Cross-sectional Area Research Articles

Effects of some locally isolated Lactobacillus species on general growth, muscular mass and bone development in mice

Probiotics are dietary supplements which contain live microorganisms, mostly different bacterial species that inhabit gut of host and ultimately benefit that host. The current investigation was done to explore the growth-promoting effects of four locally isolated probiotics strains L. paracasei, L. paracaseii, L. delbrueckii and L. rhamnosus. In this regard, 108 colony-forming units (CFU) were administered to the mice of experimental groups for 30 days. Upon administering probiotics, it was observed that the Lactobacilli species had a positive impact on body weight. The group that received L. rhamnosus exhibited the most significant increase, with a 76.53 % improvement over the control group (P < 0.05). Positive effects on somatic indices of different organs including spleen, thymus, kidneys, heart, liver, and lungs were also observed. In addition to all of these, the increases in the number of extensor digitorum longus (EDL) muscle fibers and their cross-sectional area (CSA) up to 40.70 % and 28.94 % respectively in L. rhamnosus group as compared with the control group. In the L. rhamnosus group, there was a 40.70 % increase in the number of EDL muscle fibers and a 28.94 % increase in their cross-sectional area (CSA) of muscle fiber as compared to the control group. On provision of Lacticaseibacillus rhamnosus, 50.81 % higher femur bone density was noted which endorse the overall health-improving abilities of this probiotic. The application of Lacticaseibacillus rhamnosus in animal feed is recommended.

Acetate derived from the intestinal tract has a critical role in maintaining skeletal muscle mass and strength in mice.

Acetate is a short-chain fatty acid (SCFA) that is produced by microbiota in the intestinal tract. It is an important nutrient for the intestinal epithelium, but also has a high plasma concentration and is used in the various tissues. Acetate is involved in endurance exercise, but its role in resistance exercise remains unclear. To investigate this, mice were administered either multiple antibiotics with and without oral acetate supplementation or fed a low-fiber diet. Antibiotic treatment for 2 weeks significantly reduced grip strength and the cross-sectional area (CSA) of muscle fiber compared with the control group. Intestinal concentrations of SCFAs were reduced in the antibiotic-treated group. Oral administration of acetate with antibiotics prevented antibiotic-induced weakness of skeletal muscle and reduced CSA of muscle fiber. Similarly, a low-fiber diet for 1 year significantly reduced the CSA of muscle fiber and fecal and plasma acetate concentrations. To investigate the role of acetate as an energy source, acetyl-CoA synthase 2 knockout mice were used. These mice had a shorter lifespan, reduced skeletal muscle mass and smaller CSA of muscle fiber than their wild type littermates. In conclusion, acetate derived from the intestinal microbiome can contribute to maintaining skeletal muscle performance.

Hoffmann's sign in cervical spondylotic myelopathy patients: pathological insights from neuroimaging.

Hoffmann's sign testing is a commonly used physical examination in clinical practice for patients with cervical spondylotic myelopathy (CSM). However, the pathophysiological mechanisms underlying its occurrence and development have not been thoroughly investigated. Therefore, the present study aimed to explore whether a positive Hoffmann's sign (PHS) in CSM patients is associated with spinal cord and brain remodeling and to identify potential neuroimaging biomarkers with diagnostic value. Seventy-six patients with CSM and 40 sex- and age-matched healthy controls (HCs) underwent multimodal MRI. Based on the results of the Hoffmann's sign examination, patients were divided into two groups: those with a PHS (n = 38) and those with a negative Hoffmann's sign (NHS; n = 38). Quantification of spinal cord and brain structural and functional parameters of the participants was performed using various methods, including functional connectivity analysis, voxel-based morphometry, and atlas-based analysis based on functional MRI and structural MRI data. Furthermore, this study conducted a correlation analysis between neuroimaging metrics and neurological function and utilized a support vector machine (SVM) algorithm for the classification of PHS and NHS. In comparison with the NHS and HC groups, PHS patients exhibited significant reductions in the cross-sectional area and fractional anisotropy (FA) of the lateral corticospinal tract (CST), reticulospinal tract (RST), and fasciculus cuneatus, concomitant with bilateral reductions in the volume of the lateral pallidum. The functional connectivity analysis indicated a reduction in functional connectivity between the left lateral pallidum and the right angular gyrus in the PHS group. The correlation analysis indicated a significant positive association between the CST and RST FA and the volume of the left lateral pallidum in PHS patients. Furthermore, all three variables exhibited a positive correlation with the patients' motor function. Finally, using multimodal neuroimaging metrics in conjunction with the SVM algorithm, PHS and NHS were classified with an accuracy rate of 85.53%. This research revealed a correlation between structural damage to the pallidum and RST and the presence of Hoffmann's sign as well as the motor function in patients with CSM. Features based on neuroimaging indicators have the potential to serve as biomarkers for assessing the extent of neuronal damage in CSM patients.

Ultrasound-derived rates of muscle wasting in the intensive care unit and in the post-intensive care ward for patients with critical illness: Post hoc analysis of an international, multicentre randomised controlled trial of early rehabilitation

Background and aimsMuscle wasting results in weakness for patients with critical illness. We aim to explore ultrasound-derived rates of change in skeletal muscle in the intensive care unit (ICU) and following discharge to the post-ICU ward. DesignPost hoc analysis of a multicentre randomised controlled trial of functional–electrical stimulated cycling, recumbent cycling, and usual care delivered in intensive care. MethodParticipants underwent ultrasound assessment of rectus femoris at ICU admission, weekly in the ICU, upon awakening, ICU discharge, and hospital discharge. The primary outcome was rate of change in rectus femoris cross-sectional area (ΔRFCSA) in mm2/day in the ICU (enrolment to ICU discharge) and in the post-ICU ward (ICU discharge to hospital discharge). Secondary outcomes included rate of change in echo intensity (ΔEI), standard deviation of echo intensity (ΔEISD), and the intervention effect on ultrasound measures. Echo intensity is a quantitative assessment of muscle quality. Elevated echo intensity may indicate fluid infiltration, adipose tissue, and reduced muscle quality. Results154 participants were included (mean age: 58 ± 15 years, 34% female). Rectus femoris cross-sectional area declined in the ICU (−4 mm2/day [95% confidence interval {CI}: −9 to 1]) and declined further in the ward (−9 mm2/day [95% CI: −14 to −3]) with a mean difference between ICU and ward of −5 mm2/day ([95% CI: −2, to 11]; p = 0.1396). There was a nonsignificant difference in ΔEI between in-ICU and the post-ICU ward of 1.2 ([95% CI: −0.1 to 2.6]; p = 0.0755), a statistically significant difference in ΔEISD between in-ICU and in the post-ICU ward of 1.0 ([95% CI, 0.5 to 1.5]; p = 0.0003), and no difference in rate of change in rectus femoris cross-sectional area between groups in intensive care (p = 0.411) or at hospital discharge (p = 0.1309). ConclusionsMuscle wasting occurs in critical illness throughout the hospital admission. The average rate of loss in muscle cross-sectional area does not slow after ICU discharge, even with active rehabilitation.

The effects of exercise and mitochondrial transplantation alone or in combination against Doxorubicin-induced skeletal muscle atrophy.

Doxorubicin (DOX) is a chemotherapy drug used to treat various types of cancer, but it is associated with significant side effects such as skeletal muscle atrophy. Exercise has been found to prevent skeletal muscle atrophy through the modulation of mitochondrial pathways. Mitochondrial transplantation (MT) may mitigate toxicity, neurological disorders, kidney and liver injury, and skeletal muscle atrophy. The objective of this study was to evaluate the effects of MT, exercise, and MT with exercise on DOX-induced skeletal muscle atrophy. Male Sprague Dawley rats were randomly assigned to the following groups: control, DOX, MT with DOX, exercise with DOX, and exercise with MT and DOX. A 10-day treadmill running exercise and MT (6.5µg/100 µL) to tibialis anterior (TA) muscle were administered prior to a single injection of DOX (20mg/kg). Our data showed that exercise and MT with exercise led to an increase in cross-sectional area of the TA muscle. Exercise, MT and MT with exercise reduced inflammation and maintained mitochondrial enzyme activity. Additionally, exercise and MT have been shown to regulate mitochondrial fusion/fission. Our findings revealed that exercise and MT with exercise prevented oxidative damage. Furthermore, MT and MT with exercise decreased apoptosis and MT with exercise triggered mitochondrial biogenesis. These findings demonstrate the importance of exercise in the prevention of skeletal muscle atrophy and emphasize the significant benefits of MT with exercise. To the best of our knowledge, this is the first study to demonstrate the therapeutic effects of MT with exercise in DOX-induced skeletal muscle atrophy.

Competing endogenous RNA networks were associated with fat accumulation in skeletal muscle of aged male mice

Muscle aging contributed to morbidity and mortality in the elderly adults by leading to severe outcomes such as frailty, falls and fractures. Post-transcriptional regulation especially competing endogenous RNA (ceRNA) mechanism may modulate the process of skeletal muscle aging. RNA-seq was performed in quadriceps of 6-month-old (adult) and 22-month-old (aged) male mice to identify differentially expressed ncRNAs and mRNAs and further construct ceRNA networks. Decreased quadriceps-body weight ratio and muscle fiber cross-sectional area as well as histological characteristics of aging were observed in the aged mice. Besides, there were higher expressions of atrogin-1 and MuRF-1 and lower expression of Myog, Myf4 and Myod1 in the quadriceps of aged mice relative to that of adult mice. The expression of 85 lncRNAs, 52 circRNAs, 10 miRNAs and 277 mRNAs were significantly dysregulated in quadriceps between the two groups, among which two ceRNA networks lncRNA 2700081O15Rik/circRNA_0000820-miR-673–3p-Tmem120b were constructed. Level of triglycerides and expression of PPARγ, C/EBPα, FASN and leptin were elevated and the expression of adiponectin was reduced in quadriceps of aged mice compared with that of adult mice. LncRNA 2700081O15Rik/circRNA_0000820-miR-673–3p-Tmem120b were possibly associated with the adipogenesis and fat accumulation in skeletal muscle of age male mice.

Change in Femoral Cartilage Cross-Sectional Area After Aerobic and Resistance Exercise.

We compared the immediate response and recovery of femoral cartilage morphology following aerobic or resistance exercise to a control condition. Fifteen healthy young males (23.9 years; 170.1 cm; 69.7 kg) visited the laboratory three separate days and randomly performed one of the 30-min exercise aerobic exercises (treadmill running), resistance exercises (leg presses, back squats, and knee extensions), or seated rest as the control, each followed by the 50-min recovery. Ultrasonographic images of the femoral cartilage cross-sectional area (CSA) were obtained before and after exercise and every 5 min thereafter. To test exercise effects over time, a mixed model analysis of variance and Tukey-Kramer post-hoc tests were performed (p<0.05). The femoral cartilage CSA was different (condition×time: F34,742=4.30, p<0.0001) and the femoral cartilage CSA was decreased after the aerobic (-5.8%, p<0.0001) and the resistance (-3.4%, p=0.04) exercises compared to the pre-exercise levels. Deformed femoral cartilage CSA took 35 and 10 min to return to the pre-exercise levels after aerobic and resistance exercises (p+>+0.09), respectively. Thirty minutes of moderate exertion performing aerobic or resistance exercises immediately reduced the femoral cartilage CSA. A rest period ranging from 10 to 35 min was required for cartilage recovery after weight-bearing exercises.

Identification and impact of failure of pelvic compensation in patients with adult spinal deformity

BACKGROUND CONTEXTPrevious research has identified a specific subtype known as failure of pelvic compensation (FPC) in patients with adult spinal deformity (ASD). However, the criteria for assessing FPC remain inconsistent, and its impacts on spinal sagittal alignment and health-related quality-of-life (HRQoL) scores remain unclear. PURPOSETo propose a novel criterion for identifying FPC based on variations in spinopelvic alignment during the transition from the supine to upright position and to evaluate the effects of FPC on patients' spinal sagittal alignment and HRQoL scores. STUDY DESIGN/SETTINGRetrospective cross-sectional study. PATIENT SAMPLEPatients with ASD from a monocenter database. OUTCOME MEASURESRadiographic measures, including thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt, pelvic incidence (PI), and sagittal vertical axis (SVA), were measured on lateral whole-spine radiographs. LL and SS were also measured on reconstructed lumbar computed tomography images in the sagittal view taken in the supine position. The relative functional cross-sectional area (rFCSA) of paraspinal muscles was evaluated via lumbar magnetic resonance imaging. HRQoL measures, encompassing visual analog scale for back pain (VAS-BP), Oswestry Disability Index (ODI), and Scoliosis Research Society-22R (SRS-22R), were collected. METHODSA total of 154 patients were enrolled. Based on the calculated minimum detectable change of SS, FPC was defined as the change in SS of less than 3.4° between supine and upright positions. Patients were divided into 3 groups: sagittal balance with pelvic compensation (SI-PC), sagittal imbalance with pelvic compensation (SI-PC), and sagittal imbalance with failure of pelvic compensation (SI-FPC). Radiographic parameters and HRQoL scores were compared among the groups. RESULTSThirty-six patients were categorized into the SB-PC group, 87 into the SI-PC group, and 31 into the SI-FPC group. Patients with low PI and small paraspinal muscles rFCSA were more prone to experiencing FPC accompanied by severe sagittal imbalance. The SI-FPC group exhibited less TK and a larger SS than the SI-PC group exhibited and had a similar SVA as that of the SI-PC group. Additionally, they displayed worse VAS-BP, ODI, SRS-function, and SRS-22 total scores than the SB-PC group displayed. CONCLUSIONSIn patients with ASD, an inherently low pelvic compensatory reserve and a high fatty infiltration in paraspinal muscles are pivotal factors contributing to FPC. Compared with SI-PC patients, SI-FPC patients demonstrate a thoracic-dominant compensatory pattern for sagittal malalignment. In addition, these patients experienced more severe pain and functional decline than the SB-PC patients experienced.

Analysis of Amplification Effect and Optimal Control of the Toggle-Style Negative Stiffness Viscous Damper

This paper proposes a new toggle-style negative stiffness viscous damper (TNVD), and evaluates the performance of the TNVD with the displacement amplification factor (fd) and the energy dissipation factor (fE). Firstly, the composition and characteristics of the TNVD are introduced. Subsequently, the displacement amplification factor is introduced to evaluate the displacement amplification ability of the TNVD, and it is decomposed into a geometric amplification factor and an effective displacement coefficient. Then, based on the geometric amplification factor and effective displacement coefficient, the correlation between the TNVD’s displacement amplification ability and inter-story deformation is studied, and an improved TNVD is proposed. By the comparison of the finite element calculation results, it is found that the improved TNVD can utilize the assumption of small structural deformation. After that, the impacts of plentiful aspects, such as the length of the lower connecting rod, the horizontal inclination angle of the lower connecting rod, the inter-story deformation limit, the cross-sectional area of the connecting rod, the damping coefficient, and the negative stiffness on the fd and fE of the improved TNVD, are expounded. The research results show that when the length of the TNVD’s lower connecting rod remains unchanged, the fd and fE present a trend of increasing first and then decreasing with the increase in the horizontal inclination angle of the lower connecting rod. When the inter-story deformation is fixed, there exists an optimal lower connecting rod’s length that satisfies a specific relationship to achieve the optimal geometric amplification factor of the TNVD. By adjusting the damping parameters of the TNVD, we can obtain a better effective displacement coefficient greater than 0.95 in the proposed target region. Meanwhile, the fd and fE increase with the decrease in the negative stiffness. An optimization strategy for the improved TNVD has been proposed to ensure that the TNVD has the characteristics of operational safety, ideal displacement amplification capability, and energy dissipation capability. Furthermore, a multi-objective control design method with an additional improved TNVD structure is proposed. The vibration reduction effect of the structure with the improved TNVD and the effectiveness of the optimization strategy are verified through examples.

Age and body composition of patients receiving treatment for locally advanced esophageal cancer.

e16094 Background: Standard of care for locally advanced esophageal cancer consists of chemoradiation (chemoRT) followed by esophagectomy. Fewer patients in older populations with locally advanced esophageal cancer undergo esophagectomy when compared to their younger counterparts. Furthermore, frail patients frequently forgo surgery after chemoRT. The current study examined the relationship between age, body composition, and treatment decision-making in locally advanced esophageal cancer. Methods: Patients with clinical stage T2-4, N0-2, and M0 adenocarcinoma or squamous cell carcinoma of the mid or distal esophagus diagnosed between 2010-2021 were included from 11 hospitals across our healthcare system. Treatment decision-points included receipt of chemoRT versus non-curative therapy, unresectable disease after chemoRT defined by metastatic disease or upper mediastinal lymphadenopathy, and receipt of surgery stratified by histology. Sociodemographic data including age, race, sex, insurance status, socioeconomic status, body composition data from CT imaging (skeletal muscle gauge [SMG]), and outcome data were collected. Skeletal Muscle Gauge was calculated as the product of skeletal muscle cross-sectional area at L3 normalized for height and muscle density. Fisher's exact test was used for categorical variables and Kruskal-Wallis for continuous variables. Results: 513 patients were included in the analysis, of which 399 (78%) had adenocarcinoma and 114 (22%) had squamous cell carcinoma. Median age was 66. Of the 513 patients, 472 (92%) underwent chemoRT (366 [78%] adenocarcinoma, 106 [22%] squamous cell carcinoma). Patients who were over the age of 75 were less likely to undergo chemoRT when compared to their younger counterparts (85% vs. 94%, p = 0.002). After the completion of chemoRT, 419 (89%) patients were deemed resectable, 330 adenocarcinoma and 89 with squamous cell carcinoma. Among resectable patients with adenocarcinoma, those &gt; 75 years old and lower SMG were less likely to receive surgery (p &lt; 0.001 and p =0.001). Age and body composition associated with lower receipt of surgery in locally advanced esophageal cancer patients was significant on both univariate and multivariate analyses. Conclusions: Patients over 75 are less likely to undergo chemoRT and surgical resection for locally advanced esophageal cancer. Among patients with resectable disease who have completed chemoRT, those with unfavorable body composition as measured by low SMG on CT imaging are also less likely to undergo surgical resection. These measures may be helpful in surgical decision-making in patients with locally-advanced esophageal cancer. Further study is warranted to more precisely define the relationship between age, body composition, and risk of surgery in esophageal cancer.

Hysterectomy - A Possible Risk Factor for Operative Intervention in Female Patients for Degenerative Lumbar Spine Conditions: A Case Control and Cohort Study

Researchers have recently linked hysterectomy, which alters sex hormone levels, to diseases like osteoporosis, lumbar spondylolisthesis, hypertension and diabetes etc. However, the association between hysterectomy and lumbar disc herniation (LDH)/lumbar spinal stenosis (LSS) remains unclarified. To determine whether there is a correlation between hysterectomy and surgical intervention for LDH/LSS in women, further substantiated through imaging and clinical research. A case control and cohort study. The study group comprised 1202 female patients aged 45 and older who had undergone operative treatment due to LDH/LSS (825 for LDH and 377 for LSS), and the comparison group comprised 1168 females without lumbar diseases who visited health examination clinic during the same period. One hundred and two hysterectomized patients were further selected (Hysterectomy cohort) and matched approximately with the control cohort at a 1:2 ratio from the study group with a minimum follow-up of 2 years. Odds Ratios (ORs) and 95% Confidence Intervals (CIs) were calculated to assess the association between hysterectomy and surgical intervention for LDH/LSS in women after adjusted by confounding factors. Patients from both the hysterectomy and control cohorts underwent a comprehensive assessment. This assessment included the evaluation of several parameters: the functional cross-sectional area, fat infiltration rate, relative functional cross-sectional area of the lumbar paravertebral muscles, facet joint degeneration grade, cartilage endplate damage, Modic changes for the L3/4-L5/S1 segments, Pfirrmann grade of lumbar disc degeneration, and disc height index for the L1/2-L5/S1 segments. Additionally, the Visual Analog Scale (VAS) and Japanese Orthopaedic Association (JOA) scores were recorded preoperatively and at the last follow-up. Associations between hysterectomy and patients treated surgically for LDH or LSS were analyzed using multivariate binomial logistic regression analysis. Lumbar X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) were used to evaluate the imaging variables. Imaging and clinical variables were compared. Hysterectomized women were associated with requiring surgery due to LDH/LSS, with ORs of 2.613 (P < 0.001) and 2.084 (P = 0.006), respectively. The imaging evaluation further revealed that the hysterectomy cohort had more severe degeneration of the paraspinal muscles, facet joints, endplates, and intervertebral discs, Modic changes at L3/4-L5/S1 segments, and intervertebral height reduction at L1/2-L5/S1 segments when compared to the control cohort (P < 0.01). Compared to the control cohort, the hysterectomy cohort exhibited higher preoperative and last follow-up VAS scores for low back pain, and last follow-up JOA scores (P < 0.01). Based on the findings of this study, it seems that women who have had a hysterectomy are correlated with requiring surgical intervention due to LDH/LSS. Imaging and clinical studies also indicate that hysterectomized patients exhibited more severe lumbar degeneration and back pain.

Body composition measures as a determinant of alpelisib-related toxicity.

e13093 Background: Body composition has emerged as an important prognostic factor in patients treated with cancer. Severe depletion of skeletal muscle, sarcopenia, has been associated with poor performance status and worse oncological outcomes. We studied patients with metastatic breast cancer receiving alpelisib, to determine if sarcopenia and additional body composition measures accounting for muscle and adiposity are associated with toxicity. Methods: A retrospective observational analysis was conducted, including 38 women with metastatic breast cancer and a PIK3CA mutation, treated with alpelisib as advanced line of therapy. Sarcopenia was determined by measuring skeletal muscle cross-sectional area at the third lumbar vertebra using computerized tomography. Various body composition metrics were assessed along with drug toxicity, dose reductions, treatment discontinuation, and hospitalizations. Results: Sarcopenia was observed in half of the patients (n=19, 50%), spanning normal weight, overweight, and obese individuals. Among the body composition measures, lower skeletal muscle density (SMD) was associated with an increased risk of treatment-related hyperglycaemia (P=0.03). Additionally, lower visceral adipose tissue (VAT) was associated with alpelisib-induced rash (P=0.04) and hospitalizations (P=0.04). Notably, alpelisib treatment discontinuation was not impacted by alpelisib toxicity. Conclusions: Body composition measures, specifically SMD and VAT may provide an opportunity to identify patients at higher risk for severe alpelisib related hyperglycemia, and cutaneous toxicity. These findings suggest the potential use of body composition assessment to predict toxicity, allowing for personalized therapeutic observation and intervention.

Atlantoaxial intra-articular cage fusion by posterior intermuscular approach for treating reducible atlantoaxial dislocation: a technique note with case series.

To evaluate the clinical feasibility of atlantoaxial intra-articular cage (AIC) fusion via intermuscular approach for treating reducible atlantoaxial dislocation (AAD). An analysis was conducted on the data of 10 patients who underwent C1-C2 segmental fixation and AIC fusion for AAD by unilateral intermuscular approach and contralateral open approach. Outcome assessments included Japanese Orthopaedic Association score (JOA) and Visual Analog Scale Score for Neck Pain (VASSNP). The duration of surgical exposure, screw insertion and cage insertion, and postoperative drainage volume were also compared between two approaches. Bone fusion was evaluated through computed tomography (CT) reconstruction. Postoperative paravertebral tissue edema was evaluated by paravertebral tissue cross-sectional area (CSA) and signal intensity on T2 weighted sequence of magnetic resonance imaging (MRI) at 3 days postoperatively. The intermuscular approach exhibited a longer exposure time but lower drainage postoperatively compared to the open approach (P < 0.05). After operation, JOA scores significant improved (P < 0.05), while VASSNP scores significantly decreased (P < 0.05). There was no significant difference in preoperative CSA between two approaches (P > 0.05). However, compared to the open approach, the intermuscular approach exhibited less CSA (P < 0.05) and lower T2 signal intensity on MRI postoperatively, indicating less invasive to the paravertebral tissues. AIC fusion by intermuscular approach is an effective and safe technique in the treatment of reducible AAD. Intermuscular approach could reduce the postoperative drainage volume and the extent of paravertebral tissue edema compared to open approach.

Preacinar Arterial Dilation Mediates Outcomes of Quantitative Interstitial Abnormalities in COPDGene.

Quantitative interstitial abnormalities (QIA) are a computed tomography (CT) measure of early parenchymal lung disease associated with worse clinical outcomes including exercise capacity and symptoms. The presence of pulmonary vasculopathy in QIA and its role in the QIA-outcome relationship is unknown. To quantify radiographic pulmonary vasculopathy in quantitative interstitial abnormalities (QIA) and determine if this vasculopathy mediates the QIA-outcome relationship. Ever-smokers with QIA, outcome, and pulmonary vascular mediator data were identified from the COPDGene cohort. CT-based vascular mediators were: right ventricle-to-left ventricle ratio (RV/LV), pulmonary artery-to-aorta ratio (PA/Ao), and pre-acinar intraparenchymal arterial dilation (PA volume 5-20mm2 in cross-sectional area, normalized to total arterial volume). Outcomes were: six-minute walk distance (6MWD) and modified Medical Council Research Council (mMRC) Dyspnea score ≥2. Adjusted causal mediation analyses were used to determine if the pulmonary vasculature mediated the QIA effect on outcomes. Associations of pre-acinar arterial dilation with select plasma biomarkers of pulmonary vascular dysfunction were examined. Among 8,200 participants, QIA burden correlated positively with vascular damage measures including pre-acinar arterial dilation. Pre-acinar arterial dilation mediated 79.6% of the detrimental impact of QIA on 6MWD (56.2-100%, p<0.001). PA/Ao was a weak mediator and RV/LV was a suppressor. Similar results were observed in the QIA-mMRC relationship. Pre-acinar arterial dilation correlated with increased pulmonary vascular dysfunction biomarker levels including angiopoietin-2 and NT-proBNP. Parenchymal quantitative interstitial abnormalities (QIA) deleteriously impact outcomes primarily through pulmonary vasculopathy. Pre-acinar arterial dilation may be a novel marker of pulmonary vasculopathy in QIA.

Endogenous androgens, coronary atheroma and remodeling in women with suspected ischemic heart disease: A report from the Women's Ischemia Syndrome Evaluation (WISE) study

BackgroundWomen have smaller coronary size than men independent of body surface area. Female to male heart transplantation demonstrates coronary lumen enlargement. PurposeTo investigate relationships between endogenous androgens and coronary luminal size in women with suspected ischemic heart disease (IHD). MethodsWe analyzed 69 women with available androgen levels. ResultsGroup mean age was 54 ± 10 years with 64 % post-menopausal. Lumen cross-sectional area (CSA) and external elastic membrane (EEM) CSA positively correlated with free testosterone (FT) (r = 0.29, p = 0.049; r = 0.29, p = 0.01), respectively, and negatively correlated with SHBG (r = −0.26, p = 0.03; r = −0.29, p = 0.02), respectively. Atheroma CSA positively correlated with FT (r = 0.24. p = 0.05). These correlations became non-significant after adjusting for waist circumference. ConclusionsIn women with suspected ischemic heart disease, endogenous androgens, coronary atheroma and luminal size are related, and may be moderated by waist circumference.

An evaluation on the shrinkage deformation characteristics of Chinese yam during multiphase microwave drying based on digital image processing

The deformation characteristics of Chinese yam during multiphase microwave drying (MMD) was evaluated by image processing, and the effects of MMD on the drying characteristics, physical properties, shrinkage behavior, and microstructure of the samples were also investigated. The drying time was significantly reduced by increasing microwave power density. Compared with Scheme I, the time of Scheme V was shortened by 22.22%. The moisture content at the transition point from sublimation to evaporation drying stages (TPS-E) significantly affected the shrinkage of the samples. In Scheme I, the lowest moisture content at TPS-E of 0.354 g. g−1 was found, and the dried products with the shrinkage ratio and bulk density closest to those of FD. The deformation of Chinese yam mainly appeared in the evaporation drying stage. At this stage, the rate of change in cross-sectional area of dried samples ranged from 9.74% to 26.76% for Schemes II to Scheme V, compared to 2.03% for Scheme I. Similarly, the shrinkage ratio of the dried samples in Schemes II, III, IV, and V increased from 16.82% to 21.12% at TPS-E to 29.23% to 51.28% at the end of drying, respectively. Additionally, the shrinkage caused by the pores collapse of the samples because of the high moisture content at TPS-E (Scheme III, IV, and V) during the evaporation drying stage resulted in increases of bulk density. The present study can provide valuable insights for rational control of shrinkage and deformation of fruits and vegetables in MMD. Industrial relevanceChinese yam is a widely used food and medicinal resource in China due to its rich nutritional and medicinal values. Since the moisture content of Chinese yam can reach as high as 70–80%, drying serves as an effective method to broaden its application. However, shrinkage and deformation of materials during drying are common forms of appearance deterioration that can directly impact consumer acceptability. MMD has proven to be a promising drying technology. Nevertheless, improper drying parameter settings may lead to a deterioration of the appearance quality of MMD products. Therefore, comprehending the information of shrinkage and deformation of Chinese yam during MMD and effectively regulating these processes is essential. Mastering these aspects is critical for enhancing the economic value and consumer acceptance of dried Chinese yam products.

Compensation of small data with large filters for accurate liver vessel segmentation from contrast-enhanced CT images

BackgroundSegmenting liver vessels from contrast-enhanced computed tomography images is essential for diagnosing liver diseases, planning surgeries and delivering radiotherapy. Nevertheless, identifying vessels is a challenging task due to the tiny cross-sectional areas occupied by vessels, which has posed great challenges for vessel segmentation, such as limited features to be learned and difficult to construct high-quality as well as large-volume data.MethodsWe present an approach that only requires a few labeled vessels but delivers significantly improved results. Our model starts with vessel enhancement by fading out liver intensity and generates candidate vessels by a classifier fed with a large number of image filters. Afterwards, the initial segmentation is refined using Markov random fields.ResultsIn experiments on the well-known dataset 3D-IRCADb, the averaged Dice coefficient is lifted to 0.63, and the mean sensitivity is increased to 0.71. These results are significantly better than those obtained from existing machine-learning approaches and comparable to those generated from deep-learning models.ConclusionSophisticated integration of a large number of filters is able to pinpoint effective features from liver images that are sufficient to distinguish vessels from other liver tissues under a scarcity of large-volume labeled data. The study can shed light on medical image segmentation, especially for those without sufficient data.

MEASUREMENT OF BASIC HEMODYNAMICS DURING MULTIPOST TRANSCUTANEOUS EXTERNAL EAR STIMULATION: A TWO-CASE STUDY

The objectives of the investigation were to assess the short-term responses of the cardio-vascular system on the multipost transcutaneous stimulation (tANS) of the external ear (EE). The scope was to measure the forefinger photopleths (FPPG), toe photopleths (TPPG), aortic phonocardiogram (APCG), mitral phonocardiogram (MPCG) and brachial arterial blood pressure (BABP), assuming that they could be altered with the tANS. For the tANS, stimulator, two silicone ear plugs with four platinum electrodes each, and a large common electrode (CE), were used. Trials were carried out with two female volunteers, aged 25 years and 28 years. To capture the heart sounds, two customized electronic stethoscopes (transducers) were used. BABP was measured using a pressure transducer and blood-pressure appliance. To measure the FPPGs, a pulse oximeter and SpO2 finger clip were used. To measure the TPPGs, another pulse oximeter and customized SpO2 foot clip was used. Signals were gathered using a high-performance data-acquisition system. An offline analysis was made just before and just after the start of the tANS. To record the pulsations in the right brachial artery, the 2D ultrasound mode (B) of the ultrasound device was used before and during the tANS. Then, diagrams showing the vein cross-sectional area over time were constructed. The results show that vascular time intervals between heart sounds S1 and S2, captured as APCG and systolic peaks of the FPPG in the second volunteer, were slightly larger during the separate tANS of the left white (LW) and (RW) EE post than before the tANS. Furthermore, vascular time intervals between the heart sounds S1 and S2, captured as MPCG and systolic peaks of the TPPG in the second volunteer, were slightly smaller during the separate tANS of LW and RW EE post than before the tANS. Finally, tANS of the LW post elicited a slightly lower heart rate than the one measured when LW was not stimulated. In contrast, the tANS of the RW post elicited a slightly higher heart rate than the one measured when RW was not stimulated. It was also shown that the pattern of the vein cross-sectional area over time with tANS was different compared to both the FPPG and TPPG.

Rectangular extended neck Helmholtz resonant acoustic structure for low frequency broadband sound absorption

The Helmholtz resonant structure with rectangular extended neck is designed to solve low-frequency broadband sound absorption problem in this work. Theoretical and finite element absorption models are established and be used for low-frequency acoustic design. What makes it interesting is that all parameters of the rectangular extended neck Helmholtz resonator structure can be adjusted to shift the working frequency. Based on the regularity of the structural parameters, four coupling structures with different neck depths, neck opening areas, cavity cross-sectional areas, and cavity depths are designed respectively, each of which exhibited multiple sound absorption coefficient peaks to enhance the low-frequency absorption capacity of the structure. To further analyze the effectiveness of coupling structure, the broadband acoustic absorption mechanism of the coupled structure is analyzed based on particle vibration velocity distribution. It is found that cells with different acoustic impedance contributed differently to the sound absorption, and cells with longer necks provided better noise reduction for low-frequency. The experiment is verified in the impedance tube, result shows that the coupling structure with 9 cells and a cavity depth of only 4 cm achieved an average sound absorption coefficient of above 0.8 at 210–340 Hz, which verified the accuracy of the theoretical model. Overall, the Helmholtz resonant cavity acoustic structure with rectangular extension neck designed in this work has a simple structure with low-frequency broadband acoustic absorption performance. This provides a new approach for designing low-frequency broadband acoustic structure.

Median Nerve Cross-Sectional Area and Carpal Tunnel Syndrome in Specific Populations: Sonographic Analysis of Patients with Type 2 Diabetes or Bifid Anatomy.

Evaluate diagnostic accuracy of median nerve cross-sectional area (CSA) to determine severity versus presence of carpal tunnel syndrome (CTS) across existing electrodiagnostic-based (EDX) classification systems in patients with type 2 diabetes or bifid anatomy. Retrospective analysis of cross-sectional patient data. Receiver operating characteristic analysis used to determine median nerve CSA cutoff values and associated diagnostic likelihood ratios for all consolidated and binary EDX-based classifications of CTS in patients with type 2 diabetes or bifid anatomy. Determine shifts in diagnostic probability based on established cutoff values and associated likelihood ratios. Distal CSA measured at or near carpal tunnel inlet, proximal CSA at level of pronator quadratus muscle, and delta CSA by subtracting proximal from distal. Binary categorizations of CTS were statistically superior to consolidated categorizations of CTS severity in patients with type 2 diabetes or bifid anatomy. Binary categorizations established reasonably consistent median nerve CSA cutoff values across all EDX-based classifications examined resulting in the following for distal CSA or delta CSA: ≤10 or ≤4 mm2 to rule out and ≥11 or ≥5 mm2 to rule in CTS, respectively. These cutoff values resulted in small shifts in diagnostic probability in patients with type 2 diabetes and small to conclusive shifts in diagnostic probability in patients with bifid anatomy. Binary categorizations to rule out or rule in CTS based on the proposed cutoff values provide the most meaningful information about shifts in diagnostic probability across all EDX-based classifications examined. The use of median nerve CSA to categorize severity of CTS is not recommended in patients with type 2 diabetes or bifid anatomy.