Decrease in dysbaric osteonecrosis severity as a result of 45-minute oxygen pre-breathe

2021 ◽  
pp. 279-286
Author(s):  
Jacob Lamers ◽  
◽  
Kent MacLaughlin ◽  
Dave Pegelow ◽  
Marlowe Eldridge ◽  
...  
Keyword(s):  
Bubble Formation ◽  
Minimum Amount ◽  
Future Research ◽  
Long Bones ◽  
Nitrogen Gas ◽  
The Right ◽  
Alizarin Complexone

Sudden decompression can result in bubble formation as the result of nitrogen gas (N2) dissolved in tissue during disabled submarine escape (DISSUB). This may cause dysbaric osteonecrosis (DON), a condition in long bones where bubbles in fatty marrow result in ischemia and necrosis. Previous research has shown that oxygen (O2) pre-breathe of two hours resulted in a reduction of DON; however, effects of shorter O2 pre-breathe remain uncertain. This study’s aim was to understand the effect of shorter lengths of O2 pre-breathe. Eight adult Suffolk ewes (89.5± 11.5 kg) were exposed to 33 feet of seawater (fsw) for 24 hours. They were placed randomly into four groups and exposed to either 45, 30 or 15 minutes of O2 (91-88%) pre-breathe; the controls received none. They were then rapidly decompressed. Alizarin complexone was later injected intravenously to visualize the extent of DON in the right and left long bones (radii, tibiae, femur and humeri). The 30- and 15-minute pre-breathe groups saw the greatest deposition. There was significant decrease of variance in the 45-minute group when compared with all other treatments, suggesting that 45 minutes of O2 pre-breathe is required to effectively increase confidence in the reduction of DON. Similar confidence was not reflected in the 30-minute and 15-minute groups: 45 minutes of pre-breathe was the minimum amount needed to effectively prevent against DON in DISSUB escape at 33 fsw. However, future research is needed to determine how to calculate effective dosages of O2 pre-breathe to prevent DON in any given scenario.

Transferrin-Conjugated Nanocarriers as Active-Targeted Drug Delivery Platforms for Cancer Therapy

2017 ◽  
Vol 23 (3) ◽  
pp. 454-466 ◽  
Author(s):  
Daniele R. Nogueira-Librelotto ◽  
Cristiane F. Codevilla ◽  
Ammad Farooqi ◽  
Clarice M. B. Rolim
Keyword(s):  
Drug Delivery ◽  
Cancer Therapy ◽  
Tumor Cells ◽  
Therapeutic Benefit ◽  
Active Targeting ◽  
Future Research ◽  
Passive Targeting ◽  
The Right ◽  
Review Current ◽  
Target Effects

A lot of effort has been devoted to achieving active targeting for cancer therapy in order to reach the right cells. Hence, increasingly it is being realized that active-targeted nanocarriers notably reduce off-target effects, mainly because of targeted localization in tumors and active cellular uptake. In this context, by taking advantage of the overexpression of transferrin receptors on the surface of tumor cells, transferrin-conjugated nanodevices have been designed, in hope that the biomarker grafting would help to maximize the therapeutic benefit and to minimize the side effects. Notably, active targeting nanoparticles have shown improved therapeutic performances in different tumor models as compared to their passive targeting counterparts. In this review, current development of nano-based devices conjugated with transferrin for active tumor-targeting drug delivery are highlighted and discussed. The main objective of this review is to provide a summary of the vast types of nanomaterials that have been used to deliver different chemotherapeutics into tumor cells, and to ultimately evaluate the progression on the strategies for cancer therapy in view of the future research.

scholarly journals Rational design of photocatalysts for ammonia production from water and nitrogen gas

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Seokwoo Choe ◽  
Sung Min Kim ◽  
Yeji Lee ◽  
Jin Seok ◽  
Jiyong Jung ◽  
...  
Keyword(s):  
Energy Source ◽  
Rational Design ◽  
Future Research ◽  
Ammonia Production ◽  
Significant Progress ◽  
Nitrogen Gas ◽  
Research Directions ◽  
Effective Strategies ◽  
Future Research Directions ◽  
Made In

AbstractPhotocatalytic N2 reduction has emerged as one of the most attractive routes to produce NH3 as a useful commodity for chemicals used in industries and as a carbon-free energy source. Recently, significant progress has been made in understanding, exploring, and designing efficient photocatalyst. In this review, we outline the important mechanistic and experimental procedures for photocatalytic NH3 production. In addition, we review effective strategies on development of photocatalysts. Finally, our analyses on the characteristics and modifications of photocatalysts have been summarized, based on which we discuss the possible future research directions, particularly on preparing more efficient catalysts. Overall, this review provides insights on improving photocatalytic NH3 production and designing solar-driven chemical conversions.

scholarly journals The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

2021 ◽  
Author(s):  
Suzan Dijkink ◽  
Erik W. van Zwet ◽  
Pieta Krijnen ◽  
Luke P. H. Leenen ◽  
Frank W. Bloemers ◽  
...  
Keyword(s):  
The Netherlands ◽  
Trauma Care ◽  
Trauma System ◽  
Future Research ◽  
Severely Injured ◽  
Trauma Centers ◽  
Severely Injured Patients ◽  
The Right ◽  
Injured Patients ◽  
The Impact

Abstract Background Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time. Methods All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008–2018 were included for analysis. We compared severely injured patients, with and without severe neurotrauma, directly brought to trauma centers (TC) and non-trauma centers (NTC). The proportion of patients being directly transported to a trauma center was determined, as was the total Abbreviated Injury Score (AIS), and ISS. Results The documented number of severely injured patients increased from 2350 in 2008 to 4694 in 2018. During this period, on average, 70% of these patients were directly admitted to a TC (range 63–74%). Patients without severe neurotrauma had a lower chance of being brought to a TC compared to those with severe neurotrauma. Patients directly presented to a TC were more severely injured, reflected by a higher total AIS and ISS, than those directly transported to a NTC. Conclusion Since the introduction of a well-organized trauma system in the Netherlands, trauma care has become progressively centralized, with more severely injured patients being directly presented to a TC. However, still 30% of these patients is initially brought to a NTC. Future research should focus on improving pre-hospital triage to facilitate swift transfer of the right patient to the right hospital.

scholarly journals P046 Pointing the finger: an unusual presentation of dactylitis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Natalia Cernovschi - Feasey ◽  
Julekha Wajed
Keyword(s):  
Pleural Effusion ◽  
Soft Tissue ◽  
Middle Finger ◽  
Joint Involvement ◽  
Long Bones ◽  
History Of ◽  
Systemic Symptoms ◽  
The Right ◽  
Hands And Feet ◽  
Radiographic Changes

Abstract Background/Aims  Dactylitis is commonly associated with psoriatic arthritis, and regularly presents at Rheumatology clinics. We discuss a case where progressive systemic symptoms lead to the consideration of alternate diagnoses. Methods  A 46-year-old Nepalese woman presented to the Rheumatology department with a 3 month history of diffuse swelling of the right middle finger proximal interphalangeal joint, with the appearance of dactylitis. There was pain on movement, but no other joint involvement. Simultaneously she noticed blurred and decreased vision, which on review by the ophthalmologists, was diagnosed with bilateral uveitis. There was no history of psoriasis, inflammatory bowel disease, or other past medical history of note. There was no travel history in the past 12 months. A diagnosis of a presumed inflammatory arthritis was made. Results  Blood tests showed elevated c-reactive protein 55 (normal <4 mg/l), erythrocyte sedimentation rate 138 (normal 0-22 mm/hr) and an iron deficiency anaemia. Rheumatoid factor and Anti-CCP antibody were negative. Hand radiographs were reported as normal. MRI of the third digit confirmed an enhancing soft tissue collection at the proximal phalanx of the right middle finger. She was referred for a biopsy of this lesion. Interestingly over the subsequent few months, she developed progressive breathlessness. Chest radiograph showed a left pleural effusion. Further tests showed negative serum ACE, Lyme and Toxoplasma screen. Quantiferon test was negative. Pleural aspirate showed a transudate with negative Acid-fast bacillus (AFB) test and culture. CT chest and abdomen showed a persistent pleural effusion, inflammatory changes in the small bowel and thickening of the peritoneum and omentum. In view of the systemic involvement, a peritoneal tissue biopsy was performed. This confirmed chronic granulomatous inflammation with positive AFB stain for mycobacterium tuberculosis. Our patient was started on quadruple anti- TB antibiotics for 6 months. Her systemic symptoms and dactylitis have improved, although there is on-going treatment for her ocular involvement. Conclusion  Approximately 10% of all cases of extrapulmonary TB have osteoarticular involvement. Dactylitis is a variant of tuberculous osteomyelitis affecting the long bones of the hands and feet. It occurs mainly in young children; however adults may be affected also. The first manifestation is usually painless swelling of the diaphysis of the affected bone followed by trophic changes in the skin. The radiographic changes are known as spina ventosa, because of the ballooned out appearance of the bone, although this was not seen in our case. Fibrous dysplasia, congenital syphilis, sarcoidosis and sickle cell anaemia may induce similar radiographic changes in the metaphysis of long bones of hands and feet, but do not cause soft tissue swelling or periosteal reaction. This case highlights the importance of testing for TB, especially in atypical cases of dactylitis, with other systemic features. Disclosure  N. Cernovschi - Feasey: None. J. Wajed: None.

scholarly journals Sudden Unexpected Death Associated with Arrhythmogenic Cardiomyopathy: Study of the Cardiac Conduction System

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1323
Author(s):  
Giulia Ottaviani ◽  
Graziella Alfonsi ◽  
Simone G. Ramos ◽  
L. Maximilian Buja
Keyword(s):  
Fibromuscular Dysplasia ◽  
Ventricular Myocardium ◽  
Conduction System ◽  
Cardiac Conduction ◽  
Future Research ◽  
Cardiac Conduction System ◽  
Arrhythmogenic Cardiomyopathy ◽  
Unexpected Death ◽  
The Past ◽  
The Right

A retrospective study was conducted on pathologically diagnosed arrhythmogenic cardiomyopathy (ACM) from consecutive cases over the past 34 years (n = 1109). The anatomo-pathological analyses were performed on 23 hearts diagnosed as ACM (2.07%) from a series of 1109 suspected cases, while histopathological data of cardiac conduction system (CCS) were available for 15 out of 23 cases. The CCS was removed in two blocks, containing the following structures: Sino-atrial node (SAN), atrio-ventricular junction (AVJ) including the atrio-ventricular node (AVN), the His bundle (HB), the bifurcation (BIF), the left bundle branch (LBB) and the right bundle branch (RBB). The ACM cases consisted of 20 (86.96%) sudden unexpected cardiac death (SUCD) and 3 (13.04%) native explanted hearts; 16 (69.56%) were males and 7 (30.44%) were females, ranging in age from 5 to 65 (mean age ± SD, 36.13 ± 16.06) years. The following anomalies of the CCS, displayed as percentages of the 15 ACM SUCD cases in which the CCS has been fully analyzed, have been detected: Hypoplasia of SAN (80%) and/or AVJ (86.67%) due to fatty-fibrous involvement, AVJ dispersion and/or septation (46.67%), central fibrous body (CFB) hypoplasia (33.33%), fibromuscular dysplasia of SAN (20%) and/or AVN (26.67%) arteries, hemorrhage and infarct-like lesions of CCS (13.33%), islands of conduction tissue in CFB (13.33%), Mahaim fibers (13.33%), LBB block by fibrosis (13.33%), AVN tongue (13.33%), HB duplicity (6.67%%), CFB cartilaginous meta-hyperplasia (6.67%), and right sided HB (6.67%). Arrhythmias are the hallmark of ACM, not only from the fatty-fibrous disruption of the ventricular myocardium that accounts for reentrant ventricular tachycardia, but also from the fatty-fibrous involvement of CCS itself. Future research should focus on application of these knowledge on CCS anomalies to be added to diagnostic criteria or at least to be useful to detect the patients with higher sudden death risks.

Persons with disability perception of facilities management service quality: hospital buildings in Malaysia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nuratiqah Aisyah Awang ◽  
Shirley Jin Lin Chua ◽  
Azlan Shah Ali ◽  
Cheong Peng Au-Yong ◽  
Amaramalar Selvi Naicker ◽  
...  
Keyword(s):  
Service Quality ◽  
Strategy Development ◽  
Future Research ◽  
Facilities Management ◽  
Management Service ◽  
Management Activity ◽  
Persons With Disabilities ◽  
Content Type ◽  
Quality Aspect ◽  
The Right

PurposeThis study aims to discover the perception of persons with disabilities (PWDs) towards facilities management (FM) service quality at hospital buildings in Malaysia.Design/methodology/approachA questionnaire survey was conducted with 99 respondents in selected hospitals in Selangor, Malaysia.FindingsThis study aims to discover the perception of PWDs towards FM service quality, and it has found a gap for improvement. The area that requires the highest attention includes the importance of (1) assurance on accessibility despite maintenance activity being conducted (2) criticality of facilities maintenance itself, (3) assurance on comfort and safety, (4) reliable medium to ask for assistance or giving feedback, (5) signage that is clearly seen and easily understood and (6) staff responsiveness.Research limitations/implicationsThis instrument is validated by PWDs under the physical disability category only, specifically in the hospital context. Future research is recommended to identify the FM service quality aspect for different categories of disability (sensory, mental or intellectual impairment).Practical implicationsThe findings provide evidence for FM to consider PWDs' perceptions in FM strategy development. Even FM provides a healthcare support system. FM service quality partly reflects healthcare service quality.Social implicationsAccommodating the need of PWDs through the improvement of FM service quality aspect will partly fulfil the right of PWDs for equality of access to healthcare.Originality/valueThis SERVQUAL tools can be improvised and used to measure the perception of PWDs on FM service quality systematically and holistically. Understanding the service quality aspect is important for a facility manager to precisely measure and prioritise what is truly important to the building users with special needs and try to accommodate this need in the management activity.

scholarly journals Effects of Electrical Stimulation in Tinnitus Patients: Conventional Versus High-Definition tDCS

2018 ◽  
Vol 32 (8) ◽  
pp. 714-723 ◽  
Author(s):  
Laure Jacquemin ◽  
Giriraj Singh Shekhawat ◽  
Paul Van de Heyning ◽  
Griet Mertens ◽  
Erik Fransen ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Depression Scale ◽  
Future Research ◽  
Therapeutic Effects ◽  
Long Term Effects ◽  
High Definition ◽  
Tinnitus Questionnaire ◽  
Temporal Area ◽  
Clinically Significant ◽  
The Right

Background. Contradictory results have been reported for transcranial direct current stimulation (tDCS) as treatment for tinnitus. The recently developed high-definition tDCS (HD tDCS) uses smaller electrodes to limit the excitation to the desired brain areas. Objective. The current study consisted of a retrospective part and a prospective part, aiming to compare 2 tDCS electrode placements and to explore effects of HD tDCS by matched pairs analyses. Methods. Two groups of 39 patients received tDCS of the dorsolateral prefrontal cortex (DLPFC) or tDCS of the right supraorbital–left temporal area (RSO-LTA). Therapeutic effects were assessed with the tinnitus functional index (TFI), a visual analogue scale (VAS) for tinnitus loudness, and the hyperacusis questionnaire (HQ) filled out at 3 visits: pretherapy, posttherapy, and follow-up. With a new group of patients and in a similar way, the effects of HD tDCS of the right DLPFC were assessed, with the tinnitus questionnaire (TQ) and the hospital anxiety and depression scale (HADS) added. Results. TFI total scores improved significantly after both tDCS and HD tDCS (DLPFC: P < .01; RSO-LTA: P < .01; HD tDCS: P = .05). In 32% of the patients, we observed a clinically significant improvement in TFI. The 2 tDCS groups and the HD tDCS group showed no differences on the evolution of outcomes over time (TFI: P = .16; HQ: P = .85; VAS: P = .20). Conclusions. TDCS and HD tDCS resulted in a clinically significant improvement in TFI in 32% of the patients, with the 3 stimulation positions having similar results. Future research should focus on long-term effects of electrical stimulation.

scholarly journals Longitudinal changes in brain activation during anticipation of monetary loss in bipolar disorder

2018 ◽  
Vol 49 (16) ◽  
pp. 2781-2788 ◽  
Author(s):  
Anna Manelis ◽  
Richelle Stiffler ◽  
Jeanette C. Lockovich ◽  
Jorge R. C. Almeida ◽  
Haris A. Aslam ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mood State ◽  
Brain Activation ◽  
Emotional Arousal ◽  
Occipital Cortex ◽  
Cortical Activation ◽  
Future Research ◽  
Longitudinal Changes ◽  
The Right ◽  
Cue Processing

AbstractBackgroundIndividuals with bipolar disorder (BD) show aberrant brain activation patterns during reward and loss anticipation. We examined for the first time longitudinal changes in brain activation during win and loss anticipation to identify trait markers of aberrant anticipatory processing in BD.MethodsThirty-four euthymic and depressed individuals with BD-I and 17 healthy controls (HC) were scanned using functional magnetic resonance imaging twice 6 months apart during a reward task.ResultsHC, but not individuals with BD, showed longitudinal reductions in the right lateral occipital cortex (RLOC) activation during processing of cues predicting possible money loss (p-corrected <0.05). This result was not affected by psychotropic medication, mood state or the changes in depression/mania severity between the two scans in BD. Elevated symptoms of subthreshold hypo/mania at baseline predicted more aberrant longitudinal patterns of RLOC activation explaining 12.5% of variance in individuals with BD.ConclusionsIncreased activation in occipital cortex during negative outcome anticipation may be related to elevated negative emotional arousal during anticipatory cue processing. One interpretation is that, unlike HC, individuals with BD were not able to learn at baseline that monetary losses were smaller than monetary gains and were not able to reduce emotional arousal for negative cues 6 months later. Future research in BD should examine how modulating occipital cortical activation affects learning from experience in individuals with BD.

Does Sophistication Affect Electoral Outcomes?

2016 ◽  
Vol 53 (2) ◽  
pp. 181-204 ◽  
Author(s):  
Lauri Rapeli
Keyword(s):  
Future Research ◽  
Citizen Competence ◽  
Individual Level ◽  
Electoral Outcomes ◽  
Sociodemographic Determinants ◽  
Political Left ◽  
Electoral Behaviour ◽  
Research Questions ◽  
The Individual ◽  
The Right

It is widely assumed that a representative democracy requires an enlightened citizenry in order to function properly. The competence of citizens has been studied extensively and the sociodemographic determinants of political sophistication are particularly well known. Much less is known about whether and how citizen competence affects electoral behaviour and outcomes. This article reviews the existing literature on these topics. Despite the widespread consensus that, generally speaking, citizen competence matters for electoral outcomes, the review produced a mixed result: some studies suggest that the political left would benefit from a better-informed electorate, while other studies suggest the opposite. Although the majoritarian electoral context is overrepresented in the evidence, the review shows that at the individual level, political knowledge greatly increases a person’s ability to match personal preferences with the right candidate or party in an election. The article also identifies several gaps in existing knowledge, thereby suggesting future research questions.

scholarly journals From Which Direction Does the Empire Strike (Back)?

2021 ◽  
Vol 12 ◽  
Author(s):  
Katharina Theresa Halicki ◽  
Moritz Ingendahl ◽  
Maren Mayer ◽  
Melvin John ◽  
Marcel Raphael Schreiner ◽  
...  
Keyword(s):  
Opposite Direction ◽  
Spatial Representation ◽  
Future Research ◽  
Spatial Representations ◽  
The Right ◽  
Attack And Defense

In cultures with left-right-script, agentic behavior is mentally represented as following a left-to-right trajectory, an effect referred to as the Spatial Agency Bias (SAB, Suitner and Maass, 2016). In this research, we investigated whether spatial representations of activities are universal across activities by analyzing the opposite concepts of “attack” and “defense”. Both behaviors involve similar actions (e.g., fighting) but may differ in perceived agency. Moreover “defense” is necessarily always a response to an attack and may therefore be represented by a trajectory in the opposite direction. Two studies found the classic SAB for activities representing attacking but a reduction (Study 1) and reversal (Study 2) for activities involving defense. Although the spatial representation of defense on the right was much weaker and less unequivocal than that of attack on the left, the results suggest that the spatial representations of defense and attack are located in different positions. Apparently not all actors and all activities are spatially represented on the left with a left-to-right trajectory but position and direction depend on the perceived agency. Directions for future research and applications of our findings are discussed.

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