Clinical Observations on Infliximab Treatment of Infantile Onset Takayasu Arteritis

Background: To study short-term clinical effectiveness and safety of infliximab (IFX) treatment of infants with Takayasu arteritis (TA). Methods: We investigated the therapeutic effectiveness of IFX in 10 infantile TA in a retrospective case series. Evaluation included assessment of clinical symptoms, laboratory testing, and vascular imaging. Results: Fever was the presenting symptom for 8 of 10 infants with TA. In the acute episode, leucocyte and inflammatory indices increased significantly. Vascular imaging showed that the most commonly-involved arteries were carotid arteries, abdominal aortas, and coronary arteries (9 cases, 90%). Two weeks after IFX treatment, leukocyte and platelet counts decreased, and hemoglobin levels increased. There were significant clinical differences 6 weeks after treatment compared with before treatment (p<0.05). Inflammatory indices decreased significantly 2 weeks after starting IFX treatment compared with before treatment (p<0.05). Vascular lesions began to recover within 1.5-3 months of initiating IFX therapy, and the involved vessels significantly recovered within 13 months. Some arteries remained stenotic, intimal thickening and uneven lumen wall thickness. Conclusions: TA is rare in infancy. Fever may be the main manifestation of illness, often accompanied by significantly increased inflammatory indices. Early use of IFX appears to be effective, significantly decreasing inflammatory markers and improving clinical features, leading to partial remission of vascular lesions and sustain remissions for some infants. Use of IFX reduced or eliminated need for glucocorticoids. IFX has a reasonable safety profile and does not appear to affect normal growth and development of infants with TA.

Sustainable Renewal of Underground Parking Space in the Scenario of Shared Autonomous Vehicles

Shared autonomous vehicles (SAVs) are a major development direction in international scientific and technological innovation. One of the most popular features of SAVs in the urban space is that they can significantly reduce the need for parking. The urban underground parking space (UPS) is currently the largest static traffic space, especially in high-density urban centers. Under the SAV scenario, the need for the renewal of UPS will increase in the near future. However, renewal of the UPS is difficult due to its special form features, which are greatly restricted by the external environment, thus necessitating targeted methods and strategies. This research first conducted field investigations and data collection on the spatial morphology and service conditions of typical UPSs in different areas of Hangzhou city. Based on the driver status response and the multi-objective attribute models, the time-series evaluation method and function replacement decision model for the sustainable renewal of underground parking were established. The research also discusses appropriate design strategies for the combination of spatial characteristics and functional replacement goals of typical samples. The conclusions will provide scientific guidance for the future design practice of architects and urban designers in SAV.

Ultrasound Imaging in Sport-Related Muscle Injuries: Pitfalls and Opportunities

Muscle injuries occur frequently in athletes, accounting for more than one-third of sport-related trauma. Athletes most affected by these injuries are those practicing football and track and field, with hamstrings and gastrocnemius-soleus as the mainly involved sites. Muscle injuries lead to loss of competitions, long recovery times and risk of re-injury with a consequent increase of the management costs. It is therefore advisable to make an accurate and timely diagnosis to establish appropriate interventions for proper healing in the shortest time. In this context, ultrasound imaging is widely used for diagnosis of musculoskeletal disorders because of several advantages including absence of radiation, portability, good spatial resolution, and the ability to perform dynamic tests. The aim of this review is to address the role of US in the evaluation of athletes with muscle injuries. US may play a pivotal role for the management of sport-related muscle injuries because it is fast and relatively cheap, allowing dynamic muscle assessment and time series evaluation of the healing process.

Sustainable Renewal Methods of Urban Public Parking Spaces under the Scenario of Shared Autonomous Vehicles (SAV): A Review and A Proposal

Shared autonomous vehicles (SAVs) will be an important force to in reshaping urban morphology. The high operation rate and sharing degree of SAV are considered to result in a great reduction in parking area in future cities. Parking space is now a huge and widely distributed urban stock space type, which is bound to become a major challenge and opportunity for sustainable urban renewal in the digital era. Based on the SAV scenario, this paper reviews the current research on the sustainable renewal of urban public parking spaces, and proposes the four key issues involved: how much to renew (i.e., demand forecast analysis), when to renew (i.e., update time series evaluation), what to renew (i.e., function replacement decision) and how to update (i.e., design empirical research). Furthermore, it puts forward a preliminary idea on, and constructs a research framework for, the sustainable renewal methods of parking space under the SAV scenario. Finally, the theoretical, practical and policy implications of the research on sustainable renewal methods of urban public parking space are discussed. It will have great reference value for the redevelopment and reuse of the urban space types including fragmented, widely distributed and large-scale.

Time series evaluation of ascitic syndrome condemnation at poultry abattoirs under Federal Inspection Service of Brazil (2010-2019)

ABSTRACT: Over the last decade, Brazil registered a 10.56% increase in the number of poultry slaughtered in establishments registered under the “Serviço de Inspeção Federal” (SIF - Federal Inspection Service), as a result of technological advances in management, health and genetics applied to national aviculture. At slaughter, during post-mortem inspection, carcasses can be totally or partially condemned for various reasons, including ascitic syndrome. This syndrome has economic implications for the industry, in addition to being a problem for the health and welfare of poultry. The objective of this work was to evaluate the historical series (2010-2019) of partial and total condemnations of poultry carcasses due to ascitic syndrome in slaughterhouses registered under the SIF and located in the main poultry-producing states. Through official data, the condemnation occurrence index (COI) and the adjusted seasonal index (ASI) were calculated. The condemnation rate was 1,140 carcasses condemned, totally or partially, for ascitic syndrome for every 1,000,000 poultry slaughtered. The smallest and largest COIs were found in São Paulo (February 2010) and in Goiás (January 2017), respectively. The occurrence of condemnations for this syndrome was cyclical throughout the historical series, showing peaks of condemnation in all years evaluated, with the highest ASIs in July, August and September, and with rates varying between 1.24 and 1.54 in these months. Considering the period of pre-slaughter housing, the highest ASIs coincide with the coldest period of the year (May to August) for all analyzed states. The results show that ascitic syndrome is a growing problem in Brazil, with greater occurrence during the coldest months of the year, having a negative impact on animal health and the profitability of producers and industries in the poultry production chain.

Reconstruction after Mohs Surgery for Digit Melanoma: Description of Techniques and Postoperative Limb Function

Introduction Mohs surgery and reconstruction has enabled tissue-preserving resection of cutaneous malignancies. The goal of our case series evaluation is to present reconstructive techniques and functional outcomes in patients undergoing digit-sparing treatment for primary melanoma. Materials and Methods A chart review was performed to identify consecutive patients undergoing Mohs surgery and reconstruction for melanoma of the digits. Quality of life (QOL) survey was performed to assess function after the procedure. Results Thirty-two patients (13 hand, 19 foot, Age: 65.03 +/–17.78 years) who were undergoing Mohs surgery were identified. No recurrence was identified with an average follow-up of 16.1 months (1–95 months). The average defect size was 5.79 +/–4.54 cm2. Reconstruction was performed 0–4 days after resection. The most common techniques included full-thickness skin graft (FTSG) (N = 7), collagen matrix + FTSG (N = 4), and volar advancement flap (N = 7). The reconstructive technique choice appears correlated with defect size (p = 0.0125). Neuro-QOL upper extremity survey results showed a difference that approached statistical significance between patients who underwent digit-sparing treatment (n = 7) versus direct to amputation controls (n = 5) (p = 0.072). No survey differences between digit-sparing treatment (n = 10) and amputation (n = 8) were identified in the lower extremity (p = 0.61). Conclusion Our results show digit-sparing treatment can confirm clear surgical margins and a trend toward improvement in upper extremity function compared with immediate amputation.