The Evidence Is In: Breast Implants Are Making People Sick Increasingly women find when they have their implants removed, their symptoms improve—or disappear.

Over the years, breast implants have been associated with a wide range of health issues, including cancer and autoimmune diseases, but surprisingly these issues are not well known to the public. In 1992, health concerns led the FDA to halt the use of silicone gel breast implants for cosmetic surgeries, although implants containing saline remained available (it was during this period that the Oprah segment that Gmitro remembered ran on TV). In 2006, after more research, which some experts believe was insufficient, the FDA re-approved the use of silicone implants. In 2019, a novel “textured” breast implant manufactured by Allergan that was tied to an aggressive cancer, breast implant-associated anaplastic large cell lymphoma, was recalled. Still, some 300,000 people each year continue to receive traditional saline and silicone implants, either because they want to change how their breasts look or because they’ve had a mastectomy due to cancer. There’s been a simmering controversy, meanwhile, over a condition now known as breast implant illness that appears to be associated with all kinds of breast implants. The condition is associated with a range of symptoms including autoimmune disorders, brain fog, joint pain and harrowing fatigue. One leading theory about what causes breast implant illness is that the immune system rejects the breast implant as a foreign object, and over time the body’s immune response can intensify, causing a range of debilitating symptoms. Women have complained of these problems for decades, and mostly been dismissed. But in recent years, breast implant illness, though still not a formal diagnosis, has become more widely accepted, although the scope of how many people are impacted is still in dispute. And strikingly, multiple studies show that when women have their implants removed, in the majority of cases their symptoms immediately ease, sometimes dramatically. https://docs.google.com/document/d/17EtQp0oiUaeI4johj3soMe3xrWMv0VJsj5vJd4qIvdM/edit?tab=t.

Validation of FWD Testing Results at the Virginia Smart Road: Theoretically and by Instrument Responses

Falling weight deflectometer (FWD) is currently used by most highway agencies to determine the structural condition of the highway network. Utilizing the deflections measured by the FWD, the resilient moduli of layers in the flexible pavement is determined using backcalculation software packages. The moduli can be input into semi-empirical mechanistic equations to estimate the remaining life of the pavement system and aid in informing pavement engineers about timing of maintenance and rehabilitation needs. There have been concerns among practitioners and the research community about the adequacy of the resilient moduli determined by the backcalculation software. Some of the backcalculation models have been simplified and field verification may be needed. Field-measured stresses and strains may be used to quantify the reliability of the backcalculated moduli. The Virginia Smart Road, which has 12 different flexible pavement designs and was built and instrumented with pressure cells, strain gages, thermocouples, frost probes and moisture sensors. To validate the backcalculated moduli theoretically and through instrument response, this research was conducted with following objectives: 1) to determine the resilient moduli of the unbound granular materials on the Virginia Smart Road using small and large plates of the FWD; 2) to investigate the extent of spatial and temporal variability of the FWD deflections among pavement sections; 3) to develop a temperature correction model for the backcalculated HMA resilient moduli; 4) to define an appropriate backcalculation approach and compare the four widely used software approaches; and 5) to correlate backcalculated and laboratory measured moduli. In addition, the FWD measurements were used to establish a comparison between in-situ measured and computed stresses and strains in the pavement. The analytical approaches used are linear elastic, viscoelastic, and viscoelastic combined with nonlinearity. Results show that estimation of unbound granular materials moduli using surface deflections is more reliable when 457-mm-diameter loading plate is used. Analysis of deflections from different sensors showed evidence of spatial and temporal variability. The lowest coefficient of variation of deflections (7%) within sections occurred at low temperatures (2 to 6 °C), while the highest coefficient of variation (42%) occurred at temperatures between 35 to 40 °C. This resulted in the development of a deflection temperature correction model. The model was validated at different temperature ranges. A backcalculation procedure was defined to achieve good root mean square error using four selected software packages. This resulted in the selection of the most reliable software to perform moduli backcalculation. A correlation was established between the nonlinear models produced by backcalculation and laboratory testing of the granular 21-B material. However, for the HMA materials, difference in loading period between laboratory testing and FWD loading pulse could affect the results. The study found that when utilizing the backcalculated moduli, computed strains using viscoelastic modeling were comparable to in-situ measured values. Similarly, calculated stresses compared well with the field-measured stresses; especially at high temperatures. Mix properties, temperature of testing and loading were found to have an effect on the agreement between the measured and computed strains in the wearing surface. The study also recommended further validation of FWD measurements using embedded instruments to calibrate analytical models and further analysis of deflection data so that optimum number of testing points can be determined to limit amount of testing performed for determination of deflection variability.Ph. D

In-Situ Behavior of Geosynthetically Stabilized Flexible Pavement

The purpose of a geotextile separator beneath a granular base, or subbase in a flexible pavement system is to prevent the road aggregate and the underlying subgrade from intermixing. It has been hypothesized that in the absence of a geotextile, intermixing between base course aggregate and soft subgrade occurs. Nine heavily instrumented flexible pavement test sections were built in Bedford County Virginia to investigate the benefits of geosynthetic stabilization in flexible pavements. Three groups of different base course thicknesses (100, 150 and 200mm) test sections were constructed with either geotextile or geogrid stabilization or no stabilization. Woven geotextile was used in sections 2, 5 and 8. Geogrids were used in sections 3, 6 and 9, and sections 1, 4 and 7 were controls. Six Falling weight deflectometer (FWD) tests were performed on all the nine sections over 30 months. The nine sections were subjected to at least 5 load drops with wide loading range each time. The measured deflections were analyzed using the MODULUS back-calculation program to determine layer moduli. The measured deflections were used together with elastic, viscoelastic and the MODULUS program to determine the extent of intermixing at base-subgrade interface. The study concluded that a transition layer would develop when a separator is absent, especially in the weak sections (designed to fail in three years). Other measurements such as in-situ stresses, rut depth, and subsurface profiling (using ground penetrating radar) support the conclusion of the development of a transition layer.Master of Scienc

The Role of Ultrasound in Juvenile Idiopathic Arthritis: A Narrative Review From an Imaging Perspective

Objective: Musculoskeletal sonography (MSKS) is increasingly being used in the setting of juvenile idiopathic arthritis (JIA). The purpose of this narrative review was to describe the role of sonography in JIA and outline strategies for operators of pediatric MSKS. Methods: A literature review through multiple medical databases was conducted by restricting the search to medical subject headings (MeSH). Peer-reviewed English-language articles from 2007 to 2018 were included, which focused the on common sonographic findings of JIA. Results: Twenty-six articles were selected for inclusion in the study after a complete reading. Many studies aimed to address the validity of sonographic techniques in the assessment of JIA, but few studies discussed the specific sonographic appearances of JIA, scanning pitfalls, and appropriate imaging techniques. Conclusion: MSKS reveals subclinical manifestations of arthropathy, but the true value of detecting subclinical disease is not well understood. MSKS is limited in the evaluation of articular cartilage thinning and bony erosions. Responsiveness of MSKS in JIA remains to be formally assessed with higher quality studies. </jats:sec

Longitudinal Joint Data Collection Efforts in Virginia between 2005 and 2009

Premature deterioration of asphalt concrete at longitudinal joints has been a problem for many transportation agencies for years. The primary cause of this deterioration is the lack of in-place density. To address this issue, the Virginia Department of Transportation (VDOT) and the Virginia Asphalt Association (VAA) formed an alliance to seek a solution to the problem. Instead of developing a new specification for longitudinal joint density and potentially increasing construction costs, the alliance developed a communication and training plan focused on proper joint compaction. This plan included a joint construction memorandum and a field training program. During the implementation year (2005), data collection revealed improved density values at the joints. In subsequent years (2006 and 2007) the joint densities began to decline. Therefore VDOT and VAA emphasized adherence to proper joint construction during the 2009 paving season. Results collected through July 2009 indicated a significant improvement in joint densities. A substantial improvement was noted in the SM-12.5 surface mixes. Average differences of less than 2% between mat and joint densities for the 12.5-mm mixes were obtained. Statistical results from analysis of variance and F-tests also confirmed this trend. </jats:p