Search

Rationale: SARS-CoV-2 has been associated with increased risk for thrombotic disease and respiratory failure. Therapeutic or intermediate dose anticoagulation has been associated with decreased thrombotic events and potentially improved hospital outcomes. It is not known whether this potential benefit of anticoagulation is unique to SARS-CoV-2, or if this is shared with other respiratory viruses. Our study compared chronic therapeutic anticoagulation use to non-chronic anticoagulation in hospitalized patients with SARS-CoV-2 and Influenza. Methods: This was a retrospective single center study with IRB approval. Patients were included if they were >18 years old and admitted to the University of Rochester Medical Center or affiliate with either a SARS-CoV-2 or Influenza (A/B) positive test between September 1 2019 and September 1 2020. Patients were identified using medical records and manually validated for accuracy. Chronic therapeutic anticoagulation was defined as anticoagulation >30 days prior to infection diagnosis. Baseline characteristics, reason for hospitalization, laboratory, degree of hypoxia, ICU admission, ICU management strategies, thrombotic complications, bleeding complications, in hospital, and 90 day mortality were collected. Parametric and non-parametric t-test were used. Results:A total of 495 patients were admitted with a positive SARS-CoV-2 PCR with 65 patients (13.1%) on chronic therapeutic anticoagulation. During hospitalization, 60 patients continued full dose anticoagulation and five received enhanced prophylaxis. 103 of the non-chronically anticoagulated received enhanced prophylaxis and the remaining received standard dosing. 429 patients were admitted with a positive influenza PCR with 56 (13.1%) on chronic therapeutic anticoagulation. Chronically anticoagulated patients in the SARS-CoV-2 and influenza group were significantly older, 75 (67,84) vs 65 (50, 76) and 73 (60,78) vs 60 (40, 71) respectively. Despite being older, there was no difference in inflammatory markers, respiratory failure, intubation, ICU admission, shock, or acute renal failure requiring renal replacement (Table 1). Chronically anticoagulated SARS-CoV-2 patients had 1 venous thrombotic event while the non-chronically anticoagulated patients, including enhanced prophylaxis, had 27 events (Table 1). Conclusion We found that chronic therapeutic anticoagulation may decrease severity of illness in both SARS-CoV-2 and influenza infection. In both groups the chronically anticoagulated patients were significantly older with increased comorbidities and despite that they did not have more significant disease. Our hospital system was not overwhelmed during this time and a significant number of COVID deaths were patients who opted for limited interventions. Further studies are warranted on the impact of anticoagulation with respiratory viruses. (Table Presented).

Purpose Oral treprostinil (TRE) has been shown to improve exercise capacity in patients with pulmonary arterial hypertension (PAH), but its effect on clinical outcomes was unknown. Methods In this global, event-driven study, eligible participants taking one approved PAH medication were randomized to TRE or placebo (PBO). Dosing was individualized and titrated from 0.125 mg three times daily (TID) up to 12 mg TID. Primary objective was to determine the effect of TRE on time to first adjudicated clinical worsening (CW) event: death, hospitalization due to worsening of PAH, initiation of inhaled/infused prostacyclin, disease progression (≥ 15% decrease in six minute walk distance [6MWD] and increase in functional class [FC] or worsening heart failure), or unsatisfactory long-term clinical response. Results 690 participants were randomized (346 TRE, 344 PBO). They were predominantly female and Conclusion In participants taking one oral PAH medication, early, sequential combination therapy with TRE significantly delayed disease progression compared to PBO. Functional and symptomatic improvements at W24-48 support the primary endpoint and were greatest for those achieving ≥3 mg TID at W24.

EACR-18 was the 18th biennial meeting of the European Association for Cancer Research (EACR). It attracted more than 700 delegates, providing a pivotal European forum for basic scientists, translational researchers and clinical oncologists alike. It covered most of the key areas and recent developments in cancer research. This Review presents a meeting report.

The predominant mode of fission gas release occurs through atomic diffusion to the grain boundaries. In oxide fuels the fission gases initially precipitate as an array of small lenticular bubbles of circular projection. The arrival of additional gas and vacancies causes these bubbles to grow and coalesce into fewer, larger bubbles. Depending on the irradiation conditions and temperatures, these bubbles may develop either as circular lenticular pores or as extended multi-lobed pores. Eventually the pores may intersect the grain edges where pathways may be formed which enable the gas to migrate to the outer geometry of the fuel and hence to the gap and the pin free volume. Recent extensive PIE campaigns on irradiated fuels have provided a large database of inter-granular porosity development and, from these, models of bubble growth, coalescence, morphological relaxation and venting have been developed.

SEM and EPMA examinations of the microstructure and microchemistry of British Nuclear Fuel’s quasi-homogeneous SBR MOX fuel following irradiation suggests behaviour which is very similar to that observed in UO2. Most significantly, a fission gas release of 1% in three-cycle SBR MOX PWR rods is associated with the development of a well-defined intergranular bubble network, which has not been seen previously in the more heterogeneous MOX fuels irradiated under similar conditions. The contrast between the observations is attributed to the relatively low volume fraction and small size of the Pu rich inhomogeneities in the SBR fuel which generate only 4% of the total fission gas and eject most of this into the surrounding mixed oxide matrix. The resulting perturbation in the Xe distribution has a negligible influence on the evolution of the microstructure. A key observation is made from the results of recent post-irradiation annealing experiments performed on SBR MOX and UO2. These confirm near identical fission gas behaviour in the two fuel types when the influence of thermal conductivity and rod rating are removed.

The framework for analysis of fission product release in the Halden gas flow rigs has been developed over a period of 20 years. The predominant mode of release is single gas atom diffusion to free surfaces with a small, but burn-up-dependent contribution from direct recoil. Measurements of longer-lived fission products indicated that their release appeared to be controlled by a diffusion coefficient, which, at low temperatures, was several orders of magnitude smaller than that of the shorter-lived fission products. The enhanced release of the shorter-lived products was attributed to a near-surface enhancement effect. However, a theoretical study of a two-zone diffusion model reveals that it is incapable of accounting for the observations. A model based on the fractal nature of the uranium dioxide surface circumvents these difficulties and provides a framework in which a single three-term diffusion coefficient can be used to describe the release of both short- and long-lived fission products.

Puncture results are presented for seven SBR MOX fuel rods from the first prototypical commercial irradiation that was carried out in the Beznau-1 PWR. The rod average burn-up ranged from 31.2 to 35.6 MWd/kgHM. Comparison is made with the percentage of gas released from French MOX fuels and UO 2 fuel. The results show that in the burn-up range investigated, SBR MOX fuel and MIMAS MOX fuel perform similarly, releasing up to about 1% of the fission gas inventory. Comparisons with the Halden Criterion show that SBR MOX has the same release threshold as UO 2 and this suggests that the mechanisms of release in the two fuels are similar. This is further supported by calculations made with the ENIGMA fuel performance code. It is concluded that the apparent differences in fission gas release between SBR MOX and UO 2 fuel, at least in the early stages of release, can be explained by the higher temperatures experienced by MOX fuel.

Objective: To demonstrate the binding and inactivation action of a superabsorbent dressing on proteolytic enzymes MMP-2, MMP-9 and collagenase using an established methodology. Method: An in vitro assay of MMP binding and collagenase inactivation has been conducted using the superabsorbent wound dressing (Eclypse; Advancis Medical UK). Dressings in this category, and other absorbents, have been claimed to possess MMP-binding characteristics; however, for most there is no published evidence as yet. In this series of experiments, we have used validated experimental techniques to evaluate such activity. Results: Results show that the superabsorbent dressing does have a statistically-significant effect in binding two of the most important MMPs, MMP-2 and MMP-9, as well as inhibiting collagenase. Conclusion: These results support this activity for the superabsorbent dressing and indicate a probable beneficial clinical action in reducing the influence of these enzymes in delayed wound healing. Declaration of interest: This study was funded by an unrestricted grant from Wound Resources Ltd. The authors have no financial interests in the products concerned. RW is a consultant to numerous wound products companies, including Advancis Medical. CW carried out all experimental tests and data analysis. The analysis of data and manuscript does not imply approval or endorsement of any products mentioned.

A computer program, PEAKS ® , has been written to provide a quantitative determination of the relative amounts of up to 11 crystalline phases commonly found in samples of leadacid battery materials. The necessary observed data are the heights (or areas) of a set of pre-selected X-ray powder diffraction peaks collected with Cu Kα radiation. The program is designed for use on an IBM (or compatible) personal computer and has been written in the “C” language to facilitate data input and output and to simplify user interaction with the software. The method is rapid, accurate, and does not require an expert knowledge of either diffraction or crystallography. The amount of amorphous material present in the sample may also be determined by the addition of a known proportion of an internal standard material (CeO 2 ).

This review provides a summary of the European Association for Cancer Research Award Lecture, presented at the ECCO12 meeting in Copenhagen in September 2003. It describes what we have learnt about the mechanisms responsible for deregulating RNA polymerase III transcription in transformed cells. A network has been discovered of unanticipated links to key tumour suppressors and oncogenes. Novel functions have been revealed for RB, p53 and c-Myc, that may help explain their profound biological effects.

Today, the tools are in our hands to enable us to travel away from our home planet and become citizens of the solar system. Even now, we are seriously beginning to develop the robust infrastructure that will make the 21st century the Century of Space Travel. But this bold step must be taken with due concern for the health, safety and wellbeing of future space explorers. Our long experience with space biomedical research convinces us that, if we are to deal effectively with the medical and biomedical issues of exploration, then dramatic and bold steps are also necessary in this field. We can no longer treat the human body as if it were composed of muscles, bones, heart and brain acting independently. Instead, we must lead the effort to develop a fully integrated view of the body, with all parts connected and fully interacting in a realistic way. This paper will present the status of current (2000) plans by the National Space Biomedical Research Institute to initiate research in this area of integrative physiology and medicine. Specifically, three example projects are discussed as potential stepping stones towards the ultimate goal of producing a digital human. These projects relate to developing a functional model of the human musculoskeletal system and the heart.

A 13-year-old boy with myotonic dystrophy underwent insertion of a percutaneous gastrostomy feeding tube under general anaesthesia. We used a laryngeal mask airway and a spontaneously breathing technique with propofol total intravenous anaesthesia. Postoperative vomiting and aspiration, 12 h after the procedure, subsequently required intubation and ventilation. We discuss the anaesthetic management of this case and review the features of the disease to be considered when contemplating anaesthesia in such patients.

Item does not contain fulltext BACKGROUND: Many studies have shown the clinical efficiency of occlusion therapy for psoriasis, particularly corticosteroids used under hydrocolloid dressings. However, there are no data from comparative clinical studies evaluating the remission and relapse characteristics of such occlusion therapy compared with orthodox topical steroid monotherapy. METHODS: In a randomised, open-label, parallel group study from three centres, the remission and relapse characteristics were investigated for the use of a hydrocolloid dressing (HCD) over clobetasol propionate 0.05% lotion once a week compared with the same steroid in ointment formulation used unoccluded twice a day in 61 patients with stable chronic plaque psoriasis. RESULTS: There was a pronounced treatment difference in favour of the HCD + clobetasol propionate lotion group with respect to time to clearance, but there was little evidence for a difference with respect to time to relapse. CONCLUSION: The combination of the HCD + clobetasol propionate lotion provides a fast and highly effective remission induction.

Abstract The structural integrity of FPSO's and FSU's is clearly vital to the safe operation of such installations. Current UK Health & Safety law requires that an offshore installation at all times possesses such integrity as is reasonably practicable. In a goalsetting regime as exists in the UK, it is necessary that information is available in order to help to judge what is 'reasonably practicable'. In the case of the structural integrity of FPSO's and FSU's, there is a significant experience base available from the shipping industry, although not all of this is directly relevant to the requirements for fixed offshore installations. Thus, there are areas where more information is required, and some of these have been highlighted by incidents occurring to installations. The paper describe issues that are believed to be of significance to the structural integrity of FPSO's and FSU's, and how these are being addressed by the HSE, Offshore Division (OSD), through research and dissemination. The paper is concerned with the structural integrity of FPSO's and FSU's in the UK, but will have relevance to such installations in other areas of the world and possibly to other types of floating structures. Introduction FPSO (Floating Production Storage and Offloading) and FSU (Floating Storage Unit) installations of a monohull form (i.e. ship-like) are being increasingly used, particularly for marginal fields and for deep water locations. Fifteen installations of this type are currently in operation on the UK Continental Shelf (UKCS) including West of Shetland (WoS), with several more currently under consideration for future projects. Most of these installations have been built in the last five years, although some have been converted from tankers more than 17 years old. It is likely that many of these installations will continue to be operated for several years to come. The distribution of these installations throughout the area covered by the UKCS is shown in Figure 1. Much research effort has been expended by the offshore industry in assessing the effects of a wide range of hazards (including structural hazards) on the more conventional types of installations. However, the Industry soon recognised at an early stage of developments that further work was required in assessing the effects of certain hazards for the small but growing number of monohull installations. The use of monohulls as offshore installations has been mainly supported by the use of existing oil tanker Classification and international ship standards (e.g. IMO), for design, construction and in-service inspection. However, there are some significant differences between the operational and environmental conditions for trading ships and FPSO's/FSU's. The Classification Societies have made considerable efforts to produce more specific guidance and rules for floating offshore installations. Nevertheless, knowledge is still developing and it is important that marine standards are not too readily adopted by FPSO/FSU owners and operators without careful consideration of their applicability of these standards offshore and their verification.