Survival after cardiopulmonary arrest with extreme hyperkalaemia and hypothermia in a patient with metformin-associated lactic acidosis

Potassium levels are regularly used as a prognostic factor to cease resuscitation in significant hypothermia. In this case report, we highlight how survival is still possible with extreme hyperkalaemia in severe hypothermia. We present a case of a 65-year-old Caucasian man who presented with metformin associated lactic acidosis. On presentation he had potassium of 9.1 mmol/l and a temperature of 31.5 ?C. Cardiopulmonary resuscitation was commenced when he went into asystolic arrest. This presentation would commonly make attempts at resuscitation futile with a 100% death rate. However, with appropriate management this patient's condition improved and survival was possible. We provide evidence that survival is possible in profound hyperkalaemia and hypothermia. Effective cardiopulmonary resuscitation with early haemofiltration can be successful

Localised bullous eruptions and epidermal detachment from the extravasation of hydroxyethyl starch (Voluven).

Extravasation occurs frequently with intravenous infusions. In this case report we describe the occurrence of epidermal detachment and multiple cutaneous bullous eruptions in a patient's forearm following the extravasation of hydroxyethyl starch (Voluven, Fresenius Kabi)-a colloid solution derived from corn starch, which is used to replace lost blood volume. The patient's affected body surface area was managed under the direction of our plastic surgical team. Despite a prolonged admission in hospital from other perioperative complications, he made a full recovery and was successfully discharged home. The probable pathogenesis relevant to extravasation of Voluven is discussed; as well as its management principles

Thermomechanical residual stress evaluation in multi-crystalline silicon solar cells of photovoltaic modules with different encapsulation polymers using synchrotron X-ray microdiffraction

Photovoltaic (PV) module reliability issues, due to silicon cell cracking, are gaining more and more attention due to increasing demand for solar power and reduction of cell thickness to reduce cost. Recent reports show significant effect of encapsulation polymer material on cell cracks leading to the idea of tailoring encapsulation materials for more reliable PV modules. This paper investigates the effect of encapsulation modulus on the cell residual stress using Synchrotron scanning X-ray microdiffraction (µSXRD), which has been proven to be an effective technique to probe the stress in silicon solar cells, especially once they are encapsulated. The post lamination residual stress in the encapsulated multi-crystalline silicon (mc-Si) solar cells was reported for the first time using µSXRD in this manuscript and provide quantitative evaluation of the effect of encapsulation modulus on the cell residual stress. Further, simple approximate finite element (FE) model was also developed to evaluate the effect of the encapsulation polymer on the cell stress. The FE simulations predict the trend of the stress variation with encapsulation polymer modulus very well. Dynamic mechanical analysis and rheological testing of the encapsulation polymers was also performed to correlate the polymer behaviour with the experimental and simulated stresses. Both experimental and simulation results show a similar trend of significant cell stress variation with encapsulation polymer modulus. In the case of external loading, the temperature of load application is observed to be very significant as it dictates the elastic state of the encapsulant, leading to critical conclusion that the encapsulant needs to be selected based on elastic behaviour over the temperature history of the encapsulant during module fabrication and operation. The results and discussion presented are expected to be very useful for development of more reliable PV modules

Isolation, solitude and social distancing for people who use drugs: An ethnographic perspective

COVID-19 has resulted in deepened states of crisis and vulnerability for people who use drugs throughout Europe and across the world, with social distancing measures having far-reaching implications for everyday life. Prolonged periods of isolation and solitude are acknowledged within much addiction literature as negatively impacting the experiences of those in recovery, while also causing harm to active users – many of whom depend on social contact for the purchasing and taking of substances, as well as myriad forms of support. Solitude, however, is proposed by the authors as inherent within some aspects of substance use, far from particular to the current pandemic. Certain forms of substance use engender solitary experience, even where use is predicated upon the presence of others. Adopting a cross-disciplinary perspective, this paper takes as its focus the urgent changes wrought by the pandemic upon everyday life for people who use drugs, drawing on recent ethnographic fieldwork with substance users in Scotland. Beyond the current crises, the paper proposes solitude, and by extension isolation, as an analytical framework for better apprehending lived experiences of substance use

Stress and Fracture of Crystalline Silicon Cells in Solar Photovoltaic Modules – A Synchrotron X-ray Microdiffraction based Investigation

Fracture of crystalline silicon (c-Si) solar cells in photovoltaic modules is a big concern to the photovoltaics (PV) industry. Cell cracks cause performance degradation and warranty issues to the manufacturers. The roots of cell fractures lie in the manufacturing and integration process of the cells and modules as they go through a series of elevated temperature and pressure processes, involving bonding of dissimilar materials, causing residual stresses. Evaluation of the exact physical mechanisms leading to these thermomechanical stresses is highly essential to quantify them and optimize the PV modules to address them. We present a novel synchrotron X-ray microdiffraction based techniques to characterize the stress and fracture in the crystalline silicon PV modules. We show the detailed stress state after soldering and lamination process, using the synchrotron X-ray microdiffraction experiments. We also calculate the maximum tolerable microcrack size in the c-Si cells to sustain the residual stress after lamination. We further demonstrate the effect of these residual stresses on the cell fractures using the widely accepted fracture (4-point bending) tests. These test results show that the soldering and lamination induced localized residual stresses indeed reduce the load-carrying capacity of the c-Si cells

No need to abandon focused parathyroidectomy: a multicenter study of long-term outcome after surgery for primary hyperparathyroidism

No grant i

Cellular response to nanobiomaterials

The application of nanobiomaterials in biomedical field is rapidly processing, especially in the areas where conventional approaches have limited success. Cell fate is mainly influenced by interactions between cells and their microenvironment. The effective use of several nanostructures in implants, prosthetics, tissue engineering scaffolds, and drug delivery systems is relied upon the interaction between cells and nanobiomaterials. Desirable cellular response on nanobiomaterials is crucial to avoid inflammatory response and to ensure safe excretion from the body or integration into the host tissue. Such responses are controlled by the interaction of nanomaterials with individual cells at cellular and molecular level. These nanoparticle-cell interactions occur between various cellular components such as extracellular matrix, cell membrane, intracellular components, biomolecules, and nucleus mainly dictated by morphological and surface properties of nanobiomaterials. This chapter describes how various properties of nanobiomaterials including shape, size, surface charge, and functional properties influence their interaction with cells and cellular components. Available information regarding the interaction between various types of inorganic and organic nanoparticles and various cellular components is provided.Scopu