroundA heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC).MethodsA population-based case-control study was conducted. Children &lt;18 years old, newly diagnosed with ALL and residents of GMC were included. Controls were patients without leukemia recruited from second-level public hospitals, frequency-matched by sex, age, and health institution with the cases. The residence address where the patients lived during the last year before diagnosis (cases) or the interview (controls) was used for geolocation. Kulldorff’s spatial scan statistic was used to detect spatial clusters (SCs). Relative risks (RR), associated p-value and number of cases included for each cluster were obtained.ResultsA total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (p&lt;0.0001) was observed for the main cluster. Similar results were noted for the remaining seven ones. Additionally, a proximity between SCs, electrical installations and petrochemical facilities was observed.ConclusionsThe identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL

Physical, Mechanical and Durability Properties of Ecofriendly Ternary Concrete Made with Sugar Cane Bagasse Ash and Silica Fume

In the present investigation, the physical, mechanical and durability properties of six concrete mixtures were evaluated, one of conventional concrete (CC) with 100% Portland cement (PC) and five mixtures of Ecofriendly Ternary Concrete (ETC) made with partial replacement of Portland Cement by combinations of sugar cane bagasse ash (SCBA) and silica fume (SF) at percentages of 10, 20, 30, 40 and 50%. The physical properties of slump, temperature, and unit weight were determined, as well as compressive strength, rebound number, and electrical resistivity as a durability parameter. All tests were carried out according to the ASTM and ONNCCE standards. The obtained results show that the physical properties of ETC concretes are very similar to those of conventional concrete, complying with the corresponding regulations. Compressive strength results of all ETC mixtures showed favorable performances, increasing with aging, presenting values similar to CC at 90 days and greater values at 180 days in the ETC-20 and ETC-30 mixtures. Electrical resistivity results indicated that the five ETC mixtures performed better than conventional concrete throughout the entire monitoring period, increasing in durability almost proportionally to the percentage of substitution of Portland cement by the SCBA–SF combination; the ETC mixture made with 40% replacement had the highest resistivity value, which represents the longest durability. The present electrical resistivity indicates that the durability of the five ETC concretes was greater than conventional concrete. The results show that it is feasible to use ETC, because it meets the standards of quality, mechanical resistance and durability, and offers a very significant and beneficial contribution to the environment due to the use of agro-industrial and industrial waste as partial substitutes up to 50% of CPC, which contributes to reduction in CO2 emissions due to the production of Portland cement, responsible for 8% of total emissions worldwide

Corrosion behavior of AISI 304 stainless steel reinforcements in SCBA-SF ternary ecological concrete exposed to MgSO4

In this study, ternary ecological concrete (TEC) mixtures were produced with partial substitution of the ordinary Portland cement (OPC) by 10%, 20%, and 30% of sugar cane bagasse ash (SCBA) and silica fume (SF); a control mixture (100% OPC) was prepared according to ACI 211.1 standard. The studied TEC specimens were reinforced with AISI 304 stainless steel and AISI 1018 carbon steel rebars. TEC reinforced specimens were immersed in two different electrolytes, a control (DI-water) and 3.5 wt.% MgSO4 solution, for 180 days. The electrochemical corrosion was monitored by corrosion potential (Ecorr) according to ASTM C-876-15 standard, and the linear polarization resistance (LPR) technique using ASTM G59 standard. The Ecorr and current density icorr results show that AISI 304 stainless steel rebars have a high corrosion resistance, with icorr values below 0.1 µA/cm2, which is interpreted as a level of negligible corrosion. The best corrosion performance was found for the TEC mixture made with a 20% addition of blend of sugar cane bagasse ash-silica fume (SCBA-SF) to the OPC.This research was funded by PRODEP for the support granted by the SEP, to the Academic Body UV-CA-458 “Sustainability and Durability of Materials for Civil Infrastructure”, within the framework of the 2018 Call for the Strengthening of Academic Bodies with IDCA 28593. Funding support from The University of Akron, Fellowship Program FRC–207367