bluuebunny/crossref_metadata_2025 huggingface dataset:
Calcium sulfate bone cements with nanoscaled silk fibroin as inducer
Authors: Xu Rui , Lian Xiaojie , Shen Yiling , Zhang Yue , Niu Baolong , Zhang Siruo , Guo Qi , Zhang Quanyou , Du Jingjing , Li Fen , Lu Qiang , Huang Di , Wei Yan
Published: March 2019

Both nanostructures and conformations of different protein/polysaccharide additives have critical influence on the performance of calcium sulfate (CS) bone cements. Silk fibroin (SF) as matrix and additives has been introduced to develop bone scaffolds and cements. Here, β‐sheet‐rich SF nanofibers (SFF) was used to tune the solidification of CS, achieving better mechanical and biological properties. The ratio of SFF was adjusted to further optimize CS functions. Compared to that regulated with natural silk fibers (NSF) and SF solutions (SFS), the SFF‐induced CS showed smaller size and more filament structures. Better mechanical properties were achieved, suggesting the superiority of the SFF as the solidifying solution to combine with α‐calcium sulfate hemihydrate (α‐CSH) at the same liquid/solid (L/S) ratio. Scanning electron microscope, X‐ray diffraction, Fourier transform infrared spectroscopy, setting time, porosity, mechanical performance test, degradation performance test, and water resistance test were used to demonstrate the properties of this bone repair cement. Cell culture experiments in vitro was used to evaluate the biocompatibility of this composited material. In conclusion, the results demonstrated that nanofibers was a better form of SF in the modification of CSH cement. And the research conducted in this article on improving the mechanical and biological properties of CSH would supported the reference for later clinical experiments. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B:2611–2619, 2019.
Inactivating Mutation in IRF8 Promotes Osteoclast Transcriptional Programs and Increases Susceptibility to Tooth Root Resorption
Authors: Thumbigere-Math Vivek , Foster Brian L , Bachu Mahesh , Yoshii Hiroaki , Brooks Stephen R. , Coulter Alyssa , Chavez Michael B , Togi Sumihito , Neely Anthony L , Deng Zuoming , Mansky Kim C , Ozato Keiko , Somerman Martha J
Published: March 2019

This is the first study to our knowledge to report a novel mutation in the interferon regulatory factor 8 gene (IRF8G388S) associated with multiple idiopathic tooth root resorption, a form of periodontal disease. The IRF8G388S variant in the highly conserved C-terminal motif is predicted to alter the protein structure, likely impairing IRF8 function. Functional assays demonstrated that the IRF8G388S mutant promoted osteoclastogenesis and failed to inhibit NFATc1-dependent transcriptional activation when compared with IRF8WT control. Further, similar to subjects with heterozygous IRF8G388S mutation, Irf8+/– mice exhibited increased osteoclast activity in the mandibular alveolar bone surrounding molar teeth. Immunohistochemistry illustrated increased NFATc1 expression in the dentoalveolar region of Irf8–/– and Irf8+/– mice when compared with Irf8+/+ controls. Genomewide analyses revealed that IRF8 constitutively bound to regulatory regions of several thousand genes in osteoclast precursors, and genetic aberration of IRF8 significantly enhanced many osteoclast-specific transcripts. Collectively, this study delineates the critical role of IRF8 in defining osteoclast lineage and osteoclast transcriptional program, which may help in better understanding of various osteoclast-mediated disorders, including periodontal disease. © 2019 American Society for Bone and Mineral Research.
Integrated Model to Describe Morphine Pharmacokinetics in Humans
Authors: Liu Tao , Ivaturi Vijay , Gobburu Jogarao
Published: March 2019

The pharmacokinetics (PK) of morphine has been extensively investigated. Though different publications have focused on the various aspects of morphine PK, none have quantitatively interpreted morphine PK across different publications. The objective of this research is to summarize the current understanding of morphine PK in humans quantitatively. In this research, a parent‐metabolite compartmental PK modeling approach was used to summarize the current understanding of morphine PK in humans. Plasma concentration‐time profiles and cumulative urine recovery time profiles of morphine, morphine‐3‐glucuronide, and morphine‐6‐glucuronide were digitized from the previous publications to develop the parent‐metabolite PK model. The parent‐metabolite PK model successfully described the plasma concentration‐time profiles and cumulative urine recovery of morphine as well as its two major metabolites, morphine‐3‐glucuronide and morphine‐6‐glucuronide, after intravenous and oral administration of morphine. This research separated out the first‐pass effect on morphine metabolism after oral administration. By integrating these results with two mass balance studies of morphine, a clear picture of morphine absorption and disposition is given. Though the results are mainly based on data collected from healthy volunteers or patients whose disease is not expected to impact morphine PK, the parent‐metabolite model sets a framework to further evaluate morphine PK in special populations, such as pediatrics and patients with renal impairment.
Iron alters macrophage polarization status and leads to steatohepatitis and fibrogenesis
Authors: Handa Priya , Thomas Sunil , Morgan-Stevenson Vicki , Maliken Bryan D , Gochanour Eric , Boukhar Sarag , Yeh Matthew M , Kowdley Kris V
Published: March 2019

We have previously demonstrated that iron overload in hepatic reticuloendothelial system cells (RES) is associated with severe nonalcoholic steatohepatitis (NASH) and advanced fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Recruited myeloid-derived macrophages have gained a pivotal position as drivers of NASH progression and fibrosis. In this study, we used bone marrow-derived macrophages (BMDM) from C57Bl6 mice as surrogates for recruited macrophages and examined the effect of iron on macrophage polarization. Treatment with iron (ferric ammonium citrate, FAC) led to increased expression levels of M1 markers: CCL2, CD14, iNOS, IL-1β, IL-6, and TNF-α; it also increased protein levels of CD68, TNF-α, IL-1β, and IL-6 by flow cytometry. This effect could be reversed by desferrioxamine, an iron chelator. Furthermore, iron loading of macrophages in the presence of IL-4 led to the down-regulation of M2 markers: arginase-1, Mgl-1, and M2-specific transcriptional regulator, KLF4. Iron loading of macrophages with IL-4 also resulted in reduced phosphorylation of STAT6, another transcriptional regulator of M2 activation. Dietary iron overload of C57Bl6 mice led to hepatic macrophage M1 activation. Iron overload also stimulated hepatic fibrogenesis. Histologic analysis revealed that iron overload resulted in steatohepatitis. Furthermore, NAFLD patients with hepatic RES iron deposition had increased hepatic gene expression levels of M1 markers, IL-6, IL-1β, and CD40 and reduced gene expression of an M2 marker, TGM2, relative to patients with hepatocellular iron deposition pattern. We conclude that iron disrupts the balance between M1/M2 macrophage polarization and leads to macrophage-driven inflammation and fibrogenesis in NAFLD.
Synthetic CpG oligonucleotides as potential modulators of neutrophil survival in PAMP-associated inhibition of apoptosis
Authors: Golenkina Ekaterina A , Viryasova Galina M , Galkina Svetlana I , Arifulin Evgenii A , Gaponova Tatjana V , Romanova Yulia M , Sud’ina Galina F
Published: March 2019

We studied the effects of a synthetic CpG oligonucleotide (CpG ODN2006) on polymorphonuclear leukocyte (PMNL, neutrophil) survival and oxidant status. CpG ODN2006 showed a dose-dependent effect on the apoptosis of resting neutrophils. Without affecting the viability of resting cells, low concentrations of CpG ODN2006 interfered with Salmonella typhimurium-mediated viability prolongation and increased neutrophil apoptosis to control levels. CpG ODN2006 stimulated neutrophil apoptosis by enhancing ROS generation. Even small doses of ODN could induce the production of intracellular superoxide anions. The high superoxide reactogenicity, including with respect to nitrogen oxide, led to increased levels of intracellular ROS and RNS, which ultimately caused apoptosis. The pro-oxidant effect of low concentrations of CpG ODN2006 was not sufficient to trigger irreversible pro-apoptotic mechanisms. However, the sensitivity of PMNLs to ODN2006, a modulator of apoptosis, increased significantly under conditions of infectious inflammation. Inactivated S. typhimurium proved to be suitable for simulating inflammatory conditions in vitro.
Real-time deformability cytometry reveals sequential contraction and expansion during neutrophil priming
Authors: Bashant Kathleen R , Vassallo Arlette , Herold Christoph , Berner Reinhard , Menschner Leonhard , Subburayalu Julien , Kaplan Mariana J , Summers Charlotte , Guck Jochen , Chilvers Edwin R , Toepfner Nicole
Published: March 2019

It has become increasingly apparent that the biomechanical properties of neutrophils impact on their trafficking through the circulation and in particularly through the pulmonary capillary bed. The retention of polarized or shape-changed neutrophils in the lungs was recently proposed to contribute to acute respiratory distress syndrome pathogenesis. Accordingly, this study tested the hypothesis that neutrophil priming is coupled to morpho-rheological (MORE) changes capable of altering cell function. We employ real-time deformability cytometry (RT-DC), a recently developed, rapid, and sensitive way to assess the distribution of size, shape, and deformability of thousands of cells within seconds. During RT-DC analysis, neutrophils can be easily identified within anticoagulated “whole blood” due to their unique granularity and size, thus avoiding the need for further isolation techniques, which affect biomechanical cell properties. Hence, RT-DC is uniquely suited to describe the kinetics of MORE cell changes. We reveal that, following activation or priming, neutrophils undergo a short period of cell shrinking and stiffening, followed by a phase of cell expansion and softening. In some contexts, neutrophils ultimately recover their un-primed mechanical phenotype. The mechanism(s) underlying changes in human neutrophil size are shown to be Na+/H+ antiport-dependent and are predicted to have profound implications for neutrophil movement through the vascular system in health and disease.
Enhanced uniform data sampling for constrained data‐driven modeling of antenna input characteristics
Authors: Koziel Slawomir , Sigurðsson Ari T. , Pietrenko‐Dabrowska Anna , Szczepanski Stanislaw
Published: March 2019

Data‐driven surrogates are the most popular replacement models utilized in many fields of engineering and science, including design of microwave and antenna structures. The primary practical issue is a curse of dimensionality, which limits the number of independent parameters that can be accounted for in the modeling process. Recently, a performance‐driven modeling technique has been proposed where the constrained domain of the model is spanned by a set of reference designs optimized with respect to selected figures of interest. This approach allows for significant improvement of prediction power of the surrogates without the necessity of reducing the parameter ranges. Yet uniform allocation of the training data samples in the constrained domain remains a problem. Here, a novel design of experiments technique ensuring better sample uniformity is proposed. Our approach involves uniform sampling on the domain‐spanning manifold and linear transformation of the remaining sample vector components onto orthogonal directions with respect to the manifold. Two antenna examples are provided to demonstrate the advantages of the technique, including application case studies (antenna optimization).
Gender difference of CCAAT/enhancer binding protein homologous protein deficiency in susceptibility to osteopenia
Authors: Wu Cheng‐Tien , Chen Ya‐Wen , Su Yen‐Hao , Chiu Chen‐Yuan , Guan Siao‐Syun , Yang Rong‐Seg , Liu Shing‐Hwa
Published: March 2019

Expression of CCAAT/enhancer binding protein (C/EBP) homologous protein (CHOP) is induced during endoplasmic reticulum (ER) stress, which is related to apoptosis in several cell types. CHOP null mice have been exhibited to decrease bone formation. However, a study of transgenic mice overexpressing CHOP in the bone microenvironment showed that CHOP overexpression impairs the osteoblastic function leading to osteopenia. The regulatory role of CHOP in bone formation is controversial and still remains to be clarified. Here, we investigated the alterations in bone microstructure of CHOP knockout (Chop−/−) mice and tested the gender difference of CHOP deficiency in susceptibility to osteopenia. Adult female and male mice (WT) and Chop−/− mice were used. The microcomputed tomography (µCT) analysis in trabecular bone and cortical bone of tibia was determined. Trabecular bone volume fraction (BV/TV), trabecular number, and bone mineral density (BMD) in tibia are markedly decreased in both male and female Chop−/− mice compared to the control WT mice. Unexpectedly, the BMD and BV/TV in trabecular bone of tibia in female Chop−/− mice were significantly lower than in male Chop−/− mice. The similar results could also be observed in the cortical bone of tibia in Chop−/− mice. This gender difference was also observed in the decreased capacity of osteoblast differentiation of bone marrow cells isolated from Chop−/− mice. These results indicated that ER stress‐related CHOP signaling might play an important role in the bone formation in a mouse model, especially in females. There is the gender difference of CHOP deficiency in susceptibility to osteopenia. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res
Prospective application of stem cells to prevent post‐operative skeletal fibrosis
Authors: Li Xiaolei , Chen Song , Yan Lianqi , Wang Jingcheng , Pei Ming
Published: March 2019

Post‐operative skeletal fibrosis is considered one of the major complications causing dysfunction of the skeletal system and compromising the outcomes of clinical treatment. Limited success has been achieved using current therapies; more effective therapies to reduce post‐operative skeletal fibrosis are needed. Stem cells possess the ability to repair and regenerate damaged tissue. Numerous studies show that stem cells serve as a promising therapeutic approach for fibrotic diseases in tissues other than the skeletal system by inhibiting the inflammatory response and secreting favorable cytokines through activating specific signaling pathways, acting as so‐called medicinal signaling cells. In this review, current therapies are summarized for post‐operative skeletal fibrosis. Given that stem cells are used as a promising therapeutic approach for fibrotic diseases, little effort has been undertaken to use stem cells to prevent post‐operative skeletal fibrosis. This review aims at providing useful information for the potential application of stem cells in preventing post‐operative skeletal fibrosis in the near future. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1236–1245, 2019.
Gender and disease severity determine proximal femoral morphology in developmental dysplasia of the hip
Authors: Boughton Oliver R. , Uemura Keisuke , Tamura Kazunori , Takao Masaki , Hamada Hidetoshi , Cobb Justin P. , Sugano Nobuhiko
Published: March 2019

In this computed tomography (CT) morphological study we describe the way the proximal femoral morphology differs with worsening degrees of developmental dysplasia of the hip (DDH) and describe gender differences in patients with DDH. Forty‐nine male patients with DDH were matched with 49 females with DDH, using age and the Crowe classification of DDH severity. The femoral length, anteversion, neck‐shaft angle, offset, neck length, canal‐calcar ratio, canal flare index, lateral center‐edge angle, alpha angle, pelvic tilt, and pelvic incidence were measured for each patient on their pre‐operative CT scans, prior to total hip arthroplasty surgery. Femoral anteversion and neck length were 16° and 47 mm, 25°and 36 mm, 26° and 43 mm, and 44° and 36 mm, for Crowe I and III males and Crowe I and III females, respectively. The mean male anteversion was 22° (±14), compared to 30° (±15.5) in females (p = 0.02, Confidence Interval: 1.6–14.9). Gender differences in femoral length, neck length and offset lost significance when height‐normalized and no other significant gender differences were found. In conclusion, femoral neck length reduces with increasing DDH severity, whilst anteversion tends to increase. Male patients with DDH have significantly less femoral anteversion, which has important implications for osteotomy and arthroplasty surgery in DDH. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res
Effect of trabecular metal on the elution of gentamicin from Palacos cement
Authors: Mooney Jake A. , Manasherob Robert , Smeriglio Piera , Bhutani Nidhi , Amanatullah Derek F.
Published: March 2019

Periprosthetic joint infections continues to be a common complication in total joint arthroplasty, resulting in significant morbidity, mortality, and additional cost. Trabecular metal implants with an internal cemented interface may be customizable drug delivery devices with an ingrowth interface. Thirty‐six acetabular implants were assembled in vitro, half with a trabecular metal shell and half without. The antibiotic loaded bone cement was prepared via three different mixing techniques and at two different mixing times. Mixing time had a significant effect on the total amount of gentamicin eluted. The long mixing protocol eluted up to 126% (p = 0.001) more gentamicin than the short mixing protocol at 4 h and 192% (p < 0.001) more at 7 days. Hand or mechanical mixing technique had no significant effect on elution at 4 h. At 7 days, the mechanical mixing system under vacuum eluted over 50% (p = 0.031) more gentamicin than without a vacuum and nearly 60% (p = 0.040) more gentamicin than hand mixing. The use of a trabecular metal shell had no significant effect on the bulk elution of gentamicin at 4 h (p > 0.05) but significantly reduced total gentamicin elution under certain mixing protocols at 7 days. A possible optimization strategy to improve elution kinetics would be to use a long mixing time with a mechanical mixing system under vacuum. The establishment of trabecular metal as an effective delivery vehicle for antibiotics makes possible an entirely new class of drug eluting device designs. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res
Botox‐induced muscle paralysis alters intracortical porosity and osteocyte lacunar density in skeletally mature rats
Authors: Gatti Vittorio , Ghobryal Bishoy , Gelbs Michelle J. , Gerber Michael B. , Doty Stephen B. , Cardoso Luis , Fritton Susannah P.
Published: March 2019

Reduced mechanical loading can lead to disuse osteoporosis, resulting in bone fragility. Disuse models report macroscopic bone loss due to muscle inactivity and immobilization, yet only recently has there been quantification of the effects of disuse on the vascular pores and osteocyte network, which are believed to play an important role in mechanotransduction via interstitial fluid flow. The goal of this study was to perform a high‐resolution analysis of the effects of muscle inactivity on intracortical porosity and osteocyte lacunar density in skeletally mature rats. Muscle paralysis was induced in 20‐week‐old female Sprague Dawley rats by injection of botulinum neurotoxin. Rats were injected in the right hindlimb muscles with either Botox (BTX, n = 8) or saline solution (CTRL, n = 8), with a third group used as baseline controls (n = 8). Four weeks after injection, Botox caused a ∼60% reduction in hindlimb muscle mass. High‐resolution micro‐CT analysis showed that Botox‐induced muscle paralysis increased vascular canal porosity and reduced osteocyte lacunar density within the tibial metaphysis cortex. Cortical thickness and other areal properties were diminished in the proximal tibial metaphysis, whereas no differences were found in the mid‐diaphysis. Within the BTX group, the injected limbs showed a lower cancellous bone volume fraction relative to the contralateral limb. These results indicate that diminished muscle activity alters the vascular canal porosity and osteocyte lacunar density in cortical bone, which could alter interstitial fluid flow, affecting molecular transport and the transmission of mechanical signals to osteocytes. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res
Novel Near‐Infrared Fluorescence‐Guided Surgery With Vesicular Stomatitis Virus for Complete Surgical Resection of Osteosarcomas in Mice
Authors: Sakuda Tomohiko , Kubo Tadahiko , Johan Muhammad Phetrus , Furuta Taisuke , Sakaguchi Takemasa , Nakanishi Mahito , Ochi Mitsuo , Adachi Nobuo
Published: March 2019

Attempts have been made to visualize tumor cells intraoperatively with fluorescence guidance. However, the clear demarcation and complete tumor resection have always been a challenging task. To address this, we have developed a novel fluorescence bioimaging system with vesicular stomatitis virus (VSV) incorporating Katushka, near‐infrared fluorescent protein. VSV is tumor‐specific owing to the deficiency of antiviral interferon signaling pathways in tumor cells. We aimed to evaluate the tumor specificity of the recombinant VSV‐Katushka (rVSV‐K) in osteosarcoma cells and to assess the feasibility of complete tumor resection by the rVSV‐K fluorescence guidance. In in vitro experiments, mouse and human osteosarcoma cell lines and normal human mesenchymal stem cells were infected with rVSV‐K and observed by fluorescence microscopy. Near‐infrared fluorescence was observed only in osteosarcoma cells, even at a low‐concentration of virus infections. In in vivo experiments, mouse osteosarcoma (LM8) cells were transplanted subcutaneously into the back of immune‐competent mice to produce an osteosarcoma, which was then injected with rVSV‐K. The areas emitting fluorescence were resected using a bioimaging system. The distance between the surgical and tumor margins of the fluorescence‐guided resection with rVSV‐K group was significantly larger than that of the non‐guided resection groups. The local recurrence rate was significantly lower in the fluorescence‐guided resection with rVSV‐K group than in the non‐guided resection groups. The distant metastasis rate and average survival rate were not significantly different between all groups. These results suggest that the rVSV‐K is specific to osteosarcoma cells and enables complete tumor resection of osteosarcomas in mice. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res
Durable molybdenum oxide coated solid‐phase microextraction fiber for highly selective and efficient extraction of polycyclic aromatic hydrocarbons in water
Authors: Liu Hongmei , Wang Xiaoqi , Fan Hua , Dang Shihao
Published: March 2019

A bonding method was developed for coating molybdenum oxides onto a steel wire substrate, which was used as a solid‐phase microextraction fiber, was coupled with gas chromatography. Based on the characterization, it is found that the as‐prepared molybdenum oxides material contained a nanobelt structure with a uniform size and good dispersibility. In addition, there were a large number of small protrusions on the surface of the nanobelts. These characteristics provided a large specific surface area for extraction. Molybdenum oxides exhibited a high extraction selectivity for polycyclic aromatic hydrocarbons owing to its moderate coordination. After the optimization of the factors, method detection limits of < 1.25 μg/L were achieved, and the calibration curves were linear within the range of 2–600 μg/L. In addition, repeatability was demonstrated, and the relative standard deviation < 6.4%. The molybdenum oxides coating had a high scratch resistance, which could effectively prevent coating wear and failure. Combined with the high thermal and chemical stability, the service life of the coating was improved and could be used 150 times without a significant reduction in the extraction performance. Finally, the as‐prepared fiber had a comparable extraction capacity and higher partition coefficients that those of commercial polyacrylate fibers.
Mayfield estimates versus apparent nest success in colonial geese
Authors: Kellett Dana K. , Alisauskas Ray T.
Published: March 2019

Unbiased estimates of nest survival are often required to make robust inference about population and habitat management. We studied nest survival of lesser snow (Anser caerulescens caerulescens) and Ross's (A. rossii) geese at Karrak Lake, Nunavut, in Canada's central Arctic, 1995–2012. We monitored nests throughout the nesting period, from early egg‐laying to late incubation, and revisited nests after predicted hatch dates to determine nest fate. Despite high nesting density and high nest visibility, detection of failed nests was lower than active nests; consequently, Mayfield nest success estimated with Program MARK was always lower than apparent nest success, the latter defined as the proportion of detected nests that produced ≥1 offspring. From data that included nests found after failure, however, annual nest survival estimated by Program MARK was related (r2 = 0.98 for both species) to apparent estimates, permitting accurate estimation of true nest success from apparent estimates. Nest survival probability (i.e., nest survival) in both species modeled with Program MARK varied annually (lesser snow geese = 0.234–0.795, Ross's geese = 0.273–0.901) and daily nest survival declined with nest age in most years. Within years, nests initiated later experienced lower survival for both lesser snow and Ross's geese (nest initiation date (NID), βNID = −0.068 [95% CI = −0.096, −0.041] and −0.082 [−0.119, −0.046], respectively). Nest survival was higher when days were relatively warm and dry for lesser snow geese (βdaily weather = 0.089 [0.054, 0.402]), but weather did not influence nest survival of Ross's geese. Disturbance by researchers had no influence on nest survival of either species. Sampling for contemporary estimators of nest survival that account for differential detection probabilities between active and inactive nests to produce unbiased estimates may not always be logistically feasible; thus, we urge researchers at least to derive predictive equations from a subset of nests specific to study sites and species to correct apparent estimates. © 2019 The Wildlife Society.
Aspiration in the otherwise healthy Infant—Is there a natural course for improvement?
Authors: Casazza Geoffrey C. , Graham M. Elise , Asfour Fadi , O'Gorman Molly , Skirko Jonathan , Meier Jeremy D.
Published: March 2019

Objectives/Hypothesis

Timing and indication for surgical intervention is a major challenge in managing pediatric oropharyngeal dysphagia. No study has evaluated a natural course of swallowing dysfunction in otherwise healthy infants. Our objective was to review the outcomes and time to resolution of abnormal swallow in infants with aspiration.

Study Design

Retrospective case series at a tertiary children's hospital.

Methods

Fifty patients under 1 year old with aspiration on a modified barium swallow study were included. Patients born <34 weeks, with medical or genetic comorbidities, or who underwent surgical intervention for aspiration were excluded. Patients were followed until aspiration resolved on a swallow study. Kaplan‐Meier survival analysis was performed.

Results

Forty patients (25 patients [50%] by 6 months, 10 [20%] by 1 year, three [6%] by 2 years, and two [4%] at the end of the follow‐up interval) were recommended a normal diet, and 10 patients (20%) were still aspirating by the end of the follow‐up interval. Median time to resolution was 202 ± 7 days (range, 19–842 days), probability 48% (95% confidence interval [CI]: 0.34‐0.62). The probability of resolution at 6 months was 46% (95% CI: 0.4‐0.68), at 1 year was 64% (95% CI: 0.51‐0.77), at 2 years was 76% (95% CI: 0.64‐0.88), and at the end of the follow‐up interval 81.3% (95% CI: 0.7‐0.92).

Conclusions

The majority of infants with aspiration and without any other major comorbidities improved within 1 year. Future research should be directed toward better understanding swallowing dysfunction in neurologically normal infants.

Level of Evidence

4 Laryngoscope, 130:514–520, 2020
Topical anesthetic techniques in office‐based laryngeal surgery: A comparison of patient preferences
Authors: Naunheim Matthew R. , Woo Peak
Published: March 2019

Objectives

Multiple topical anesthesia techniques exist for office‐based laryngeal surgery. Our objective was to assess patient and surgeon satisfaction for three different techniques.

Study Design

Cohort study.

Methods

All consecutive patients presenting to an outpatient laryngology office for awake surgical procedures were enrolled. Patients were anesthetized with local anesthesia (2 cubic centimeters of 4% lidocaine) in one of three ways: 1) nebulizer, 2) flexible cannula through a channeled laryngoscope, or 3) transtracheal instillation. Demographics, procedure times, and surgeon satisfaction were recorded. A validated 11‐item patient satisfaction questionnaire (Iowa Satisfaction with Anesthesia Survey) was administered after the procedure to calculate an overall satisfaction score (−3[worst] to 3[best]). Descriptive and correlative statistics were performed.

Results

One hundred consecutive patients were included (37 females, 73 males), with relatively equal numbers between groups (32 nebulizer, 35 cannula, 33 transtracheal). Seven procedures were aborted (4 nebulizer, 2 cannula, 1 transtracheal) due to movement, anxiety, or technical issues. Three patients did not adequately complete the survey. Of the 90 remaining patients, patient satisfaction was highest with the transtracheal technique (2.04) versus cannula (1.46) or nebulizer (1.45), and this was statistically significant (P = 0.0167). This difference was driven by decreased pain and nausea scores in the transtracheal group. Surgeon satisfaction was lower with nebulizer and higher with transtracheal injection (P = 0.0081). There was a correlation between surgeon satisfaction and patient satisfaction (P < 0.0001).

Conclusion

Transtracheal instillation was favored by both patients and the surgeon. Choice of local anesthetic techniques may impact patient preferences and surgical success. This may serve as a basis for optimizing anesthetic care in office‐based laryngeal surgery.

Level of Evidence

4 Laryngoscope, 130:166–170, 2020
Initial clinical application of tissue pH neutralization after esophageal button battery removal in children
Authors: Jatana Kris R. , Barron Christine L. , Jacobs Ian N.
Published: March 2019

Objectives/Hypothesis

Pediatric esophageal button battery (BB) injuries can progress even after removal and continue to be a significant source of morbidity and mortality. The objective in this case series is to present initial safety data for the human application of intraoperative tissue pH neutralization using 0.25% acetic acid irrigation after BB removal.

Study Design

Retrospective case series.

Methods

Pediatric patients who underwent rigid esophagoscopy for BB removal between October 2016 and December 2017 and who had the injury site irrigated with 120 to 150 mL sterile 0.25% acetic acid (pH = 3) were included in the study. Outcome measures included visual tissue appearance after irrigation, immediate or delayed esophageal perforation, and evidence of eventual esophageal stricture formation.

Results

Six pediatric patients (aged 19 months–10 years) had a 3 V lithium BB lodged in the esophagus for 2 to 18 hours and had irrigation of the esophageal injury site with sterile 0.25% acetic acid in the operating room after BB removal. None of the patients showed any evidence of thermal tissue injury. By surgeon assessment, all cases had improved visual esophageal tissue appearance. Neither immediate post‐operative or delayed onset esophageal perforation nor eventual stricture development were seen.

Conclusions

Esophageal irrigation in the operating room with sterile 0.25% acetic acid after BB removal, to neutralize the highly alkaline tissue microenvironment (pH 10–13) was safe and resulted in improved visual mucosal appearance. This immediate tissue pH neutralization may help halt the progression of liquefactive necrosis by immediately bringing tissue pH to physiologic range. This post‐removal irrigation technique is recommended by current National Capital Poison Center BB guidelines.

Level of Evidence

4

Laryngoscope, 129:1772–1776, 2019
The association between the Nutrition‐Related index and morbidity following head and neck microsurgery
Authors: Parhar Harman S. , Durham J. Scott , Anderson Donald W. , Rush Barret , Prisman Eitan
Published: March 2019

Objectives/Hypothesis

Despite consensus that preoperative nutritional assessment is of importance in the head and neck surgical oncology population, it remains unclear how exactly malnutrition is associated with perioperative morbidity especially among those undergoing microvascular surgery. We aimed to study this association to help inform preoperative risk stratification, guide the use of nutritional interventions, and ultimately help prevent malnutrition related morbidity.

Study Design

Database analysis.

Methods

Retrospective, linked analysis of the 2011 to 2016 National Surgical Quality Improvement Program. After identifying eligible patients and stratifying according to the Nutrition‐Related Index, a univariate screen of preoperative demographic and clinical covariates was performed. Subsequently, propensity score matching was utilized to control for differences in baseline covariates. Perioperative complications and mortality were then analyzed using the propensity score–matched cohorts.

Results

Among 977 identified patients, 276 (28.2%) were malnourished. Malnourished patients had higher rates of comorbidity, were more likely to actively smoke, and were more likely to have primaries in the oropharynx or hypopharynx/larynx. After propensity score matching to control for confounders, malnourished patients had higher rates of pulmonary complications (21.5% vs. 11.6%, P < .01), higher rates of bleeding or need for transfusion (56.6% vs. 43.0%, P < .01), higher rates of venous thromboembolism (3.7% vs. 0.8%, P = .03), and a higher 30‐day mortality rates (3.7% vs. 0.0%, P < .01).

Conclusions

This nationwide analysis finds that 28.2% of patients undergoing surgery for head and neck cancers with free flap reconstruction are malnourished. Malnourishment was found to be independently associated with postoperative pulmonary complications, bleeding or need for transfusion, and 30‐day mortality.

Level of Evidence

NA Laryngoscope, 130:375–380, 2020
Seasonal dynamics of internal waves governed by stratification stability and wind: Analysis of high‐resolution observations from the Dead Sea
Authors: Arnon Ali , Brenner Steve , Selker John S. , Gertman Isaac , Lensky Nadav G.
Published: March 2019

Internal waves in stratified lakes are affected by the seasonally varying stratification and the wind forcing. We studied the seasonal dynamics of internal waves by means of high‐resolution observations and model simulations for the Dead Sea. A two‐layer hydrostatic model provided high correlations between measured thermocline depth and the lake level oscillations. Seasonally, the amplitude of the thermocline fluctuations were anticorrelated with the density difference between the water layers; the largest fluctuations were observed when stratification was weak in spring/fall and moderate to weak fluctuations in mid‐summer when stratification was fully developed. The surface and the internal waves propagated counterclockwise along the coasts at a speed of ~0.5 m s−1. Power spectra of the observed wind as well as the measured and simulated lake level and thermocline depth show a pronounced diurnal period during summer, suggesting forcing by the diurnally varying wind. During spring and fall, when the water column stability diminishes, a hint of longer wind periods appear in addition to the diurnal mode. Accordingly, the lake level and thermocline depth fluctuations respond at lower frequencies. In the fall, the longer wind periods are close to the lake's first vertical normal mode, suggesting that resonant amplification of the internal waves may explain the observed lower frequency response of the level and thermocline oscillations. Reduction of the stratification stability originating from anthropogenic water diversion over the past four decades, associated with lake level decline and salinity increase, have led to increases of internal waves amplitude and periods.
High‐Temperature Spray‐Dried Polymer/Bacteria Microparticles for Electrospinning of Composite Nonwovens
Authors: Reich Steffen , Kaiser Patrick , Mafi Mahsa , Schmalz Holger , Rhinow Daniel , Freitag Ruth , Greiner Andreas
Published: March 2019

Living Micrococcus luteus (M. luteus) and Escherichia coli (E. coli) are encapsulated in poly(vinyl alcohol), poly(vinylpyrrolidone), hydroxypropyl cellulose, and gelatin by high‐temperature spray drying. The challenge is the survival of the bacteria during the standard spray‐drying process at temperatures of 150 °C (M. luteus) and 120 °C (E. coli). Raman imaging and transmission electron microscopy indicate encapsulated bacteria in hollow composite microparticles. The versatility of the spray‐dried polymer bacteria microparticles is successfully proved by standard polymer solution–processing techniques such as electrospinning, even with harmful solvents, to water‐insoluble polyacrylonitrile, polystyrene, poly(methyl methacrylate), and poly(vinyl butyrate) nanofiber nonwovens, which opens numerous new opportunities for novel applications.
A Bi‐Layer PVA/CMC/PEG Hydrogel with Gradually Changing Pore Sizes for Wound Dressing
Authors: Li Yang , Zhu Chenhui , Fan Daidi , Fu Rongzhan , Ma Pei , Duan Zhiguang , Li Xian , Lei Huan , Chi Lei
Published: March 2019

Wound dressings are vital for cutaneous wound healing. In this study, a bi‐layer dressing composed of polyvinyl alcohol/carboxymethyl cellulose/polyethylene glycol (PVA/CMC/PEG) hydrogels is produced through a thawing–freezing method based on the study of the pore size of single‐layer hydrogels. Then the physical properties and healing of full‐thickness skin defects treated with hydrogels are inspected. The results show that the pore size of the single‐layer PVA/CMC/PEG hyrogel can be controlled. The obtained non‐adhesive bi‐layer hydrogels show gradually increasing pore sizes from the upper to the lower layer and two layers are well bonded. In addition, bi‐layer dressings with good mechanical properties can effectively prevent bacterial penetration and control the moisture loss of wounds to maintain a humid environment for wounds. A full‐thickness skin defect test shows that bi‐layer hydrogels can significantly accelerate wound closure. The experiment indicates that the bi‐layer PVA/CMC/PEG hydrogels can be used as potential wound dressings.
Functional and structural neural bases of task specificity in isolated focal dystonia
Authors: Bianchi Serena , Fuertinger Stefan , Huddleston Hailey , Frucht Steven J. , Simonyan Kristina
Published: March 2019

Background

Task‐specific focal dystonias selectively affect movements during the production of highly learned and complex motor behaviors. Manifestation of some task‐specific focal dystonias, such as musician's dystonia, has been associated with excessive practice and overuse, whereas the etiology of others remains largely unknown.

Objectives

In this study, we aimed to examine the neural correlates of task‐specific dystonias in order to determine their disorder‐specific pathophysiological traits.

Methods

Using multimodal neuroimaging analyses of resting‐state functional connectivity, voxel‐based morphometry and tract‐based spatial statistics, we examined functional and structural abnormalities that are both common to and distinct between four different forms of task‐specific focal dystonias.

Results

Compared to the normal state, all task‐specific focal dystonias were characterized by abnormal recruitment of parietal and premotor cortices that are necessary for both modality‐specific and heteromodal control of the sensorimotor network. Contrasting the laryngeal and hand forms of focal dystonia revealed distinct patterns of sensorimotor integration and planning, again involving parietal cortex in addition to inferior frontal gyrus and anterior insula. On the other hand, musician's dystonia compared to nonmusician's dystonia was shaped by alterations in primary and secondary sensorimotor cortices together with middle frontal gyrus, pointing to impairments of sensorimotor guidance and executive control.

Conclusion

Collectively, this study outlines a specialized footprint of functional and structural alterations in different forms of task‐specific focal dystonia, all of which also share a common pathophysiological framework involving premotor‐parietal aberrations. © 2019 International Parkinson and Movement Disorder Society
Cohesive dry ECG sensor using silver nanowires and PDMS tuned for adhesion
Authors: Helgason Rick , Banavali Amey , Lai Yongjun
Published: March 2019

A technique is exploited to develop a dry ECG sensor using polydimethylsiloxane (PDMS) with enhanced adhesion to skin. The sensor consists of silver nanowires (AgNWs) embedded in PDMS. The adhesive solution presented is a novel technique which combines using high‐ratio 25:1 PDMS selectively deposited in a thin layer on the surface of a sensor body that is made from 15:1 PDMS. With this adhesive mechanism, we demonstrate a cohesive ECG sensor which can adhere to a subject without the use of additional sticky adhesives and that is compatible with current ECG technology. PDMS is residue free and highly biocompatible meaning this is a solution suitable for long‐term wear. We demonstrate that our sensor can be filtered to similar quality of a traditional ECG sensor, and further show that our sensors stay in place for more than 24 hr and it can adhere to skin with an average maximum force of about 1.09 N.
Carbon multi‐electrode arrays as peripheral nerve interface for neural recording and nerve stimulation
Authors: Zhang Xinuo , Chen Chaoyang , Ni Guoxin , Hai Yong , Chen Biao , Zhou Yang , Zhang Boshen , Chen Gui , Cheng Mark Ming‐Cheng
Published: March 2019

Microelectrodes are widely used as a peripheral nerve interface (PNI) to connect the peripheral nerve to a computer for restoration of sensorimotor function and bionic device motion control. Materials used for implantable microelectrode are still facing the challenges from biocompatibility and bio‐fidelity in neural signal recording and nerve stimulating. In this study, we report that carbon multi‐electrode arrays (cMEAs) can be fabricated using carbon ink, micro resin dimethylsiloxane and 3D printing technology and ink for PNI. In vitro cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) demonstrated that the cMEAs have higher charge storage capacity (CSC) and less impedance than conventional platinum (Pt) electrode. In vivo studies using an animal model demonstrated that cMEAs are more effective in stimulating the nerve to elicit muscle contraction and recording compound muscle action potentials (CMAPs) than the Pt electrode. The cMEAs has lower stimulating threshold to elicit muscle activity, higher signal‐to‐noise (SNR) in CMAP. Our studies demonstrate that cMEAs can be an advanced healthcare materials in nerve signal nerve stimulation for PNI and muscle bioelectrical signal recording for peripheral muscle interface (PMI).
Weighted generalized functions and hyperbolic Riesz B‐potential
Authors: Shishkina Elina
Published: March 2019

The paper is devoted to the study of the fractional integral operator, which is a negative real power of the singular wave operator generated by Bessel operator using weighted generalized functions. We give conditions for this operator to be bounded in appropriate spaces, obtain formula for the Hankel transform of this operator, and get formula of connection between this operator and natural degree of singular wave operator generated by Bessel operator.
Large field of view distortion assessment in a low‐field MR‐linac
Authors: Nejad‐Davarani Siamak P. , Kim Joshua P. , Du Dongsu , Glide‐Hurst Carri
Published: March 2019

Purpose

MR‐guided radiation therapy (RT) offers unparalleled soft tissue contrast for localization and target tracking. However, MRI distortions may be detrimental to high precision RT. This work characterizes the gradient nonlinearity (GNL) and total distortions over the first year of clinical operation of a 0.35T MR‐linac.

Methods

For GNL characterization, an in‐house large field of view (FOV) phantom (60 × 42.5 × 55 cm3, >6000 spherical landmarks) was configured and scanned at four timepoints with forward/reverse read polarities (Gradient Echo sequence, FA/TR/TE = 28°/30 ms/6 ms). GNL was measured in Anterior‐Posterior (AP), Left‐Right (LR), and Superior‐Inferior (SI) frequency‐encoding directions based on deviation of the auto‐segmented landmark centroids between rigidly registered MR and CT images and assessed based on radial distance from magnet isocenter. Total distortion was assessed using a 30 × 30 cm2 grid phantom oriented along the cardinal axes over >1 year of operation.

Results

The scanner's spatial integrity within the first ~10 months was stable (maximum total distortion variation = 10/6/8%, maximum distortion = 1.41/0.99/1.56 mm in Axial/Coronal/Sagittal planes, respectively). GNL distortions measured during this time period <10 cm from isocenter were (−0.74, 0.45), (−0.67, 0.53), and (−0.86, 0.70) mm in AP/LR/SI directions. In the 10‐20 cm range, <1.5% of the distortions exceeded 2 mm in the AP and LR axes while <4% of the distortions exceeded 2 mm for SI. After major repairs and magnet re‐shim, detectable changes were observed in total and GNL distortions (20% reduction in AP and 36% increase in SI direction in the 20–25 cm range). Across all timepoints and axes, 38–53% of landmarks in the 20–25 cm range were displaced by >1 mm.

Conclusions

GNL distortions were negligible within a 10 cm radius from isocenter. However, in the periphery, non‐negligible distortions of up to ~7 mm were observed, which may necessitate GNL corrections for MR‐IGRT for treatment sites distant from magnet isocenter.
High‐order local discontinuous Galerkin method for a fractal mobile/immobile transport equation with the Caputo–Fabrizio fractional derivative
Authors: Zhang Min , Liu Yang , Li Hong
Published: March 2019

In this article, a local discontinuous Galerkin (LDG) method is studied for numerically solving the fractal mobile/immobile transport equation with a new time Caputo–Fabrizio fractional derivative. The stability of the LDG scheme is proven, and a priori error estimates with the second‐order temporal convergence rate and the (k + 1)th order spatial convergence rate are derived in detail. Finally, numerical experiments based on Pk, k = 0, 1, 2, 3, elements are provided to verify our theoretical results.
Fluorescent Imaging for Cysteine Detection In Vivo with High Selectivity
Authors: Duan Zhuwen , Zhu Youming , Yang Yuyun , He Zixu , Liu Ju , Li Ping , Wang Hui , Tang Bo
Published: March 2019

As an essential amino acid, cysteine is involved in various biosynthetic and metabolic processes, such as protein synthesis, hormone synthesis, and redox homeostatic maintenance. Inordinate cysteine levels are often associated with serious diseases. Thus, designing and synthesizing a novel fluorescent probe for determining the concentration of cellular cysteine, which could indirectly monitor the prevalence of these diseases, is essential. We developed a florescence probe P−Cy with good sensitivity for cysteine detection in vivo. P−Cy only exhibited good response toward cysteine but did not show response toward other biothiols, such as homocysteine (Hcy) and glutathione (GSH). In this study, we used P−Cy by successfully imaging cellular endogenous and exogenous cysteine levels. Furthermore, P−Cy was also performed in mice to detect cysteine level, indicating that P−Cy is a powerful tool for cysteine detection in situ.