bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between the lateral acromion angle and postoperative persistent pain of distal clavicle fracture treated with clavicle hook plate
Authors: Wu Kailun , Su Xinlin , Roche Stephen J. L. , Held Michael F. G. , Yang Huilin , Dunn Robert N. , Guo Jiong Jiong
Published: June 2020

Background

The clavicular hook plate is an accepted surgical procedure for distal clavicle fractures. The relationship of the characteristics of the hook plate, acromioclavicular joint and acromion morphology, and clinical outcome has remained poorly understood. We reviewed the clinical records of patients who had distal clavicle fractures with different lateral acromion angles treated using a clavicle hook plate and evaluated their clinical outcomes with respect to shoulder pain and acromial morphology.

Methods

We retrospectively reviewed 102 patients with distal clavicle fractures treated with hook plates at our institution from 2010 to 2017. They were divided into four groups according to lateral acromion angle on shoulder AP view X-rays. The angle was defined as the incline angle between the superior surface of distal clavicle and the inferior facet of acromion on coronal plane. We reviewed their clinical features, including Neer’s impingement sign, MRI findings, and outcomes using Japanese Orthopaedic Association Scores. The mean follow-up was 25.5 months (range, 24 to 28 months).

Results

All patients in group D (large lateral acromion angle (α) > 40°, acromion coronal angle (β) < 60°) complained of postoperative symptoms. Compared to those with common lateral acromion angle, the incidence of postoperative impingement in group D was undoubtedly much higher (100%). Japanese Orthopaedic Association (JOA) scores in group D were worse at 3 months post-surgery, 3 months post plate removal, and at the last follow-up despite a slightly earlier removal in this group.

Conclusion

Lateral acromion angle appears to be an important factor in the development of postoperative pain and worse outcomes (JOA scores) in patients treated with the hook plate. The incidence of subacromial impingement and rotator cuff lesion (RCL) increased with the α angle. Early limited mobility and removal of the implant may improve the prognosis and resolve the postoperative shoulder pain.

Study design

Retrospective review, level of evidence IV.
Primary repair of transposition of the great arteries with an interrupted aortic arch: a case report and literature review
Authors: Xu Qiteng , Duan Shuhua , Xing Pengchao , Chen Rui
Published: June 2020

Transposition of the great arteries (TGA) and interruption of the aortic arch (IAA) are uncommon congenital heart diseases. The association between TGA and IAA is rare. The aim of this study is to present a case with combined TGA and IAA, who underwent the primary repair and review the literature with similar cases. The one-month-old patient was admitted with tachypnea and cyanosis. Delayed diagnosis was caused due to the absence of prenatal examination. Echocardiography and computed tomography angiography confirmed TGA with anterior-posterior-oriented great arteries, wide patent ductus arteriosus, type B IAA, ventricular septal defect (VSD) and pulmonary arterial hypertension. The patient underwent a single-stage primary surgical repair process leading to VSD closure, reconstruction of the aortic arch and arterial switch operation in October 2019. The patient is doing well at a 3-month follow-up post-surgery. The echocardiogram suggests a normal systolic function of the ventricles and trivial regurgitation for both aortic and pulmonary valves.

Conclusions

The single-stage repair with VSD closure, reconstruction of aortic arch and arterial switch operation might be an applicable approach for most of the patients with combined TGA and IAA. Long term follow-up is required as a high re-intervention rate for recurrent coarctation, supravalvular aortic stenosis, neoaortic valve regurgitation, obstruction of the right heart system and coronary stenosis has been reported.
Effect of different orthotic materials on plantar pressures: a systematic review
Authors: Gerrard James M. , Bonanno Daniel R. , Whittaker Glen A. , Landorf Karl B.
Published: June 2020

Background

The effect of different orthotic materials on plantar pressures has not been systematically investigated. This study aimed to review and summarise the findings from studies that have evaluated the effect of orthotic materials on plantar pressures.

Methods

We conducted a systematic review of experimental studies that evaluated the effect of foot orthotic materials or shoe insole materials on plantar pressures using in‐shoe testing during walking. The following databases were searched: MEDLINE, CINAHL, Embase and SPORTDiscus. Included studies were assessed for methodological quality using a modified Quality Index. Peak pressure, pressure‐time integral, maximum force, force‐time integral, contact area, and contact time were variables of interest. Data were synthesised descriptively as studies were not sufficiently homogeneous to conduct meta‐analysis. Standardised mean differences (Cohen's d) were calculated to provide the size of the effect between materials found in each study.

Results

Five studies were identified as meeting the eligibility criteria. All five studies were laboratory‐based and used a repeated measures design. The quality of the studies varied with scores ranging between 20 and 23 on the modified Quality Index (maximum index score 28). The included studies investigated the effects of polyurethane (including PORON®), polyethylene (including Plastazote®), ethyl vinyl acetate (EVA) and carbon graphite on plantar pressures. Polyurethane (including PORON®), polyethylene (including Plastazote®) and EVA were all found to reduce peak pressure.

Conclusion

Based on the limited evidence supplied from the five studies included in this review, some orthotic materials can reduce plantar pressures during walking. Polyurethane (including PORON®), polyethylene (including Plastazote®) and EVA reduce peak pressure beneath varying regions of the foot. Future well‐designed studies will strengthen this evidence.
Proteogenomic analysis of Inhibitor of Differentiation 4 (ID4) in basal-like breast cancer
Authors: Baker Laura A. , Holliday Holly , Roden Daniel , Krisp Christoph , Wu Sunny Z. , Junankar Simon , Serandour Aurelien A. , Mohammed Hisham , Nair Radhika , Sankaranarayanan Geetha , Law Andrew M. K. , McFarland Andrea , Simpson Peter T. , Lakhani Sunil , Dodson Eoin , Selinger Christina , Anderson Lyndal , Samimi Goli , Hacker Neville F. , Lim Elgene , Ormandy Christopher J. , Naylor Matthew J. , Simpson Kaylene , Nikolic Iva , O’Toole Sandra , Kaplan Warren , Cowley Mark J. , Carroll Jason S. , Molloy Mark , Swarbrick Alexander
Published: June 2020

Background

Basal-like breast cancer (BLBC) is a poorly characterised, heterogeneous disease. Patients are diagnosed with aggressive, high-grade tumours and often relapse with chemotherapy resistance. Detailed understanding of the molecular underpinnings of this disease is essential to the development of personalised therapeutic strategies. Inhibitor of differentiation 4 (ID4) is a helix-loop-helix transcriptional regulator required for mammary gland development. ID4 is overexpressed in a subset of BLBC patients, associating with a stem-like poor prognosis phenotype, and is necessary for the growth of cell line models of BLBC through unknown mechanisms.

Methods

Here, we have defined unique molecular insights into the function of ID4 in BLBC and the related disease high-grade serous ovarian cancer (HGSOC), by combining RIME proteomic analysis, ChIP-seq mapping of genomic binding sites and RNA-seq.

Results

These studies reveal novel interactions with DNA damage response proteins, in particular, mediator of DNA damage checkpoint protein 1 (MDC1). Through MDC1, ID4 interacts with other DNA repair proteins (γH2AX and BRCA1) at fragile chromatin sites. ID4 does not affect transcription at these sites, instead binding to chromatin following DNA damage. Analysis of clinical samples demonstrates that ID4 is amplified and overexpressed at a higher frequency in BRCA1-mutant BLBC compared with sporadic BLBC, providing genetic evidence for an interaction between ID4 and DNA damage repair deficiency.

Conclusions

These data link the interactions of ID4 with MDC1 to DNA damage repair in the aetiology of BLBC and HGSOC.
Tick-borne encephalitis virus (TBEV) prevalence in field-collected ticks (Ixodes ricinus) and phylogenetic, structural and virulence analysis in a TBE high-risk endemic area in southwestern Germany
Authors: Ott Daniela , Ulrich Kristina , Ginsbach Philip , Öhme Rainer , Bock-Hensley Oswinde , Falk Ulrich , Teinert Martina , Lenhard Thorsten
Published: June 2020

Background

Tick-borne encephalitis (TBE) is the most common viral CNS infection with incidences much higher than all other virus infections together in many risk areas of central and eastern Europe. The Odenwald Hill region (OWH) in southwestern Germany is classified as a TBE risk region and frequent case numbers but also more severe infections have been reported within the past decade. The objective of the present study was to survey the prevalence of tick-borne encephalitis virus (TBEV) in Ixodes ricinus and to associate TBEV genetic findings with TBE infections in the OWH.

Methods

Ticks were collected by the flagging methods supported by a crowdsourcing project implementing the interested public as collectors to cover completely and collect randomly a 3532 km2 area of the OWH TBE risk region. Prevalence of TBEV in I. ricinus was analysed by reversed transcription quantitative real-time PCR. Phylogeographic analysis was performed to classify OWH TBEV isolates within a European network of known TBEV strains. Mutational sequence analysis including 3D modelling of envelope protein pE was performed and based on a clinical database, a spatial association of TBE case frequency and severity was undertaken.

Results

Using the crowd sourcing approach we could analyse a total of 17,893 ticks. The prevalence of TBEV in I. ricinus in the OWH varied, depending on analysed districts from 0.12% to 0% (mean 0.04%). Calculated minimum infection rate (MIR) was one decimal power higher. All TBEV isolates belonged to the European subtype. Sequence analysis revealed a discontinuous segregation pattern of OWH isolates with two putative different lineages and a spatial association of two isolates with increased TBE case numbers as well as exceptional severe to fatal infection courses.

Conclusions

TBEV prevalence within the OWH risk regions is comparatively low which is probably due to our methodological approach and may more likely reflect prevalence of natural TBEV foci. As for other European regions, TBEV genetics show a discontinuous phylogeny indicating among others an association with bird migration. Mutations within the pE gene are associated with more frequent, severe and fatal TBE infections in the OWH risk region.
Flight of the COVID-19 patient: experience with a Wuhan evacuee: a case report
Authors: Segar Sandeep , Bouland Daniel , Torriani Francesca , Kwak Kevin , Asudani Deepak , Taplitz Randy , Gupta Vineet
Published: June 2020

Background

Coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, was declared a global pandemic by the World Health Organization in March 2020.

Case presentation

We report a case of a 51-year-old Chinese woman who was evacuated from Wuhan, China and diagnosed with coronavirus disease 2019 infection at a Southern California quarantine facility. Her clinical course was notable for high fevers, night sweats, productive cough, transient leukopenia, lymphopenia, thrombocytopenia, and transaminitis. Evolving hypoxia and infiltrates on chest imaging warranted the trial of an investigational antiviral drug - remdesivir. Our patient recovered and was discharged after 2 weeks of hospitalization.

Conclusions

This case highlights our patient’s clinical course, including diagnostic work-up, medical management, and challenges in defining non-infectivity in a relatively unknown disease.
MiR-101-containing extracellular vesicles bind to BRD4 and enhance proliferation and migration of trophoblasts in preeclampsia
Authors: Cui Jinhui , Chen Xinjuan , Lin Shuo , Li Ling , Fan Jianhui , Hou Hongying , Li Ping
Published: June 2020

Background

Preeclampsia (PE) is a frequently occurring pregnancy disorder in the placenta, which results in various maternal and fetal complications. The current study aims to evaluate the role of extracellular vesicles (EVs)-encapsulated microRNA (miR)-101 in biological processes of trophoblasts in PE and its underlying mechanism.

Methods

Human umbilical cord mesenchymal stem cell (HUCMSC) and HUCMSC-derived EVs were isolated and cultured, after which EV characterization was carried out using PKH67 staining. In silico analyses were adopted to predict the downstream target genes of miR-101, and dual luciferase reporter gene assay was applied to validate the binding affinity. Furthermore, loss- and gain-of-function approaches were adopted to determine the role of miR-101 and bromodomain-containing protein 4 (BRD4) in trophoblast proliferation and invasion using EDU staining and transwell assay. In addition, a rat model of PE was established to verify the function of EV-encapsulated miR-101 in vivo.

Results

Placental tissues obtained from PE patients presented with downregulated miR-101 expression and upregulated BRD4 and CXCL11 expression. EV-encapsulated miR-101 from HUCMSCs could be delivered into the trophoblast HTR-8/SVneo cells, thus enhancing proliferation and migration of trophoblasts. Mechanically, miR-101 targeted and negatively regulated BRD4 expression. BRD4 knockdown promoted the proliferation and migration of trophoblasts by suppressing NF-κB/CXCL11 axis. EV-encapsulated miR-101 from HUCMSCs also reduced blood pressure and 24 h urine protein in vivo, thereby ameliorating PE.

Conclusion

In summary, EV-encapsulated miR-101 promoted proliferation and migration of placental trophoblasts through the inhibition of BRD4 expression via NF-κB/CXCL11 inactivation.
Leftover opioids following adult surgical procedures: a systematic review and meta-analysis
Authors: Schirle Lori , Stone Amanda L. , Morris Matthew C. , Osmundson Sarah S. , Walker Philip D. , Dietrich Mary S. , Bruehl Stephen
Published: June 2020

Background

US opioid prescribing and use escalated over the last two decades, with parallel increases in opioid misuse, opioid-related deaths, and concerns about diversion. Postoperatively prescribed opioids contribute to these problems. Policy makers have addressed this issue by limiting postoperative opioid prescribing. However, until recently, little data existed to guide prescribers on opioid needs postoperatively. This meta-analysis quantitatively integrated the growing literature regarding extent of opioids leftover after surgery and identified factors associated with leftover opioid proportions.

Methods

We conducted a meta-analysis of observational studies quantifying postoperative opioid consumption in North American adults, and evaluated effect size moderators using robust variance estimation meta-regression. Medline, EMBASE, Cumulative Index of Nursing and Allied Health Literature, and Cochrane Database of Systematic Reviews were searched for relevant articles published January 1, 2000 to November 10, 2018. The Methodological Index for Non-Randomized Studies (MINORS) tool assessed risk of study bias. The proportion effect size quantified the primary outcome: proportion of prescribed postoperative opioids leftover at the time of follow-up. Primary meta-regression analyses tested surgical type, amount of opioids prescribed, and study publication year as possible moderators. Secondary meta-regression models included surgical invasiveness, age, race, gender, postoperative day of data collection, and preoperative opioid use.

Results

We screened 911 citations and included 44 studies (13,068 patients). The mean weighted effect size for proportion of postoperative opioid prescriptions leftover was 61% (95% CI, 56-67%). Meta-regression models revealed type of surgical procedure and level of invasiveness had a statistically significant effect on proportion of opioids leftover. Proportion of opioids leftover was greater for “other soft tissue” surgeries than abdominal/pelvic surgeries, but did not differ significantly between orthopedic and abdominal/pelvic surgeries. Minimally invasive compared to open surgeries resulted in a greater proportion of opioids leftover. Limitations include predominance of studies from academic settings, inconsistent reporting of confounders, and a possible publication bias toward studies reporting smaller leftover opioid proportions.

Conclusions and implications of key findings

A significant proportion of opioids are leftover postoperatively. Surgery type and level of invasiveness affect postoperative opioid consumption. Integration of such factors into prescribing guidelines may help minimize opioid overprescribing while adequately meeting analgesic needs.
Contingency management for smoking cessation among individuals with type 2 diabetes: protocol for a multi-center randomized controlled feasibility trial
Authors: Martinez Sydney A. , Quaife Samantha L. , Hasan Afsheen , McMillan Kathryn A. , Beebe Laura A. , Muirhead Fiona
Published: June 2020

Background

Individuals with type 2 diabetes (T2D) who smoke are at increased risk for many types of cancers as well as an accelerated progression of microvascular and macrovascular complications. Smoking cessation is recommended as a standard treatment for T2D; however, individuals with T2D are faced with competing lifestyle changes. Glycemic and blood pressure control often take precedence over smoking cessation, and patients are often unmotivated to quit. Contingency management in combination with standard smoking cessation treatment has been demonstrated to improve cessation outcomes in various populations. The purpose of this randomized controlled feasibility trial is to explore the feasibility of contingency management and biochemical verification using a remote smartphone-based carbon monoxide monitor for smoking cessation among individuals with T2D.

Methods

A three-arm, randomized controlled feasibility trial will be conducted in two study sites that include the USA and UK. We will recruit 60 participants who will each receive usual care smoking cessation treatment (counseling and nicotine replacement therapy) and be randomized to a short term incentives (6 weeks), long term incentives (12 weeks), or no incentives (control) group. Participants will receive a smartphone and carbon monoxide monitor to complete daily remote assessments throughout the 12 weeks and will complete an exit interview at the end of the study. The primary outcomes for this feasibility study include completion of the protocol and proportion of daily assessments completed. Secondary outcomes include recruitment measures, acceptability, and smoking abstinence.

Discussion

We will explore the feasibility of recruiting smokers with T2D and their engagement in the program, particularly related to the use of the remote biochemical verification and smartphone application. In addition, we will evaluate the intervention content, study procedures, data collection methods, and follow-up and will qualitatively assess the participants’ acceptability of the program. The results of this study will inform the design of a larger trial to test the efficacy of the contingency management program for improving smoking cessation outcomes among individuals with T2D.

Trial registration

This randomized controlled feasibility trial has been registered at ClinicalTrials.gov with an ID NCT03527667 on May 4, 2018.
Anesthetic management of a patient with musculocontractural Ehlers-Danlos syndrome undergoing scoliosis surgery
Authors: Wakabayashi Ryo , Tanaka Satoshi , Tsuchiyama Keiko , Yamamoto Katsumi , Maruyama Yuki , Numata Kaori , Kawamata Mikito
Published: June 2020

Background

Musculocontractural Ehlers-Danlos syndrome is a new and rare subtype of Ehlers-Danlos syndrome in which anesthetic considerations for airway and respiratory management, prevention of skin injuries and joint dislocations, and hemostatic management for severe perioperative bleeding are required.

Case presentation

A 19-year-old woman with musculocontractural Ehlers-Danlos syndrome was scheduled to undergo posterior spinal fusion from the 4th thoracic to the 4th lumbar vertebrae under general anesthesia. Her trachea was easily intubated with a videolaryngoscope despite a small mouth and micrognathia. Pressure-controlled ventilation with limited peak inspiratory pressure was performed for prevention of pneumothorax. Skin damage and joint luxation were prevented by using a low rebounding mattress, terpolymer-based barrier film, and careful patient positioning. Blood transfusion was effectively performed on the basis of point-of-care viscoelastic hemostatic assay monitoring. She had an uneventful postoperative course without any complications.

Conclusions

We safely managed a patient with musculocontractural Ehlers-Danlos syndrome undergoing scoliosis surgery.
Opioid-free anesthesia for a child with trisomy 13 with obstructive sleep apnea: a case report
Authors: Yamamoto Makiko , Miyazaki Izumi , Kishikawa Hiroaki , Sakamoto Atsuhiro
Published: June 2020

Background

Most children with trisomy 13 display central apnea, and are prone to opioid-induced respiratory depression. We conducted opioid-free anesthesia for a patient with trisomy 13 and obstructive sleep apnea, and safely extubated the patient in the operating room.

Case presentation

A 27-month-old girl with trisomy 13 underwent tonsillectomy. Given her high sensitivity to opioids, general anesthesia was introduced and maintained only with 2–5% sevoflurane and 33% nitrous oxide in oxygen. We used acetaminophen for postoperative analgesia. The tracheal tube was removed under stable breathing pattern 10 min after the surgery in the operating room. Two years later, opioid-free anesthesia with 2–5% sevoflurane and 33% nitrous oxide in oxygen was again performed safely for tube insertion into both eardrums.

Conclusion

Opioid-free anesthesia with adequate non-narcotic analgesics is safe for children with trisomy 13 with multiple apnea-related comorbidities.
Emotional judgments of scenes are influenced by unintentional averaging
Authors: Alwis Yavin , Haberman Jason M.
Published: June 2020

Background

The visual system uses ensemble perception to summarize visual input across a variety of domains. This heuristic operates at multiple levels of vision, compressing information as basic as oriented lines or as complex as emotional faces. Given its pervasiveness, the ensemble unsurprisingly can influence how an individual item is perceived, and vice versa.

Methods

In the current experiments, we tested whether the perceived emotional valence of a single scene could be influenced by surrounding, simultaneously presented scenes. Observers first rated the emotional valence of a series of individual scenes. They then saw ensembles of the original images, presented in sets of four, and were cued to rate, for a second time, one of four.

Results

Results confirmed that the perceived emotional valence of the cued image was pulled toward the mean emotion of the surrounding ensemble on the majority of trials, even though the ensemble was task-irrelevant. Control experiments and analyses confirmed that the pull was driven by high-level, ensemble information.

Conclusion

We conclude that high-level ensemble information can influence how we perceive individual items in a crowd, even when working memory demands are low and the ensemble information is not directly task-relevant.
Retraction Note: Effects of DA-5513 on alcohol metabolism and alcoholic fatty liver in rats
Authors: Yu Jae Young , Nguyen Hanh Thuy , Yong Chul Soon , Park Hyoung Geun , Jun Joon Ho , Kim Jong Oh.
Published: June 2020

An amendment to this paper has been published and can be accessed via the original article.
Effects of gonadotropin-releasing hormone agonist (GnRH-a) as luteal phase support in intracytoplasmic sperm injection (ICSI) cycles: a randomized controlled trial
Authors: Saharkhiz Nasrin , Salehpour Saghar , Hosseini Sedighe , Hosseinirad Hossein , Nazari Leila
Published: June 2020

Background

This paper describes a blind randomized controlled trial (RCT) designed to evaluate the effect of gonadotropin-releasing hormone agonist (GnRH-a) administration on outcomes of intracytoplasmic sperm injection (ICSI) in subjects stimulated with the gonadotropin-releasing hormone (GnRH) antagonist protocol. A total of 268 women who underwent ICSI cycles with GnRH antagonist ovarian stimulation protocol were included in the study. Patients were randomly assigned to the intervention (GnRH-a) and control groups. The intervention group received a single dose injection of triptorelin (0.1 mg) subcutaneously 6 days after oocyte retrieval while the control group received placebo. The rates of chemical and clinical pregnancy were defined as the primary outcome values.

Results

Two hundred forty participants accomplished the study, and their data were analyzed. No significant difference was detected between the chemical pregnancy rates of the intervention and control groups. However, the clinical pregnancy rate was significantly higher in the GnRH-a group than in the placebo group.

Conclusions

The findings of the present study suggest that the GnRH-a support in the luteal phase can result in a significant improvement of pregnancy rates in ICSI cycles following the ovarian stimulation with GnRH antagonist protocol.
Broadband finite-difference Q-compensated reverse time migration algorithm for tilted transverse isotropic media
Authors: Zhou Tong , Hu Wenyi , Ning Jieyuan
Published: June 2020

[Formula: see text]-compensated reverse time migration (Q-RTM) is effective for improving the seismic imaging quality degraded by low-[Formula: see text] anomalies. However, it is difficult to apply existing pseudospectral-based Q-RTM methods to large-scale problems due to the obstacles to high-efficient parallelization posed by the global pseudospectral operators. On the other hand, finite-difference Q-RTM is intrinsically appropriate for domain decomposition and parallel computation, thus being suitable for industrial-sized problems but facing a twofold challenge: (1) to effectively compensate the phase in a broad-bandwidth sense during the wave back-propagation process and (2) to accurately handle the tilted transverse isotropic (TTI) medium with attenuation. We have developed a new framework of finite-difference Q-RTM algorithm by expanding the linear viscoacoustic constitutive relation to a series of integer-order differential terms and a unique integral term that can decouple the amplitude and the phase to allow accurate compensation in a broader frequency range. This framework has two typical implementations: (1) optimizing the frequency-dependent phase velocity (while fixing the negative constant [Formula: see text]) and (2) optimizing the [Formula: see text] value (while fixing the frequency-dependent phase velocity). We generalize this broadband finite-difference Q-RTM algorithm to TTI media, where an artificial [Formula: see text] is applied to suppress the shear-wave artifacts induced by the acoustic TTI approximation. Numerical examples demonstrate that this Q-RTM method accurately compensates the phase and amplitude in a broad frequency range of 5–70 Hz and produces high-quality images. Due to the local nature of finite-difference operators, this algorithm is expected to outperform the existing pseudospectral-based Q-RTM methods in terms of computational efficiency and implementation convenience for real-world Q-RTM projects.
Sinkhole detection with 3D full seismic waveform tomography
Authors: Mirzanejad Majid , Tran Khiem T. , McVay Michael , Horhota David , Wasman Scott J.
Published: June 2020

Sinkhole collapse may result in significant property damage and even loss of life. Early detection of sinkhole attributes (buried voids, raveling zones) is critical to limit the cost of remediation. One of the most promising ways to obtain subsurface imaging is 3D seismic full-waveform inversion. For demonstration, a recently developed 3D Gauss-Newton full-waveform inversion (3D GN-FWI) method is used to detect buried voids, raveling soils, and characterize variable subsurface soil/rock layering. It is based on a finite-difference solution of 3D elastic wave equations and Gauss-Newton optimization. The method is tested first on a data set constructed from the numerical simulation of a challenging synthetic model and subsequently on field data collected from two separate test sites in Florida. For the field tests, receivers and sources are placed in uniform 2D surface grids to acquire the seismic wavefields, which then are inverted to extract the 3D subsurface velocity structures. The inverted synthetic results suggest that the approach is viable for detecting voids and characterizing layering. The field seismic results reveal that the 3D waveform analysis identified a known manmade void (plastic culvert), unknown natural voids, raveling, as well as laterally variable soil/rock layering including rock pinnacles. The results are confirmed later by standard penetration tests, including depth to bedrock, two buried voids, and a raveling soil zone. Our study provides insight into the application of the 3D seismic FWI technique as a powerful tool in detecting shallow voids and other localized subsurface features.
Recognizing fracture pattern signatures contributed by seismic loadings
Authors: Xu Shiqing
Published: June 2020

The impacts of seismic loadings to fault zone rocks still are not well understood. Although field and experimental studies have suggested several markers, such as pseudotachylytes and pulverized rocks, for indicating seismic loadings, the corresponding markers of other types or at larger scales still are lacking. Drawing from the results of dynamic ruptures with off-fault damage, we have recognized several additional fracture features that may be used to reflect the involvement of seismic loadings. For strike-slip faults stressed at moderate to high angles, synthetic R shear is more favored during rupture propagation, but pronounced antithetic R′ shear can be generated around the termination end of the rupture. In addition, suitably oriented weak structures off the main fault can further facilitate the activation of R′ shear. For low-angle thrust faults such as subduction zones, splay faults in the form of forethrusts and backthrusts still can be generated above the coseismic rupture zone. These faults show an increased spatial extent toward the updip direction, effectively defining an outer wedge susceptible to pervasive compressional failure over its entire depth range. Moreover, a deeply nucleated megathrust rupture that eventually reaches the trench can sequentially load the frontal wedge in compression and then in extension, with the potential to leave a mixture of triggered reverse and normal faults at the final stage. Because the above results also are supported by many observations, they raise a caution that existing fault models ignoring dynamic effects should be used with care and that seismic loadings must be considered more seriously by future fault zone studies.
Metabolic Effects of Late Dinner in Healthy Volunteers—A Randomized Crossover Clinical Trial
Authors: Gu Chenjuan , Brereton Nga , Schweitzer Amy , Cotter Matthew , Duan Daisy , Børsheim Elisabet , Wolfe Robert R , Pham Luu V , Polotsky Vsevolod Y , Jun Jonathan C
Published: June 2020

Context

Consuming calories later in the day is associated with obesity and metabolic syndrome. We hypothesized that eating a late dinner alters substrate metabolism during sleep in a manner that promotes obesity.

Objective

The objective of this work is to examine the impact of late dinner on nocturnal metabolism in healthy volunteers.

Design and Setting

This is a randomized crossover trial of late dinner (LD, 22:00) vs routine dinner (RD, 18:00), with a fixed sleep period (23:00-07:00) in a laboratory setting.

Participants

Participants comprised 20 healthy volunteers (10 male, 10 female), age 26.0 ± 0.6 years, body mass index 23.2 ± 0.7 kg/m2, accustomed to a bedtime between 22:00 and 01:00.

Interventions

An isocaloric macronutrient diet was administered on both visits. Dinner (35% daily kcal, 50% carbohydrate, 35% fat) with an oral lipid tracer ([2H31] palmitate, 15 mg/kg) was given at 18:00 with RD and 22:00 with LD.

Main Outcome Measures

Measurements included nocturnal and next-morning hourly plasma glucose, insulin, triglycerides, free fatty acids (FFAs), cortisol, dietary fatty acid oxidation, and overnight polysomnography.

Results

LD caused a 4-hour shift in the postprandial period, overlapping with the sleep phase. Independent of this shift, the postprandial period following LD was characterized by higher glucose, a triglyceride peak delay, and lower FFA and dietary fatty acid oxidation. LD did not affect sleep architecture, but increased plasma cortisol. These metabolic changes were most pronounced in habitual earlier sleepers determined by actigraphy monitoring.

Conclusion

LD induces nocturnal glucose intolerance, and reduces fatty acid oxidation and mobilization, particularly in earlier sleepers. These effects might promote obesity if they recur chronically.
Ketone Body, 3-Hydroxybutyrate: Minor Metabolite - Major Medical Manifestations
Authors: Møller Niels
Published: June 2020

Ketone bodies – 3-hydroxybutyrate (3-OHB), acetoacetate, and acetone – are ancient, evolutionarily preserved, small fuel substrates, which uniquely can substitute and alternate with glucose under conditions of fuel and food deficiency. Once canonized as a noxious, toxic pathogen leading to ketoacidosis in patients with diabetes, it is now becoming increasingly clear that 3-OHB possesses a large number of beneficial, life-preserving effects in the fields of clinical science and medicine. 3-OHB, the most prominent ketone body, binds to specific hydroxyl-carboxylic acid receptors and inhibits histone deacetylase enzymes, free fatty acid receptors, and the NOD-like receptor protein 3 inflammasome, tentatively inhibiting lipolysis, inflammation, oxidative stress, cancer growth, angiogenesis, and atherosclerosis, and perhaps contributing to the increased longevity associated with exercise and caloric restriction. Clinically ketone bodies/ketogenic diets have for a long time been used to reduce the incidence of seizures in epilepsy and may have a role in the treatment of other neurological diseases such as dementia. 3-OHB also acts to preserve muscle protein during systemic inflammation and is an important component of the metabolic defense against insulin-induced hypoglycemia. Most recently, a number of studies have reported that 3-OHB dramatically increases myocardial blood flow and cardiac output in control subjects and patients with heart failure. At the moment, scientific interest in ketone bodies, in particular 3-OHB, is in a hectic transit and, hopefully, future, much needed, controlled clinical studies will reveal and determine to which extent the diverse biological manifestations of 3-OHB should be introduced medically.
Pitfalls of HbA1c in the Diagnosis of Diabetes
Authors: Bergman Michael , Abdul-Ghani Muhammad , Neves João Sérgio , Monteiro Mariana P , Medina Jose Luiz , Dorcely Brenda , Buysschaert Martin
Published: June 2020

Many health care providers screen high-risk individuals exclusively with an HbA1c despite its insensitivity for detecting dysglycemia. The 2 cases presented describe the inherent caveats of interpreting HbA1c without performing an oral glucose tolerance test (OGTT). The first case reflects the risk of overdiagnosing type 2 diabetes (T2D) in an older African American male in whom HbA1c levels, although variable, were primarily in the mid-prediabetes range (5.7-6.4% [39-46 mmol/mol]) for many years although the initial OGTT demonstrated borderline impaired fasting glucose with a fasting plasma glucose of 102 mg/dL [5.7 mmol/L]) without evidence for impaired glucose tolerance (2-hour glucose ≥140-199 mg/dl ([7.8-11.1 mmol/L]). Because subsequent HbA1c levels were diagnostic of T2D (6.5%-6.6% [48-49 mmol/mol]), a second OGTT performed was normal. The second case illustrates the risk of underdiagnosing T2D in a male with HIV having normal HbA1c levels over many years who underwent an OGTT when mild prediabetes (HbA1c = 5.7% [39 mmol/mol]) developed that was diagnostic of T2D. To avoid inadvertent mistreatment, it is therefore essential to perform an OGTT, despite its limitations, in high-risk individuals, particularly when glucose or fructosamine and HbA1c values are discordant. Innate differences in the relationship between fructosamine or fasting glucose to HbA1c are demonstrated by the glycation gap or hemoglobin glycation index.
Approach to the Patient With Thyrotoxicosis Using Telemedicine
Authors: Griffith Michelle L , Bischoff Lindsay A , Baum Howard B A
Published: June 2020

Context

The potential for endocrine care via telemedicine has been recognized since the early 2000s when clinical outcome data demonstrated improvements in glycemic control with telemedicine. The widespread use of telemedicine during the COVID-19 pandemic has pushed telemedicine beyond diabetes care and into clinical areas with a paucity of published data. The evaluation and treatment of thyrotoxicosis heavily relies on laboratory assessment and imaging with physical exam playing a role to help differentiate the etiology and assess the severity of thyrotoxicosis.

Case Description

We describe a patient presenting for evaluation of new thyrotoxicosis via telemedicine, and describe modifications to consider for thorough, safe evaluation via telemedicine.

Conclusion

Telemedicine may be an ideal way to assess and treat patients with thyrotoxicosis who are not able to physically attend a visit with an endocrinologist but still have access to a laboratory for blood draws. Potential challenges include access to imaging and high-volume surgeons if needed. Clinical and economic outcomes of telemedicine care of thyrotoxicosis should be studied so that standards of care for endocrine telemedicine can be established.
The cell biologist's guide to super-resolution microscopy
Authors: Jacquemet Guillaume , Carisey Alexandre F. , Hamidi Hellyeh , Henriques Ricardo , Leterrier Christophe
Published: June 2020

Fluorescence microscopy has become a ubiquitous method to observe the location of specific molecular components within cells. However, the resolution of light microscopy is limited by the laws of diffraction to a few hundred nanometers, blurring most cellular details. Over the last two decades, several techniques – grouped under the ‘super-resolution microscopy’ moniker – have been designed to bypass this limitation, revealing the cellular organization down to the nanoscale. The number and variety of these techniques have steadily increased, to the point that it has become difficult for cell biologists and seasoned microscopists alike to identify the specific technique best suited to their needs. Available techniques include image processing strategies that generate super-resolved images, optical imaging schemes that overcome the diffraction limit and sample manipulations that expand the size of the biological sample. In this Cell Science at a Glance article and the accompanying poster, we provide key pointers to help users navigate through the various super-resolution methods by briefly summarizing the principles behind each technique, highlighting both critical strengths and weaknesses, as well as providing example images.
Keep calm and hang on: EMG activation in the forelimb musculature of three-toed sloths (Bradypus variegatus)
Authors: Gorvet M. A. , Wakeling J. M. , Morgan D. M. , Hidalgo Segura D. , Avey-Arroyo J. , Butcher M. T.
Published: June 2020

Sloths exhibit below branch locomotion whereby their limbs are loaded in tension to support the body weight. Suspensory behaviors require both strength and fatigue resistance from the limb flexors; however, skeletal muscle mass of sloths is reduced compared to other arboreal mammals. Although suspensory locomotion demands that muscles are active to counteract the pull of gravity, it is possible that sloths minimize muscle activation and/or selectively recruit slow motor units to maintain support, thus indicating neuromuscular specializations to conserve energy. Electromyography (EMG) was evaluated in a sample of three-toed sloths (B. variegatus: N=6) to test this hypothesis. EMG was recorded at 2000 Hz via fine-wire electrodes implanted into two suites of four muscles in the left forelimb while sloths performed suspensory hanging (SH), suspensory walking (SW), and vertical climbing (VC). All muscles were minimally active for SH. During SW and VC, sloths moved slowly (Duty Factor: 0.83) and activation patterns were consistent between behaviors; the flexors were activated early and for a large percentage of limb contact, whereas the extensors were activated for shorter burst durations on average and showed biphasic (contact and swing) activity. Muscle activities were maximal for the elbow flexors and lowest for the carpal/digital flexors, and overall activity was significantly greater for SW and VC compared with SH. Wavelet analysis indicated high mean EMG frequencies from the myoelectric intensity spectra coupled with low burst intensities for SH, although the opposite pattern occurred for SW and VC, with the shoulder flexors and elbow flexor, m. brachioradialis, having extremely low mean EMG frequencies that are consistent with recruitment of slow fibers. Collectively, these findings support the hypothesis and suggest that sloths may selectively recruit smaller, fast motor units for suspensory postures but have the ability to offset the cost of force production by recruitment of large, slow motor units during locomotion.
To walk or to run – a question of movement attractor stability
Authors: Raffalt Peter C. , Kent Jenny A. , Wurdeman Shane R. , Stergiou Nick
Published: June 2020

During locomotion, humans change gait mode between walking and running as locomotion speed is either increased or decreased. Dynamical Systems Theory predicts that the self-organization of coordinated motor behaviors dictates the transition from one distinct stable attractor behavior to another distinct attractor behavior (e.g. walk to run or vice versa) as the speed is changed. To evaluate this prediction, the present study investigated the attractor stability of walking and running across a range of speeds evoking both self-selected gait mode and non-self-selected gait mode. Eleven subjects completed treadmill walking for 3 minutes at 0.89, 1.12, 1.34, 1.56, 1.79, 2.01, 2.24, 2.46 m/s and running for 3 minutes at 1.79, 2.01, 2.24, 2.46, 2.68, 2.91, 3.13, 3.35 m/s in randomized order while lower limb joint angles and sacrum displacements was recorded. Attractor stability was quantified by continuous relative phase and deviation phase of lower limb segment angles, and the largest Lyapunov exponent, correlation dimension and movement variability of the sacrum marker displacement and the hip, knee and ankle joint angles. Lower limb attractor stability during walking was maximized at speeds close to the self-selected preferred walking speed and increased during running as speed was increased. Furthermore, lower limb attractor stability was highest at a particular gait mode closest to the corresponding preferred speed, in support of the prediction of Dynamical Systems Theory. This was not the case for the sacrum displacement attractor, suggesting that lower limb attractor behavior provides a more appropriate order parameter compared to sacrum displacement.
Air-entrapping capacity in the hair coverage of Malacosoma castrensis (Lasiocampidae: Lepidoptera) caterpillar: a case study
Authors: Kovalev Alexander , Rebora Manuela , Salerno Gianandrea , Gorb Stanislav
Published: June 2020

The moth Malacosoma castrensis (Lasiocampidae) is commonly found along the Northern Germany coasts whose habitat is mainly represented by salt marshes subjected to sea level variations. Surprisingly, terrestrial caterpillars can withstand many hours being flooded by the seawater. The ability to withstand periods of submersion in a terrestrial insect raises the problem of respiration related to avoiding water percolation into the tracheal system. In the present study, we investigated under laboratory conditions the role of water-repellent cuticle structures in oxygen supply in caterpillars of M. castrensis submerged in water. For this purpose, air-layer stability tests using force measurements, and micromorphology of cuticle structures using SEM and fluorescence microscopy were performed.

A plastron appeared when a caterpillar is under water. Plastron stability, its’ gasses composition, and internal pressure were estimated. The plastron is stabilized by long and rare hairs, which are much thicker than the corresponding hairs of aquatic insects. Thick and stiff hairs with sclerotized basal and middle regions protrude into the water through plastron – water interface, while substantial regions of thin and flexible hairs are aligned along the plastron – water interface and their side walls can support pressure in plastron even below atmospheric pressure. Additional anchoring points between hair's stalk and microtrichia near to the hair base provide enhanced stiffness to the hair layer and prevent hair layer from collapse and water entering between hairs. Advancing contact angle on hairs is more than 90°, which is close to the effective contact angle for the whole caterpillar.
Diagnostic value and forensic relevance of a novel photorealistic 3D reconstruction technique in post-mortem CT
Authors: Böven Judith , Boos Johannes , Steuwe Andrea , Morawitz Janna , Sawicki Lino Morris , Caspers Julian , Küppers Lisa , Hartung Benno , Thomas Christoph , Antoch Gerald , Aissa Joel
Published: June 2020

Objectives:

Evaluation of performance and forensic relevance of a novel, photorealistic, 3D reconstruction method (cinematic rendering, (CR)) in comparison with conventional post-mortem CT (PMCT) and volume rendering (VR) technique for visualization of traumatic injuries.

Methods:

112 pathologies (fractures, soft tissue injuries and foreign bodies) from 33 human cadavers undergoing whole body PMCT after traumatic death were retrospectively analyzed. Pathologies were reconstructed with CR and VR techniques. Fractures were classified according to their dislocation. Images were evaluated according to their expressiveness and judicial relevance by two forensic pathologists using a five-level Likert-scale (1: high expressiveness, 5: low expressiveness). They decided whether CR reconstructions were suitable for judicial reviews. The detection rate of pathologies was determined by two radiologists.

Results:

CR was more expressive than VR for all three trauma categories (p < 0.01) and than conventional CT when used for fractures with dislocation (p < 0.001), injuries of the ventral body surface (p < 0.001), and demonstration of foreign bodies (p = 0.033). CR and VR became more expressive with a higher grade of fracture dislocation (p < 0.001). 20% of all pathologies in the CR and VR reconstructions were not detectable by radiologists.

Conclusion:

CR reconstructions are superior to VR regarding the expressiveness. For fractures with substantial dislocation, soft tissue injuries, and foreign bodies in situ, CR showed a significantly better expressiveness than conventional PMCT. CR and VR have significant limitations in cases of fractures with minor dislocations and covered soft tissue injuries.

Advances in knowledge:

CR is a helpful tool to present pathologies found in PMCT for judicial reviews.