Aberrant right subclavian artery syndrome: A case of chronic cough1 1Competition of interest: none.

AbstractA young, otherwise healthy man had chronic cough of 16 months’ duration. Evaluation revealed an aberrant right subclavian artery. Kommerell’s diverticulum without aneurysmal degeneration was present. Imaging studies showed compression of the esophagus but not the trachea. Results of methacholine challenge test were negative for evidence of reactive airway disease, but suggested mild variable intrathoracic obstruction. While aberrant right subclavian artery syndrome most commonly involves dysphagia, our patient’s only symptom was cough. Right subclavian artery to right common carotid artery transposition was performed, with oversewing of the subclavian artery stump to the left of the esophagus through a right supraclavicular incision. This treatment was curative, with complete resolution of symptoms

Institutionalizing resilience in U.S. universities: Prospects, opportunities, and models

The United States is taking a largely region-specific approach to addressing challenges posed by climate change, in contrast with national and international approaches in most of the rest of the world. In locations such as Hampton Roads,New Orleans, and coastal Connecticut, the impacts of climate change tend to be addressed as they become locally evident rather than as part of a larger anticipatory national plan. Given that regional focus, universities can play a unique role in how the United States responds to the challenges of a changing climate

Semantic Material Bank: A web-based linked data approach for building decommissioning and material reuse

One of the barriers to circular construction is the lack of availability or visibility of reusable materials and components at the right time and place. Therefore, this paper suggests a digital solution based on identified key stakeholders’ information requirements and market motivations. This solution helps close the material loop between the decommissioning phase and the new construction phase through semantic technology-based information exchanges among stakeholders. The proposed ontologies are twofold: 1) a Decommissioning & Reuse Ontology (DOR) that enriches information models with circular and End-of-Life cycle information while 2) the Ontology for Environmental Product Declaration (OEPD) digitalising standardised and comparable sustainable information. Both ontologies are employed in the Semantic Material Bank (SMB) proof-of-concept: a BIM-compliant digital urban mining solution through which defined stakeholders can evaluate the availability and status of reusable and recyclable elements for future construction projects

Investigating social deprivation and comorbid mental health diagnosis as predictors of treatment access among patients with an opioid use disorder using substance use services: a prospective cohort study

Background: Opioid use is a major public health concern across the globe. Opioid use and subsequent access to care is often shaped by co-occurring issues faced by people using opioids, such as deprivation, mental ill-health, and other forms of substance use. We investigated the role of social deprivation and comorbid mental health diagnoses in predicting re-engagement with substance use services or contact with crisis and inpatient services for individuals with opioid use disorder in secondary mental health care in inner-city London. Methods: We conducted a prospective cohort study which followed individuals diagnosed with a first episode of opioid use disorder who accessed substance use services between September 2015 and May 2020 for up to 12 months, using anonymised electronic health records. We employed negative binominal regression and Cox proportional survival analyses to assess associations between exposures and outcomes. Results: Comorbid mental health diagnoses were associated with higher contact rates with crisis/inpatient services among people with opioid use disorder: incidence rate ratios (IRR) and 95% confidence intervals (CI) were 3.91 (1.74–9.14) for non-opioid substance use comorbidity, 8.92 (1.81–64.4) for a single comorbid mental health diagnosis, and 15.9 (5.89–47.5) for multiple comorbid mental health diagnoses. Social deprivation was not associated with contact rates with crisis/inpatient services within this sample. Similar patterns were found with time to first crisis/inpatient contact. Social deprivation and comorbid mental health diagnoses were not associated with re-engagement with substance use services. Conclusion: Comorbid substance and mental health difficulties amongst people with an opioid use disorder led to earlier and more frequent contact with crisis/inpatient mental health services during the first 12 months of follow up. Given the common co-occurrence of mental health and substance use disorders among those who use opioids, a better understanding of their wider needs (such as social, financial and other non-medical concerns) will ensure they are supported in their treatment journeys

Biological Properties and Health-Promoting Functions of Laminarin: A Comprehensive Review of Preclinical and Clinical Studies

Marine algal species comprise of a large portion of polysaccharides which have shown multifunctional properties and health benefits for treating and preventing human diseases. Laminarin, or β-glucan, a storage polysaccharide from brown algae, has been reported to have potential pharmacological properties such as antioxidant, anti-tumor, anti-coagulant, anticancer, immunomodulatory, anti-obesity, anti-diabetic, anti-inflammatory, wound healing, and neuroprotective potential. It has been widely investigated as a functional material in biomedical applications as it is biodegradable, biocompatible, and is low toxic substances. The reported preclinical and clinical studies demonstrate the potential of laminarin as natural alternative agents in biomedical and industrial applications such as nutraceuticals, pharmaceuticals, functional food, drug development/delivery, and cosmeceuticals. This review summarizes the biological activities of laminarin, including mechanisms of action, impacts on human health, and reported health benefits. Additionally, this review also provides an overview of recent advances and identifies gaps and opportunities for further research in this field. It further emphasizes the molecular characteristics and biological activities of laminarin in both preclinical and clinical settings for the prevention of the diseases and as potential therapeutic interventions

A comprehensive review of outdoor thermal comfort in urban areas: effective parameters and approaches

Increased urban air temperature considerably affects the health, comfort and consequently the quality of life in urban spaces. Urban design and planning studies, therefore, face an increasing challenge as they aim to improve Outdoor Thermal Comfort (OTC) and microclimate conditions of urban environments. Analysing OTC is more challenging when compared to indoor thermal comfort since a wider range of interrelated parameters exists in outdoor environments. Therefore, this research aims to classify urban studies that investigate OTC by conducting a comprehensive review based on key metrics such as approaches taken, methodologies and spatial and temporal scales. By extracting the key findings, this research forms an integrated framework of these metrics that presents a thorough view of the OTC concept in the context of climate-sensitive studies. Furthermore, this research elaborates on the main two groups of parameters affecting OTC including environmental and human-based parameters. Exploring the intricate inter-relationships of these two groups of parameters clarifies their contribution to OTC. Results of this study help architects and urban planners to improve their climate-sensitive strategies and support the decision-making process by providing a comprehensive perspective about different aspects of OTC. Finally, recommendations for future research are outlined

Dry eye following cataract surgery: The effect of light exposure using an in-vitro model

Purpose: Cataract surgery can lead to the temporary development or worsening of dry eye symptoms.Contributing factors may include corneal incisions, agents used before, during or after surgery, light from the operating microscope, disruption of ocular surface tissues and inflammatory processes. The purpose of this study was to observe the effect of light exposure on conjunctival fibroblasts in order to determine whether light has an effect on wound healing closure, assuming that operating microscopes might have an effect on the ocular surface. Method: An in vitro scratch assay was performed on porcine conjunctival fibroblasts. Ten minutes of light exposure from a light microscope with halogen bulb was performed after the scratch assay. Fibroblasts were kept in culture for 48 hours post-exposure and the wound closure rates were visualized by live/dead staining. The fibroblasts which were exposed to light were compared to those without light exposure. Cell viability was also analysed by MTT assay. Results: Slower wound closure rate was found when fibroblasts were exposed to light compared to the non-light exposed controls. Cell viability reduced by 20% with light exposure compared to controls in p3 cells (p = 0.04; however, the trend was not observed with p4 and p5 cells (p > 0.05). Conclusions: These results suggest that light exposure might be one of the possible contributory factors for dry eye after ophthalmic surgery. Further evaluation of light effects should be carried out with different ocular surface cell

Impact of stoichiometry and strain on Ge1−x Sn x alloys from first principles calculations

We calculate the electronic structure of germanium-tin (Ge1-x Sn x ) binary alloys for 0 ≤ x ≤ 1 using density functional theory (DFT). Relaxed alloys with semiconducting or semimetallic behaviour as a function of Sn composition x are identified, and the impact of epitaxial strain is investigated by constraining supercell lattice constants perpendicular to the [001] growth direction to the lattice constants of Ge, zinc telluride, or cadmium telluride substrates. It is found that application of 1% tensile strain reduces the Sn composition required to bring the (positive) direct band gap to zero by approximately 5% compared to a relaxed Ge1-x Sn x alloy having the same gap at Γ. On the other hand, compressive strain has comparatively less impact on the alloy band gap at Γ. Using DFT calculated alloy lattice and elastic constants, the critical thickness for Ge1-x Sn x thin films as a function of x and substrate lattice constant is estimated, and validated against supercell DFT calculations and experiment. The analysis correctly predicts the Sn composition range at which it becomes energetically favourable for Ge1-x Sn x /Ge to become amorphous. The influence of stoichiometry and strain is examined in relation to reducing the magnitude of the inverted ('negative') Γ7-Γ8+ band gap, which is characteristic of semimetallic alloy electronic structure. Based on our findings, strategies for engineering the semimetal-to-semiconductor transition via strain and quantum confinement in Ge1-x Sn x nanostructures are proposed. © 2021 IOP Publishing Ltd