76 research outputs found
Monolith formation and ring-stain suppression in low-pressure evaporation of poly(ethylene oxide) droplets
When droplets of dilute suspensions are left to evaporate the final dry residue is typically the familiar coffee-ring stain, with nearly all material deposited at the initial triple line (Deegan et al, Nature, vol. 389, 1997, pp. 827-829). However, aqueous poly(ethylene oxide) (PEO) droplets only form coffee-ring stains for a very narrow range of the experimental parameters molecular weight, concentration and drying rate. Instead, over a wide range of values they form either a flat disk or a very distinctive tall central monolith via a four-stage deposition process which includes a remarkable bootstrap-building step. To predict which deposit will form, we present a quantitative model comparing the effects of advective build-up at the triple line to diffusive flux and use this to calculate a dimensionless number χ. By experimentally varying concentration and flux (using a low-pressure drying chamber), the prediction is tested over nearly two orders of magnitude in both variables and shown to be in good agreement with the boundary between disks and monoliths at χ ≈ 1.6
The dose of hemodialysis and patient mortality
The dose of hemodialysis and patient mortality. The relationship between the delivered dose of hemodialysis and patient mortality remains somewhat controversial. Several observational studies have shown improved patient survival with higher levels of delivered dialysis dose. However, several other unmeasured variables, changes in patient mix or medical management may have impacted on this reported difference in mortality. The current study of a U.S. national sample of 2,311 patients from 347 dialysis units estimates the relationship of delivered hemodialysis dose to mortality, with a statistical adjustment for an extensive list of comorbidity/risk factors. Additionally this study investigated the existence of a dose beyond which more dialysis does not appear to lower mortality. We estimated patient survival using proportional hazards regression techniques, adjusting for 21 patient comorbidity/risk factors with stratification for nine Census regions. The patient sample was 2,311 Medicare hemodialysis patients treated with bicarbonate dialysate as of 12/31/90 who had end-stage renal disease for at least one year. Patient follow-up ranged between 1.5 and 2.4 years. The measurement of delivered therapy was based on two alternative measures of intradialytic urea reduction, the urea reduction ratio (URR) and Kt/V (with adjustment for urea generation and ultrafiltration). Hemodialysis patient mortality showed a strong and robust inverse correlation with delivered hemodialysis dose whether measured by Kt/V or by URR. Mortality risk was lower by 7% (P = 0.001) with each 0.1 higher level of delivered Kt/V. (Expressed in terms of URR, mortality was lower by 11% with each 5 percentage point higher URR; P = 0.001). Above a URR of 70% or a Kt/V of 1.3 these data did not provide statistical evidence of further reductions in mortality. In conclusion, the delivered dose of hemodialysis therapy is an important predictor of patient mortality. In a population of dialysis patients with a very high mortality rate, it appears that increasing the level of delivered therapy offers a practical and efficient means of lowering the mortality rate. The level of hemodialysis dose measured by URR or Kt/V beyond which the mortality rate does not continue to decrease, though not well defined with this study, appears to be above current levels of typical treatment of hemodialysis patients in the U.S
A preliminary study of the effect of closed incision management with negative pressure wound therapy over high-risk incisions
Background
Certain postoperative wounds are recognised to be associated with more complications than others and may be termed high-risk. Wound healing can be particularly challenging following high-energy trauma where wound necrosis and infection rates are high. Surgical incision for joint arthrodesis can also be considered high-risk as it requires extensive and invasive surgery and postoperative distal limb swelling and wound dehiscence are common. Recent human literature has investigated the use of negative pressure wound therapy (NPWT) over high-risk closed surgical incisions and beneficial effects have been noted including decreased drainage, decreased dehiscence and decreased infection rates. In a randomised, controlled study twenty cases undergoing distal limb high-energy fracture stabilisation or arthrodesis were randomised to NPWT or control groups. All cases had a modified Robert-Jones dressing applied for 72 h postoperatively and NPWT was applied for 24 h in the NPWT group. Morphometric assessment of limb circumference was performed at six sites preoperatively, 24 and 72 h postoperatively. Wound discharge was assessed at 24 and 72 h. Postoperative analgesia protocol was standardised and a Glasgow Composite Measure Pain Score (GCPS) carried out at 24, 48 and 72 h. Complications were noted and differences between groups were assessed.
Results
Percentage change in limb circumference between preoperative and 24 and 72 h postoperative measurements was significantly less at all sites for the NPWT group with exception of the joint proximal to the surgical site and the centre of the operated bone at 72 h. Median discharge score was lower in the NPWT group than the control group at 24 h. No significant differences in GCPS or complication rates were noted.
Conclusions
Digital swelling and wound discharge were reduced when NPWT was employed for closed incision management. Larger studies are required to evaluate whether this will result in reduced discomfort and complication rates postoperatively
The Contribution of Advective Fluxes to Net Ecosystem Exchange in a High-Elevation, Subalpine Forest
The eddy covariance technique, which is used in the determination of net ecosystem CO2 exchange (NEE), is subject to significant errors when advection that carries CO2 in the mean flow is ignored. We measured horizontal and vertical advective CO2 fluxes at the Niwot Ridge AmeriFlux site (Colorado, USA) using a measurement approach consisting of multiple towers. We observed relatively high rates of both horizontal (Fhadv) and vertical (Fvadv) advective fluxes at low surface friction velocities (u*) which were associated with downslope katabatic flows. We observed that Fhadv was confined to a relatively thin layer (0–6 m thick) of subcanopy air that flowed beneath the eddy covariance sensors principally at night, carrying with it respired CO2 from the soil and lower parts of the canopy. The observed Fvadv came from above the canopy and was presumably due to the convergence of drainage flows at the tower site. The magnitudes of both Fhadv and Fvadv were similar, of opposite sign, and increased with decreasing u*, meaning that they most affected estimates of the total CO2 flux on calm nights with low wind speeds. The mathematical sign, temporal variation and dependence on u* of both Fhadv and Fvadv were determined by the unique terrain of the Niwot Ridge site. Therefore, the patterns we observed may not be broadly applicable to other sites. We evaluated the influence of advection on the cumulative annual and monthly estimates of the total CO2 flux (Fc), which is often used as an estimate of NEE, over six years using the dependence of Fhadv and Fvadv on u*. When the sum of Fhadv and Fvadv was used to correct monthly Fc, we observed values that were different from the monthly Fc calculated using the traditional u*-filter correction by -16 to 20 g C·m-2·mo-1; the mean percentage difference in monthly Fc for these two methods over the six-year period was 10%. When the sum of Fhadv and Fvadv was used to correct annual Fc, we observed a 65% difference compared to the traditional u*-filter approach. Thus, the errors to the local CO2 budget, when Fhadv and Fvadv are ignored, can become large when compounded in cumulative fashion over long time intervals. We conclude that the ‘‘micrometeorological’’ (using observations of Fhadv and Fvadv) and ‘‘biological’’ (using the u* filter and temperature vs. Fc relationship) corrections differ on the basis of fundamental mechanistic grounds. The micrometeorological correction is based on aerodynamic mechanisms and shows no correlation to drivers of biological activity. Conversely, the biological correction is based on climatic responses of organisms and has no physical connection to aerodynamic processes. In those cases where they impose corrections of similar magnitude on the cumulative Fc sum, the result is due to a serendipitous similarity in scale but has no clear mechanistic explanation
Altered Gene Expression in Early Atherosclerosis Is Blocked by Low Level Apolipoprotein E
BACKGROUND: Mice deficient in apolipoprotein E (apoE(-/-)) develop atherosclerosis. The possible linkage between expression of adhesion molecules/cofactors and atherosclerosis was probed at the level of mRNA and protein expression. The hypothesis of a linkage between changes of adhesion molecules/cofactors and atherosclerosis was tested further by suppression of aortic lesion formation in apoE(-/-) mice by expression of very low levels of transgenic apolipoprotein E. METHODOLOGY/PRINCIPAL FINDINGS: We show that at 8.5 months of age, the apoE(-/-) mice display elevated expression of mRNA for LFA-1, MAC-1, VCAM-1, ICAM-1, and for CD44, as well as MCP-1, cathepsin B, and COX-2 (but not that for eNOS) in atherosclerotic aortic arches. At earlier age, (10-13 week old) apoE(-/-) mice already display elevated expression of mRNA of CD44, LFA-1, MAC-1, VCAM-1, ICAM-1, cathepsin, and of COX-2 in lesioned aortic arches. Expressing very low levels of transgenic apolipoprotein E suppresses both aortic lesions and the expression of mRNA of LFA-1, VCAM-1, MCP-1, cathepsin B, and of ICAM-1 in ApoE(-/-) mice. We tested at the level of protein, the observations obtained for mRNA expression. CD11a (a component of LFA-1), VCAM-1 and cathepsin B expression was found to be elevated in apoE(-/-) aortas at 8-9 months; low level expression of transgenic apolipoprotein E rectifies these changes. CONCLUSIONS/SIGNIFICANCE: Atherosclerotic lesions in apoE(-/-) mice are detected as early as 4 weeks of age. Expression of low levels of apoE is shown to be both atheroprotective and to suppress these changes in key adhesion and inflammatory molecules observed in early atherosclerotic lesions
Treatments for people who use anabolic androgenic steroids: a scoping review.
BACKGROUND: A growing body of evidence suggests that anabolic androgenic steroids (AAS) are used globally by a diverse population with varying motivations. Evidence has increased greatly in recent years to support understanding of this form of substance use and the associated health harms, but there remains little evidence regarding interventions to support cessation and treat the consequences of use. In this scoping review, we identify and describe what is known about interventions that aim to support and achieve cessation of AAS, and treat and prevent associated health problems. METHODS: A comprehensive search strategy was developed in four bibliographic databases, supported by an iterative citation searching process to identify eligible studies. Studies of any psychological or medical treatment interventions delivered in response to non-prescribed use of AAS or an associated harm in any setting were eligible. RESULTS: In total, 109 eligible studies were identified, which included case reports representing a diverse range of disciplines and sources. Studies predominantly focussed on treatments for harms associated with AAS use, with scant evidence on interventions to support cessation of AAS use or responding to dependence. The types of conditions requiring treatment included psychiatric, neuroendocrine, hepatic, kidney, cardiovascular, musculoskeletal and infectious. There was limited evidence of engagement with users or delivery of psychosocial interventions as part of treatment for any condition, and of harm reduction interventions initiated alongside, or following, treatment. Findings were limited throughout by the case report study designs and limited information was provided. CONCLUSION: This scoping review indicates that while a range of case reports describe treatments provided to AAS users, there is scarce evidence on treating dependence, managing withdrawal, or initiating behaviour change in users in any settings. Evidence is urgently required to support the development of effective services for users and of evidence-based guidance and interventions to respond to users in a range of healthcare settings. More consistent reporting in articles of whether engagement or assessment relating to AAS was initiated, and publication within broader health- or drug-related journals, will support development of the evidence base
Planck 2015 results. XVI. Isotropy and statistics of the CMB
We test the statistical isotropy and Gaussianity of the cosmic microwave background (CMB) anisotropies using observations made by the Planck satellite. Our results are based mainly on the full Planck mission for temperature, but also include some polarization measurements. In particular, we consider the CMB anisotropy maps derived from the multi-frequency Planck data by several component-separation methods. For the temperature anisotropies, we find excellent agreement between results based on these sky maps over both a very large fraction of the sky and a broad range of angular scales, establishing that potential foreground residuals do not affect our studies. Tests of skewness, kurtosis, multi-normality, N-point functions, and Minkowski functionals indicate consistency with Gaussianity, while a power deficit at large angular scales is manifested in several ways, for example low map variance. The results of a peak statistics analysis are consistent with the expectations of a Gaussian random field. The “Cold Spot” is detected with several methods, including map kurtosis, peak statistics, and mean temperature profile. We thoroughly probe the large-scale dipolar power asymmetry, detecting it with several independent tests, and address the subject of a posteriori correction. Tests of directionality suggest the presence of angular clustering from large to small scales, but at a significance that is dependent on the details of the approach. We perform the first examination of polarization data, finding the morphology of stacked peaks to be consistent with the expectations of statistically isotropic simulations. Where they overlap, these results are consistent with the Planck 2013 analysis based on the nominal mission data and provide our most thorough view of the statistics of the CMB fluctuations to date
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