Asbestos — A hazard to the community

During a recent study of pulmonary fibrosis in one clinic area in Glasgow 21 proven cases of lung pathology associated with exposure to asbestos have come to light.

Difficulties in diagnosis may be due to “patient error” in that the patient may not remember that he had been in contact with asbestos, or know that he is exposed to asbestos in his current occupation — a joiner, for example, sawing up asbestos boards.

Examples are given of asbestosis or pleural tumours occurring many years after a short period of exposure to the dust.

Persons in innocent-looking occupations, such as joinery, may be in great danger from working near persons like laggers, who use asbestos. Especially in confined spaces on shipboard.

The importance is stressed of taking a very full occupational history, from the time the patient left school, where there is obscure pulmonary fibrosis.

The value of open lung biopsy is shown in diagnosing doubtful cases of early asbestosis.

The impression is gained that the incidence of asbestosis is increasing, and that it may come to assume great public health importance owing to the increased importation and more widespread use of asbestos.

The proposal to mix asbestos with tarmacadam for road use is viewed with concern.     

Characterization of hepatitis B virus infection and viral DNA integration in non-Hodgkin lymphoma

Hepatitis B virus (HBV) infection has been reported to be associated with non-Hodgkin lymphoma (NHL). However, the evidence is limited to the seroepidemiological study. There is a lack of evidence showing the HBV infection and integration in NHL cells. Here, we reported that in the Shanghai area, the positive rates of serum HBsAg (OR: 3.11; 95% CI: 2.20-4.41) and HBeAg (OR: 3.99; 95% CI: 1.73-9.91) were significantly higher in patients with NHL. HBsAg, HBcAg and HBV DNA were detected in 34.4%, 45.2% and 47.0% of the NHL tissues, respectively. Furthermore, by using a high-throughput viral integration detection approach (HIVID), integrated HBV DNA was identified from 50% (6/12) HBV-related NHL tissues. There were a total of 313 HBV integration sites isolated from the NHL tissues, among which four protein-coding genes (FAT2, SETX, ITGA10 and CD63) were interrupted by HBV DNA in their exons. Seven HBV preferential target genes (ANKS1B, HDAC4, EGFLAM, MAN1C1, XKR6, ZBTB38 and CCDC91) showed significantly altered expression levels in NHL, suggesting a potential role of these genes in NHL development. Taken together, HBV integration is a common phenomenon in NHL. This finding opens up a new direction of research into the mechanistic link between HBV infection and NHL.     

Cortico-thalamic dysconnection in early-stage schizophrenia: a functional connectivity magnetic resonance imaging study

European Archives of Psychiatry and Clinical Neuroscience - Studies have indicated thalamus-related network dysfunction in schizophrenia and psychotic disorders. However, whether thalamus-related...     

After-hours esophagectomy may pose additional risk to patients with esophageal cancer

BackgroundThe increase in the incidence of esophageal cancers (ECs) combined with fewer surgeons working at large centers will increase the likelihood of surgery for ECs being performed during later hours. This study aimed to compare esophagectomies’ operative outcomes for EC performed at different surgical starting times.MethodsThis was a single-center, retrospective study. Risk-adjusted cumulative sum curve analysis and Cox regression analysis were used to identify the potential change-point of surgical starting times. The participants were then divided into 2 groups according to the change-point time. Propensity score matching was used to control confounding factors between the 2 groups. We compared the short- and long-term outcomes in both groups.ResultsA total of 702 patients who underwent potentially radical esophagectomy from 7 May 2014 to 31 December 2017 in our institute were included. The 3-year all-cause mortality showed a significant change-point at 16:42, with an increment from 56.5% to 76.9% (P=0.043). Esophagectomy that commenced between 17:00–18:59 was associated with significantly lower overall survival (OS) [multivariate hazard ratio (HR): 2.47; 95% confidence interval (CI): 1.25 to 4.90; P=0.010] and disease-free survival (DFS) (multivariate HR: 2.14; 95% CI: 1.08 to 4.21; P=0.028). The participants were allocated to the during-hours group and the after-hours group according to the change-point of 17:00. A total of 84 participants in the during-hours group were matched to 33 participants in the after-hours group. The median operative time was shorter in the after-hours group [309 (during-hours) vs. 239 (after-hours) minutes, P=0.014); the after-hours group had a greater incidence of respiratory complications (22.63% vs. 45.45%, P=0.023) and 90-day mortality (0 vs. 9.09%, P=0.021). The 5-year OS (P=0.042) and DFS (P=0.030) were significantly higher in the during-hours group.ConclusionsEsophagectomies started during after-hours are correlated with poorer surgical outcomes. It is recommended to cancel selective esophagectomies due to commence after 17:00.     

Study on the Actuating Performance of an Embedded Macro Fiber Composite Considering the Shear Lag Effect

Macro fiber composite (MFC), which are new ultrathin piezoelectric smart materials, are mostly applied in the fields of shell structure deformation and vibration control. Among others, the application of embedded MFCs in sandwich structures has received wide attention. Currently, its actuating force formula is primarily acquired based on the Bernoulli–Euler Model, which does not consider the shear lag effect and actuating force of MFC ends. To study the actuating performance of an MFC in a sandwich structure, according to its action characteristics, the MFC is divided into upper and lower actuating units without any interaction between to two under the condition of plane strain, and the shear lag effect is considered between the units and the top and bottom of the sandwich structure. The actuating force of the MFC ends is obtained by considering its influence on the bending deformation of the sandwich structure, which deduces the actuating force formula of the embedded MFC. In contrast to ANSYS piezoelectric simulation, the distribution of the MFC interior normal stress is similar to the result from ANSYS piezoelectric simulation, and there is a very small deviation between the MFC end and central normal stress and the result from ANSYS piezoelectric simulation. Taking the end deflection of the sandwich structure with an embedded MFC as an example, the actuating force simulation of the MFC considering the shear lag effect is compared with the ANSYS piezoelectric simulation and actuating force simulation based on the Bernoulli–Euler model. The result indicates that the actuating force simulation of the MFC considering the shear lag effect is closer to the ANSYS piezoelectric simulation, which proves the rationality and necessity of considering the shear lag effect and end actuating force of the MFC.