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McKenna McCracken posted an update 9 hours, 28 minutes ago
BACKGROUND Mechanisms underpinning ongoing symptoms in chronic whiplash associated-disorder (WAD) are not well understood. People with chronic WAD can exhibit sensory dysfunction consistent with small nerve fibre pathology, including thermal hypoaesthesia and hyperalgesia. This study investigated small fibre structure and function in chronic WAD. METHODS Twenty-four people with chronic WAD (median [IQR] age 49 [15] years, 16 females) and 24 pain-free controls (50 [17] years, 16 females) were recruited. Intraepidermal nerve fibre density (IENFD) and dermal innervation were assessed by skin biopsy. This was performed at (a) the lateral index finger on the primary side of pain and (b) superior to the lateral malleolus on the contralateral side. Quantitative sensory testing was performed over the hand. RESULTS The WAD group exhibited lower IENFD at the finger (WAD median [IQR] 4.5 [4.9] fibres/mm; control 7.3 [3.9]; p = .010), but not the ankle (WAD mean [SD] 7.3 [3.7] fibres/mm; control 9.3 [3.8]; p = .09). Dermal innervation was lower in the WAD group at the finger (WAD median [IQR] 3.7 [2.8] nerve bundles/mm2 ; controls 4.9 [2.1]; p = .017) but not the ankle (WAD median [IQR] 2.1 [1.9] nerve bundles/mm2 ; controls 1.8 [1.8]; p = .70). In the WAD group, hand thermal and light touch detection were impaired, and heat pain thresholds were lowered (p ≤ .037). CONCLUSIONS Findings suggest small fibre structural and functional deficits in chronic WAD, implicating potential involvement of small fibre pathology. SIGNIFICANCE Our study found decreased intraepidermal nerve fibre density, reduced dermal innervation, thermal hypoaesthesia and hypersensitivity in people with chronic WAD, suggestive of small fibre pathology. This observation of peripheral nervous system pathology in chronic whiplash provides novel insights on mechanisms underpinning symptoms and challenges commonly held beliefs regarding this condition. © 2020 European Pain Federation – EFIC®.Surgical ablation of atrial fibrillation (AF) in conjunction with other cardiac surgery is now a class I guideline recommendation. Multiple studies have demonstrated that the concomitant surgical ablation of AF can be performed safely and effectively during valve and coronary artery bypass grafting (CABG) resulting in a return to sinus rhythm postoperatively and improved long-term results. However, the surgical ablation of AF at the time of other cardiac surgery is performed less often than it should be, especially in patients undergoing CABG and aortic valve surgery. Randomized-controlled trials designed to determine the effect of treating AF concomitantly with other cardiac surgical procedures have lacked long-term follow up, but multiple, large observational studies have demonstrated an improved quality of life, a decrease in long-term strokes, and improved late survival in patients who undergo AF ablation. However, the potential survival benefit of concomitant AF ablation was not addressed by either the Society of Thoracic Surgery or American Association for Thoracic Surgery guideline committees. Left atrial appendage closure is an important part of the surgical ablation of AF as it significantly reduces the long-term risk of stroke following cardiac surgery and improves the success of AF treatment. In this study, we update the electrophysiology and surgical community on the recommended surgical techniques for AF ablation and its effect on perioperative morbidity, perioperative mortality, as well as its long-term effects on stroke, quality of life, and survival. © 2020 Wiley Periodicals, Inc.Electret filters are widely used in HVAC systems to decrease particulate matter in indoor environments. The previous standard in Europe for testing air filters for general ventilation was EN 779. In July 2018, it was replaced by the new international standard ISO 16890. One major change is the discharging process It is now performed by treating the filters with saturated isopropyl alcohol (IPA) vapor. The process is intended to simulate a worst-case scenario of the filtration efficiency due to the reduction of the electret effect. These minimal efficiencies are a principal part of the filter classification. Therefore, two round robin tests with different filter classes (F9 and F7 according to EN 779) and up to eleven participants were carried out to evaluate the new test method by comparing the filtration efficiencies and pressure drops before and after the IPA treatment. Pressure drop measurements showed no mechanical altering of the material due to the discharging process. The calculated filter classes had a maximum deviation of 5%. Even with different equipment, the results indicate that the new ISO 16890 seems to be a viable test standard and a decent replacement for previous national standards. © 2020 The Authors. Indoor Air published by John Wiley & Sons Ltd.Various cathode materials have been proposed for high performance rechargeable batteries. Genipin Vanadyl phosphate is a promising member of the polyanion cathode family. VOPO4 has seven known crystal polymorphs with tunneled or layered frameworks, which allow facile cation (de)intercalations. Two electrons transfer per formula unit can be realized using VV/VIV and VIV/VIII redox couples. The electrochemical performance is closely related to the structures of VOPO4 and types of inserted cations.This review outlines the crystal structures of VOPO4 polymorphs and their lithiated phases. The research progresses of vanadyl phosphate cathode materials for different energy storage systems, including lithium-ion batteries, sodium-ion batteries, potassium-ion batteries, multivalent batteries and supercapacitors, as well as the related mechanism investigations are summarized. We hope the review would help with further directions of using vanadyl phosphate materials for energy storage. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.OBJECTIVES To report on the clinical outcomes of one-piece mini dental implants (MDIs) retaining mandibular implant overdentures (IODs), including marginal bone-level alterations (ΔMBLs), clinical peri-implant parameters, and technical- and biological complications during a 5-year follow-up. The null hypothesis was that ΔMBLs would be equal in subjects older than 65 years relative to younger subjects. MATERIALS AND METHODS Four 1.8-mm diameter one-piece MDIs with ball attachments were placed in the interforaminal region of 20 edentulous subjects. The existing complete dentures were converted to IODs. Standardized radiographs of each implant were taken at implant placement (baseline) and during the five-year follow-up. ΔMBLs and potential influencing factors were evaluated, and peri-implant parameters, and biological and technical complications were recorded. RESULTS The implant and prosthetic survival rates were both 100%. IODs fractured in seven participants. The overall mean ΔMBL after 5 years was -1.18 mm (standard deviation 0.