We describe herein a patient who presented with painful ophthalmoplegia and was ultimately diagnosed via magnetic imaging resonance studies and successfully treated for Tolosa-Hunt syndrome. Tolosa-Hunt syndrome is a ...We describe herein a patient who presented with painful ophthalmoplegia and was ultimately diagnosed via magnetic imaging resonance studies and successfully treated for Tolosa-Hunt syndrome. Tolosa-Hunt syndrome is a rare, reversible and painful ophthalmoplegia characterized by recurrent unilateral orbital pain, ipsilateral oculomotor paralysis and prompt response to steroids. Specific criteria for its diagnosis exist and are discussed herein. Individuals affected may display signs of select cranial nerve palsies, ptosis, facial numbness, diplopia, midrosis, and proptosis. Appropriate recognition of the disease can allow for immediate intervention and thus decrease the length and severity of symptoms especially as symptoms may not spontaneously resolve without treatment which leads to unnecessary suffering through pain, anxiety, and decreased vision. We describe the case presentation and keys for diagnosis emergency medicine that physicians should know for this potentially devastating condition.展开更多
Numerous studies have been undertaken to improve the viability, durability and suitability of materials and methods used for aquaculture enclosures. While many of the previous studies considered macro-deformation of n...Numerous studies have been undertaken to improve the viability, durability and suitability of materials and methods used for aquaculture enclosures. While many of the previous studies considered macro-deformation of nets, there is a paucity of information on netting micro-deformation. When aquaculture pens are towed, industry operators have observed the motion described as ＂baffling＂ – the transverse oscillation of the net planes parallel and near parallel to the flow. The difficulty to observe and assess baffling motion in a controlled experimental environment is to sufficiently reproduce netting boundary conditions and the flow environment experienced at sea. The focus of the present study was to develop and assess experimental methods for visualisation and quantification of these transverse oscillations. Four netrig configurations with varied boundary conditions and model-netting properties were tested in a flume tank. While the Reynolds number was not equivalent to full-scale, usage of the pliable and fine mesh model netting that enabled baffling to develop at low flow velocities was deemed to be of a larger relevance to this initial study. Baffling was observed in the testing frame that constrained the net sheet on the leading edge, similarly to a flag attachment onto a pole. Baffling motion increased the hydrodynamic drag of the net by 35%–58% when compared to the previously developed formula for taut net sheets aligned parallel to the flow. Furthermore, it was found that the drag due to baffling decreased with the increasing velocity over the studied Reynolds numbers（below 200）; and the drag coefficient was non-linear for Reynolds numbers below 120. It is hypothesised that baffling motion is initially propagated by vortex shedding of the netting twine which causes the netting to oscillate; there after the restoring force causes unstable pressure differences on each side of the netting which excites the amplitude of the netting oscillations.展开更多
Background:Antiretroviral therapy(ART)has reduced mortality among people living with HIV(PLWH)in China,but co-infections of hepatitis B virus(HBV)and hepatitis C virus(HCV)may individually or jointly reduce the effect...Background:Antiretroviral therapy(ART)has reduced mortality among people living with HIV(PLWH)in China,but co-infections of hepatitis B virus(HBV)and hepatitis C virus(HCV)may individually or jointly reduce the effect of ART.This study aimed to evaluate the impacts of HBV/HCV coinfections on treatment drop-out and mortality among PLWH on ART.Methods:A retrospective cohort study analysis of 58,239 people living with HIV(PLWH)who initiated antiretroviral therapy(ART)during 2010-2018 was conducted in Guangxi Province,China.Data were from the observational database of the National Free Antiretroviral Treatment Program.Cox proportional hazard models were fitted to evaluate the effects of baseline infection of HBV or HCV or both on death and treatment attrition among PLWH.Results:Our study showed high prevalence of HBV(11.5%),HCV(6.6%)and HBV-HCV(1.5%)co-infections.The overall mortality rate and treatment attrition rate was 2.95[95%confidence interval(CI):2.88-3.02]and 5.92(95%CI:5.82-6.01)per 100 person-years,respectively.Compared with HIV-only patients,HBV-co-infected patients had 42%higher mortality[adjusted hazard ratio(a HR)=1.42;95%CI 1.32-1.54],HCV-co-infected patients had 65%higher mortality(a HR=1.65;95%CI:1.47-1.86),and patients with both HCV and HBV co-infections had 123%higher mortality(a HR=2.23;95%CI:1.87-2.66).Conclusions:HBV and HCV coinfection may have an additive effect on increasing the risk of all-cause death among PLWH who are on ART.It is suggested that there is need for primary prevention and access to effective hepatitis treatment for PLWH.展开更多
文摘We describe herein a patient who presented with painful ophthalmoplegia and was ultimately diagnosed via magnetic imaging resonance studies and successfully treated for Tolosa-Hunt syndrome. Tolosa-Hunt syndrome is a rare, reversible and painful ophthalmoplegia characterized by recurrent unilateral orbital pain, ipsilateral oculomotor paralysis and prompt response to steroids. Specific criteria for its diagnosis exist and are discussed herein. Individuals affected may display signs of select cranial nerve palsies, ptosis, facial numbness, diplopia, midrosis, and proptosis. Appropriate recognition of the disease can allow for immediate intervention and thus decrease the length and severity of symptoms especially as symptoms may not spontaneously resolve without treatment which leads to unnecessary suffering through pain, anxiety, and decreased vision. We describe the case presentation and keys for diagnosis emergency medicine that physicians should know for this potentially devastating condition.
文摘Numerous studies have been undertaken to improve the viability, durability and suitability of materials and methods used for aquaculture enclosures. While many of the previous studies considered macro-deformation of nets, there is a paucity of information on netting micro-deformation. When aquaculture pens are towed, industry operators have observed the motion described as ＂baffling＂ – the transverse oscillation of the net planes parallel and near parallel to the flow. The difficulty to observe and assess baffling motion in a controlled experimental environment is to sufficiently reproduce netting boundary conditions and the flow environment experienced at sea. The focus of the present study was to develop and assess experimental methods for visualisation and quantification of these transverse oscillations. Four netrig configurations with varied boundary conditions and model-netting properties were tested in a flume tank. While the Reynolds number was not equivalent to full-scale, usage of the pliable and fine mesh model netting that enabled baffling to develop at low flow velocities was deemed to be of a larger relevance to this initial study. Baffling was observed in the testing frame that constrained the net sheet on the leading edge, similarly to a flag attachment onto a pole. Baffling motion increased the hydrodynamic drag of the net by 35%–58% when compared to the previously developed formula for taut net sheets aligned parallel to the flow. Furthermore, it was found that the drag due to baffling decreased with the increasing velocity over the studied Reynolds numbers（below 200）; and the drag coefficient was non-linear for Reynolds numbers below 120. It is hypothesised that baffling motion is initially propagated by vortex shedding of the netting twine which causes the netting to oscillate; there after the restoring force causes unstable pressure differences on each side of the netting which excites the amplitude of the netting oscillations.
基金This work was supported by National Natural Science Foundation of China[82160636,11971479,31871329]Guangxi Natural Science Foundation Project(Grants 2020GXNSFAA159020)+1 种基金Guangxi Key Laboratory of AIDS Prevention Control and Translation[ZZH2020010]Guangxi Bagui Honor Scholarship,and Chinese State Key Laboratory of Infectious Disease Prevention and Control.
文摘Background:Antiretroviral therapy(ART)has reduced mortality among people living with HIV(PLWH)in China,but co-infections of hepatitis B virus(HBV)and hepatitis C virus(HCV)may individually or jointly reduce the effect of ART.This study aimed to evaluate the impacts of HBV/HCV coinfections on treatment drop-out and mortality among PLWH on ART.Methods:A retrospective cohort study analysis of 58,239 people living with HIV(PLWH)who initiated antiretroviral therapy(ART)during 2010-2018 was conducted in Guangxi Province,China.Data were from the observational database of the National Free Antiretroviral Treatment Program.Cox proportional hazard models were fitted to evaluate the effects of baseline infection of HBV or HCV or both on death and treatment attrition among PLWH.Results:Our study showed high prevalence of HBV(11.5%),HCV(6.6%)and HBV-HCV(1.5%)co-infections.The overall mortality rate and treatment attrition rate was 2.95[95%confidence interval(CI):2.88-3.02]and 5.92(95%CI:5.82-6.01)per 100 person-years,respectively.Compared with HIV-only patients,HBV-co-infected patients had 42%higher mortality[adjusted hazard ratio(a HR)=1.42;95%CI 1.32-1.54],HCV-co-infected patients had 65%higher mortality(a HR=1.65;95%CI:1.47-1.86),and patients with both HCV and HBV co-infections had 123%higher mortality(a HR=2.23;95%CI:1.87-2.66).Conclusions:HBV and HCV coinfection may have an additive effect on increasing the risk of all-cause death among PLWH who are on ART.It is suggested that there is need for primary prevention and access to effective hepatitis treatment for PLWH.
