Gender Was Associated with Depression but Not with Gastrointestinal Dysfunction in Patients with Parkinson’s Disease

Objective. To investigate the association between gender and gastrointestinal (GI) dysfunctions, as well as gender and other motor symptoms/nonmotor symptoms, in a sample of PD patients. Methods. 186 patients with PD were recruited into this study and divided into male PD group (M-PD) and female PD group (FM-PD). Demographic and PD-related clinical information of the participants were collected by the same neurologist. PD patients were objectively assessed by a spectrum of rating scales of motor symptoms and nonmotor symptoms (including GI dysfunctions). The data were analyzed by SPSS 20 statistical software. Results. Totally 95 cases (51.08%) were in the M-PD group and 91 cases (48.92%) in the FM-PD group. There were no significant differences in age, BMI, and lifestyles between the two groups (P > 0.05). Males had higher educational level (P = 0.002). Females were more likely to have early satiety and loss of appetite (P = 0.025, P = 0.001). There were no significant differences in LED disease duration, age of motor symptoms onset, types of motor symptoms onset, location of motor symptoms onset, and phenotype of motor symptoms between the two groups (P > 0.05). Females had significantly higher UPDRS-III and HAMD scores than males (P = 0.037, P = 0.034). There were no significant differences in PQSI, ESS, RLS, RBD, HAMA, HAMD, and MoCA scores between the two groups. Gender was associated with HAMD (OR = 0.682, P = 0.019). Conclusions. Gender is a risk factor for depression, but not for GI dysfunctions in patients with PD.

Comparing Efficacy of Punctum-incised Surgery versus Punctum- Sparing Surgery in Primary Canaliculitis Patients

Purpose: This study aims to describe the characteristics of canaliculitis patients and compare the operative outcomes between punctum-sparing canaliculotomy and traditional punctum-incised canaliculotomy.Methods: The medical records of 58 patients who were diagnosed with canaliculitis were reviewed from March 1, 2010, to December 31, 2020. The demographic characteristics, symptoms, time to disease onset, location of involvement, operation information, and prognosis were recorded and analyzed.Results: Canaliculitis showed a female (67%) predominance. Epiphora with discharge was the most common symptom which happened in 56 (97%) patients. The recurrence rates of the punctum-incised group and the punctum-sparing group were 5% and 9% respectively, and there was no significant difference between the two groups. (p=0.514)Conclusion: The recurrence rate of the punctum-sparing group showed no significant difference with punctum-incised group. Patients with recurrence finally recovered after multiple treatments. Squeezing by tweezers was a good way to locate the infected lacrimal duct. Punctum-incised surgery can be the first-line therapy for canaliculitis.

Effects of Surface Waviness on Fan Blade Boundary Layer Transition and Profile Loss—Part II: Experimental Assessments and Applications

Part II describes the experimental assessment and the application of the ideas in Part I concerning the mechanisms that determine the role of blade surface waviness on laminar-turbulent transition and their consequent effect on civil aircraft fan performance. A natural transition wind tunnel was designed and constructed to characterize the impact of surface waviness on transition, using both hotwire anemometry and infrared thermography. The experimental results support the new hypothesis presented in Part I, concerning the way in which blade surface waviness affects fan performance through motion of the transition onset location due to interaction between surface waviness and Tollmien–Schlichting (TS) boundary layer instability. In particular, the theoretical amplification of the TS waves, and the corresponding transition onset location movement due to surface waviness, was borne out over a range of variations in Reynolds number, nondimensional surface wavelength, nondimensional surface wave height, and location of surface wave initiation, relevant to composite fan blade parameters. Further, the increase of receptivity coefficient, and thus, the initial amplitude of disturbances due to geometric resonance between surface wavelength and TS wavelength was also confirmed by the experiments. Surface waviness was estimated, in some cases, to result in a nearly 1% decrease in fan efficiency compared to a nonwavy blade. Suggestions are given for mitigation of the effects of waviness, including the idea of blade curvature rescheduling as a method to delay transition and thus decrease loss.

Effects of Surface Waviness on Fan Blade Boundary Layer Transition and Profile Loss—Part I: Methodology and Computational Results

This two-part paper describes a new approach to determine the effect of surface waviness, arising from manufacture of composite fan blades, on transition onset location movement and hence fan profile losses. The approach includes analysis and computations of unsteady disturbances in boundary layers over a wavy surface, assessed and supported by wind tunnel measurements of these disturbances and the transition location. An integrated framework is developed for analysis of surface waviness effects on natural transition. The framework, referred to as the extended eN method, traces the evolution of disturbance energy transfer in flow over a wavy surface, from external acoustic noise through exponential growth of Tollmien–Schlichting (TS) waves, to the start and end of the transition process. The computational results show that surface waviness affects the transition onset location due to the interaction between the surface waviness and the TS boundary layer instability and that the interaction is strongest when the geometric and TS wavelengths match. The condition at which this occurs, and the initial amplitude of the boundary layer disturbances that grow to create the transition onset is maximized, is called receptivity amplification. The results provide first-of-a-kind descriptions of the mechanism for the changes in transition onset location as well as quantitative calculations for the effects of surface waviness on fan performance due to changes in surface wavelength, surface wave amplitude, and the location at which the waviness is initiated on the fan blade.

Effects of Surface Waviness on Fan Blade Boundary Layer Transition and Profile Loss — Part I: Methodology and Computational Results

This two-part paper describes a new approach to determine the effect of surface waviness, arising from manufacture of composite fan blades, on transition onset location movement and hence fan profile losses. The approach includes analysis and computations of unsteady disturbances in boundary layers over a wavy surface, assessed and supported by wind tunnel measurements of these disturbances and the transition location. An integrated framework is developed for analysis of surface waviness effects on natural transition. The framework, referred to as the extended eN method, traces the evolution of disturbance energy transfer in flow over a wavy surface, from external acoustic noise through exponential growth of Tollmien-Schlichting (TS) waves, to the start and end of the transition process. The computational results show that surface waviness affects the transition onset location due to the interaction between the surface waviness and the TS boundary layer instability, and that the interaction is strongest when the geometric and TS wavelengths match. The condition at which this occurs, and the initial amplitude of the boundary layer disturbances that grow to create the transition onset is maximized, is called receptivity amplification. The results provide first-of-a-kind descriptions of the mechanism for the changes in transition onset location as well as quantitative calculations for the effects of surface waviness on fan performance due to changes in surface wavelength, surface wave amplitude, and the location at which the waviness is initiated on the fan blade.

Effects of Surface Waviness on Fan Blade Boundary Layer Transition and Profile Loss — Part II: Experimental Assessments and Applications

Part II describes the experimental assessment and the application of the ideas in Part I concerning the mechanisms that determine the role of blade surface waviness on laminar-turbulent transition and their consequent effect on civil aircraft fan performance. A natural transition wind tunnel was designed and constructed to characterize the impact of surface waviness on transition, using both hotwire anemometry and infrared thermography. The experimental results support the new hypothesis presented in Part I, concerning the way in which blade surface waviness affects fan performance through motion of the transition onset location due to interaction between surface waviness and Tollmien-Schlichting (TS) boundary layer instability. In particular, the theoretical amplification of the TS waves, and the corresponding transition onset location movement due to surface waviness, was borne out over a range of variations in Reynolds number, non-dimensional surface wavelength, non-dimensional surface wave height, and location of surface wave initiation, relevant to composite fan blade parameters. Further, the increase of receptivity coefficient, and thus the initial amplitude of disturbances due to geometric resonance between surface wavelength and TS wavelength, was also confirmed by the experiments. Surface waviness was estimated, in some cases, to result in a nearly 1% decrease in fan efficiency compared to a non-wavy blade. Suggestions are given for mitigation of the effects of waviness, including the idea of blade curvature rescheduling as a method to delay transition and thus decrease loss.

Prospective evaluation of pin site infections in 39 patients treated with external ring fixation

Introduction: Pin site infection is a common complication to external ring fixation. While the aetiology is well described, monitoring of onset, location, and the distribution of infection among the pin sites still needs further attention. The present pilot study evaluates the feasibility of a prospective registration procedure for reporting, evaluating, and monitoring of pin site infections in patients treated with external ring fixation. This may promote communication between team members and assist decision-making regarding treatment. Methods: A total of 39 trauma, limb deformity, and bone infection patients (15 female, 24 males; mean age 49 years (range: 12–88)) treated with external ring fixation were followed in the outpatient clinic using the pin site registration tool. Pin site infection (Checketts and Otterburn (CO) grade, onset, location), use of oral or intravenous antibiotics, and any unplanned procedures due to pin sites complications (wire removal and/or replacement, premature frame removal, amputation, etc.) were registered until frame removal. Results: The mean (SD) frame time was 164 (83) d (range: 44–499). We performed 3296 observations of 568 pin sites. Pin infection was registered in 171 of the 568 pin sites (30 %), of which 112 (65 %) were categorized as CO 1, 42 (25 %) as CO 2, 9 (5 %) as CO 3, and 8 (5 %) as CO 5. Neither CO 4 nor CO 6 was observed. A total of 35 patients (90 %) encountered CO 1–3 at least once during the observation time, while 1 patient (2.5 %) developed a major infection at eight pin sites (CO 5). Antibiotics were administered to 22/39 (56 %) of the patients. Conclusion: In an effort to monitor pin site infections in this complex patient group and to ensure the best clinical outcomes, our registration procedure in the outpatient clinic helped to recognize pin site infections early and eased communication between team members providing a concise overview of the treatment course.

Parameters controlling the substorm onset location

<p>Substorm onset location varies over a range of magnetic local time (MLT) and magnetic latitudes (MLat). It is well known that about 5% of the variation in onset MLT can be explained by variations in interplanetary magnetic field orientation and dipole tilt angle. Both parameters introduce an azimuthal component in the magnetic field in the magnetosphere such that the projection of the onset MLT in the ionosphere is shifted. The MLT of the onset near the magnetopsheric equatorial plane is even less predictable. Recent studies have suggested that gradients in the ionospheric Hall conductance lead to a duskward shift of tail dynamics, which could also influence the location of substorm onset. Our goal is to test these ideas by quantifying the dependence of the spatial variation of the onset location on external and internal conditions. We focus on the correlation between the substorm onset location with conditions prior to the onset, such as the interplanetary magnetic field By component, dipole tilt angle, and estimates of the Hall conductance. Linear regression analysis is used to determine the substorm onset location dependence on the proposed variables.</p>

Abstract P165: Characteristics and Predictors of Mimics and Confirmed Strokes in a Stroke Alerts System at a Large Urban Medical Center

Background: Stroke alert systems provide rapid evaluation of suspected strokes to aid timely thrombolysis and mechanical thrombectomy. Given consequences of delayed or missed diagnosis, these systems are intentionally more sensitive than specific for confirmed stroke. However, substantial physician and hospital resources are involved. We sought to evaluate characteristics and predictors of stroke mimics and confirmed strokes in a large stroke alert program. Methods: The study is a retrospective investigation of the stroke alert system at the University of Colorado Hospital. Variables included patient, clinical, stroke and stroke alert characteristics, and outcome. Variables were compared for patients with confirmed stroke, and mimics. Results: Stroke alerts were evaluated in 125 patients over a one-month period in 2019. Median age was 60 years (IQR 47-72), 52% were female, 51% were white, and 24% black or African American. Median initial NIHSS score was 4 (IQR 1-11), and onset was outside the hospital in 70%. One third of stroke alerts were confirmed stroke or TIA, and 66% were mimics. Most stroke alerts were called by the departments of Emergency Medicine (78%), Medicine (10%) and Surgery (9%). The most common of more than 40 stroke alert symptoms and combinations were weakness (45%), aphasia (20%), altered mental status (16%) and facial droop or numbness (each 14%). Stroke mimics were more likely to be female (58% female vs. 41% male, OR 2.206, 95% CI 1.025-4.745, p=0.041), had better initial NIHSS scores [3 (IQR 1-9) mimics vs. 6 (IQR 2-15) stroke, p=0.015), and were more often discharged to home (77% mimics vs. 51% strokes, OR 2.051, 95% CI 1.269-3.316, p=0.004). Stroke onset location and service initiating stroke alert were not associated with confirmed stroke. Weakness was the only symptom associated with confirmed stroke (58% stroke vs. 37% mimics, OR 2.447, 95% CI 1.137-5.268, p=0.021). Conclusions: Of stroke alerts in our institution, two thirds were stroke mimics, and these were more likely to be female patients. Weakness as a stroke alert symptom, alone or with other symptoms, was associated with confirmed stroke. Additional study is warranted to improve specificity and optimize utilization of physician and hospital resources in stroke alert programs.