Association of Cystic Medial Necrosis of the Aorta and Undiagnosed Thyroiditis [Scripta Medica]

We have recently seen two patients with cystic medial necrosis of the aorta. The first patient died of a dissecting aneurysm of the thoracic aorta. At autopsy, classical Hashimoto’s thyroiditis was discovered. The second patient died of a rupture of the ascending aorta. At autopsy, chronic thyroiditis was seen with multiple large germinal center and diffuse fibrosis. Neither patient was clinically suspected of thyroid dysfunction although the second patient had had a partial thyroidectomy in the remote past

A smart end-effector for assembly of space truss structures

A unique facility, the Automated Structures Research Laboratory, is being used to investigate robotic assembly of truss structures. A special-purpose end-effector is used to assemble structural elements into an eight meter diameter structure. To expand the capabilities of the facility to include construction of structures with curved surfaces from straight structural elements of different lengths, a new end-effector has been designed and fabricated. This end-effector contains an integrated microprocessor to monitor actuator operations through sensor feedback. This paper provides an overview of the automated assembly tasks required by this end-effector and a description of the new end-effector's hardware and control software

Analysis of Hydrologic Data for the White River Basin

The value of the natural resources of the White River Basin (Basin), AR is recognized by the area's designation as a "Wetland of International Importance". The Basin constitutes one of the Nation's largest remaining intact forested wetland landscapes, second only to the Atchafalya Basin. It supports the North American continent's largest concentration of over-wintering mallard ducks, a world-class trout fishery, the last vestige of a big river fishery remaining in the Mississippi River Basin, and numerous threatened and endangered species. The continued viability of this wetland ecosystem depends on the suitability of the hydrologic environment to the resident flora and fauna. Numerous modifications of the Basin hydrologic features in the past century have seriously impaired the sustainability of these resources. The Basinwide alterations of hydrologic processes (e.g., impoundment and regulatory releases of flows and volumes in the upper reaches, navigational modifications of lower reaches, and consumptive demands for agricultural use throughout) have affected the hydrology of the system profoundly. The result is highly regulated flows and stages, vastly altered hydrologic patterns, over-stabilized water levels, and disruption of seasonal water distribution patterns. Given the critical nature of hydrology in regulating the structure and function of wetland ecosystems, the impacts have been devastating, particularly to the critical bottomland hardwoods that support the Basin's fish and wildlife resources. To date these piece-meal, system-wide, hydrologic alterations have cornmutatively degraded the habitat value of this resource for fish and wildlife in the Basin, and have lead to changes in their numbers and distributions. In spite of the enormous stakes involved, there has been no comprehensive characterization of the Basin hydrology. System alterations such as channel deepening, dam construction, water allocation plans, and flood control measures are currently pending. These projects will potentially hrther modify the hydrologic environments of the Basin, and no doubt require mitigation measures. In addition, there is genuine interest in restoring aspects of the Basin's historic hydrologic regime within some set of reasonable limits. In order to proceed with this effort, the anticipated effects of these modifications and restorations on the Basin ecology require thorough study of the area's historic hydrology, so that connectivity among Basin precipitation patterns, flow fluctuations, and land use changes can be made. A basin hydrologic characterization is an initial component of this effort. The focus of this effort was to determine and assemble the data set from which characterization of the hydrologic environments of the Basin using historic and recent water level, flow, (primarily by USGS-WRD) at locations throughout the Basin could proceed. ( Document has 11 pages.

Sulfide unhairing: rethinking the received wisdom

Content: The removal of hair from a hide or skin by dissolving it with a mixture of lime and sulfide is a fundamentally understood feature of leather technology. Or is it? For a long time, it has been accepted within the leather literature that, in water, sulfide may be present as either hydrogen sulfide (H2S), hydrosulfide (HS-) or sulfide (S2-), depending on the pH. pH 12 H2S(aq) ⇌ HS-(aq) ⇌ S2-(aq) The generally accepted mechanism of hair burning is sulfide attack at the cystine disulfide linkages in keratin. Also, it is believed that the unhairing reaction only proceeds at an appreciable rate in the presence of the dianionic S2- species, because that fits with the technological observation that unhairing reactions only proceed at pH greater than 12. However, recent publications have provided substantive proof that the S2- species does not exist in aqueous media at any pH: researchers were unable to observe any evidence of the S2- species in a solution of Na2S dissolved in hyper-concentrated NaOH and CsOH using Raman spectroscopy. The assigned second pKa for removal of the second proton has now been estimated to be 19, making the concentration of S2-(see below) vanishingly small. HS- ⇋ S2- + H+ There is a clear contradiction between the currently accepted mechanism for sulfide unhairing with the evidenced speciation of sulfide species in aqueous environment. Here the implications for this important process are discussed and possible alternative mechanisms postulated that fit with the new knowledge. Take-Away: It is a truism that we must understand the mechanistic principles of a process in order to control it. Here, we have a big change in thinking for ‘sulfide unhairing’, so it is vital that we understand the implications for leather science and leather technology of that change

Development of a Novel Method to Reduce the Impact of Cutaneous chemical attacks

Content: Acid attacks are a global problem: from 2011 to 2016 there were 1,464 incidents involving a corrosive substance in London alone. The most common chemicals used in these attacks are sulfuric, nitric and hydrochloric acids. Concentrated solutions of strongly alkaline substances including sodium hydroxide and sodium hypochlorite are also used. Current first-aid advice suggests diluting the exposed area with water and transfer to a hospital for further treatment. An immediate neutralisation treatment is avoided as incorrect identification of the corrosive could worsen the damage. In addition, there are concerns the enthalpy of solvation and neutralisation causes secondary burns. These limitations demonstrate the need for an amphoteric neutralising treatment with a low enthalpy of neutralisation. Aqueous formulations of natural water-based surfactants with natural plant-based substances have been trialled as neutralisers of sulfuric acid, sodium hydroxide and sodium hypochlorite. pH titrations demonstrated that the natural formulations are amphoteric, capable of effectively neutralising acidic and alkaline corrosives with minimal heat of neutralisation and no gas evolution. In addition, the studies have shown that the formulations can reduce oxidisers such as sodium hypochlorite. The experiments compared intact collagen with attacked but untreated collagen and collagen that had a corrosive applied but followed by treatment at different time intervals. Scanning electron microscopy (SEM) showed the reaction with concentrated sulfuric acid is rapid; significant collapse and gelatinisation of the fibre structure was observed within 5 seconds. Pigskin was utilised to model human skin: the observations demonstrated the importance of the epidermis in protecting the skin from chemical damage. Five minutes exposure to sulfuric acid, sodium hydroxide and sodium hypochlorite did not penetrate the epidermis, although damage was observed. The formulations of natural products recently tested at the University of Northampton have been shown to mitigate secondary chemical burns, whereas treatment with water alone resulted in secondary burns due to residual corrosive in the skin structure not being neutralised. The trials indicate that the product could be usefully applied by first responders and emergency services personnel. Take-Away: The findings have the potential to change current first-aid reccomendations by demonstrating an applicable neutralisation mechanism, whereas neutralisation with sodium bicarbonate has been shown to cause further damage to skin structure via gas evolution. Formulations of natural products have been shown to mitigate secondary chemical burns, whereas treatment with water resulted in secondary burns due to residual corrosive in the skin structure not being neutralised. Trials indicate these natural formulations could be usefully applied by first responders and emergency services personnel

Validation of the Saint George's Respiratory Questionnaire in Uganda.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) will soon be the third leading global cause of death and is increasing rapidly in low/middle-income countries. There is a need for local validation of the Saint George's Respiratory Questionnaire (SGRQ), which can be used to identify those experiencing lifestyle impairment due to their breathing. METHODS: The SGRQ was professionally translated into Luganda and reviewed by our field staff and a local pulmonologist. Participants included a COPD-confirmed clinic sample and COPD-positive and negative members of the community who were enrolled in the Lung Function in Nakaseke and Kampala (LiNK) Study. SGRQs were assembled from all participants, while demographic and spirometry data were additionally collected from LiNK participants. RESULTS: In total, 103 questionnaires were included in analysis: 49 with COPD from clinic, 34 community COPD-negative and 20 community COPD-positive. SGRQ score varied by group: 53.5 for clinic, 34.4 for community COPD-positive and 4.1 for community COPD-negative (p<0.001). The cross-validated c statistic for SGRQ total score predicting COPD was 0.87 (95% CI 0.75 to 1.00). SGRQ total score was associated with COPD severity (forced expiratory volume in 1 s per cent of predicted), with an r coefficient of -0.60 (-0.75, -0.39). SGRQ score was associated with dyspnoea (OR 1.05/point; 1.01, 1.09) and cough (1.07; 1.03, 1.11). CONCLUSION: Our Luganda language SGRQ accurately distinguishes between COPD-positive and negative community members in rural Uganda. Scores were correlated with COPD severity and were associated with odds of dyspnoea and cough. We find that it can be successfully used as a respiratory questionnaire for obstructed adults in Uganda

Fiber Four-Wave Mixing Source for Coherent Anti-Stokes Raman Scattering Microscopy

We present a fiber-format picosecond light source for coherent anti-Stokes Raman scattering microscopy. Pulses from an Yb-doped fiber amplifier are frequency-converted by four-wave mixing in normal dispersion photonic crystal fiber to produce a synchronized two-color picosecond pulse train. We show that seeding the four-wave mixing process overcomes the deleterious effects of group-velocity mismatch and allows efficient conversion into narrow frequency bands. The source generates more than 160 mW of nearly-transform-limited pulses tunable from 775 to 815 nm. High-quality coherent Raman images of animal tissues and cells acquired with this source are presented.Chemistry and Chemical Biolog

Efficacy and safety of ipratropium bromide/albuterol compared with albuterol in patients with moderate-to-severe asthma: a randomized controlled trial

Abstract Background Many patients with asthma require frequent rescue medication for acute symptoms despite appropriate controller therapies. Thus, determining the most effective relief regimen is important in the management of more severe asthma. This study’s objective was to evaluate whether ipratropium bromide/albuterol metered-dose inhaler (CVT-MDI) provides more effective acute relief of bronchospasm in moderate-to-severe asthma than albuterol hydrofluoroalkaline (ALB-HFA) alone after 4 weeks. Methods In this double-blind, crossover study, patients who had been diagnosed with asthma for ≥1 year were randomized to two sequences of study medication “as needed” for symptom relief (1–7 day washout before second 4-week treatment period): CVT-MDI/ALB-HFA or ALB-HFA/CVT-MDI. On days 1 and 29 of each sequence, 6-hour serial spirometry was performed after administration of the study drug. Co-primary endpoints were FEV 1 area under the curve (AUC 0–6 ) and peak (post-dose) forced expiratory volume in 1 s (FEV 1 ) response (change from test day baseline) after 4 weeks. The effects of “as needed” treatment with ALB-HFA/CVT-MDI were analyzed using mixed effect model repeated measures (MMRM). Results A total of 226 patients, ≥18 years old, with inadequately controlled, moderate-to-severe asthma were randomized. The study met both co-primary endpoints demonstrating a statistically significant treatment benefit of CVT-MDI versus ALB-HFA. FEV 1 AUC 0-6h response was 167 ml for ALB-HFA, 252 ml for CVT-MDI (p <0.0001); peak FEV 1 response was 357 ml for ALB-HFA, 434 ml for CVT-MDI (p <0.0001). Adverse events were comparable across groups. Conclusions CVT-MDI significantly improved acute bronchodilation over ALB-HFA alone after 4 weeks of “as-needed” use for symptom relief, with a similar safety profile. This suggests additive bronchodilator effects of β 2 -agonist and anticholinergic treatment in moderate-to-severe, symptomatic asthma. Trial registration ClinicalTrials.gov No.: NCT00818454; Registered November 16, 2009

Investigation of novel deep eutectic systems for the reduction of water usage in leather manufacture

Water in the wet processes of leather manufacture acts as a solvent, transportation medium, support system and is an integral component of the collagen matrix stability at the macro and molecular levels. There have been proposals as to what extent water can be substituted with non-aqueous media, partly due to its role in collagen and processing. As the water content increases from bulk to float water, the system acts as a transport medium for chemical as well as a support system in processing vessels. Here, Deep Eutectic Solvents (DES) are investigated as an alternative solvent system to conventional tanning systems. The novel solvent is non-aqueous, has a high solubility for metal salts, low toxicity, is readily biodegradable and operates at variable temperatures without the release of harmful vapours. These properties make the DES system a potential alternative in leather processing, improving reagent uptake with the potential of lowering effluent discharge. The research focuses on the role of the solvent associated with stabilising collagen, such as the influence of inter- and intra-fibrillar, as well as bulk water, using type 2 DES systems. Thermal, mechanical analysis and electron microscopy were undertaken to determine the effects of the solvent system. The studies indicated that the solvent used, as well as the choice of counter ion, have an important effect on the thermal and mechanical stability of collagen

Urogenital Abnormalities in Men Exposed to Diethylstilbestrol in Utero: A Cohort Study

Background: Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women during the 1940s70s, has been shown to cause reproductive problems in the daughters. Studies of prenatally-exposed males have yielded conflicting results. Methods: In data from a collaborative follow-up of three U.S. cohorts of DES-exposed sons, we examined the relation of prenatal DES exposure to occurrence of male urogenital abnormalities. Exposure status was determined through review of prenatal records. Mailed questionnaires (1994, 1997, 2001) asked about specified abnormalities of the urogenital tract. Risk ratios (RR) were estimated by Cox regression with constant time at risk and control for year of birth. Results: Prenatal DES exposure was not associated with varicocele, structural abnormalities of the penis, urethral stenosis, benign prostatic hypertrophy, or inflammation/infection of the prostate, urethra, or epididymus. However, RRs were 1.9 (95% confidence interval 1.13.4) for cryptorchidism, 2.5 (1.54.3) for epididymal cyst, and 2.4 (1.54.4) for testicular inflammation/ infection. Stronger associations were observed for DES exposure that began before the 11th week of pregnancy: RRs were 2.9 (1.65.2) for cryptorchidism, 3.5 (2.06.0) for epididymal cyst, and 3.0 (1.75.4) for inflammation/infection of testes. Conclusion: These results indicate that prenatal exposure to DES increases risk of male urogenital abnormalities and that the association is strongest for exposure that occurs early in gestation. The findings support the hypothesis that endocrine disrupting chemicals may be a cause of the increased prevalence of cryptorchidism that has been seen in recent years