343 research outputs found

    Acute leukaemoid reaction following cardiac surgery

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    Chronic myelomonocytic leukaemia is an atypical myeloproliferative disorder with a natural history of progression to acute myeloid leukaemia, a complex and poorly understood response by the bone marrow to stress. Cardiac surgery activates many inflammatory cascades and may precipitate a systemic inflammatory response syndrome. We present a case of undiagnosed chronic myelomonocytic leukaemia who developed rapidly fatal multi-organ dysfunction following cardiac surgery due to an acute leukaemoid reaction

    Flood Suspended Sediment Transport: Combined Modelling from Dilute to Hyper-concentrated Flow

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    YesDuring flooding, the suspended sediment transport usually experiences a wide-range of dilute to hyper-concentrated suspended sediment transport depending on the local flow and ground con-ditions. This paper assesses the distribution of sediment for a variety of hyper-concentrated and dilute flows. Due to the differences between hyper-concentrated and dilute flows, a linear-power coupled model is proposed to integrate these considerations. A parameterised method combining the sediment size, Rouse number, mean concentration, and flow depth parameters has been used for modelling the sediment profile. The accuracy of the proposed model has been verified against the reported laboratory measurements and comparison with other published analytical methods. The proposed method has been shown to effectively compute the concentration profile for a wide range of suspended sediment conditions from hyper-concentrated to dilute flows. Detailed com-parisons reveal that the proposed model calculates the dilute profile with good correspondence to the measured data and other modelling results from literature. For the hyper-concentrated profile, a clear division of lower (bed-load) to upper layer (suspended-load) transport can be observed in the measured data. Using the proposed model, the transitional point from this lower to upper layer transport can be calculated precisely

    REVIEW OF SUSPENDED SEDIMENT TRANSPORT MATHEMATICAL MODELLING STUDIES

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    This paper reviews existing studies relating to the assessment of sediment concentration profiles within various flow conditions due to their importance in representing pollutant propagation. The effects of sediment particle size, flow depth, and velocity were considered, as well as the eddy viscosity and Rouse number influence on the drag of the particle. It is also widely considered that there is a minimum threshold velocity required to increase sediment concentration within a flow above the washload. The bursting effect has also been investigated within this review, in which it presents the mechanism for sediment to be entrained within the flow at low average velocities. A review of the existing state-of-the-art literature has shown there are many variables to consider, i.e., particle density, flow velocity, and turbulence, when assessing the suspended sediment characteristics within flow; this outcome further evidences the complexity of suspended sediment transport modelling

    Reliability of measuring abductor hallucis muscle parameters using two different diagnostic ultrasound machines

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    <p>Abstract</p> <p>Background</p> <p>Diagnostic ultrasound provides a method of analysing soft tissue structures of the musculoskeletal system effectively and reliably. The aim of this study was to evaluate within and between session reliability of measuring muscle dorso-plantar thickness, medio-lateral length and cross-sectional area, of the abductor hallucis muscle using two different ultrasound machines, a higher end Philips HD11 Ultrasound machine and clinically orientated Chison 8300 Deluxe Digital Portable Ultrasound System.</p> <p>Methods</p> <p>The abductor hallucis muscle of both the left and right feet of thirty asymptomatic participants was imaged and then measured using both ultrasound machines. Interclass correlation coefficients (ICC) with 95% confidence intervals (CI) were used to calculate both within and between session intra-tester reliability. Standard error of the measurement (SEM) calculations were undertaken to assess difference between the actual measured score across trials and the smallest real difference (SRD) was calculated from the SEM to indicate the degree of change that would exceed the expected trial to trial variability.</p> <p>Results</p> <p>The ICCs, SEM and SRD for dorso-plantar thickness and medial-lateral length were shown to have excellent to high within and between-session reliability for both ultrasound machines. The between-session reliability indices for cross-sectional area were acceptable for both ultrasound machines.</p> <p>Conclusion</p> <p>The results of the current study suggest that regardless of the type ultrasound machine, intra-tester reliability for the measurement the abductor hallucis muscle parameters is very high.</p

    Association of Race and Ethnicity With COVID‐19 Outcomes in Rheumatic Disease: Data From the COVID‐19 Global Rheumatology Alliance Physician Registry

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    OBJECTIVE: Racial/ethnic minorities experience more severe outcomes of COVID-19 in the general United States (US) population. The aim of this study was to examine the association between race/ethnicity and COVID-19 hospitalization, ventilation status, and mortality in people with rheumatic disease. METHODS: US patients with rheumatic disease and COVID-19 entered into the COVID-19 Global Rheumatology Alliance physician registry March 24 - August 26, 2020 were included. Race/ethnicity was defined as white, Black, Latinx, Asian and other/mixed race. Outcomes included hospitalization, requirement for ventilatory support, and death. Multivariable regression models were used to estimate odds ratios (OR) and 95% confidence intervals controlling for age, sex, smoking, rheumatic disease diagnosis, comorbidities, medications taken prior to infection, and rheumatic disease activity. RESULTS: A total of 1,324 patients were included, of whom 36% were hospitalized and 6% died; 26% of hospitalized patients required mechanical ventilation. In multivariable models, Black (OR=2.74, 95% CI 1.90, 3.95), Latinx (OR=1.71, 95% CI 1.18, 2.49), and Asian (OR=2.69, 95% CI 1.16, 6.24) patients had higher odds of being hospitalized compared to white patients. Latinx patients also had three-fold increased odds of requiring ventilatory support (OR=3.25, 95% CI 1.75, 6.05). No differences in mortality based on race/ethnicity were found, though power may have been limited to detect associations. CONCLUSION: Similar to findings in the general US population, racial/ethnic minorities with rheumatic disease and COVID-19 had increased odds of hospitalization and ventilatory support. These results illustrate significant health disparities related to COVID-19 in people with rheumatic diseases. The rheumatology community should proactively address the needs of patients currently experiencing inequitable health outcomes during the pandemic

    Movement of environmental threats modifies the relevance of the defensive eye-blink in a spatially-tuned manner.

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    Subcortical reflexive motor responses are under continuous cortical control to produce the most effective behaviour. For example, the excitability of brainstem circuitry subserving the defensive hand-blink reflex (HBR), a response elicited by intense somatosensory stimuli to the wrist, depends on a number of properties of the eliciting stimulus. These include face-hand proximity, which has allowed the description of an HBR response field around the face (commonly referred to as a defensive peripersonal space, DPPS), as well as stimulus movement and probability of stimulus occurrence. However, the effect of stimulus-independent movements of objects in the environment has not been explored. Here we used virtual reality to test whether and how the HBR-derived DPPS is affected by the presence and movement of threatening objects in the environment. In two experiments conducted on 40 healthy volunteers, we observed that threatening arrows flying towards the participant result in DPPS expansion, an effect directionally-tuned towards the source of the arrows. These results indicate that the excitability of brainstem circuitry subserving the HBR is continuously adjusted, taking into account the movement of environmental objects. Such adjustments fit in a framework where the relevance of defensive actions is continually evaluated, to maximise their survival value
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