Septic Arthritis Caused by Legionella dumoffii in a Patient with Systemic Lupus Erythematosus-Like Disease

We describe a patient with systemic lupus erythematosus (SLE)-like disease on immunosuppressive treatment who developed septic arthritis of the knee involving Legionella dumoffii. Cultures initially remained negative. A broad-range 16S PCR using synovial fluid revealed L. dumoffii rRNA genes, a finding that was subsequently confirmed by positive Legionella culture results

The impact of self-heating and SiGe strain-relaxed buffer thickness on the analog performance of strained Si nMOSFETs

The impact of the thickness of the silicon–germanium strain-relaxed buffer (SiGe SRB) on the analog performance of strained Si nMOSFETs is investigated. The negative drain conductance caused by self-heating at high power levels leads to negative self-gain which can cause anomalous circuit behavior like non-linear phase shifts. Using AC and DC measurements, it is shown that reducing the SRB thickness improves the analog design space and performance by minimizing self-heating. The range of terminal voltages that leverage positive self-gain in 0.1 μm strained Si MOSFETs fabricated on 425 nm SiGe SRBs is increased by over 100% compared with strained Si devices fabricated on conventional SiGe SRBs 4 μm thick. Strained Si nMOSFETs fabricated on thin SiGe SRBs also show 45% improvement in the self-gain compared with the Si control as well as 25% enhancement in the on-state performance compared with the strained Si nMOSFETs on the 4 μm SiGe SRB. The extracted thermal resistance is 50% lower in the strained Si device on the thin SiGe SRB corresponding to a 30% reduction in the temperature rise compared with the device fabricated on the 4 μm SiGe SRB. Comparisons between the maximum drain voltages for positive self-gain in the strained Si devices and the ITRS projections of supply-voltage scaling show that reducing the thickness of the SiGe SRB would be necessary for future technology nodes

The Effects of Selected Sugars on the Rheological Properties of Rehydrated Vital Gluten

Solutions of four common sugars, sucrose, maltose, glucose, and fructose were individually mixed with rehydrated vital gluten. The mixtures were then subjected to a standard baking test and to rheological examination. In both instances the addition of sugar significantly altered stress-strain relationships. The viscosity and extensibility of all the mixtures containing sugar were greater than that of the pure gluten. This suggests that the sugars had peptized the gluten and inhibited its thermal coagulation during baking. Significant differences between the action of individual sugars could not be ascertained, however. A Maxwell model for visoelastic behavior was found to fit the rheological data quite well within experimental limits. Meaningful comparisons between experimentally measured coefficients for viscosity and shear moduli and literature values were difficult because of differences in purity and sources of the gluten. However, the measured elastic moduli were an order of magnitude greater than those reported earlier for gluten in wheat flour doughs. This was attributed to a higher purity of the test gluten and to a better testing technique than had been used heretofore

Drug Registries and Approval of Drugs:Promises, Placebo, or a Real Success?

Purpose: As part of the approval process, regulatory authorities often require postauthorization studies that involve patient registries; it is unknown, however, whether such registry studies are adequately completed. We investigated whether registry studies for new drugs were performed as agreed at time of approval. Methods: This study reviewed protocols and follow-up reports for 73 registry studies that were proposed for 43 drugs approved by the Committee for Medicinal Products for Human Use in Europe in the period 2007 to 2010. Results: The data lock point of January 1, 2016, was taken to allow a 5-year follow-up period for each drug after approval. At that time, 2 studies (3%) in registries had been finalized, 19 registries (26%) had not enrolled any patients, and 52 studies (71%) were ongoing. The median enrollment was 31% (interquartile range [IQR], 6–104) of the required number of patients for 41 registry studies that had a predefined sample size, 30% (IQR, 2–101) for nonimposed registries, and 61% (IQR, 18–144) for imposed registries. Implications: Enrollment of patients into postapproval registries is poor, although the results for imposed registries seem better. Currently, registries only have a limited impact on resolving gaps in the knowledge of a drug's benefits and risks at time of marketing authorization

Projected Demand and Potential Impacts to the National Airspace System of Autonomous, Electric, On-Demand Small Aircraft

Electric propulsion and autonomy are technology frontiers that offer tremendous potential to achieve low operating costs for small-aircraft. Such technologies enable simple and safe to operate vehicles that could dramatically improve regional transportation accessibility and speed through point-to-point operations. This analysis develops an understanding of the potential traffic volume and National Airspace System (NAS) capacity for small on-demand aircraft operations. Future demand projections use the Transportation Systems Analysis Model (TSAM), a tool suite developed by NASA and the Transportation Laboratory of Virginia Polytechnic Institute. Demand projections from TSAM contain the mode of travel, number of trips and geographic distribution of trips. For this study, the mode of travel can be commercial aircraft, automobile and on-demand aircraft. NASA's Airspace Concept Evaluation System (ACES) is used to assess NAS impact. This simulation takes a schedule that includes all flights: commercial passenger and cargo; conventional General Aviation and on-demand small aircraft, and operates them in the simulated NAS. The results of this analysis projects very large trip numbers for an on-demand air transportation system competitive with automobiles in cost per passenger mile. The significance is this type of air transportation can enhance mobility for communities that currently lack access to commercial air transportation. Another significant finding is that the large numbers of operations can have an impact on the current NAS infrastructure used by commercial airlines and cargo operators, even if on-demand traffic does not use the 28 airports in the Continental U.S. designated as large hubs by the FAA. Some smaller airports will experience greater demand than their current capacity allows and will require upgrading. In addition, in future years as demand grows and vehicle performance improves other non-conventional facilities such as short runways incorporated into shopping mall or transportation hub parking areas could provide additional capacity and convenience

Exploring the impact of gut microbiota and diet on breast cancer risk and progression

There is emerging evidence that resident microbiota communities, that is, the microbiota, play a key role in cancer outcomes and anticancer responses. Although this has been relatively well studied in colorectal cancer and melanoma, other cancers, such as breast cancer (BrCa), have been largely overlooked to date. Importantly, many of the environmental factors associated with BrCa incidence and progression are also known to impact the microbiota, for example, diet and antibiotics. Here, we explore BrCa risk factors from large epidemiology studies and microbiota associations, and more recent studies that have directly profiled BrCa patients' gut microbiotas. We also discuss how in vivo studies have begun to unravel the immune mechanisms whereby the microbiota may influence BrCa responses, and finally we examine how diet and specific nutrients are also linked to BrCa outcomes. We also consider future research avenues and important considerations with respect to study design and implementation, and we highlight some of the important unresolved questions, which currently limit our overall understanding of the mechanisms underpinning microbiota‐BrCa responses

Emulating Fast Processes in Climate Models

Cloud microphysical parameterizations in atmospheric models describe the formation and evolution of clouds and precipitation, a central weather and climate process. Cloud-associated latent heating is a primary driver of large and small-scale circulations throughout the global atmosphere, and clouds have important interactions with atmospheric radiation. Clouds are ubiquitous, diverse, and can change rapidly. In this work, we build the first emulator of an entire cloud microphysical parameterization, including fast phase changes. The emulator performs well in offline and online (i.e. when coupled to the rest of the atmospheric model) tests, but shows some developing biases in Antarctica. Sensitivity tests demonstrate that these successes require careful modeling of the mixed discrete-continuous output as well as the input-output structure of the underlying code and physical process.Comment: Accepted at the Machine Learning and the Physical Sciences Workshop at the 36th conference on Neural Information Processing Systems (NeurIPS) December 3, 202

Long-term quality of life and cost-effectiveness of treatment of partial thickness burns: A randomized controlled trial comparing enzyme alginogel vs silver sulfadiazine (FLAM study)

The clinical effectiveness and scar quality of the randomized controlled trial comparing enzyme alginogel with silver sulfadiazine (SSD) for treatment of partial thickness burns were previously reported. Enzyme alginogel did not lead to faster wound healing (primary outcome) or less scar formation. In the current study, the health-related quality of life (HRQoL), costs, and cost-effectiveness of enzyme alginogel compared with SSD in the treatment of partial thickness burns were studied. HRQoL was evaluated using the Burn Specific Health Scale-Brief (BSHS-B) and the EQ-5D-5L questionnaire 1 week before discharge and at 3, 6, and 12 months postburn. Costs were studied from a societal perspective (health care and nonhealth-care costs) for a follow-up period of 1 year. A cost-effectiveness analysis was performed using cost-effectiveness acceptability curves and comparing differences in societal costs and Quality Adjusted Life Years (QALYs) at 1 year postburn. Forty-one patients were analyzed in the enzyme alginogel group and 48 patients in the SSD group. None o

Hydrosurgical and conventional debridement of burns:randomized clinical trial

Background: Tangential excision of burned tissue followed by skin grafting is the cornerstone of burn surgery. Hydrosurgery has become popular for tangential excision, with the hypothesis that enhanced preservation of vital dermal tissue reduces scarring. The aim of this trial was to compare scar quality after hydrosurgical versus conventional debridement before split-skin grafting. Methods: A double-blind randomized within-patient multicentre controlled trial was conducted in patients with burns that required split-skin grafting. One wound area was randomized to hydrosurgical debridement and the other to Weck knife debridement. The primary outcome was scar quality at 12 months, assessed with the observer part of the Patient and Observer Scar Assessment Scale (POSAS). Secondary outcomes included complications, scar quality, colour, pliability, and histological dermal preservation. Results: Some 137 patients were randomized. At 12 months, scars of the hydrosurgical debrided wounds had a lower POSAS observer total item score (mean 2.42 (95 per cent c.i. 2.26 to 2.59) versus 2.54 (95 per cent c.i. 2.36 to 2.72; P =0.023)) and overall opinion score (mean 3.08 (95 per cent c.i. 2.88 to 3.28) versus 3.30 (95 per cent c.i. 3.09-3.51); P = 0.006). Patient-reported scar quality and pliability measurements were significantly better for the hydrosurgically debrided wounds. Complication rates did not differ between both treatments. Histologically, significantly more dermis was preserved with hydrosurgery (P < 0.001). Conclusion: One year after surgery scar quality and pliability was better for hydrosurgically debrided burns, probably owing to enhanced histological preservation of dermis