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The early abnormal pulmonary vasoreactivity observed in babies at risk of Bronchopulmonary dysplasia (BPD) increases the pulmonary vascular resistance. This can be assessed non-invasively using Time to Peak Velocity:Right Ventricular Ejection Time ratio (TPV:RVET) measured from pulmonary artery Doppler waveform obtained using echocardiogram. We postulate that screening for this early can predict BPD in this cohort. The objective of the study was to determine the utility of TPV:RVET in early prediction of BPD in Extremely Low Birth Weight (ELBW) babies born less than 1250grams Birth Weight.This was a single-center retrospective cohort study of ELBW babies born29 weeks over 4 year period who had echocardiogram between 7-21 days of life. TPV:RVET ratio was measured from pulmonary artery Doppler waveform obtained using echocardiogram. The main outcome was BPD at 36 weeks corrected gestation. The predictive ability of TPV:RVET (cut off 0.34) for subsequent development of BPD was analyzed using ROC.Of 589 ELBW29 weeks, 207 babies were eligible. BPD was found in 60.4%. The TPV:RVET at 0.34 had sensitivity 76.8% (95%CI 68.4-83.9), specificity 85.4% (95%CI 75.8-92.2), positive predictive value 88.9% (95%CI 81.4-94.1), negative predictive value 70.7% (95%CI 60.7-79), and ROC area 0.811 (95%CI 0.757-0.864). Odds ratio of having BPD for TPV:RVET at 0.34 was 19.9 (95%CI 8.19-48.34) and increased by 1.07 (95%CI 1.05-1.09) with every additional days of mechanical ventilation. TPV:RVET ratio had 92.75% inter-observer agreement with kappa 0.83.TPV:RVET ratio is a good and reliable early screening tool for subsequent development of BPD in ELBW babies with substantial inter-observer agreement.

To examine patient characteristics, hospital course, and medical outcomes of neonatal tracheostomy at a single center.Retrospective cohort study.Level III neonatal intensive care units (NICUs) in Edmonton, Canada.Infants admitted to NICU who underwent tracheostomy between January 2013 and December 2017 inclusive.Hospital course, discharge, and 3-year post-tracheostomy outcomes were compared between preterm infants29 weeks gestation and infants with congenital anomalies.Forty-three infants were identified; seven were lost to follow-up and excluded. Of the 36 analyzed, 86% survived to discharge. At discharge, 13% were decannulated, 36% required no mechanical ventilation, and 52% required mechanical ventilation. Median hospitalization was 295 days. At 3 years post-tracheostomy, 97% were alive. Proportions of infants with tracheostomy in situ was 80%, 73%, and 60% at 1, 2, and 3 years post tracheostomy. Tracheostomy incidence was 2.7% for preterm infants29 weeks gestational age with 55% for subglottic stenosis. All preterm infants received postnatal steroids. Preterm infants underwent tracheostomy at later chronological age (123 vs. 81 days, p 0.001), but similar corrected gestational age (42 + 5 vs. 51 + 2 weeks, p = 0.095). Preterm infants had more intubation attempts (17 vs. 4, p 0.001), total extubations (8 vs. 2, p 0.001), and days on ventilation before tracheostomy (100 vs. 78, p 0.001).Infants who underwent tracheostomy in a Canadian public healthcare setting demonstrated decreasing tracheostomy dependence and high survival post tracheostomy, despite prolonged hospitalization. Preterm infants had more intubation and extubation events which may have contributed to airway injury.

COVID-19 poses a major threat to global health and socioeconomic structures, and the need for a highly effective, antimicrobial face mask has been considered a major challenge for protection against respiratory diseases. Here, we report the development of a universal, antiviral, and antibacterial material that can be dip-/spray-coated over conventional mask fabrics to exhibit antimicrobial activities. Our data shows that antimicrobial fabrics rapidly inactivated multiple types of viruses, i.e., human (alpha/beta) coronaviruses, the influenza virus, and bacteria, irrespective of their modes of transmission (aerosol or droplet). This research provides an immediate method to contain infectious diseases, such as COVID-19.

The assessment of systemic blood flow is a complex and comprehensive process with clinical, laboratory, and technological components. Despite recent advancements in technology, there is no perfect bedside tool to quantify systemic blood flow in infants that can be used for clinical decision making. Each option has its own merits and limitations, and evidence on the reliability of these physiology-based assessment processes is evolving. This article provides an extensive review of the interpretation and limitations of methods to assess systemic blood flow in infants, highlighting the importance of a comprehensive and multimodal approach in this population.

Objective Prematurity and bronchopulmonary dysplasia (BPD) are associated with poorly understood abnormalities of ventricular function. We therefore comprehensively compared biventricular function in infants with and without BPD. Methods Prospective observational study in extremely preterm infants with (n = 20) and without (n = 38) BPD using conventional and advanced echocardiography at 28 days (T1) and near-term (T2). Results Infants with BPD had lower birth gestational age (26.7±1.9 vs 27.4±1.1 weeks, p = 0.047) and weight (884±207 vs 1108±190 g, p = 0.0001). BPD was associated with larger right ventricles (RV) and reduced RV systolic strain rate at T1 and pulmonary hypertensive indicators at T2 (pulmonary artery acceleration time BPD 51±17 vs no BPD 63±12 ms, p = 0.017). At T1/T2, infants with BPD had lower RV tissue Doppler velocities (e', a' and s) and higher E/e' ratios (T1: BPD 10.4±2.4 vs no BPD 6.2±3.1 cm/sec, p = 0.001; T2: BPD 8.0±3.1 vs no BPD 5.6±2.6 cm/sec, p = 0.02), altered LV diastolic function (apical circumferential T1 early diastolic strain rate BPD 2.8±0.8 vs no BPD 3.6±1.0 /sec, p = 0.04; T2 late diastolic strain rate, BPD 2.29 ± 0.99 vs no BPD 1.67±0.84 /sec, p = 0.03) and LV rotational mechanics (T1: twist rate BPD 90±16 vs no BPD 130±48 deg/sec, p = 0.008; untwist rate (UTR) BPD -69±90 vs no BPD -147±68 deg/sec, p = 0.008; torsion BPD 2.78±0.56 vs no BPD 4.48±1.74 deg/cm, p = 0.009; and T2: UTR BPD -132±69 vs no BPD -179±57 deg/sec, p = 0.013). Conclusion BPD is associated with altered RV diastolic function that persists near term, with elevated pulmonary vascular resistance, and with persistent alterations in LV apical strain rate and rotational mechanics.

IntroductionPatent ductus arteriosus (PDA) is the most common cardiovascular problem that develops in preterm infants and evidence regarding the best treatment approach is lacking. Currently available medical options to treat a PDA include indomethacin, ibuprofen or acetaminophen. Wide variation exists in PDA treatment practices across Canada. In view of this large practice variation across Canadian neonatal intensive care units (NICUs), we plan to conduct a comparative effectiveness study of the different pharmacotherapeutic agents used to treat the PDA in preterm infants.Methods and analysisA multicentre prospective observational comparative-effectiveness research study of extremely preterm infants born Standard dose ibuprofen (10 mg/kg followed by two doses of 5 mg/kg at 24 hours intervals) irrespective of postnatal age (oral/intravenous).Adjustable dose ibuprofen (oral/intravenous) (10 mg/kg followed by two doses of 5 mg/kg at 24 hours intervals if treated within the first 7 days after birth. Higher doses of ibuprofen up to 20 mg/kg followed by two doses of 10 mg/kg at 24 hours intervals if treated after the postnatal age cut-off for lower dose as per the local centre policy).Acetaminophen (oral/intravenous) (15 mg/kg every 6 hours) for 3–7 days.Intravenous indomethacin (0.1–0.3 mg/kg intravenous every 12–24 hours for a total of three doses).OutcomesThe primary outcome is failure of primary pharmacotherapy (defined as need for further medical and/or surgical/interventional treatment following an initial course of pharmacotherapy). The secondary outcomes include components of the primary outcome as well as clinical outcomes related to response to treatment or adverse effects of treatment.Sites and sample sizeThe study will be conducted in 22 NICUs across Canada with an anticipated enrollment of 1350 extremely preterm infants over 3 years.AnalysisTo examine the relative effectiveness of the four treatment strategies, the primary outcome will be compared pairwise between the treatment groups using χ2 test. Secondary outcomes will be compared pairwise between the treatment groups using χ2 test, Student’s t-test or Wilcoxon rank sum test as appropriate. To further examine differences in the primary and secondary outcomes between the four groups, multiple logistic or linear regression models will be applied for each outcome on the treatment groups, adjusted for potential confounders using generalised estimating equations to account for within-unit-clustering. As a sensitivity analysis, the difference in the primary and secondary outcomes between the treatment groups will also be examined using propensity score method with inverse probability weighting approach.Ethics and disseminationThe study has been approved by the IWK Research Ethics Board (#1025627) as well as the respective institutional review boards of the participating centres.Trial registration numberNCT04347720.

As COVID-19 exemplifies, respiratory diseases transmitted through aerosols or droplets are global threats to public health, and respiratory protection measures are essential first lines of infection prevention and control. However, common face masks are single use and can cause cross-infection due to the accumulated infectious pathogens. We developed salt-based formulations to coat membrane fibers to fabricate antimicrobial filters. Here, we report a mechanistic study on salt-induced pathogen inactivation. The salt recrystallization following aerosol exposure was characterized over time on sodium chloride (NaCl), potassium sulfate (K2SO4), and potassium chloride (KCl) powders and coatings, which revealed that NaCl and KCl start to recrystallize within 5 min and K2SO4 within 15 min. The inactivation kinetics observed for the H1N1 influenza virus and Klebsiella pneumoniae matched the salt recrystallization well, which was identified as the main destabilizing mechanism. Additionally, the salt-coated filters were prepared with different methods (with and without a vacuum process), which led to salt coatings with different morphologies for diverse applications. Finally, the salt-coated filters caused a loss of pathogen viability independent of transmission mode (aerosols or droplets), against both DI water and artificial saliva suspensions. Overall, these findings increase our understanding of the salt-recrystallization-based technology to develop highly versatile antimicrobial filters.

Primary Subject area Neonatal-Perinatal Medicine Background Stage III necrotizing enterocolitis (NEC-III) is a serious intestinal inflammatory disease in neonates, with high case fatality rate and significant morbidities including need for surgical intervention. Research focusing on risk factors for the development of NEC-III are lacking. Objectives To determine the risk factors for NEC-III and its outcomes among neonates born under 33 weeks gestational age (GA). Design/Methods This was a single-centre retrospective case-control study of preterm neonates born under 33 weeks GA who were admitted to Stollery Children’s Hospital neonatal intensive care unit (NICU), Edmonton, Alberta, between January 2015 and December 2018. NEC-III cases were compared with Stage II NEC (NEC-II) and matched with 2-4 non-NEC controls by GA ± 1 week and date of birth within 3 months. Univariate and multivariate analysis compared the risk factors for NEC-III, adjusting for GA, birth weight, and sex. Results Out of 1360 babies born There was a trend towards lower Apgar score Conclusion In this case-control study of neonates born under 33 weeks GA, after adjustment for known confounders, duration of UAC and prolonged rupture of membranes were significantly associated with increased incidence of NEC-III. Composite outcome of mortality or short bowel syndrome were higher in NEC-III.

Continuous Class F (CCF) power amplifiers (PAs) overcome Class-F PA's disadvantage of narrow bandwidth by relaxing the short-circuit requirement at the 2nd harmonic while still maintaining 90.7% peak efficiency over the band of interest. This paper proposes four different CCF output networks, with their design procedure, suitable for on-chip implementation in the 2.1-2.7GHz band. The output stage with 2nd harmonic trap and no RF choke is favoured due to its flat real impedance, low fundamental reactance, and compact layout. Using a 40nm CMOS process, a passive efficiency of 68% at 2.4GHz for this structure is in reach.

Respiratory protection is key in infection prevention of airborne diseases, as highlighted by the COVID-19 pandemic for instance. Conventional technologies have several drawbacks (i.e., cross-infection risk, filtration efficiency improvements limited by difficulty in breathing, and no safe reusability), which have yet to be addressed in a single device. Here, we report the development of a filter overcoming the major technical challenges of respiratory protective devices. Large-pore membranes, offering high breathability but low bacteria capture, were functionalized to have a uniform salt layer on the fibers. The salt-functionalized membranes achieved high filtration efficiency as opposed to the bare membrane, with differences of up to 48%, while maintaining high breathability (> 60% increase compared to commercial surgical masks even for the thickest salt filters tested). The salt-functionalized filters quickly killed Gram-positive and Gram-negative bacteria aerosols in vitro, with CFU reductions observed as early as within 5 min, and in vivo by causing structural damage due to salt recrystallization. The salt coatings retained the pathogen inactivation capability at harsh environmental conditions (37 °C and a relative humidity of 70%, 80% and 90%). Combination of these properties in one filter will lead to the production of an effective device, comprehensibly mitigating infection transmission globally.

A photoresponsive microstructured composite is fabricated through the impregnation of cellulosic filter paper (FP) with a spiropyran-modified acrylic polymer. The polymer enwraps uniformly each individual cellulose fiber, increases the thermal stability of cellulose, and ensures the preservation of the composite functionalities even upon removal of the surface layers through mechanical scratching. The photochromic spiropyran moieties of the polymer, even while embedded in the cellulosic sheet, can reversibly interconvert between the colorless spiropyran and the pink merocyanine isomeric states upon irradiation with UV and visible light, respectively. Moreover, the photochromic polymer presents a faster photochromic response and a higher resistance to photodegradation, with an outstanding reusability for more than 100 switching cycles when it is incorporated in the cellulose network. Most importantly, the acidochromism of the modified FP, attributed to the spiropyran molecules after UV activation, allows the real-time optical and visual detection of acidity changes and spoilage in food products, such as wine and milk. Spoilage due to bacterial degradation and oxidation processes generates acidic vapors that induce the protonation of the merocyanine. This results in a visually detectable chromic transition from pink to white of the treated cellulose fibers, corresponding to a blue shift in the absorption spectrum. The developed photoresponsive cellulose composite can serve as cost-effective robust optical component in integrated functional platforms and consumer-friendly indicators for smart food packaging, as well as portable on demand acidoresponsive interfaces for gas monitoring in industrial and environmental applications.

Background Pulmonary hypertension is a significant complication in extremely low gestational age newborns who develop bronchopulmonary dysplasia, and it is associated with significantly high morbidity and mortality. Commonly, the detection of this serious condition is made late during the hospitalization course of the premature infant. Early detection of at-risk group provides a valuable tool for disease control through close monitoring and timely intervention. Objectives To test the predictive ability of echocardiographic markers; pulmonary artery acceleration time to right ventricle ejection time ratio and eccentricity index for subsequent development of pulmonary hypertension in extreme premature infants. Methods This is a retrospective matched case control study of extreme premature infants Results The mean gestational age for both groups was 25.3 weeks. The mean age for early echocardiograms was 11.8 days ± 3.7. Mean pulmonary artery acceleration time ratio for both groups were 0.34 (95% CI 0.31-0.38) and 0.43 (95% CI 0.4-0.45), Odds ratio (OR) for 0.1 unit increase in the ratio was 0.33 (P value: 0.0015), area under the curve (AUC) was 0.73 (95% CI 0.61, 0.85). Mean eccentricity index for both groups were 1.24 (95% CI 1.14-1.35) and 1.06 (95% CI 1.01-1.11), OR for 0.1 unit increase in the index was 1.63 (P value: 0.002), AUC was 0.76 (95% CI 0.65, 0.88). A multi-variate analysis combining both parameters resulted in an AUC of 0.79 (95% CI 0.66, 0.91). Conclusion Pulmonary artery acceleration time to right ventricle ejection time ratio and eccentricity index could be useful screening tools for subsequent development of pulmonary hypertension in extreme premature infants. Combining both parameters seems to have better predictive value.

In this work, we studied the light induced self-assembly of F-actin and heavy meromyosin (HMM) in tubular vesicles or "tubularsomes" during initiation by ATP. To mimic nature, light-induced ATP synthesis was used for the F-actin/HMM self-assembly inside these vesicles created from a triblock copolymer reconstituted with the membrane protein bacteriorhodopsin (bR) and F1F0-ATPase along with F-actin and HMM in the core.

Introduction/Background BPD is a chronic lung disease that affects ELBW babies and contributes significantly to their morbidity and mortality. The early abnormal vasoreactivity observed in babies at risk of BPD increases the pulmonary vascular resistance and can be assessed non-invasively using Time to Peak Velocity: Right Ventricular Ejection Time ratio (TPV: RVET) that is calculated from pulmonary artery doppler waveform. We postulate that screening for this condition early may be useful to predict BPD in this cohort, which may provide prognostic information as well as early clinical management of the ELBW at risk of developing BPD and therefore can potentially present a window of opportunity for therapeutic intervention. Objectives 1. To determine utility of TPV/RVET ratio in predicting the risk for BPD in ELBW babies in a tertiary center. 2. To determine utility of TPV/RVET(c) ratio in predicting the risk for BPD in ELBW babies in a tertiary center. Design/Methods This is a retrospective cohort study of ELBW babies Results Out of 589 ELBW babies Conclusion TPV/RVET and its corrected ratio are good and reliable early screening tools for subsequent development of BPD in ELBW babies with substantial inter-observer agreement. Two variable model namely TPV/RVET

This chapter discusses the use of biopolymers/natural polymers in sustainable systems to solve current concerns over petroleum-based polymers. A comprehensive understanding and assessment of the current status of traditional biopolymers through the integration of various disciplines, such as engineering, biotechnology, chemistry, and biology, is expected to provide a systematic view on future research directions. Biopolymers have re-emerged into a new era of sustainable materials, and are expected to take an increasingly central role in the development of revolutionary applications. The competitive position of biopolymers can be achieved through technological progress to resolve multiple drawbacks related to materials developments, properties, and production costs.

A gas responsive hybrid membrane is fabricated by surface-grafting PDEAEMA on carbon nanotubes. The reversable surface wettabilites switch from hydrophobic to hydrophilic by the introduction of carbon dioxide and nitrogen gases. These can be utilized for oil/water and oil/water emulsion separations. The switchable characteristics of the CNT/PDEAEMA membrane can effectively prevent membrane clogging.

The transfer of bio-functionality from natural living organisms to stable engineered environments opens a wide horizon of applications. Our work focusses on the creation of materials and devices that transform bio traits and collect, process and act on the information in response to changes in their local environment, thus promoting additive manufacturing from 3D space to a four-dimensional, functional space. In this work we have expanded the set of tools enabling the incorporation of biological function as an intrinsic property in the devices we print with a new class of light curable bio nano ink. This novel approach allows the 3D printing of acrylic polymer compositions containing biological materials, especially, membrane proteins using a photo (407 nm) curing stereolithography (SLA)/digital light processing (DLP) 3D printer. Retaining the bio functionality of these proteins gives a fourth dimensional (4D) aspect to this construct. Herein, we report the 4D printing of a bio-inspired nano hybrid electrode for water-splitting applications using a polymeric resin with proton-pumping bacteriorhodopsin (bR), silver nanoparticles (Ag NP) and carbon nanotubes (CNT). These printed photo electrochemical cells exhibit high durability, low onset over potential, and upon light irradiation (535 nm) produces hydrogen by a synergistic effect of Ag NP and bR.

A building shall be classified as high performance building if it is energy efficient and durable and at the same time provides comfortable and healthy indoor environment for occupants. To achieve this objective, the hygrothermal performance of alternative building designs should be evaluated based on the simultaneous analysis of these three functional requirements rather than separately. In this article, a Whole-Building Hygrothermal model is used for evaluation of various retrofit design parameters that potentially enhance the overall performance of an existing residential house. The retrofit options considered in this study include changes to the reference house’s ventilation rate and operation, windows, insulation level, and various combinations of these options. Energy efficiency, building envelope and moisture management potential, indoor humidity control, and window condensation potentials are considered to be the four performance indicators in searching for a retrofit option that delivers an optimal performance. The hygrothermal simulation results indicate that changing a design parameter to improve one of the design goals may result in less optimal results in the other one or both goals, or even in some cases result in severe negative consequences.

There is a continuous dynamic heat, air and moisture (HAM) interaction between the indoor environment, building envelope and mechanical systems. In spite of these interdependences, the current indoor, building envelope and energy analysis tools are used independently. In this paper a holistic HAM model that integrates building envelope enclosures, indoor environment, HVAC systems, and indoor heat and moisture generation mechanisms, and solves simultaneously for the respective design parameters is developed. The model is benchmarked with internationally published test cases that require simultaneous prediction of indoor environmental conditions, building envelope moisture performance and energy efficiency of a building.

Most building materials are porous, composed of solid matrix and pores. The time varying indoor and outdoor climatic conditions result heat, air and moisture (HAM) transfer across building enclosures. In this paper, a transient model that solves the coupled heat, air and moisture transfer through multilayered porous media is developed and benchmarked using internationally published analytical, numerical and experimental test cases. The good agreements obtained with the respective test cases suggest that the model can be used to assess the hygrothermal performance of building envelope components as well as to simulate the dynamic moisture absorption and release of moisture buffering materials.

The moisture design of exterior walls in a building envelope is an important task that needs to be carried out systematically to generate a sustainable and healthy built environment. Many conventional methods or practice guidelines are available for this purpose, based primarily on local traditions and with limited performance assessment records. In recent years, with the rapid development of global free trade and economy, new wall systems and unconventional materials have been introduced in every part of the world for reasons such as aesthetic appeal, cost effectiveness and so on. However, neither the long-term moisture management performance of these new wall systems nor the uses of unconventional materials have been assessed in a systematic way. The primary reason for this lack of assessment is the absence of a design-oriented methodology to perform the task. This paper presents selected results from a recently completed research project that demonstrate that it is indeed possible to assess the moisture management performance of exterior walls in a systematic way, using a hygrothermal modeling tool together with key inputs from a limited number of laboratory and field investigations. In this project the hygrothermal responses of exterior walls and their components were assessed with a novel moisture response indicator, called the RHT index, which is derived from relative humidity and temperature data over a time period. The results and discussion presented in this paper clearly show the need and usefulness of the application of hygrothermal simulation tool for the optimum moisture design of exterior wall systems in various geographic locations, when sufficient information is available from laboratory and field experiments.

Several advanced non-destructive techniques are available to measure the evolution of content profiles with time, allowing the analysis of unsaturated flow and the determination of the moisture diffusivity of porous building materials. The reliability of six different techniques is investigated: the NMR-technique, the MRItechnique, the γ-ray attenuation technique, the capacitance method, the X-ray projection method and the TDR-technique. All of them were applied to measure the moisture content evolution during free uptake experiments on two building materials. Considering the limitations of some of the techniques, a good overall agreement is obtained. The work presented is an outcome of the EU-initiated HAMSTAD-project.

The precision of methods used for the determination of hygric properties of porous building materials was investigated. The study was performed in the framework of the EU-initiated HAMSTAD-project. Six laboratories measured the selected hygric properties of three porous building materials. While the most measured properties show acceptable agreement, yet, it was found that some of the existing standards or commonly accepted measurement methods need improvement. Most striking were large variations in the results of the vapour transmission tests performed in accordance to the existing European Standard.

Water absorption coefficient of a material governs the liquid moisture movement into it. In the case of various components of a building envelope, in particular exterior claddings, this is one of the most important hygrothermal material properties that needs to be assessed to determine the overall moisture management strategy. In different geographical locations, components of the building envelope, in particular the surface of the exterior cladding, are exposed to various temperature regimes. However, the effect of various temperature regimes on the water absorption coefficient of common building materials has not been adequately investigated. This study looks at the water absorption characteristic, determined through water absorption test, of three commonly used building materials (i.e., eastern white pine, red clay brick and concrete)at four temperature levels at the surface of the material, ranging from 3 to 35° C. A clear surface temperature effect on water absorption coefficient and derived liquid diffusivity value is shown in eastern white pine whereas changing the surface temperature shows no effect on the water absorption characteristic of red clay brick and concrete.

Background Comorbid anxiety disorders and depression are commonly seen in men with sexual disorders such as erectile dysfunction (ED) and premature ejaculation (PE). However, they are often undiagnosed and untreated, and their relationship to sexual dysfunction is complex. This study examines the frequency and correlates of comorbid anxiety and depression in men with ED or PE. Methods The case records of 64 men with ED or PE attending a clinic for psychosexual disorders in a general hospital psychiatry unit during the period 2010–14 were reviewed. Information on comorbid anxiety disorders and depression was extracted from these records, and their clinical and demographic associations were analyzed. Results Eight (12.5%) men had comorbid depressive disorders, and fifteen (23.4%) had anxiety disorders. These disorders predated the onset of sexual dysfunction in the majority of patients. Generalized anxiety disorder was the commonest anxiety disorder. Men with comorbid depression had significantly elevated rates of suicidal ideation or behavior related to their sexual dysfunction, and were more likely to report a lack of libido. Men with pre-existing anxiety disorders were more likely to experience performance anxiety related to sex, and to have PE without comorbid ED. Conclusions Depression and anxiety affect a substantial minority of men with sexual dysfunction. Men presenting for the evaluation of ED and PE should be carefully screened for these disorders. The links between anxiety disorders and sexual performance anxiety merit further investigation in this patient group.

Objective: Premature ejaculation is one of the most common forms of male sexual dysfunction. Recent clinical and genetic evidence suggests that it can be classified into 4 subtypes, which may have distinct clinical profiles. Psychological factors, such as anxiety, may play a specific role in the acquired subtype. The objective of this study was to assess the association between psychological factors, particularly anxiety and marital disharmony, and the various subtypes of premature ejaculation. Method: The case records of 28 men presenting with premature ejaculation to a clinic for psychosexual disorders in India between January 2012 and January 2013 were reviewed. The patients were classified into 4 subtypes (lifelong, acquired, natural variable, and premature-like ejaculatory dysfunction) and compared in terms of demographic and clinical profile. Results: Performance anxiety during intercourse was significantly associated with the acquired subtype of premature ejaculation (P = .011, Fisher exact test). Marital disharmony was equally common in the lifelong and acquired subtypes of premature ejaculation (P = not significant, Fisher exact test) and, in most cases, could be attributed to the distress caused by premature ejaculation itself. Discussion: Our results are consistent with existing literature that shows an association between anxiety and premature ejaculation, particularly the acquired subtype. Anxiety may play a causal or perpetuating role in these patients. If replicated, such a finding would have important therapeutic implications.

When computer models are used for predicting field performance of moist insulation products, we must learn how to quantify the variability in measured properties. This is an issue of adequate material characterization. A description by the EPS type is not sufficient. By using additional elements of material characterization such as specimen density, one improves the precision of measurements of physical properties. In the case of thermal properties, a second element of material characterization, namely the coefficient describing attenuation of thermal radiation in the material (specific extinction coefficient) is also needed. In effect, variation in thermal properties of EPS products is fully accounted for when defining only a few parameters such as bulk density, specific extinction coefficient, and thickness and temperature of the specimen.

When durability of EIFS-clad houses located in some coastal ar eas with high moisture exposure was questioned, the EIFS industry introduced new solutions. Most of the newly developed EIFS products are based on the prem ise that a weather resistant, continuous, exterior skin can be difficult to achieve, let alone maintain, during the service life of a building. These new systems have two identifiable features: (1) EIFS cladding and (2) a multifunctional second-line of de fense to contain and manage water that passed the cladding. Three subsystems and systems, namely, source drained (SD-EIFS), drained screen (DS-EIFS), and vented screen (VS-EIFS), rely on water drainage from the wall assembly. The fourth multifunctional EIFS is primarily based on the storage and drying capabilities of the wall assembly. Another prerequisite of a functional wall assembly is the presence of an air barrier. Experience indicates that only the redundant wall system with multiple defense mechanisms presents the opportunity for a durable and low-maintenance building envelope.

The Canadian approach to design accepts the presence of some con struction deficiencies and calls for a multiple-line of defense Until now, such a design has been based on the qualitative assessments rooted in experience, i.e., tradition, and involved little integration with the newly emerging analytical tools, e.g., advanced hygrothermal models. The relation between the design and climatic conditions acting on a building is not well established. Research should be undertaken to clarify the rela tionship between climate and the moisture performance of a given wall assembly, i.e., to enhance the predictability of moisture performance for different wall assemblies when constructed with some deficiencies and exposed to a given climate. To improve the correlation between climatic conditions and design practice, mois ture management of a building envelope must involve the flow-through principles. The flow-through approach is, however, much more difficult than the currently used approach with barriers. The flow-through approach requires performing computer calculations of moisture balance of all layers of the wall with regard to heat, air and moisture transport over an entire year. This is the critical element of the integrated moisture management strategy. Four papers are being written to facilitate the use of analytical tools into EIFS wall