A new, biocompatible hyaluronic acid (HA)-silk hydrogel composite was fabricated and tested for use as a securable drug delivery vehicle. The composite consisted of a hydrogel formed by cross-linking thiol-modified HA with poly(ethylene glycol)-diacrylate, within which was embedded a reinforcing mat composed of electrospun silk fibroin protein. Both HA and silk are biocompatible, selectively degradable biomaterials with independently controllable material properties. Mechanical characterization showed the composite tensile strength as fabricated to be 4.43 ± 2.87 kPa, two orders of magnitude above estimated tensions found around potential target organs. In the presence of hyaluronidase (HAse) in vitro, the rate of gel degradation increased with enzyme concentration although the reinforcing silk mesh was not digested. Composite gels demonstrated the ability to store and sustainably deliver therapeutic agents. Time constants for in vitro release of selected representative antibacterial and anti-inflammatory drugs varied from 46.7 min for cortisone to 418 min for hydrocortisone. This biocomposite showed promising mechanical characteristics for direct fastening to tissue and organs, as well as controllable degradation properties suitable for storage and release of therapeutically relevant drugs.

We explored the relative strength of environmental and social factors associated with pediatric asthma in middle class families and considered the efficacy of recruitment for an educational study at a science museum. Eligibility criteria were having a child aged 4–12 and English fluency. Our questionnaire included information on demographics, home environment, medical history, and environmental toxicant exposures. Statistically significant associations were found for: child’s age (t = −2.46; p = 0.014), allergies (OR = 11.5; 95%CI = 5.9–22.5), maternal asthma (OR = 2.2; 95%CI = 1.2–3.9), parents’ education level (OR = 0.5; 95%CI = 0.3–0.9), family income (OR = 2.4; 95%CI = 1.1–5.5), water damage at home (OR = 2.5; 95%CI = 1.1–5.5), stuffed animals in bedroom (OR = 0.4; 95%CI = 0.2–0.7), hospitalization within a week after birth (OR = 3.2; 95%CI = 1.4–7.0), diagnosis of pneumonia (OR = 2.8; 95%CI = 1.4–5.9), and multiple colds in a year (OR = 2.9; 95%CI = 1.5–5.7). Several other associations approached statistical significance, including African American race (OR = 3.3; 95%CI = 1.0–10.7), vitamin D supplement directive (OR = 0.2; 95%CI = 0.02–1.2), mice in the home (OR = 0.5, 95%CI = 0.2–1.1), and cockroaches in the home (OR = 4.3; CI = 0.8–21.6). In logistic regression, age, parents’ education, allergies, mold allergies, hospitalization after birth, stuffed animals in the bedroom, vitamin D supplement directive, and water damage in the home were all significant independent predictors of asthma. The urban science museum was a low-resource approach to address the relative importance of risk factors in this population.

Epidural neuraxial analgesia is a standard procedure for pain control during labor and delivery. One rare complication is accidental epidural catheter placement in the subdural space, a potential space between the arachnoid and dura membranes.The incidence of the subdural blockade during neuraxial block is unknown. The subdural block suspicion arises when the clinical signs and symptoms do not fit epidural or subarachnoid local anesthetic injection. The clinical picture includes delayed or gradual onset, extensive sensory block with minimal motor block, hypotension more than an epidural neuraxial block, and less than spinal neuraxial block, and it can rarely track intracranially and causes dyspnea and loss of consciousness.In this article, we report a case of inadvertent subdural catheter placement that was diagnosed clinically with unexpectedly high block involving the upper extremities. No radiological confirmation was used for the diagnosis.

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