bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Disinfection Device Based on Ionic Membrane Electrolysis Technology: Biological Efficacy Assay and Optimization of Operating Conditions*
Authors: Jia Yannan , Gao Zhanyi , Ding Kunlun , Wu Xiaomei , Song Weikun , Li Xiaoqin
Published: May 2020

A novel disinfection device based on ionic membrane electrolysis technology was developed in this study. To test the feasibility of the newly developed system in rural and emergency water supply, biological assay for the electrolytic system was carried out. The biological efficacy results show that a high concentration of coliform bacteria can be effectively inactivated both in synthetic contaminated water and natural source water, while the chemical indicators of water quality changed only slightly after disinfection. To reduce the operating cost of the system, the electrolyte feeding method and flow rate of the electrolytic cell were optimized. Results of operating conditions show that the operation cost can be reduced by changing the electrolyte feeding method from pump‐driven to gravity‐driven. As the flow rate was 2.4 L ·h−1, the system has the lowest operation cost, which was 93% lower than adding commercial sodium hypochlorite solution. This paper suggests promising applications of the novel disinfection device based on ionic membrane electrolysis technology in drinking water disinfection or emergency water treatment. © 2020 International Commission for Irrigation and Drainage
Mechanistic insights into the reduced developmental capacity of in vitro matured oocytes and importance of cumulus cells in oocyte quality determination
Authors: Li Ang , Wang Feng , Li Li , Fan Li‐Hua , Meng Tie‐Gang , Li Qian‐Nan , Wang Yue , Yue Wei , Wang Huai‐Xiu , Shi Ya‐Ping , Li Hong‐Xia , Schatten Heide , Sun Qing‐Yuan , Guo Xing‐Ping
Published: May 2020

In vitro maturation of oocytes is a promising assisted reproductive technology (ART) for infertility treatment, although it is still not a routine technique for human ART due to reduced embryonic development. The aim of the present study was to clarify the possible reasons for reduced capacity of in vitro matured oocytes. Our results showed that the oocytes matured in vitro displayed increased abnormal mitochondrial distribution, reduced mitochondrial membrane potential, and increased reactive oxygen species levels when compared to in vivo matured oocytes. These results were not different in oocytes matured in vitro with or without cumulus cells. Notably, in vitro matured oocytes displayed increased mitochondrial DNA numbers probably due to functional compensation. In vitro matured oocytes showed significantly lower activation and embryonic development rates, and their ability to produce Ca2+ oscillations was much lower in response to parthenogenetic activation, especially in oocytes matured in vitro without cumulus cells with nearly half of them failing to produce calcium waves upon strontium chloride stimulation. These data are important for understanding the reasons for reduced developmental potential of in vitro matured oocytes and the importance of cumulus cells for oocyte quality.
Long noncoding RNA CCAT1 inhibits miR‐613 to promote nonalcoholic fatty liver disease via increasing LXRα transcription
Authors: Huang Feizhou , Liu Huaizheng , Lei Zhao , Li Zhenzhou , Zhang Tianyi , Yang Mingshi , Zhou Kefu , Sun Chuanzheng
Published: May 2020

Nonalcoholic fatty liver disease (NAFLD) is regarded as a threat to public health; however, the pathologic mechanism of NAFLD is not fully understood. We attempted to identify abnormally expressed long noncoding RNA (lncRNAs) and messenger RNA that may affect the occurrence and development of NAFLD in this study. The expression of differentially expressed lncRNAs in NAFLD was determined in oleic acid (OA)‐treated L02 cells, and the functions of CCAT1 in lipid droplet formation were evaluated in vitro. Differentially expressed genes (DEGs) were analyzed by microarray analysis, and DEGs related to CCTA1 were selected and verified by weighted correlation network analysis. The dynamic effects of LXRα and CCTA1 on lipid droplet formation and predicted binding was examined. The binding between miR‐631 and CCAT1 and LXRα was verified. The dynamic effects of miR‐613 inhibition and CCTA1 silencing on lipid droplet formation were examined. The expression and correlations of miR‐631, CCAT1, and LXRα were determined in tissue samples. As the results show, CCAT1 was induced by OA and upregulated in NAFLD clinical samples. CCAT1 silencing significantly suppressed lipid droplet accumulation in vitro. LXRα was positively correlated with CCAT1. By inhibiting miR‐613, CCAT1 increased the transcription of LXRα and promoted LXRα expression. The expression of LXRα was significantly increased in NAFLD tissues and was positively correlated with CCAT1. In conclusion, CCAT1 increases LXRα transcription by serving as a competing endogenous RNA for miR‐613 in an LXRE‐dependent manner, thereby promoting lipid droplet formation and NAFLD. CCAT1 and LXRα might be potent targets for NAFLD treatment.
Feasibility of high‐flow nasal oxygen therapy and two‐stage sedation during endoscopic hypopharyngeal therapy
Authors: Riddell Zoe , Pressler Nickki , Siau Keith , Mulder Chris J J , Shalmani Hamid M , Downs Andrew , Gait Andrea , Ishaq Sauid
Published: May 2020

Background

Structural disorders of the hypopharynx can lead to dysphagia‐related morbidity. Endoscopic therapy in this area, for example, myotomy for Zenker's diverticulum (ZD), has traditionally been performed under general anesthesia (GA). We have developed a two‐stage sedation process, which is used along with high‐flow nasal oxygen therapy (HFNOT) to facilitate endoscopic hypopharyngeal procedures.

Methods

In this prospective, single‐center study, patients undergoing endoscopic procedures between June 2016 and March 2018 were included. All endoscopies were performed with propofol and/or remifentanil and supported with HFNOT. In patients with ZD, the diverticulum and stomach were cleared of debris under conscious sedation to reduce the risk of aspiration, before sedation was deepened to facilitate myotomy. Sedation‐related adverse events were recorded.

Results

A total of 50 patients were included for analysis (mean age of 71.1, range 31–93; 58% male); 48% were categorized as American Society of Anesthesiologists (ASA) Grade III and 6% as Grade IV. The median procedure time was 20 min. Of patients, 83% were sedated with both propofol and remifentanil using a target‐controlled infusion under specialist anesthetic supervision. Sedation‐related adverse events included transient hypotension (38%), bradycardia (8%), and hypoxia (8%). No procedures were abandoned due to complications, and no patients required conversion to GA. Patients achieved full postprocedure recovery from sedation after a median duration of 5 min.

Conclusions

HFNOT is a useful adjunct to two‐stage sedation, which can enable high‐risk patients to safely undergo deep sedation during hypopharyngeal endoscopic procedures.
Association of lymphotoxin‐alpha gene polymorphisms (rs909253, rs1800683 and rs2229094) and risk of large‐artery atherosclerosis stroke in Iranian population
Authors: Fasihi Ali , Pourhamedi Saeede , Zahedi Mohmmadsaeid , Goudarzian Maryam , Ramazi Shahin , Kafashzadeh Mehrnoosh , Heydari‐Zarnagh Hafez
Published: May 2020

Background

Lymphotoxin‐alpha (LTA), a proinflammatory cytokine, is significantly associated with the progression of atherosclerosis as an independent hazard factor for stroke. According to new genetic studies, polymorphisms in the LTA gene that influence its expression or biological function may play a role in the progress of stroke; thus, the present case–control study investigated LTA gene polymorphisms (rs909253, rs1800683 and rs2229094) and the risk of large artery atherosclerosis stroke (LAA) in an Iranian population.

Methods

For 211 large artery atherosclerosis patients and 186 ischemic stroke‐free controls, genotypes were determined using the tetra‐primer amplification‐refractory mutation system polymerase chain reaction method. Linkage disequilibrium and estimated haplotypes were analyzed using SNP Analyzer 2 software. The strength of the link between LTA gene polymorphisms (rs1800683, rs909253, and rs2229094) and the risk of stroke was determined using conditional logistic regression.

Results

Analysis revealed that the patterns of the rs1800683, rs909253 and rs2229094 genotypes showed no significant difference between the LAA and control group, although the distribution of the GAT (rs1800683G, rs909253A and rs2229094T) haplotype was significantly higher in the control group (odds ratio = 0.707, 95% confidence interval = 0.53–0.942, p = 0.0355).

Conclusions

Our results indicate that the GAT haplotype in LTA gene is associated with a decreased risk of LAA incidence in a northeastern Iranian population.
Organic acidurias: Major gaps, new challenges, and a yet unfulfilled promise
Authors: Dimitrov Bianca , Molema Femke , Williams Monique , Schmiesing Jessica , Mühlhausen Chris , Baumgartner Matthias R. , Schumann Anke , Kölker Stefan
Published: May 2020

Organic acidurias (OADs) comprise a biochemically defined group of inherited metabolic diseases. Increasing awareness, reliable diagnostic work‐up, newborn screening programs for some OADs, optimized neonatal and intensive care, and the development of evidence‐based recommendations have improved neonatal survival and short‐term outcome of affected individuals. However, chronic progression of organ dysfunction in an aging patient population cannot be reliably prevented with traditional therapeutic measures. Evidence is increasing that disease progression might be best explained by mitochondrial dysfunction. Previous studies have demonstrated that some toxic metabolites target mitochondrial proteins inducing synergistic bioenergetic impairment. Although these potentially reversible mechanisms help to understand the development of acute metabolic decompensations during catabolic state, they currently cannot completely explain disease progression with age. Recent studies identified unbalanced autophagy as a novel mechanism in the renal pathology of methylmalonic aciduria, resulting in impaired quality control of organelles, mitochondrial aging and, subsequently, progressive organ dysfunction. In addition, the discovery of post‐translational short‐chain lysine acylation of histones and mitochondrial enzymes helps to understand how intracellular key metabolites modulate gene expression and enzyme function. While acylation is considered an important mechanism for metabolic adaptation, the chronic accumulation of potential substrates of short‐chain lysine acylation in inherited metabolic diseases might exert the opposite effect, in the long run. Recently, changed glutarylation patterns of mitochondrial proteins have been demonstrated in glutaric aciduria type 1. These new insights might bridge the gap between natural history and pathophysiology in OADs, and their exploitation for the development of targeted therapies seems promising.
Epicardial adipose tissue affects the efficacy of left atrial posterior wall isolation for persistent atrial fibrillation
Authors: Nakatani Yosuke , Sakamoto Tamotsu , Yamaguchi Yoshiaki , Tsujino Yasushi , Kinugawa Koichiro
Published: May 2020

Background

Epicardial adipose tissue (EAT) contributes to atrial fibrillation (AF). However, its impact on the efficacy of left atrial posterior wall isolation (LAPWI) is unclear.

Methods

Forty‐four nonparoxysmal AF patients underwent LAPWI after pulmonary vein isolation. EAT overlap on LAPWI was assessed by fusing computed tomography images with electro‐anatomical mapping.

Results

During the 21 ± 7 months of follow‐up, AF recurred in 10 patients (23%). The total and left atrial EAT volumes were 113 ± 36 and 33 ± 12 cm3, respectively. No differences were found between the AF‐free and AF‐recurrent groups regarding EAT volume. The EAT overlaps on LAPWI lines and LAPWI area were 1.2 ± 1.0 and 0.5 ± 0.9 cm2 respectively. Although no difference was found between groups regarding the EAT overlap on LAPWI area, the AF‐free group had a significantly larger EAT overlap on LAPWI lines (1.4 ± 1.0 vs 0.6 ± 0.6 cm2, P = .014). Multivariate analysis identified EAT overlap on LAPWI lines as an independent predictor of AF recurrence (hazard ratio: 0.399, 95% confidence interval: 0.178‐0.891, P = .025). Kaplan‐Meier analysis revealed that, during follow‐up, 92% of the large EAT overlap group (≥1.0 cm2) and 58% of the small EAT overlap group (<1.0 cm2) remained AF‐free (P = .008).

Conclusions

EAT overlap on LAPWI lines is related to a high AF freedom rate. Direct radiofrequency application to EAT overlap may be necessary to suppress AF.
Evaluation of SMOFlipid in Pediatric Intestinal‐Failure Patients and Its Effects on Essential Fatty Acid Levels
Authors: Ho Beatrice E. , Chan Stacie C. , Faino Anna V. , Mortensen Melissa , Williamson Nila , Javid Patrick J. , Horslen Simon P. , Wendel Danielle
Published: May 2020

Background

SMOFlipid is a mixed‐lipid emulsion approved for adults in the United States as an alternative to soybean oil–based lipid (SO). There are limited data on the use of SMOFlipid in pediatrics and its effect on the fatty acid (FA) profile. Our objective was to characterize changes in FA profile, liver function, and growth in pediatric patients with intestinal failure (IF), following transition from SO or a fish‐oil (FO) and SO combination to SMOFlipid.

Methods

A retrospective case series was conducted on pediatric parenteral nutrition–dependent IF patients transitioned to SMOFlipid. Demographics, anthropometrics, labs, and achievement of nutrition goals were assessed. Linear mixed‐effect models assessed effects on FA levels and clinical outcomes.

Results

One hundred thirty‐nine FA panels were collected from 20 patients. Median SMOFlipid dose at study completion was 2 g/kg/d (interquartile range, 1.6–2). During the 1.5 years after SMOFlipid initiation, ω‐6 FA increased to physiologic levels, arachidonic acid increased from 298 to 461 nmol/mL (P < .001), and linoleic acid increased from 1172 to 1922 nmol/mL (P < .001). ω‐3 FA remained within normal limits. Body mass index z‐score and length z‐score increased, though no significant changes were found. In addition, no significant changes were found in mead acid, hepatic function, triene‐to‐tetraene ratio, or triglycerides.

Conclusion

In 20 pediatric IF patients, SMOFlipid allowed greater ω‐6 FA provision while maintaining ω‐3 FA, hepatic function, and patient growth. This longitudinal study identified improved FA profile associated with SMOFlipid use in comparison with SO with or without FO.
Contrast‐Enhanced Ultrasound for the Evaluation of Renal Transplants
Authors: Kazmierski Brittany J. , Sharbidre Kedar G. , Robbin Michelle L. , Grant Edward G.
Published: May 2020

Contrast‐enhanced ultrasound has emerged as a useful imaging modality for the evaluation of the transplant kidney. Advantages over traditional imaging modalities such as computed tomography and magnetic resonance imaging include the ability to visualize a lesion's enhancement pattern in real time, the lack of nephrotoxicity, and relatively low cost. Potential uses of contrast‐enhanced ultrasound include characterization of solid and cystic transplant renal masses, assessment for pyelonephritis and identification of its complications, and evaluation of transplant complications in immediate and delayed settings. Contrast‐enhanced ultrasound will likely play an increasing role for evaluating the transplant kidney, as an accurate diagnosis based on imaging can direct treatment and prevent unnecessary interventions.
Ultrasound Imaging Is Reliable for Tibialis Posterior Size Measurements
Authors: Johnson A. Wayne , Bruening Dustin A. , Violette Victoria A. , Perkins Keisha V. , Thompson Christopher L. , Ridge Sarah T.
Published: May 2020

Objectives

The tibialis posterior (TP) is a vital muscle for controlling the medial longitudinal arch of the foot during weight‐bearing activities. Dysfunction of this muscle is associated with a variety of pathologic conditions; thus, it is important to reliably assess its morphologic characteristics. Ultrasound (US) has been used to assess characteristics of TP tendons but not the muscle cross‐sectional area (CSA). The purpose of this study was to establish a reliable US technique to measure the TP CSA and thickness.

Methods

Twenty‐three healthy volunteers participated. We evaluated the CSA and thickness at 4 measurement locations (anterior and posterior views at both 30% and 50% of the shank length).

Results

The participants included 12 female and 11 male volunteers (mean age ± SD, 31.23 ± 14.93 years). Excellent reliability was seen for the CSA and thickness at all locations (intraclass correlation coefficients, 0.988–0.998). Limits of agreement (LoA) and standard errors of the measurement (SEMs) were slightly lower at the 30% locations (LoA at 30%, 4.6–9.2; LoA at 50%, 6.4–9.7; SEM at 30%, 0.03–0.05; SEM at 50%, 0.04–0.07). Strong correlations were seen between anterior and posterior measurements of the CSA (30%, r = 0.99; P < .0001; 50%, r = 0.94; P < .0001) and thickness (30%, r = 0.98; P < .0001; 50%, r = 0.95; P = .0001).

Conclusions

Based on these results, the TP can be measured accurately with US at any of the tested locations. Due to the ease of collection and the quality of the data, we recommend the anterior view at 30% of the shank length to measure the CSA. The ability to assess muscle size of the TP will aid in a variety of medical and research applications.
Avian Predation on Steelhead is Consistent with Compensatory Mortality
Authors: Haeseker Steven L. , Scheer Gabriel , McCann Jerry
Published: May 2020

Numerous factors such as predation, disease, injury, and environmental conditions (e.g., river flows, hydropower operations) can influence survival rates of fish. Although mortality due to predation is commonly assumed to be additive and result in a directly proportional reduction on survival rates, compensatory processes may work to counteract or negate the effects of predation mortality on survival rates. We applied a random effects model to a long‐term, mark‐recapture‐recovery data set on anadromous steelhead (Oncorhynchus mykiss) from the Snake River Basin in the northwestern United States to assess whether avian predation mortality constitutes an additive or compensatory source of mortality. Specifically, our assessment focused on predation mortality due to double‐crested cormorants (Phalacrocorax auritus) and Caspian terns (Hydroprogne caspia) on colonies in the Columbia River estuary. In addition, we evaluated several candidate environmental indices to examine potential interactions between the effects of predation versus environmental conditions on steelhead survival rates. Average predation rates were 3.3% for the double‐crested cormorant colony and 17.0% for the Caspian tern colony. For both colonies, the estimated correlation between the predation rate and survival rate of steelhead was near zero, indicating that mortality due to avian predation is compensatory. Models that included variables for river flow, juvenile migration timing, and an index of forage biomass in the ocean accounted for 56–59% of the variation in steelhead survival, whereas avian predation rates accounted for <1% of the variation. Management efforts to reduce the abundance of the bird colonies are unlikely to improve the survival or conservation status of steelhead; however, results indicate that steelhead survival could be improved by hydropower management decisions that increase river flows and reduce juvenile migration delays. © 2020 The Wildlife Society.
Anatomy of the Round Window Region With Relation to Selection of Entry Site Into the Scala Tympani
Authors: Pringle Michael B. , Konieczny Katarzyna M.
Published: May 2020

Objectives/Hypothesis

The aim of cochlear implantation is to safely insert an electrode array into the scala tympani (ST) while avoiding damage to surrounding structures. There is disagreement on the optimal way of entering the ST—the round window (RW) approach versus cochleostomy. Regardless of the chosen approach, it is vital to understand the regional anatomy, which is complex, difficult to conceptualize, and rarely dissected in temporal bone courses. The goal of this study was to examine the anatomy of the RW to gain more in‐depth knowledge on the local relationships of the anatomical structures and propose an approach for entering the ST in cochlear implant surgery tailored to the encountered anatomy.

Study Design: Cadaveric prevalence study and expert opinion with literature review.

Methods

Cadaveric temporal bone dissection (n = 13) by the first author assessing the RW anatomy.

Results

The round window membrane (RWM) and the osseous spiral lamina (OSL) are curved structures, each with a horizontal and a vertical part. The two horizontal portions are very closely apposed. The relationship between the OSL and the RWM determines the best site for a cochleostomy, which if required is best placed anteroinferiorly to the RWM. The distance between the oval window inferior margin and the RW membrane is less than 2 to 3 mm. The ST initially extends inferiorly and medially to the RW.

Conclusions

The findings of our dissection have implications for cochlear implant surgery in aiming to avoid trauma to the OSL and basilar membrane and aid decision making in choosing the safest surgical approach.

Level of Evidence

5. Laryngoscope, 131:E598–E604, 2021
Comparison of Clinical Characteristics and Magnetic Resonance Imaging of Salivary Glands With Magnetic Resonance Sialography in Sjögren's Syndrome
Authors: André Raphaël , Becker Minerva , Lombardi Tommaso , Buchholzer Samanta , Marchal Francis , Seebach Jorg D.
Published: May 2020

Objectives/Hypothesis

To compare the results of magnetic resonance imaging with magnetic resonance sialography (MRSIAL) and the clinical and laboratory characteristics in a well‐characterized cohort of patients with primary or secondary Sjögren's syndrome (SS) meeting the American–European Consensus Group criteria.

Study Design: Retrospective, observational, monocentric study.

Methods

Thirty‐six patients (81% female, mean age = 48 ± 35 years) with primary or secondary SS who underwent MRSIAL were included in the study.

Results

MRSIAL revealed characteristic radiological signs in the parotid, sublingual, and submandibular salivary glands in 35/36 patients (97%). Patients presenting with anti‐Sjögren's syndrome–related antigen A (SSA) autoantibodies showed more often fatty infiltration, a “pepper‐and‐salt” appearance, ductal stenosis, and/or ductal dilation of the parotid gland (88%, 88%, and 72% respectively) than patients negative for anti‐SSA (12%, 4%, and 28% respectively). MRSIAL demonstrated signs characteristic of SS in all 11 patients with negative minor salivary gland biopsy. For 15 patients undergoing ultrasound examination only, 11 (73%) had SS findings, but all 15 had SS findings on MRSIAL. Two cases of parotid lymphoma were detected by MRSIAL (6%).

Conclusions

MRSIAL is a reliable technique to detect glandular anomalies in patients with SS, and seems to provide a valuable aid in the diagnosis of SS.

Level of Evidence

4 Laryngoscope, 131:E83–E89, 2021
Oil palm cultivation enhances soil pH, electrical conductivity, concentrations of exchangeable calcium, magnesium, and available sulfur and soil organic carbon content
Authors: Behera Sanjib K. , Shukla Arvind K. , Suresh Kancherla , Manorama Kamireddy , Mathur Ravi K. , Kumar Anil , Harinarayana Parasa , Prakash Chandra , Tripathi Ajay
Published: May 2020

The land area under oil palm (Elaeis guineensis Jacq.) cultivation (OPC) is increasing in different parts of world. Assessment of the soil parameters of oil palm plantations (OPP) is essential to judge the sustainability of land use for maintaining soil fertility and avoiding land degradation. The effects of OPC in India on soil parameters are poorly understood. Therefore, we evaluated the impact of OPC over the years (by considering oil palm plantations of 6, 12, and 18 years age) on soil properties, nutrient availability, soil organic carbon (SOC) pools, and SOC stock in comparison with those parameters in adjacent fallow land (FL) of southern India. Soils of OPP showed enhanced soil pH value, electrical conductivity, the concentrations of exchangeable calcium and magnesium and available sulfur, and SOC content in 0–20, 20–40, and 40–60 cm depths of soil compared with those parameters in FL. Available phosphorus concentration in soil increased with plantation age revealing the need for rational phosphorus management. However, the concentration of available nitrogen, potassium, exchangeable calcium and magnesium, and available sulfur and boron did not change with plantation age. The contents of SOC and very labile carbon were higher in surface soil layers of OPP than that in FL. Oil palm cultivation led to 20, 18, and 45% enhancement in SOC stock in 6, 12, and 18 years‐old OPP, respectively, compared with SOC stock in FL indicating C sequestration due to OPC. The very labile and less labile C stock in FL, 6 and 12 years‐old OPP were similar, whereas the values of these parameters were higher in 18 years‐old OPP. Positive correlation (p < .01) of SOC with very labile, labile, and less labile carbon pools indicated their inter‐relatedness. This information will be utilized in devising rational nutrient management options for the existing as well as ensuing OPP due to variations in soil properties and available nutrients.
Relationships between Very Low‐Density Lipoproteins–Ceramides, −Diacylglycerols, and –Triacylglycerols in Insulin‐Resistant Men
Authors: Mucinski Justine M. , Manrique‐Acevedo Camila , Kasumov Takhar , Garrett Timothy J. , Gaballah Ayman , Parks Elizabeth J.
Published: May 2020

This short report describes the relationships between concentrations of ceramides (CER), diacylglycerols (DAG), triacylglycerols (TAG) in very low‐density lipoproteins (VLDL) particles, and hepatic lipid accumulation. VLDL particles were isolated from male subjects (n = 12, mean ± SD, age 42.1 ± 5.4 years, BMI 37.4 ± 4.1 kg/m2, ALT 45 ± 21 U/L) and apolipoprotein B100 (apoB100), VLDL‐TAG, ‐CER, and ‐DAG quantified. The contents of all three lipids were highly correlated with VLDL particle number (r ≥ 0.768, p ≤ 0.003). The molar quantity of VLDL‐TAG was 3× that of DAG and 137× that of CER (14,053 ± 5714, 5004 ± 2714, and 105 ± 49 mol/mol apoB100, respectively). Reduced VLDL‐CER concentrations were associated with both higher insulin levels (r = −0.645, p = 0.024) and intrahepatic‐TAG (r = −0.670, p = 0.017). In fatty liver, the secretion of hepatic TAG, CER, and DAG may be suppressed and contribute to intrahepatic lipotoxicity. The mechanisms by which hepatic‐CER and ‐DAG synthesis and assembly into VLDL is coordinately controlled with TAG will be important in understanding the emerging role of elevated CER contributing to cardiometabolic disease.
Postsurgical Myoclonus of the Pectoralis Major
Authors: de Paula Tiago Gomes , Vale Thiago Cardoso , Pedroso José Luiz , Barsottini Orlando Graziani Povoas
Published: May 2020

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Movement Disorders Associated with GABAA Receptor Encephalitis: A Video Case Report
Authors: Vacchiano Veria , Giannoccaro Maria Pia , Rinaldi Rita , Guarino Maria , Liguori Rocco
Published: May 2020

View Supplementary Video 1
Surface engineering of magnetic nanoparticles for hyperthermia and drug delivery
Authors: Lucena Guilherme N. , dos Santos Caio C. , Pinto Gabriel C. , Amantéa Bruno E. , Piazza Rodolfo D. , Jafelicci Júnior Miguel , Marques Rodrigo Fernando C.
Published: May 2020

Magnetic nanoparticles (MNP) have emerged as a relevant material for biomedical applications based on drug delivery systems and magnetic hyperthermia. When carefully tailored, their surface properties can enhance the solubility, bioavailability, permeability, metabolism, excretion, cell internalization and recognition of many medicines, which are parameters highly desired when one think in the development and efficiency increasing of several therapies. Allied to it, an interesting synergism can be achieved by the use of magnetic fields as trigger of drug release from thermosensitive polymer‐modified MNP or as a tool to increase accumulation of medicine in specific site. Faced it, here it shows how surface engineering of MNP can improve its biomedical relevance due to enhancement of cellular recognition, biocompatibility and drug release of several medicines. Furthermore, particular attention will be paid to the use of magnetic hyperthermia, which has acted synergic to improve MNP effects of many drug delivery systems.
Bipedicled dorsal intercostal artery propeller flaps for reconstruction of extensive cervicothoracic midline defects
Authors: Schmidt Magali , Cristofari Sarra , Al Madani Omar , Romano Golda , Qassemyar Quentin , Pascal‐Moussellard Hugues , Atlan Michael
Published: May 2020

Background

Propeller flaps have been reported to cover cervicothoracic midline defects with lower donor site morbidity compared to muscle flaps. When these defects are extensive, we propose a propeller flap technique that we have named dorsal intercostal artery perforator plus (DICAP+) flap based on two perforator pedicles, to secure the large skin paddle. In this article, we present our experience.

Methods

Six propeller DICAP+ flap procedures were performed on five patients, to reconstruct cervicothoracic midline defects. Three of them were caused by tumors and two were secondary to hardware exposure after spinal surgery. Defect sizes ranged from 16 × 5 to 24 × 9 cm. Every propeller flap was harvested on two perforators including one DICAP, and rotated from 80° to 180°.

Results

Skin ellipse size ranged from 15 × 7 cm or 82.4 cm2 to 25 × 12 cm or 235.5 cm2, equal to a mean surface area of 160 cm2. The donor site was closed by primary suturing in four of the six procedures, by a contralateral propeller DICAP flap in one patient, and was left to heal by secondary intention in another one. All six flaps successfully covered the underlying defects with no evidence of partial or complete necrosis. No other complications were observed at recipient and donor sites. The follow‐up period ranged from 9 months to 2 years.

Conclusions

Propeller flaps based on two dorsal perforators including one dorsal intercostal artery perforator, DICAP+, are a reliable means of reconstructing extensive cervicothoracic midline defects.
Soft tissue coverage of a total gluteal defect with a combination of perforator‐based flaps: A case report
Authors: Scaglioni Mario F. , Grufman Vendela , Meroni Matteo , Fritsche Elmar
Published: May 2020

Soft tissue defects in the buttock area are often related to decubitus ulcers, which are usually small to medium‐large size and can be regularly treated with local flaps. However, when the defects have bigger size, such as those involving the whole gluteal region, the coverage can become more challenging, since this specific area needs both a good resistance to pressure and an acceptable functional result. The most common solution for similar cases is the use of multiple local flaps, or, in extreme situations, a free flap. In particular, local flaps based on perforator vessels are, in selected cases, a consolidated alternative to free flap allowing an efficient reconstruction of soft tissue defects using adjacent similar tissues, providing the benefit of “like with like” coverage. Here we present a case of a large mycosis fungoides nidus of the gluteal region measuring 25 cm × 18 cm reconstructed using two large perforator flaps adjacent to the defect combined with a remote one for coverage of the donor site. The cranial flap was designed based on a perforator arising from the superior gluteal artery and transferred into the defect by means of a V–Y advancement, while the two caudal propeller flaps in the posterior thigh were both based on perforators of the profunda femoris artery and rotated 180°, respectively. To obtain a tension‐free cover of the donor site defect we applied the concept of “sequential” propeller flaps. Post‐operative course was uneventful and the patient was ambulatory with assistive devices after 1 week. At 6 months follow‐up, wounds were completely healed without complications and a good functional result was obtained. This report showed the great coverage potential of multiple perforator‐based local flaps when properly combined allowing primary closure of the donor site. In particular, we managed to reconstruct a total gluteal defect using just ipsilateral side tissue, reducing morbidity, and obtaining a stable result.
Two‐tone continuous‐wave Doppler radar based on envelope detection method
Authors: Park Jae‐Hyun , Yang Jong‐Ryul
Published: May 2020

A continuous‐wave (CW) Doppler radar using two‐tone frequencies is presented for the measurement of short‐range distance. The envelope detection method is proposed to discriminate each frequency signal in the output waveform of the two‐tone CW Doppler radar sensor. The phase difference in each frequency is obtained from the nonlinearly demodulated I/Q baseband signals, following calibration of the I/Q imbalance and DC offset voltages. The absolute distance is derived from the phase differences at the two‐tone frequencies with a 100 MHz spacing. The measurement results in the two‐tone radar system show a maximum error of 2.5 cm in the 20 to 50 cm distance range.
Technical Note: Cardiac synchronized volumetric modulated arc therapy for stereotactic arrhythmia radioablation — Proof of principle
Authors: Poon Justin , Kohli Kirpal , Deyell Marc W. , Schellenberg Devin , Reinsberg Stefan , Teke Tony , Thomas Steven
Published: May 2020

Purpose

Ventricular tachycardia (VT) is a rapid, abnormal heart rhythm that can lead to sudden cardiac death. Current treatment options include antiarrhythmic drug therapy and catheter ablation, both of which have only modest efficacy and have potential complications. Cardiac radiosurgery has the potential to be a noninvasive and efficient treatment option for VT. Cardiac motion, however, must be accounted for to ensure accurate dose delivery to the target region. Cardiac synchronized volumetric modulated arc therapy (CSVMAT) aims to minimize the dose delivered to normal tissues by synchronizing beam delivery with a cardiac signal, irradiating only during the quiescent intervals of the cardiac cycle (when heart motion is minimal) and adjusting the beam delivery speed in response to heart rate changes.

Methods

A CSVMAT plan was adapted from a conventional VMAT plan and delivered on a Varian TrueBeam linear accelerator. The original VMAT plan was divided into three interleaved CSVMAT phases, each consisting of alternating beam‐on and beam‐off segments synchronized to a sample heart rate. Trajectory log files were collected for the original VMAT and CSVMAT deliveries and the dose distributions were measured with Gafchromic EBT‐XD film.

Results

Analysis of the trajectory log files showed successful synchronization with the sample cardiac signal. Film analysis comparing the original VMAT and CSVMAT dose distributions returned a gamma passing rate of 99.14% (2%/2 mm tolerance).

Conclusions

The film results indicated excellent agreement between the dose distributions of the original and cardiac synchronized beam deliveries. This study demonstrates a proof of principle cardiac synchronization strategy for precise radiation treatment plan delivery and adjustment to a variable heart rate. The cardiac synchronized technique may be advantageous in radioablation for VT.
Detailed identification of epidermal growth factor receptor mutations in lung adenocarcinoma: Combining radiomics with machine learning
Authors: Li Shu , Luo Ting , Ding Changwei , Huang Qinlai , Guan Zhihao , Zhang Hao
Published: May 2020

Purpose

To investigate the use of radiomics in the in‐depth identification of epidermal growth factor receptor (EGFR) mutation status in patients with lung adenocarcinoma.

Methods

Computed tomography images of 438 patients with lung adenocarcinoma were collected in two different institutions, and 496 radiomic features were extracted. In the training set, lasso logistic regression was used to establish radiomic signatures. Combining radiomic index and clinical features, five machine learning methods, and a tenfold cross‐validation strategy were used to establish combined models for EGFR+ vs EGFR−, and 19Del vs L858R, groups. The predictive power of the models was then evaluated using an independent external validation cohort.

Results

In the EGFR+ vs EGFR− and 19Del vs L858R groups, radiomic signatures consisting of 12 and 7 radiomic features were established, respectively; the area under the curves (AUCs) of the lasso logistic regression model on the validation set was 0.76 and 0.71, respectively. After inclusion of the clinical features, the maximum AUC of combined models on the validation set was 0.79 and 0.74, respectively. Logistic regression analysis showed good performance in the two groups, with AUCs of 0.79 and 0.71 on the validation set. Additionally, the AUC of combined models in the EGFR+ vs EGFR− group was higher than that of the 19Del vs L858R group.

Conclusions

Our study shows the potential of radiomics to predict EGFR mutation status. There are imaging phenotypic differences between EGFR+ and EGFR−, and between 19Del and L858R; these can be used to allow patients with lung adenocarcinoma to choose more appropriate and personalized treatment options.
Fast and accurate calculation of myocardial T1 and T2 values using deep learning Bloch equation simulations (DeepBLESS)
Authors: Shao Jiaxin , Ghodrati Vahid , Nguyen Kim‐Lien , Hu Peng
Published: May 2020

Purpose

To propose and evaluate a deep learning model for rapid and accurate calculation of myocardial T1/T2 values based on a previously proposed Bloch equation simulation with slice profile correction (BLESSPC) method.

Methods

Deep learning Bloch equation simulations (DeepBLESS) models are proposed for rapid and accurate T1 estimation for the MOLLI T1 mapping sequence with balanced SSFP readouts and T1/T2 estimation for a radial simultaneous T1 and T2 mapping (radial T1‐T2) sequence. The DeepBLESS models were trained separately based on simulated radial T1‐T2 and MOLLI data, respectively. The DeepBLESS T1‐T2 estimation accuracy was evaluated based on simulated data with different noise levels. The DeepBLESS model was compared with BLESSPC in simulation, phantom, and in vivo studies for the MOLLI sequence at 1.5 T and radial T1‐T2 sequence at 3 T.

Results

After DeepBLESS was trained, in phantom studies, DeepBLESS and BLESSPC achieved similar accuracy and precision in T1‐T2 estimations for both MOLLI and radial T1‐T2 (P > .05). For in vivo, DeepBLESS and BLESSPC generated similar myocardial T1/T2 values for radial T1‐T2 at 3 T (T1: 1366 ± 31 ms for both methods, P > .05; T2: 37.4 ms ± 0.9 ms for both methods, P > .05), and similar myocardial T1 values for the MOLLI sequence at 1.5 T (1044 ± 20 ms for both methods, P > .05). DeepBLESS generated a T1/T2 map in less than 1 second.

Conclusion

The DeepBLESS model offers an almost instantaneous approach for estimating accurate T1/T2 values, replacing BLESSPC for both MOLLI and radial T1‐T2 sequences, and is promising for multiparametric mapping in cardiac MRI.
Optimizing telemedicine to facilitate amyotrophic lateral sclerosis clinical trials
Authors: Govindarajan Raghav , Berry James D. , Paganoni Sabrina , Pulley Michael T. , Simmons Zachary
Published: May 2020

Amyotrophic lateral sclerosis (ALS) has the largest drug pipeline among neuromuscular diseases, with over 160 companies actively involved in ALS research. There is a growing need to recruit trial participants, but ALS patients often have limited mobility and most ALS trials are conducted in a small number of major centers. These factors effectively limit patient participation, particularly for those in rural areas. The current coronavirus disease 2019 (COVID‐19) pandemic has necessitated the more widespread use of telemedicine technology for clinical care, and has prompted consideration of its increased use for clinical trials. In this opinion piece, we describe the current state of telemedicine for recruitment, consenting, and screening of participants for clinical trials. We also summarize the available data on remote administration of outcome measures. Current challenges include validation of outcome measures for remote assessment, as well as technological, regulatory, and licensure barriers.
Form factor analysis of the surface electromyographic interference pattern
Authors: Nandedkar Sanjeev D. , Barkhaus Paul E. , Stålberg Erik V.
Published: May 2020

Introduction

In contrast to needle electromyography (EMG), surface EMG recordings are painless. It is of interest to develop methods to analyze surface EMG for diagnostic purposes.

Methods

Surface EMG interference pattern (SIP) recordings from the abductor pollicis brevis muscle of healthy subjects and subjects with amyotrophic lateral sclerosis (ALS) were analyzed by measuring root‐mean‐square (RMS) voltage, mean rectified voltage, form factor (FF), and the clustering index (CI). The FF vs SIP area plot was used for analysis.

Results

The SIP FF was increased and abnormal in ALS subjects, especially when SIP area was less than 200 mVms. Power regression showed a faster FF decline with SIP area in ALS patients than in healthy subjects. The CI and FF showed a strong correlation.

Discussion

FF is easy to calculate and demonstrates abnormalities in ALS patients.
Compound muscle action potential scan and MScanFit motor unit number estimation during Wallerian degeneration after nerve transections
Authors: Kesim‐Sahin Ozlem , Sirin Nermin Gorkem , Erbas Bahar , Artug Tugrul , Oguz‐Akarsu Emel , Kocasoy‐Orhan Elif , Baslo Mehmet Baris , Mammadova Nermin , Emekli Ufuk , Oge Ali Emre
Published: May 2020

Background

Compound muscle action potential (CMAP) scan and MScanFit have been used to understand the consequences of denervation and reinnervation. This study aimed to monitor these parameters during Wallerian degeneration (WD) after acute nerve transections (ANT).

Methods

Beginning after urgent surgery, CMAP scans were recorded at 1–2 day intervals in 12 patients with ANT of the ulnar or median nerves, by stimulating the distal stump (DS). Stimulus intensities (SI), steps, returners, and MScanFit were calculated. Studies were grouped according to the examination time after ANT. Results were compared with those of 27 controls.

Results

CMAP amplitudes and MScanFit progressively declined, revealing a positive correlation with one another. SIs were higher in WD groups than controls. Steps appeared or disappeared in follow‐up scans. The late WD group had higher returner% than the early WD and control groups.

Conclusions

MScanFit can monitor neuromuscular dysfunction during WD. SIs revealed excitability changes in DS.
Model Reduction Framework with a New Take on Active Subspaces for Optimization Problems with Linearized Fluid‐Structure Interaction Constraints
Authors: Boncoraglio Gabriele , Farhat Charbel , Bou‐Mosleh Charbel
Published: May 2020

In this paper, a new take on the concept of an active subspace for reducing the dimension of the design parameter space in a multidisciplinary analysis and optimization (MDAO) problem is proposed. The new approach is intertwined with the concepts of adaptive parameter sampling, projection‐based model order reduction, and a database of linear, projection‐based reduced‐order models equipped with interpolation on matrix manifolds, in order to construct an efficient computational framework for MDAO. The framework is fully developed for MDAO problems with linearized fluid‐structure interaction constraints. It is applied to the aeroelastic tailoring, under flutter constraints, of two different flight systems: a flexible configuration of NASA's Common Research Model; and NASA's Aeroelastic Research Wing #2 (ARW‐2). The obtained results illustrate the feasibility of the computational framework for realistic MDAO problems and highlight the benefits of the new approach for constructing an active subspace in both terms of solution optimality and wall‐clock time reduction.
Coupled optimization of macroscopic structures and lattice infill
Authors: Geoffroy‐Donders Perle , Allaire Grégoire , Michailidis Georgios , Pantz Olivier
Published: May 2020

This article is concerned with the coupled optimization of the external boundary of a structure and its infill made of some graded lattice material. The lattice material is made of a periodic cell, macroscopically modulated and oriented. The external boundary may be coated by a layer of pure material with a fixed prescribed thickness. The infill is optimized by the homogenization method while the macroscopic shape is geometrically optimized by the Hadamard method of shape sensitivity. A first original feature of the proposed approach is that the infill material follows the displacement on the exterior boundary during the geometric optimization step. A second key feature is the dehomogenization or projection step which build a smoothly varying lattice infill from the optimal homogenized properties. Several numerical examples illustrate the effectiveness of our approach in 2‐d, which is especially convenient when considering design‐dependent loads.
A modified cutting‐plane time integration scheme with adaptive substepping for elasto‐viscoplastic models
Authors: Li Jian , Yin Zhen‐Yu
Published: May 2020

Integration of stress‐strain‐time relationship is a key issue for the application of elasto‐viscoplastic models to engineering practice. This article presents a novel adaptive substepping cutting‐plane time integration scheme for elasto‐viscoplastic models keeping the advantage of original cutting‐plane (OCP) with only the first derivatives of loading surface required. The deficiency of OCP time integration algorithm is first discussed taking a simple overstress theory based elasto‐viscoplastic modified Cam‐Clay model (EVP‐MCC) as example. To overcome this, a new algorithm is developed with three features: (1) an evolution function for the hardening variable of dynamic loading surface is innovatively deduced for the Taylor series approximation, (2) the elastic predictor is modified to account for the initial viscoplastic strain rate with more accuracy, and (3) a new adaptive substepping technique for restricting simultaneously both strain and time incremental sizes based on the overstress distance is proposed. For easy understanding, the proposed algorithm is first presented for one‐dimensional condition, and then extended to three‐dimensional condition. The new integrated EVP‐MCC model using the proposed algorithm is examined by simulating laboratory tests at both levels of integration point and finite element with a good performance in terms of accuracy and convergence.
A semi‐implicit stabilized particle Galerkin method for incompressible free surface flow simulations
Authors: Pan Xiaofei , Wu Cheng‐Tang , Hu Wei
Published: May 2020

A new particle Galerkin method is introduced to solve the Naiver‐Stokes equations in a Lagrangian fashion. The present method aims to suppress key numerical instabilities observed in the strong form Lagrangian particle methods such as smoothed particle hydrodynamics (SPH), incompressible SPH, and moving particle semi‐implicit for incompressible free surface flow simulations.

It is well‐known that strong form Lagrangian particle methods usually rely on ad hoc particle stabilization techniques based on particle shifting, artificial viscosity, or density‐invariant condition due to some formulation inconsistency issues. In the present method, we introduce a momentum‐consistent velocity smoothing algorithm which is used to combine with the second‐order rotational incremental pressure‐correction scheme to stabilize the pressure field as well as to enforce the consistency of Neumann boundary condition. To further impose slip‐free or nonslip boundary conditions for the fluid flow, a penalty method which is free of ghost or dummy particles is developed. Finally, a particle insertion‐deletion adaptive scheme is proposed when the violent fluid flow is considered. Four numerical examples are studied to validate the accuracy and stability of the present method.