2,135 research outputs found

    The impact of insite, North America's first supervised injection facitity, and possible implementation in Massachusetts

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    The impact of the opioid crisis has been worsening in recent years. Opioid-related overdose deaths in the United States have reached 9.0 per 100,000 people and in Massachusetts the number is even worse at 17.3 per 100,000. People who inject drugs (PWID) are at high risk of overdose death, of superficial and deep tissue bacterial infections, and of chronic viral infections such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV), which can be transmitted through shared injection equipment. Although abstinence from substances is the best way to avoid these outcomes, the complicated nature of substance use disorder (SUD) means that not everyone will be able to stop substance use at any given time. The concept of harm reduction is based on engaging PWID who are not ready or able to stop substance use, to reduce the frequency of adverse outcomes. One intervention supported by harm reductionists is medically supervised infection facilities (SIFs), which are locations where PWID may inject substances under medical supervision. People are provided with clean equipment and are monitored post-injection so that medical intervention can be provided in case of an overdose. Furthermore, people are able to access a variety of health services, including wound care, condom access, and referrals to SUD treatment. In 2003, Insite in Vancouver, Canada became North America’s first legally sanctioned SIF. Research conducted since its opening has shown many positive benefits. Insite has been credited with the prevention of overdose deaths and the encouragement of safer injection practices both inside and outside of the facility. In addition, the facility has been shown to be an effective bridge to addiction treatment, particularly among higher risk PWID. The presence of Insite has also been associated with a reduction in public injections. Furthermore, Insite does not appear to increase the number of people who are actively injecting, nor does it serve as a location for people who are injecting drugs for the first time. Because of these benefits, there has been growing interest in establishing an SIF within the United States. Advocacy groups, including the Massachusetts Medical Society, have begun to press for one within Massachusetts. Moreover, the PWID community in Boston has expressed interest in taking advantage of the harm reduction benefits that an SIF can offer. Efforts to establish an SIF, however, face several barriers including state and federal drug laws and political opposition to such a facility. The stigma associated with SUD and the very idea of an SIF is an issue that must be addressed in order to bring this life saving tool to Massachusetts

    3D Bioprinted Implants for Cartilage Repair in Intervertebral Discs and Knee Menisci

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    Cartilage defects pose a significant clinical challenge as they can lead to joint pain, swelling and stiffness, which reduces mobility and function thereby significantly affecting the quality of life of patients. More than 250,000 cartilage repair surgeries are performed in the United States every year. The current gold standard is the treatment of focal cartilage defects and bone damage with nonflexible metal or plastic prosthetics. However, these prosthetics are often made from hard and stiff materials that limits mobility and flexibility, and results in leaching of metal particles into the body, degeneration of adjacent soft bone tissues and possible failure of the implant with time. As a result, the patients may require revision surgeries to replace the worn implants or adjacent vertebrae. More recently, autograft – and allograft-based repair strategies have been studied, however these too are limited by donor site morbidity and the limited availability of tissues for surgery. There has been increasing interest in the past two decades in the area of cartilage tissue engineering where methods like 3D bioprinting may be implemented to generate functional constructs using a combination of cells, growth factors (GF) and biocompatible materials. 3D bioprinting allows for the modulation of mechanical properties of the developed constructs to maintain the required flexibility following implantation while also providing the stiffness needed to support body weight. In this review, we will provide a comprehensive overview of current advances in 3D bioprinting for cartilage tissue engineering for knee menisci and intervertebral disc repair. We will also discuss promising medical-grade materials and techniques that can be used for printing, and the future outlook of this emerging field

    A rare case of suture material obstructing the closure mechanism of a prosthetic aortic valve: a case report

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    Prosthetic aortic valve dysfunction presenting as aortic regurgitation is a complication of mechanical valve replacement. We describe a case of late valve dysfunction caused by an annular suture of excessive length obstructing the closure mechanism of a bileaflet prosthetic valve

    Impaired Host Response and the Presence of Acinetobacter baumannii in the Serum Microbiome of Type-II Diabetic Patients

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    Type II diabetes (T2D) affects over 10% of the US population and is a growing disease worldwide that manifests with numerous comorbidities and defects in inflammation. This dysbiotic host response allows for infection of the host by numerous microorganisms. In the course of T2D disease, individuals can develop chronic infections including foot ulcers and periodontitis, which lead to further complications and opportunistic infections in multiple body sites. In this study, we investigated the serum of healthy subjects and patients with T2D with (T2DP) or without periodontitis for both microbiome signatures in addition to cytokine profiles. Surprisingly, we detected the presence of Acinetobacter baumanii in the serum of 23% individuals with T2D/T2DP tested. In T2DP, IL-1β, TNF-α, MCP-1, IL-6, IL-8, and IFN-γ were significantly elevated in ABC-positive subjects. As an emerging pathogen, A. baumanii infection represents a risk for impaired inflammation and the development of comorbidities in subjects with T2D

    How to manage the left subclavian artery during endovascular stenting of the thoracic aorta

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    We performed a systematic review of the literature to establish whether revascularisation of the left subclavian territory is necessary when this artery is covered by a stent. We retrieved data from 99 studies incorporating 4906 patients. Incidences of left-arm ischaemia (0.0% vs 9.2%, p=0.002) and stroke (4.7% vs 7.2%, p≪0.001) were significantly less following revascularisation, although mortality (10.5% vs 3.4%, p=0.032) and endoleak incidence (25.8% vs 12.6%, p=0.008) were increased. No significant differences in spinal-cord ischaemia were seen. Revascularisation may reduce downstream ischaemic complications but can cause significant risk. Indications must be carefully considered on an individual patient basi

    Photocatalytic Activity Of Core/shell Semiconductor Nanocrystals Featuring Spatial Separation Of Charges

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    The present study investigates the photocatalytic activity of ZnSe/CdS core/shell semiconductor nanocrystals. These nanoparticles exhibit a spatial separation of photoinduced charges between the core and the shell domains, which makes them potentially viable for photocatalytic applications. Unfortunately, one of the excited charges remains inside the core semiconductor and thus cannot efficiently react with the external environment. Here, we explore this issue by investigating the mechanisms of hole extraction from the ZnSe core to the surface of the CdS shell. In particular, the effect of shell thickness in ZnSe/CdS core/shell nanocrystals on the ability of core-localized charges to perform oxidative reactions was determined. By using a combination of time-resolved spectroscopy and electrochemical techniques, we demonstrate that the use of hole-scavenging surfactants facilitates an efficient transfer of core-localized holes to the surface even in the case of shells exceeding 7 nm in thickness. These measurements further demonstrate that photoinduced holes can be extracted from the core faster than they recombine with shell-localized electrons, indicating that most of the absorbed energy in ZnSe/CdS nanocrystals can be used to drive catalytic reactions

    CASPER: Context-Aware IoT Anomaly Detection System for Industrial Robotic Arms

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    Industrial cyber-physical systems (ICPS) are widely employed in supervising and controlling critical infrastructures (CIs), with manufacturing systems that incorporate industrial robotic arms being a prominent example. The increasing adoption of ubiquitous computing technologies in these systems has led to benefits such as real-time monitoring, reduced maintenance costs, and high interconnectivity. This adoption has also brought cybersecurity vulnerabilities exploited by adversaries disrupting manufacturing processes via manipulating actuator behaviors. Previous incidents in the industrial cyber domain prove that adversaries launch sophisticated attacks rendering network-based anomaly detection mechanisms insufficient as the "physics" involved in the process is overlooked. To address this issue, we propose an IoT-based cyber-physical anomaly detection system that can detect motion-based behavioral changes in an industrial robotic arm. We apply both statistical and state-of-the-art machine learning (ML) methods to real-time Inertial Measurement Unit (IMU) data collected from an edge development board attached to an arm doing a pick-and-place operation. To generate anomalies, we modify the joint velocity of the arm. Our goal is to create an air-gapped secondary protection layer to detect "physical" anomalies without depending on the integrity of network data, thus augmenting overall anomaly detection capability. Our empirical results show that the proposed system, which utilizes 1D-CNNs, can successfully detect motion-based anomalies on a real-world industrial robotic arm. The significance of our work lies in its contribution to developing a comprehensive solution for ICPS security, which goes beyond conventional network-based methods

    On the Clustering of Sub-millimeter Galaxies

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    We measure the angular two-point correlation function of sub-millimeter galaxies (SMGs) from 1.1-millimeter imaging of the COSMOS field with the AzTEC camera and ASTE 10-meter telescope. These data yields one of the largest contiguous samples of SMGs to date, covering an area of 0.72 degrees^2 down to a 1.26 mJy/beam (1-sigma) limit, including 189 (328) sources with S/N greater than 3.5 (3). We can only set upper limits to the correlation length r_0, modeling the correlation function as a power-law with pre-assigned slope. Assuming existing redshift distributions, we derive 68.3% confidence level upper limits of r_0 < 6-8 h^-1 Mpc at 3.7 mJy, and r_0 < 11-12 h^-1 Mpc at 4.2 mJy. Although consistent with most previous estimates, these upper limits imply that the real r_0 is likely smaller. This casts doubts on the robustness of claims that SMGs are characterized by significantly stronger spatial clustering, (and thus larger mass), than differently selected galaxies at high-redshift. Using Monte Carlo simulations we show that even strongly clustered distributions of galaxies can appear unclustered when sampled with limited sensitivity and coarse angular resolution common to current sub-millimeter surveys. The simulations, however, also show that unclustered distributions can appear strongly clustered under these circumstances. From the simulations, we predict that at our survey depth, a mapped area of two degrees^2 is needed to reconstruct the correlation function, assuming smaller beam sizes of future surveys (e.g. the Large Millimeter Telescope's 6" beam size). At present, robust measures of the clustering strength of bright SMGs appear to be below the reach of most observations.Comment: 23 pages, 8 figures, accepted for publication in The Astrophysical Journa
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