Unique Condition Research Articles

Chemical characteristics and formation mechanism of secondary inorganic aerosols: The decisive role of aerosol acidity and meteorological conditions

In recent years, there has been a growing concern about air pollution and its impact on the air quality and human health, especially for fine particulate matter (PM2.5) and its associated secondary aerosols in urban areas. This study conducted a year-long field campaign to collect PM2.5 samples day and night in an urban area of central Taiwan. Higher PM2.5 mass concentrations were observed in winter (27.7 ± 9.7 μg/m3), followed by autumn (22.5 ± 8.3 μg/m3), spring (19.2 ± 6.4 μg/m3), and summer (11.0 ± 3.1 μg/m3). The dominant formation mechanism of secondary inorganic aerosols was heterogeneous reactions of NO3− at night and homogeneous reactions of SO42− during the day. Additionally, significant correlations were observed between aerosol liquid water content (ALWC) and NO3− during nighttime, indicating the importance of aqueous-phase NO3− formation. The role of aerosol acidity was explored and a unique alkaline condition was found in spring and summer, which showed lower PM2.5 concentrations than the neutralized condition. Under the neutralized condition, higher PM2.5 concentrations were commonly found when combining the ammonium-rich regime with molar ratios of [NO3−]/[SO42−] exceeding 1.6, suggesting the importance of reducing both NH3 and NOx. Furthermore, the results showed that reducing NH3 should be prioritized under high temperature conditions, while reducing NOx became important under low temperature conditions. Clustering of backward trajectories showed that long-range transport could enhance the formation of secondary aerosols, but local emissions emerged as the main factor driving high PM2.5 concentrations. This study provides insights for policymakers to improve air quality, suggesting that different mitigation strategies should be formulated based on meteorological variables and that using clean energy for vehicles and electricity generation is important to alleviate air pollution.

Structural design and surface networking analysis of a truss antenna based on hexagonal frustum deployable mechanism units

With the development of space technology, deployable mechanism has been widely applied in large aperture space antennas. In this paper, a hexagonal frustum deployable antenna unit and an innovative modular assembling concept are proposed for large parabolic truss antenna. Screw topology diagram and screw constraint matrix are established to solve degree of freedom (DOF) of the antenna mechanism. By separating column vectors of screw constraint matrix, whole actuations of antenna mechanism are obtained according to unique solution condition. A new hexagon antenna network method based on hexagon frustum units and rotation transformation matrix is proposed, and correctness and efficiency of the modeling principle are proved by simulation. Finally, a prototype of the proposed hexagonal frustum truss deployable antenna mechanism is constructed, and a deployment experiment is conducted, which demonstrate the mobility and deployment performance of the mechanism. The mechanism proposed in this paper provides a theoretical reference for the parabolic truss deployable antenna mechanism, which is potentially valuable in the application of large aperture deployable antennas.

Tailoring the spectro-temporal mode of photon pairs generated from interspatial-mode four-wave mixing.

We investigate the spectro-temporal mode property of the photon pairs generated via interspatial-mode spontaneous four-wave mixing (FWM) in a few-mode fiber (FMF) that supports two linearly polarized spatial modes in the 1550 nm telecom band. The two pulsed pumps for the process are in distinct spatial modes, while the created signal and idler photon pairs are also occupying different spatial modes. By exploiting the unique inter-mode phase matching condition in the FMF, we can tailor the spectro-temporal mode structure of the photon pairs by changing the pulse duration (spectral bandwidth) of the two pumps. Especially, photon pairs with a nearly round-shaped factorable joint spectrum are experimentally realized. The techniques are valuable for generating and manipulating quantum states in multi-mode waveguides and exploiting the spatial degree of freedom in quantum information processing.

How the Microbiota May Affect Celiac Disease and What We Can Do.

Celiac disease (CeD) is an autoimmune disease with a strong association with human leukocyte antigen (HLA), characterized by the production of specific autoantibodies and immune-mediated enterocyte killing. CeD is a unique autoimmune condition, as it is the only one in which the environmental trigger is known: gluten, a storage protein present in wheat, barley, and rye. How and when the loss of tolerance of the intestinal mucosa to gluten occurs is still unknown. This event, through the activation of adaptive immune responses, enhances epithelial cell death, increases the permeability of the epithelial barrier, and induces secretion of pro-inflammatory cytokines, resulting in the transition from genetic predisposition to the actual onset of the disease. While the role of gastrointestinal infections as a possible trigger has been considered on the basis of a possible mechanism of antigen mimicry, a more likely alternative mechanism appears to involve a complex disruption of the gastrointestinal microbiota ecosystem triggered by infections, rather than the specific effect of a single pathogen on intestinal mucosal homeostasis. Several lines of evidence show the existence of intestinal dysbiosis that precedes the onset of CeD in genetically at-risk subjects, characterized by the loss of protective bacterial elements that both epigenetically and functionally can influence the response of the intestinal epithelium leading to the loss of gluten tolerance. We have conducted a literature review in order to summarize the current knowledge about the complex and in part still unraveled dysbiosis that precedes and accompanies CeD and present some exciting new data on how this dysbiosis might be prevented and/or counteracted. The literature search was conducted on PubMed.gov in the time frame 2010 to March 2024 utilizing the terms "celiac disease and microbiota", "celiac disease and microbiome", and "celiac disease and probiotics" and restricting the search to the following article types: Clinical Trials, Meta-Analysis, Review, and Systematic Review. A total of 364 papers were identified and reviewed. The main conclusions of this review can be outlined as follows: (1) quantitative and qualitative changes in gut microbiota have been clearly documented in CeD patients; (2) intestinal microbiota's extensive and variable interactions with enterocytes, viral and bacterial pathogens and even gluten combine to impact the inflammatory immune response to gluten and the loss of gluten tolerance, ultimately affecting the pathogenesis, progression, and clinical expression of CeD; (3) gluten-free diet fails to restore the eubiosis of the digestive tract in CeD patients, and also negatively affects microbial homeostasis; (4) new tools allowing targeted microbiota therapy, such as the use of probiotics (a good example being precision probiotics like the novel strain of B. vulgatus (20220303-A2) begin to show exciting potential applications.

Using respiratory challenges to modulate CSF movement across different physiological pathways: An fMRI study

Abstract With growing evidence signifying the impact of cerebrospinal fluid (CSF) flow in facilitating waste clearance from the brain and potential pathophysiological links to neurodegenerative disorders, it is of vital importance to develop effective methods to modulate CSF flow in the brain. Here, we attempt this by means of simple commonly used respiratory challenges—paced breathing and breath holding. Functional Magnetic Resonance Imaging scans of the brain and neck respectively were used to record the craniad and caudad CSF movements at the fourth ventricle from eight healthy volunteers during paced breathing and breath holding. Further, we utilized a novel approach for the first time to combine these separately acquired unidirectional CSF movement signals to compare the CSF flow in both directions (in the fourth ventricle) with the respiratory stimuli as a physiological control. Our results demonstrate that these respiratory challenges enhance the magnitude as well as control the direction of CSF movement in the fourth ventricle. They also reveal the capability of blood CO2 concentration changes (induced by respiratory challenges) in the low-frequency range to bring about these CSF movement modulations. Finally, we also successfully report our novel approach where we use these breathing challenges as a unique control condition to detect the small net CSF flows from independently captured unidirectional signals.

Variations of the shock and secondary flow structure in a transonic compressor cascade with outlet back pressure

The effects of back pressure on the transonic cascade operating state are crucial and can determine the structure of internal shock waves and secondary flows. In this paper, numerical methods validated by experiments were employed to investigate the evolution mechanisms of the inlet flow field, shock structure, secondary flow structure, and cascade performance under different back pressures. Analysis revealed that transonic cascade exhibited unique incidence characteristics in the inlet flow field under both subsonic and supersonic regimes, although these two regimes involved different physical mechanisms. The results revealed that the operating state of the transonic compressor cascade under the unique incidence condition was influenced by the outlet back pressure, and there existed a critical static pressure ratio. The critical static pressure ratio shifted from 1.61 for two-dimensional flow to 1.37 for three-dimensional (3D) flow at M1 = 1.1, due to the corner separation and the characteristics of 3D shocks. The 3D shock structure exhibited a non-uniform distribution along the spanwise direction due to the influence of back pressure and the separated boundary layer. The vortex structures analysis revealed that the secondary flow structure on the sidewalls of the transonic compressor cascade was primarily dominated by corner vortices, whose formation mechanism was related to the interaction between the shock wave and the sidewall boundary layer. Additionally, this interaction also led to the formation of detached shock and lip shock vortex structures. Finally, loss analysis indicated that the wake region of the transonic cascade primarily includes six types of loss, and the total loss of the cascade decreased with the rise in back pressure.

MILD combustion stabilization issues through the analysis of hysteresis behaviors: The case of new energy carriers

MILD combustion processes are renewed to reveal a strong resilience to extinction phenomena and/or instabilities, whereas the oxidation process is stabilized trough ignition phenomena. Under MILD conditions, igni-diffusive and/or perfectly mixed kernels, forming during the mixing process between hot products and fresh reactants, are so much diluted and pre-heated to escape classical feed-back flammable flames stabilization mechanisms, while ignition and extinction events merge in a unique condition through “anhysteretic” behaviors. So far, considering methane as reference fuel, it has been largely demonstrated the mentioned “anhysteretic” condition is very conservative and defines a sub-domain of MILD combustion processes, following Cavaliere and de Joannon's definition. Furthermore, the coincidence of ignition and extinction phenomena can occur also preserving hysteresis phenomena. In turns, this condition strongly enlarges the stabilization domain of MILD combustion processes, starting from the upper branch of the hysteresis behaviors to the real extinction, with characteristic unstable loci to consider as further/last opportunity to promote stable operative conditions through the formation of local thermo-kinetic conditions in the combustion chamber during hot products/fresh reactants mixing process (injection configuration/burner design), or by forced ignition events. The hysteresis behaviors of renewable/alternative fuels, relevant within the decarbonization policies of several energy sectors, are thoroughly discussed under MILD conditions through numerical studies in model reactors in order to shed light on common and/or different features, and outline practical rules towards the definition of stable MILD combustion domains. Results show that, as MILD combustion is a chemical kinetics-driven processes, stability issues have to be discussed in relation to fuel nature, albeit with common behavior can be derived. The coincidence between extinction/ignition phenomena is reached for extremely diluted conditions, already ascribable to MILD combustion conditions, thus defining a small sub-domain of the process. This condition can be reached through “hysteretic” or “anhysteretic” behaviors.

A novel fiber Bragg grating-based smart clamp with macro strain measurement: design, modeling, and application to incipient looseness detection

Ensuring the safety and optimal performance of hydraulic pipelines, particularly in aircraft, is of paramount importance. The challenge of detecting incipient looseness in fasteners within a time-varying temperature environment has garnered widespread recognition, making it a focal point in the field of structural health monitoring. In this study, we propose an innovative solution—a smart clamp based on Fiber Bragg Grating (FBG). This clamp aims to detect incipient looseness in hydraulic pipe systems by measuring its macro strain. Notable advantages include its ability to avoid the chirping of the FBG, the ease of building a distributed sensing network, especially for the blind-hole connected structure, and its applicability for monitoring clamps connected with small-diameter bolt. The analytical model of the clamp under the preload of the connected bolt, along with the unique condition for the measurement, is provided. Demonstrating a force resolution [Formula: see text], the clamp exhibits a strong capability in detecting incipient looseness. Furthermore, environmental temperature interference is mitigated by configuring two FBGs. Conducting application experiments in a hydraulic system, the results indicate that the proposed clamp can effectively detect the loosening and tightening processes in real time, even under the time-varying temperature environment.

Treatment Case Studies in the Consolidation and Adhesion of Cellulose Nitrate

ABSTRACT Cellulose nitrate artifacts from the collections of the Queen’s University Master of Art Conservation Program and Glanmore National Historic Site were examined and treated by graduate students in the Master of Art Conservation Program at Queen’s. Each object was in a varied state of degradation with unique condition problems. Under the supervision of the artifacts conservation professor, graduate students identified the materials constituting their objects and tested various treatment methods for consolidation and structural repair. Paraloid® B-67 in n-butanol and Aquazol® resins in isopropanol and distilled water were found to be effective in different roles, depending on the object and its state of degradation. This paper will discuss the factors that influenced decision-making for each object, with the aim of expanding interventive treatment strategies for cellulose nitrate objects.

A Novel Surgical Treatment Management Algorithm for Elbow Posterolateral Rotatory Instability (PLRI) Based on the Common Extensor Origin Integrity.

Background: Here, we introduce a comprehensive treatment algorithm for posterolateral rotatory instability (PLRI) of the elbow, a condition affecting elbow mobility. We outline a diagnostic approach and a novel surgical management plan through the arthroscopic surgeon's point of view. Methods: The central focus of this management approach is the integrity of common extensor origin (CEO). High clinical suspicion must be evident to diagnose PLRI. Special clinical and imaging tests can confirm PLRI but sometimes the final confirmation is established during the arthroscopic treatment. The most appropriate treatment is determined by the degree of CEO integrity. Results: The treatment strategy varies with the CEO's condition: intact or minor tears require arthroscopic lateral collateral ligament imbrication, while extensive tears may need plication reinforced with imbrication or, in cases of retraction, a triceps tendon autograft reconstruction of the lateral ulnar collateral ligament alongside CEO repair. These approaches aim to manage residual instability and are complemented using a tailored rehabilitation protocol to optimize functional outcomes. Conclusion: PLRI is a unique clinical condition and should be treated likewise. This algorithm offers valuable insights for diagnosing and treating PLRI, enhancing therapeutic decision-making.

Withania somnifera showed neuroprotective effect and increased longevity in Drosophila Alzheimer’s disease model

Alzheimer’s disease is a unique neurodegenerative condition in humans that is characterized by amyloid beta accumulation in the brain parenchyma. Withania somnifera, commonly known as Ashwagandha, is a plant that has been used for centuries in Indian Ayurvedic medicine to treat various health conditions. The active compound in Ashwagandha has shown to be beneficial in treating several neurodegenerative diseases, including Alzheimer's disease (AD). This study used a Drosophila melanogaster AD model to investigate the effect of Ashwagandha in reducing amyloid beta toxicity and promoting longevity. The findings showed that 20 mg/mL of Ashwagandha root powder effectively rescued the "rough eye phenotype" in AD Drosophila and increased longevity in both AD model and wild-type Drosophila. Overall, the results suggest that Ashwagandha may have potent therapeutic potential for treating AD and maintaining cellular well-being.

Parkinson's Disease Psychosis and the Marketing of Pimavanserin.

In 2016, Nuplazid (pimavanserin) became the first FDA-approved treatment for Parkinson's Disease Psychosis (PDP). We explored the possibility that PDP was a term created to market Nuplazid. We examined trends in perceptions of psychosis in Parkinson's disease from the 1990s to 2020 through MEDLINE search term frequency, neurology textbooks, guidance from professional societies, Acadia annual reports, sponsored websites, and a sponsored meeting held by the National Institutes of Health (NIH). We analyzed continuing medical education (CME) activities on PDP and analyzed the connection between payments by the manufacturer of pimavanserin and prescriptions. Our analysis of nine sponsored CME activities reveals misleading themes, including: PDP is common, progressive, and not always drug-induced; there is no such thing as a benign hallucination, and psychotic symptoms always worsen; PDP increases mortality; and competing treatments are ineffective or dangerous while pimavanserin is safe and effective for treating PDP. Industry-sponsored CME was used to disseminate inaccurate and misleading marketing messages on psychosis related to Parkinson's disease. Some professional societies and some textbooks also resisted the PDP label. Reframing PDP as a unique condition is a typical example of condition branding. The establishment of PDP expanded the use of pimavanserin and is likely to have resulted in many avoidable deaths.

Indications for Nonbiological Reconstruction of Posttraumatic Bone Defects About the Knee.

3D printing and modeling has continued to grow in popularity over the past decade because the technology has matured and become more affordable and widely available. The main indications for nonbiological reconstruction of large bone defects are principally those patients where the candidate is unlikely to be successful if reconstructed by other means. Bespoke, custom, patient-specific implants can be designed to very effectively address bone loss, incorporating design elements that are particular to the needs of any given unique clinical condition. These implants are generally designed as titanium scaffolds that encourage bony incorporation at the host implant junction both proximal and distal. These scaffolds are typically considered a cellular solid, with high porosity that also promotes bone ingrowth directly into the substance of the body of the implant. Titanium scaffolds of this type have become a useful treatment alternative for large segmental bone defects around the knee, especially distal femoral defects. These are often adult patients with local or systemic compromise, or instead they may be too young to be considered candidates for reconstruction using a megaprosthesis. The process requires careful evaluation of individual patients, then matching that patient with the best treatment option, while recognizing the expectations and demands specific to that particular patient. Several cases are presented here to illustrate the variety of indications that can be successfully addressed with this technology, highlighting the quality of the clinical outcome that can be achieved despite the complexity of the pathology encountered.

Dorsal Wrist Impingement Syndrome Pain After Ganglion Cyst Removal

A ganglion cyst is a benign fluid-filled sac that typically appears on the dorsal aspect of the wrist, arising idiopathically near the joint capsule or tendon sheath. Diagnosis is primarily clinical, with MRI and ultrasound serving as confirmation tools. Treatment options range from immobilization, aspiration, hydrossection, steroid or hyaluronidase injection, to surgical intervention. Although relatively uncommon, Dorsal Ganglion Cysts (DGC) can lead to Dorsal Wrist Impingement (DWI) syndrome. This syndrome results from the thickening of the wrist capsule due to overuse, injury, or repetitive activities. This thickening can lead to the compression of the extensor carpi radialis brevis (ECRB) tendon during wrist extension and produce tenderness around the lunate. In some refractory cases, MRI findings may show recurrent ganglion cysts, while in others, they may appear "normal." Consequently, the diagnosis remains clinical, and imaging is primarily employed to rule out secondary causes. Management strategies encompass rest, immobilization, occupational therapy, non-steroidal anti-inflammatory drugs (NSAIDs), cortisone injections, and, in certain instances, surgical intervention. Despite the clinical significance of these conditions, limited studies have explored their interrelationship. In this context, we present a rare case involving a 23-year-old female with recurrent DGC accompanied by DWI syndrome. Initially, the patient reported idiopathic left dorsal wrist pain localized around the tendon sheath. Her initial X-ray did not reveal any abnormalities, but MRI identified two ganglion cysts. A series of treatments were initiated, including left tendon sheath hydrossection, corticosteroid injections into the left wrist, and the excision of ganglion cysts from the left wrist. Furthermore, occupational therapy, oral Meloxicam, and Voltaren gel treatments were integrated into the management plan. Subsequent imaging confirmed the resolution of the cysts and an overall enhancement in the range of motion and wrist strength. However, the patient experienced only minimal pain relief, and pain was still elicited during end-range wrist extension and upon dorsal wrist palpation. An electromyography (EMG) test ordered to rule out neuropathic causes did not yield any conclusive results. Nonetheless, a repeat X-ray revealed mild soft tissue swelling on the dorsal side of the wrist, and a follow-up MRI detected ganglion cysts on the dorsal aspect of the lunate and the ECRB tendons. These findings indicated a re-accumulation of dorsal ganglion cysts with a concurrent dorsal impingement syndrome component. Consequently, the patient was referred to an orthopedic surgeon for evaluation and potential revision surgery. This unique case underscores the possibility of developing DWI Syndrome after the removal of a DGC. The diagnosis of this syndrome can be elusive, particularly when X-rays, MRIs, and EMGs yield negative results. Trauma, such as repeated hand surgery or recurrent ganglion cysts, may exacerbate wrist pain despite improvements in range of motion and strength. Special consideration should be given to patients who undergo surgical cyst excisions, as this procedure heightens the risk of recurrence and can irritate the tendon sheath. Collaborative efforts between Physical Medicine and Rehabilitation (PM&R), Occupational Therapy (OT), and surgical teams may play a pivotal role in managing pain associated with these conditions. We propose that future research endeavors should focus on establishing guidelines for the management of this unique condition.

Postpartum and interpregnancy care of women with a history of hypertensive disorders of pregnancy.

Hypertensive disorders of pregnancy (HDP) are common complications associated with maternal and neonatal morbidity and mortality worldwide. Insights gained from long-term cohort studies have revealed that women with a history of HDP are predisposed to recurrent HDP in subsequent pregnancies and face heightened risks for cardiovascular and metabolic diseases later in life. Pregnancy is a unique condition that overloads maternal cardiac and metabolic functions, and is recognized as a "maternal stress test" for future cardiovascular and metabolic diseases. Pregnancy and postpartum period provide a valuable opportunity for identifying women with underlying and unrecognized cardiovascular and metabolic risk factors. Establishing an effective postpartum healthcare program for women who have experienced HDP is crucial in reducing the future risk of health complications. Postpartum care consists of supportive care for both mothers and children, including not only the assessment of physical and psychological well-being but also long-term postpartum preventive health management. Interpregnancy care is a continuum from postpartum care and includes supportive care to prepare for future pregnancies. Various initiatives across nations have been initiated to establish follow-up programs for women with a history of HDP; however, sufficient evidence of the impact of such programs is not available. Substantial challenges persist in establishing an efficient postpartum follow-up program, including educational strategies, selection of effective lifestyle interventions, and collaboration among various healthcare providers. This review outlines the postpartum and interpregnancy care of women who have experienced HDP as well as the current status and challenges of related healthcare initiatives in Japan.

Spontaneous Coronary Artery Dissection with Cardiogenic Shock in the United States.

Spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic separation of the epicardial coronary artery walls that creates a false lumen. SCAD poses a difficult challenge in management, as decisions regarding revascularization and medical management seem to be tailored to the individual patient. We evaluated and compared outcomes based on cardiogenic shock in patients with SCAD utilizing Nationwide Readmissions Database (NRD) between January 1, 2016, to December 30, 2020. We utilized the NRD 2016-2019 to carry out this study. We evaluated demographics (e.g., age, gender), conventional risk factors, comorbidities present on the index admission, and in-hospital outcomes using their specific ICD-10-CM codes. The primary outcomes were In-hospital mortality and 30-day readmission, and the secondary outcome was to compare the complications in SCAD patient with cardiogenic shock (CS) compared to those without CS. We analyzed 2473 individuals with SCAD, 2199 of these individuals did not have cardiogenic shock whereas 274 of these individuals did have cardiogenic shock. When comparing SCAD with cardiogenic shock to SCAD without cardiogenic shock, there was a statistically significant increased odds ratio (OR) for death (propensity matched OR 24.93 (7.49-83.05), use of mechanical circulatory support (propensity matched OR 15.30 (6.87-34.04), ventricular tachycardia (propensity matched OR 4.45 (1.92-10.34), utilization of blood transfusions (propensity matched OR 3.82 (1.86-7.87), acute kidney injury (propensity matched OR 4.02 (1.45-11.13), need for mechanical ventilation (propensity matched OR 8.87 (3.53-22.31), and respiratory failure (propensity matched OR 4.95 (1.83-13.41)))))))). There was no statistically significant difference in 30-day readmission rates between the two groups. SCAD is a unique condition that can lead to many complications. In our analysis, we showed that SCAD associated with cardiogenic shock compared to SCAD not associated with cardiogenic shock results in greater odds of complications including death, use of mechanical circulatory support, need for blood transfusions, ventricular tachycardia, acute kidney injury, use of mechanical ventilation, and respiratory failure. SCAD with cardiogenic shock represents a significantly critical clinical scenario that requires a multi-disciplinary approach to prevent the many potential complications associated with this disease process.

Gambaran Gejala Berdasarkan Skrining Abbreviated Conners Rating Scale pada Pasien Attention Deficit Hyperactivity Disorder Anak di RSUD Abdoel Wahab Sjahranie

Gambaran Gejala Berdasarkan Skrining Abbreviated Conners Rating Scale pada Pasien Attention Deficit Hyperactivity Disorder Anak di RSUD Abdoel Wahab Sjahranie

Harlequin Ichthyosis – Genetic and Dermatological Challenges: A Case Report and Literature Review

Harlequin ichthyosis (HI) is an extremely rare and severe genetic skin disorder characterized by thick, diamond-shaped scales covering the body, often giving the appearance of a harlequin costume. This paper provides an overview of the genetic and dermatological aspects of HI, delving into its etiology, clinical manifestations, and management. The genetic underpinnings of HI involve mutations in the ABCA12 gene, leading to impaired skin barrier function and abnormal keratinization. Understanding the molecular basis of the disorder is crucial for accurate diagnosis and potential therapeutic interventions. Clinically, HI presents challenges related to skin integrity, thermoregulation, and potential complications, such as infections. The management of HI requires a multidisciplinary approach involving dermatologists, geneticists, and other healthcare professionals. Supportive care, including emollients, careful bathing, and prevention of infections, is essential to improve the quality of life for individuals affected by this condition. Despite its rarity and severity, advancements in medical research and genetic therapies offer hope for improved treatments and interventions. This paper aims to contribute to the collective understanding of HI, fostering ongoing research and compassionate care for those living with this unique and challenging dermatological condition. We presented a premature eutrophic harlequin baby, born at 32+ weeks of gestation via emergency C-section. A clinical diagnosis was established minutes after birth, based on the typical features of HI, from scaly skin, marked fissures, and limbs in flexion contractures to prominent eclabium and bilateral ectropion.

Enhanced quasi-static and dynamic tensile properties of stainless steel 316L produced by laser aided additive manufacturing in controlled argon environment

In this paper, laser aided additive manufacturing (LAAM) of stainless steel 316L (SS 316L) in a controlled argon environment was investigated. The controlled argon environment can significantly reduce the oxidation and fundamentally change the process conditions. It was found that after inhibiting oxidation, the surface of the deposited SS 316L showed remarkably high reflectance (71%) to laser radiation, which minimised heat accumulation. Subsequently, stable melt pool temperature and high cooling rate (4.1 × 104 K/s) were also observed. Furthermore, nano-sized oxides were found to be nucleated owing to excessively low internal oxygen content (220 ppm). The unique process condition resulted in enhanced strengthening effect due to cellular structure refinement and dispersed nano-sized oxides. Consequently, a desirable balance of high strength and ductility was achieved for the as-deposited materials under both quasi-static tension (strain rate 10−3 s−1, yield stress 560.0 MPa, ultimate tensile strength 717.2 MPa, and elongation 64.0%) and dynamic tension (strain rate 3150 s−1, maximum flow stress 1241 MPa, and elongation 37.5%).

Assessment of sensitivity of acoustic reflex decay test in diagnosis of patulous eustachian tube

Abstract Background It has long been believed that the patulous eustachian tube is a unique but uncommon condition, with an estimated incidence ranging from 0.3 to 6.6% in the general population. Hearing one’s own voice and breathing, or autophony and aerophony, are the most common symptoms of PET, along with frequent auditory fullness. Aim This study is to establish a standardized protocol for the audiological evaluation of patulous Eustachian tube using acoustic reflex decay test during different breathing tasks. Methods Between January 2022 and December 2022, the ENT department at Suez Canal University Hospitals undertook an observational case-control study. Fifty-two adult patients who present to the Suez Canal University ENT department with complaints of autophony, auditory fullness, or aerophony are diagnosed with patulous eustachian tube dysfunction through endoscopic examination of the tympanic membrane’s synchronized movement with respiration. Results The incidence rate of PET among adults was approximately 3 patients/1000 patients/year. The age of the whole studied group ranged from 20 to 60 years with mean ± SD of 37.4 ± 12.6 years. They included 23 males (44.2%) and 29 females (55.8%). The most common symptom among the studied group was aural fullness (46%), while the least common symptom was aerophony (12%); the most common risk factor among the studied patients was allergy (46.2%), while the least common was radiotherapy (3.9%); 66.7% of the patients with GERD were males, while 66.7% of the patients who lost weight were females; 58.3% of the patients with allergies were females, and also 60% of the patients with thin built were females. In the case group, there is a significant higher change of middle ear compliance in ipsilateral nostril breathing than the mouth breathing and nasal breathing. The sensitivity of the acoustic reflex decay test to diagnose PET with reference to the gold standard test is 88.5% (23/26*100), the specificity is 100% (26/26*100), and the positive predictive value is 100% (23/23*100). Conclusion The sensitivity of the acoustic reflex decay test to diagnose PET with reference to the gold standard test is high, and the specificity is very high with very good diagnostic accuracy.