BACKGROUND: Air-purifying, tight-fitting facepieces are examples of respiratory protective equipment and are worn to protect workers from potentially harmful particulate and vapors. Research shows that the presence of facial hair on users' face significantly reduces the efficacy of these devices. This article sets out to establish if an acceptable seal could be achieved between facial hair and the facepiece. The team also created and investigated a low-cost “pressure testing” method for assessing the efficacy of a seal to be used during the early design process for a facepiece designed to overcome the facial hair issue. METHODS: Nine new designs for face mask seals were prototyped as flat samples. A researcher developed a test rig, and a test protocol was used to evaluate the efficacy of the new seal designs against facial hair. Six of the seal designs were also tested using a version of the conventional fit test. The results were compared with those of the researcher-developed test to look for a correlation between the two test methods. RESULTS: None of the seals performed any better against facial hair than a typical, commercially available facepiece. The pressure testing method devised by the researchers performed well but was not as robust as the fit factor testing. CONCLUSION: The results show that sealing against facial hair is extremely problematic unless an excessive force is applied to the facepiece's seal area pushing it against the face. The means of pressure testing devised by the researchers could be seen as a low-cost technique to be used at the early stages of a the design process, before fit testing is viable.
Hair ; Masks ; Methods

On 31 March 2013, the National Health and Family Planning Commission, China notified the World Health Organization of three cases of human infection with avian influenza A(H7N9) from Shanghai and Anhui.1 By 8 May, 131 cases, including 26 deaths, had been notified from 11 provinces/municipalities.1,2 The majority (81%) of reported cases were from Shanghai municipality and Zhejiang and Jiangsu provinces. Available data indicate that more than three quarters of cases (59/77, 76%) had recent exposure to animals. Among these, 58% (34/59) had direct contact with chickens and 64% (38/59) visited a live bird market (LBM).3 Provincial and national authorities in China have collected more than 80 000 samples from LBMs, poultry slaughter houses, poultry farms, wild bird habitats, pig slaughter houses and their environments. As of 7 May, 50 samples were positive for avian influenza A(H7N9): 39 samples from poultry from LBMs in Anhui, Jiangsu, Jiangxi, Guangdong, Shanghai and Zhejiang provinces/municipalities (26 chickens, three ducks, four pigeons, six unknown) and 11 environmental samples from LBMs in Shanghai, Henan and Shandong provinces.4 None of the samples from poultry farms or pigs were positive

INTRODUCTIONThis review addresses the different prosthetic socket designs for trans-tibial amputees, the biomechanics behind the designs and the current state of the field. Of particular focus is the classic patella-tendon bearing (PTB) socket and the more recent sockets manufactured using pressure casting techniques and the theory, biomechanics and clinical implications of the two designs. Methods to examine and compare these designs are also addressed.

MATERIALS AND METHODSJournal papers by various investigators which have clinical significance/impact on the field of trans-tibial socket design were chosen for this review. Articles were chosen over a period of over 50 years to demonstrate the evolution of knowledge.

RESULTSThe engineering of the trans-tibial socket has been largely subjected to empirical derivations and biomechanical theory that remains, for the most part, unproven. The fundamental principles of the PTB socket have been widely refuted. Hydrostatic theory based on pressure casting techniques, on the other hand, provides an optimal scenario to produce a more uniform stump/socket interface pressure.

CONCLUSIONPreliminary studies indicate the pressure casting technique has the potential to produce comfortable sockets, providing an alternative to the PTB design. Various studies have been attempted to quantitatively compare the 2 types of socket designs. However, further quantitative biomechanical studies are needed to explain the fundamental theory surrounding the pressure cast technique. Methods that could help further understand the pressure cast concept include amputee gait analysis, stump/socket interface pressure measurements, computer aided socket design and finite element modelling techniques.

Amputation ; Amputees ; Artificial Limbs ; Biomechanical Phenomena ; Equipment Design ; Finite Element Analysis ; Humans ; Knee Joint ; surgery ; Patella ; Pressure ; Tibia ; surgery ; Tissue Engineering ; methods

To identify the 'physiatry' in a single word is difficult. This may be due that physiatry originated from two different fields, physical medicine and rehabilitation and focuses on assisting the general improvement of functional recovery in disabled patients. In addition, physiatry has new markets to develop; health and welfare. Therefore, the identity of physiatry will change depending on how physiatrists act in these fields. We attempt to define the physiatry from several aspects.
Humans ; Physical and Rehabilitation Medicine

Scimitar syndrome (SS) is a rare congenital anomaly characterized by hypoplasia of the right lung and partially anomalous pulmonary venous drainage to the inferior vena cava. The term scimitar derives from the shadow created by the anomalous pulmonary vein on chest X-ray that closely resembles that of a curved Turkish sword. It rarely presents as an isolated abnormality. Various cardiac and non-cardiac anomalies have been association with SS, such as right lung hypoplasia, dextroposition of the heart, hypoplasia of the right pulmonary artery, systemic arterial blood supply to the right lower lung from the infra-diaphragmatic aorta, and a secundum type of atrial septal defect. However, an imperforate anus has not been reported previously in association with SS. We describe the first case of infantile scimitar syndrome accompanied with an imperforate anus in a newborn who presented with tachypnea and right pulmonary atelectasis.
Anus, Imperforate ; Aorta ; Drainage ; Heart ; Heart Septal Defects, Atrial ; Humans ; Infant, Newborn ; Lung ; Pulmonary Artery ; Pulmonary Atelectasis ; Pulmonary Veins ; Scimitar Syndrome ; Tachypnea ; Thorax ; Vena Cava, Inferior

BACKGROUND: Although Tat plays a role as a potent transactivator in the viral gene expression from the Human Immunodeficiency Virus type 1 long terminal repeat (HIV-1 LTR), it does not function efficiently in rodent cells implying the absence of a human specific factor essential for Tat-medicated transactivation in rodent cells. In previous experiments, we demonstrated that one of chimeric forms of TAR (transacting responsive element) of HIV-1 LTR compensated the restriction in rodent cells. METHODS: To characterize the nature of the compensation, we tested the effects of several upstream binding factors of HIV-1 LTR by simple substitution, and also examined the role of the configuration of the upstream binding factor(s) indirectly by constructing spacing mutants that contained insertions between Sp1 and TATA box on Tat-mediated transactivation. RESULTS: Human Sp1 had no effect whereas its associated factors displayed differential effects in human and rodent cells. In addition, none of the spacing mutants tested overcame the restriction in rodent cells. Rather, when the secondary structure of the chimeric HIV-1 TAR construct was destroyed, the compensation in rodent cells was disappeared. Interestingly, the proper interaction between Sp1 and TATA box binding proteins, which is essential for Tat-dependent transcription, was dispensable in rodent cells. CONCLUSION: This result suggests that the human-specific Tat cofactor acts to allow Tat to interact effectively in a ribonucleoprotein complex that includes Tat, cellular factors, and TAR RNA, rather than be associated with the HIV-1 LTR upstream DNA binding factors.
Compensation and Redress ; DNA ; Genes, Viral ; HIV Long Terminal Repeat ; HIV* ; HIV-1* ; Humans* ; Ribonucleoproteins ; RNA ; Rodentia* ; TATA Box ; TATA-Box Binding Protein ; Terminal Repeat Sequences ; Trans-Activators ; Transcriptional Activation

BACKGROUND: Although Tat plays a role as a potent transactivator in the viral gene expression from the Human Immunodeficiency Virus type 1 long terminal repeat (HIV-1 LTR), it does not function efficiently in rodent cells implying the absence of a human specific factor essential for Tat-medicated transactivation in rodent cells. In previous experiments, we demonstrated that one of chimeric forms of TAR (transacting responsive element) of HIV-1 LTR compensated the restriction in rodent cells. METHODS: To characterize the nature of the compensation, we tested the effects of several upstream binding factors of HIV-1 LTR by simple substitution, and also examined the role of the configuration of the upstream binding factor(s) indirectly by constructing spacing mutants that contained insertions between Sp1 and TATA box on Tat-mediated transactivation. RESULTS: Human Sp1 had no effect whereas its associated factors displayed differential effects in human and rodent cells. In addition, none of the spacing mutants tested overcame the restriction in rodent cells. Rather, when the secondary structure of the chimeric HIV-1 TAR construct was destroyed, the compensation in rodent cells was disappeared. Interestingly, the proper interaction between Sp1 and TATA box binding proteins, which is essential for Tat-dependent transcription, was dispensable in rodent cells. CONCLUSION: This result suggests that the human-specific Tat cofactor acts to allow Tat to interact effectively in a ribonucleoprotein complex that includes Tat, cellular factors, and TAR RNA, rather than be associated with the HIV-1 LTR upstream DNA binding factors.
Compensation and Redress ; DNA ; Genes, Viral ; HIV Long Terminal Repeat ; HIV* ; HIV-1* ; Humans* ; Ribonucleoproteins ; RNA ; Rodentia* ; TATA Box ; TATA-Box Binding Protein ; Terminal Repeat Sequences ; Trans-Activators ; Transcriptional Activation

Aged ; Aortic Aneurysm ; diagnostic imaging ; etiology ; Aortic Valve Insufficiency ; diagnostic imaging ; Echocardiography ; Giant Cell Arteritis ; complications ; diagnostic imaging ; Humans ; Male

Purpose To promote the systematic development, interests, practice, research and clinical applications of health psychology in general hospitals in Hong Kong and the mainland of China.Data sources The targets and aims of therapeutic work with patients in pain, cancer patients, child and adolescent patients, patients with chronic illnesses, the elderly, and patients requiring organ transplantation are highlighted. Study selection The psychological interventions described are experiences derived from routine clinical services carried out in the Clinical Health Psychology Unit where the authors are affiliated, and can be seen as an example of a more comprehensive psychological intervention program for physically ill patients in Hong Kong.Results Psychological interventions have intrinsic values in reducing patients' distress and sufferings. The services are also an integral part of modern day comprehensive patient care with positive effects on treatment effectiveness and eventual illness outcome.Conclusions Physical illnesses affect a person physically as well as psychologically. Psychological care in general hospitals is cost effective and beneficial in reducing undue psychological complications precipitated by physical afflictions as well as in promoting better overall outcomes.