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To determine the effect of applied power settings, coil wetness conditions, and e-liquid compositions on the coil heating temperature for e-cigarettes with a \"top-coil\" clearomizer, and to make associations of coil conditions with emission of toxic carbonyl compounds by combining results herein with the literature. The coil temperature of a second generation e-cigarette was measured at various applied power levels, coil conditions, and e-liquid compositions, including (1) measurements by thermocouple at three e-liquid fill levels (dry, wet-through-wick, and full-wet), three coil resistances (low, standard, and high), and four voltage settings (3-6 V) for multiple coils using propylene glycol (PG) as a test liquid; (2) measurements by thermocouple at additional degrees of coil wetness for a high resistance coil using PG; and (3) measurements by both thermocouple and infrared (IR) camera for high resistance coils using PG alone and a 1:1 (wt/wt) mixture of PG and glycerol (PG/GL). For single point thermocouple measurements with PG, coil temperatures ranged from 322 ‒ 1008°C, 145 ‒ 334°C, and 110 ‒ 185°C under dry, wet-through-wick, and full-wet conditions, respectively, for the total of 13 replaceable coil heads. For conditions measured with both a thermocouple and an IR camera, all thermocouple measurements were between the minimum and maximum across-coil IR camera measurements and equal to 74% ‒ 115% of the across-coil mean, depending on test conditions. The IR camera showed details of the non-uniform temperature distribution across heating coils. The large temperature variations under wet-through-wick conditions may explain the large variations in formaldehyde formation rate reported in the literature for such \"top-coil\" clearomizers. This study established a simple and straight-forward protocol to systematically measure e-cigarette coil heating temperature under dry, wet-through-wick, and full-wet conditions. In addition to applied power, the composition of e-liquid, and the devices' ability to efficiently deliver e-liquid to the heating coil are important product design factors effecting coil operating temperature. Precautionary temperature checks on e-cigarettes under manufacturer-recommended normal use conditions may help to reduce the health risks from exposure to toxic carbonyl emissions associated with coil overheating.

Results show that regional deposition varies widely along the depth of the lung regardless of the particle sizes used. Peak deposition was found in the lung regions situated between 150 and 200 ml from the mouth. Sites of peak deposition shifted proximally with a decrease in particle size. Deposition dose per unit surface area was largest in the proximal lung regions and decreased rapidly with an increase in lung depth. Peak surface dose was 5–7 times greater than the average lung dose. The results indicate that local enhancement of dose occurs in normal lungs, and such a dose enhancement may play an important role in the potential health effects of ultrafine aerosols.

A factor analytic model has been applied to resolve and apportion particles based on submicron particle size distributions downwind of a United States-Canada bridge in Buffalo, NY. The sites chosen for this study were located at gradually increasing distances downwind of the bridge complex. Seven independent factors were resolved, including four factors that were common to all of the five sites considered. The common factors were generally characterized by the existence of two or more number and surface area modes. The seven factors resolved were identified as follows: fresh tail-pipe diesel exhaust, local/street diesel traffic, aged/evolved diesel particles, spark-ignition gasoline emissions, background urban emissions, heavy-duty diesel agglomerates, and secondary/transported material. Submicron (>0.5 µm) and ultrafine (>0.1 µm) particle emissions downwind of the bridge were dominated by commercial diesel truck emissions. Thus, this study obtained size distinction between fresh versus aged vehicle exhaust and spark-ignition versus diesel emissions based on the measured high time-resolution particle number concentrations. Because this study mainly used particles <300 nm in diameter, some sources that would usually exhibit number modes >100 nm were not resolved. Also, the resolved profiles suggested that the major number mode for fresh tailpipe diesel exhaust might exist below the detection limit of the spectrometer used. The average particle number contributions from the resolved factors were highest closest to the bridge.

An aerosol bolus dispersion technique (ABDT) was developed for the detection of acute changes in the small airways. A NaCl aerosol bolus was used to broaden the experimental subject base possible, potentially including children. This ABDT system was developed to accommodate the hygroscopic properties of NaCl. It included a laser particle detector specifically designed for this study to count particles. A chamber test showed a flat response over a range of particle sizes, suggesting hygroscopic particle growth in the lungs does not substantially bias the detector's accuracy. The system demonstrated a level of reliability comparable to other small airway tests. The ABDT system was applied in a field study on Governors Island, N.Y., with U.S. Coast Guard personnel as subjects (ages 25 to 45 yrs old). There were significant small airway effects associated with time-weighted ozone exposure for 21 nonsmoking healthy males (23.7 $\\pm$ 0.6 min, n = 134) who jogged outdoors. Within the upper 50th percentile of exposures (19 to 61 ppb-hours) the ABDT measures of dispersion (i.e., half-width and variance) increased by 1.3%/ppb-hr and 0.8%/ppb-hr, respectively (p $<$ 0.05), whereas bolus deposition decreased by 1.1%/ppb-hr (p = 0.043). In comparison, spirometry indices were not strongly associated with ozone; only FEF$\\sb{(50)}$ was positively correlated (p = 0.033) with O$\\sb3$-exposure, and only when temperature was not in the model. However, only 87 cases were available to evaluate spirometry, and the lung function results may not be as representative as the ABDT results. Some of the results in this field application of the NaCl ABDT were unexpected. One possible explanation is that deposition decreased with exercise duration (p = 0.056), consistent with suggestive evidence from a previous report on small airway lung function (e.g., Keefe, et al., 1991). Overall, the extent of physiologic changes attributable to O$\\sb3$ by the NaCl ABDT was found to be comparable to those indicated by other small airway lung function tests. With further refinement of the system, characterization of hygroscopic particle growth, and controlled ozone chamber exposures, the NaCl ABDT could provide a useful tool for epidemiologic and clinical studies in the future.

Ultrafine particles (less than 0.10 μm in diameter) are ubiquitous in the atmosphere and possess unique physicochemical characteristics that may pose a potential health risk. To help elucidate the potential health risk, we measured respiratory dose of ultrafine particles (0.04, 0.06, 0.08 and 0.10 μm in diameter) in healthy young adults using a novel serial bolusdelivery method. Under normal breathing conditions (i.e. tidal volume of 500 ml and respiratory flow rate of 250 ml s−1), bolus aerosols were delivered sequentially to a lung depth ranging from 50–500 ml in 50 ml increments and deposition was measured for each of ten equal-volume compartments. Results show that regional deposition varies widely along the depth of the lung regardless of the particle sizes used. Peak deposition was found in the lung regions situated between 150 and 200 ml from the mouth. Sites of peak deposition shifted proximally with a decrease in particle size. Deposition dose per unit surface area was largest in the proximal lung regions and decreased rapidly with an increase in lung depth. Peak surface dose was 5–7 times greater than the average lung dose. The results indicate that local enhancement of dose occurs in normal lungs, and such a dose enhancement may play an important role in the potential health effects of ultrafine aerosols.

Consensus holds that pottery technology came to Central Europe from the Northern Balkans with independent pottery traditions existing concurrently in Eastern Europe. An unusual grass-tempered pottery dating back to around 5800 cal BC found in lake sediments at Santovka, Slovakia, predated the earliest known Neolithic pottery in the region (~ 5500 cal BC), suggesting unexplored narratives of pottery introduction. Analyses of the pottery’s technology, origin, and grass temper shedding light on ceramic traditions' spread can unveil mobility patterns and community lifestyles. Our findings indicate a non-local provenance, low temperature firing, Festuca sp. grass temper and unique rectangular or cylindrical vessel shapes which align with Eastern European hunter-gatherer practices. Moreover, the pottery style and technology have no analogies in the contemporary Danubian pottery traditions and have more similarities to those of the Eastern traditions. The pottery's raw materials likely originated from distant areas, indicating extensive territorial access for its creators. Our findings imply late Mesolithic hunter-gatherers as the probable artisans and with implications for the site's significance in the late Mesolithic landscape.

Drug-eluting stents with durable biocompatible or biodegradable polymers have been developed to address the risk of thrombosis associated with first-generation drug-eluting stents. We aimed to compare the safety and efficacy of a biodegradable polymer-coated biolimus-eluting stent with a thin-strut everolimus-eluting stent coated with a durable biocompatible polymer. This open-label, prospective, randomised, controlled, non-inferiority trial was undertaken at 12 sites across Europe. We used limited exclusion criteria (age >18 years, life expectancy >5 years, reference vessel diameter 2·0–4·0 mm) to enrol patients eligible for percutaneous coronary intervention. Patients were randomly allocated (2:1) by computer-generated random numbers to receive either a biodegradable polymer biolimus-eluting stent (Nobori, Terumo, Tokyo, Japan) or a durable fluoropolymer-based everolimus-eluting stent (Xience V or Prime, Abbott Vascular, Santa Clara, CA, USA, or Promus, Boston Scientific, Natick, MA, USA). The primary endpoint was a composite of safety (cardiac death and non-fatal myocardial infarction) and efficacy (clinically indicated target vessel revascularisation) at 12 months, analysed by intention to treat. Patients received dual antiplatelet therapy for 12 months after discharge. The trial is registered with ClinicalTrials.gov, number NCT01233453. From Jan 12, 2009, to Feb 7, 2011, we enrolled 2707 patients (4025 lesions), 1795 of whom were assigned to receive the biolimus-eluting stent (2638 lesions) and 912 to an everolimus-eluting stent (1387 lesions). 2688 (99·3%) patients completed 12 months' follow-up. Significantly more patients in the biolimus-eluting stent group received a non-assigned stent than did those in the everolimus-eluting stent group (105 [5·9%] vs 19 [2·1%]; p<0·0001). The primary endpoint occurred in 93 (5·2%) patients in the biolimus-eluting stent group and 44 (4·8%) patients in the everolimus-eluting stent group at 12 months (relative risk 1·07 [95% CI 0·75–1·52]; pnon-inferiority<0·0001). Analysis per protocol did not change the outcome of this trial (pnon-inferiority<0·0001). Biodegradable polymer biolimus-eluting stents are as safe and efficacious as the current standard of a thin-strut everolimus-eluting stent with a durable biocompatible polymer. We need to follow-up patients for longer to show whether the biolimus-eluting stent reduces the risk of stent thrombosis after 1 year when compared with the everolimus-eluting stent. Terumo Europe (Leuven, Belgium) and the Research Foundation of the Cardiology Department, Maasstad Hospital (Rotterdam, Netherlands).

IntroductionSince the first description of gain of function (GOF) mutations in signal transducer and activator of transcription (STAT) 1, more than 300 patients have been described with a broad clinical phenotype including infections and severe immune dysregulation. Whilst Jak inhibitors (JAKinibs) have demonstrated benefits in several reported cases, their indications, dosing, and monitoring remain to be established.MethodsA retrospective, multicenter study recruiting pediatric patients with STAT1 GOF under JAKinib treatment was performed and, when applicable, compared with the available reports from the literature.ResultsTen children (median age 8.5 years (3–18), receiving JAKinibs (ruxolitinib (n = 9) and baricitinib (n = 1)) with a median follow-up of 18 months (2–42) from 6 inborn errors of immunity (IEI) reference centers were included. Clinical profile and JAKinib indications in our series were similar to the previously published 14 pediatric patients. 9/10 (our cohort) and 14/14 patients (previous reports) showed partial or complete responses. The median immune deficiency and dysregulation activity scores were 15.99 (5.2–40) pre and 7.55 (3–14.1) under therapy (p = 0.0078). Infection, considered a likely adverse event of JAKinib therapy, was observed in 1/10 patients; JAKinibs were stopped in 3/10 children, due to hepatotoxicity, pre-HSCT, and absence of response.ConclusionsOur study supports the potentially beneficial use of JAKinibs in patients with STAT1 GOF, in line with previously published data. However, consensus regarding their indications and timing, dosing, treatment duration, and monitoring, as well as defining biomarkers to monitor clinical and immunological responses, remains to be determined, in form of international prospective multicenter studies using established IEI registries.

Background Studying surgical secondary events is an evolving effort with no current established system for database design, standard reporting, or definitions. Using the Clavien–Dindo classification as a guide, in 2001 we developed a Surgical Secondary Events database based on grade of event and required intervention to begin prospectively recording and analyzing all surgical secondary events (SSE). Methods Events are prospectively entered into the database by attending surgeons, house staff, and research staff. In 2008 we performed a blinded external audit of 1,498 operations that were randomly selected to examine the quality and reliability of the data. Results Of 4,284 operations, 1,498 were audited during the third quarter of 2008. Of these operations, 79 % ( N  = 1,180) did not have a secondary event while 21 % ( N  = 318) had an identified event; 91 % of operations (1,365) were correctly entered into the SSE database. Also 97 % (129 of 133) of missed secondary events were grades I and II. There were 3 grade III (2 %) and 1 grade IV (1 %) secondary event that were missed. There were no missed grade 5 secondary events. Conclusions Grade III–IV events are more accurately collected than grade I–II events. Robust and accurate secondary events data can be collected by clinicians and research staff, and these data can safely be used for quality improvement projects and research.