Bronchoscopy, Imaging, and Concurrent Diseases in Dogs with Bronchiectasis: (2003-2014).

BackgroundBronchiectasis is a permanent and debilitating sequel to chronic or severe airway injury, however, diseases associated with this condition are poorly defined.ObjectiveTo evaluate results of diagnostic tests used to document bronchiectasis and to characterize underlying or concurrent disease processes.AnimalsEighty-six dogs that had bronchoscopy performed and a diagnosis of bronchiectasis.MethodsRetrospective case series. Radiographs, computed tomography, and bronchoscopic findings were evaluated for features of bronchiectasis. Clinical diagnoses of pneumonia (aspiration, interstitial, foreign body, other), eosinophilic bronchopneumopathy (EBP), and inflammatory airway disease (IAD) were made based on results of history, physical examination, and diagnostic testing, including bronchoalveolar lavage fluid analysis and microbiology.ResultsBronchiectasis was diagnosed in 14% of dogs (86/621) that had bronchoscopy performed. Dogs ranged in age from 0.5 to 14 years with duration of signs from 3 days to 10 years. Bronchiectasis was documented during bronchoscopy in 79/86 dogs (92%), thoracic radiology in 50/83 dogs (60%), and CT in 34/34 dogs (100%). Concurrent airway collapse was detected during bronchoscopy in 50/86 dogs (58%), and focal or multifocal mucus plugging of segmental or subsegmental bronchi was found in 41/86 dogs (48%). Final diagnoses included pneumonia (45/86 dogs, 52%), EBP (10/86 dogs, 12%) and IAD (31/86 dogs, 36%). Bacteria were isolated in 24/86 cases (28%), with Streptococcus spp, Pasteurella spp, enteric organisms, and Stenotrophomonas isolated most frequently.Conclusions and clinical importanceBronchiectasis can be anticipated in dogs with infectious or inflammatory respiratory disease. Advanced imaging and bronchoscopy are useful in making the diagnosis and identifying concurrent respiratory disease

Roscoe Reid Graham (1890 to 1948): a Canadian pioneer in general surgery.

Roscoe Reid Graham, a Canadian surgeon trained at the University of Toronto, was a true pioneer in the field of general surgery. Although he may be best known for his omental patch repair of perforated duodenal ulcers-often referred to as the Graham patch -he had a number of other significant accomplishments that decorated his surgical career. Dr. Graham is credited with being the first surgeon to successfully enucleate an insulinoma. He ventured to do an essentially brand new operation based solely on his patient\u27s symptoms and physical findings, a courageous move that even some of the most talented surgeons would shy away from. He also spent a large portion of his career dedicated to the study of rectal prolapse, working tirelessly to rid his patients of this awful affliction. He was recognized by a number of different surgical associations for his operative successes and was awarded membership to those both in Canada and the United States. Despite all of these accolades, Dr. Graham remained grounded and always fervent in his dedication to the patient and their presenting symptom(s), reminding us that to do anything more would be meddlesome. In an age when medical professionals are often all too eager to make unnecessary interventions, it is imperative that we look back at our predecessors such as Roscoe Reid Graham, for they will continually redirect us toward our one and only obligation: the patient

Assessment of the Effects of Scanning Variations and Eddy Current Probe Type on Crack Detection

Eddy current procedures are currently the most capable, of the nondestructive evaluation (NDE) techniques that are being applied in industry. The performance capability of an NDE procedure is that of the probability of detection as a function of flaw size. Prediction of the performance capability of a given procedure has been inexact, due to the lack of supporting theory, and has therefore been either validated experimentally or has been assumed to be applicable to a test problem by its similarity to a “time proven” application. Rigorous experimental validation of an NDE procedure is laborious and must be repeated for each new application and/or change in NDE parameters. Attention has been focused on this problem and much of the work described in this volume is directed toward the determination of critical characteristics of NDE applications and in the generation of supporting theory to facilitate predictive modeling of NDE performance capability. The experimental work described in this paper expands on previous work on the characterization of eddy current probes, as applied to flaw detection [1,2], and is directed to support the expansion of application theory [3]

Mary H. Gibbon: teamwork of the heart.

Mary Maly Hopkinson Gibbon was born on September 25, 1903, to an affluent New England family who encouraged her to embrace her intelligence and to follow that by which she was intrigued. In doing this, Maly pursued work in scientific research, where she ultimately met her first husband, Dr. John ‘‘Jack’’ H. Gibbon. Jack and Maly were partners in every sense of the word. Their collaboration, both within and beyond the walls of the research laboratory, made it possible for the Gibbon dream of the heart–lung machine to be realized

Breath Figure Patterns in the Oxidation of Boron Nitride

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66276/1/j.1551-2916.2008.02480.x.pd

GHZ-type and W-type entangled coherent states: generation and Bell-type inequality tests without photon counting

We study GHZ-type and W-type three-mode entangled coherent states. Both the types of entangled coherent states violate Mermin's version of the Bell inequality with threshold photon detection (i.e., without photon counting). Such an experiment can be performed using linear optics elements and threshold detectors with significant Bell violations for GHZ-type entangled coherent states. However, to demonstrate Bell-type inequality violations for W-type entangled coherent states, additional nonlinear interactions are needed. We also propose an optical scheme to generate W-type entangled coherent states in free-traveling optical fields. The required resources for the generation are a single-photon source, a coherent state source, beam splitters, phase shifters, photodetectors, and Kerr nonlinearities. Our scheme does not necessarily require strong Kerr nonlinear interactions, i.e., weak nonlinearities can be used for the generation of the W-type entangled coherent states. Furthermore, it is also robust against inefficiencies of the single-photon source and the photon detectors.Comment: 8 pages, 5 figures, to be published in Phys. Rev.

To Fib or Not to Fib: Misdiagnosis of Atrial Fibrillation on Telemetry Case Presentation and Root Cause Analysis

Case presentation, current practices of telemetry management, root cause analysis, goals for improvement, proposed intervention and next steps

Determining the date of diagnosis – is it a simple matter? The impact of different approaches to dating diagnosis on estimates of delayed care for ovarian cancer in UK primary care

Background Studies of cancer incidence and early management will increasingly draw on routine electronic patient records. However, data may be incomplete or inaccurate. We developed a generalisable strategy for investigating presenting symptoms and delays in diagnosis using ovarian cancer as an example. Methods The General Practice Research Database was used to investigate the time between first report of symptom and diagnosis of 344 women diagnosed with ovarian cancer between 01/06/2002 and 31/05/2008. Effects of possible inaccuracies in dating of diagnosis on the frequencies and timing of the most commonly reported symptoms were investigated using four increasingly inclusive definitions of first diagnosis/suspicion: 1. "Definite diagnosis" 2. "Ambiguous diagnosis" 3. "First treatment or complication suggesting pre-existing diagnosis", 4 "First relevant test or referral". Results The most commonly coded symptoms before a definite diagnosis of ovarian cancer, were abdominal pain (41%), urogenital problems(25%), abdominal distension (24%), constipation/change in bowel habits (23%) with 70% of cases reporting at least one of these. The median time between first reporting each of these symptoms and diagnosis was 13, 21, 9.5 and 8.5 weeks respectively. 19% had a code for definitions 2 or 3 prior to definite diagnosis and 73% a code for 4. However, the proportion with symptoms and the delays were similar for all four definitions except 4, where the median delay was 8, 8, 3, 10 and 0 weeks respectively. Conclusion Symptoms recorded in the General Practice Research Database are similar to those reported in the literature, although their frequency is lower than in studies based on self-report. Generalisable strategies for exploring the impact of recording practice on date of diagnosis in electronic patient records are recommended, and studies which date diagnoses in GP records need to present sensitivity analyses based on investigation, referral and diagnosis data. Free text information may be essential in obtaining accurate estimates of incidence, and for accurate dating of diagnoses

White blood cell count and risk of incident lung cancer in the UK Biobank

Background The contribution of measurable immunological/inflammatory parameters to lung cancer development remains unclear, particularly among never-smokers. We investigated the relationship between total and differential white blood cell (WBC) counts and incident lung cancer risk overall and among subgroups defined by smoking status and sex in the United Kingdom (UK). Methods We evaluated 424,407 adults aged 37-73 years from the UK Biobank. Questionnaires, physical measurements, and blood were administered/collected at baseline in 2006-2010. Complete blood cell counts were measured using standard methods. Lung cancer diagnoses and histological classifications were obtained from cancer registries. Multivariable Cox regression models were used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) of incident lung cancer in relation to quartiles (Q) of total WBC and subtype-specific counts, with Q1 as the reference. Results There were 1,493 incident cases diagnosed over an average 7-year follow-up. Overall, the highest quartile of total WBC count was significantly associated with elevated lung cancer risk (HRQ4=1.67, 95% CI:1.41-1.98). Among women, increased risks were found in current-smokers (ncases/n=244/19,464, HRQ4=2.15, 95% CI:1.46-3.16), former-smokers (ncases/n=280/69,198, HRQ4=1.75, 95% CI:1.24-2.47), and never-smokers without environmental tobacco smoke exposure (ncases/n=108/111,294, HRQ4=1.93, 95% CI:1.11-3.35). Among men, stronger associations were identified in current-smokers (ncases/n=329/22,934, HRQ4=2.95, 95% CI:2.04-4.26) and former-smokers (ncases/n= 358/71,616, HRQ4=2.38, 95% CI:1.74-3.27) but not in never-smokers. Findings were similar for lung adenocarcinoma and squamous cell carcinoma and were driven primarily by elevated neutrophil fractions. Conclusions Elevated WBCs could potentially be one of many important markers for increased lung cancer risk, especially among never-smoking women and ever-smoking men

Experimental survey of FPGA-based monolithic switches and a novel queue balancer

This paper studies small to medium-sized monolithic switches for FPGA implementation and presents a novel switch design that achieves high algorithmic performance and FPGA implementation efficiency. Crossbar switches based on virtual output queues (VOQs) and variations have been rather popular for implementing switches on FPGAs, with applications in network switches, memory interconnects, network-on-chip (NoC) routers etc. The implementation efficiency of crossbar-based switches is well-documented on ASICs, though we show that their disadvantages can outweigh their advantages on FPGAs. One of the most important challenges in such input-queued switches is the requirement for iterative scheduling algorithms. In contrast to ASICs, this is more harmful on FPGAs, as the reduced operating frequency and narrower packets cannot “hide” multiple iterations of scheduling that are required to achieve a modest scheduling performance.Our proposed design uses an output-queued switch internally for simplifying scheduling, and a queue balancing technique to avoid queue fragmentation and reduce the need for memory-sharing VOQs. Its implementation approaches the scheduling performance of a state-of-the-art FPGA-based switch, while requiring considerably fewer resources